Chromosome 6

by Robin Cook

  “I suppose that means a large staff,” Raymond said.

  “We’re down to one nurse,” Mrs. Auchincloss said. “It’s hard to find appropriate help these days.”

  Yeah, sure, Raymond mused. One nurse for four examining rooms unquestionably meant the doctor was struggling. But Raymond didn’t vocalize his thoughts. Instead he let his eyes roam around the carefully wallpapered walls and said: “I’ve always admired these old-school, Park Avenue offices. They are so civilized and serene. They can’t help but impart a feeling of trust.”

  “I’m sure our patients feel the same way,” Mrs. Auchincloss said.

  An interior door opened and a bejeweled, Gucci-draped, elderly woman stepped into the reception area. She was painfully thin and had suffered so many face-lifts that her mouth was drawn into a taut, unremitting smirk. Behind her was Dr. Waller Anderson.

  Raymond’s and Waller’s eyes crossed for a fleeting moment as the doctor guided his patient to the receptionist and gave instructions of when he should see her next.

  Raymond assessed the doctor. He was tall and had a refined look that Raymond sensed he possessed as well. But Waller wasn’t tanned. In fact, his complexion had a grayish cast, and he looked strained with sad eyes and hollow cheeks. As far as Raymond was concerned, hard times were written all over his face.

  After warm goodbyes to his patient, Waller motioned Raymond to follow him. He led down a long corridor that gave access to the examining rooms. At the end he preceded Raymond into his private office, then closed the door after them.

  Waller introduced himself cordially but with obvious reserve. He took Raymond’s hat and coat, which he carefully hung in a small closet.

  “Coffee?” Waller asked.

  “By all means,” Raymond said.

  A few minutes later, both with coffee, and with Waller behind his desk and Raymond sitting in a chair in front, Raymond began his pitch.

  “These are tough times to be practicing medicine,” Raymond said.

  Waller made a sound that was akin to a laugh, but it was bereft of humor. Obviously he wasn’t amused.

  “We can offer you an opportunity to significantly augment your income as well as provide a state-of-the-art service to select patients,” Raymond said. For the most part Raymond’s presentation was a practiced speech that he’d perfected over the years.

  “Is there anything illegal about this?” Waller interjected. His tone was serious, almost irritable. “If there is, I’m not interested.”

  “Nothing illegal,” Raymond assured him. “Just extremely confidential. From our phone call, you said you would be willing to keep this conversation just among you, me, and Dr. Daniel Levitz.”

  “As long as my silence is not felonious in and of itself,” Waller said. “I will not be duped into being an accessory.”

  “No need to worry,” Raymond said. He smiled. “But if you do decide to join our group, you will be asked to sign an affidavit concerning confidentiality. Only then will you be told the specific details.”

  “I don’t have any trouble with signing an affidavit,” Waller said. “As long as I’m not breaking any law.”

  “Well, then,” Raymond said. He put his coffee cup on the edge of Waller’s desk to free up his hands. He fervently believed that hand gestures were important for impact. He started by telling about his chance meeting seven years previously with Kevin Marshall who’d given a poorly attended presentation at a national meeting that dealt with homologous transposition of chromosome parts between cells.

  “Homologous transposition?” Waller questioned. “What the devil is that?” Having been through medical school prior to the revolution in molecular biology, he was unfamiliar with the terms.

  Raymond patiently explained and used for his example the short arms of chromosome 6.

  “So this Kevin Marshall developed a way to take a piece of chromosome from one cell and exchange it for the same piece in the same location of another cell,” Waller said.

  “Exactly,” Raymond said. “And for me it was like an epiphany. I immediately saw the clinical application. Suddenly it was potentially possible to create an immunological double of an individual. As I’m sure you are aware, the short arm of chromosome six contains the major histocompatibility complex.”

  “Like an identical twin,” Waller said with growing interest.

