Miracle Cure

by Michael Palmer

  They found two seats on an aisle toward the right, six rows back from the stage, which was a half-circle about twenty feet across and ten deep, raised three feet off the floor. Hazy sunlight filtered through the stained glass, painting the room. The huge screen behind the stage was down. Seated between it and the narrow lectern were Ernest Pickard, Art Weber, Carolyn Jessup, and, at the end nearest to where Phil and Brian were sitting, a woman in her early-to-mid-thirties.

  “She’s the FDA person?” Phil said, incredulous. “She looks like Jodie Foster on a good day.”

  “What’s that disbelief in your voice supposed to mean, you sexist pig?”

  “Hey, I am what I am, Bri. That woman up there not only has Jodie’s looks, she’s either an M.D., a Ph.D., or both. That impresses me as much as it intimidates me.”

  “Jodie Foster graduated from Yale, Phil.”

  “Well, she intimidates me, too. It’s genetic. My mother used to scare the crap out of me.”

  Brian wasn’t sure the woman on the stage resembled Jodie Foster all that much, but he would have been lying to say that her fine features and warm coloring weren’t incredibly appealing to him. She was San Francisco to Carolyn Jessup’s Upper East Side Manhattan. And at that moment, facing a full house in one of the nation’s foremost teaching hospitals, she didn’t look the least bit ill at ease.

  At the stroke of twelve, Ernest Pickard approached the lectern.

  Phil leaned over to Brian and whispered, “Distinguished Ernie, Elegant Carolyn, Leading Man Art, and Jodie. It’s like a frigging casting call up there. The only thing missing from the group is you as mild-mannered reporter Clark Kent.”

  “Ladies and gentlemen,” Pickard began, “welcome. These are exciting times for White Memorial Hospital and Boston Heart Institute. As you know, for the past several years we have been involved in a joint research effort with Boston-based Newbury Pharmaceuticals. Today, we would like to share the results of our investigations with you. But first, I would like to introduce those who will be conducting these rounds with me. Dr. Carolyn Jessup, professor of cardiology and associate director of BHI; Dr. Art Weber, director of the Vasclear project and liaison from Newbury Pharmaceuticals to BHI; and finally, our special guest, Dr. Teri Sennstrom, team leader of the cardiovascular drug evaluation unit of the Food and Drug Administration.”

  “Teri,” Phil whispered. “I like that name. You must, too. You’ve been staring at her nonstop.”

  “Put a sock in it, Phil.”

  The first half-hour of Grand Rounds told Brian nothing new. It was a coming-out party for Vasclear, complete with a glossy slide show presented by Weber that chronicled significant milestones in its life. Following Weber, Carolyn Jessup got more scientific, with a discussion of dosage schedules and clinical results, as well as before-and-after arteriogram shots from several patients. She worked the stage, lectern, screen, and audience like a symphony conductor.

  Throughout the presentations, despite his reluctance to prove Gianatasio correct, Brian had trouble keeping his eyes off Teri Sennstrom. But even more unsettling was that she often seemed to be looking straight at him as well. Their connections were brief and never acknowledged by either of them with so much as a nod. But they were real. Brian was certain of it.

  Jessup wound down her presentation and entertained a few scientific questions, for which she was so well prepared that Brian wondered if they had been planted. Then she reintroduced Teri Sennstrom.

  “You got her phone number yet?” Gianatasio whispered as Teri approached the lectern. “She looked like she was blinking it out to you in Morse code.”

  “Philip, will you grow up?”

  “ ‘When the moon-a hits-a you eyes like a big-a pizza pie …’ Hey, I don’t see a wedding ring.”

  Brian was too proud to admit that he had noticed the same thing. A list of his personal attributes would never have included dealing cheerfully with being teased.

  “This is science,” he shot back. “Pay attention.”

  Teri Sennstrom was wearing a brown gabardine suit with a cream-colored blouse. Her dark blond hair was held back in a tortoiseshell clip, revealing small pearl earrings. Facing four hundred souls in a steeply banked amphitheater, she appeared a bit more tentative than she had while sitting in the background.

