The Magic Bullet

by Harry Stein

  Briefly, it looked like a miracle cure. By the following day, Tilley reported he was feeling better than he had in months.

  But the day after that, the dizziness was as bad as ever.

  As test after test came up dry, the patient’s few days in Washington became almost two weeks. Disappointed as he was on Tilley’s behalf, Logan’s curiosity continued to mount. Every second day Tilley arrived at the ACF clinic to be examined and pumped full of salt water. Sure enough, he would feel better; yet, just as surely, within two days he was dizzy again, his blood pressure dropping sharply.

  Finally, at long last, the tests yielded up the reason for Tilley’s persistent dehydration. His adrenal cortex had ceased to produce the hormones that enable the kidneys to retain salt and water. To Logan, the reason seemed apparent: the protocol drug was somehow blocking the normal function of the organ.

  And yet, going over the lengthy proposal that had led to the Compound J test, he found nothing to indicate that the drug might have so alarming a side effect. Nor, as far as he knew, had it so affected even one other patient on the protocol.

  The afternoon the test data came in, Logan could focus on nothing else. It simply didn’t make any sense: what was it in the makeup of this patient—or in the specifics of his condition, or in some heretofore unrecognized aspect of the drug itself—that could have produced such a result?

  Yet already he had begun to formulate an even more pertinent question: Could such a discovery have some meaningful practical application?

  The day’s events crystallized in Logan’s mind an intention that had earlier been only a vague thought: he saw Shein’s secretary and picked up a ticket in the ACF box for that evening’s ball game. His favorite team, the California Angels, was in town, and since boyhood he had done some of his best thinking at the ballpark.

  Arriving at Baltimore’s Camden Yards early for batting practice, he was not surprised to find himself alone in the box—he’d heard it was seldom used.

  The box was on the mezzanine level, slightly to the first-base side of home plate, and Logan had a commanding view of the stunning new stadium. He bought himself a hot dog and beer and settled in, reveling in the feel of the place.

  It wasn’t until the fourth inning, with the Angels already enjoying a three-run lead, that he reached into his briefcase and withdrew Larry Tilley’s case history. His plan was to review it from the beginning, prior even to the diagnosis of the disease; looking for some clue in Tilley’s past, anything that might—

  “Dan?”

  He looked up and there, to his astonishment, a cardboard food tray in her hands, stood Sabrina Como.

  She smiled uncertainly. “I hope you do not mind to be bothered.”

  Hurriedly, he replaced the papers in his briefcase. “No, of course not. I’m just … surprised.”

  “Most times no one else is here.” She took a seat beside him.

  “Aha …” He stared at her wonderingly. “You like baseball?”

  She nodded. “It is a game of numbers. I like numbers, my mother teaches statistics.” She pointed at the scoreboard in right field. “The Orioles, they are not doing so very well. Only three hits and two errors already.”

  He nodded. “Tim Salmon hit a home run for the Angels.” This was crazy; no way she could know who Tim Salmon was.

  “And Bo Jackson? That is a big reason I came—to see a man with a hip replacement run around on the bases.” She smiled. “That is a real medical miracle, no? Better than our little tricks.”

  He smiled uncertainly. “I know. Unfortunately, he’s not playing.”

  “No … I know he is hitting only .233, not so high.” She was staring down at her scorecard, matching the numbers listed on the board in centerfield with those in print. “Tonight instead they use this other man, Davis.”

  Logan was overwhelmed. He couldn’t have dreamt up such a woman. He strained to think of something to say. “So … what are you eating?”—then instantly berated himself. Why was it that every time this woman spoke to him forty points seemed to drop from his IQ?

  She picked up the hamburger from her tray. “Not the best.”

  “Well, at least it beats the food at the ACF.” He hesitated. “Is hospital food any better in Italy?”

  “No, maybe even not so good. What could be worse than days-old pasta? But there the doctors may bring their own food to eat. Sometimes I do the same here—Italian pastries and chocolates.”

