The Prize

by Irving Wallace

  ‘Yes, of course,’ said Farelli. ‘What have you heard? I thought you knew the entire story.’

  ‘Some of it, but-’

  ‘The Nazi Fascists had been using Jews, Polish and Russian prisoners for their guinea pigs, and one day Himmler wrote that instead of common prisoners, it might be wise to obtain five qualified doctors, heart specialists, who were also Jews or political prisoners, and try the experiments on them. The idea was that we would undergo fifteen-mile-altitude tests, without equipment, and be brought to the point of death, but not quite. Then we would be revived, and be made to set down our reactions and judgments, as physicians who had endured this, in medical papers, for the benefit of the Luftwaffe and the Medical Service of the Waffen-SS. I was the fourth one that day. Brand and Brauer had died, and they dragged out Stirbey half-dead-he is in a sanatorium in Vienna still-and then, it was my turn-’

  Garrett reached blindly for a chair, and found himself in it. God Almighty, God Almighty, he thought, and felt like a man who had slipped to the brink of the Grand Canyon, and been snatched from the fall by an unseen hand, and still had not recovered from what might have been.

  He had missed some of what Farelli had been saying, and with effort he tried to hear the rest above the pounding in his ears.

  ‘-and they kept pumping the air out of the chamber, and there I was, strapped in the pilot’s seat with the electro-cardiograph equipment attached to me, and the altitude gauge rising and rising, and-but what is the use to remember it now? At thirteen miles altitude, I gave up breathing and blacked out, as the aviators say-there was blood all over my face-and those animals carried me out, and I lived because I am a dray horse and will not die like that.

  ‘I was in the Dachau infirmary three weeks, too ill to be of use to them, and when I recovered, I said I was still too weak to write their medical paper, but pledged to write it for Dr. Rascher and Himmler if they sent me back to my beloved prison in Rome. So they sent me back, but then everyone was busy with the landings, and I never wrote their paper. I also never recovered. I am still under medical care. Just as Dr. Stirbey and Dr. Gorecki are. I heard from old Gorecki the week before I came here, congratulating me, and recalling the horror of that day. He will write a book about it, he says. I hope he does. Someone should, to show the thin borderline that divides the doctors of Hippocrates from the sadist doctors of Satan. You know, I often think, it is not that men of our profession indulged in such bestialities that troubles me, but that not one man of our profession, in all of Germany, had the courage to raise his voice against these human experiments. Ah, well, it is past.’

  For Garrett, at first his brain so long fastened to the obsession that Farelli had been the prosecutor of the evil and not its victim, the turnabout had been too dizzying to comprehend. But once comprehension came, there came with it the relief of self-preservation, that he had not leaked a falsehood, to be denied and disproved and to make of him an ostracized leper. Now that Farelli was through speaking, one last emotion gnawed through Garrett, and that emotion was shame.

  Because he had to live with himself, he now tried to tell himself that even if he had been so wrong about this, his conscience-his conscience and Öhman and Craig-had not permitted him to go ahead with the canard. Too, the other irritations still existed-Farelli’s use of his discovery, although his wrongness about Dachau made him doubt himself about this point-Farelli’s self-promotion, although even here… but now, Garrett saw that these rationalizations were of no use. Shame sat fat and mocking on his head and shoulders. He had been a victim of himself. What would Dr. Keller call it? Paranoia. He knelt to the truth.

  Raising his head, meaning to say something, anything, that might be placating to Farelli, he realized that Farelli had turned sideways from him and was staring at the door. He followed Farelli’s gaze, and then he, too, saw Dr. Erik Öhman in the door.

  He had never seen Öhman like this before. His picture of Öhman was of a reddish granite person of zeal and indestructibility, and now the picture was shattered. The reddish granite had been pulverized, and zeal had been crushed also, and what stood in the doorway was the representation of all anti-strength-in one person frailty, lassitude, bafflement, nullification, repudiation, and embodiment of every loss on earth.

  ‘He’s dying,’ Öhman croaked. He came unsteadily into the room, limply carrying his surgical mask. ‘Count Ramstedt is dying. The transplantation has failed.’

  He tripped slightly, and Farelli grabbed him, and helped lower him into a chair.

  Garrett scrambled to his feet, beside Farelli at once.

  ‘What do you mean?’ Farelli was demanding. ‘What do you mean by that? Speak some sense to us!’

