The Magic Bullet

by Harry Stein

  Sabrina paused a moment before responding. “Where do I stand?” she asked, betraying nothing. “This is something I have not even decided.”

  “I’d guess you’d want patients at fifty to sixty percent on the Karnovsky Scale.” The reference was to the standard shorthand measure of a cancer patient’s condition. Ninety percent or above means close to fully functional; thirty percent, bed bound; ten percent, moribund. At fifty to sixty percent, a patient would most likely be in decline; still ambulatory, but easily fatigued and steadily losing weight.

  She couldn’t argue. That was precisely the sample that would accurately gauge Compound J’s effectiveness. “And you would want something higher? Sixty to seventy?”

  “Eighty-five and above.”

  She snorted. “These people are almost well already. These people you can take out dancing. Or”—she strained to come up with something appropriately outrageous—“watch them play American football!”

  “What’s wrong with that? Damn good game.”

  Sabrina felt herself flushing. Eminently reasonable herself, she was always at a loss in the face of what she took to be lunacy. “Listen to me, Reston, do you not believe in this compound? Logan and me, we do. Very much.”

  “You understand all our careers are on the line here? You DO understand that?”

  “And a trial with such a bias? This will help your career?”

  “Don’t exaggerate, these women are sick with breast cancer.”

  Her rising contempt was hard to hide. “Such a proposal”—she shook her head—“when the data comes out they will laugh. And they will be right.”

  “Think of it as a negotiating position. We can drop down to eighty percent, maybe even a little lower.”

  “We should not discuss this now. We will all talk when Logan has returned.”

  Turning her back to him, she worked to regain control.

  “What should we talk about, then?”

  “I do not know.”

  “Is there an Italian version of the expression beautiful when mad?”

  “What?”

  “There should be.”

  Suddenly, incomprehensibly, she felt his arms around her waist, his breath against her neck.

  “John, what are you doing?”

  He didn’t move. “I guess this isn’t the greatest time to try this, huh?”

  “You STOP. Right now!”

  “But you look so good, I can’t resist. I’ve been thinking about it all day.”

  She twisted her upper body, trying to pull away.

  “Hey, take it easy.” He kissed her neck. She could feel his crotch pressing against her. “C’mon, Sabrina, what’s Logan got that I don’t?”

  “Bastardo! Figlio di puttana!”

  With a violent lurch, she wrenched herself free.

  He held up his hands in a gesture of uncomprehending innocence, like a basketball player unjustly charged with a foul. “You’re not interested, fine. It was worth a try.”

  “You get out, Reston. Right now!”

  “C’mon. don’t be stupid. Let’s get back to work.”

  “You get out NOW.”

  Never had he heard any words spoken more coldly.

  “Look, I’m only human. It won’t happen again.” But already he was reaching to a nearby chair for his down jacket. “I really mean it, Sabrina, I’m sorry.”

  He zipped the jacket closed and took a few steps toward the door. “Please, let’s just keep this in perspective, all right? And to ourselves.”

  Before the conference was half over, Logan had decided it was impossible to compete with Shein’s private life. He would save the subject of Compound J—and the forthcoming protocol proposal—for the trip home.

  Yet two hours into the return flight, he was still trying to find an opening. To his frustration, if not his surprise, once again he was the captive audience, forced to listen to the particulars of Shein’s latest escapade. It seemed things had worked out well with Christina after all. Though she had persisted in refusing to listen to reason on the probabilities of HIV transmission, she’d revealed a delightful and unexpected kinky streak: they’d spent most of their last afternoon together reading aloud pornographic letters from back issues of Penthouse. “A terrific young woman!”

  Now, his tale complete, the scientist appeared to be dozing contentedly.

  “Dr. Shein, is there any particular aspect of the conference you’d like to discuss? I took extensive notes.”

  “Later.”

  He hesitated. “I had quite a particularly interesting experience when I went to the place where Paul Ehrlich once worked.”