  Reaching into her pocket, she withdrew a piece of candy wrapped in gold foil. The label read Maracini. “Would you like?”

  He unwrapped it and popped it in his mouth. “It’s delicious.”

  “They are not to be eaten so fast, Logan,” she said, smiling. “They are not Hershey’s Kisses.”

  “Oh. Sorry.”

  “I give them sometimes to my patients in the hospital.”

  “You do?” Fleetingly, Logan wondered if that might violate some regulation.

  She shrugged. “I started this practice back home. In the hospital there we had many children.”

  “A pediatric ward?”

  She nodded. “But it is good with adults too. Such a small thing, but it helps create good relations with patients.”

  “I find it pretty hard working with kids.”

  “Pardon?” He’d said it so softly, she actually hadn’t heard.

  “I don’t know, when I go into a children’s ward and see those little tables and chairs …” He hunched his shoulders slightly. “I have trouble even reading the literature about kids and cancer.”

  Though her gaze didn’t waver, she studied Logan with new interest. “Well, you are very lucky then we do not treat children at the ACF.”

  “No.” He hesitated, struck by the change in her manner. An explanation seemed in order, if not an apology. “I know it’s not very professional …”

  She turned away to stare out at the field. “Ah, Mr. Ripken is coming to bat.”

  He felt a rising sense of alarm. “So,” he picked up, “are you enjoying your work at the ACF?”

  “Enjoying?” She turned back to him, seemingly baffled by the word. “It is like a medieval Italian city-state, I think. It makes me go back and read Machiavelli.”

  Gratefully, Logan burst out laughing. “That’s true.”

  “Some of the people there … just horrible!” She paused. “You are not friends with them, I hope.”

  “No. It’s strictly professional.”

  “Like this Larsen and Stillman. Among the greatest experts in ovarian cancer and breast cancer—no?—and they do not like women. Not at all. How could such a thing happen?”

  On the field, the Orioles were rallying, and the crowd let out a roar as a ball shot between a pair of infielders into left field. Logan shook his head. “I really don’t know.”

  The crowd noise died down. “Even the work—it really is not so interesting as I expected.”

  “I think a lot of us feel that way.”

  “Back in Florence—this is where I did my training—I had a year of specialization in endocrinology. You see? But here”—she offered a helpless shrug to indicate the immensity of her frustration—“here what is the use of such a specialization?”

  “I didn’t know you were an endocrinologist,”

  “Yes, and very good too.” She laughed. “No good hiding it under a bush.”

  Her laugh was a lovely sound. He leaned forward. “Listen, I’ve got something you might be interested in.…”

  He withdrew the pages from his briefcase; then, in broad strokes, he outlined the Tilley case, stressing his continuing confusion over what appeared to be the patient’s bizarre reaction to the protocol drug.

  Eyes fixed on the field, Sabrina listened intently. “You are sure in the protocol proposal there is nothing at all about such side effects?”

  He shook his head. “Absolutely not. Who knows, maybe it has nothing to do with Compound J. Maybe it’s a result of the disease itself.”

  “You know,�
� she said, “I have several patients also on the Compound J protocol. One of them, she has similar symptoms.”

  “Weakness? Dizziness? Dramatic change of blood pressure?”

  She nodded. “Only not so severe. Her doctor in New Jersey, he is handling it.” She paused. “You have been to the library at the Foundation? You have checked for information on Compound J?”

  “I’ve just made a start.” In fact, the ACF archives had the vastest collection of data on cancer and related diseases anywhere in the world; and most of what it didn’t have was retrievable electronically. The only real limits on a dedicated researcher were those he imposed on himself. “Unfortunately,” Logan confessed, “I’m not strong in languages. Only English and some German.”

  Sabrina shook her head. “This is truly a disgraceful thing about you Americans”—then, worried that she might be offending him, “I don’t mean this in a bad way.”

  He couldn’t keep from laughing. “I can see that.”

  “Anyway, my English is not so perfect also.”

  “Just drop it, Sabrina, you’re in too deep.’

