by Robin Cook
Stepping through the door Sean saw Ramirez look up from adjusting a Polaroid camera mounted on a tripod. Ramirez pointed toward a stool in front of a blue curtain, and Sean sat down.
HARRIS CLOSED the door to the camera room, went back to his desk, and sat down. Sean had been worse than he’d feared. The idea of some wiseass kid coming down from Harvard had not appealed to him in the first place, but he hadn’t expected anyone looking like a hippie from the sixties.
Lighting a cigarette, Harris cursed the likes of Sean. He hated such liberal Ivy League types who thought they knew everything. Harris had gone through the Citadel, then into the army where he’d trained hard for the commandos. He’d done well, making captain after Desert Storm. But with the breakup of the Soviet Union, the peacetime army had begun cutting back. Harris had been one of its victims.
Harris stubbed out his cigarette. Intuition told him Sean would be trouble. He decided he’d have to keep his eye on him.
WITH A new photo ID clipped to his shirt pocket, Sean left security. The experience didn’t mesh with the welcome sign, but one fact did impress him. When he’d asked the reticent Ramirez why security was so tight, Ramirez had told him that several researchers had disappeared the previous year.
“Disappeared?” Sean asked with amazement. He’d heard of equipment disappearing, but people!
“Were they found?” Sean had asked.
“I don’t know,” Ramirez had said. “I only came this year.”
“Where are you from?”
“Medellín, Colombia,” Ramirez had said.
Sean had not asked any more questions, but Ramirez’s reply added to Sean’s unease. It seemed overkill to head security with a man who acted like a frustrated Green Beret and staff it with a group of guys who could have been from some Colombian drug lord’s private army. As Sean followed Ramirez into the elevator to the seventh floor his initial positive impression of Forbes security faded.
“Come in, come in!” Dr. Randolph Mason repeated, holding open his office door. Almost immediately Sean’s unease was replaced by a feeling of genuine welcome. “We’re pleased to have you with us,” Dr. Mason said. “I was so happy when Clifford called and suggested it. Would you like some coffee?”
Sean acquiesced and was soon balancing a cup while sitting on a couch across from the Forbes director. Dr. Mason looked like everyone’s romantic image of a physician. He was tall with an aristocratic face, classically graying hair, and an expressive mouth. His eyes were sympathetic and his nose slightly aquiline. He seemed the type of man you could tell a problem to and know he’d not only care but he’d solve it.
“The first thing we must do,” Dr. Mason said, “is have you meet our head of research, Dr. Levy.” He picked up the phone and asked his secretary to have Deborah come up. “I’m certain you will be impressed by her. I wouldn’t be surprised if she were soon in contention for the big Scandinavian prize.”
“I’ve already been impressed with her earlier work on retroviruses,” Sean said.
“Like everyone else,” Dr. Mason said. “More coffee?”
Sean shook his head. “I have to be careful with this stuff,” he said. “It makes me hyper. Too much and I don’t come down for days.”
“I’m the same way,” Dr. Mason said. “Now about your accommodations. Has anyone discussed them with you?”
“Dr. Walsh just said that you would be able to provide housing.”
“Indeed,” Dr. Mason said. “I’m pleased to say that we had the foresight to purchase a sizable apartment complex several years ago. It’s not in Coconut Grove, but it’s not far either. We use it for visiting personnel and patients’ families. We’re delighted to offer you one of the apartments for your stay. I’m certain you will find it suitable, and you should enjoy the neighborhood as it’s so close to the Grove.”
“I’m pleased I didn’t have to make my own arrangements,”
Sean said. “And as far as entertainment is concerned, I’m more interested in working than playing tourist.”
“Everyone should have a balance in life,” Dr. Mason said. “But rest assured, we have plenty of work for you to do. We want your experience here to be a good one. When you go into practice we hope you will be referring us patients.”
“My plan is to remain in research,” Sean said.
“I see,” Dr. Mason said, his enthusiasm dimming slightly.
