The Magic Bullet

by Harry Stein

  Logan could only smile wearily. “Actually, based on what I’ve seen, you’d probably do very well there.”

  When Sabrina opened her front door, Logan knew she had some bad news of her own.

  “What is it, Sabrina? What’s wrong.”

  “There was a call a while ago. From Pennsylvania. Mrs. Rhome died today.”

  He hardly reacted at all—the same way she took his news from Delaware. Whether by training or instinct, they pressed on.

  There was, after all, something vital upon which to focus. If Compound J was killing the very women whose cancer it destroyed, there still remained one such woman unaccounted for.

  When there was no answer at Mrs. Kober’s home, Logan suspected the worst.

  “Relax, Logan,” said Sabrina, though she was thinking the same thing. “Probably she’s just not at home. We would surely hear something otherwise.”

  “At ten o’clock at night? Where would she be?”

  “You left a message. When she gets it, she will call.”

  But when they didn’t hear from her, both spent a fitful night; and it was Sabrina who awoke early—before six o’clock—to call again.

  “Listen,” she repeated, with diminished conviction, “if she’s in a hospital, someone would call us. There is no doubt.”

  “If they knew they should.”

  “This is what happened with Mrs. Williams and Mrs. Rhome.”

  “Both of them had family. Mrs. Kober is alone.”

  1 November 1937

  Frankfurt

  More and more I see that my own profession is as bad as the rest. Worse! For should not these men be dedicated above all others to truth?

  Today I learn Eisenstadt has been arrested in Berlin. One of our greatest chemists. For what? No reasons are needed anymore! Yet not a word of protest.

  Best results yet on version #612. Toxicity marginal—diminished energy and slight loss of appetite. Reason for hope? Must get more rabbits somehow!

  Emma nearly ill with fear. Cannot blame her. Who will be next?

  Thinking back on it later, Logan was most amazed by not how quickly their support melted away, but how unembarrassed some of his co-workers were by their own behavior. But that morning, arriving at the ACF, there it was. He was a pariah.

  Individuals who after the Grand Rounds presentation, barely a week before, had embraced him as a close friend and colleague, now hurried by stonefaced. More than simple slights, these were willful acts of negation, meant to instantly dispel any illusion Logan might have that there existed a relationship between them.

  Logan knew he shouldn’t be surprised. After fifteen months at this place? What the hell’s wrong with me? But he was, more than he let on.

  That afternoon he found the note in his box. He would learn it was identical to the ones Sabrina and Reston found in theirs. Written on the stationery of the director of the Medical Branch, it was vintage Larsen; devious even as it seemed to come right to the point:

  In light of recent developments surrounding the clinical trial of Compound J in metastatic breast cancer, and because of questions that have arisen about the conduct of this trial, as well as other issues, you are hereby requested to meet with representatives of the Department of Medicine. This meeting will occur tomorrow, Friday, October 14, at 3:00 P.M. in the conference room of the Department office.

  Logan noticed that Larsen had signed his name with an unusually zestful flourish.

  * * *

  At least the timing was a blessing. As most experienced doctors know, human nature tends toward the morbid; in desperate circumstances, almost anyone with enough time to fret about the possibilities starts dwelling on the worst. More than once, Logan had himself seen patients in for serious surgery, at first upbeat about their chances, then increasingly drained of spirit when the procedure had to be delayed.

  Now, with the meeting barely twenty-four hours off, they had far too much to do to let their imaginations run wild. There were patient records to comb through, autopsy findings to be reexamined, a defense of the protocol to be prepared.

  After all, reality was more than bad enough. Larsen clearly intended to rake them over the coals; and probably, finally, if he could find a way to circumvent normal procedures, try to shut down the Compound J trial by executive fiat.

  Beyond that?

