by Robin Cook
“Put in a call to this iPS RAPID!” Ben called out to Jacqueline through the open connecting door. “You’re right about this article. Get the CEO’s name and get him on the line!”
Jacqueline’s head poked through the doorway, her red hair back-lit from the sun streaming into her office.
“Didn’t you notice that iPS RAPID is in San Diego, where it’s just after six in the morning?” Jacqueline said patiently.
For a moment Ben just stared at her without being able to make out her facial features in the glare. It took him a moment to comprehend that it was far too early on the West Coast to get anyone on the line. “Then get me Carl,” he said. “And what do I have scheduled for this morning?” He was thinking of canceling everything to get right on the issue of iPS RAPID.
“Other than in-house meetings, you are supposed to meet with Michael Calabrese in his downtown office at ten-forty-five. Did you forget?”
“I forgot,” Ben admitted. He thanked himself for having hired someone as good as Jacqueline to keep tabs on his schedule. He considered himself more of a concept guy. Although it was important to deal with the issue of this new company, in the long run it was more important to deal with Michael and break off the Mafia-Yakuza connection. Intuitively, he understood that the longer the association went on, the harder it was going to be to stop it. He also knew that if the connection were ever leaked he’d probably have to resign, or at the very least he’d have to kiss good-bye any chance of launching an IPO anytime soon. What he didn’t let himself even consider was the possibility of an indictment.
With Jacqueline off to find Carl, Ben went back to the article, musing over what class of small molecules was involved. He guessed it was probably some kind of suppression of growth factor inhibitor, but that was only the obvious. As he read he marveled over the speed of biomedical discoveries, especially knowing that such discoveries invariably pointed to other possibilities, which spawned even more discoveries, in a quickening self-fulfilling process. He also knew there were discoveries and there were discoveries, meaning some were huge steps and others not so huge. He considered this present discovery to be one of the relatively big ones, at least in relation to the commercialization of iPS cells.
“You wanted to see me?” a voice called from the doorway to the hall a few minutes later.
Carl was standing there with his tie loosened, the top button unbuttoned on his shirt, and his sleeves rolled up to just above the elbows. He was the picture of the hard-working accountant rather than the CFO, which was why he was so good at what he did. There was nothing beneath him. He was involved in every aspect of the business’s finances from the mundane to the conceptual, and Ben trusted him implicitly and relied on him completely.
“Come in! Sit down and take a look at this!” Ben said, handing Carl the article.
Ben watched his chief financial officer’s expression as he read, noticing a frown develop. Then, in an apparent moment of frustration when he was finished, Carl slapped the journal down onto the surface of Ben’s desk and lifted his face to him. “There’s something I have to come clean about. It’s a confession of sorts.”
“What in the blazes are you talking about?” Ben asked, while in his mind he was concerned about being blindsided by some kind of major financial problem just when things were looking so rosy.
“This is something I should have admitted a year or two ago,” Carl said so contritely that Ben’s concerns soared.
What now? Ben thought silently, trying to prepare himself for the worst, such as that the company had run out of money from having been embezzled or from some other disaster. With the contract signing yesterday, he’d been confident their financial situation was solid, especially with the contract certainly upping their market value.
“I hate to admit it, but I just don’t know enough about stem cells,” Carl said guiltily. “I understand up to a certain point, but when you hand me something really technical like this, it’s just beyond me. I’m sorry. As the CFO of this company, I should be more knowledgeable with it, but the fact of the matter is that I’m better on the financial side than the scientific side. Remember! You recruited me from the financial world, not biotech.”
For a moment Ben was stunned into a brief silence by a combination of relief and surprise. As a biomolecular scientist, he was so familiar with the material that he had trouble believing everyone else wasn’t equally well informed. Quickly the relief and surprise turned to humor, and Ben found himself laughing. At that point it was Carl’s turn to be confused. “Why are you laughing?” he questioned, genuinely bewildered. He had expected surprised irritation from Ben, not laughter.
“I can’t help it,” Ben admitted. “You’ve always convinced me you understood the field as much as anyone. Hell, I’ve asked you your opinion on a lot of issues, and I’ve always felt you gave me solid advice. How could that be?”
“Most of the advice I’ve given has been financial, and whether a company deals with stem cells or oranges, that advice is usually pretty similar. If it was outside of the financial arena, I suggested you ask Brad, Marcus, or Lesley. That was always good advice, and has worked pretty well. I’ve been trying to pick up more info as time’s passed—there’s so much to learn.”
“How about a quick review,” Ben said.
“It would be most welcome.”
“Okay,” Ben said, thinking about how to begin. “It all started in the early sixties, when a couple of Canadian researchers found the first stem cells in mouse blood. These were rather primitive cells that could divide and make progeny, of which, say, half became various blood cells and half would be merely self-renewing. Then there was about a thirty-five-year gap before a researcher in Wisconsin was able to isolate similar human stem cells from very early embryos and make them grow outside the body in glass dishes by a process called in vitro. At the same time other researchers learned to turn these stem cells into every different kind of cell in the body, such as heart cells, kidney cells, and the like, opening up the very real possibility for creating human replacement cells and parts to cure degenerative disease.
