Last Shot

by Gregg Hurwitz

  Jenner again: “How about A-Rod?”

  “Too expensive, overrated, and can’t hit postseason,” Dean said. “I want an extreme athlete. How about that rock-climber kid who sawed off his own arm a few years back? I doubt he’s wading through offers. Plus, I want to buy soft mentions—pardon the pun. How much would it cost to get Sean Connery to shill Viterol in a Matt Lauer interview? Get me numbers.”

  The director of Sales pitched in: “We can’t get around the fact that Pfizer’s outpricing us.”

  Now Bernie, Accounting: “We can’t price down any further. Our profit margin’s too tight.”

  “Then inflate the wholesale and sell it to doctors for cheaper,” Chase said. “Let them keep the spread.”

  “Temporary fixes,” Dean said, with a flick of his hand.

  The dismissal brought a few moments of reflection.

  “To boost earnings in a way that’s significant,” White ventured, “we need to widen out its applications, push doctors to prescribe off-label.”

  They went in various directions at once. Dean tuned out. Taking potshots at Viagra. Christ, what pikers.

  Eighteen pens were scribbling on eighteen pads in sixty-five hundred dollars’ worth of Coach and Gucci notebooks.

  Little again: “Come on, we’ve got Viterol covered from every angle, from the shape of the pill to the coating—”

  “Can we patent taste?”

  “Bad taste, sure. Would Beverly Hills exist otherwise?”

  Dean cut in on the yuk yuk yuk. “Remember, all of you”—he cast a hawkish gaze around the table—“examiners in the FDA receive bonuses based on how many applications they handle, and a patent app is easier to approve than deny. It just comes back the next year anyway, adds to the pile.”

  Jane watched Chase mouth the final clause as Dean spoke it.

  Dean went on. “What’s next?”

  Chase said, “Vector.”

  A deep inhalation brought Dean upright in his chair. For the first time, his expression brightened.

  Biogenics was the future of the big drug companies, and Dean had sensed it in his brittle bones. As the progenitor of a $40 billion pharmaceutical company, he was no fool; he’d long anticipated the need for fresh technologies to replenish the drying pipeline of conventional meds. The major PhRMA companies had spent the past twenty years chasing one another with me-too drugs, creating ever paler imitations of meds already in profitable existence. Me-too drugs targeted common, lifelong conditions—arthritis, depression, high blood pressure. Antibiotics were seldom blockbusters because infections don’t last long enough for repeat sales. People with rare diseases formed a limited market, and thus their conditions were of little economic interest. Meds geared toward lethal diseases were a losing bet because the consumer didn’t stick around long enough to rack up substantial expenses. So Big Pharma had focused on picking off the low-hanging fruit, letting their development wells run dry. Except Beacon-Kagan, which had implemented an aggressive biogenics strategy early on. Beating the competition into the field, Dean had supported Vector to a tune of $80 million, an amount expressly chosen to shatter the start-up biotech funding record. He’d since poured in tens of millions more.

  The others’ focus remained on the head of the table, so Dean made a show of deferring to his son, whom he’d installed as Vector’s CEO at the outset.

  Chase nodded his thanks, glad to assume brief command. “Do you want the good news or the good news?” Polite chuckles. “Since with Xedral there’s no need to moderate dosage levels or study metabolism effects, and because kids are dying from AAT deficiency every day, the FDA approved our request for a combined Phase I and II. Three months long, randomized, double blind, placebo controlled, starting next week as planned. Once the Xedral injection is shown to take, and if the kids don’t combust”—a current of polite laughter generally reserved for Dean—“we roll out wide before the new year.”

  “Any trouble securing subjects?” Jenner asked.

  “We’ve been beating off a virtual stampede.”

  Various impressed nods and noises from the others. Scarcity of human subjects usually caused the biggest delay in getting a new drug to market.

  “Families are desperate,” Chase continued. “They have kids languishing on the liver waiting list. No need to pay bounties to doctors for enrollees—these parents just want our help.”

  Bernie said, “Let’s have those numbers again.”

