There was a pause as he considered this. “I can’t say I’ve ever heard of a ‘MediPrixe.’ Or of Rx using trial contractors, for that matter. Why do you ask?”
Maggie sighed and let the ragged towel fall from her fingertips. “Oh, I came across an old vaccine trial that MediPrixe administered. It looks like the trial was never completed at its location in Mexico, and I can’t find any actual data about the trial itself. I don’t know if the data was misplaced, if the trial failed and moved or if the NCE made its way to the FDA and got stalled there. I’m hoping you can fill in the blanks. It’s related to a new discovery I’m working on. Seems like anyone who knows anything is out of the office.”
Out of the office. Dead. Tomato. Tomahto.
“Honestly, none of that sounds familiar. But the FDA is a big beast, so that’s no big surprise. Do you have a New Drug Application number?”
“No. My information is a little…spotty.”
“No worries,” Dan said jovially. “I’ll see what I can do and call you if I find anything. You’re at work today?”
“I’m actually not at the office today. If you could call my cell that would be great.”
“Will do, mildew. Talk soon.”
Maggie thanked him and hung up. She was grateful for his time, but couldn’t help feeling deflated. It was another dead end. She walked into the living room and plunked down beside Constantine. “He didn’t know anything about it. Hadn’t heard of MediPrixe, didn’t know about an Rx vaccine trial that was abandoned. He said he’d look into it, though. Hopefully he’ll find something useful before it’s—”
She couldn’t bring herself to say “too late,” but the unsaid was already gaining power. She’d been so preoccupied by the possibility of finding answers in Ethan’s files that she’d been able to avoid what the phone’s app had foretold. She’d put it into the basement where all the other things she hid from herself lived. Now she felt it stir. Growing hungry.
“Aw, don’t look so glum, chum,” Constantine said. “I struck gold on my internet mining expedition while you were talking to Professor Pastel.”
Maggie hopped onto her knees, threw her arms around Constantine’s neck and planted a kiss on his cheek. “Constantine, you beautiful genius, you. Tell me everything.”
Constantine looked at the floor and rubbed the back of his neck, which glowed red. “Well, don’t get too excited. I haven’t filled in all of the details yet.”
As Constantine turned the laptop toward Maggie, a soft thud sounded from outside the window.
Maggie’s heart jumped. She looked at Constantine. He raised his eyebrows. Another thump, something loud and heavy against the house, vibrated through Maggie. Maggie felt her eyes grow wide and her pulse quicken. Had she allowed herself to be followed? Had she been so careless that she had put both herself and Constantine in harm’s way? She opened her mouth to say something and emitted a raspy squeaking sound like a bicycle tire losing air.
Constantine put his forefinger to his lips. He slid to the floor and crawled across the stained carpet toward the window. He crouched beside the painted wooden frame, then slid the curtain away from the window just enough to expose a sliver of glass. He peered outside.
He turned toward Maggie with one eyebrow raised.
“What is it?” she whispered.
“Probably the neighbor’s dog,” he whispered back. He hitched his thumb toward the door, signing that he’d go check it out.
Maggie felt her heart jump again. Her whole body flinched as if she’d been jumpstarted by a defibrillator. “Constantine, no,” she hissed. She shook her head emphatically.
“Shhh,” he whispered back. “You don’t want Fido to hear you. He’s hated me since I moved in, probably because I peed on his tree.” He sprung to his feet. “I’ll be right back.”
Maggie watched Constantine ease the door closed behind him. She stared at it, wondering what was on the other side. Was it really the neighbor’s dog, nosing through trash left to decay during the sanitation strike? Or was it a ruse, a ploy to lure Constantine out into the open so he could be eliminated as a barrier to the killer’s next target?
Constantine’s sneakered feet whispered down the stairs. She murmured a silent prayer, the thousandth she’d said since Zartar’s murder, promising reform, piety—anything—for Constantine’s safe return.
The minutes ticked by. Maggie slid the curtains to peer outside. Nothing moved but the tops of the trees, which swayed to the silent music of the wind. She sat back down and chewed her lip.