  Öhman looked up blankly. ‘I cannot explain it. The immunity mechanism, the white cells and other agents, they are destroying the foreign tissue. There is activated rejection. All the signs-cyanosis-tachycardia-hypotension-’

  ‘But you can’t know so soon!’ Garrett found himself shouting, ‘There must be a mistake-it takes three weeks to know!’

  Öhman shook his head. ‘Dr. Garrett, you go in there-you can see-he will be dead by nightfall.’

  Garrett felt faint, and gripped Farelli’s arm to right himself. Farelli alone stood strong, but the news had drained his countenance.

  ‘Something must have been overlooked, something in administering the serum, or the surgery-’ Farelli began.

  Once more, Öhman shook his head. ‘No,’ he said. ‘If-uhhh-if I had performed this myself-uhhh-I would think so-my inexperience-but both of you were present-you witnessed every move-you supervised-you saw me-you assisted-’

  Garrett tried to think, reviewing each step of the transplantation in his mind, but nothing had been omitted or been different, every move had conformed to the grafts he had made in the past. He realized that Farelli was reviewing the surgery, too, and that Farelli’s conclusion coincided with his own. It had been perfect. The transplantation had been merely a routine extension of their own discovery and their own experiments and successes. Because they had proved its worth, they had won the Nobel Prize, and now suddenly, inexplicably, it had failed, and all that had come before or might be planned ahead was blackened by doubt. ‘Proved’ had been stamped over by the old Scotch verdict ‘Not Proven’-meaning neither guilty nor innocent but simply Unknown (with Some Doubt).

  ‘It can’t be,’ murmured Garrett. ‘It doesn’t make sense.’

  ‘There is always the exception one fears,’ said Farelli, more to himself than to anyone.

  ‘We’ve got to do something!’ cried Garrett. ‘Why, if this gets out-’

  The same thought, and projection of it, seemed to strike Farelli at the same time, for he turned to Garrett, and their eyes met in a common bond of fear.

  ‘It has got to get out,’ said Öhman helplessly. ‘Half the members of the royal family are in the waiting-room. I must report to the King-’

  Garrett articulated the common fear first. ‘But the prize,’ he said. ‘It’ll discredit our prize.’

  ‘Uhhh-yes-yes, I have thought of that already. This will support the minority of the Nobel Medical Committee, who felt the vote for you was-uhhh-premature. The moment this is in the newspaper there will be controversy-a scandal, if you accept the prize this afternoon. You must-must turn it down-refuse the award before the Ceremony-send a joint note to the committee explaining more work will have to be done-but the prize is out of the question now.’

  ‘Are you crazy, Öhman? Che diavolo!’ Farelli was in a temper, unreasoningly furious with the suggestion. ‘What about Dr. Garrett’s years of experimentation and my own-our discovery-our proved successes?’

  ‘Please-please-it is not in my hands,’ begged Öhman. ‘I am telling you what will happen. If your discovery had a hundred proved successes, and the hundred-and-first was a failure, by the same method, it would mean-in the eyes of the medical world-the public-your discovery is not infallible-not fully proved-is-uhhh-open to doubt. They will let you gracefully withd
raw from accepting the prize-there will be talk about next year or the year after or someday-but if you refuse to withdraw, they will be forced to disgrace you by withholding the prize. They will do this, because they do not dare to have a repetition of the Dr. Koch fiasco.’

  Garrett leaned over Öhman. ‘Dr. Koch fiasco? What is that? What the devil are you talking about?’

