BLIND TRIAL

by Brian Deer

  “You can’t fool me. I saw your writing.”

  “We did have that SPIRE study to satisfy, if you recall. A pure red herring, I assure you. Ramirez was nothing to do with our issue here. You see, we do need to address these misperceptions.”

  “So you killed him too?”

  “Of course not. What kind of monster do you think I am? There’s nothing wrong with Ramirez. The last we heard he’s employed at a 7–Eleven in San Francisco. Frank surmised we needed to lose somebody from the placebo arm of the study to balance the data. So he told him not to come back.”

  “That’s ridiculous, and you know it.”

  “Exactly right. I agree. On the statistical significance of our cohort, the precaution was quite unnecessary. But Frank doesn’t always listen to what I say.”

  “You sicken me.”

  “Trudy, there have been three cases of potential concern. And the others are hardly sick at all. A thirty-one-year-old male. Lester something, I believe. A software writer in Boston, Massachusetts, I am given to understand. And a fifty-year-old dentist in central Florida. They are both up and about, doing very much better than Ms. Glinski. They have diagnoses of mild, transient myalgic encephalomyelitis. They’re expected to recover completely.”

  “Always knew there was something about you. Ben, call the police.”

  The kid didn’t move: cool under fire. Ten out of ten. Hoffman smiled.

  Doctorjee moved a leg, making the back seat sag. “Please, let’s not trade unpleasantness. Suffice it to say, my ethical standards are wholly unoccluded on this matter. I have not destroyed our trial. We have an excellent result. Your vaccine is what you always said it would be, a beacon of hope.”

  “What, with folks getting sick and you killing them? For God’s sake, you need help. Call the police.”

  “Trudy, please. We must accept the product’s profile is not ideal. Of course. But we anticipated imperfection, did we not? Our world is imperfection, is it not? On how many occasions have you indicated yourself that WernerVac wouldn’t be perfect? But, even with this imperfection, at a population level we have the chance to protect life with your invention on a scale that can hardly be countenanced. Nothing has fundamentally changed.”

  “What, with murder?”

  “Oh, come, come. You really must strive not to see this predicament in such inflammatory language. Ms. Glinski didn’t suffer. Not at all. We performed a kindness.”

  “Good god.”

  “Trudy, nobody suffers from death. It’s the dying that’s the suffering. And remember, we acted only to protect your discovery, for the public good. It’s in the interests of humanity. And that’s the truth.”

  “Really?”

  “Ask Mr. Hoffman.”

  This wasn’t a lawyer’s moment to intrude.

  “Now Trudy, can you sincerely imagine the consequences a year ago if the media heard of Ms. Glinski’s issues?” The sag in the back seat lifted. “An experimental vaccine making the disease worse. That’s what they would have said. Even with a single case. Just one. And how would that have played when she turned up on Fox News?”

  “Don’t you talk to me about Fox News.”

  “In forty-eight hours, our centers would be empty. Anti-vaccine campaigners would be giving speeches on Tenth Street and waving placards at the gates of every one of our units. Lost to follow-ups would have been ninety-nine percent.”

  “If there was only the one, we could have handled it. You didn’t have to do that to the poor woman.”

  Doctorjee clapped his hands. “Absolutely. You’re right, I agree with you. We could have handled it. We could. But could they? Could the great unwashed public? Could that babbling phalanx of anti-vax ignorance which parades itself whenever we hold a press briefing? Trudy, what is the history of vaccine scares? They simply wouldn’t have comprehended that one serious adverse event in a trial of nearly twenty-seven thousand is, statistically speaking, nothing.”

  “It’s not nothing.”

  “Excuse me? For a first-generation product for a life-threatening pandemic infection? Let me tell you, that’s a far superior profile than we’re seeing with InderoMab. You might perhaps stop by on your next visit to the office and see what we’re getting with that.”

  “You didn’t have to kill her, for God’s sake.”

  “That’s arguable, of course. It’s a view. Yes. A legitimate opinion. But let me say this, tobacco products, including I’d assume your much-loved Dorals, kill nearly half a million Americans every year.”

  “A life’s a life.”