Moments later, the knob turned. Maggie held her breath. A dribble of sweat snaked down her back. The killer had found her. He’d followed her, bided his time, then lured Constantine out into the night so she’d be alone, vulnerable, trapped.
She tensed, ready to run or hide or fight back. The door swung wide. Constantine traipsed in humming “Goodnight, Ladies.”
Maggie released the breath she was holding.
“It was Fido. Guess someone had put some questionable chicken into the trash. He thought he’d won the jackpot.” He pulled off his shoes and socks and jumped onto the couch beside Maggie. “Did you read what I had on-screen?”
“No, I was too busy worrying about you.”
“Moi?” Surprise touched his eyes. “Really? Well, don’t. Worrying about you is my job.”
His eyes held hers for a moment, then dropped to the laptop, a fringe of black lashes like crescents on his cheekbones. She was sure he was blushing again.
“Back to Dolores Hidalgo,” he said. “The short story is that MediPrixe went to Dolores with lots of money and even more swagger. They opened shop in one of the local clinics and told the residents they wanted to help them live longer, healthier lives and help them stave off dangerous flu strains—indefinitely.”
“Wow. Nice job, Sherlock.” She grabbed a handful of peanuts from the Spock-shaped bowl on the coffee table and eased back against the cushions, a facsimile of relaxation manufactured to convince herself she was fine. That everything was going to be fine. “What happened?”
“A little thing called informed consent.”
“Ooh.”
“And a bigger thing called people dying.”
“Oh, no.”
“Oh, yes,” Constantine said. “I think this part of the program calls for fortification.”
He walked to the kitchenette, pulled out a bottle of Irish whiskey from the cupboard and poured it, and his signature rotgut coffee, into mugs. He returned and placed the mugs on the coffee table. “At first MediPrixe could say, ‘Old Gramps was too frail and elderly. That’s why he kicked off.’ But then it got harder to explain when Mom died and then little brother.”
“Oh my God.” Maggie’s head hurt even more as she tried to assimilate the information. Entire families destroyed by the very thing that was supposed to save them. “What did they die from?”
“Besides the natural causes they told the families? Pneumonia.”
“And people kept participating in the study? Kept…dying?”
“It took some time for people to make the connection. There were assurances from the company that the deaths were coincidental or bad luck. When that stopped working, the incentives began. Money to locals for participating. Bribes to government officials for looking the other way.” He grabbed his mug, slurped the Irish coffee, then stared into the cup for a few moments before returning it to the coffee table. “Finally, the wrong person died: the wife of the mayor. And that, as they say, was the end of that.”
“What happened?”
Constantine laced his fingers behind his head. “MediPrixe was escorted out of town by the local ‘peacekeepers,’ armed to the teeth and mad as hell. MediPrixe paid them off, lucky to get their crew out alive.”
Maggie shook her head. “Sounds bad.” The power of understatement. The whole thing sickened and infuriated her. �
�And you got all of this off the internet? In just a few minutes?”
“Most of it from local news stories, plus a few from blog entries. I was an Evelyn Woods speed-reading graduate.”
“But why would MediPrixe, and Rx, for that matter, engage in such obviously illegal conduct in order to test this vaccine? I don’t know anything about MediPrixe, but Rx is on the brink of an IPO. Why would they take these kinds of risks?”
“Money? Not very original, but very popular. Maybe they didn’t want to spend a lot to test it, or lose their shirts if the vaccine turned out to be unsafe.”
Maggie sighed. “I guess. The truth is that it’s getting harder and harder to find participants for some of these trials. The pool is small and, depending on what the study is for, can become even smaller when we add in demographics, combinations of disease characteristics, et cetera. If we’re talking Phase II trials, they’d need hundreds of people. Sometimes the greatest barrier to completing the study is the shortage of human subjects.”
Maggie grabbed her mug and took a swig. “So MediPrixe and Rx banked on a lack of informed consent to conduct a clinical trial on the cheap. A problem came to light, and they tried to come up with a solution. But things went south in Dolores and they couldn’t continue there. So they moved.”
