“Bingo.” He thought for a moment. “I know what I wanted to ask you about. Consent forms. We’re in the process of overhauling our donor consent forms right now, and we’re wrestling with how much detail to include. On your forms do you spell out all the things you might do to bodies in the course of your research?”
“We don’t,” I said. “Our consent form is just two sentences long. It starts out, ‘I do hereby dispose of and give my body, after my death, to The University of Tennessee, Knoxville, for use by the Department of Anthropology or its designee for educational and research purposes.’ The second sentence asks family members to notify us immediately when the donor dies.”
“Short and sweet,” he mused. “And very broad. That phrase ‘or its designee’ gives you a lot of latitude.”
“It does. It frees us up to let DMORT or the National Forensic Academy or the FBI use our donated bodies.”
“The FBI?”
Oh, crap, I thought, I’ve just blown it. I nodded, hoping my face hadn’t turned crimson. “They were testing sonar as a way of finding submerged bodies, so they asked us to loan them a couple of cadavers.”
“How’d it turn out? The sonar experiment?”
“They didn’t tell me. Just brought back the waterlogged bodies a couple weeks later. The FBI tends to hold its cards pretty close to the vest.”
“Even though you provided the bodies?”
I nodded.
“For free?”
I nodded again, and he shook his head at the injustice of it. He pressed his index finger into a pile of crumbs on his paper plate, then raised it to his mouth and sucked off the crumbs. His eyes swiveled up to me.
“You work with them often?”
I felt myself tensing — was he onto me? was he possibly even toying with me? — but I willed myself to relax. “I wouldn’t say ‘often.’ More like ‘occasionally.’ A handful of cases in the past ten years.”
“Hmm,” he grunted. I was bracing myself for a barrage of follow-up questions when he shifted in his plastic chair and held up a finger. “Excuse me just a second.” He pulled a vibrating BlackBerry from his pocket and scrolled down the display, frowning. “Well, hell,” he said. “Dr. Brockton, I’m sorry, but I need to go put out a little brushfire.”
He stood to go, so I did likewise, feeling a mixture of relief and disappointment: relief at escaping further interrogation about my dealings with the FBI, disappointment that I hadn’t managed to set the hook and land the fish.
I was just about to offer a handshake and a good-bye when he stopped me. “I’d love to continue our conversation about trainings, if you’ve got time and any interest.”
I felt my face breaking into a smile, which I hoped wasn’t transparently triumphant. “Sure,” I said. “I’ve got an early flight in the morning. The ivory tower calls. But I’m free late this afternoon or early this evening, if that works for you.”
“Perfect. How about seven o’clock? And how about we get out of this cheesy hotel?”
“Fine with me,” I said. “Do you know the restaurants? Is there someplace you’d recommend?”
“Actually,” he said, “I had a slightly different idea just now. How would you feel about getting together at the library? I try to go there anytime I’m in town.”
“The library?” It was an unexpected suggestion, but I liked it. The quiet and calm would be a welcome contrast to the relentless barrage of noise and lights that filled the public areas of the hotel and the streets. “That’s my kind of place. Is it walking distance from the hotel?”
“I’m afraid not, but it’s worth a trip. I’d share a cab with you, but I’ve got a meeting at a hospital late this afternoon, so I won’t be coming straight from the hotel.” He reached into his coat pocket again and took out a business card, then scrawled on the back. “The driver’s bound to know where it is, but here’s the address, just in case.”
“And they’ll be open at seven?”
“Oh, for sure. I’ve been there plenty of times at seven.”
“Okay, sounds good,” I said. “I’ll let you get back to your brushfire. See you at the library at seven.”
He smiled broadly. “See you there. Looking forward to it.”
CHAPTER 24
Glen Faust’s talk was titled “synthetic tissue,” a phrase bound to draw a crowd — an interested and potentially nervous or hostile crowd — at a tissue-bank convention.
He began with a brief PowerPoint tour of OrthoMedica’s R&D complex in Bethesda. The facility was easily twice the size of UT’s biomedical engineering building. It bristled with medical-imaging equipment, robotic surgical tools, and computer-controlled machine lathes. I was impressed: OrthoMedica looked like a cross between a research university, a teaching hospital, an automotive assembly line, a NASA clean room, and a computer factory.