  Realistically, what could he do? Ten months remained on the two-year contracts they had signed as incoming junior associates. And, in any case, despite everything, who could deny their promise as oncological researchers? Even at the ACF, vindictiveness had its limits. The likeliest scenario was a stem reprimand, a PR move designed to ward off potential embarrassment. Patients on this trial were dying. If the press got wind of it, the ACF had to be seen as having taken some action.

  At any rate, this is how Logan evaluated things. Even Sabrina, the ultimate pragmatist, chose to see the positive aspects of what was obviously to be a painful encounter. They would take their shots, but at least there was to be a dialogue; a chance, after all the simmering hostility and silent undercutting, for them to make their case.

  And as they worked on it in the library that day and into the evening, that case seemed to them eminently defensible. Yes, of course there had been setbacks, major ones. They were more heartsick about the Compound J–related deaths than anyone. They’d come to know these women, in a couple of cases to admire them deeply.

  But, as those who’d be assessing them well knew, developing new cancer treatments was a gruesome business. It must not be forgotten that this had been conceived as a highly experimental trial; initially its object had been nothing more than to establish that this compound was active. In fact, it was only because they had so dramatically exceeded that goal that it could now be viewed as a disappointment. Suddenly Compound J was being judged by the much more rigorous performance and safety standards normally applied to drugs in Phase Three trials.

  Who could doubt, even now, that it would be a mistake to abandon this drug?

  The logic seemed so compelling that by late evening, Sabrina wished it were already the next day.

  “This night will be hard, I think,” she told Logan as he pulled up before her apartment. “Waiting is the hardest.”

  “Tell me about it. God, I hate those bastards.”

  She led him inside. “It is late,” she said. “Just one glass of wine”—then retreated to the back to check her messages.

  “Logan,” she said, reappearing a moment later. “Come here.”

  “What?”

  Wordlessly, she took his hand and led him toward the bedroom. Sitting on the edge of the bed, she punched a button on her answering machine. After a brief pause, there came the familiar voice.

  “What’s all this fuss about?” demanded an obviously perplexed Mrs. Kober. “I get back from my sister’s and there are three messages on my machine. Anyhow, if you still need me, I’ll be in tonight. If not, I’ll be in next week for my regular treatment.” She laughed. “Hooray! The last one!”

  “That’s some good news, no?” said Sabrina. “Maybe an omen.”

  Logan smiled. “Think we ought to give her a call?”

  Snatching up her book, she dialed the number.

  It turned out that Mrs. Kober had indeed felt ill briefly several days before. “A little fluish, you know? That’s why my sister was looking after me.”

  “But now it is past?”

  “It was the flu—a few chills, a little vomiting, and it went away.” There was a questioning tone in her voice. “Why, what’s going on?”

  “Then you are all right now?”

  “Don’t hold back on me, Dr. Como. Is there something I should know?”

  Logan, listening to her end of the conversation, watched Sabrina shrug. “Some people on the protocol have gotten quite sick, so we are checking. But, no, it sounds like you are fine.”

  “I am fine, you sweet girl. But if that changes, I promise, you’ll be the first to know.”

  When Sabrina
got off, she grinned at Logan. “For her, I really think this drug has worked.”

  “Forget the omens, that’s called ammo.”

  “You’re right. We must go in that room tomorrow aggressive.”

  He reached out for her across the bed. “Why does it do something to me when you talk that way?”

  “Because I almost never do.” Smiling, she gave his hand a loving squeeze. “Not tonight, Logan, I want you to go home. We must both be alert for tomorrow.”

  At least there wasn’t any suspense. As soon as they walked into the room, it was clear the process was rigged. Larsen sat at the head of the conference table. Around him were a who’s who of the protocol’s enemies: Stillman, Marion Winston, Peter Kratsas, and, representing their peers, Allen Atlas.

  Also present, of course, looking utterly miserable in his seat at the opposite end of the table, was John Reston. As Logan and Sabrina moved to their own places nearby he nodded, but—at least some of the others had to notice—edged his chair a couple of inches in the other direction.

