Wright caught on. “I think he is telling you that you have become an honorary Iban headhunter.”
Robert nodded enthusiastically, making everyone laugh again.
“I think I could have used a sharper knife,” Nick joked.
Robert grabbed Nick’s hands and kissed them.
Wright turned to Dr. Fang. “Dr. Fang, my company has developed a new medication that stimulates IGF-1, promoting rapid healing and tissue regeneration. We plan on going to market within the year.” He put his hand on Nick’s shoulder. “Dr. Hart has agreed to work with us on its launch and research. The potential is quite something. Looking at Robert here, I’m wondering if you would help us with some clinical trials on wound healing.”
“Of course, Mr. Paul. Whatever assistance I can offer would be my honor.”
“There is no time like the present,” Wright said. “I will have the good doctor here arrange for Robert to get started on the medication this afternoon.”
The declaration seemed to surprise Dr. Fang. It certainly did Nick. Typically, these kinds of experimental trials took months, if not years, of committees, discussions, and regulatory approvals. But Dr. Fang said, “Yes, that would be fine. I will talk with Mr. Kwek to fast-track the approval.”
Nick glanced at Robert and couldn’t tell how he felt about being a guinea pig, but he was too distracted by Wright’s hand on his shoulder to think about it.
“We are sending you over to Zelutex later this morning,” Wright told Nick, “where the team will fully bring you up to speed on the medication. I will leave it up to you and Dr. Fang to work out the trial.”
Nick’s mind flashed to Star Trek, one of his favorite shows growing up, and Jean-Luc Picard telling Riker, “Make it so, Number One.”
“Sure,” Nick said. He thought he should salute and say aye, aye, sir. Instead, he chalked it up to another glimpse of how quickly the power of money opened locked doors.
“In fact,” Wright added, “since your team will be operating on the girl with the deformed face, we might as well add her to the trial, don’t you think, Dr. Fang?”
The plastic surgeon hesitated but said, “Yes, that would be splendid.”
Nick figured it was hard to say no to the man who had paid for the hospital wing they stood in.
* * *
Nick and Ms. Boxler sat in an expansive conference room. Though only the two of them sat at the massive mahogany table, Nick felt strangely claustrophobic. Wright called her Leah, but she never offered Nick the same familiarity. He thought it strange that she’d chosen to meet here when a small office would suffice. Maybe it was a show of power.
“So, you were a surgeon?” Ms. Boxler asked Nick.
“Well, I am a surgeon…I guess.” Nick tried not to sound defensive.
“You have decided to give up surgery for this?” She raised her hand in a gesture that included Wright’s entire domain.
“Yes.” He wanted to remind her that Wright had pursued him, not the other way around.
“Interesting,” she said, looking down at the papers in front of her, reading and nodding occasionally. “Your résumé is quite impressive. We will call you if someone falls and breaks their leg.”
He couldn’t tell if she was snarky or attempting humor.
“I hope you don’t feel like a fish out of water here,” she continued. “The business world is different from what you’re used to.”
“So I’ve been told.”
She continued to read Nick’s CV, seemingly word for word. Nick observed her while he waited. He thought Ms. Boxler was as strange in affect as she was in appearance—an unfortunate cross between Michael Jackson and Joan Rivers. She’d apparently spent thousands on plastic surgery, but as so often happens, the more the surgeons did, the more alien she appeared. A pinched nose sat uneasily upon engorged red lips. Her tattooed eyebrows sat too high. Her hair might even be fake, but Nick decided he’d already stared too long. Whether it was real or not, it was jet black, short and curly. Her affect brought to mind an Auschwitz guard—her tone clipped and cruel.
She turned to the last page. It was a hand-scribbled note from Wright that included the salary Nick had requested. It made her eyebrows go up, even though Nick didn’t think that was possible. She nodded, then stared at him with cold gray eyes.
“Doktar, Mr. Paul has offered you a most generous salary. You will be the third top money maker at Zelutex.”
Nick figured after Wright and herself.
“The other eight thousand employees are not going to be fond of the fact that you are so highly paid.”
