The Rationing

by Charles Wheelan

  “Then you and I need to take up golf—because we’re going to have a lot of spare time on our hands when the board sees this,” Goyal said.

  “I don’t like golf. It takes too long,” the CFO replied. His attempt at levity fell flat. Goyal shook his head from side to side in disagreement, almost like a tremble. It was a distinctly Indian gesture that the Internet cameras liked to capture during the trial.

  “We had a bad quarter. It happens. The board is smart enough to realize that,” the CFO said. “We can brief them before the meeting. They don’t like surprises, but they do tolerate bad news.”

  “What happened to the Dormigen revenues?” Goyal asked.

  “We booked it all last quarter,” Swensen said.

  “Then why do we have this huge Dormigen expense now?”

  The CFO explained the terms of Centera Biomedical Group’s contract with the U.S. Department of Health and Human Services (HHS). Centera was chosen to provide the federal government with twenty million doses of Dormigen a year to be stockpiled in case of a virulent pandemic, a terrorist attack with a biological weapon, or some other widespread biomedical emergency. Epidemiologists have always considered this a possibility; the flu pandemic of 1918–19 killed some forty million people around the globe. If anything, we are more vulnerable to a pandemic now than we were a hundred years ago. An outbreak of some nasty disease in Ningde, China—or some other place you have never heard of—will not stay isolated, as it would have in 1915. One business executive visiting a T-shirt factory in Ningde can spread a killer virus to Manhattan or Tokyo in a matter of hours. And there are plenty of nasty viruses: polio, avian flu, Ebola, swine flu, HIV, MRSA.

  Dormigen works against them all. Ironically, it was the HIV virus that inspired us to believe that something like Dormigen might be possible. HIV has a unique ability to change its form; when the human body produces antibodies to fight back, HIV modifies itself—actually changes its form—so that the antibodies become ineffective. As soon as the human body finds the right key to disable the virus, HIV changes the lock. Some bold researchers reckoned that antibodies could be engineered to do the same thing, only for the “good guys.” Why couldn’t we engineer antibodies that would change form until they were able to destroy whatever pathogen had invaded the body? These antibodies would show up with a whole ring of keys, like the janitor who lets me into my office when I lock myself out. He takes the huge ring of keys hanging off his belt and patiently tries one after another; eventually one of them opens my door. Ten billion dollars and fifteen years later, we invented the most powerful drug since penicillin: a giant antibody key ring.

  “Dormigen is alive,” Swensen told his boss at that fateful meeting at Centera Biomedical Group.

  “It’s a pill, right?” Goyal asked.

  “Yes and no,” Swensen offered. “It’s a gel cap. But my point is that it’s alive. It’s a package of enzymes that we cultivate—”

  “Never mind,” Goyal said, literally waving away the science with a sweep of his fleshy arm. Obviously, if he cared more about the science, fewer people would have died. Dormigen is engineered by splicing several key human genes into a host embryo, usually a chicken egg. The process is not terribly complicated, but it does require twenty-one days for the genetically engineered cells to mature in their host embryos, after which they are harvested and grafted onto a common human antibody that can be injected back into the body and easily absorbed. As the Centera CFO correctly pointed out, Dormigen is alive. There is nothing unique or even terribly interesting about that; many vaccines are alive. It does explain, however, why Centera Biomedical Group was paid a lot of money to manufacture Dormigen, store it, destroy it—and then do it all over again.

  “Dormigen has a shelf life of about a hundred and eighty days,” Swensen explained to his overwrought boss. “We make twenty million doses, then six months later we destroy them. That’s what we do, over and over again—unless there is a need for them, in which case the government would draw down the stockpile.”

  Goyal tapped a line item in the budget. “We’ll spend a hundred and twenty million dollars this quarter to destroy something that cost us a hundred and twenty million to produce last quarter?”

  “No,” the CFO said. “We’ll spend about fifteen million to destroy the old doses and a little over a hundred million making the new ones.”