  Larsen looked solemnly around the table. “Thank you all for being so prompt,” he began. “Courtesy is something I’m afraid we could use a lot more of at this institution. Now then, let us move on to the business that brings us here.

  “You are all by now aware of the deaths of several patients on the roster of the trial of so-called Compound J. I am sure you share my sense of the extreme gravity of this situation.” He paused, leaning forward slightly, his blue-gray eyes boring in on the Compound J team. “And I must tell you, it is my intention to rectify it.”

  Only now did Logan see with absolute clarity how bad it was going to be. There would not even be the pretense of allowing them their say. The verdict was already in, it was just a matter of going through the formality of reaching it.

  Larsen turned to the patient care rep. “Ms. Winston, I believe you have some preliminary observations.”

  Logan sneaked a sideways glance at Sabrina. Her expression was absolutely blank, but the rhythmic movement of her jaw muscles let him know her insides were churning as much as his.

  “Yes, I do,” said Winston evenly. She opened a file folder and stared down at the page. “This is not a pleasant exercise for someone in my position to have to go through. I am interested in helping people, that’s why I got into this business. I am not interested in doing harm to anyone’s career.” Now she looked up and surveyed the table. “But I’m afraid there is considerable evidence that at least one member of this team, its principal investigator, Dr. Logan, has been extremely negligent in regard to patients. I expressed this concern before this protocol was approved, and in light of what’s occurred since, I feel it even more strongly today. I would like to bring before this group two women who have had what can only be called emotionally devastating experiences under this doctor’s care.”

  Logan, flushed, raised his hand. “Excuse me—”

  “You are speaking out of turn, Doctor,” reprimanded Larsen. “Please allow Ms. Winston to continue.”

  “I was only going to say,” pressed Logan, “that I could produce any number of patients who—”

  “Perhaps you could,” he was cut off. “But this is not a game of numbers. Treating even one patient with contempt is unacceptable.”

  Logan sunk down in his seat, resigned.

  The women, of course, were Rochelle Boudin and Faith Byrne.

  Called in first and taking her place at the table, Boudin went through the litany of Logan’s supposed abuses. How he’d systematically neglected her needs. How he’d made a point of belittling her concerns. How he’d consistently failed to deliver the treatment her condition demanded. “He just always made me feel,” she summed up softly, “that the fact I had cancer was an inconvenience to him.”

  The bitter thought, having crossed Logan’s mind, refused to leave: Funny, isn’t it? If I treated you so miserably, how’d you end up cured?

  Byrne, who followed, was even worse. In self-dramatizing detail, she told the story of her initial treatment with Compound J: emphasizing her concern—and his complete absence of same—for what turned out to be the drug’s very real dangers. Never mind that she was, at the time, being carefully monitored and showed no danger signs; never mind that the best measure of Logan’s performance was the fact that she was sitting here, right now, alive; Byrne’s fable was accorded serious weight. Around the table, she was met with sympathetic nods.

  “The worst of it,” chimed in Winston, “was that subsequently, on his own authority and against her will, Dr. Logan removed Mrs. Byrne from the protocol. I personally regard this as an act of petty vindictiveness.”

  At this, Logan actually came close to smiling. These people would say anything. Which was it—he was a monster for knowingly subjecting patients to a horribly dangerous drug, or a monster for NOT allowing them to take it?

  But by now, logic seemed the farthest thing from anyone’s mind.

  “I’d like to say something, if I might,” said Allen Atlas, as soon as Byrne left the room. Ever the kiss-ass, he glanced meaningfully toward Stillman and Kratsas. “I don’t know if this is the appropriate time to raise this, but one thing that might be considered here is that Drs. Logan and Como developed a second, related drug. They call it Compound J-lite, I believe.”

  Beside him, Peter Kratsas snorted. “Real clever,” he observed, sarcastically.

  But Logan was too stunned to notice. How did Atlas even know about the variant on the original drug?

  “When tested in lab rabbits,” continued Atlas, “this compound at first showed a good deal of activity—followed by extreme toxicity.”