“I thought those sorts of things were supposed to be confidential,” Nick said, fighting his irritation with the woman.
“They seem to have a way of escaping.”
Like the children you torture in your basement? He bit his tongue.
“Doktar, please follow me and I will show you to your office.” She stood abruptly, then led him out of the room and down the hall.
It was hard to believe that she and Wright existed on the same planet, not to mention in the same company. She is his right-hand person? Maybe she was the alter ego, the bad cop. It was a good thing Wright had warned him; otherwise, Nick might have turned around and walked out the door. “She has the personality of a sour lemon, but she has one of the most brilliant minds for business,” Wright had told him. “I promise that you won’t have to interact with her much…unless you get in trouble,” he’d said. Nick wasn’t sure what that meant.
“Doktar.” He hated that she did not use his name and he didn’t care for her harsh German inflection.
“Doktar, Mr. Paul is the visionary and I’m the realist. I know he has told you that you can work from anywhere in the world, but I’m sure I don’t need to remind you that the company is here in Singapore and the research center in Borneo. You will be required to do extensive traveling—teaching, lecturing, and marketing events, but after that, you should have time to go visit your family on occasion in the US.” She said the last two letters with disdain.
Definitely the bad cop.
Partway down the hall, she stopped, turned and squared off to him, forcing him to hit the brakes so as not to touch her. She didn’t move.
“Doktar, I know you are used to being the god of the operating theater. I’m afraid we don’t tolerate that size of ego here at Zelutex.”
Nick was sure her ego was big enough for the whole company. He hated the comparison to God anyway. Very few doctors that he knew, including surgeons, even came close to feeling that way about themselves. Most were just trying to navigate one of the most challenging callings in the world. He crossed his arms, wondering if he’d made a mistake in taking the job. Was it too late to say no? Probably. Okay, he’d collect his salary, have an ironclad contract for shares in the company, and see how it went. What’s the worst that can happen? They fire me?
“I understand, Ms. Boxler. I’m just happy to be here.”
* * *
Nick was sure everyone would have to remind him of their names again. His team, scattered throughout the building, included marketers, sales reps, regulatory folks, attorneys, and scientists. An impressive number of people were assigned to the new medication, and this was only the tip of the iceberg, Ms. Boxler indicated.
She also told him she hoped he had the intelligence to get up to speed quickly. She didn’t want him to be an encumbrance. He must move into the leadership role. She made no attempt to hide her doubt. The team was cordial and treated him with respect, but he could tell they had a twinge of skepticism. He understood. After all, he was an outsider and a complete unknown. They talked fondly of Dr. Amy, and he even saw a tear or two shed for her.
He thought it poor form that Ms. Boxler chose to give him Dr. Amy’s old office. The shadow of the removed nameplate lingered solemnly under his new shiny plaque. Nick entered tentatively. This office compared to the one at the research center was heavily sanitized, or she’d rarely used it.
Ms. Boxler shut
the door behind her, leaving Nick with a young biochemist who set her laptop on his desk, unwound a power cord and plugged it into the wall outlet. He offered her a chair and she adjusted the computer so both of them could see the screen. “Kerri Kim,” he said, observing the thin, attractive Chinese woman with impressive credentials.
She waited until after they could no longer hear Ms. Boxler’s heels clicking down the hallway. “Never mind the mother of dragons.” She smiled warmly at Nick. “We’ve all had to endure the initiation. Cut a wide circle around her, and you’ll do well.” She pushed a button on her computer and the computer screen lit with the Zelutex logo.
“Yeah, thanks. I was beginning to think it was just me.”
She laughed easily, putting him at ease. Maybe I can do this after all.
“Dr. Hart, I want to brief you, but please don’t let me offend you. How much do you know about IGF-1?”
“Kerri, you better start from the beginning…biochemistry 101.”
She seemed pleased at that and started her PowerPoint.