  ‘Uhhh-Dr. Garrett, my friend-we are friends, believe me-I owe what I am to you-I am not the prize-giving committee or the public, so do not blame me.’ Öhman rubbed his forehead. ‘I owe you the truth, before the world falls on your head, on both of your heads. Were there many medical discoverers in history greater than Dr. Robert Koch, of the Berlin Institute for Infectious Diseases? Consider his work with infections, anthrax bacilli, the solidifying media for bacteria-his discoveries, in eight years, of the tubercle bacillus, cholera bacillus, tuberculin. As you know so well, Dr. Koch found the bacillus that causes tuberculosis, and then he found the miracle drug, tuberculin, that might cure it. The whole world was in a fever of excitement, and the Kaiser commanded the nomination of Dr. Koch for the Nobel Prize, even though Dr. Koch wanted more time to experiment. So-in 1905 we made him a laureate, gave him the Nobel Prize in physiology and medicine “for his investigations and discoveries in relation to tuberculosis”-which the world knew was for his discovery of tuberculin. Dr. Koch took his-uhhh-medal and diploma and money and went back in triumph to Berlin-and six months later his serum, hailed because it cured, suddenly began to kill. Hundreds of tuberculosis patients were killed by the serum, because tuberculin was not ready, except for cattle, and maybe Koch knew it. When he died, five years later, I am sure he died of-uhhh-of-uhhh-grief. And the Caroline Nobel committee was made to appear accomplices to murder, and scientific dunces, and since then, they have been conservative, always conservative. Now, this morning, the first time since 1905, what happened to Dr. Koch has happened again-a great discovery-my life is devoted to it-I believe in it-but now, there is an important patient in my surgery, expected to benefit from it, but now dying because of it-and soon, the truth of the failure will be everywhere.’

  Farelli had begun nodding during the last of this painful recital, and he was nodding still. ‘Yes, Dr. Öhman,’ he said, ‘you are trying to help us, you are a decent fellow. We will behave correctly, have no worry. If the patient is to die, we will die with him. We will know what to do. I am certain Dr. Garrett is as one with me.’

  ‘You are speaking for me,’ said Garrett quietly. ‘We’re in this together.’

  ‘I do not want to lose the Nobel Prize, when I am hours from winning it,’ said Farelli fervently to Öhman. ‘Is it only the prize money and honour I will lose? No, it is a life of work, and every hope I have. I know what I say. If we take the prize, and the Count dies, it is a scandal, and if we do not take the prize, and he dies, it is a sensation. Either way we lose, because the world loves to prick bubbles, tear down idols, discredit. It is history. It is true. I know what awaits Dr. Garrett and myself-infamy-as if we had foisted on the public a hoax, a lie. We know better, but we will not convince mankind in a lifetime. Only when we are dead, and others live because of us, will we be honoured again. No, I repeat, it is not the loss of the prize alone that troubles me. It is the loss of our standings, our grants, our co-operation, our future work. A generation will suffer for this one man’s death. Dr. Garrett and I do not go down alone. Progress in medicine goes down with us.’ He halted and stared from Öhman to Garrett. ‘I want to prevent that regression. I want to fight for that one man-because that way, we fight for all men.’

  ‘I’m with you,’ said Garrett.

  Farelli looked at him. ‘For the same reasons?’

  ‘For none other.’

  Öhman had been observing the exchange with awe. He felt Farelli’s hand on his arm.

  ‘Dr. Öhman,’ said the Italian, ‘go back to the surgery where you belong. Keep an eye on the patient. Do what you can. Dr. Garrett and I wish to consult on this privately. Make no announcements. Show no white flag. Stand by your post. In a while, Dr. Garrett and I will come to you-for better or for worse.’

  Dazed, obedient, Öhman came out of the chair and left the room.

  The second that the door closed, Farelli wheeled towards Garrett. ‘I meant every word I said to him.’

  ‘I know you did,’ said Garrett.

  ‘I could not tell him everything, but to you I can reveal. I know very well what you have thought of me this past week-that I am an egotist, a promoter, a self-seeker who wishes too much credit for himself. It is not so, but it must appear that way to you, who are so quiet and self-effacing, an honest man of the laboratory. I was raised in Milan, Dr. Garrett. It is a busy and prosperous city, but not if you are poor and outside. My father sold spoiled fruit for what you call pennies. My mother scrubbed other people’s dirty clothes. We lived in a shanty, six of us, wearing rags and sick from malnutrition. I robbed and cheated and procured for pimps, as a street boy, to go to school and escape and be better. The whole story is too long-but when you come from that, Dr. Garrett, you are always insecure, you want never to go back, you live in fright, and your body emits the stench of fear. I was so driven that I was made twice the man I was-and by perseverance and fright and a good Lord in the heaven, I made my discovery which is truly ours. But for all of this-and I swear it-I would willingly sink back to the past, if that one old man in that room could be made to live. It is because today I realize, maybe the first time, I am more a healer than an opportunist who wants self-survival above all else. That old man must live-and to devil with this prize and all prizes-because our work must not die. That is how I feel.’

