There was a parking area off to the left, and she drove into the nearest slot and turned off her engine. This was the moment she'd been both anticipating and dreading. The clock on the dash read eleven-fifteen; she was fifteen minutes ahead of the appointed hour.
"Okay, Mom, how do you feel?"
Nina turned and stared at her, uncertainty in her eyes. "Where are we, Ally? I don't recognize anything."
"This is the institute I told you about last night. Can you remember anything we talked about then?"
"This is the place you were … Didn't you say there's a doctor here who can do something for my… memory?"
"We're both here now to just talk to him." She turned to the backseat. "Maria, can you get Mom's purse?"
She nodded, then reached hesitantly for the door. She was clearly reluctant to get out.
Ally walked around and opened the door for her mother.
"Okay, Mom, time to stretch your legs."
Ally held her hand and together they headed across the oval brick driveway. Birds were chirping around them and she could smell the scent of the lake, borne up the hill by a fresh wind. Then, through the trees, she saw two women walking up the trail that led down to the lake. They were, she assumed some of the patients.
They both looked to be in their early sixties, but also athletic and nimble. One was wearing Nikes and a pale green pantsuit. The other had on a blue dress and a white cap and Ally realized she must be a nurse. She'd been taking the other woman out for a stroll.
They were engrossed in conversation, but as they approached, the woman Ally had decided was on staff looked up and smiled a greeting.
"Can I help you?"
She introduced herself and Nina and Maria. The woman smiled again but didn't introduce herself in turn.
"We're here to see Dr. Van de Vliet," Ally went on, "about the trials. But we're a couple of minutes early and I was wondering if we could look around a bit first? I'm trying to understand what the institute is really like."
"Well, dear," the woman said, "even those of us who work here aren't allowed everywhere. You know, into the research lab in the basement. Some places here have to be completely hygienic. Of course, for patients who are in the recovery phase, strolling around outside is definitely recommended, as long as they're able. But that's getting way ahead of ourselves. First we'll have to check you in. There's a lot of paperwork for the clinical trials." She seemed puzzled. "They're almost over, you know. But come along and I'll let him know you're here. He's always down in the lab at this time of the morning. It's well after his rounds. They're so busy now."
Then she turned to the other woman. "Sophie, do you think you can find your way back to your room? It's number two-eighteen, on the second floor, remember?"
Sophie appeared to be pondering the question for a long moment before she huffed "Don't be silly. I know exactly where it is."
As she strode on ahead, the nurse watched her carefully, as though unsure what she might do next. She pushed a buzzer at the door and then a man in a white uniform opened it and let her in. Only after Sophie had disappeared through the doorway did the nurse turn back.
"I'm Elise Baker. Please forgive Sophie if she seems a little … confused. Her procedure is still under way."
"Her 'procedure'? What-"
"She was diagnosed with Parkinson's before she came here. She's improved an enormous amount, but we're not allowed to say so."
"Why is that?"
"We're in clinical trials. No one is allowed to discuss our results. Everyone here had to sign a secrecy agreement."
Now Maria was helping Nina up the steps. The porch, with its soaring white Doric columns, was definitely magisterial. The front door, however, was not wooden or decorative. It was solid steel, albeit painted white to blend in.
Elise walked to the door, which had a video camera mounted above it, and a split second later, it buzzed, signaling it was unlocked.
This is a lot of security, Ally thought,for a clinic doing research on cells.Are they worried about spies getting in, or patients getting out?
But the locked steel door was just the beginning of the security. Next they entered a small room just inside the door with an X-ray machine to see into purses and parcels.
"The first floor is reception and dining," Elise explained as she swept through the metal detector. "There are rooms-we call them suites-upstairs for patients, and the research lab and offices are in the. . lower area."
"What. . what is all this security for?" Ally asked.
"The work here is highly proprietary. No one is allowed to bring in any kind of camera or recording equipment."