  Shein didn’t so much as open an eye. “I know about that lab. They’re not doing anything worth wasting your breath on.”

  “It has nothing to do with that. I went into the basement and ran across some equipment. Ancient stuff. I have a pretty good idea it’s from Paul Ehrlich’s own lab.”

  He sat up and looked at Logan in genuine surprise. “What the hell were you doing in the goddamn basement?”

  “Well, see—”

  “Take anything? Get any souvenirs?”

  Flustered, Logan reached into his inside jacket pocket for the sheet of paper. “This.”

  “Thattaboy.” He reached out a hand for it. “Schmuck, don’t you know I could have you arrested?”

  Putting on his reading glasses, Shein looked it over quickly.

  “I found it in a crate of old chemical bottles. As packing.”

  “And?”

  “Well, I thought it was pretty interesting.”

  “Why? Some scribbling on an old scrap of paper?”

  “You’re right. But if you look at it closely …”

  Shein shot him a hard look. “Logan, when the hell you gonna come clean? You and I both know this is an early version of the chemical structure you and the Italian babe have been looking at.”

  Now that the moment had presented itself, Logan found himself completely unprepared for it. “That’s right,” he acknowledged.

  “What do the words say?”

  “The words?” He looked at the page as if for the first time. “You want a translation?”

  “Yes, Logan, I believe that’s what they call it.”

  “Well”—he hesitated. “Basically, it just describes the compound in the picture.”

  “A polysulfonated aromatic.”

  “But the language is strange, a bit stilted. I was thinking it might’ve been written by one of Ehrlich’s Japanese researchers as part of some kind of journal—”

  Shein brushed this aside. “Deal in facts, Logan. What does this little find of yours mean?” He waved the paper aloft. “If anything.”

  “Well”—he paused—“I think it’s pretty meaningful. I mean, we’d read that this compound may have originated in Germany, way back when. It’s fun to find what seems like direct confirmation.”

  “So which is it, Logan—meaningful or fun? You’re a scientist, they’re not the same.”

  Logan looked crestfallen. “No, I suppose it doesn’t mean much—not in scientific terms.”

  “All right. You want fun, go body surfing. Or go fuck something.” He paused. “Now, we got time to kill: I want the whole story of what the hell you’ve been up to. Every detail.”

  So over the next couple of hours he told it, starting with Larry Tilley’s appearance in the examining room. Shein sometimes seemed impatient—cutting into the narrative with a sharp comment or a challenging question—but his interest never wavered.

  “Compound J for breast cancer?” he said at the end. “Well, it’s a novel notion, I gotta give you that. Where do you stand now?”

  “I’m hoping Sabrina and Reston will have something on paper when we get back.”

  “So it’s just you three?” His tone was ominously noncommittal.

  “So far.”

  Closing his eyes again, he settled back in his seat. “Sounds like a pretty involved way to set up a ménage à trois, if that’s wha
t you’re after.”

  Logan’s reaction was sharper than he intended. “Look, Dr. Shein, I don’t need to hear that. We’ve put a lot of time into this project. We think it has real potential.”

  Surprised, Shein opened his eyes and shrugged—as close as he knew how to come to an apology. “Oh, excuse me, you didn’t say you were shtupping her. Why the hell are you always less open with me than the other way around?”

  “I’m just trying to tell you how much—”

  But Shein cut him off with a consoling squeeze on his arm. “It’s a good idea. I’m impressed. Of course, I’ll wanna see your data. I’ll wanna see your proposal.”

  “So you’re interested? You’ll help us?” asked Logan, flabbergasted.

  “Why do you think I took you along on this goddamn trip?”

  21 September 1919

  Frankfurt

  An anniversary of sorts—six years exactly since we began working on the compound in the laboratory of Professor Ehrlich. How long ago it seems! How naive I was to think answers could be found quickly! Many days now I despair that they will ever come.

