by J. R. McLeay
“Right,” Director Inzucchi intoned. “You’ll need to advise the FDA and WHO about those shipments. Our primary concern here today is how this discrepancy found its way into your system. Who has access to the ingredients placed in the patch?”
Bruce checked with both Jamieson and Alan, and they nodded their assent to proceed .
“The primary ingredients are added from a secure mix room staffed with two people at a time.”
“But you run two shifts a day?”
“Yes…so taking into account our seven-days-a-week production schedule and personal vacations, that means we have six clean room mixers.”
“We’ll need to talk with each of them.”
“We can arrange that,” Jamieson offered, “but I can’t imagine you’ll find any wrongdoing by these operators, since not only do they receive intensive training, but they all know every batch is carefully checked for discrepancies—so any attempted tampering of the product would be quickly exposed.”
“Who supplies and manufactures the ingredients added in the mix room?” asked Agent Sanchez.
“We produce all of the ingredients in-house, in this facility,” Bruce replied.
“How many people are involved in that process?”
“Thousands, but each ingredient is carefully tested to ensure proper consistency and quality before being sealed into steel drums.”
“Who else has access to the drums before they’re used in the mix room?”
“They’re stored in a secure storage facility adjacent to the mixing chamber. But we’ve found no evidence that those drums were opened or tampered with.”
“We’ll need to conduct our own investigation,” Director Inzucchi declared. “You’ll need to provide our forensic team access to those drums, and to each of the other locations.”
“Of course,” Jamieson said, glancing uneasily at Alan. “We’ll provide full cooperation. Just let us know what you need.”
“What I don’t understand,” Inzucchi continued, “is how such a huge discrepancy could get out of your factory, let alone in to it. Don’t you have sophisticated quality control equipment and procedures to detect this sort of thing before it gets out the door?”
“Yes, of course we do—and we’re currently undertaking an intensive internal audit of that department to find out where and how that happened.”
“Who’s in charge of the quality control operation? And why didn’t you invite him to this meeting?”
“Unfortunately, I’ve been unable to locate him,” Jamieson said. “He hasn’t shown up to work since last Tuesday, and we haven’t been able to reach him.”
Inzucchi scribbled something quickly in his notepad.
“We’re going to need all the particulars for that employee. In the meantime, I’d like you to provide Special Agent Sanchez with a tour of each of the areas you’ve referenced today and access to all of the relevant personnel. There’s going to be quite a few more investigators showing up here over the next few days. We’re treating this as a crime scene, so you’re going to have to cease production in the specified areas until we can finish our investigation.”
“How long will you need?!” asked Jamieson, sounding alarmed. “We can’t shut down for too long—we need to maintain a constant supply of patches to keep everyone supplied with the essential medication.”
“You said every pharmacy around the world has two days’ supply on hand, right? We’ll be done here before then.”
Director Inzucchi turned to Special Agent Sanchez. “Sanchez, please keep me abreast of what else you find here today. I’m going to get our forensics team scrubbing the clean room and storage area immediately.”
As the two police officers stood to leave and shook hands with each executive, Director Inzucchi paused to look into the eyes of each of the three men—particularly Jamieson and Bruce Ellis. He had over twenty-five years’ experience reading the faces of criminals from all walks of life, and he looked for the slightest twitch or sign of nervousness that might indicate either one was hiding any material facts. He knew that both were highly motivated not only to protect the interests of their employer—but also their own hides.
Neither betrayed any sign of nervous tension. For Director Inzucchi, that was a problem.
35
When Rick returned to his office after the meeting with Mount Sinai’s Chief of Staff, he had a message waiting for him from Tian Yin. He could hear some anxiety in her voice, but he noticed something else in her tone—it sounded strangely deeper and more mature.
Calling back immediately, she picked up on the second ring.
“Tian, it’s Rick. I just got your message.”
“Rick—thank heavens you called,” Tian replied in a strangely disembodied voice. “So much has happened in the last couple of days. Have you been following the latest news?”
“Yes, I’ve been scrambling all morning to collect more information, and there are some key details I wanted to discuss with you.”
“I’ve arranged a special meeting for one o’clock with the Director-General of the World Health Organization—can it wait ‘til then?”
Rick considered telling Tian what he’d discovered about the bad batch of Endogen patches, but based on Jennifer’s report of her condition, he decided it would be best to discuss the particulars when he saw her personally.
“Yes, of course—see you then.”
Three hours later, when his cab pulled up in front the Secretariat Building, Rick was relieved to see no sign of protestors—only the familiar sculpture of Reutersward’s twisted gun, standing vigil over the eerily silent courtyard. But he knew it was only a matter of time before a new group of angry citizens descended on the square, demanding answers and restitution. The utopian lifestyle the state had created for every juvenile had cultivated a sense of entitlement that he knew would not easily be surrendered.