  “There look to be about a hundred thousand people in the U.S. with AAT deficiency and an equivalent number in Europe. Calculating in other moneyed populations—Australia, Japan, what-have-you—brings us to at least three hundred thousand. But. Most estimates show that less than ten percent of people with AAT deficiency have been diagnosed, even though it can be determined by a simple blood test. So we can push for more screening as a public health measure, which will allow doctors to identify the disorder early, save lives, and raise our consumer population. To that end we’re rolling out a preceptorship program for pediatricians, hepatologists, pulmonologists, and geneticists. We’ll get young, attractive drug reps—”

  “New blood,” Dean said. “Redheads seem smarter. Troll the campuses.”

  “—to shadow doctors, educate them about Xedral, even get in the room with patients. For their troubles the sponsoring docs will receive three hundred dollars a day. Going off the most conservative numbers—the three hundred thousand diagnosed patients—an annual treatment cost of twenty thousand dollars grosses us over six billion dollars our first year.”

  Bernie again: “Isn’t that treatment cost too ambitious?”

  “Yes. It is.” Chase drew out the silence an extra few seconds, a trick, Dean noted with satisfaction, he’d appropriated from his old man. “Of course, for people with resources it isn’t. Is your child’s life worth twenty thousand dollars a year? Absolutely. But for middle- and lower-class patients, we have a few hurdles. However, Vector has invested a sizable sum of money in an AAT deficiency public health rationing study, the results of which will post the week after the IPO. Our argument is simple: This is a lifesaving treatment, and poor patients shouldn’t be deprived of it because of cost. Frankly put, it’s unethical, akin to class genocide. We’ll capitalize on the momentum from the study with continued aggressive lobbying in Washington. We have word from inside that if we bring the heat, Medicaid will widen eligibility and reimburse for half cost.”

  A literal gasp went up from around the table.

  “We’ve been upping our sponsorship of AAT deficiency patient-advocacy groups over the past year to ensure they have a voice, which we’ll continue to make use of. In a few months, we’ll do a big fat airlift to a few poor countries. That’ll make ’em teary even in the red states, gets us a hundred million bucks in publicity for a million in cost. In the meantime, we’ll keep booking local network and nationals and continue to spin marketing off the advertising to pick up extra mileage. Our polling showed that the KCOM news segment last month made a favorable market impression.”

  “The story about the kid?” Jenner asked. “That was great. Really moving.”

  “And we found our new mascot.” Chase held up a design layout of the corporate brochure. The boy’s picture on the cover had been replaced by a doe-eyed girl, strawberry blond pigtails, lopsided smile, smear of chocolate artfully positioned on her chin. “Cute as hell, and they don’t break the bank.”

  Dean punched the button on the table, the door clicked, and the assistant again slid into view. “Summon Dolan from the Ivory Tower.”

  “I’m here already, sir.” The door creaked open another fifteen degrees, and Dolan stepped into the boardroom, a spray of Coomassie blue staining his lab coat from pocket to hem.

  “Glad you dressed for the occasion.” A few laughs, and then Dean added, with manufactured pride, “The absentminded professor.”

  “Sorry I’m late.”

  “You’re not late. You were joining us at seven-thirty. It’s seven-ten. But have a seat. We�
��re always eager to talk Vector.”

  All the plush leather chairs around the table were occupied. Dolan tugged over the stool from the telephone nook. Jenner and Bernie made a show of shifting their chairs to make space, but there was nowhere for them to go.

  Dolan folded his hands over a knee and stared down the spit-shined length of mahogany.

  “I have good news,” Dean said. “The business and legal counterparts have reached an equitable and mutually beneficial arrangement. Beacon-Kagan will pay Vector a licensing fee—a significant licensing fee—to become the exclusive worldwide manufacturer for Xedral. Your first eight-figure deal. Nine by this time next year. How does it feel?”

  “Great.” Dolan mustered a smile. “What are the terms?”

  Chase slipped his BlackBerry into a pocket and tapped the circle of his fingertips on the three-inch-thick document before him. “Sucker boilerplate.”

  “Vector obviously doesn’t have the infrastructure to manufacture big numbers,” Dean added, “and big numbers we’ll be doing. This is a fine deal, and you’re to be congratulated.”