The guard dressed in white looked like a retired policeman, with perhaps a few too many jelly doughnuts over his career. He had a beefy red face and a hefty spare tire. But he was certainly alert to his responsibilities, eyeing the three newcomers with scarcely disguised suspicion.
In fact, Ally sensed a palpable paranoia in the air.Well, she told herself, medical research is a high-stakes game.It's understandable they would be concerned about industrial espionage.
After the security check, they went through another steel door and entered the actual lobby. The first thing she noticed was a grand staircase leading up to the second floor, and then to the third. Off to the right was a modern elevator with a shiny steel door.
A number of patients were coming down the stairs and heading for a hallway leading to the back. They were mostly women, whose ages ranged anywhere from forty-five to well beyond seventy.
Whoarethese people? Ally wondered. They must have been sufferers of various kinds of debilitating afflictions, but now they were certainly ambulatory, if not downright sprightly. She wanted to talk to some of them, watching them moving along chatting and smiling, but this was not the moment.
"At eleven-thirty we have meditation in the dining hall," Elise was saying as she led them through the lobby, "for those who care to participate, and after that a vegetarian lunch is served at twelve-thirty sharp." Then she glanced back. "After you see Dr. Van de Vliet-and assuming you're admitted-there'll be an orientation and then you're welcome to begin participating fully in our activities."
"Actually," Ally said, "if people are well enough to be in 'activities,' why can't they be outpatients?"
"These clinical trials require twenty-four-hour supervision," Elise explained, heading for the wide desk in the center of the room. "Now, if you would all sign in here at the desk, Ellen can take you downstairs to the medical reception."
A dark-haired woman smiled from behind the desk, then got up and came around. A sign-in book was there on a steel stand. Ally finally noticed that light classical music was wafting through the room, Tchaikovsky's Swan Lake suite.
"You must be Ms. Hampton," the woman said. "And this must be your mother. We were told to expect you."
She nodded a farewell to Elise, who said, "It was so nice to meet you. Good luck."
She then turned and headed for the back.
Ally signed all three of them in.
"Good," the woman said as she checked the information.
"My name is Ellen O'Hara, by the way. I'm in charge of the nursing staff here. We're ready to go downstairs now."
Ellen O'Hara had a knowing, earnest face that fairly lit up when she smiled. She had short brown hair streaked with gray and was pleasantly full-figured.
When they reached the elevator, she zipped a small plastic card through the reader on the wall and the doors slid open. As they emerged on the lower level, Ally realized they were in the precincts of a very sophisticated medical laboratory. Occupying most of the floor was a glassed-in area, inside of which she could see three men and two women, all dressed in white. She also noticed rows of steel containers that seemed to be ovens or incubators of some kind as well as racks and racks of vials. At the far end of the laboratory, there was a blackboard on which one of the men was drawing something that looked like hexagonal molecules, linking them together.
"That's
Dr. Van de Vliet," Ellen said pointing. "I'll let him know you're here. The laboratory is a special environment. The entrance there is actually an air lock. The air inside is filtered and kept under positive pressure."
She walked over to a communications module, buzzed then announced into the microphone, "Dr. Vee, your eleven-thirty appointment is here."
He turned and stared in their direction, then smiled and waved. Next he walked to a microphone near the center of the room and clicked it on.
"I'll be with you in a minute. Can you please wait in the receiving room? And Ellen, can you start getting them ready?"
"Of course." She nodded then clicked off the microphone and turned. "Receiving is just down at the end of the hall. Next to his office. Please come with me."
She led them through a large wooden door, into a room with a retractable metal table covered in white paper and several chairs. It was a typical examination room, with a device on the wall to monitor blood pressure, a stethoscope, and other examination paraphernalia.
"If you'll kindly take a seat," Ellen said, "I'm sure he'll be here as soon as he can, in a few minutes at most. But while we wait, I need to take your temperature and blood pressure, and start a chart."
"Ally, where are we?" Nina asked. Her face was becoming alarmed, and Maria reached to comfort her. "Are we in a hospital somewhere?"