The subtitle of Faust’s presentation—“Rebuilding the Human Body”—gave him a launching pad to showcase the company’s many products: artificial hips, knees, shoulders, elbows, and orthopedic hardware, as well as a line of surgical tools, developed to allow surgeons to install OrthoMedica parts — and only OrthoMedica parts — with precision and ease. “Our next generation of products and procedures will be custom-fit to every patient,” Faust said. “We’re developing interfaces that can translate a patient’s CT scan into specifications for computer-controlled fabricating systems — lathes and molds and laser cutting systems — to create parts and assemblies in better, stronger alloys and ceramics and plastics. We’ll custom-build replacement parts — synthetic bones and artificial joints — accurate to within one ten-thousandth of an inch.” He capped off the brief sales pitch with a swift series of 3-D animations, showing diseased and damaged human joints and limbs undergoing robotic surgery, their flaws fixed with the new, improved products and procedures being pioneered, at that very moment, by OrthoMedica.
Moving on, he discussed synthetic scaffolds: fine meshes of carbon, collagen, and other fibers that provided frameworks for bone or cartilage to grow into. He showed micrographs and animations of nanomaterials — tiny rods and tubes only a few molecules in diameter — that could, in the not-too-distant future, be delivered to an injured bone or ligament with a syringe, whereupon they’d assemble themselves into a precisely shaped scaffold. They reminded me of tiny Tinkertoys, these nanomaterials around which a patient’s body would mend itself. “Rebuilding the body,” Faust reminded us.
Next came bone. “Chemically, bone is mostly calcium phosphate,” he said. “When we think about creating synthetic bones, one of the first materials that comes to mind is ceramic.” He lifted a white coffee mug from the podium — one of the mugs from the tables at the back of the room — and tossed it upward six inches. He watched it spin end over end, then caught the base in his palm, as if he’d flipped a flapjack in a skillet. “This mug’s made of aluminum oxide. Aluminum oxide’s cheap and easy to mass-produce. It can withstand heavy static loads”—he bent and set the mug on the floor, upside down, then placed one foot on it and stood—“such as the weight of the human body.” He retrieved the mug from the floor, flipping and catching it again. “But the human skeleton has to withstand more than just static loads.” He tossed the mug a third time, but this time he made no move to catch it. The mug tumbled end over end past his hand, past the end of the podium, then shattered on the marble floor below the stage. The sharp crash made me jump, even though I’d seen it coming, and I wasn’t the only one in the ballroom who did.
“This is ceramic, too,” he said, taking a gleaming white sphere from his hip pocket. The sphere measured about an inch and a half in diameter; he rotated it in his fingertips, and as he did, the PowerPoint screen displayed a three-foot image of the same glossy object, also rotating. A small portion of the sphere had been sliced off, creating a flat spot the size of a quarter, pierced by a hole the diameter of my little finger. “This is the femoral head — the ball — from our best hip replacement. It makes a great ball bearing, because it’s harder
, smoother, and more corrosion-resistant than titanium or other metals.” He tossed it into the air a foot, then caught it. “Like the coffee cup, this is made of aluminum oxide.” He lofted it ten feet into the air and let it fall to the marble floor. Instead of shattering, it bounced several times, then rolled to a stop against the front of the stage. Faust retrieved it and tossed and caught it a third time — the man liked threes — then held it up again. “But the difference between the fifty-cent mug and the hundred-dollar femoral head is that the femoral head has microscopic fibers embedded in the ceramic. It’s reinforced, like concrete with steel rebar, on a much finer scale. So is human bone: The load-bearing, brittle minerals in bone are reinforced with collagen fibers. Bone’s better — lighter, stronger, and far more flexible — than reinforced concrete. And though it pains me to admit it, bone’s better than any synthetic substitute we’ve been able to engineer at OrthoMedica.” He smiled. “So far, that is. But I hope not for long.”