  “Yes. And there are three hundred and thirty million gods. One genetically disadvantaged Californian is not material in the grand scheme of things.”

  “She could have gotten treatment.”

  “Correct. Indeed, she could. And isn’t that the point? Haven’t you hit the nail on the head, once again? Couldn’t I have played it straight with Ms. Glinski, and told her what we suspected?”

  “Yes, you could.”

  “We could. Yes. But not before the license. You see? That would have made your achievements vulnerable, would it not? She would have been aware of our predicament, obviously. And how would we have kept her—and her lawyers—quiet? Every one of our volunteers, and the whole world, would know within days. But from next week—after licensure—any such unfortunates will be treated. They will live with the virus as comfortably as anyone does today.”

  “Not when FDA hears about this. Not when you’re in jail.”

  Doctorjee sighed. “Of course, you may need a little time to contemplate the options. The company is trying to do the right thing here, I assure you.”

  “You’re a psychopath.”

  “You’re entitled to that opinion. Of course. But let me point out, psychopaths don’t act from compassion, Trudy. The data still support the imperative to license WernerVac, and we still have a humanitarian duty to see that through to completion. You want me to explain further?”

  “I want you to rot in hell.”

  “Yes, I can see you’re upset. Believe me when I say I understand. This is bound to be difficult for you. But let’s look at the data, shall we? Could we have some illumination perhaps?”

  Ben fumbled around the dash, then opened the driver’s door. The interior light snapped on.

  “Now, let’s see.” Doctorjee rooted in his briefcase and produced a draft press release. “Now, of the 26,712, we have 13,308 on the vaccine arm of the study, and the rest on placebo. Yes?”

  “Wouldn’t trust one word.”

  “It’s all perfectly straightforward, I can assure you. We’re concealing nothing from you. Are we Mr. Hoffman?”

  “Huh? Better not be.”

  “So that’s one significant case of this enhanced progression, deceptive imprinting, whatever we want to call it, that might make the subject somewhat less advantaged in the event of a breakthrough infection. We’ll accept that as established.”

  “Somewhat less advantaged?”

  “Please. And that’s out of the vaccine arm of a little over thirteen thousand. Forget Boston and Florida. They’re both within the threshold of a typical package insert caution. I don’t entirely understand why we didn’t write them up.”

  “Better ask your attorney there. You’re gonna need him.”

  “So that’s one in thirteen thousand. Quite acceptable. That’s a tremendous safety profile.”

  The old girl snorted. “That’s not the figure. If your mind wasn’t so fouled-up, you’d take it from the number who got WernerVac and seroconverted HIV positive. Not the total treatment arm. Most of those folks would never have gotten the virus anyway. How often does the vaccine make folks who do get HIV worse? That’s the attributable risk.”

  “Fair enough. That’s a reasonable point. If you want that figure, you can have it too.” Doctorjee tapped his phone.

  “I don’t want anything from you.”

  “Of our more than thirteen
thousand on the vaccine arm, we had 156 who, shall we say, were less than wholly protected by WernerVac in the shape of sterilizing immunity. They became HIV positive, despite inoculation. Yes?”

  “Alright, I’ve heard enough of this. Just stop now.”

  Doctorjee continued to poke at his phone. “So, as we know, Ms. Glinski was one of those.”

  “Just stop.”

  “So, to get the percentage, we divide one by 156. Yes?”

  Ben ran the numbers in his head. “Point six four and change.”

  Hoffman watched the EVP do the math.

  1 ÷ 156% = 0.6410

  Doctorjee held his phone in the old girl’s face. “You see? Zero point six four one. Just point six four—less than two thirds—of one percent of those actually infected do appreciably less well interacting with your vaccine. And they would, of course, be suitable for appropriate treatment. Just as they are today. That is a phenomenal safety profile.”

  “You think?”

  “Why, Trudy, that’s excellent. For a retroviral RNA infection? These data tell us not only that those who get the vaccine enjoy a tremendous benefit of more than sixty percent efficacy protection, but they are vanishingly unlikely to come to any harm. The risk-benefit profile is remarkable.”

  The old girl didn’t reply.