Constantine raised his eyebrows. “Where?”
“Somewhere they could continue to fly under the radar. Right in plain sight.”
Chapter 40
Constantine looked at her, waiting. “More under the radar than Dolores Hidalgo, Mexico?”
“You found out what happened on the internet, didn’t you?”
“Well, yeah, but I’m a genius. A beautiful genius.”
“What if they decided it was easier to hide behind who they were testing rather than where?”
“Okay, you lost me.”
Maggie felt her breath quicken, the tickle-prickle of hair rising on the back of her neck as an idea flowered in her mind. “What if they selected a group of people that wasn’t exactly credible—not only because of economic status, but because they’re branded as erratic—even crazy?”
Constantine polished off his Irish coffee and walked into the kitchenette. Maggie followed him. He opened the refrigerator and placed packages of deli ham and Swiss cheese, a loaf of Wonder bread and a jar of Miracle Whip on the counter, then looked at her quizzically. “I assume you’re not talking about Congress?”
“I’m talking about the homeless. More specifically, homeless people suffering from severe, untreated mental illness.” She opened the bag of Wonder, took out four slices and began slathering the bread with the slightly gelatinous condiment. “Think about it. Rx could keep their eye on the trials, make adjustments as needed in the lab. And not have to worry about anyone—or anyone sane—complaining about violating their rights.”
Constantine shook his head. “I dunno, Mags. The Dolores Hildago testing sounded a little Constant Gardener-y. This sounds impossible.”
“Not at all. And it wouldn’t be the first time this kind of thing has happened. I took an ethics in pharmaceuticals class from Dan in college. It covered all kinds of stuff: laws governing the industry, treatment of patients. And unethical practices in the past.”
“The dark ages of pharmaceuticals?” Constantine stacked the ham and Swiss over the Miracle Whip and handed Maggie a sandwich.
“Yeah, only it wasn’t exactly in medieval times. Playing fast and loose with informed consent still happens. A few years ago, a pharmaceutical needed a human trial for approval for a new antibiotic. They went to a small African village and set up a tent near a medical station where doctors were treating people for cholera. The pharmaceutical got two hundred kids to participate in the trial without consent of any kind on a drug that had shown problems in animal testing.” She turned and faced Constantine. “Some kids died. Others suffered brain damage.”
Constantine gave a low whistle. “Nice business you’re in, Mags.”
“That’s the exception, not the rule. But there’s more. As late as the 1990s, people suffering from mental illness were forced to take part in drug trials. Many of them were in prison. Some were in institutions. Most were also poor and minorities. These practices were later condemned as immoral and inhumane, and laws were put in place to protect trial participants. But as the African village debacle shows, not everyone plays by the rules.”
Constantine took a giant bite of his sandwich. “So you’re thinking Rx goes abroad to play fast and loose with testing protocols. When the good people of Dolores Hidalgo realize the potential cure was worse than the actual disease, Rx moves on to a new group to exploit.”
“Exactly,” she said with her mouth half-full. “Rx wouldn’t have to worry about pesky details like informed consent or ethical practices. They could steamroll, intimidate, fool or cajole their new subjects into participating.”
“But not everyone who is homeless suffers from mental illness,” Constantine pointed out.
“True,” Maggie replied. “And only a small portion of those with mental illness have delusions or hallucinations or thought disorders. But…” She licked a glob of mayo from the corner of her mouth. “Nearly 25 percent of those who are homeless do have acute, untreated mental illness, including psychotic disorders. It’s a vulnerable group, ripe for exploitation. I mean, who are the authorities going to believe: the homeless guy convinced that the FBI installed a camera in his cardboard TV, or the stuffed shirts at your friendly, neighborhood pharmaceutical?”
“It is the perfect setup,” Constantine admitted. “No limits. No questions. No autopsies if the test subjects die. No one to believe them if they don’t.”
