by Robin Cook
“I’d hate to see him jeopardize his academic career,” Kim said. “Before Ultra, teaching was his first love.”
Kim began to dress the salad.
Stanton watched her work and didn’t say anything until he’d caught her eye. “Have you guys been getting along okay?” he asked. “I don’t mean to be nosy, but since I’ve been working with him on this project, I’ve found that Edward is not the easiest person to deal with.”
“It’s been a bit stressful of late,” Kim admitted. “Moving up here hasn’t been as smooth as I’d anticipated, but of course I hadn’t taken into account Ultra and Omni. As I said, Edward’s been under a lot of pressure.”
“He’s not the only one,” Stanton said.
The front door opened and Edward and the researchers trooped in. Kim went out to greet them to make the best of the situation, but it wasn’t easy. They were all in an irritable mood, even Gloria and David. It seemed that no one had wanted to come to the cottage for dinner. Edward had to order them to attend.
The worst response was from Eleanor. As soon as she got wind of the menu she announced petulantly that she did not eat red meat.
“What do you normally eat?” Edward asked her.
“Fish or chicken,” she said.
Edward looked at Kim and raised his eyebrows as if to say: “What are we going to do?”
“I can get some fish,” Kim said. She got her car keys and went out and got in the car. It was certainly a rude response on Eleanor’s part, but in actuality Kim liked getting out of the house for a few minutes. The mood in there was depressing.
There was a market which sold fresh fish within a short drive, and Kim bought several salmon filets in case someone besides Eleanor preferred fish. On the drive back, Kim wondered with some trepidation what she would be encountering on her return.
Entering the cottage, she was pleasantly surprised. The atmosphere had improved. It still wasn’t a joyous gathering by any stretch of the imagination, but it was less strained. In her absence the wine and beer had been opened and drunk with more gusto than she’d expected. She was glad she’d bought as much as she had.
Everyone was sitting in the parlor, grouped around the trestle table, with the portrait of Elizabeth staring down at them. Kim nodded to those who looked in her direction and proceeded directly into the kitchen. She washed the fish and put it on a platter next to the meat.
With her own glass of wine in her hand, Kim walked back to the parlor. Stanton had stood up while she’d been in the kitchen and given everyone a handout. He was now standing in front of the fireplace, directly below the portrait.
“What you are looking at is a forecast of how quickly we will run out of money at the present burn-rate,” he said. “Obviously that’s not a good situation. Thus I need some idea when each of you will get to various milestones in order to best advise how to raise more capital. There are three choices: go public, which I doubt would work, at least not to our advantage until we have something to sell—”
“But we do have something to sell!” Edward interrupted. “We’ve got the most promising drug since the advent of antibiotics, thanks to the Missus.” Edward raised his beer bottle to Elizabeth’s portrait. “I’d like to make a toast to the woman who may yet become Salem’s most famous witch.”
Everyone except Kim raised their drinks. Even Stanton joined after getting his beer from where he’d placed it on the end of the mantel. After a moment of silence they all drank eagerly.
Kim squirmed uncomfortably, half expecting Elizabeth’s expression in the portrait to change. She felt Edward’s comments were disrespectful and in bad taste. Kim wondered how Elizabeth would feel if she were there to see these talented people maneuvering for personal gain in her house from a discovery related to her misfortune and untimely death.
“I’m not denying we have a potential product,” Stanton said after putting his beer back down. “We all know that. But we don’t have a currently marketable product. So trust me, in the current economic climate, it is not the time for a public offering. What we could do is a private offering, which has the benefit of less loss of control. The last alternative is to approach additional venture capitalists. Of course this approach would require the most sacrifice of stock and hence equity. In fact we’d have to dilute what we already hold.”
A murmur of dissatisfaction arose from the researchers.
“I don’t want to give away any more stock,” Edward said. “It’s going to be too valuable when Ultra hits the market. Why can’t we just borrow the money?”
“We don’t have any collateral to secure such a loan,” Stanton said. “Borrowing the kind of money we’ll need without collateral means paying exorbitant interest since it will not come from the usual sources. And since it’s not from the usual sources, the people you have to deal with don’t allow any hiding behind a corporate shield should things go sour. Do you understand what I’m saying, Edward?”
“I get the drift,” Edward said. “But investigate the possibility anyway. Let’s not leave any stone unturned that would avoid giving up any more equity. It would be a shame, because Ultra is such a sure thing.”
“Are you as confident of that as you were when we formed the company?” Stanton asked.
“More so,” Edward said. “Every day I’m more convinced. Things are going very well, and if they continue as they are we might be in a position to file an IND—an Investigative New Drug application—within six to eight months, which is far different than the usual three and a half years.”
“The faster you move, the better the financial situation becomes,” Stanton said. “It would be even better if you could pick up the pace.”
Eleanor let out a short, derisive laugh.
“We are all working at maximum velocity,” François said.
“It’s true,” Curt said. “Most of us are sleeping less than six hours a night.”