He ended the talk with a brief discussion of stem cells — the simple, undifferentiated cells in the early stages of the human embryo, from which every specialized cell, tissue, and organ in the body eventually develops. Stem-cell researchers were already conducting clinical trials in which stem cells were being used to patch damaged hearts and repair spinal-cord injuries, he noted. “This isn’t just pie in the sky,” he stressed. “In Spain in 2008, a tuberculosis patient with a damaged windpipe got a new one, grown from stem cells and airway cells. Stem cells created a true replacement part for her.” As he flashed up graphics showing how the windpipe had been created in the spinning chamber of a “bio-reactor” and then transplanted into the patient, I heard murmurs of amazement from the audience.
Faust stilled the murmurs with a rhetorical question. “So is this the beginning of the end for tissue banks? The dying days of allograft tissue transplants from deceased donors?” He shook his head decisively. “Not in our lifetimes anyway. Case in point: That windpipe created from the patient’s own stem cells? The stem cells needed a scaffold, and where did that scaffold come from? From the windpipe of a deceased donor. A cadaver. Everything but the collagen matrix of the cadaver windpipe was removed — dissolved and washed away — and the patient’s cells were cultured around that collagen matrix. So the stem-cell magic couldn’t have happened without cadaver tissue. That won’t always be the case; maybe someday cadaver tissue will no longer be necessary. Unlikely. But if that day ever dawns, it will bring with it a new era of medical miracles, and won’t that be a great day for humanity?” He paused to let us contemplate that. “Thank you for your time and attention.”
I stayed around to speak to him after the Q&A session. “Very interesting,” I said. “Impressive research and production facilities you’ve got. No wonder OrthoMedica’s doing so well.”
“We try.” He smiled.
“But you’re not on the verge of turning stem cells into replacement hands.”
“I wish,” he said. “You’re thinking about your friend? What’s his name? Dr. Garcia?”
I nodded, surprised he remembered.
“Someday we might be able to grow a new pair of hands for Dr. Garcia. Start with a few of his bone-marrow cells, reverse-engineer them into stem cells, and then program those stem cells to turn into a hand-shaped assembly of bones and muscles and nerves and blood vessels.”
“But that’s not six months or a year or even five years away,” I speculated.
“More like fifty,” he said. “In my most wildly optimistic moments — my delusional moments, my colleagues would probably say — I’d guess that we’re five years from being able to grow livers or kidneys, twenty years from hearts, and half a century from hands or feet. Reality is, we’ll probably never be able to grow hands and feet in the lab.” He smiled again. “I grew up on Popular Science magazine, and every month the cover showed some incredible invention that was about to change our lives forever. Flying cars. Personal jet packs. Elevators to the moon. Colonies on Mars. Limitless power from a gallon of seawater.” He shook his head good-naturedly. “I don’t much care about the elevator to the moon, but I’m still disappointed I don’t have the flying car or the jet pack.”
I returned the smile. I, too, had spent many youthful hours anticipating Popular Science breakthroughs that never quite materialized.
“On the other hand,” Faust went on, “sometimes they got it right. I seem to recall stories about heart transplants and microwave ovens and this clunky-looking gadget called the personal computer. Surely stem cells, too. But growing replacement hands and feet? I doubt even Popular Science is that optimistic.”
“So could I circle back to something we talked about on your visit to Tennessee? The i-Hand? You recommended that for Dr. Garcia, and he was all set to get one, but now he can’t.”
He winced. “I’m sorry about the timing of that. The decision to withdraw the i-Hand was made by our board of directors,” he said. “I was opposed to it. Still am. But OrthoMedica’s a multibillion-dollar company, and the people in the boardroom are the ones responsible for making the tough business decisions.”
“Any chance there’s a spare i-Hand still tucked in a warehouse somewhere? A leftover left hand?”
“I’ll check,” he said. “I hate to sound discouraging, but don’t hold your breath.”
I nodded, disappointed.
“On the bright side, though, the lawyers don’t seem to be finding anything too objectionable in the research collaboration I’m proposing with UT. You still want that CT scanner we’ve been talking about?”
“Absolutely. I’ve been talking to the facilities people about putting it in the spot I showed you, right by the gate of the Body Farm.”