  Doctorjee snapped shut his briefcase. “We’re not keeping anything from you here, I guarantee. Had you been able to spend more time in the office, we might have discussed this months ago.”

  Ben shut the door, and the light cut out.

  “I’ll be no part of this,” the old girl snarled.

  “For goodness sake, four-and-a-half thousand people are infected with HIV every day. Humanity needs a vaccine, just as it did with the coronavirus, measles, polio, smallpox. You have, of course, seen Whitley’s work on herd immunity, comparing the effects on the spread of the virus at a population level of even a modestly successful product now, compared with a highly effective product delayed for years.”

  “You’ll never get away with it.”

  Doctorjee leaned forward, speaking close to a pillow. “Indeed, it is possible you are, again, correct. There’s a risk. But these are presentational matters, not the science. Presentation is an area for compromise, where perhaps your scientific work is not. The fact we have before us is your vaccine is a stupendous achievement, cutting the spread of infection as nothing else could. The rest is an illusion, a dream, a dance.”

  The old girl grunted. “And what happens when there’s more cases? There’s going to be more Helen Glinskis. We only went 102 weeks. What happens after that? We don’t know, do we?”

  “All in good time, Trudy. In the end, we value truth. We are a most ethical company, as you know. Once the vaccine is marketed—with all appropriate warnings, of course—the risks and benefits will become very much clearer to us. You yourself could perhaps draft a proposal for more rigorous post-marketing surveillance.”

  “It will all come out in the end. You mark my words. You can’t hide something like that forever.”

  Doctorjee sighed. “That is a slight risk. We can’t wholly deny that. But I honestly cannot envisage why it should. We’re all colleagues here, Frank’s content, and we appear to have satisfied Dr. Honda about the matters she’s aware of. We were concerned she may become a problem when her friend Murayama turned up on Tuesday. But Ben here has dealt with them both brilliantly. Brilliantly. Sumiko Honda turned out to be nothing but a shameless slut.”

  Forty-five

  HE WOULDN’T be a hero. But he’d be decisive. He’d deal with this insanity. Now. Ben opened the driver’s door of the white Nissan Sentra and twisted till his sneakers touched asphalt. Any feelings of discovery, curiosity, or wholeness had passed with the mention of Sumiko. Her name seemed to wake him, like she woke him that morning with the first faint light of day.

  “Need to relieve my discomfort, what with the coffee and everything. Be back in a second. Okay?”

  A half-moon shone through a break in the clouds, casting a creamy glow across the lot. He strolled toward the carwash to the right of the Bottle Shop and stood facing a rough brick wall.

  Should he pull out his dick, or go for his phone? Either could be seen from the Sentra. How quick would local cops or deputies respond? He unzipped and loosed a bladderful of urine.

  He repacked his pants and returned to the cars. But not to the white sedan. He walked past it to the Camaro, opened the driver’s door, crouched, and drew his Samsung.

  The phone hadn’t powered before he heard another door. Then Hoffman’s voice. “What you doing?”

  “Lost my Maui Jims.”

  “Your what?”

  “My shades. Put them down here somewhere. Can’t find them. Be over in a second. Be right with you.”

  He heard the Sentra door shut. He hit 9–1–1.

  One ring tone… A second… A third…

  Then Hoffman stepped round the car.

  “Fuck you doing there?”

  Ben rose and stepped backward. “Nothing, you know. Was checking the weather. That’s all.”

  Hoffman moved forward, right arm swinging, and clamped his paw round the phone. “Gimme that now. Told you, keep it off. Fuck’s the matter with you?”

  Ben snatched at empty air. Too late.

  Hoffman raised an arm and grabbed Ben’s throat.

  Ben swung a fist and missed.

  Now Hoffman let him go and hurled the phone. It clattered onto asphalt in the dark.

  “You can’t do that.” Ben lunged toward him.

  But a fist caught him square in the face.

  Pain. Such pain. His eyes filled with liquid. He reeled against the Camaro and held his nose. “You asshole. That’s assault. You might have broke my fucking nose.”

  “Lucky I don’t send you home in pet food.”

  “You try.” Ben lunged again. He’d get Hoffman’s phone. Or he’d ask Doc Mayr for hers.