  “Anyway,” she added, her green eyes luminous, “this is why I went into medicine—the fun of the hunt.”

  “That’s a nice way of putting it.”

  “And you?”

  He thought a moment. “The same. But I guess I’d also have to tell you about my father.”

  “He is a doctor also?”

  He shook his head. “He owns a stationery store.”

  “He wanted for you to be a doctor? This was his dream for you?”

  “Actually, what he mainly wants is for me to make a lot of money. I speak with my family every few weeks. He never fails to remind me that I’m not.”

  She laughed. “This story has no connection.”

  “He was someone who could’ve done just about anything. He was smart enough. Only, his father died when he was in high school and he had to help out the family. So he got a job, and never really got back on track.” He shrugged. “That’s it, nothing dramatic. A lot of people have the same story.”

  “I am sure he is proud of you.”

  Logan managed a pained smile. “Actually, no. He resents me.” He paused, feeling terribly awkward; he’d probably told this woman too much already. All this wimpy self-revelatory stuff would only scare her off. “Do you play any sports yourself?”

  She noted the change of subject and respected it. “In Italy, in the high school, I ran. The four hundred and the eight hundred meters. But now I do not even walk fast.”

  “Well”—he hesitated—“maybe one day we could go out and throw a ball around.”

  She nodded. “Yes.”

  He glanced at his watch and reluctantly he rose to his feet. “Will you be all right here? I’m afraid I have an early flight to New York tomorrow.”

  “Why New York?”

  “That’s where I did my internship and residency. At Claremont Hospital.”

  “Ah, and you maybe have a friend there?”

  Incredibly—or was it just his hopeful imagination?—Logan thought he detected a note of jealousy. “Well, yeah. That’s one of the reasons I’m going up … he’s getting divorced.”

  “Ah,” she said, her tone betraying nothing. “You are a good friend.”

  He smiled. “Nah. Just a guy looking for an excuse to get away from the ACF for a day. But this lets me rack up a few good-guy points.”

  “Well”—she rose to her feet and extended a hand—“I am pleased to know you at last. You seem to me like not such a bad guy after all.”

  Her smile was so disarming, Logan entirely missed the faintness of the praise. “Thank you, Sabrina. That’s nice of you to say.”

  Catching the 8:00 A.M. shuttle out of National Airport, Logan made it into midtown Manhattan before 10:00. Not scheduled to meet Perez till half past twelve—his only appointment—he viewed the day before him as an almost sinful indulgence, and he was determined to take full advantage. He had the cab drop him off at the Metropolitan Museum, and spent the next hour in his favorite sections—Egyptian art and medieval armaments; then headed over to another old haunt, the small, quirky Museum of the City of New York, with its current exhibit on New York sports history. Hurrying down to Fifty-ninth Street, he still had a little time to wander through F.A.O. Schwarz, examining new toys and gadgets that struck his fancy.

  Ruben Perez was on time, waiting across the street, in front of the Plaza. As Logan approached he held up a deli bag.

  “I figured we’d eat in the park.”

  “Some things never change.” Logan grinned as they shook hands. “Why do I keep imagining you have class?”

  “Hey, not all of us make doctors’ dough.”

  “I don’t make doctors’ dough. I’m at the ACF, remember?”

  “That’s why I didn’t suggest a restaurant. Didn’t want to embarrass you.”

  Having established nothing had changed between them, they began almost instantly comparing notes on their respective institutions.

  “You’re not gonna believe this,” said Logan, as they walked toward Central Park, “but a lot of people’d say the ACF’s as bad a work environment as Claremont. Maybe even worse.”

  “I had the impression you liked the place.”

  “I do, personally. But I’m a scientist, I’m giving you objective data.”

  His friend shook his head vigorously. “Oh, c’mon, man. You forget what Claremont was like. Assholetown, U.S.A.”

  “I’m telling you, some of these guys at the ACF are just unbelievable bullies. Cross ‘em, even by accident, and you can kiss your career good-bye.”