“Insulin-Like Growth Factor-1, IGF-1 has a molecular structure similar to insulin, which is how it got its name.” The projected illustration showed the two molecules side by side. “Unlike insulin, it has a weak effect on glucose levels and is more of a somatotropin—a growth hormone secreted by the anterior pituitary gland. But instead of being secreted by the pituitary, it is mostly manufactured in the liver. However, part of our research has demonstrated that most tissues manufacture it as well, only in smaller quantities. You might be most interested to note that IGF-1 is highly involved in the formation of bone.”
Nick nodded, leaned back in his chair and rubbed his head. He had the same overwhelming feeling he had experienced the first day of medical school.
“IGF-1 has an uncanny number of properties, including anabolic—critical in tissue growth and regeneration; antioxidant—it’s a true anti-aging hormone; and anti-inflammatory and cytoprotective action. Among others,” she added.
“Doesn’t a congenital lack of IGF-1 cause dwarfism?” Nick asked.
“Yes, you’re exactly right, one form of it.”
“So, is the new medication a replacement for IGF-1?”
“No, that’s the beauty of it. That’s where my research began, but we learned that just giving more IGF-1 was fraught with issues, including some pretty horrendous side effects, including tumor growth. If IGF-1 can stimulate tissue growth, it can also stimulate cancer growth. It was pretty ugly,” she said, looking at the floor.
“So how does this new medication work?”
“The medication stimulates autogenous production…the body’s own IGF-1.”
“I seem to remember that the pituitary gland secretes growth hormones to stimulate the manufacturing of IGF-1 in the liver. Once you increase IGF-1, doesn’t that have a feedback loop to stop the secretion of the growth hormone and therefore slow the production of IGF-1?” He straightened and leaned toward the screen.
“Yes, good. Now you are thinking like a biochemist. Remember, Dr. Hart, these hormones are like keys, unlocking pathways to turn on processes throughout the body. In other places, hormones lock pathways to turn them off. It is highly regulated. But think of it this way: what if a patient needs bone laid down in a fracture of their leg? What if we can tell the body to turn on IGF-1 in that particular bone without affecting the rest of the body or shutting itself off?”
“And you…it can do that?” Nick’s excitement was palpable.
“Yes.” She smiled coyly. “We are using epigenomics to tap a patient’s individual DNA expression so we can target where the IGF-1 is specifically needed…Skin? Bone? Heart? You get the picture.”
“Yes, but I need some coffee. Where can I get coffee?”
CHAPTER 38
SILENCE
Wright walked with Maggie and Dr. Fang toward Daisy’s room. He was pleased to have Maggie to himself, or at least he would soon. He was full of energy from the medication and wondered if Maggie felt the same. He wished they could talk about it, but for now, the Welltrex would stay hidden in her morning coffee. She appeared energetic.
“I thought Robert looked remarkable. He sure is in good spirits,” Maggie said. “You did an amazing job, Dr. Fang.”
“Well, we have an accomplished team of doctors and nurses here, Ms. Russell.”
Wright tilted his head as if to shake off the jealousy he was unaccustomed to. He’d hoped the medication would eliminate the feeling, but it was only his second day on Welltrex. Give it more time. Should he up the dose? Maybe both?
“Wait until we start him on my IGF-1 drug. You will see an accelerated recovery,” Wright said.
Dr. Fang smiled and nodded as they entered Daisy’s room. Nothing had changed. The mother still sat detached in the corner, staring out the window, and Daisy sat in the middle of her bed, staring at the door, looking pitiful and lonely.
Maggie started right for Daisy, but Wright grabbed Maggie’s arm and opened his briefcase. “I have something for her, but I would love for you to give it to her.” He pulled out a teddy bear and a short stack of coloring books and pencils.
“That’s so sweet,” Maggie said and hugged the soft bear. Holding the gifts behind her back, she walked to the child. “Hi, Daisy. Guess what dear Mr. Paul has brought you?” She leaned in to kiss the child’s forehead. But as she did, the child cowered as if Maggie was going to strike her. Maggie backed off, looking at the mother, who ignored them. She turned to Wright. “Does the mother speak English?”
Wright asked the mother in Iban. She finally acknowledged them but shook her head.
“This poor child has been abused,” Maggie said. Color moved up Maggie’s neck. Wright knew the issue had hit a hot button. “I’ve seen this look before with some of our kids coming off the street. She needs more than the reconstruction of her face; she needs a full spiritual transformation.”