“There’s one thing that I haven’t started doing,” Edward said. “I’ve not yet contacted the people I know at the FDA. I want to start laying the groundwork to get Ultra at least considered for the expedited track. What we’ll do eventually is try the drug on severe depression as well as AIDS and maybe even terminal cancer patients.”
“Anything that saves time helps,” Stanton said. “I can’t stress that fact enough.”
“I think we get the message,” Edward said.
“Any better idea of Ultra’s mode of action?” Stanton asked.
Edward asked Gloria to tell Stanton what they’d just discovered.
“Just this morning we found low levels of a natural enzyme in the brains of rats that metabolize Ultra,” Gloria said.
“Is that supposed to excite me?” Stanton asked sarcastically.
“It should,” Edward said, “provided you remember anything from the four years you wasted at medical school.”
“It strongly suggests that Ultra could be a natural brain molecule, or at least structurally very close to a natural molecule,” Gloria said. “Additional support for this theory is the stability of the binding of Ultra to neuronal membranes. We’re beginning to think the situation could be somewhat akin to the relationship between morphine-like narcotics and the brain’s own endorphins.”
“In other words,” Edward said, “Ultra is a natural brain autocoid, or internal hormone.”
“But the levels are not the same throughout the brain,” Gloria said. “Our initial PET scans suggests Ultra concentrates in the brain stem, the midbrain, and the limbic system.”
“Ah, the limbic system,” Stanton said. His eyes lit up. “That I remember. That’s the part of the brain associated with the animal inside us and his basic drives: like rage, hunger, and sex. See, Edward, my medical education wasn’t a complete waste.”
“Gloria, tell him how we think it works,” Edward said, ignoring Stanton’s comment.
“We think it buffers the levels of the brain’s neurotransmitters,” Gloria said. “Something similar to the way a buffer maintains
the pH of an acid-base system.”
“In other words,” Edward said, “Ultra, or the natural molecule if it is different than Ultra, functions to stabilize emotion. At least that was its initial function. It was to bring emotion back from extremes created by a disturbing event like seeing a saber-tooth tiger in your cave. Whether the extreme emotion is fear or anger or whatever, Ultra buffers the neurotransmitters, allowing the animal or primitive human being to quickly return to normal to face the next challenge.”
“What do you mean by ‘initial function’?” Stanton asked.
“With our latest work we believe the function has evolved as the human brain has evolved,” Edward said. “Now we believe the function has gone from merely stabilizing emotion to bringing it more into the realm of voluntary control.”
Stanton’s eyes lit up again. “Wait a second,” he said as he struggled to understand. “Are you saying that if a depressed patient were to be given Ultra, all he’d have to do is desire not to be depressed?”
“That’s our current hypothesis,” Edward said. “The natural molecule exists in the brain in minute amounts but plays a major role in modulating emotion and mood.”
“My God!” Stanton said. “Ultra could be the drug of the century!”
“That’s why we’re working nonstop,” Edward said.
“What are you doing now?” Stanton asked.
“We’re doing everything,” Edward said. “We’re studying the molecule from every vantage point possible. Now that we know it binds to a receptor, we want to know the binding protein. We want to know the binding protein’s structure or structures since we suspect Ultra binds with different side chains in different circumstances.”
“When do you think we can start marketing in Europe and Japan?” Stanton asked.
“We’ll have some idea once we start clinical trials,” Edward said. “But that won’t happen until we get the IND from the FDA.”
“We’ve got to speed the process up somehow,” Stanton said. “This is crazy! We’ve got a billion-plus drug and we could go bankrupt.”
“Wait a second,” Edward said suddenly, drawing everyone’s attention. “I just got an idea. I just thought of a way to save some time. I’ll start taking the drug myself.”
For a few minutes there was absolute silence in the room save for the ticking of a clock on the mantel and the raucous cry of sea gulls down by the river.
“Is that a wise move?” Stanton asked.
“Damn right it is,” Edward said, warming to the idea. “Hell, I don’t know why I didn’t think of it before. With the results of the toxicity studies we’ve already done, I’m confident to take Ultra without the slightest qualm.”
“It’s true we’ve seen no toxicity whatsoever,” Gloria said.
“Tissue cultures seem to thrive on the stuff,” David said. “Particularly neural cell cultures.”
“I don’t think taking an experimental drug is a good idea,” Kim said, speaking up for the first time. She was standing in the doorway to the foyer.
Edward flashed her a scowl for interrupting. “I think it is a masterful idea,” he said.
“How will it save time?” Stanton asked.
“Hell, we’ll have all the answers before we even begin clinical trials,” Edward said. “Think how easy it will make designing the clinical protocols.”
“I’ll take it as well,” Gloria said.
“Me too,” Eleanor said.
One by one the other researchers agreed that it was a fabulous idea and offered to participate.
“We can all take different dosages,” Gloria said. “And six people will even give us a modicum of statistical significance when trying to evaluate the results.”
“We can do the dosage levels blindly,” François suggested. “That way we won’t know who’s on the highest dose and who’s on the lowest.”