  “We can’t put it out until after the IPO of course,” Chase said, “which brings us to our big news. We got approval for the S-1. Vector goes public a week from Wednesday.”

  A round of congratulations. Dean was smiling now, a genuine grin. “Vector will be upping laboratory tours for patients and key investors as a ramp-up to Friday’s pre-IPO presentation.” His eyes found Dolan. “Be cordial. And dress. But remember, you’re in the quiet period until the stock’s been trading twenty-five days. No leaks, no asides, no press releases.” Chase rolled his eyes at Jane—like Dolan’s plugged in tight at CNBC. “For the next month, accessible but low-profile is the rule. We’ll celebrate tonight at the house.” His head cocked, his grin fading. “You’re not jumping up and down?”

  The other eighteen sets of eyes shifted to Dolan. “I think we have a window to bring Lentidra through another stage, see if we can attain permanent transgene integration.”

  “Chase says the numbers—”

  “He’s not a scientist, sir,” Dolan said.

  Chase’s posture firmed, bringing him out of his slump. Jane coughed into a curl of manicured fingers. The other execs got busy examining papers and PalmPilots.

  Dean glowered at Dolan. “There is more than one kind of numbers.”

  The fair skin of Chase’s face had colored. “While you’re busy stamping out disease, we’re building an infrastructure around you and other researchers so we can effectively deliver your theragenes to patients in need.”

  “They’re actually called transgenes,” Dolan said.

  “Not anymore. Show some appreciation for the work the rest of us do. Without us you’re a guy with an idea and a university stipend.”

  Dean watched Dolan squirming in his chair. Dolan’s birthright and duty as the elder Kagan offspring should have been to inherit one day the helm of the vast family-run corporation, but he’d eschewed business for science. As a sacrifice of sorts, on the eve of acquiring his doctorate and a humble NIH STTR grant, Dolan had offered up his gene-therapy research to his father in the form of an amateurish business pitch. After a consult with the director of UCLA’s Office for Technology and Trademark Licensing, a gray old friend, Dean had taken over Vector Biogenics as he took over most matters, funding it in return for owning it lock, (especially) stock, and barrel.

  Dean had raised two sons, one in his mold, the other who still required molding. But it was the latter who’d come up with the winning lottery ticket.

  Dolan lifted his hands, palms out. “I guess I’m just disappointed in myself. For Lentidra’s failure. For Vector’s.”

  Winifred said, “You’ve done top-notch work, Dolan, on a remarkable timeline.”

  “We have an eager market and dying kids,” Chase added. “Plus. We’re on a clock with the IPO. That is gonna give you and Vector the longevity to pursue twenty-five times what your present resources would.”

  “Let’s get to new business.” Dean’s festive mood had dissipated. He waved a pale, smooth hand at his younger son. “Chase, please?”

  This was also Dolan’s exit cue.

  Offering a curt nod, Dolan withdrew. Dean waited impatiently for the door to close behind him.

  It was early, and there was much work to be done.

  Chapter 17

  Tyler’s sturdy legs flexed as he tried to reverse his head out of the railing of the plastic slide. His face turned red, his ears poking forward like a monkey’s. Tim heard the deep breath but couldn’t get there quick enough to avert the wail. He guided Ty’s head through the gap and held him, standing on the dew-wet grass and checking his son’s soft skin for scratches.

  “Come on, bub. Let’s go draw.”

  He stepped back into the living room and set Tyler on the plastic sheet laid down between Magic Marker and carpet. Distracted by scribble potential, Ty finally stopped crying, trading tears for a fist grip on Blinding Yellow. He attacked a length of butcher paper with vigor.

  “Kaiyer draw Daddy.”

  Evidently Tim was an anatomical freak, stick legs and bread-loaf feet topped by a head like a nineteen-inch Trinitron. He tried to help Tyler clutch the marker effectively but had trouble translating finger placement to his son’s left-handed grip.

  Muffin stuck in her mouth, Dray came around from the kitchen, bringing Tim a smoothie and a piece of peanut butter toast. She halved her muffin, offered Tyler a chunk he inverted on the mat beside him, and turned a quizzical gaze to Tim’s manipulation of their son’s tiny splayed fingers.