“In fact, the reason I wanted to come here…” Sean began, but before he could complete the statement, Dr. Deborah Levy walked into the room.
Deborah Levy was a strikingly attractive woman with dark olive skin, large almond-shaped eyes, and hair even blacker than Sean’s. She was stylishly thin and wore a dark blue silk dress beneath her lab coat. She walked with the confidence and grace of the truly successful.
Sean struggled to get to his feet.
“Don’t bother to get up,” Dr. Levy said in a husky yet feminine voice. She thrust a hand at Sean.
Sean shook Dr. Levy’s hand while balancing his coffee in the other. She gripped his fingers with unexpected strength and gave Sean’s arm a shake that rattled his cup in its saucer. Her gaze bore into him with intensity.
“I’ve been instructed to say welcome,” she said, sitting across from him. “But I think we should be honest about this. I’m not entirely convinced your visit is a good idea. I run a tight ship here in the lab. You’ll either pitch in and work or you’ll be out of here and on the next plane back to Boston. I don’t want you to think…”
“I drove down,” Sean interrupted. He knew he was already being provocative, but he couldn’t help himself. He didn’t expect such a brusque greeting from the head of research.
Dr. Levy stared at him for a moment before continuing. “The Forbes Cancer Center is no place for a holiday in the sun,” she added. “Do I make myself clear?”
Sean cast a quick glance at Dr. Mason who was still smiling warmly.
“I didn’t come here for a holiday. If Forbes had been in Bismarck, North Dakota, I would have wanted to come. You see, I’ve heard about the results you’ve been getting with medulloblastoma.”
Dr. Mason coughed and moved forward in his seat, placing his coffee on the table. “I hope you didn’t expect to work on the medulloblastoma protocol,” he said.
Sean’s gaze shifted between the two doctors. “Actually, I did,” he said with some alarm.
“When I spoke with Dr. Walsh,” Mason said, “he emphasized that you have had extensive and successful experience with the development of murine monoclonal antibodies.”
“That was during my year at MIT,” Sean explained. “But that’s not my interest now. In fact, I feel it is already yesterday’s technology.”
“That’s not our belief,” Dr. Mason said. “We think it’s still commercially viable and will be for some time. In fact, we’ve had a bit of luck isolating and producing a glycoprotein from patients with colonic cancer. What we need now is a monoclonal antibody in hopes it might be an aid to early diagnosis. But, as you know, glycoproteins can be tricky. We’ve been unable to get mice to respond antigenically, and we’ve failed to crystallize the substance. Dr. Walsh assured me you were an artist when it comes to this kind of protein chemistry.”
“I was,” Sean said. “I haven’t been doing it for some time. My interest has changed to molecular biology, specifically oncogenes and oncoproteins.”
“This is just what I feared,” Dr. Levy said, turning to Dr. Mason. “I told you this was not a good idea. We are not set up for students. I’m much too busy to babysit a medical student extern. Now if you’ll excuse me, I must get back to my work.”
Dr. Levy got to her feet and looked down at Sean. “My rudeness is not meant to be personal. I’m very busy, and I’m under a lot of stress.”
“I’m sorry,” Sean said. “But it is difficult not to take it personally since your medulloblastoma results are the reason I took this elective and drove all the way the hell down here.”
“Frankly, that’s n
ot my concern,” she said, striding toward the door.
“Dr. Levy,” Sean called out. “Why haven’t you published any articles on the medulloblastoma results? With no publications, if you’d stayed in academia, you’d probably be out looking for a job.”
Dr. Levy paused and cast a disapproving look at Sean. “Impertinence is not a wise policy for a student,” she said, closing the door behind her.
Sean looked over at Dr. Mason and shrugged his shoulders. “She was the one who said we should be honest about all this. She hasn’t published for years.”
“Clifford warned me that you might not be the most diplomatic extern,” Dr. Mason said.
“Did he now?” Sean questioned superciliously. He was already beginning to question his decision to come to Florida. Maybe everybody else had been right after all.