  And that was when the plan was hatched. Both men denied any knowledge of it at first, when the FBI raided the headquarters of Centera at the beginning of the Outbreak. Later, at trial, each would blame the other for the scheme. The jury found neither convincing and convicted them both. In any event, their plan was simple and good for the bottom line: stop producing new Dormigen until revenues turned healthier, probably in just a few quarters. Goyal and/or Swensen decided to gamble. Rather than spending a lot of money to produce a new batch of Dormigen—vials that would sit in a warehouse only to be destroyed six months later—they would keep the old stuff around. “I never thought it would matter,” Swensen explained during the sentencing phase of his trial. “We were just a safety valve.”

  That was the exact language in the contract: safety valve. Centera was only obligated to provide the Department of Health and Human Services with Dormigen after the government had exhausted 75 percent of its own stock. The U.S. government had tens of millions of doses, most of which went unused in a normal year. The Centera scheme was like loaning out the spare tire on your car for a few weeks. How often do you get a flat? There was virtually no chance that the government would need Dormigen this quarter, when Centera could really use the extra revenue. As soon as the business environment improved, the company could go back to making and destroying Dormigen without anyone being the wiser.

  Goyal and Swensen were vilified as the embodiment of evil, two guys willing to sacrifice lives in order to goose quarterly profits. The truth is subtler. Goyal and Swensen cut a corner. They did something selfish and dishonest—but they did not believe anyone would get hurt. They did not run into a crowded stadium and start firing weapons. They did not drink pitchers of margaritas at happy hour and then drive home. Their crime was the corporate equivalent of running a yellow light. They lost perspective. They were three minutes late for an appointment that did not really matter in the grand scheme of things; when the stoplight went from green to yellow, they sped up—just a little, in their eyes. The rest of the world did not figure into that calculation. Their three minutes were more important. Who knew that a group of schoolchildren might enter the crosswalk? If you think about it, the people who run yellow lights are more dangerous than the people who run red lights, because there are so many more of us.

  Goyal and Swensen were in complete agreement on how their fateful conversation ended. Goyal once again insisted that Swensen take up golf. “You can’t run marathons forever. The knees are not made for it,” the CEO said.

  “There is no exercise in golf,” Swensen protested.

  “There is if you walk,” Goyal insisted.

  “Most people take carts.”

  “Not where I play, at the Wood Hollow Club. We have caddies. I can get you in like that,” Goyal said, snapping his fingers. “Your kids can use the swimming pool.”

  “I don’t see the point of trying to hit a small ball into a small hole from a long distance,” Swensen joked with his CEO. The conversation drifted back to a familiar place. Levity crept into the room.

  “That’s exactly the point!” Goyal exclaimed. “When I focus on hitting the ball, my mind is purged of all this nonsense.” He made a sweeping gesture across his desk.

  “And then you get angry when you miss a shot.”

  “Now, that is true!” Goyal laughed heartily. “Still, it’s yoga for the mind, I am telling you. This evening, I am going to the driving range. I am certain of that!”

  Goyal walked his CFO to the door. According to his testimony at trial, Goyal did in fact hit two buckets of balls at the Wood Hollow driving range later that afternoon.

&n
bsp; 4.

  MY PARENTS WANTED ME TO GO TO LAW SCHOOL. I TOOK THE LSAT my senior year in college just to placate my mother. I also took a summer job working for a Washington, D.C., firm that was litigating an enormous patent infringement case in the defense industry. As a college student, I was a peon—albeit a peon billed out to the client at $75 an hour. (I was paid $15 an hour, with no benefits.) I moved boxes around. I did some background research on missile defense systems. During one three-week stretch I put fifteen thousand trial documents in chronological order. The law school interns had only slightly less menial tasks, though they were billed out at $125 an hour. Even the young lawyers did not seem to be doing a whole lot of intellectually interesting work. Our collective paper pushing did not resemble the fancy courtroom dramas on television.

