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The Magic Bullet

Page 13

by Harry Stein


  “No,” conceded Van Meter. “What we have is far too … ill defined for practical use.”

  “I should say so. The American FDA will never approve the stuff! They tend to be such sticklers about knowing what you put into patients.” The Englishman laughed. “Well, I suppose you’ll at least have your bit of fun with it.”

  “Naturally, for the moment, I’m concerned only with the principle,” returned Van Meter defensively. “Down the road, we will certainly need better compounds, but for now …”

  But Logan had already heard more than he needed to know. Nodding pleasantly, he turned and resumed moving up the aisle.

  “Where the hell you been?”

  Logan would know that voice anywhere—and never had he been so glad to hear it. He had to resist the impulse to take Shein in his arms.

  Though red eyed, unshaven, and still wearing the same clothes in which he’d arrived, Shein appeared just fine.

  “I’ve just been attending the conference, Dr. Shein.” He paused. “I was worried about you.”

  “About me? Didn’t you get my note?” Suddenly he leaned in close. “I gotta get changed for my damn speech. Come up with me, I’ll tell you everything.”

  Shein was fairly bursting with the news.

  “Remember the woman at the airport?” he blurted out suddenly, as they rode up in the elevator.

  Logan glanced uneasily at the only other passenger, a bellboy with a food cart. “The blonde?” he replied softly.

  “She has a name, for Chrissakes. Christina. Logan, your problem’s you got no respect for women.”

  The door opened and Logan gratefully stepped out. “You were with her? How’d you find her?”

  Shein smiled with pride. “You’re not as smart as you look—I read her luggage tag. Turned out she’s a translator, can you believe that? Talks better than you and me put together.”

  As they headed down the corridor, Logan glanced at his watch. The speech was in less than twenty-five minutes.

  “Only one hitch—she won’t sleep with me!”

  Though some sort of response seemed called for, Logan was at a loss as to what it might be. “That’s too bad,” he ventured.

  “Wants me to have an AIDS test. Me? Can you believe that?”

  Fifteen minutes later, standing in his underwear before the sink, face covered with foam, Shein was still on the subject. “I try to explain to her the statistical probabilities, right? A guy my age, my background, number of sexual partners. But it’s like talking to the Berlin Wall!” He laughed. “That’s what I call her, my little Berlin Wall. She loves it.”

  “Dr. Shein, I’m getting a little concerned about the time.” That, and the fact that his colleague evidently hadn’t given his talk so much as a moment’s thought.

  “I tell you, Logan,” he said, shaking his head ruefully, “this really hits home how much goddamn ignorance and hysteria there is out there about this disease!”

  Not that Logan need to have worried. Shein was brilliant. Speaking without notes on the granulocyte colony stimulating factor—a genetically engineered protein that enables bone marrow to quickly regenerate, thus rendering tolerable extremely high doses of chemotherapy—he kept the overflow audience in the main auditorium mesmerized. In the question-and-answer session that followed, completely in his element, he described his own research experience with the compound in ways almost unheard of at such gatherings; discussing not only the technical aspects, but his interactions with patients and their families; along the way getting laughs from this gathering of senior scientists that would have delighted a veteran Borscht Belt comic.

  “That was amazing,” enthused Logan, greeting him at the podium afterward. “I don’t know how you do it.”

  But to his surprise, Shein looked almost crestfallen. “Christ, it’s too easy. From these people you think you’d get a little more skepticism.”

  Logan just stared at him.

  “C’mon, Logan, you know it as well as me—it’s all bullshit. The survival rate for metastatic breast cancer hasn’t changed in twenty years. And all the goddamn colony stimulating factors on the planet aren’t gonna raise it one bit.”

  Like almost everyone else of her generation, she still felt young. Was it possible it had been eighteen years since she was back in Sacramento, writing on local politics for the Bee? Sometimes, closing her eyes, she could see herself, hair still shoulder length, wearing one of those ridiculous pants suits, working away at her heavy old Underwood, struggling to meet a deadline.

