by Lee Vance
She touches a finger to my lips, shaking her head, and then points to the door.
“Our friend’s place is just a few minutes down the beach.” Rummaging in her shoulder bag, she pulls out a banana. “Eat this to get your blood sugar up and we can walk there. We’ll talk on the way.”
Gagging on the richness, I gulp a third in a single bite while she fetches my coat from the wardrobe. She takes the fruit from me so I can slip my good arm into one sleeve, holds it to my mouth for me to take another bite, and then moves closer to help guide my bad arm into the other sleeve. Her eyelashes are blond, and there’s a spray of faded freckles across her nose. I feel awkward, shy in retrospect about her undressing me earlier.
“So tell me,” I say, searching for small talk. “Do you usually keep fruit in your bag?”
“I grabbed the banana downstairs with you in mind,” she says, smiling as she holds it up again for me to finish. “But since you ask, yes. The Gypsy children in Moscow are all undernourished, and the smaller ones never get to keep any of the money they beg. I buy what I can afford and scrounge the rest from tourist hotels. Bananas are the most nutritious.”
“The hotel staff don’t say anything?” I ask, amused by an image of Emily lurking in opulent lobbies, surreptitiously swiping fruit from silver bowls.
“It’s not a problem,” she says, dropping the peel in the trash and beginning to button my coat with deft fingers. “Everybody knows me. I’m the American doctor who collects bananas and hands out condoms. And no jokes, please. I’ve heard them all, in English and Russian. Although it is true the bananas sometimes do double duty—they’re a useful teaching aid in my line of work.”
“I met a couple of your Gypsy kids in an underpass,” I say sourly. “One took my watch.”
“You did well if you hung on to your wallet,” she says sympathetically. “They’re incredibly quick. One got my watch a few years back, and a ring I was partial to. I don’t wear jewelry anymore.”
“But you pack fruit for them.”
“Never give up on children,” she says, carefully lifting my bad arm and tucking the hand inside my coat, propping my wrist on a button. “My guiding principle. If there’s a single thing that keeps me going, it’s the fact that so many of my patients are children. Ready?”
I feel like I’ve been waiting an eternity.
“Absolutely,” I say. “Lead on.”
The policeman’s gone from the hall, and there’s no sign of the SUV on the beach. Emily and I walk toward the ocean until we reach the damp sand at the water’s edge and turn left, the moon lighting our way. My fervor to see Andrei is rapidly devolving into uneasiness. I’ve been too busy looking for him to have given much thought to our meeting. The worst possibility is that he already knows Lyman’s employers were responsible for Jenna’s murder, and never communicated the truth to me for his own selfish or guilty reasons. If so, I can never forgive him. But if he didn’t know about Lyman, I really can’t understand why he never got in touch with me, regardless of what happened between me and Katya, or how shamed he felt by his theft.
“Andrei never told you that he was gay, did he?” Emily asks, interrupting my train of thought.
“No,” I say, feeling embarrassed.
“And that makes you angry.”
“I don’t care who he sleeps with,” I reply stiffly. “But we were friends for a long time. It’s not right that he didn’t say anything.”
“Did he ever actually lie to you?” she demands. “Or did you just make the assumptions you wanted to make?”
I remember what Andrei said to me in Rome: that my worldview was so rigid that I didn’t always see things or people the way they really were.
“It’s not just that he didn’t tell me he was gay,” I say defensively. “There are other things he didn’t tell me, more important things.”
“And there’s nothing you ever concealed from him?”
Only the fact that I betrayed Jenna, one of his close friends, by sleeping with his sister. I don’t respond.
“Let me ask you a question,” she says, skipping sideways as a rogue wave threatens her shoes. “You and Andrei were in the same business, right?”
“More or less,” I reply, relieved at the change of subject.
“He told me that he’d call up people he never met, all over the world, and agree to exchange hundreds of millions of dollars’ worth of stock or bonds just on the basis of a phone call.”
“That’s pretty much how the financial markets work at the institutional level.”