  The case never went to trial. All of the work was just a prelude to a negotiated settlement, a very expensive and time-consuming bluff. The settlement was very advantageous to our client, and we were supposed to be excited. Instead, most of the team was exhausted and cynical. We knew it was not our brilliant legal analysis that had brought the case to closure; neither firm wanted to roll the dice with a jury trial. We had hired an expensive jury consultant who told us that twelve laypeople would have little ability to grasp the key technical details of the case. I could have offered the same advice more cheaply. At about the same time I was putting those fifteen thousand trial documents in chronological order—lab notebooks with pages of equations, long memos with detailed weapons specifications, and the like—I had to go to the Department of Motor Vehicles to get my driver’s license renewed. As I looked around the DMV, I lost a fair bit of confidence in our prospective jury pool.

  After the settlement, the firm had a massively expensive party in a ballroom at the Four Seasons, including a caviar bar and small Kobe beef sandwiches passed around on trays. There was a guy making martinis in the corner of the ballroom with boutique gins. (Unlike vodka, you really can taste the difference with gin.) I stumbled home with a perky second-year law student from Harvard whom I had been lusting after since the day I arrived at the firm. The next morning, while she was still naked in the bedroom of her small but charming Georgetown apartment, she rolled toward me and kissed me gently on the chest. I was expecting more great things. Instead, she said, “Promise me you won’t go to law school.”

  That was not exactly a binding legal commitment. And it is not the story I told my parents about why I did not want to become a lawyer. Still, I did not apply to law school. I stumbled into virology almost by accident. My dad is an accountant; my mom was a marketing consultant until she quit to raise my sister and me. My people tend to be service providers, not scientists. I had never met anyone with a Ph.D. until I arrived at Dartmouth. Several years later I woke up as an economics major. The math was relatively easy for me; economics was considered to be the most direct route to Wall Street, or someplace equally lucrative and respectable. Anyone who graduated with a respectable GPA and decent social graces could tap into the impressive Dartmouth alumni network to become at least a mini-titan of finance. Guys who had spent a good portion of senior year drunk in fraternity basements were handling millions of dollars for hedge funds by homecoming of the following year (or so they said).

  I am not one to shake up the social order, but it did strike me—even at the time—that most of the “career planning” going on senior year did not involve much planning, let alone introspection. Rather, it felt like a warm, comfortable current sweeping smart people gently toward investment banking, consulting, law school, and a few other low-risk, high-reward careers. When we entered as freshmen, our class dean pointed out in her matriculation speech that our class of roughly one thousand had three hundred and eleven high school valedictorians. We also supposedly had twenty-three soccer captains (which boggles the mind given the awful performance of the soccer team during my four years). I was surrounded by high achievers who, to that point in life, had excelled by doing a prescribed set of tasks faster or better than everyone else. High school is a brilliantly designed machine for beating the originality and creativity out of anyone. One does not thrive by creating original work, or inventing something, or questioning authority, or working well with others (cheating).

  By senior fall at Dartmouth, all of this was bouncing around in my mind. The inner competitive streak among my high-achieving classmates had been unleashed full force. When McKinsey & Company* arrived on campus, it felt like the corporate equivalent of the Beatles’ arrival in America. All conversation revolved around which members of our class had been selected for “closed” interviews—those that were offered by invitation only. In what struck me as a cruel gesture, McKinsey also offered “open” interviews to the first twenty-five students in line at Career Services on a particular Monday morning. Scores of students lined up the night before. The weather was so bad (it would fall below freezing that night) that students at the back of the line began to hope that those at the front would get sick and leave. They actually said that out loud.

  I was having a small existential crisis when I arrived in Professor Huke’s Biology of Parasites class at the beginning of the winter quarter. I wish I could say that I had scoured the course guide looking for a class that would take me to a new intellectual plane. In fact, my adviser had sent me an e-mail the previous week pointing out that I had not yet completed my laboratory science requirement. I had a keen interest in graduating, and I was running out of terms to finish my electives, so I decided to sign up for a lab science class. There were two choices. (Actually, there were six choices, but four of them either met before nine a.m. or were held in buildings that would have been a nose-hair-freezing walk from my dorm during January and February.) It had to be Bio 3 (Biology of Everyday Life) or Microbiology 32 (Biology of Viruses and Parasites). The Biology of Everyday Life was a known “layup,” meaning that anyone who put in a modicum of effort could count on an A- or better. The bulk of the course consisted of collecting samples of living things and looking at them under a microscope. Other than the week on “bodily fluids,” which was apparently pretty cool, the course was an embarrassment to the Ivy League. Still, three hundred people enrolled every time it was offered—most of the humanities and social sciences majors on campus—because it was an easy way to boost the GPA and fulfill the lab science requirement at the same time.