  Please, Brian thought as she set some file cards of notes on the lectern. Please tell me what to expect for my dad.

  “Well, this is quite a day,” Teri began, after thanking her hosts and conveying the best wishes and hopes of FDA chief Dr. Alexander Baird. “We appear to be at the leading edge of a miraculous advance in cardiovascular pharmacology. The data presented in brief here is a distillation of thousands of pages of reports and dozens of arteriograms, which my team at the FDA has been reviewing for over a year. We are impressed, Dr. Weber, with the care and thoroughness of your research design. We are impressed, Dr. Pickard and Dr. Jessup, with the scrupulous manner in which the research protocol has been carried out. And mostly, we are impressed with the results to this point.

  “It is Dr. Baird’s wish, as well as that of the President, that the patients in need of this drug receive treatment with it as soon as possible. To do so means that we will have to make concessions to the importance of Vasclear, just as our agency has done with other drugs in the past. Dr. Weber, Dr. Jessup, Dr. Pickard, we at the FDA believe that we are in the homestretch in our evaluation process. Dr. Baird feels that Vasclear deserves the status of a lifesaving new drug, and it is his intention to move forward with its approval for general use.”

  A smattering of applause began and spread quickly throughout the hall, reverberating off the stained-glass ceiling until the Hippodome seemed to quake.

  Yes! Brian thought. Yes!

  “Our goal is to sign our approval of Newbury Pharmaceuticals’ new-drug application for Vasclear in this historic amphitheater in two weeks.”

  Again there was applause. Gianatasio pumped his fist.

  “You think you can keep your old man going that long?” he asked.

  “We can try,” Brian replied, suddenly wondering what preexisting factors might distinguish the twenty-five-percent failures from the rest. Two weeks, he was thinking. We can do two weeks.

  “Now, however,” Teri continued, “it is time for us at the FDA to ask a favor of you. As you know, our mandate is to protect the safety of the public while not unnecessarily delaying the release of any needed medication. I would like to encourage every one of you who has questions or information on Vasclear—positive or negative—to contact me. Dr. Weber and Dr. Jessup were aware that I planned to make this request, and it is to their credit that they stand by it one hundred percent. May I have the slide, please.”

  The lights dimmed, and a slide with Teri’s name, the Rockville, Maryland, address of the FDA, and an 800 phone number appeared on the screen.

  “She spells it with an ‘i,’ ” Gianatasio whispered. “I like women who end their first names with ‘i.’ ”

  “Even when they have an M.D. or a Ph.D.?”

  “I don’t know. I don’t think I’ve ever run into that combination before.”

  “Again,” Teri Sennstrom was saying, “any of you who has worked with this drug or with patients who have received it are encouraged to call my office with reports of any adverse effects or unexplained symptoms. I promise that your call will be treated with the strictest confidence. I cannot stress enough that it is much, much easier to keep a drug off the market than it is to stop its sale and recall it once it is in general use. Several times over the next two weeks, I intend to be here at Boston Heart and White Memorial. I’ll be happy to meet with any of you in person to discuss any aspect of Vasclear. Meanwhile, I think you can all share in the pride of what your institution has accomplished. Thank you.”

  The applause was vigorous, and for a moment, Brian thought the staid staffs of WMH and BHI were going to give Teri a standing ovation.

  “Well, she’s a winner,” Phil said, as the crowd rose and beg
an to file out of the dome.

  “She is that,” Brian replied, already planning how he was going to get the next two weeks’ worth of Vasclear.

  “You going to meet her?”

  “Another time, maybe.”

  “How about now?”

  Brian shook his head.

  “Can’t.”

  “Well, I think you should reconsider.”

  “Why?”

  “Because she’s about ten feet behind you and she’s coming right this way. You’re on your own, pal. I’ll watch the master at work from afar.”

  Before Brian could respond, Phil was lumbering up the stairs. Brian, standing with a group of others, turned just as Teri Sennstrom arrived. She shook hands with each of them, but hesitated a second longer with Brian, and turned away from the group just enough so that she could speak to him without being overheard. Her eyes met his for a moment.