"Yes, Mom, it's actually the institute I told you about last night The doctor here wants to see if he can do anything to … help you."
"Oh," she said, "is he the one you told me about? I thought that was just a dream."
"No, he's real. Whether he can help you or not that part is what’s still a dream. But we're all praying."
She looked around at the pure white walls and wondered again what she was getting into. Meeting a new specialist in the sterile white cold of an examination room, could be frightening in itself. God, how many times before had she done this as she trudged through HMO hell? Maria was so unsettled she was deathly pale.
Ellen took their blood pressure and temperature, including Maria's, even though she protested mildly, half in Spanish-a sign of how unsettling it was to her. Ellen had only just finished putting all the numbers on clipboard charts for each of them when Karl Van de Vliet opened the door and strode in.
Chapter 13
Tuesday, April 7
11:39 a.m.
He had a high forehead and prominent cheekbones, just like in the photo. And just as in his photo, there was a genuine dichotomy between his face, which looked to be early forties and unwrinkled, and his gray eyes, which were much older. That was it. That was what seemed odd. He was different ages.
Underneath his white lab coat he was wearing a black suit and an open-necked blue shirt. Ally noticed that his fingers were long and delicate, like those of a concert pianist, and overall he had a kind of ghostly presence, as though he were more spirit than man. Although he looked exactly as he did in the photograph in the Gerex Corporation brochure, in person there was an added dimension, a kind of raw magnetism about him. It was more than simply a physician's bedside manner, it was the allure of a pied piper. The first thing you wanted to ask him was How oldareyou, really?Maybe the next thing you'd want to do was ask him to dinner.
What had she expected? Maybe a self-absorbed nerd researcher in wrinkled stained lab attire, anxious to scurry back to his test tubes. But in person Karl Van de Vliet was debonair and youthful, living proof that his photo wasn't retouched and was recent. He had to be twenty years older than she was, easily, but to look at him you'd guess he was close to the same age. She was dying to ask him about that but she couldn't think of a polite way to raise the subject.
She introduced herself. "We spoke yesterday." Then she introduced her mother and Maria. "Mom and I talked last night about the clinical trials, and she said she's interested. This morning, unfortunately, I'm not sure she remembers what we discussed."
He placed a hand on Nina's shoulder and studied her face as he smiled at her, embracing her with his eyes. "Well, we're going to see what we can do about that aren't we, Mrs. Hampton?"
"I've got a question right up front" Ally said. "Have we already been entered into the National Institutes of Health clinical trials?"
He seemed taken aback for a moment, caught off guard, but then he stepped up to the question.
"As a matter of fact I did take the liberty of authorizing the preliminary NIH paperwork for both of you. Of course it doesn't obligate you in any way. The thing is, there's a lot of red tape, so if you do decide to participate, the sooner we get that part started the better. On the other hand, if you decide not to, we can just terminate everything at this preliminary stage and you won't even be part of the official record."
Well, Ally thought,that undoubtedly explains why Stone saw our names on the NIH Web site. But why did Van de Vliet look so funny when I brought it up?
He focused on Nina. "Mrs. Hampton, I'm Dr. Van de Vliet. You're a pretty lady, and we've had some luck helping other ladies like you."
"Honey, if I had you in my bedroom, then maybe you could help me."
OMG, Ally thought, she's about to go ribald on us. But that's a sign she's coming out of her funk.
But then she had another thought. Maybe Nina sensed he was older than he looked. Like that paranormal perception that told her Grant was involved in something evil. So far, however, that particular perception hadn't panned out (though Grant clearly was up tosomething).
Maria was mortified. She blushed and made a disapproving animal noise low in her throat and turned her face away, but Van de Vliet simply smiled even more broadly.
"Mrs. Hampton, I don't think you should be talking that way in front of your daughter." He gave her a wink. "What you and I do together is none of these people's business. But I do think we should consider keeping them informed if only a couple of hints."