  “So how you handling it?” Perez took a seat on an empty bench.

  The simple question seemed to hit a raw nerve. “There’s no handling it. You just work hard and try like hell to stay out of harm’s way.”

  “Right.”

  “Problem is, you get known as a kiss-ass for the trouble. What the hell am I supposed to do, do crappy work? That makes me a hero?”

  His friend was taken aback by Logan’s intensity. “Hey, man, I’m not accusing you of sucking up to anyone. Sounds like they’re working you too hard down there.” He patted the bench. “Sit down.”

  Logan did so. “Sorry. I only wish the work came without all the other crap.”

  “Dream on, pal. Just don’t get me worried about your mental state. I got my hands full worrying about my own.”

  “Yeah, I know.”

  “How’d we even get started on your problems? I mean, it’s so typical.”

  Logan couldn’t help but smile. “Fine. Your turn.” He extended his hand. “Give me my sandwich and talk to me.”

  But as Perez launched into his story, the tenor of the encounter quickly changed. In fact, his impending divorce was far messier than Logan had realized. It seemed his estranged wife was drinking heavily. Increasingly bitter, she’d been denying him access to their young daughter. He’d begun to feel he had no alternative but to consider a custody fight.

  Having zero firsthand experience with such a nightmarish scenario, knowing nothing about the emotional needs of children beyond what he’d picked up in a month-long mental-health course he’d had to take as a medical student, Logan understood he was in no position to offer advice. He mainly listened. But this seemed to be fine with Perez.

  “It’s so damn hard,” he softly concluded. “Just because I want out, everyone thinks I’m the bad guy.” He stopped and brushed a sleeve over suddenly damp eyes.

  Awkwardly, Logan threw an arm over his friend’s shoulder. “You know I’ll do everything I can.” He’d almost forgotten—perhaps only now fully grasped—the depth of his feelings for this man.

  “I mean, no one knows what really goes on inside a family. How people treat each other. I’m trying to save my kid, man. I’m working three extra shifts a week just to finance this.”

  Looking to ease the tension, Logan went for a laugh. “Eighteen more hours a week at Claremont? Now, that’
s depressing.”

  He was immediately sorry. But, typically, Perez offered him a smile. “I know, man. You ain’t kidding.”

  Half an hour later, as Perez hurried off in the general direction of Claremont Hospital, Logan found himself at a loss. What to do now? He tended to see life as a series of firm commitments and he’d set aside this as a leisurely day of R and R. Still, the idea of spending the afternoon alone suddenly seemed immensely less appealing.

  He considered heading home immediately. As always, there was work to be done. Patients who’d be delighted to see him. Slides to study in the Screening Clinic. Data to be input into the computer system—including Tilley’s, which, in his preoccupation with their significance the night before, he’d neglected to enter.

  Doggedly, Logan headed off to the movies, where he spent the rest of the afternoon. Afterward, feeling better, he decided to stay for dinner at his favorite Thai restaurant. Needing something to read, he made it over to the bookstore at Sloan-Kettering just before closing and picked up the latest edition of Vincent DeVita’s authoritative Principles and Practice of Oncology.

  He found the book so absorbing that it was only after ordering coffee that he thought to call in and check his messages.

  The first several were routine: a hospital secretary with word of a protocol patient who’d checked back in; an old college friend planning to be in Washington over Christmas. But the third caught him entirely by surprise.

  “Hello, Dr. Logan. Or perhaps I now know you well enough to say Danny? Anyway, never mind. This is Sabrina Como calling and I am eager to talk with you as soon as possible. I think I have found something important. So if you will please call me as soon as you can. (703) 555-4103. Ciaò.”

  Logan checked his watch—it was eight-sixteen. Hurriedly dialing Sabrina’s number, he got her machine and left a message: he was hoping to make the nine o’clock shuttle. He’d try her again when he reached home.

  It wasn’t until he was in the cab, speeding toward the airport, that he realized he’d left his book on the table.