“Of course then disaster struck, involving the use of embryos originally created as part of the in vitro fertilization industry to get stem cells. Brushing up against the long-standing and very emotional abortion debate, the idea of getting stem cells from embryos caused Bush Two to restrict federal funding for stem cell research except from a narrow source of existing stem cell lines.”
“I remember all this,” Carl interrupted. “But what’s all this about induced pluripotent stem cells? Are they the same as embryonic stem cells?”
“Amazingly enough, they do seem to be pretty much the same, and in ways their creation defies what science thought about development. For a long time scientists thought development of a cell from a primitive stage to a mature cell was a one-way street. But that turns out not to be the case. In studying the process of development, there appeared to be about thirty genes that are involved in varying amounts and timing in the maturation process. By packaging these genes in different amounts and mixtures, and putting them inside a fully developed mature cell with the help of viruses, reprogramming was shown to occur, taking the mature cell back to an embryonic state, seemingly the equivalent of an embryonic stem cell.”
“So that’s why these new stem cells are called ‘induced’?” Carl questioned.
“Exactly!” Ben said. “And that’s why they are also called pluripotent, meaning like embryonic stem cells, they are capable of forming any of the three hundred or so cells that make up the human body.”
“It is surprising,” Carl exclaimed.
“It’s more than surprising, in my estimation,” Ben said. “It’s more like astounding. The science of induced pluripotent cells is racing ahead at breakneck speed. Four years ago it was the genes associated with development that were put into mature cells by viruses, and some of these genes were oncogenes, closely associated with cancer-causing capabilities. Even the virus vectors were known to be
occasionally carcinogenic, or cancer-causing, so the resulting induced pluripotent stem cells could never be used in patients, as they would be far too dangerous. But since that early beginning just four years ago, genes have been placed as the agents to reprogram the cells to a more primitive state with the protein products of the genes, and the insertion by potentially dangerous viruses has been changed to using electric current called electroporation, or even more recently by certain chemicals that pull the development proteins in through the cell membranes without damaging them.”
“Okay,” Carl said. “Astounding is a better word than surprising.”
“More important, does this give you a better understanding of the field?”
“Much better. I’ve finally got some context.”
“I’m always happy to give you an explanation of the science. Don’t feel embarrassed to ask.”
“I will take you at your word,” Carl said, putting his hand back on the reprint. “So if I understand correctly, this article is concerned with a process that speeds up the production of induced pluripotent stem cells, and it’s another one of those key processes that we need to control?”
“Yes, and I believe, by the way, this iPS RAPID is behaving like it’s for sale, an issue you know more about than I. My sense is that they would be better to control than the company in Massachusetts. It would be a coup to snap them up before they get a chance to test the market. Do we have significant equity on hand?”
“Probably not, but with the signing yesterday, we’re in good shape market value-wise, and it won’t take long to be able to estimate what we could raise in the short run.”
“Do it,” Ben ordered.
“It’ll be done,” Carl said, and got up from his chair. “Thanks again.” A moment later he was gone.
Ben got up and poked his head into Jacqueline’s office. He had to squint into the sun shining through her windows facing east. “Any sign of Satoshi?” he called out to her.
Since she was on the phone, Jacqueline merely waved and shook her head, voicelessly indicating that she’d not seen him.
Returning back to his desk, Ben half joked to himself that in regard to Satoshi he felt somewhat akin to the father of a teenage son, constantly concerned to a degree where the kid was and what he was doing. It was now going on ten, and Satoshi had yet to show up or call. Ben sighed, recognizing that he was always nervous until Satoshi appeared at the office, even though the man had nothing specific to do. Ben had asked him to at least call if he wasn’t planning on coming in, but Satoshi never bothered. One time Satoshi didn’t show up for a week and never bothered to call or even turn his cell phone on, causing Ben significant concern. When Satoshi did show up, he said he had taken his family to Niagara Falls. Although things were obviously better now with the licensing agreement signed and notarized, losing Satoshi would be more than inconvenient.
Thinking about Satoshi reminded Ben that he’d promised to call up to Columbia and check on the status of his request to lease laboratory space. As he put the call through, he mildly chided himself for not following up on it sooner. Knowing Satoshi as he now did, had he been more responsible, he wouldn’t have to worry about Satoshi’s whereabouts, because the man would spend all his time in the lab.
The conversation with the powers-that-be at Columbia was short and sweet, and very positive. The space was definitely available, the price was high but fair, and all Satoshi would have to do was provide a list of equipment and reagents, which the school would be happy to provide.
On a three-by-five card Ben scribbled the words Columbia bench space available, can start immediately, need to know reagents and special equipment.
Adding the index card to the already sizable stack of contract, wills, and trust, Ben reached for the phone. He’d waited long enough, and his impatience had taken over. He dialed Satoshi’s cell phone number, which he’d committed to memory.
With an uncomfortable premonition building with each hollow ring, Ben impatiently drummed his fingers on the edge of the desk. When the prerecorded generic outgoing message came on, Ben’s premonition was unhappily vindicated. When appropriate, he left a message for Satoshi to return the call, adding that he had some good news to report. It was Ben’s hope that such a message was the best way to ensure a call back as soon as possible.
