Lethal Intent

by Cara C. Putman

  “Say as little as you can while getting them the right information. After this meeting I’ll come help you. We’ve got to do all we can to help these kids.”

  “Understood. The good news is Brian didn’t destroy the kids’ engineered cells. It took a little searching, but we found them.”

  “Is it too late for any of these kids?”

  Lori hesitated. “I don’t know. I’m not a doctor and haven’t seen recent labs.” She sighed. “I don’t know what happened to Brian. If you’d asked me a week ago, I would have denied this was possible.”

  Caroline closed her eyes and prayed somehow any rejections could be abated and the right CAR T cells would provide the healing each child’s body desperately needed. Then she forced herself to refocus. “What do you think next steps should be?”

  “I’ll have Tod run a second batch of confirmatory tests this afternoon. Make sure we’re convinced the engineered cells are what we think they are. Then I’m developing a protocol to make sure we have the necessary checks and balances in place to prevent this from recurring.”

  “That’s good, but Brian was in a position to circumvent any systems we had.”

  “True, but we can improve to prevent a repeat.”

  “Let me know if you need anything or if something comes up. Otherwise, let’s meet at one.”

  “Will do.” Lori paused. “Caroline, this isn’t who we are as a company. I don’t know what happened to Brian, but this won’t happen again.”

  “Thank you.” She appreciated Lori’s conviction, because somehow Caroline would have to convince the FDA of that fact. After her computer woke up, she pulled up the Robbinses’ informed consent and compared it with Bethany’s.

  Informed consent was an important idea at the intersection of law and medicine. Its goal was to provide protections to patients so that doctors couldn’t perform procedures or treatments on them without their full knowledge and understanding. To attain informed consent, the patient had to understand the nature of the procedure, the risks and benefits associated with that procedure, whether reasonable alternatives existed, and the risks and benefits of those alternatives. The consent had to demonstrate the patient understood both the procedure and its alternatives.

  As she compared the two, she could see how Bethany’s had been altered to be broader than CAR T research trials. It was signed by someone with the Virginia Department of Child Protective Services. A Tara Descane, who was probably her caseworker. In all likelihood the woman wouldn’t have understood the nuances. Caroline wouldn’t have before working here.

  She hit Print and copied the documents before marching to Quentin’s office.

  The mood was somber as she strode to the table where Quentin, Samson, and Hannah waited. Samson looked like he hadn’t slept, which would be appropriate, because Brian had reported to him.

  He stood and extended his hand to Caroline as she reached the table. “I owe you an apology.” There was something courtly about the way he said it. “You suffered at the hands of my employee. I’m still trying to understand the extent of what he did. How do I make this right?”

  “Help me save this company.” She sank into the vacant chair and pulled out the papers she’d worked on before the funeral. “First, we’re going to get rid of what could be a distraction. When you spun off Genetics for You, Quentin, you didn’t get rid of the liability, so we’ll make a generous settlement offer to the women impacted by the testing.” She slid the proposed offer across the table.

  Quentin sucked in air. “Brian lied to me about that too? So much for our friendship.” He rubbed his forehead. “What are our options?”

  She tapped the paper. “You have to resolve this so we can focus on saving what you have here now.” She waited until he looked at her. “Praecursoria is doing important research. We’re going to change our processes to better protect our patients, but we can’t do that if we are distracted by lawsuits related to the genetic testing.”

  Hannah nodded. “I agree. Let’s get this taken care of and focus on the new therapies.”

  “I’m not made of money.” Quentin glanced around the table. “Where do you think this money will come from?”

  “We’ll have to make it a payment plan and take it from some of the research funds, but it’s that or go bankrupt. Your choice.”

  The words seemed to shock him, but he started working with her. An hour later she had authority to call the women’s attorney and make the offer. Half an hour after that, she had a promise from the man to take it to his clients.

  Then they discussed systems that could be put in place to provide guardrails for future research and trials while also developing an immediate plan to work with the FDA. “This won’t be an easy process,” Caroline said as she made eye contact with each of the leadership team. “But it will be a critical piece to keeping this company viable. Do you believe in what we’re doing?”

  Quentin and Hannah nodded.

  Samson cleared his throat. “With everything in me.”

  “Then we are going to humble ourselves and go before the FDA with a commitment to do better and cooperate fully with any restrictions they place on us. That means no running to Mexico. We have to be fully committed to the system. And I’m going to pray that Bethany and the other children don’t die.” She looked around the table. “This is a start, but don’t think it’s going to be easy. It will be a long road for the company to recover from what Brian Silver did.”

  She gathered her things. “Now I’m going to go check on Bethany.”

  Chapter 41

  A knock at the door pulled Brandon’s attention from a spreadsheet he was reviewing. Jeff stood there, looking ready for a fishing trip. He wore cargo shorts and a ratty T-shirt with a floppy hat covering his head. “You got a minute?”

  Brandon paused because he really wanted to finish so he could get to the hospital for Bethany. “Sure.” He swiveled from the monitor, leaving the numbers behind. “What can I do for you?”

