by Rene Fomby
Lantanna smiled. “I’d have to agree with you on that. But, for our sakes, and the future wealth of our clients, let’s hope we’re in the minority.” He reached over to grab a can of Diet Coke off his desk, raising it in a mock toast. “Here’s to Alleurea! Long may she live!”
“Here, here,” Bowser agreed with a grin. “Here, here.”
11
La Jolla
Kelley was sitting alone at his desk, mulling over what in the world he was going to do with the rest of his life. It was abundantly clear now that coming to Labarum had been a huge mistake, no matter how much money they paid him. And it was equally clear that Boucher was hiding something, something very important. Something buried in all that missing data.
He pulled up a biotech job site on the Internet and was just starting to scroll through a short list of current openings when suddenly his cell phone buzzed. It was a call from the lab. He considered letting it go to voicemail, but at the last moment he reached over and pressed the green button to answer.
“Kelley here. What’s up?” His own voice seemed strange to him. Alien. Like it was coming from another body, a body he no longer fully inhabited.
“Great news, Robert!” The bubbly voice on the other end was from Claire Johnson, the double-PhD who oversaw the quality assurance labs. “I think we finally found something!”
Kelley was out of his seat in an instant. “I’ll be right there!”
※
“So I walked into my office this morning, and there on top of my keyboard was this book.” The usually taciturn Dr. Johnson was so excited, she was dancing in place as she talked. “It’s titled ‘Trans’ as in Transgender. I thought it was maybe a book about some guy who got changed into a woman. That’s all in the news these days. Anyway, I walked into the room, and this book was just sitting there on my keyboard, and I was thinking, you know, what the hell is this? How did this crazy book wind up on my desk? And then I picked it up, and checked out the first page. And there it was, written big as you please. ‘Chirality.’ You know? I mean, how stupid could I be? Of course! The answer to the whole thing is chirality. That’s what the book was all about. Trans. Not as in transgender. As in cis trans.”
12
La Jolla
All of a sudden, the whole plan came into focus for Kelley. “Boucher. Goddammit! The book—he knew!”
Dr. Johnson shifted instantly from ebullient to deeply guarded. “What about the book, Robert? What in the world are you talking about?”
Kelley reached out and snatched the book out of her hand. There, on the front leaf. It had been painstakingly blacked out with a magic marker, but when he held the page up to the light, he could just see it. From the library of Peter Boucher. Without thinking, he pushed Johnson roughly to the side and raced down the hallway to Boucher’s office.
The secretary rose up to stop him as he headed at full throttle toward Boucher’s door. “Stop! You can’t just—”
Kelley ignored her and charged straight through the door, stopping only when the massive mahogany desk caught him mid-thigh. Blocked from getting any closer, Kelley leaned over the desk, shaking a finger just a foot from Boucher’s unflinching face. “Doctor Johnson told me when she came to her office early this morning to check on progress with the assays, there was a book lying on top of her keyboard. A book about what she thought was transgenders. She thought that was really odd, but when she opened the book up to the first page, there it was, written in your handwriting. Chirality. Cis and trans. And instantly she realized that was the answer, the answer to what had really happened to Allurea. What caused all the sudden heart attacks. But of course—that wasn’t just a coincidence. That book didn’t just show up serendipitously. You did it. You put that book there.”
Boucher slowly spread his hands apart, smiling back innocently. “Cis and trans? I have no idea what you’re talking about, Robert. You’re speaking total gibberish now.”
“No, no, that’s it! You knew what the problem was all along. Somehow you knew, but you weren’t going to say anything. You decided to act like you were ignorant, counting on us to eventually stumble on to the answer. But it wasn’t happening fast enough, was it? No. For some reason, you needed to give things a little shove, didn’t you? So you left that little hint behind in Johnson’s office. A book on chirality. Your book, from a guy who knows next to nothing about pharmacochemistry. But you knew all along, didn’t you, you son of a bitch! You knew, and didn’t say anything! And that’s why you didn’t want me looking into the data, isn’t it? There’s something about the missing data from the Phase IIIs that you don’t want anyone finding out about. People had arrhythmias even back then, didn’t they? You knew, and you had it all deleted. Like you said, you handled that submission yourself. You’re responsible for all those people dying!”