“Isn’t taking an unapproved investigational drug against the law?” Kim asked.
“What kind of law?” Edward asked with a laugh. “An institutional review board law? Well, as far as Omni goes, we are the institutional review board as well as every other committee, and we haven’t passed any laws at all.”
All the researchers laughed along with Edward.
“I thought the government had guidelines or laws about such things,” Kim persisted.
“The NIH has guidelines,” Stanton explained. “But they are for institutions receiving NIH grants. We’re certainly not getting any government money.”
“There must be some applicable rule against human use of a drug before the animal trials are completed,” Kim said. “Just plain intuition tells you that it is foolhardy and dangerous. What about the thalidomide disaster? Doesn’t that worry you people?”
“There is no comparison with that unfortunate situation,” Edward said. “There wasn’t any question of thalidomide being a natural compound, and it was generally far more toxic. But, Kim, we’re not asking you to take Ultra. In fact you can be the control.”
Everyone laughed anew. Kim blushed self-consciously and left the parlor for the kitchen. She was amazed how the atmosphere of the meeting had changed. From its strained beginning it had become buoyant. It gave Kim the uncomfortable feeling that some degree of group hysteria was occurring due to a combination of overwork and heightened expectations.
In the kitchen Kim busied herself with getting the rolls from the oven. From the parlor she heard continued laughter and loud, excited talk about building a science center with some of the billions they foresaw in their futures.
While she was transferring the rolls to a breadbasket, Kim sensed that someone had come into the kitchen behind her.
“I thought I’d offer to help,” François said.
Kim turned and glanced at the man, but then looked quickly away, surveying the kitchen. She made it seem as if she were thinking about what he could do. In reality the man disturbed her with his forwardness, and she was still uncomfortable from the episode in the parlor.
“I think everything is under control,” she said. “But thank you for asking.”
“May I fill my wineglass?” he asked. He already had his hand wrapped around the neck of the wine jug.
“Of course,” Kim said.
“I’d love to see some of the environs when the work calms down,” François said as he poured the wine. “Perhaps you could show me some of the sights. I hear Marblehead is charming.”
Kim hazarded another quick glance at François. As she expected, he was regarding her with his intense stare. When he caught her eye he smiled wryly, giving Kim the uncomfortable feeling that he was flirting with her. It also made her question what Edward had said to him about their relationship.
“Perhaps your family will be here by then,” Kim said.
“Perhaps,” François answered.
After Kim finished her usual bedtime routine, she purposefully left her door completely ajar so that she could see into the half-bath the two bedrooms shared. Her intention was to stay awake to talk with Edward when he came back from the lab to sleep. Unfortunately she didn’t know what time that might be.
Sitting up comfortably against her pillows, Kim took Elizabeth’s diary off her night table and opened it to where she was currently reading. The diary hadn’t proven to be what she’d originally expected: except for the last entry it had been a disappointment. For the most part Elizabeth merely recorded the weather and what happened each day instead of expressing her thoughts, which Kim would have found much more interesting.
Despite her attempt to stay awake, Kim fell fast asleep around midnight with her bedside light still on. The next thing she was aware of was the sound of the toilet flushing. Opening her eyes, she could see Edward in the half-bath.
Kim rubbed her sleep-filled eyes and tried to concentrate on the clock. It was after one in the morning. With some effort she got herself out of bed and into her robe and slippers. Feeling a bit more awake, she padded into the half-bath. Edward was busy brushing his teeth.
> Kim sat on the closed toilet seat and hugged her knees to her chest. Edward gave her a questioning look but didn’t say anything until he’d finished with his teeth.
“What on earth are you doing up at this hour?” Edward asked. He sounded concerned, not irritated.
“I wanted to talk to you,” Kim said. “I wanted to ask you if you really intend to take Ultra.”
“Sure do,” he said. “We’re all going to start in the morning. We set up a blind system so no one will know how much they are taking compared to the others. It was François’s idea.”
“Do you really think this is a wise move?”
“It’s probably the best idea I’ve had in ages,” Edward said. “It will undoubtedly speed up the whole drug-evaluation process and Stanton will be off my back.”
“But there must be a risk,” she said.
“Of course there is a risk,” Edward said. “There is always a risk, but I’m confident it is an acceptable risk. Ultra is not toxic, that we know for sure.”
“It makes me feel very nervous,” Kim said.
“Well, let me reassure you of one significant point,” Edward said. “I’m no martyr! In fact I’m basically a chicken. I wouldn’t be doing this if I didn’t feel it was perfectly safe, nor would I allow the others. Besides, historically we’ll be in good company. Many of the greats in the history of medical research used themselves as the first experimental subjects.”
Kim raised her eyebrows questioningly. She wasn’t convinced.
“You’re just going to have to trust me,” Edward said. He vigorously washed his face, then began to towel it dry.
“I have another question,” Kim said. “What have you told people at the lab about me?”
Edward lowered the towel from his face and looked at Kim. “What are you talking about? Why would I be telling the people at the lab anything about you?”
“I mean about our relationship,” Kim said.