Making his way once again past the gently swinging Foucault Pendulum in the public lobby, he was reminded of the powerful connection between the forces of biology and physics. Perhaps, he thought, it was too much to expect humankind could repudiate the laws of nature that had guided the cycle of life for millennia. He knew Tian would likely have some strong opinions on this subject and that she would need some delicate counseling in view of the recent developments in her own life.
When he got to the top floor and Tian rose to greet him in the Secretary-General’s office, Rick was shocked by how much she’d changed. Noticeably taller than when he last saw her, she seemed to tower over the diminutive Director-General standing next to her. Even more obvious were her newly proportioned curves, as her swelling hips and bosom formed a distinct hourglass shape in her now overly tight skirt and blouse.
Standing awkwardly in half-profile in a failing effort to disguise her newly budding form, she quickly dispensed with introductory salutations before retreating behind the sanctity of her large executive desk.
“Rick, you remember Dr. Sanjeet Singh?” she began.
Rick had met the Director-General only a few weeks ago, when the World Health Assembly elected India’s Minister of Health as the new head of the WHO.
“Yes, of course. It’s good to see you again, Dr. Singh. Though it’s unfortunate we have to meet again so soon, under such extraordinary circumstances.”
“Indeed,” Dr. Singh sighed. “It seems my appointment will start with a trial by fire.”
“Sadly, yes,” Tian remarked. “I called you both here today to get your opinions on how we should address this hormone…” she paused to search for the right choice of words, “disequilibrium that we’ve witnessed over the last few days and which became public today. Obviously, it will require an immediate response and a coordinated international effort.”
“I’ve already begun a number of initiatives to investigate the cause and possible containment of the problem,” Rick said, trying his best to sound reassuring.
“Could you fill us in on what you know?”
“Our testing lab at Moun
t Sinai confirmed the Endogen patch has a number of ingredients that are significantly out of spec, and we’ve determined it’s limited to one batch of patches that were produced last Monday.”
“I suspected there was something wrong with the patches,” Tian said, as her hand drifted down to her abdomen. “Is there any way of identifying which ones are bad?”
Rick handed Tian a hand-scribbled note across her desk.
“Yes—we’ve identified they are all marked with this lot number.”
“Endogen also called my office this morning to advise us of the discrepancy,” Dr. Singh added. “Our Director of Communications is in the process of issuing a Stage Six alert, advising all juveniles to check their patches and replace those bearing the defective lot numbers with new patches. I’ve also notified our regional offices to begin removing and recalling the defective patches from inventory, in cooperation with Endogen’s local distributors.”
“Unfortunately,” Rick advised, “that’s not going to make much of a difference now. All these defective patches are now nearing expiration, which means most will have already been replaced in the normal course of weekly turnover. It looks like the damage has already been done. The good news is that all subsequent patch production appears to be fine.”
“What does that mean for those who’ve already been affected?” Tian asked, as she quietly peeled back the adhesive on the patch underneath her blouse.
“Many of the less severe symptoms of hormone overdose such as edema, hypermelanosis, and acne can be quickly reversed—but others may take longer to adjust. We’ve never experienced anything like this before, so to some degree we’re just going to have to see what happens when everyone’s endocrine levels are returned to normal.”
Dr. Singh asked the question they both suspected was foremost on Tian’s mind.
“Do you think those who’ve been affected will respond to the lower levels of hormone infusion?”
“That really is the essential issue now. It remains to be seen if the more mature bodies of those who’ve been affected will return to homeostasis with the prior juvenile hormone levels, or if it will be necessary to boost their hormone infusions to meet the new demands...”
“How can so much change and maturity happen in only a week?!” Tian interjected, finding it increasingly difficult to contain her mounting anger.
Rick knew the extraordinary levels of hormones that Tian had been subjected to over the last week were also making her unusually testy and volatile.
“Unfortunately,” he continued, “the hormone levels in these particular patches was so extreme—more than ten times normal—that it was equivalent to receiving ten weeks of adolescent doses, which historically has been more than enough to push juveniles past puberty.”
“How could this have happened?” Tian cried, surrendering any remaining pretense of objectivity and throwing her now-crumpled patch in the wastebasket in disgust. “We both reviewed and approved the quality control procedures at Endogen when we qualified them as our primary producer years ago!”
“It appears,” Rick replied softly, trying to calm Tian‘s nerves, “that this may have been the work of one or two disgruntled employees working alone or in tandem, whom the FBI are now trying to find. But I understand that Endogen is working on new, more stringent controls as we speak to prevent this kind of problem happening again.”
“That won’t help them much in the next round of bidding,” Tian said bitterly. “This should virtually eliminate any chance of them qualifying as one of the new suppliers.” She paused for a moment to calm down. “It’s too bad we didn’t start this redistribution initiative sooner—we might have avoided this catastrophe.”
“Maybe—but I think wherever there are sufficiently motivated people, there will always be a way to circumvent protocols and security procedures.”
“What kind of person would possibly want to risk this kind of harm to so many people, anyhow?” wondered Dr. Singh. “And how could they be certain they or their loves ones wouldn’t be affected?”