  “Please call me at the Boston Radisson Hotel, room four-eighteen,” she said softly before turning away with a bright smile for an approaching hospital official.

  CHAPTER FOURTEEN

  THE RADISSON HOTEL WAS LOCATED JUST A FEW BLOCKS from White Memorial. Brian signed out to Phil for an hour and a half, and following Teri Sennstrom’s instructions, took a circuitous route over Beacon Hill, past the State House, and back down to the hotel. He entered it through the main lobby, then took the stairs to the fourth floor and room 418. Teri had insisted that he tell absolutely no one about their meeting, including the friend who was covering for him. She had not backed down when he protested, and had promised him a full explanation for the cloak-and-dagger secrecy. And in the end, Brian told Phil Gianatasio that his therapist had found it necessary to switch his appointment.

  It was two-fifteen when Brian reached the Radisson. The day, which had begun for him at six that morning, wasn’t going to end until late the following afternoon. He had Vasclear clinic from four until eight, and then was scheduled to cover the clinical research ward throughout the night—his first night of being on-call in-hospital since his cardiac fellowship. His responsibilities would include carrying the Code 99 beeper for the entire hospital. Any crash emergency anywhere in BHI or WMH, and he would be part of the team. He would only be on in-house call every tenth night, so he was especially elated. In a hospital as large as White Memorial, it was almost certain there would be action.

  He tapped on the door to room 418, and Teri answered in seconds. She was still dressed as she had been at Grand Rounds, although without her suit jacket. Her body was willowy, but her silky blouse highlighted her breasts, which were hardly boyish. Brian felt edgy at being alone in a hotel room with her, but if Teri was the least bit uncomfortable at the situation, she hid it well.

  “Come in, come in,” she said, shaking his hand once more. Her fingers, long and fine, were still completely enveloped by his. “I thought you might not have had a chance to eat, so I had them send up some food.” She motioned at a room-service table to one side of the bed, set for two. “You okay with that?”

  “If you only knew what I would have eaten at the hospital, you’d never bother with that question.”

  Teri Sennstrom didn’t seem to be wearing perfume, but she carried a subtle, fresh, intoxicating scent that smelled to Brian like a spring rain. She took the chair closest to the bedside table, and he settled in across from her, determined to maintain decorum despite having eaten nothing all day but a bagel.

  As if reading his mind, Teri took the pressure off by immediately uncovering the food then diving into her salad.

  “I’m too nervous to eat for hours before a presentation like that,” she said, not worrying that she hadn’t completely finished chewing the mouthful, “and too wired to eat for hours afterward.”

  “Actually, you looked pretty cool up there.”

  “Thanks. I did a lot of theater as an undergraduate at Princeton. Little did I know that acting was going to be more important for my career than all those science courses put together.”

  “You like working for the FDA?”

  “I always had a thing for mathematics and statistics, as well as for biology. So in a way, the job is perfect for me. But my real moment of truth came on my first day on the wards as a third-year medical student, when an alcoholic with a GI bleed threw up a quart of blood on me. Oops, sorry, I forgot we were eating.”

  “I’m about as sensitive to that sort of thing as a yak,” Brian said. “If some alcoholic threw up a quart of blood on me, there’s a good chance I might not even notice. My life’s goal was always to be a football player.”

  “Yes,” she said. “I know.”

  Brian set his fork down and stared at her.

  “A quarterback,” she added. “And a very good one.”

  “I don’t think I like this.”

  “I guess I wouldn’t, either. Sorry for being so dramatic. Should I get started with some explanations, or would you like to finish lunch first?”

  “We’d better do both. I don’t have a great deal of time, and I have very poorly developed curiosity-management skills.”

  Teri Sennstrom’s smile enveloped her ocean-green eyes as well as her sensuous mouth.

  “Well, as you can probably guess,” she began, “Vasclear is the hottest potato the FDA has had to deal with in many years, if not ever. My boss, Dr. Alexander Baird, is from Missouri—literally and philosophically.”

  “The Show-Me State?”