  Near the end of the war we thought things could not get worse. Now we know how wrong we were! Everyone is hungry. Beggars everywhere! Naturally, some work supplies impossible to come by. We joke of catching rats for laboratory use in the cellar—only, seeing the larder empty, they have all fled.

  Still, I press on. This morning, finished latest variation of the compound: #74—beautiful white crystals, darkening slightly upon exposure to sunlight. Am hopeful of increased activity. Perhaps answer is in the length of molecule!

  More than ever, I miss Dr. Ehrlich’s strength and counsel!

  Staring at the page, bone tired, Reston suddenly began to laugh. Across the room, Logan and Sabrina simultaneously looked up from the pages they’d been reading.

  “I don’t know about you guys,” explained Reston, “but I’ve read this damn proposal so many times, it doesn’t even register anymore. It might as well be in ancient Greek.”

  “We are all tired, Reston,” snapped Sabrina. “That’s no reason to stop working.”

  “I mean,” added Reston, ignoring this, “I just read providing a meaningful cure as procuring a meaningful whore. I didn’t think we’d put in anything so interesting.”

  “I’ll bet that would catch their interest,” said Logan.

  “Especially Shein’s,” agreed his friend.

  Logan laughed; he’d naturally passed on every detail of his remarkable conversations with the senior man.

  “This is nothing to joke about,” said Sabrina sharply. “I do not think Shein wants a protocol to laugh at. Or the review committee either.”

  Once again, Logan found himself caught short: What was going on with her? Why these sudden lapses into humorlessness? And the constant low-level hostility toward Reston?

  It had begun the very day he returned from Germany. That evening, over dinner, Sabrina told him of their seemingly irreconcilable differences on the issue of patient eligibility.

  “This is a big conflict,” she put it. “I know you like Reston, but I really do not think we can let this man work with us.”

  Logan, too, recognized the argument as a source of serious concern. Yet he found that when it came down to it, Reston proved eminently—even uncharacteristically—reasonable. True, he forcefully made his case at their first joint meeting after the holidays, producing statistics on the success rates of similar protocols over the years to buttress the arguments he’d made to Sabrina. But once it became clear he was not going to win, he made no attempt to drag out the battle.

  “So,” Logan asked, “I take it you still want to be part of this? Even though we can’t guarantee success?”

  “Hey, what else have I got going? I mean, it’s not as if I didn’t expect it. If this thing’s gonna work, I guess we’ll all have to get used to majority rule”—he smirked—“even when the majority’s wrong.” And, opening up his briefcase, he produced a split of champagne. “I think a toast’s in order.” He looked meaningfully at Sabrina. “Something along the lines of ‘All for one and one for all!’ ”

  In the weeks since, the scientific disagreements among the three of them had been minimal. Yet Sabrina’s attitude toward Reston seemed unchanged. Nor did Logan find himself able to discuss it with her. The couple of times he tried, she flatly refused to acknowledge there was even a problem.

  “Look,” Logan said now, “we’re all nervous about Shein’s reaction to the draft. Why don’t we try and relax?”

  “Bet I’m not as nervous as you,” offered Reston. “Shein expects nothing of me.”

  “Thanks a lot,” said Logan, conceding the point. “It’s so great to know you’re always there with a reassuring word.”

  In fact, since he was the one who’d recruited Shein as senior advisor to the project—and the senior man so obviously saw him as a comer—Logan had infinitely more at risk than his colleagues. So far, Shein had kept his distance, choosing to let the three junior associates work out the draft of the protocol proposal on their own. It was a courtesy that was also a challenge: only now, having studied it, would he let them know whether he’d give them his full backing.

  “Well,” said Logan, sighing, “we’ll know in”—he glanced at his watch—“anytime. How do you like that, the son of a bitch is late!”

  “Me, I am not worried,” reassured Sabrina. “It is good work.”

  Sighing, Logan flipped his copy of the protocol proposal shut; at fifty-five pages, plus reprints of six articles and other supporting data, it had the solid feel of a corporate annual report.