  But the regrets rarely lingered. The choice to set aside a promising career had been hers alone, prompted not only by altered circumstances but by a changed sense of herself. Fourteen years ago, when Charlie was born, she had wanted to stay home—and considered herself immensely fortunate to be in a position to do so. She wanted to watch her children grow up, to be there when they needed her. Seven years later, by the time her second child, Allison, was old enough for school, her old life no longer seemed feasible. Now, unavoidably, John’s career came first. Sacramento was only pleasant memories, the house where they’d lived then replaced by a larger one, before they’d ended up here. When she entered a newspaper office now—struck by the silence, computers having replaced clattering typewriters—it was always at her husband’s side.

  True enough, over the years she’d sometimes resented this. It wasn’t easy living in the shadow of a rising political star. Always, the moment he entered a public place, he changed, his eyes turning hard even as his cheek muscles fixed in a grin. His frequent absences were especially hard on the children.

  Still, she told people theirs was a good marriage, and unlike most political spouses, she meant it. Maybe it wasn’t so rock solid as that her parents had made, but what else was new? These were changed times, difficult times. If John was ambitious, well, wasn’t that part of the reason she’d married him?

  Above all, she respected him. She alone knew how much he agonized over the compromises he felt bound to make; and how often, under fire, he struggled to remain true to his best self. She saw herself as an essential part of that process, a partner in far more than name only. He trusted her absolutely.

  Perhaps even more, she realized now, than she trusted him. For almost a week after the gnawing ache in her lower back returned, she failed to mention it to him. After all, the doctor was still reassuring. He said he was suggesting a biopsy only as a precaution. (As a precaution for whom? she thought, with reflexive irreverence. Whose future was he REALLY worried about?)

  She finally agreed because it was easier than fighting it. Anyway, it would put her own mind at ease.

  Still, she decided not to tell John. It just wasn’t a good time, he had so much on his mind. She’d let him know afterward, when the results came in, when she was free and clear.

  The biopsy was set for day after tomorrow. Looking in the mirror, she again succeeded in quieting the doubts. This was not a sick woman staring back at her. This was a woman who looked exactly as she felt—unbelievably young.

  The following morning, Shein was gone again. But Logan no longer saw this as his concern. Never mind appearances, this guy was obviously as capable of fending for himself as anyone he’d ever known.

  Anyway, he had other things on his mind. This was the day he was to visit the building in which Paul Ehrlich had conquered syphilis, now a cancer research center. Its directors had taken advantage of their proximity to the conference to arrange a tour and various sessions.

  Logan didn’t have much interest in the topics to be discussed, but he had another reason for coming. This was a pilgrimage. He was coming to this place as a wide-eyed tourist and unembarrassed fan, the way others, back home, visited Elvis’s home at Graceland; imagining, like them, that he might pick up some small sense of what made the great man tick.

  The chartered bus from the convention center deposited Logan and two dozen others before the building shortly before eleven. Instantly, he was disappointed. From the outside it was curiously uni
mpressive; a massive, ivy-covered cube of gray stone fronting a narrow street (renamed the Paul Ehrlich Allee after the war) and adjoined on either side by buildings of nearly identical size and shape. The only sign of its remarkable history was a tiny metal marker in the corner.

  Entering, Logan was further disheartened to note that the interior seemed to have been lately refurbished; incongruously, the large reception area was filled with the kind of ultramodern furniture Logan had come to associate with eager-to-impress Park Avenue physicians like Sidney Karpe. Now it was the few remaining traditional touches that seemed out of place: A pair of large, ornate Oriental vases, filled with peacock feathers. A stately portrait of an elderly woman in turn-of-the-century attire—identified as the wife of the home’s original owner and Ehrlich’s benefactress. An alabaster bust of the scientist himself on a marble plinth, his name and the dates 1854–1915 inscribed on the base.