Maggie handed the teddy bear to Daisy, who stared blankly at it. Universally, children would reach out for the toy and cuddle it. She finally reached for the stuffed animal. She looked at it, then dropped it to her side without acknowledging the toy any further. Daisy did not know how to show the cuddly bear affection because no affection had ever been extended to her.
“You have someone working with her?” Maggie asked Fang.
The doctor shook his head. “I’m afraid, Ms. Russell, we have no street children in Singapore. There are no orphans. We are ill-equipped to deal with such a case.”
“Your case is a little girl,” Maggie shot back but then flushed. “I’m sorry, Dr. Fang. I have no right. I’m just a little sensitive about this issue. Please forgive me.”
Wright interceded. “Ms. Russell is right. This child needs some support.” He turned to Maggie. “Dr. Fang is correct, Singapore has few social problems because of its economic stability. Dr. Fang, I’m sure your staff and Ms. Russell could have a splendid exchange of ideas…Grand Rounds or the like?”
“That’s a splendid idea. We have Grand Rounds at 5:30 a.m. tomorrow morning. Her case…er…the child is on our agenda. Please, will you join us, Ms. Russell?”
“Certainly, Dr. Fang. It would be my honor.”
* * *
Wright had taken Maggie to a noodle shop a few blocks from the hospital. They’d sat at a table in the shade of a large oak tree. Wright was not exaggerating when he said that Singapore did not suffer from the same ailments as other large cities. It was the cleanest and most beautiful she’d seen—a far cry from Central America. Even the hole-in-the-wall Chinese wok kitchen was spotless. She had to laugh when Wright told her that selling bubblegum was outlawed in the city with penalties of up to two years in jail or a one-hundred-thousand-dollar fine. Feeding pigeons was a five-hundred-dollar penalty, and not flushing the urinal a hundred-and-fifty-dollar fine.
They’d returned to Wright’s island retreat, and now Maggie sat alone on her bed. She pulled her cell phone out of her purse and turned it on. The screen saver was a picture of her an
d John in front of the Hope Center; it was pouring rain the day the picture was taken, and they were soaked. John had his arm around her, and they were laughing in the deluge.
Strange. Typically, emotions welled up whenever she studied the picture…tears of great joy and sorrow. But now her emotions were flat, muted somehow. She shrugged off the sensation and dialed the international number to Guatemala.
It rang seven times. She was calling before sunrise, and everyone was probably still sleeping.
“Hello?”
It was Joseph, one of the faithful guards at the Hope Center, who answered in a sleepy voice. She could almost smell the smoky warmth of her home and her family.
“Hola, Joseph, Cómo estás?”
“Ms. Maggie! We are well, thank you. Missing you of course. How are you?”
“It is so good to hear your voice. I’m sorry I am calling so early. Is everyone still sleeping?”
“Yes, even the roosters.” He chuckled.
“How is everyone?”
“Oh, they are doing very well, thank you…no hay problemas. We have often thought of calling you but didn’t know what time it would be there and worried the call might cost too much.”
Maggie sighed. What a strange feeling. Here she was, jetting around, eating at banquets that would feed her orphans for weeks, and sleeping in places that could house hundreds more. She smiled at her staff’s frugality—recycling their stale bread into bread pudding and making do by mending the kids’ socks time after time. If they only knew how she was living.
“I miss you all so much, Joseph. Please give my love to everyone.”
“When will you be home, Ms. Maggie?”
“I hope within the week.”
“I hope you get some rest. You sound cansada.”
“I am a little tired, yes. Thank you, Joseph. I will see you soon.”
Maggie hung up, put her phone on the bed, and knelt beside it.
“Father, bless them all.”
Her thoughts were at war with themselves. She’d made up her mind in India that Wright’s advances would have to stop, but ever since getting back to Singapore, she didn’t know if she still wanted that. She’d never been this indecisive or confused in her life, except for maybe when the hormonal rage of adolescence hit her.
The Rusted Scalpel Page 27