  Garrett tried to smile his understanding but could not. ‘I have stopped thinking of two people-Farelli and Garrett-and begun thinking of only one-Count Ramstedt. My personal concerns have left me. They’ve been made too small to live on a morning like this.’

  ‘But now, what is to be done, Dr. Garrett? I told the Swede I want to fight for that one man. It was bravery without arms. I can think of nothing. I depend on you.’

  Garrett received Farelli’s dependence upon him without feeling superiority, but with all the comfort that collaboration often produced. He had left the butt of his cigar in an ashtray, and now he retrieved it, and lit it, thinking all the while. His head had never been clearer.

  ‘One idea keeps recurring,’ said Garrett, as he slowly circled the room. ‘Even though we have learned to neutralize the rejection mechanism with Anti-reactive Substance S, I have had my secret fears about potential steroid dangers-the side effects, that is. And so I always sought to improve it. I have never written this in a paper, but once, for a period, I experimented on dogs with another version of the serum, an anti-histamine I called Anti-reactive Substance AH-and the early experiments were remarkably effective.’

  ‘Substance AH?’

  ‘Yes. While it’s been somewhat less reliable than the steroid version in blocking phlogistic response, it has been far superior in other respects-more selective-more effective in holding off the rejection, yet permitting immunity, strong immunity, against infection.’

  ‘Would it be possible?’ Farelli wondered.

  ‘I have never tried this mixture on a human being,’ said Garrett. ‘I intended to do more experiments on animal specimens when I returned to-’

  ‘Dr. Garrett, I would be willing to take the chance here, now,’ said Farelli suddenly. ‘Can it be prepared here?’

  ‘Easily,’ said Garrett, but his mind was elsewhere. ‘If only we had some insurance,’ he mused.

  ‘What do you mean?’

  ‘If there were something else in the event that this failed.’

  Farelli pursed his lips thoughtfully. ‘We could try a modified outside pump, a portable pump-’

  Garrett shook his head. ‘Too impermanent. I am thinking-you know-possibly-’ He halted, privately weighing something.

  ‘Possibly what?’

  ‘Something else is on my mind,’ said Garr
ett slowly, ‘something more permanent. I hesitated, because it is premature. Still-at a time like this-’

  ‘Please-what is it, Dr. Garrett?’

  ‘In this last year since our discovery, I have gone along on an entirely new offshoot, new tangent, of cardiac grafting. I have not published preliminary data, because I have not gone far-there has not been time-but I must openly confess what I have in mind. As you doubtless know, there is one tissue that can survive the rejection mechanism-I refer to living embryonic tissue. It is virtually nonreactive-it doesn’t have any antigenic specificity. I confirmed this, to my satisfaction, with recent tests on rats. I determined to attempt a pancreas transplantation. I started by transferring a mature pancreas from one adult rat to another, and it wouldn’t grow at all, it was rejected. Then I did something else. I typed a rat’s estrogen cycle to find out when the rat was pregnant, and then-listen to this-at an early stage, I took pancreas tissue out of the fœtus-although pancreatic tissue per se was not the object-and grafted this embryonic tissue into another rat, and, Dr. Farelli, it grew healthy and strong. It was not rejected at all. I kept wondering if the same could be undertaken, successfully, with an embryonic heart.’

  Farelli was staring at Garrett, his mind bounding ahead, his temples corded with concentration. ‘But why not?’ he asked suddenly. ‘Let us say that a pregnant mother miscarries in the first trimester-’

  ‘Remember the obstetrician who looked in on Öhman early this morning? He has a miscarriage he is handling, under this roof, in the fourth week of gestation.’

  Farelli could hardly contain himself. ‘We take this tiny four-week-old heart tissue and hook it up with an external circulation pump, induce speedy growth-even apply the new growth hormone those men down in-’

  ‘Wait, Dr. Farelli, you’ve given me a better idea. Why develop this four-week embryonic heart externally? Why not internally? It won’t be rejected. We graft this embryonic heart into Count Ramstedt’s groin-the way kidney transplants have been placed in the neck-a heterotopic graft. We put the embryonic heart in the inguinal area, because the blood vessels there are twice as big as-don’t you see? We hook it into the arteries and veins-we keep Count Ramstedt on Substance AH as well as Anti-reactive Substance S while the embryonic heart grows. Shortly after, as it develops, we-or Öhman, for that matter-begin to waltz it-move it into the abdominal area where it can work on bigger blood vessels.’