  “It’s what we can do for you.” A big grin cracked Jeff’s face. “We’re staying. Alaina and I are in this as long as you are.”

  Brandon’s shoulders collapsed and he launched from his chair. “Really?”

  “Yep.”

  Brandon crushed the smaller guy in a bear hug. “That is great news.”

  After talking through details, Brandon grabbed his keys. No way he could look at numbers with the relief coursing through him. This was really going to work. He called Caroline as he drove to the hospital, but when she didn’t answer, he didn’t leave a message.

  He wanted to share the good news with her, not with her voicemail.

  An hour later he sat in Bethany’s room, the beep of the machines feeling loud in the space. The lights were dimmed, and somewhere instrumental music played in the background, barely audible under the beeps as Brandon sat in the chair pulled next to Bethany’s hospital bed. He wanted to punch something as he watched her chest barely rise and fall on each breath. The medical staff had put her on a ventilator Sunday. Bethany no longer fought the tubing, and that felt like a bad development.

  It didn’t help knowing why she struggled.

  Her body was fighting hard against an invader.

  There was a tap at the door, and Brandon looked up to see Caroline. He started to push to his feet, but she waved him back.

  “How is she?” Caroline kept her voice pitched low enough it didn’t disturb the resting child as she entered the room.

  “No change really.” He leaned back against the chair. “They’re running a battery of tests. She’s so weak right now, her status is doubtful. They plan to infuse her CAR T cells starting tomorrow. It really is a Hail Mary this time.”

  Caroline came to stand next to him, her face white as she looked at Bethany. “She looks even smaller. Paler too.”

  “I can hear you.” The words were soft, but he caught them and stiffened.

  Brandon put his hand on her head. “Hey, Bethany.”

  “Hey.�
�� Her voice tremored, but she smiled. “You’re the first person to keep coming.”

  “I like doing it.”

  “The doctors told me I have to have another treatment.”

  He glanced at Caroline and she stepped forward.

  “Hi, Bethany. My name is Caroline.”

  “I think I saw you before.”

  “I was here once a while ago. I work for the company that made the treatment.” She sighed. “I’m very sorry, but the first one we gave you was the wrong one. But Dr. Anna knew there was a problem. With her help, I figured out how to look for the solution. Tomorrow the doctors want to give you the right one. This one will have your ninja cells.”

  “Do you think it will work?”

  Caroline flinched slightly at the words, then sank onto the edge of the bed. “I’m not a doctor, Bethany, so I don’t know. What I do know is that we’re going to do everything we can to help your body win this time. There are also people praying for you. We really want you to get better and never have to come back and stay in a bed here. It’s just going to take time to see if we get our wish.”

  A nurse entered and smiled at them. “I need to help our patient get ready for tomorrow.” She looked at the monitors and then at Bethany. “It’s going to be a big day for you. Your friends can come back tomorrow after the procedure.”

  “We’ll leave in a moment. I’m going to pray for you first. You need a good night’s sleep and God to strengthen you for this next step.” Brandon took Bethany’s hand and felt Caroline’s slip into his. He cleared his throat and then prayed over her. A holy hush filled the room, and he held on tightly for a moment, then stood. “Keep fighting, kiddo.”

  “You too.” Her smile was sweet but scared, so he touched her cheek.

  “I will be back.” He would as many times as she needed.

  Then he followed Caroline into the hall and to the waiting room. They sat and he raked his hands through his hair, then braced his elbows on his knees. “I should do more.”

  “Like what?”

  He shook his head. “I don’t know.”

  “You’re here and you pray for her. That’s a powerful combination.” Caroline placed a hand on his shoulder, the warmth pulling him toward her touch. “If Brian had given her the right treatment, it could have worked. It’s been a lifeline for others. The literature is really good for 50 percent of patients.”

  “Bethany’s in the wrong part of the 50 percent.”

  “Actually, we don’t know.” Caroline balled her hands. “It’s going to take work to forgive Brian. I can’t imagine getting so caught up in the science that I’d believe it’s worth risking lives to see what happens.”

  He felt the disconnection of her touch. “Anna told me last week that it would take a miracle.” The words grated his soul. “And now she’s not here to help Bethany fight.”

  * * *

  The fierce light in his eyes emphasized how much Brandon believed his words.

  Caroline wished she had the answers that would save Bethany. As she had talked with the young girl in the bed, she couldn’t deny that sorrow and fear weighed on her.

  Bethany was one complication away from never going home.

  Brandon pushed to his feet and led her to the elevator. “Bethany needs someone here that she knows. I’m not her parent and shouldn’t be making these decisions.”

  “But you are here, and she knows you.” Caroline reached up and touched his face, feeling the stubble that hadn’t been shaved. It wasn’t a beard, but it was more than his typical clean-shaven look. He leaned into her palm as if taking strength from her. “What do you need?”

  “Wisdom.” He sighed so heavily she felt it to her bones. “This is so much bigger than anything I’ve done before.”

  She smiled at the words. “Brandon, that’s not true. I’ve watched you wrestle with what’s best for your kids since you had only a couple.”

  “But this is her life.”

  “And without you, she’d be gone.” Caroline glanced back toward the hallway and her room. “Do you see what I see?”