  On a Thursday night in the first week of the quarter, I had a conversation in the basement of a fraternity that changed my life trajectory, like a boulder dropped into a stream that sends the current coursing in a new direction. I ran into Sloan Hill near the beer tap in the Alpha Delta house. We talked for a while. One can draw a straight line, or series of lines, from my conversation with Sloan that evening to the Oval Office, where I would spend hours huddled with the President of the United States a decade later.

  5.

  SLOAN AND I APPROACHED THE BEER TAP FROM DIFFERENT directions and I offered to fill her cup. She was effortlessly cute: gray-blue eyes, short blond hair, no makeup to speak of, and a killer smile, especially when she was a little tipsy. Sloan squinted when she smiled, and that was cute, too. She was also “wicked smart,” as we liked to say in New Hampshire, even in a sea of overachievers. She worked hard enough; the work came easy to her, as it did to a lot of those high school valedictorians wandering around campus. But what set Sloan apart were her impressively eclectic intellectual interests. While the rest of us complained about too much work, she found time to read for fun, even fiction. Her RealNews blastbox was filled every day with writers who ranged from counterculture to intellectually unhinged. (“We all need to know what they’re saying,” she explained to me once.) I explicitly remember her citing a column in the Jerusalem Post one day in the context of some meandering discussion on the Middle East. Who in New Hampshire reads the Jerusalem Post unless it is assigned for a class? (Even then, most of us tried to cut corners on the assigned reading.) I remember seeing Sloan at the bus stop one Friday afternoon, waiting for the Dartmouth Coac
h. She was headed to New York to wander through museums all weekend. “I just need to recharge,” she said, looking comfortably alone with a small duffel at her feet.

  Sloan was the student that we all should be, the student that our parents probably thought that we were. She took classes that interested her. She worked hard but was indifferent to grades. She visited her professors during office hours to talk about concepts in the class, rather than to haggle for more points. Sloan lived in my freshman dorm, just down the hall. We had become friends before she disappeared to date older guys and pursue different campus activities. Still, the bonds of freshman year are deep, and I really liked her. She was one of a handful of people whose opinions I valued. To my credit, I did not really spend a lot of time obsessing about what other people thought of me. I did care what Sloan thought.

  As I filled Sloan’s glass with beer from the tap, she asked, “So, what are you taking this quarter?”

  “Monetary Policy,” I said. “And a writing class that looks pretty good. I’m still shopping for a lab science.”

  “You’re not taking Bio 3, are you?” she asked accusingly.

  “No way,” I said. It was the truth, as of that moment. Yes, I had sat in on Bio 3 twice that week, and it fit perfectly into my schedule, but once Sloan asked me that question, in that tone, I was not going to take Bio 3. “I’m thinking about that parasites course.”

  “Really?” she said, with more than the usual amount of enthusiasm for a desultory conversation in a fraternity basement. “Were you there this week? I didn’t see you. I’m doing my Presidential Scholar thesis on the anthropology of contagious diseases, so I’m sitting in on the class.”

  The next morning I signed up for Microbiology 32. I could fulfill my lab science requirement; I also entertained visions of sitting next to Sloan every day in class, sharing notes, studying together. Sometimes I imagined that we would work together late into the night, and then when the readings no longer made sense, and we had grown punchy from too little sleep and too much coffee, I would lean over and kiss her. And she would kiss me back, because the bond developed over weeks of studying together was inexorable . . . There were a lot of variations on what happened next, though invariably we had sex in some public study space and then went on to ace the exam, after which we became a prominent campus couple.