  Tim said, “Can’t we just force him to be right-handed?”

  “Bind his left arm behind his back and call him a devil child? I’ve read that’s bad for self-esteem these days.” She took a bite of Tim’s toast before handing it to him. “You got him his OJ?”

  “Right over there.” Tim checked his watch—a little past 7:00 A.M. Eager to start digging into Walker’s background, he’d do better at the office than at home on just a few hours’ sleep. His colleagues could be distracting as hell, but they didn’t cry and spill things. Well, Bear spilled things, but at least he didn’t cry.

  Dray said, “I got Elliott. He said he’d be happy to. He’s working a P.M., so I’ll meet him at Palmdale Station, walk through the files with him to get the skinny on the sister’s suicide, and bring copies by your office tonight.” Before Tim could thank her, her attention shifted to the Typhoon. “Did he get up the steps and down the slide by himself?”

  “I worry about that slide. It gets his head stuck.”

  “He gets his head stuck. And he’ll learn how to get it unstuck. That’s what playground equipment is for.”

  Tim followed Dray’s sharp stare to Tyler, who was standing with his knees pressed together, cupping his crotch.

  Tim hoisted him up by his armpits, swept him down the hall, and deposited him on the kiddy toilet. In solidarity Tim followed suit once Tyler was done, without the aid of the red plastic booster.

  As Tim flushed, Ty applauded clumsily. “Good job, Daddy.”

  “Thanks, pal. I been at this awhile, so it actually no longer constitutes a big accomplishment.”

  As Tyler toddled back to his markers, Tim heard him sneeze a couple times. Holstering his .357 as he came back into the living room, Tim asked, “You’re gonna take him to the doctor today, right? Check out his cold?”

  Dray toed the carpeted hearth. “You don’t want to keep doing this to him.”

  At her tone he straightened. “Doing what?”

  “The plastic railing and a doctor’s trip after three sneezes. You’ll make him a sick kid. You’re teaching him that’s how to live in the world.”

  Capitalizing on the distraction, Tyler had his shirt off and Ernie and Bert negotiating a fine domestic matter at too-loud volume.

  “What’s your biggest fear?” Tim asked.

  “Having the hiccups indefinitely?”

  “Dray.”

  “Go
ing to jail for a crime I didn’t commit? Speculums?” Eyebrows raised, she studied his irritated expression. “Okay, I give up.”

  “Mine is having something happen to him that we could have prevented.”

  “Okay.” Dray took a few steps forward, arms folded so her firm biceps showed against her cutoff academy T-shirt. “I don’t have a ‘biggest’ fear. I gave them up with best friends. But here’s one of my bigger ones: raising a timid, shy boy who’s terrified of adventure and risk and regards the world as a dangerous place. And right up there with that is the fear of being a parent who’d do that to him.”

  “The world is a dangerous place.”

  “Right. But that’s not just a fact of life, it’s one of the facts that gives life meaning and excitement. Even a kid can learn enough anxiety to lose sight of that.”

  Tim looked at Tyler, nakedly scribbling with a stunt helmet on. “I don’t see that in him.”

  Dray’s gaze shifted, then caught. Tyler was studying his feet intently, holding the uncapped yellow marker like a wand. “Ty, what are you doing?”

  In response he leapt up and spun in circles.

  “Okay,” Tim said, “I’ll work on it.”

  “Do more than that. Work on your head, sure. But act differently in the meantime. Now, finish your toast and go catch Walker Ja—” Dray stiffened.

  A trail of tiny yellow footprints across the white carpet betrayed Tyler’s escape route. The markers were kicked in all directions, food spilled across the sheet. Dray studied the scene, her jaw tensed. She drew a deep breath, closing her eyes and exhaling slowly as if to decelerate her temper. Finally she took a few steps over and studied the sticky TV. Orange juice had been splashed right into Elmo’s hapless face.

  “Field analysis would indicate the absence of a sippy cup,” she said, “an open container being the only reasonable explanation for the spatter on the television screen.”