“But he also said you were extremely bright. And I think Dr. Levy came on a bit stronger than she meant. At any rate she has been under great strain. In fact we all have.”
“But the results you’ve been getting with the medulloblastoma patients are fantastic,” Sean said, hoping to plead his case. “There has to be something to be learned about cancer in general here. I want desperately to be involved in your protocol. Maybe by looking at it with fresh, objective eyes I’ll see something that you people have missed.”
“You certainly don’t lack self-confidence,” said Dr. Mason. “And perhaps someday we could use a fresh eye. But not now. Let me be honest and open with you and give you some confidential information. There are several reasons you won’t be able to participate in our medulloblastoma study. First, it is already a clinical protocol and you are here for basic science research. That was made clear to your mentor. And second of all we cannot permit outsiders access to our current work because we have yet to apply for the appropriate patents on some of our unique biological processes. This policy is dictated by our source of funding. Like a lot of research institutions, we’ve had to seek alternate sources for operating capital since the government started squeezing research grants to everything but AIDS. We have turned to the Japanese.”
“Like the Mass General in Boston?” Sean questioned.
“Something like that,” Dr. Mason said. “We struck a forty-million-dollar deal with Sushita Industries, which has been expanding into biotechnology. The agreement was that Sushita would advance us the money over a period of years in return for which they would control any patents that result. That’s one of the reasons we need the monoclonal antibody to the colonic antigen. We have to produce some commercially viable products if we hope to continue to receive Sushita’s yearly payments. So far we haven’t been doing too well in that regard. And if we don’t maintain our funding we’ll have to shut our doors which, of course, would hurt the public which looks to us for care.”
“A sorry state of affairs,” Sean said.
“Indeed,” Dr. Mason agreed. “But it’s the reality of the new research environment.”
“But your short-term fix will lead to future Japanese dominance.”
“The same can be said about most industries,” Dr. Mason said. “It’s not limited to health-related biotechnology.”
“Why not use the return from patents to fund additional research?”
“There’s no place to get the initial capital,” Dr. Mason said. “Well, that’s not entirely true in our case. Over the last two years we’ve had considerable success with old-fashioned philanthropy. A number of businessmen have given us hefty donations. In fact, we are hosting a black-tie charity dinner tonight. I would very much like to extend an invitation to you. It’s at my home on Star Island.”
“I don’t have the proper clothes,” Sean said, surprised at being invited after the scene with Dr. Levy.
“We thought of that,” Dr. Mason said. “We’ve made arrangements with a tux rental service. All you have to do is call in your sizes, and they will deliver to your apartment.”
“That’s very thoughtful,” Sean said. He was finding it difficult to deal with this on-again, off-again hospitality.
Suddenly the door to Dr. Mason’s office burst open and a formidable woman in a white nurse’s uniform rushed in, planting herself in front of Dr. Mason. She was visibly distressed.
“There’s been another one, Randolph,” she blurted out. “This is the fifth breast cancer patient to die of respiratory failure. I told you that…”
Dr. Mason leapt to his feet. “Margaret, we have company.”
Recoiling as if slapped, the nurse turned to Sean, seeing him for the first time. She was a woman of forty, with a round face, gray hair worn in a tight bun, and solid legs. “Excuse me!” she said, the color draining from her cheeks. “I’m terribly sorry.” Turning back to Dr. Mason, she added, “I knew Dr. Levy had just come in here, but when I saw her return to her office, I thought you were alone.”
“No matter,” said Dr. Mason. He introduced Sean to Margaret Richmond, director of nursing, adding, “Mr. Murphy will be with us for two months.”
Ms. Richmond shook hands perfunctorily with Sean, mumbling it was a pleasure to meet him. Then she took Dr. Mason by the elbow and steered him outside. The door closed, but the latch didn’t catch, and it drifted open again.
Sean could not help but overhear, especially with Ms. Richmond’s sharply penetrating voice. Apparently, another patient on standard chemotherapy for breast cancer had unexpectedly died. She’d been found in her bed totally cyanotic, just as blue as the others.