Maggie wiped her hands on her shorts. “And it fits with Joyce’s disappearing residents, Al’s account of people being lured away never to be seen again, even what that strange old woman at Carson’s funeral said.”
“The one you had the nice chat with?”
“I realized the shirt I wore to the funeral had an Rx logo embroidered on the pocket. She must have seen that, and it set her off.”
Constantine chewed, considering that. He set his plate on the counter and folded his arms across his chest. “So we have ties with Elsa, Carson, Al, the homeless shelters and the former Miss America from Carson’s funeral,” Constantine said. “How does Mia fit in?”
“Mia knew the Montgomerys professionally and Miles personally. My guess is that Miles told Mia about the flu vaccine they were developing in order to inflate the company’s value.”
“Classic ‘pump and dump’ IPO scheme,” Constantine said with his mouth full.
“Never heard of it, but okay. I think Mia found out the vaccine had problems. She figured Rx would want to bury the damning data before the IPO. And voila: a blackmailer is born.”
“Guess Rx didn’t count on Miles not being able to keep his mouth—or his pants—zipped.”
“Or on anyone noticing this invisible population vanishing,” Maggie said. She picked at her thumbnail. “Once Rx got wind of Elsa’s and Carson’s story, they made sure they’d never tell.”
“So Rx put Elsa’s, Carson’s and Mia’s last days on the calendar and sent reminders to a hit man to ensure they’d meet with death. So to speak.”
“Looks like it,” Maggie said.
“So who sent the video of Mia’s murder to me? And why?”
Constantine stared at the sink. Silent. Thinking. “I’m not sure, but my money’s still on the cloud. The more pressing question is what we should do next. I mean, other than reporting Rx to the Better Business Bureau.”
Maggie grabbed an old Burger King plastic cup from the counter, filled it from the tap, took a drink, then tossed it into the sink. The plastic landed with a loud clunk in the stainless steel basin. “I know what we do next. We pay them a visit.”
Chapter 41
“Do you want to get the straightjacket or
should I?”
“Okay, maybe it’s a little nuts. But so is waiting around for someone to kill you.”
“A little nuts? Try a lot. You’ll be walking into the lion’s den, and I don’t think you’ll have Daniel’s luck. In fact—”
“You have a better idea?” Maggie looked at Constantine. She could see herself reflected in the liquid chocolate of his eyes: arms across her chest, pointed chin thrust upward. A challenge.
Constantine was quiet a moment, then shook his head. “No, no. Just checking. I think it sounds quite sensible. Although we could wait. I forgot to mention the previous owner of your phone clicked through that fake email we set up.”
“What? Why didn’t you tell me?”
“I got kind of distracted by the threat to your life. Anyway, the IP address he was using is allocated to a local internet service provider, which happens to employ a very good friend of mine. He’s going to do some digital digging and let me know who the IP address belongs to. All we have to do is wait.”
“We don’t have the luxury of waiting.” She walked to the back of the kitchen, where a key rack shaped like a zombie’s hand perched above a tiny microwave. She plucked the keys from the zombie’s middle finger and dropped them into Constantine’s hand. “Let’s roll.”
Constantine parked a block away from Rx beneath a willow that seemed to suckle the earth with its sagging branches. They walked silently to the Rx complex, hoping for nonchalance but feeling ridiculously conspicuous in the head-to-toe black they’d picked up at a sporting goods store.
The gate to the Rx entrance was locked with an electronic arm that looked more suitable for an Eastern European military base than an American corporation. Fortunately, it wasn’t hard to squeeze by. Maggie slipped beside the metal arm. “The gate’s really just a suggestion,” she whispered to Constantine.
“I’ve heard you say the same thing about stoplights,” he hissed back.
Maggie waved him on. He gave an “okay already” wave back and jogged to join her. Maggie walked toward the main building, head held high and with an air of I Belong Here accented with a dash of Don’t Screw With Me or I’ll Have Your Job. Constantine walked behind her, eyes scanning for the security guard Maggie said patrolled the grounds after dark.
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