  “Even better than an identical twin,” Raymond said. “The immunological double is created in an appropriately sized animal species that can be sacrificed on demand. Few people would be able to have an identical twin sacrificed.”

  “Why wasn’t this published?” Waller asked.

  “Dr. Marshall fully intended to publish,” Raymond said. “But there were some minor details he wanted to work out before he did so. It was his department head that forced him to present at the meeting. Lucky for us!

  “After hearing the talk, I approached him and convinced him to go private. It wasn’t easy, but what tipped the scales in our favor was that I promised him the lab of his dreams with no interference from academia. I assured him that he would be given any and every piece of equipment he wanted.”

  “You had such a lab?” Waller asked.

  “Not at the time,” Raymond admitted. “Once I had agreement from him, I approached an international biotechnology giant, which will go nameless until you agree to join our group. With some difficulty I sold them on the idea of creatively marketing this phenomenon.”

  “And how is that done?” Waller asked.

  Raymond moved forward in his chair and locked eyes with Waller. “For a price we create an immunological double for a client,” he said. “As you can well imagine, it is a significant price but not unreasonable for the peace of mind it affords. But how we really make money is that the client must pay a yearly tuition to maintain his double.”

  “Sort of like an initiation fee and then dues,” Waller said.

  “That’s another way to look at it,” Raymond agreed.

  “How do I benefit?” Waller asked.

  “Myriad ways,” Raymond said. “I’ve constructed the business like a merchandising pyramid. For every client you recruit, you get a percentage, not only of the initial price but each year from the tuition. On top of that, we will encourage you to recruit other physicians like yourself with collapsing patient bases but who still have a number of wealthy, health-conscious, cash-paying patients. With every successful physician recruitment, you get percentages from each of his recruitment efforts. For instance, if you choose to join, Dr. Levitz, who recommended you, will receive percentages from all your successes. You don’t have to be an accountant to understand that with a little effort you could be earning a substantial income. And as an added incentive, we can offer the payments offshore so they will accrue tax-free.”

  “Why all the secrecy?” Waller asked.

  “For obvious reasons as far as the offshore accounts are concerned,” Raymond said. “As for the whole program, there have been ethical issues that have been overlooked. Consequently, the biotechnology company that is making this all possible is paranoid about bad publicity. Frankly, the use of animals for transplantation offends some people, and we certainly do not want to be forced to deal with animal-rights zealots. Besides, this is an expensive operation and can be made available to only a few highly select people. That violates the concept of equality.”

  “May I ask how many clients have taken advantage of this plan?”

  “Laymen or physicians?” Raymond asked.

  “Laymen,” Waller said.

  “Around one hundred,” Raymond said.

  “Has anybody had to utilize the resource?”

  “As a matter of fact, four have,” Raymond said. “Two kidneys and two livers have been transplanted. All are doing superbly without medication and without any signs of rejection. And, I might add, there is a substantial additional charge for the harvest and transplantation, and the involved physicians get the same percentages of these fees.”

  “How m
any physicians are involved?” Waller asked.

  “Fewer than fifty,” Raymond said. “We started slowly on recruitment, but it is now speeding up.”

  “How long has this program been going on?” Waller asked.

  “About six years,” Raymond said. “It’s been a significant outlay of capital and a lot of effort, but it is now beginning to pay off handsomely. I should remind you that you will be getting in at a relatively early date, so the pyramid structure will benefit you greatly.”

  “It sounds interesting,” Waller said. “God knows I could use some additional income with my falling patient base. I’ve got to do something before I lose this office.”

  “It would be a pity,” Raymond agreed.

  “Can I think about it for a day or so?” Waller asked.

  Raymond stood up. Experience told him he’d made another score. “By all means,” he said graciously. “I’d also invite you to call Dr. Levitz. He’d recommended you highly, and he’s extraordinarily satisfied with the arrangements.”