“It’s hard for me to understand. When the clinic bought a copying machine, I had to sign a thirty-page contract.”
“The top end of the financial market is like an English men’s club,” I say, welcoming an opportunity to play the expert with her for a change. “Your word is your bond. The worst thing you could ever do would be to jeopardize your reputation.”
“The very point I was driving at,” she says. “Andrei didn’t think your men’s club was very open to diversity. He was concerned about his reputation.”
“He seems to have gotten over that,” I say testily.
“I don’t like your tone.”
“And I don’t like the fact that you’re apologizing for him.”
“I’m not apologizing. I’m trying to explain.” She takes a deep breath and then exhales loudly. “There’s something I need to tell you before we get to Andrei’s house.”
“What?”
“Andrei has AIDS.”
“Christ,” I say, feeling as if I’ve been kicked in the gut. “Is he okay?”
“No. I wouldn’t be here if he were. I diagnosed him with Burkitt’s lymphoma in August. That’s a nasty lymphatic cancer that’s associated with HIV/AIDS. Treatments in the United States are better than I could provide in Moscow, so I checked him into Stony Brook University Hospital here on Long Island. They’ve got a good AIDS oncology program, and I know some of the staff.”
“Why’s he out of the hospital, then?” I ask, a growing sense of dread suggesting the answer.
“He didn’t respond to treatment,” she says softly. “The doctors at Stony Brook discharged him as a kindness, so he could die in a more comfortable setting.”
Tears start from my eyes. An image comes to me from our days at Klein, before business school: Andrei grinning at the top of the key after I’d dunked a no-look pass, his hair wet with sweat and his face flushed with pleasure. I don’t know if I can face another loss at this point.
“There.” Emily points to a glass house set back above the grassy dunes and takes my arm, guiding me toward it. I balk at the steps, fearful of seeing Andrei wasted and dying. She tugs my hand.
“Come on,” she says. “It’s important to say good-bye.”
The stairs rise to a porch. I wipe my face with my sleeve as Emily opens a sliding door onto a cement-floored kitchen. A heavyset black man in green scrubs is sitting at a hexagonal metal table, drinking Diet Coke and reading a newspaper by the light of a bare hanging flood. There’s a baby monitor on the table by his elbow. The sound’s turned low, but I can hear a woman singing a simple tune unaccompanied. The man looks up as we enter.
“No change. I gave him his meds twenty minutes ago. He’s been in and out.”
Emily leads the way to a double-height living room, its cinder-block walls crisscrossed by sculpture made of rusting pipe, branches snaking crazily and interspersed with broken-faced gauges. We climb aluminum steps to a darkened balcony, where she taps softly on a door before opening it.
Andrei’s lying in a hospital bed, an IV drip hanging from a pole and a gas cylinder affixed to the metal headboard. The clear plastic walls of an oxygen tent distort his features. He looks shrunken, eyes covered by bandages and a pale blue knit cap on his head. A partially opened window admits sea air, gauze curtains fluttering in the breeze. Votive candles flicker on the windowsill, on a marble mantel over a faux fireplace, and on the pickled-wood floor. Mrs. Zhilina sits on the far side o
f the bed, crooning to Andrei quietly as she clasps one of his hands in hers.
“I’ve warned you repeatedly,” Emily whispers, squatting to lift two brilliantly guttering candles near the bed. “Oxygen’s heavier than air. It puddles. You’re going to start a fire.”
“There’s nothing to burn in this house,” Mrs. Zhilina replies stonily. “Renting it was a mistake. It’s ugly.”
“Have you met?” Emily asks, looking from Mrs. Zhilina to me.
“We have,” Mrs. Zhilina says, glancing at me expressionlessly.
I think to ask why she said she didn’t know where Andrei was when we last spoke, but I realize it’s not the right time. I’m here for Andrei, not to try to fathom her deceptions.
“I’m going to make some tea,” she says, leaning on her cane as she rises from the chair. “Perhaps the two of you would be good enough to keep Andrei company until I return.”