  “I don’t know.” His words were hesitant yet tinged with the edges of hope.

  “I see a young girl who is alone day after day, hour after hour, except when you come to visit. The state hasn’t found any family members who care, but you do. I’ve seen you show up in the ways that matter for so many kids.” She turned to him and waited until he looked in her eyes. He needed to hear this, but even more it needed to seep into his soul. “And it doesn’t end when the kids leave. I’ve seen the stacks of cards going out in the mail. You are amazing.”

  “I’m not.” He shook his head, ending their eye contact.

  She put her hands on either side of his face even though it meant she was practically on tiptoe. “Oh, but you are. To each of those kids you’re a hero.” She paused. “You are to me too.”

  He hesitated, then leaned close and put his forehead on hers. The touch was light, not a kiss that electrified her, but a moment that solidified them. They would do what they could for Bethany. It might be enough. It might not. That part was in God’s hands. But they would work together.

  Caroline saw the moment her words sank into his heart and soul.

  His edge of constant alertness relaxed in a good way. He knew he was safe with her.

  And she was safe with him.

  A minute later they stepped from the elevator and he led her to a small garden off the back of the cafeteria. A couple of patients in wheelchairs were settled next to park benches, enjoying the sunshine.

  Caroline followed Brandon to a vacant bench. The warmth felt good after the stale hospital air. It felt good to just be with him.

  The man beside her had earned the right a long time ago to be her best friend. She trusted him with her thoughts and her hopes. He’d never let her down intentionally. Sure, there had been a time or two he’d been too casual with their friendship, but he’d always come around.

  She’d watched him in good times and hard times. He’d battled through so many challenges with a focus and intensity that inspired her. Through it all he was steady and dependable. Someone who was always there.

  He glanced at her. “What are you thinking?”

  “Not much.”

  He snorted and turned to her. “I’ll never believe that. You are many things, Caroline Bragg, but not someone whose mind settles into nothing.”

  “Sometimes it does, big guy.”

  “Not the woman I know.” He took her hand and rubbed his thumb over her knuckles. The motion was simple but sent pulses of electricity racing up her arm. How could a simple touch from the gentle giant next to her leave her feeling so incredibly protected and leaning in for more?

  He must have seen the question in her eyes, because he leaned closer and tipped her chin up. An intensity in his expression signaled that whatever he said next would be important. She leaned closer and pressed her lips to his.

  They could deal with intense tomorrow.

  Right now she wanted to sink into the moment.

  They’d survived.

  The future wasn’t a clear road, but if they had each other, she’d thrive.

  He broke the connection about the time she felt light-headed and leaned his forehead against hers. “Bragg, you’re going to be my undoing.”

  “Is that a bad thing?”

  “Not at all. But we’re in the midst of intense times.”

  “Oh, I know what I want.” She leaned up again and kissed him.

  “I guess you do.” He grinned and then deepened the kiss until she flat out could not think. When he pulled back, she moaned.

  “Do you know what you want?” The words whispered between them, and she couldn’t believe she’d found the courage to ask them.

  “That’s easy. All I want is you next to me on this journey of life.” He stroked her cheek, his touch like velvet, which was surprising coming from someone who’d used his strength to batter others and protect her. “Can you imagine that?”r />
  “I don’t want anything else.”

  “I come with a passel of kids.”

  “I love them, each one.”

  “And I love you.” His words soaked into the dry spaces of her heart, the ones that still wondered if she was worth loving. Worth protecting.

  The amazing thing was that when she was with him, she believed the value he saw.

  She was better with him, just as she hoped she called him to his better self too.

  The road wouldn’t be easy. Life hadn’t worked that way for either of them. But if her best friend, the one her heart loved, was beside her, the journey would be worth every step—each hilltop vista as well as every valley.

  A Note from the Author

  Each book I write has a unique background and story. Caroline’s is no exception.

  The genesis of Praecursoria is the story of a friend’s son—in many ways his story mirrors Patrick’s and Bethany’s. Heather introduced me to her son’s oncologist who was the inspiration for Dr. Anna Johnson. Meeting with them over coffee at Panera humanized the battle on both sides: as the parents who will do anything to help their son and the doctor who will hunt for protocols and Hail Marys. If you ever hear CAR T-cells called ninja cells, it may be because of Heather. The thread on the genetics testing was inspired by real-life stories as well. Medicine and scientific advances can be life altering for the good—or the bad.

  Many of you have been waiting for Caroline’s story almost as long as I have! She and Brandon have been waving their hands for a book since the beginning. The irony is that the law governing foster care group homes was literally changing as I wrote the book and still is as I write this letter. At the time of the final draft, Virginia hadn’t finalized its interpretation of the federal Families First law. If you know me, you know getting it right matters deeply to me. So if you are a foster family in Virginia reading this and the law has changed, my apologies. I did the best I could with the state of the law and talking to a group home executive director in Arkansas. Adoptions are happy law, but they often come at the end of a journey that is filled with heartache. Foster care can play a key role in the in between time for children waiting for a forever home. If you are a foster parent, thank you.