  He wasn’t a big fighter: always talked out of trouble. But somewhere in the pain sprang a mindless fury, like the way he’d once scrapped in the schoolyard. A kid said something about his family being crooks, and Ben pummeled the kid’s head on a concrete step. A crowd gathered. There was crying and blood.

  He threw a right. Missed. Then a left. Missed again. Then a right, another right… All missed.

  His fury was for nothing. He didn’t gain a yard before more powerful hands took control. Hoffman saw a fist coming, fast and low like a ball, and—slap—caught it hard in a mitt. Ben threw the other and—slap—caught again, in stronger, thicker, fingers than his own.

  He felt his wrists levered, his forearms pivot. He sank and felt stones in his knees.

  Then he felt a storm of kicks: again and again. His shoulders, then his head, hit the ground.

  THE KID looked pathetic, lying there in the dark. Probably pissed himself, like the old girl. Was Henry’s boy a rat, making calls on his phone? With all that behind him? After everything? Hoffman felt the ache of betrayal as sharply as the sting of his sore, skinned fists.

  So where was the struggle? If Ben was determined, what the hell was he doing on the ground? He was, what, six-one? With a linebacker’s build. And the offensive capability of a rabbit. He might have landed a punch or pulled free his sweaty fingers. Guts a mess of collards. What a dope.

  “Who were you phoning?”

  “Fuck off, creep.”

  “So that’s the way you talk to me now?”

  Hoffman called to Doctorjee, who’d climbed from the Sentra. “Give us five. Me and this kid need to talk.”

  The EVP coughed and moved off toward the street.

  The old girl remained sunk in her pillows.

  “Now, you look here, kid. You’re making me mad.”

  “I’m not a fucking kid.”

  “Right, okay. Guess you’re not.” Hoffman surveyed the lot. “Now you look, Ben Louviere, you gotta wise up. We don’t need this shit. Not
now.”

  The kid half-crawled to a sitting position and pressed his fingers to his face.

  Hoffman offered a hand. “Look, this thing’s gonna seem damn harsh to you. Damn harsh. I can see that. Come on, get up.”

  Ben shuffled backward. “Yeah, well that so-called doctor there’s a murderer. And that’s crossing the line. Wherever you’re coming from, that’s evil.”

  The dog barked down by the airstrip.

  “Can’t argue with that. I agree with you there.”

  “Yeah? And you’re in on it. You’re in on it too. And if I hadn’t been with Sumiko last night, you were gonna kill her too.”

  “Me? kill Dr. Honda? You’re crazy. Grow up. I’ve never killed anyone, personally.”

  “So what about the drapes then? What was all that? And what about the subway in DC?”

  “Look, all we wanted to know was if Murayama was going back to that apartment of hers. Was he stopping the night there? If you were there fucking the goddam woman’s brains out, you know I got the crazy idea the Jap would be heading on back to his hotel. That’s all. We needed to know. Nobody was gonna kill anyone. What a joke.”

  Ben tapped his teeth and said nothing.

  “Damn. That woman’s gotten to you, hasn’t she?”

  No reply.

  “That’s what it is. Goddamn. We send you out here to get to her, keep her sweet, and she’s gone and gotten to you. Damn that woman.”

  “Bullshit.”

  “Look, this whole thing ain’t how it seems here. You’re getting it all wrong. Now, you walk over here with me. Let’s take a walk here now, away from that motherfucker, and I’ll explain.”

  “Fuck off.”

  “Then, if you want, you can call the cops. Use my phone.” He started toward the carwash, turned, and waited.

  A truck’s lights broke from the darkness.

  Ben didn’t move. Seconds passed… And more… This was a make-or-break moment: decision time.

  Then yes. Slowly… slowly… the kid rose from the ground… brushed his shirt and pants… and followed.

  Hoffman stopped at the wall, now slashed with urine, turned his back and raised a foot against the bricks. “That guy?” He pointed toward the street. “Let me tell you about that motherfucker. I wasn’t in on what him and Wilson did. And when I found out about it yesterday—yesterday let me tell you—I felt pretty much how you’re gonna be feeling now.”