  Five minutes later Raymond exited onto the sidewalk and turned south down Park Avenue. His walk had an extra bounce to it. With the blue sky, the clear air, and the hint of spring, he felt on top of the world, especially with the pleasurable rush of adrenaline that a successful recruitment always gave him. Even the unpleasantness of the previous couple of days seemed insignificant. The future was bright and full of promise.

  But then near disaster came out of nowhere. Distracted by his victory, Raymond almost stepped from the curb into the path of a speeding city bus. Wind from the hurling vehicle blew off his hat while filthy gutter water sprayed the front of his cashmere coat.

  Raymond staggered back, dazed from his narrow escape from what might have been a horrible death. New York was a city of sudden extremes.

  “You okay, buddy?” a passerby asked. He handed Raymond his dented fedora.

  “I’m fine, thank you,” Raymond said. He looked down at the front of his coat and felt ill. The episode seemed metaphorical and brought back the anxiety he’d experienced over the unfortunate Franconi business. The muck reminded him of having to deal with Vinnie Dominick.

  Feeling chastened, Raymond crossed the street with much more care. Life was full of dangers. As he walked toward Sixty-fourth Street, he began to worry about the other two transplant cases. He’d never considered the problem an autopsy posed to his program until the Franconi dilemma.

  All at once, Raymond decided he’d better check the status of the other patients. There was no doubt in his mind that Taylor Cabot’s threat had been real. If one of the patients happened to be autopsied sometime in the future for whatever reason, and the media got hold of the results, it could spell disaster. GenSys would probably drop the whole operation.

  Raymond quickened his pace. One patient lived in New Jersey, the other in Dallas. He thought he’d better get on the phone and talk with the recruiting doctors.

  CHAPTER 9

  March 5, 1997

  5:45 P.M.

  Cogo, Equatorial Guinea

  “Hello!” Candace’s voice called out. “Anybody home?”

  Kevin’s hand flinched at the unexpected noise. The lab techs had long since left for the day, and the laboratory had been silent save for the low hum of the refrigeration units. Kevin had stayed to run another southern blot analysis to separate DNA fragments, but at the sound of Candace’s voice, he’d missed one of the wells with the micropipette. The fluid had run out over the surface of the gel. The test was ruined; he’d have to start again.

  “Over here!” Kevin yelled. He put down the pipette and stood up. Through the reagent bottles atop the lab bench, he could see Candace across the room, standing in the doorway.

  “Am I coming at a bad time?” Candace asked as she approached.

  “No, I was just finishing up,” Kevin said. He hoped he wasn’t being too transparent.

  Although he was frustrated about the wasted time he’d spent on the procedure, Kevin was pleased to see Candace. During lunch that day, he’d worked up the courage to invite Candace and Melanie to his house for tea. Both had accepted with alacrity. Melanie had admitted that she’d always been curious to see what the house looked like on the inside.

  The afternoon had been a big success. Undoubtedly, the key ingredient for the afternoon’s success was the personalities of the two ladies. There was never a pause in the conversation. Another contributing factor had been the wine that they’d all decided upon instead of tea. As a member of the Zone’s elite, Kevin was given a regular allotment of French wine which he rarely drank. Consequently, he had an impressive cellar.

  The major topic of conversation had been the U.S., a favorite pastime for temporary American expatriates. Each of the three had extolled and argued the virtues of their hometown. Melanie loved New York and contended it was in a class all its own; Candace said that Pittsburgh’s quality of life was rated one of the highest; and Kevin praised the intellectual stimulation of Boston. What they had purposefully avoided discussing was Kevin’s emotional outburst at the commissary during lunch.

  At the time, both Candace and Melanie questioned what he’d meant by being terrified of overstepping the bounds. But they didn’t persist when it became clear that Kevin was overly upset and reluctant to explain. Intuitively, the women had decided it best to change the subject, at least for the time.

  “I’ve come to see if I can drag you over to meet Mr. Horace Winchester,” Candace said. “I told him about you, and he’d like to thank you in person.”

  “I don’t know if that is a good idea,” Kevin said. He could feel himself tense.