  The visiting doctors and researchers were greeted by an earnest young researcher who identified himself as the assistant to their host, the center’s director. In impeccable English, he gave a brief rundown of the kinds of work being conducted here. As they would shortly see on their tour, the Institute’s labs were state of the art; less than two years before, the upper floors had been gutted and rebuilt. Lunch would be served at the conclusion of the tour, with the featured speaker, the center’s research director, speaking over dessert and coffee. He and his colleagues were, of course, very much looking forward to questions, remarks, and observations from the distinguished guests.

  Inwardly, Logan shuddered. This had nothing to do with the magical place that had stirred his imagination all those years before. From the sound of it, even those who worked here had little appreciation of the extraordinary things that had once been said and done within the walls; no sense that they were inheritors of one of the most remarkable research legacies in the history of science.

  Perhaps it would have been wiser not to come; leaving the illusion, at least, intact.

  By the time, half an hour later, they were midway through the tour, he was sure. Logan was ready to bolt the place—and would have, if he’d had any idea where, in this quiet, dull neighborhood, he could grab a cab. The labs the young researcher was showing off were identical to those Logan had worked in himself: in fact, the flow cytometer of which he seemed so proud—a machine that shoots cells into the path of a laser beam so they can be studied individually—was the model the ACF was about to retire.

  As the group moved en masse up the stairs toward the top floor, housing yet another set of labs, Logan slipped down the stairs, heading for the reception area. He’d been sipping coffee throughout and it had caught up with him.

  “Pardon me, do you speak English?”

  The receptionist cast him an impatient look. “Yes, of course.”

  “Can you tell me where the bathroom would be?”

  She nodded in the general direction of the front hallway. “Go through there and down the stairs. Then straight on to the next room. Turn left. And turn left again. You will see it on the right.”

  He was certain he’d done precisely as told—which is why he was confused to suddenly find himself in a narrow corridor that dead-ended against a wooden door.

  Was this what he was looking for?

  Tentatively, he pushed the door open—and instantly knew he should close it again. Wooden stairs led downward into the basement. But, after a moment’s hesitation, he flicked on the light instead. Moving quietly, feeling an almost perverse sense of exhilaration, he moved down a few steps and bent low to peer beneath an overhang.

  What he saw convinced him to go the rest of the way down: vintage lab equipment, the kind he’d seen before only in photographs, neatly arranged within old glass-fronted oak cabinets lining the walls.

  Moving closer, he was as baffled as he was intrigued. These were museum pieces, as useless to contemporary researchers as mortars and pestles. Oversized bronze microscopes. A polished steel balance. Hand-blown glass condensers with beautiful spiral cooling coils. More prosaic Bunsen burners and ring stands. Over it all lay a thick cover of dust, as if no one had even laid eyes on this magnificent junk in decades.

  A skeptic by nature as well as training, Logan nonetheless could not wholly suppress the thought: Was it remotely possible these had once been used by Paul Ehrlich himself?

  Now, in the corner, he noticed a stack of wooden crates. Gingerly, he lifted off the top one and set it on the floor. Within were exquisite old bottles that had once contained chemicals, each protectively wrapped in a single sheet of yellowed newspaper. Though their contents had long since vanished, the raised lettering on several indicated what they’d held: concentrated HCl, H2SO4, ammonium hydroxide. Other bottles bore glued labels, now brown with age, the spindly handwriting faded almost to invisibility.

  Keenly aware that he’d already been down here too long—lunch might already have started—Logan began hastily rewrapping the bottles. But he paused to note the date on the newspaper—7 Juli 1916—and, despite himself, was soon caught up trying to decipher that long-ago day’s events. A terrible battle was in full swing—could it have been the infamous Battle of the Somme?—and the German people were being urged to even greater sacrifices on behalf of their Kaiser and his glorious troops.