“This cannot go on!” Margaret snapped. “Someone must be doing this deliberately. There’s no other explanation. It’s always the same shift, and it’s ruining our stats. We have to do something before the medical examiner gets suspicious. And if the media gets ahold of this, it will be a disaster.”
“We’ll meet with Harris,” Dr. Mason said soothingly. “We’ll tell him he has to let everything else slide. We’ll tell him he has to stop it.”
“It can’t go on,” Ms. Richmond repeated. “Harris has to do more than run background checks on the professional staff.”
“I agree,” Dr. Mason said. “We’ll talk to Harris straight away. Just give me a moment to arrange for Mr. Murphy to tour the facility.”
The voices drifted away. Sean moved forward on the couch hoping to hear more, but the outer office remained silent until once again the door burst open. Guiltily he sat back as someone else dashed into the room. This time it was an attractive woman in her twenties dressed in a checkered skirt and white blouse. She was tanned, bubbly, and had a great smile. Hospitality had refreshingly returned.
“Hi, my name’s Claire Barington.”
Sean quickly learned that Claire helped run the center’s public relations department. She dangled keys in front of his face, saying: “These are to your palatial apartment at the Cow’s Palace.” She explained that the center’s residence had gotten its nickname in commemoration of the size of some of its earlier residents.
“I’ll take you over there,” Claire said. “Just to make certain it’s all in order and you’re comfortable. But first Dr. Mason told me to give you a tour of our facility. What do you say?”
“Seems like a good idea to me,” Sean said, pulling himself up from the couch. He’d only been at the Forbes Center for about an hour, and if that hour were any indication of what the two months would be like, it promised to be a curiously interesting sojourn. Provided, of course, he stayed. As he followed the shapely Claire Barington out of Dr. Mason’s office, he began seriously considering calling Dr. Walsh and heading back to Boston. He’d certainly be able to accomplish more there than here if he was to be relegated to busywork involving monoclonal antibodies.
“This, of course, is our administrative area,” Claire said as she launched into a practiced tour. “Henry Falworth’s office is next to Dr. Mason’s. Mr. Falworth is the personnel manager for all non-professional staff. Beyond his office is Dr. Levy’s. Of course, she has another research office downstairs in the maximum containment lab.”
&nbs
p; Sean’s ears perked up. “You have a maximum containment lab?” he asked with surprise.
“Absolutely,” Claire said. “Dr. Levy demanded it when she came on board. Besides, the Forbes Cancer Center has all the most up-to-date equipment.”
Sean shrugged. A maximum containment lab designed to safely handle infectious microorganisms seemed a bit excessive.
Pointing in the opposite direction, Claire indicated the clinical office shared by Dr. Stan Wilson, chief of the hospital’s clinical staff, Margaret Richmond, director of nursing, and Dan Selenburg, hospital administrator. “Of course, these people all have private offices on the top floor of the hospital building.”
“This doesn’t interest me,” Sean said. “Let’s see the research areas.”
“Hey, you get the twenty-five-dollar tour or none at all,” she said sternly. Then she laughed. “Humor me! I need the practice.”
Sean smiled. Claire was the most genuine person he’d met so far at the Center. “Fair enough. Lead on!”
Claire took him over to an adjacent room with eight desks manned by busy people. A huge collating copy machine stood off to the side busily functioning. A large computer with multiple moderns was behind a glass enclosure like some kind of trophy. A small glass-fronted elevator that was more like a dumbwaiter occupied another wall. It was filled with what appeared to be hospital charts.
“This is the important room!” Claire said with a smile. “It’s where all the bills are sent for hospital and outpatient services. These are the people who deal with the insurance companies. It’s also where my paychecks come from.”
After seeing more of administration than Sean would have liked, Claire finally took him downstairs to see the laboratory facilities which occupied the middle five stories of the structure.
“The first floor of the building has auditoriums, library, and security,” Claire droned as they entered the sixth floor. Sean followed Claire down a long central corridor with labs off either side. “This is the main research floor. Most of the major equipment is housed here.”