Ally found herself wanting just to listen to his voice. There was an intelligent warmth about it that reminded her of a kindly professor at Columbia, a truly gifted architect who also could quote Keats and make you cry. You wanted to give yourself to him. My God, she thought, how am I going to stand up to this man?
"There're some issues you and I need to discuss," he said turning back to Ally. "The first thing I need to do is take a look at Mrs. Hampton’s records. But whatever they say, it won't do any harm to run what we call a 'mental state examination' for her, to establish a general baseline of cognitive impairment as of now."
"How long will that take?"
"Actually, Ellen can start in just a few minutes," he said "Of course, we'll need to hear about the usual danger signs everybody knows. Does Mrs. Hampton have recent-memory loss? Does she get confused about places and people? Does she have trouble handling money and paying her bills?"
"The short answer is yes."
All of those things, Ally knew, had accelerated in the last six months. It was the tragic, recognizable onset of the latter stages of Alzheimer's. Already more than once Maria had said there were times when she didn't think Nina recognized her. More and more she seemed to be confused, unable some days to find her way around the apartment, and she'd started repeating herself. She often had trouble finding the right words, and she was increasingly paranoid and suspicious. Maria, who had worked with other Alzheimer’s patients, feared she might begin hallucinating soon, seeing things that weren't there.
Ally turned to her. It felt obscene to talk about her when she was sitting right there with them.
"Mom, sweetie, do you understand what Dr. Van de Vliet is asking? Do you think you have trouble doing everyday things?"
She knew the answer but she was determined that her mother not be treated like a potted plant.
"Ally, you know that half the time I can't remember a blessed thing. I'm getting crazy as a bloody coot."
Then Nina turned and looked Van de Vliet in the eye.
"I don't want to lose my mind, Doctor. I don't want to see the shade closing in. I can't do crosswords anymore. I used to do
them all the time. And all the music I used to know. It was my love and now. . now I can't tell Scriabin from Strauss half the time. It wasn't supposed to happen that way. I thought my mind would go on forever."
"Mrs. Hampton, if you'll let me, what I want to do is try to work on your recollection. I don't know how much I can help you with crosswords, but then I've never been much good at them myself either. Your memory of music should improve, though. There are no guarantees, but-"
"Then I'm ready to try it, Doctor," she cut in. "You're all that stands between me and losing the only thing I have left, my past" Next came a burst of rationality. "Now, I hate to be a pest but could you explain what exactly it is you're going to do. I want Ally to hear this too and then maybe she can go over it with me later and help me understand it."
He smiled and reached over and stroked her slightly thinning hair. "I'd be happy to try, Mrs. Hampton. It's actually pretty simple."
Then he turned to Ally. "We touched on some of this on the phone. Do you want to hear it again?"
"Yes, I'm still trying to get it all into my simple mind."
"Well," he began, "to go back to the very beginning of my interest in stem cells the focus of our research has been directed toward challenging the notorious Hayflick limit. Back in the 1960s, Professor Leonard Hayflick discovered that when tissue cells are taken from the body and cultured in a laboratory dish, those cells grow and divide about fifty times, give or take, and then they stop. They have reached old age, senescence. The physical basis of the Hayflick limit is a section of DNA known as telomere, which gets shorter each time the cell divides. Eventually the telomeres become so short that all cell division stops. It's like an internal clock telling them the game is over. They've had their innings."
"And you're saying you've found a way to beat the clock, to stop the telomeres from getting shorter?"
"All cells possess a gene known as the telomerase gene, which can restore the telomeres to their youthful length. But in most cells the gene is permanently repressed and inactive. It is only found in egg and sperm cells, and in cancer cells." He gazed away for a moment as though collecting his thoughts. Then he turned back. "However, we've found that by isolating and inserting an active copy of the telomerase enzyme into adult stem cells, which can be found in minute quantities throughout the body, we can set their clock back to zero. We extract cells, 'immortalize' them with telomerase, and then return them to the body as a youthful infusion."
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