“That’s what the FBI is trying to figure out,” Rick said. “It’s probably some kind of fringe group or loner holding a grudge.”
“Like our friend at the Garden of Eden church?” Tian suggested. “I hope the FBI starts their investigation with him.”
“Calvin certainly would appear to be a motivated party. The good news is that he’s already behind bars, which will expedite his questioning. We’ll have to see if or how he’s connected with this.”
“Is there anything else you think we can do to contain the situation,” Dr. Singh asked Rick, “to prevent it from happening again?”
“I think we’ve done pretty much everything we can at this point, beyond the issuance of a press release informing everybody what’s happening and what they need to do to minimize further damage. We should advise those who’ve experienced unusual symptoms in the last week to see a qualified medical practitioner immediately and of course to replace their patch. As Tian mentioned, we will probably also have to review and strengthen the qualification standards and manufacturing protocols for future suppliers, not to mention those currently in place at Endogen. And we should be prepared for further questions and fallout from those who’ve already been affected—especially if they don’t return to their prior equilibrium.”
“Sanjeet,” Tian asked, beginning to refocus her thoughts after her earlier outburst, “has the WHO kept track of the total number of hormone poisoning cases around the world?”
“Yes. It’s already well into the hundreds of thousands, though we’ve had some trouble keeping up with the accelerating reports coming in today. It’s hard to say how many of these might simply be an overreaction from the press coverage.”
“It shouldn’t be difficult to identify valid concerns with a simple blood test,” Tian said, remembering the sample Dr. Austin had taken from her during her visit to the hospital yesterday.
“I think we should expect these numbers will rise even higher,” Rick suggested. “It’s my understanding that the single defective batch produced three hundred million patches, and with these levels of overdose, I would imagine just about everybody wearing one of those patches will be affected in one way or another.”
“Do you think we might see more serious complications than those already reported?” Tian asked, becoming newly concerned about her own health.
“Hopefully, the rapid return to normal hormone levels from the re-application of good patches will bring everybody back to proper homeostasis. But it’s possible those who’ve experienced thyroid or pancreatic dysfunction could develop more serious complications, such as diabetes or Grave’s Disease.”
“It might be a good idea,” Dr. Singh added, “to mobilize temporary walk-in clinics, especially in remote regions, to manage the higher expected caseloads, and to offer specialized treatment for those most seriously affected. That way, at least we can take some of the pressure off local hospitals.”
“Yes—that would be extremely helpful,” Rick said. “The sooner we can make that happen, the better.”
“I agree,” intoned Tian. “All right then. We seem to have a workable plan for dealing with this crisis, at least in the short term. Let’s just see what happens when all the defective patches are replaced. Sanjeet, please keep me apprised as you get more information about the numbers affected and regarding your progress setting up the local clinics. Rick—can you stay behind for a few more minutes to discuss another matter?”
Dr. Singh stood abruptly, taking his signal to leave.
“Thank you, Madam-Secretary, I’ll be sure to let you know as soon as I have any new information to report.”
Tian waited a few moments for the Director-General to let himself out and close the door behind him.
“Rick, there was something else I wanted to ask you about personally. As you’ve probably noticed…”—she paused as her throat choked with emotion—“…I was one of the unlucky ones wearing the defective patch this week.”
Rick didn’t think it would be useful to mention that he already knew she’d been treated and that Jennifer had advised him of her condition.
“I’ve seen a specialist at your hospital,” she continued, “who was very clear about my condition. But I wanted to ask you something she couldn’t answer.”
“Yes, of course Tian.”
“When I look at myself in the mirror…I see somebody I don’t recognize. I never thought such an image could be so unsettling—or grotesque. But the worst thing is, I’ve had my first…”
“Yes, I know,” Rick said, as he moved closer to comfort Tian. “And I assure you, you’re as beautiful as ever.”
“But…my period?”
“Let’s just see how your body responds to the new round of hormone therapy,” Rick replied, unsure for the first time of his own words. “Maybe in this case, one period doesn’t truly signal menarche. The human body is an amazingly adaptive organism…”
“You mean—” Tian asked plaintively, “this doesn’t have to be a death sentence?”
“Let’s not talk like that. We’re going to do everything in our power to make this better. If you want, I can act as your personal physician in this matter. I brought you a supply of good patches to start with. If there’s a way to turn this around, we’ll find it together.”
“Thank you Rick,” Tian said, as she wrapped her arms around Rick’s neck and pressed her breasts against him. “I always knew I could count on you.”
36
In the four days since Elias’s aborted hypophysectomy operation, his condition had stabilized, but he remained in the Intensive Care Unit of Mount Sinai Medical Center under close observation. From all appearances, the emergency closure of his carotid artery in the midst of Calvin’s attempted intervention had been successful, and subsequent brain scans showed the wound to be healing normally. Now it was simply a matter of time for the arterial lining to repair itself behind the temporary patch of fibrin glue.