With that accomplished, Ben went into his closet and dragged out his coat. It was time to leave for his morning meeting with Michael.
5
MARCH 25, 2010
THURSDAY, 10:18 a.m.
Laurie realized she was not concentrating as she went back once again to the beginning of the chapter of the book she was reading. With nothing else to do, she resigned herself to reviewing general forensics, reading up on gunshot wounds. She had chosen GSW after hearing Lou’s story about the case that Jack was currently doing down in the pit. The trouble was that her mind was running all over creation, jumping from one thing to another. She’d already called Leticia so many times just to check in that she had detected a bit of frustration on Leticia’s part. During her last call Laurie had even detected irritation. While Leticia said everything was fine, she suggested that perhaps she, Leticia, should be the next to call, and only if there was a problem of any sort. In her highly sensitive state, Laurie felt as if she was being told that she was not quite as important as she thought and that it was she who was having the problem of adapting, not JJ.
As for her general reception at OCME, Jack had been right. Everyone from the janitorial staff and building engineers all the way up to the chief and the deputy chief had been effusive in welcoming her back. The universality of the response had been warming, but it had done nothing for her professional anxieties. If anything, they’d hardened partially as a consequence of not having been assigned a case. She had found herself unreasonably interpreting the situation not as a favor to her to get acclimated but rather because they, meaning Bingham, didn’t think she could do it to their expectations. The problem, however, was more because she had too much time on her hands with essentially nothing to do.
Laurie’s eyes drifted around her office. There were no Post-its clinging to the tops, sides, or bottom of her computer screen, as there usually were. No stacks of case files on the corner of her desk waiting for information or laboratory results before they could be signed out. In fact, the entire room looked so clean as to be sterile. The microscope standing by itself without slide trays seemed the most lonely, with protective covers on its eyepieces.
Laurie was about to give up trying to read, thinking she would wander down to the autopsy room and at least participate with Jack and Lou on the GSW case. By doing so she hoped she would feel that she was participating, if not contributing. Instead her phone surprised her by filling the room with its persistent jangle. Laurie snapped it up as if it was a desperate emergency, thankful that someone wanted to talk with her.
“Laurie, I have a problem,” a voice said. It took her a moment to recognize that it was Dr. Arnold Besserman, the on-call medical examiner who’d denied her a case that morning and who was thereby guilty of intensifying her anxieties, or so she irrationally and unfairly thought.
“Oh?” Laurie questioned with a glimmer of hope. Maybe a new case had just come in.
“Kevin’s going home sick,” Arnold continued. Kevin was Dr. Kevin Southgate, one of Arnold’s sidekicks. The two argued over everything, particularly religion and politics, despite being quite fond of each other. “I gave him only one post, from the looks of it an easy one at that: an apparently natural death following a collapse on the Fifty-ninth Street platform of the A train. It’s just a routine case. Anyway, he claims he’s coming down with H1N1, and he’s heading home.” Arnold laughed into the phone. “Have you seen Bingham yet, and if you have, could you come down and take over? I know I said I’d give you the day as a freebie, but I’m kinda stuck, and you’re the only one available. What do you say?”
Laurie smiled. Of course she wanted the case, even if it turned out to be a n
atural death. In fact, she thought a natural death was probably a good way to start; it was hard to screw up a natural death. What made her smile was the fact that Arnold didn’t mention whether he was busy or not. Often when he was the on-call medical examiner, he rarely assigned himself any cases.
“Who’s the mortuary tech on the case?” Laurie asked, more out of curiosity than anything else.
“Marvin,” Arnold said. “That’s another reason I thought you might be willing to take over.”
Arnold was speaking the truth. Marvin Fletcher was Laurie’s favorite tech, and she worked with him as often as she could.
“I’ll be happy to do it,” Laurie said. “I’ll be right down.”
True to her word, Laurie left her office as soon as she’d replaced the receiver, and wasted no time pulling on a Tyvek suit, gloves, and her plastic face mask. So attired, she pushed into the autopsy room and glanced around. All eight tables were in use, and Marvin waved from where he was standing at the head of the fourth table. As luck would have it, Jack and Lou were at the neighboring fifth table. They were just finishing up by closing the autopsy incision, with Lou doing the stitching. He’d become such a frequent visitor that he enjoyed helping. Laurie made a brief stop to say hello.
“Hey, how’s it going?” Jack said, catching sight of her. “I’d heard you were to have a free day, thanks to our fearless leader. What brings you down here?”
“That was before Kevin Southgate fell ill next to you guys.”
Jack glanced at the table just behind him and nodded to Marvin, who was patiently waiting. “I had no idea,” Jack said, returning his gaze to Laurie. “Of course, Arnold couldn’t come down and stand in for his friend.”
“Of course not,” Laurie agreed. “But I’m pleased. I wanted a case, particularly a straightforward case.” Since she didn’t want to get into a discussion of Arnold’s shirking tendencies, which was one of Jack’s pet peeves, she changed the subject and asked how the GSW case had gone.