“Of course,” Emily says. “Peter and I still have a lot to talk about.”
44
“SIT THERE,” Emily says, pointing to Mrs. Zhilina’s seat. “I’ll pull up a stool on this side.”
I walk around the bed and sink down into the vacant chair, staring through the plastic walls of the oxygen tent. Andrei’s face is a husk, his cheeks sunken and lips bloodless. Only the slightest movement of the crisp white sheet covering his chest hints that he’s alive at all.
“Take his hand,” Emily says. “Gently.”
Andrei’s near hand lies palm-up on the bed, fingers slightly curled. I hesitate, afraid to touch him.
“You won’t hurt him,” Emily says. “And he’s not contagious.”
His skin is hot and dry, as if a fire were burning within. I slip two fingers into his grasp, covering his hand with mine, and feel a slight pressure in response.
“Is he conscious?” I ask, startled.
“Not really. He drifts in and out. I’m trying to keep him under as much as possible because he’s in so much pain.”
“This is awful,” I say, choking back a sob. I look at my friend lying in bed, blind and drugged, death the only release. “Isn’t there anything you can do?”
“It’s not my decision,” Emily says. “Mrs. Zhilina has his proxy. It’s difficult to let go of a child. When she’s ready, she’ll tell me.”
“That’s not what I meant,” I say despondently, realizing I don’t know what I did mean. Sitting at Andrei’s deathbed with his feverish hand clasped in mine, the only truth I’m sure of is that I’m about to lose one more of the very few people I ever cared about.
“I haven’t got any miracles to offer,” Emily says gently. “We all die. I’ve sat next to dozens of beds like this. It’s a blessing that we have enough drugs to ease his way. That’s not always the case.”
“When Mrs. Zhilina is ready,” I say, stumbling over the words, “will you …”
“Of course,” she replies. “There aren’t many doctors in my line of work who haven’t crossed that bridge at some point.”
Andrei’s wearing a hospital gown, the neck loose, and I can see the edge of his rugby scar, a puckered line circling his shoulder. We fell out of the habit of playing basketball after business school, our schedules seemingly too difficult to coordinate. Looking back, my devotion to Klein seems a puzzling waste. I should have paid more attention to the people I loved.
“You have questions,” Emily says. “I’m sorry Andrei can’t answer them for you. I’ll tell you what I can, though.”
“A man named Lyman was looking for Andrei,” I say, pulling myself together. “Do you know why? Or who he was working for? I think he’s with the same people who were after me in Moscow.”
“I don’t recognize the name,” she says. “All Andrei told me was that he had a problem, that some people were looking for him, and that I should be careful of phones and e-mail. He said they might be able to use the local cops to hassle his friends but that Vladimir could use the clinic’s connections to protect me, and that I should let Vladimir or one of his boys escort me around Moscow.”
So Andrei trusted Vladimir to the last. He wouldn’t have recommended that Emily seek Vladimir’s protection if he hadn’t.
“When was this?”
“Early September.”
“You must have asked him what was going on,” I say insistently.
“I told you before,” she replies, tucking loose hair behind her ears, “Andrei and I had an understanding. There were things I couldn’t know without risking my professional standing.”
“Things like what?” I ask, wondering if she’s alluding to Andrei’s theft from Turndale.
“You recall my telling you about the problems we’re facing with multidrug-resistant TB and the fact that none of the pharmaceutical companies are willing to do work on it because there isn’t a paying market?”
“Right,” I say tentatively, wondering where she’s going with this.
“A little over a year ago, I was talking to a colleague at a conference in Vienna. He’d heard rumors that a Swiss company had stumbled onto a treatment that attacked the bacilli from an entirely different angle.”
Andrei shifts on the bed, mouth opening as he mumbles a few words. Emily lifts his other hand and strokes it. There’s a network of plastic tubes taped to his forearm.
“How do you stumble onto a treatment?” I ask.