  Logan picked up another discarded page to look for more. But his eye was quickly drawn to something else: a crumpled sheet of lined notebook paper, wedged in the corner. He picked it up and smoothed out the page. In pencil—difficult to read in the dim light—was the date 25 November 1916, followed by a line of tight script. But what seized his interest was the sketch beneath: twin hexagons sharing a common side and, protruding from the end of each hexagon, additional sulfonate molecules. He took a deep breath, sucking in the musty air. What he held in his hands defied all logic. A primitive version of Compound J!

  Carefully, he folded the page, stuck it in his pocket, and resumed putting the bottles back in the crate. Five minutes later, heart racing, he rejoined the group.

  Sabrina had always been good at keeping her feelings under wraps and she gave John Reston no reason to suspect she’d opposed his involvement with the project. Her philosophy on human relations was simple: Don’t go looking for problems, resist the impulse to make them. In scientific collaboration, especially, team harmony is essential—even, if as is often the case, it is forced or artificial.

  “Give him the benefit of the doubt, can’t you?” Logan had urged. “Give me the benefit of the doubt.” And that, finally, was what she’d decided to do.

  By now, even she was sure that was the right course. In the couple of days since Logan’s departure, her ill will had completely dissipated. Working with Reston on the protocol proposal, spending much of that Saturday hunched together over her computer, she found him every bit as bright as advertised; and what she had before taken as self-centeredness increasingly seemed nothing more than garden-variety masculine insecurity; the kind that, taken in the right frame of mind, can actually be endearing.

  What mattered was they were so obviously on the same wavelength. Given the severe handicaps under which the team would be operating—their youth, the fact that Compound J had failed so dismally in AIDS trials, the likelihood of serious opposition—the proposal had to be close to flawless. The distinctions between this protocol and all that had come before had to be meticulously spelled out, the case for its likely success vigorously and creatively argued.

  Like Logan, Sabrina had had the basic arguments for Compound J down pat for weeks. But it was only now, with Reston manning the keyboard, that she saw them being marshaled for maximum effect. He was a gifted editor—and in a field where such a skill is rare. Sabrina knew that Logan had been right: Reston’s presence could be crucial to the eventual outcome.

  By midafternoon they had completed a rough draft of the introduction to the proposal, six pages’ worth.

  “You are excellent with words, Reston,” she said, reading it over. “You make everything so cle
ar.”

  He smiled up at her. “Coming from you, I appreciate that.”

  “From the way it sounds, who would not wish to support such a protocol?”

  “It’s called piling on the bull. Now we get to the hard part—the particulars.” He paused. “Say, got any liquor around here?”

  She nodded. “But I do prefer not drinking and working at the same time.”

  “I figured maybe it was time for a break.”

  “Why? The sooner we start, the faster we will end, no?”

  Reston laughed. “I swear, sometimes you talk like someone in a spaghetti western.”

  “I do not know what this is.”

  “Don’t worry about it, it’s great.” He smiled. “C’mon, just a glass of wine?”

  She shook her head. “After.”

  “Look, I gotta tell you, I’ve got an agenda. There’s a good chance we’re going to have a serious argument in a few minutes, and I was hoping to dull your mind so you won’t win quite so easily.”

  She suppressed a smile. “Oh, yes? What kind of argument?”

  “Before we go much further, we’re going to have to discuss patient eligibility for this protocol. I have a pretty good idea where both you and Logan stand on this.”

  Sabrina was taken aback. The question of how relatively sick or well a patient ought to be to qualify for such a protocol was absolutely fundamental. She’d simply taken it for granted that it was something on which they’d all see eye to eye.

  To the outsider a seemingly straightforward medical question, in fact the matter of patient eligibility is also a political, even a moral, decision. Like edgy speculators in real estate or finance, many ambitious researchers will try to secure an edge in advance, limiting their treatment protocols to patients whose relative good health going in vastly increases the odds of a high success rate.

 

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