  That was part of the point, of course. Even with Shein’s support, the task before them would be daunting: to impress upon a skeptical review board that, though young and woefully inexperienced, they were dedicated and resourceful researchers, working on something with genuine promise. Yet—this is what made the balancing act so exceptionally complex—neither could they risk appearing unrealistic about their goals, or more than modestly hopeful about their chances for success.

  In fact, starting with the title, “A Phase Two Clinical Trial of Compound J in Metastatic Breast Cancer,” they’d lent the proposal a tone of calculated blandness; as if it had been written by a trio of old, knowing souls, certain only that the world almost never surrenders its secrets.

  Too, they’d paid unusual attention to the Informed Consent Document that made up the proposal’s concluding section. Since Compound J had no clinical history as an anticancer agent, they could only speculate on how patients treated with it in such a trial might react. But this they made a point of doing at considerable length, listing possible toxicities that other researchers might have readily discounted.

  They’d given the same care to almost every aspect of the proposed trial. The toughest decisions after the one on patient eligibility had been essentially technical. They involved the dosing schedule and—since Compound J cannot be absorbed if taken orally—the choice of which intravenous delivery system would prove more effective: a continuous drip or more concentrated doses in sporadic bursts, via a large slug known as a bolus.

  After several long evenings of largely fruitless back and forth, they’d opted for the drip. After all, like so much else, such a choice finally involves little more than guesswork. Were cancer cells more likely to be worn down by a steady level of medication in the bloodstream? Or would they be destroyed only if overwhelmed by toxins—a course that obviously could also place healthy cells at greater risk?

  In the end, it was this possibility that determined their decision. The drip was clearly the more conservative choice; and, determined to come off as responsible, they decided, after hours of discussion, that made it the sounder one.

  “Sorry,” offered Shein, when he finally turned up at Logan’s apartment, forty minutes late, “a guy from Health and Human Services came by my office and I couldn’t get rid of him.”

  “That’s okay, Dr. Shein.”

  “Those
bureaucratic bastards never rest. Now they want summaries of every damn clinical trial going on at the ACF. Can you believe that? It’s not like they’d even understand what they were reading!”

  Logan nodded, impatient. “Right.” How long did Shein plan to string them along?

  “Well, glad to see you’re all here.” Shein laughed. “I love this cloak-and-dagger stuff. I trust you were all careful you weren’t followed.”

  “May I take your coat, Dr. Shein?” asked Logan.

  “It’s Seth, Logan. How many times you gonna make me tell you that?”

  Logan naturally took this as an encouraging sign. He smiled. “Sorry. May I take your coat, Seth?”

  “No, Alice expects me home—I gotta spend a little time with her, too, for Chrissakes. What I have to say won’t take long.”

  It felt like a blow to the solar plexus, but Logan showed nothing.

  “Not a bad place,” observed Shein, glancing around the room.

  “Thank you.”

  “So—what?—you furnish it totally through the Salvation Army or did you step up to Goodwill?”

  “Actually, Dr. Shein—excuse me, Seth—I went to Ikea.”

  “What’s wrong with you, Logan, losing your sense of humor?”

  “He does that a lot,” piped up Reston. “Not one of his better traits.”

  “I think,” said Sabrina evenly, “that we all are concerned to hear what you think of the proposal.”

  Shein beamed her way. “See that. At least one person here’s got the balls to say it straight out.” Unbuttoning his coat, he tossed it on an empty chair. From the inside pocket of his rumpled tweed jacket he removed a folded copy of the protocol proposal. It appeared to have been well read. “You got something to drink in this place?”

  “Please, Dr. Shein.”

  Shein cast Logan a baleful glance. “Okay. It’s good. It’s very good.”

  Logan could breathe again. He waited an instant. “You really think so?”

  Shein looked from Reston to Sabrina, the pleasure—or was it just relief?—apparent on both faces. “Wait a minute. Not that I don’t got some serious criticism.”