  “I think what Dr. Atlas is driving at,” picked up Stillman, speaking for the first time, “is that this is the same pattern observed in the deceased patients. Now, obviously this is speculation. The evidence is only circumstantial.” His eyes narrowed and he flashed an odd half-smile. “But it seems the possibility must be considered that these doctors substituted this second drug for the one that had been approved for protocol use.”

  Instantly, Logan was on his feet. “That’s a damn lie! Compound J-lite was a private experiment. We did NOT violate the protocol!”

  “Dr. Logan, sit down!” shouted Larsen.

  “Logan is right,” said Sabrina loudly, pointing a finger Stillman’s way. “You know we did not do this thing! Why would you say so?”

  It was as close to losing control as anyone had ever seen her, and momentarily Larsen seemed at a loss. “Dr. Como … please.”

  “No, this is not to be smoothed over. To say such things, that is wrong—not what we did!”

  “All right,” said Larsen, decisive again, “we are going to take a break now. And when we come back, I expect both of you”—he stared at Logan and Sabrina—“to control yourselves. You are not doing yourselves any good here.”

  Leaving the room quickly, they moved down the corridor, turned up another, and retreated to a quiet corner. Both were seething. “I’m going to bring up Mrs. Kober,” said Logan quietly. “We’ve gotta say something on the drug’s behalf.”

  “They will not let you.”

  “We should’ve brought her down here, no way they could’ve stopped us.” He shook his head bitterly. “That son of a bitch Atlas. How’d he even know about those fucking rabbits?”

  “Oh, here you are!”

  And there, to their astonishment, stood Gregory Stillman.

  “Sorry to interrupt,” said Stillman, ingratiatingly, “I know how it is.” He nodded back toward the meeting room. “Tough going in there.”

  Sabrina eyed him with undisguised loathing. “What kind of man are you, Dr. Stillman?” she said, her voice hard enough to cut glass.

  In response, he actually managed a smile. “Look, I understand how you feel. I really do. All I can tell you is that it’s not personal. We’re competitors, sure, but we share the same goals.” He paused. “Dr. Logan understands that, don’t you?

  “Me? Not for a second.”

/>   “Your friend Reston does.” He flashed that smile again. “I’ve just gotten through talking with him.”

  Logan and Sabrina exchanged a glance, but made no reply.

  “Look,” added Stillman, a model of sweet reason, “no one denies you’ve had some interesting results. But when there are legitimate questions about methodology, we’ve got an obligation to raise them.”

  Abruptly, Logan knew what this was about. “You want to take over this drug, don’t you?”

  “That’s a hell of an accusation,” said the other, without missing a beat. “Let’s just say that, given the history of this protocol, it’s pretty obvious it could use an experienced guiding hand.” He looked from one to the other. “I’d even say Compound J’s finished without it.”

  “No,” said Sabrina flatly. “We don’t even want to talk with you!”

  Stillman shot her daggers. “You don’t want to talk to me? Perhaps you fail to grasp the position you’re in.”

  “You’re doing this to us only because your own protocol has shown no results. Anyone can see that!”

  Logan could see the effort it took for the man to retain a semblance of calm. No one spoke to the esteemed Gregory Stillman this way. “Well,” he said, “why don’t we just let your boyfriend, the principle investigator here, answer for himself?”

  “So we would still have a major role?” asked Logan evenly.

  “Absolutely. This has been your baby. I don’t for a second flatter myself that I could pull this off without you.”

  An astonishing admission. This guy wanted this thing bad.

  But Logan’s interest in the proposition was as counterfeit as his seeming calm. The bastard’s intention couldn’t have been clearer if he posted it on the bulletin board in the administration building: Compound J was to become a Stillman project. Their dogged work with the compound would earn them nothing more than inclusion among a long list of junior associates—if that. For who could doubt that, once Stillman had his hands on their research, he’d cut them out entirely?