“Sounds perfect.” He flashed me a thumbs-up. “If you’d put those people in touch with my assistant, we’ll see if we can get those wheels in motion.” He clapped me on the shoulder and shook my hand. “Now, if you’ll forgive me, I’ve got a conference call to make to my masters back in Maryland.” He turned to go, then stopped and reached into his pocket. “Here,” he said. “For good luck.” He handed me the ceramic femoral head.
The sphere’s perfect smoothness and heft felt reassuring in my hand at first. But soon I found my fingers worrying at the flat spot and the hole at its center. The hole, my rational mind knew, was simply the attachment point for the metal neck of the artificial hip implant. But somehow, in my mind, the cavity evoked something else: the dark, hollow place into which I was about to crawl with Raymond Sinclair of Tissue Sciences and Services.
CHAPTER 25
Ray had been right. As soon as I told the cabdriver I was heading to the library, he pulled away from the hotel. The sun was going down in the distance, and the neon was coming up all around me. “Do you need the address?”
“Naw, I know where it is,” he said, waving off the card Sinclair had given me. The cab headed east on Tropicana Avenue. In a few short blocks, the bustle and blare of the Strip receded and I felt myself sink into the seat. The cab smelled of stale cigarettes and stale coffee and soured sweat, but I was too tired to care. I was just beginning to doze off when I heard the driver say, “Sir, we’re here.”
I opened my eyes and looked out the window. At first I felt half sleepy and half confused, but then I felt merely totally confused. The cab had stopped in front of a low cinder-block building that pulsed with music. I tapped the cabdriver on the shoulder. “Excuse me,” I said. “I think you misunderstood. I need to go to the library. Here’s the address.” I thrust the card at him; he took it grudgingly and gave it the briefest of glances.
“Yup, that’s the address. And yeah, that’s where we are.” He pointed to a sign above the building’s entrance. I had to lean to the side and look overhead to see the red neon letters: THE LIBRARY. Another large, flashing sign at the edge of the road proclaimed GIRLS! GIRLS! GIRLS! Underneath those words was the line CHECK OUT OUR SEXY LIBRARIANS!
I felt a sinking feeling in my stomach. “Listen, I need to make a phone call,”
I told the driver, “and I might need you to take me back to my hotel. Can you give me some privacy for a couple minutes? Maybe stretch your legs or take a smoke break? You can leave the meter running.”
“Sure, no sweat.” He pulled forward, away from the entrance, and angled the cab into a parking spot. Leaving both the meter and the engine running, he got out and lit up.
I leaned down and spoke to my chest, waving my hand in front of my tie. Strapped to my chest was a tiny microphone, with a digital recorder and transmitter tucked under my armpit; my tiepin was actually a miniature video camera, feeding images to a tiny flash drive. Two hours earlier Rankin and a New Jersey agent named Spellman had slipped into my hotel room and fitted me with the surveillance gear. “Rooster, are you there? Spellman? Where are you guys?” Through the fabric of my shirt, I tapped the microphone three times. “Can you hear me? Call me on my cell right away. This is not good.”
Nothing happened, so I scrolled through the recent calls on my cell phone and hit “send” when I got to Rankin’s number. Pick up, pick up, pick up, I prayed. Rankin’s voice answered my prayer. “Christ, Doc, what’s wrong? He’s not even here yet. And don’t thump the mike — you damn near blew out our eardrums.”
“Sorry; it was an SOS signal,” I explained. “Sinclair wasn’t talking about the place where you borrow books. He was talking about a strip club called The Library.” Suddenly it hit me: Rankin had used the word “here.” I scanned the parking lot. “Where are you?”
“Across the street in a panel truck. Six of us. But don’t look.”
I looked anyway. There it was, a carpet-cleaning van. “You knew,” I said. “You knew he was bringing me to a strip club.”
“I didn’t know at first, but I did know before you got in the cab,” he admitted. “We can’t send an informant someplace we haven’t checked out ahead of time. That’d be dangerous. And shoddy.” He laughed. “A strip club called The Library. Only in Vegas, huh, Doc? You gotta love it.”
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