“It happens more often than you’d imagine. Genomics will change things eventually, but for the moment, drug development is pretty haphazard. The Swiss were working on acne. Like TB, severe acne is treated with antibiotics and, like TB, the use of antibiotics has encouraged resistant strains. The Swiss were experimenting with a drug that inhibited the synthesis of metabolic enzymes—in effect, starving the acne bacilli to death. It looked good in the lab, so they began clinical trials in Russia.”
“Why Russia?”
“Please,” she says. “The target market for acne products is teenagers. Would you let your teenager sign up for a drug trial if you could afford other treatments?”
“No,” I concede.
“Russians can’t afford other treatments, and the clinical standard there is pretty good, despite the lack of money. A researcher reviewing the posttrial work-ups noticed something unusual. Forty percent of the subjects had been infected with latent TB before the trial, which means they carried TB bacilli but didn’t exhibit any symptoms. That’s not unusual: As much as a third of the global population carries latent TB. After completing the Swiss acne protocol, though, every single clinical subject’s TB load went to zero. The researcher reported his findings up the chain and the company commissioned a second acne trial, this time using a prison population. That was clever of them. By going into prisons, they got a subject group more likely to be infected by virulent TB strains without having to disclose to anyone external the real purpose of their study. The results were the same: The drug seemed to be a golden bullet for all strains of TB, with no significant adverse side effects.”
“You heard all that as a rumor?” I ask, still trying to figure out why she’s telling me this.
“The rumor was just that there was a new drug, and that the company had decided to sit on it. Everything else I learned later.”
“But why would the company sit on it?”
“The Swiss were making a bet,” Emily says bitterly. “If MDR-TB makes the leap to the developed world, the drug will be worth billions. They think it’s going to happen, and I agree with them. Ten years ago, there was an outbreak of MDR-TB in Florida that took almost two and a half years to eradicate. Twenty-six out of eighty-one patients died, all with access to the best health care available. Imagine the demand if a more widespread outbreak occurred.”
“You told Andrei about the rumor you’d heard,” I say, suddenly understanding.
“I did,” she replies. “A few months later, he gave me some CDs containing clinical trial data for a new antibiotic—raw results as well as the researcher’s notes. The drug being tested inhibited synthesis of metabolic enzymes
, and seemed particularly effective against TB. He asked for my opinion. I reanalyzed the results independently and told Andrei that the drug looked like the real thing.”
He must have bribed someone at the company, I realize, not quite sure how I feel about that. The gauze curtains begin flapping loudly, and I get up to close the open window. The votives on the sill and mantel have all blown out.
“A couple of weeks after that,” Emily continues, “Andrei told me he was on the board of a charitable foundation that had obtained the formula for a new TB drug and wanted to conduct a clinical study of the drug’s efficacy against MDR-TB. He asked me to design it.”
“Hang on,” I say as I resume my seat, my brain going in too many different directions. “Drugs get patented, right?”
“They do. Sometimes just the underlying molecule, sometimes the molecule and the manufacturing process.”
“And wouldn’t a company patent a drug before they got to the point of doing clinical trials on it?”
“Undoubtedly.”
“Then what you’re telling me doesn’t make any sense. If the Swiss had already patented the drug, why would Andrei’s foundation want to conduct an independent trial on it?”
“I don’t know that Andrei’s drug was the Swiss drug,” she says, reminding me that Andrei kept the particulars from her.
“Suppose it was.”
“Then I’d imagine that Andrei’s foundation intended to publish their results and let public opinion pressure the Swiss into manufacturing it.”
“But you already had clinical results.”
“Those studies were targeted at acne,” she says patiently, “not full-blown TB. They were highly indicative, but not conclusive.”
I’m feeling wired now, my brain humming the way it used to when I was working on a big trade.
“That rumor you heard,” I say. “What was the name of the Swiss company?”
“Zeitz,” she says. “They’re huge. Part of a European conglomerate that does all sorts of things.”
Tilling told me that Lyman had worked security for some big Swiss pharmaceutical company a few years back. More of the puzzle snaps into focus. I’d lay odds that the company he worked for was Zeitz.