  “Exactly. His mandate has been caution and strict adherence to procedure, but now, there’s an enormous amount of pressure on him, political as well as medical, to do the one thing that comes the hardest for him—abandon scientific process. As I said at rounds, Dr. Baird’s agreed to approve the NDA for Vasclear—that’s new-drug application—in about two weeks. But that doesn’t mean he’s giving up on our investigation of the drug. Questions?”

  “None yet, other than why I’m here.”

  A well-traveled briefcase lay on the bed just to Teri’s left. She snapped it open, took out a single sheet of paper, and set it on the bed beside Brian. He glanced down at it, but didn’t have to pick it up. It was a copy of the MedWatch report he had filed on the defective Ward-Dunlop cardiac catheter.

  “Everybody at the FDA knows the pressure Dr. Baird is under. You may have seen on the news the way he was ambushed by Senator Louderman at a public oversight-subcommittee hearing. We’re trying to help him as much as possible. The head of the MedWatch program noticed that you work at Boston Heart Institute, and sent your report over to Dr. Baird, who insisted that I make a point of speaking with you when I came up here.”

  “But first he did a little checking up.”

  Brian emphasized his point by passing an imaginary football her way. She surprised him by catching it almost in tempo. Her eyes met his and held. Instinctively, he cleared his throat, swallowed against the sudden dryness there, and finally took a sip of Coke. She would never make the cover of anyone’s glamour or beauty magazine, yet there was not one thing about her looks that didn’t excite him.

  “I’m afraid the phrase ‘a little checking up’ doesn’t do our efforts justice,” she said. “I hate this sort of thing, Brian, but once you’ve spent a little time working in Paranoington, D.C., you sort of get used to it.”

  She took a manila folder from her briefcase and then opened it up for him. The first thing that caught his eye was a photograph of him blown up from his high school yearbook.

  “Lord,” he said as he flipped through the papers.

  There was a biography of him that filled three single-spaced sheets, along with numerous photographs and copies of newspaper articles, many of them from the sports pages. There were also his grades from high school, college, and medical school, a detailed credit report, which gave him a C-minus rating, reconnaissance-type photos of Phoebe and the girls, and the police reports, board rulings, and newspaper clippings surrounding his prescribing irregularities.

  “There’s an agency in Washington that does this,” she said. “I w
as as flabbergasted as you are to see how thorough they were. It’s like all they have is an on-off switch. They either do you or they don’t. Aldrich Ames, Brian Holbrook, it doesn’t seem to matter to them. For all I know there’s one of these in someone’s file cabinet with my name on it. You’ve been through quite a lot. I really admire that you’ve made it back.”

  Brian looked up at her angrily.

  “I’m surprised they don’t have my discharge summary from Fairweather.”

  “If that’s the hospital you were in last year, I think they tried.”

  “So?”

  “One of the articles mentioned that your problems began after you got hurt playing football.”

  “It’s not a good sport for anyone with knees.”

  “Dr. Baird doesn’t like doing this sort of stuff, Brian. You’ll have to take my word on that. But he’s still very nervous over the step he’s about to take with Vasclear. Remember, the evaluation of a new drug by the FDA requires an enormous amount of trust in the very company that stands to benefit most by its release. We just don’t have the resources to conduct business any other way. And most of the time, the pharmaceutical companies are ethical. But we have virtually no experience with Newbury Pharmaceuticals, and there have been instances with other companies where information was conveniently omitted from reports, or numbers were changed to jack a result up from probably to definitely effective.”

  “Maybe you’d better get to the point.”

  “Brian, not everyone sends in a defective-product report the way you did. Most of the medical centers are conducting product research under some sort of profit-sharing agreement with the manufacturers or drug houses.”

  “So I’ve been told.”

  “Well, it turns out that in fact, one other person, at the university medical center in Wisconsin, encountered the same defect in that product as you did. The FDA is investigating now, but we’ve already come across what we think was a third case. That hasn’t been confirmed yet, but the first of those other patients required surgery to get the catheter piece out, and the other one died. We’re close to issuing an order to stop the use of the catheter until further notice. We can do that fairly easily because it hasn’t been approved for general use yet. You may have helped save I don’t know how many lives.”