  “On the contrary,” Candace said. “After what you said at lunch, I think you should see the good side of what you have been able to accomplish. I’m sorry that what I said made you feel so terrible.”

  Candace’s remark was the first reference to Kevin’s lunch outburst since its occurrence. Kevin’s pulse quickened.

  “It wasn’t your fault,” he said. “I’d been upset before your comments.”

  “Then come meet Horace,” Candace said. “His recovery is fantastic. He’s doing so well, in fact, that an intensive-care nurse like me is just about unnecessary.”

  “I wouldn’t know what to say,” Kevin mumbled.

  “Oh, it doesn’t matter what you say,” Candace said. “The man is so thankful. Just a few days ago, he was so sick he thought he was going to die. Now he feels like he’s been given a new lease on life. Come on! It can’t help but make you feel good.”

  Kevin struggled to think up a reason not to go and then was saved by another voice. It was Melanie.

  “Ah, my two favorite drinking buddies,” Melanie said, coming into the room. She’d caught sight of Candace and Kevin through the open door. She’d been on her way to her own lab down the hall. She was dressed in blue coveralls which had ANIMAL CENTER embroidered on the breast pocket.

  “Are either of you guys hungover?” Melanie asked. “I’ve still got a little buzz. God, we went through two bottles of wine. Can you believe it?”

  Neither Candace or Kevin responded.

  Melanie looked back and forth between their faces. She sensed something was wrong.

  “What is this—a wake?” she asked.

  Candace smiled. She loved Melanie’s outspoken irreverence. “Hardly,” Candace said. “Kevin and I are at a standoff. I was just trying to talk him into going over to the hospital to meet Mr. Winchester. He’s already out of bed and feeling chipper. I told him about you guys, and he’d like to meet both of you.”

  “I hear he owns a string of resort hotels,” Melanie said with a wink. “Hey, maybe we can finagle some vouchers for complimentary drinks.”

  “As appreciative and as wealthy as he is, you could very well do better than that,” Candace said. “The problem is that Kevin doesn’t want to go.”

  “How come, sport?” Melanie asked.

  “I thought it would be a good idea for him to see the good side of what he’s been able to
accomplish,” Candace added.

  Candace caught Melanie’s eye. Melanie understood Candace’s motivations immediately.

  “Yeah,” Melanie said. “Let’s get some positive feedback from a real, live patient. That should justify all this hard work and give us a boost.”

  “I think it will make me feel worse,” Kevin said. Ever since getting back to the lab, he’d been trying to concentrate on basic research to avoid facing his fears. The ploy had worked to an extent until his curiosity made him call up the Isla Francesca graphic on his computer terminal. Playing with the data had had an effect as bad as the smoke.

  Melanie put her hands on her hips. “Why?” she asked. “I don’t understand.”

  “It’s hard to explain,” Kevin said evasively.

  “Try me,” Melanie challenged.

  “Because seeing him will remind me of things I’m trying not to think about,” Kevin said. “Like what happened to the other patient.”

  “You mean his double, the bonobo?” Melanie asked.

  Kevin nodded. His face was now flushed, almost as bad as it had been at the commissary.

  “You’re taking this animal-rights issue even more seriously than I am,” Candace remarked.

  “I’m afraid it goes beyond animal rights,” Kevin said.

  A tense silence intervened. Melanie glanced at Candace. Candace shrugged, suggesting she was at a loss.

  “Okay, enough is enough!” Melanie said with sudden resolve. She reached up, placed both hands on Kevin’s shoulders, and pushed him down onto his laboratory stool.

  “Up until this afternoon I thought we were just colleagues,” she said. She leaned over and put her sharp-featured face close to Kevin’s. “But now I feel differently. I got to know you a little bit, which I must say I appreciated, and I no longer think of you as an icy, aloof, intellectual snob. In fact I think we are friends. Am I right?”

  Kevin nodded. He was forced to look up into Melanie’s black, marblelike eyes.