Boucher sat back in his chair and gazed quietly at his fingernails throughout Kelley’s explosion. When Kelley finally stopped, standing quivering on the opposite side of the desk, shaking with almost uncontrollable anger, Boucher looked up and fixed him with a steady but lethal glare. “What I hear you saying, Dr. Kelley, is that your lab finally isolated the root cause for all the deaths, the thousands of deaths, caused by Allurea. That is very good news, indeed. Now we can move forward with formulating a solution, and then establish a testing protocol to assure the public that this will never happen again. That no one else is ever injured by this drug. Injured, as a matter of fact, by your personal failure to identify in the first place the risk that this drug could become a killer.” Boucher paused and pointed toward the door. “Why don’t you take the rest of the day off and think this one through. Your staff can manage for one more day without you. Go home, spend some more time with your family. And learn to be thankful that we found the answer to the Allurea mystery before anyone else had to suffer.”
“You sick bastard! I’m not done with this—”
A small frown had spread across Boucher’s face, belying the little glimmer in his eyes. “You’ll take the rest of the day off and reflect on your responsibilities going forward, Robert. And, by the way, there will be no more repeats of this kind of behavior in the future. I can guarantee that. Now get out of my goddamned office before I call security and have you hauled out.” He nodded to his assistant, who had cracked open the door in the middle of Kelley’s rant to make sure her boss was okay. “Betty, please see Dr. Kelley out.”
Kelley suddenly felt deflated, broken. “I’ll get you, Boucher. Somehow, some way, I’ll make sure word gets out, that someone looks into whatever it is you’re hiding. This isn’t over one bit!”
Peter Boucher looked up, and Kelley could swear he saw the man’s sapphire eyes darken by at least a shade. “Actually, Kelley. It is. For you at least, it is over.”
13
La Jolla
The room was packed and buzzing as Josh McCarren stalked up to the podium from the wings to begin the press conference, his dark gray suit and somber tie perfect against his cafe au lait skin. McCarren had been head of Investor and Public Relations for less than a month, and his mouth was bone dry with anxiety over juggling his very first presser. But, on the positive side, he finally had good news to report.
McCarren had been born into the projects in South Philly, his family having originally arrived in Philadelphia during the first Great Migration of southern blacks in the early 20th century. His parents had been very protective of their only child, almost overly so, impressing on him very early on the importance of working hard in school and making good grades. Basketball got him out of the projects and into Penn State, and his undergraduate grades and a high GMAT score got him into the Wharton School, where he focused on marketing communications and finance. From Wharton he joined Merck as a professional science liaison for several years before being recruited by Labarum just prior to the launch of Allurea. And—amazingly— just ten months later he had stepped into the role of VP of Investor and Public Relations when his predecessor ran afoul
of the income tax code and was hauled off to federal prison.
He looked up from the podium to face a veritable sea of still and video cameras and reporters from every major press organization in the country. Taking a long sip of water from a glass on the podium to calm his nerves, he cleared his throat and began, focusing for the moment on his carefully prepared and heavily rehearsed opening remarks.
“Good morning, everyone! I’m glad to see that so many of you were able to make it in today. Personally, after all the lousy weather we’ve been having, when I looked outside this morning and saw what a lovely day this was becoming, I considered packing it in myself and playing hooky for a day or two.” That generated a small wave of polite laughter from the crowd, but it managed to break the ice somewhat. The ice that was now lodged at the bottom of his stomach.
“I have some prepared comments to make, and then I’ll turn it over to questions from the audience.” He paused to shuffle his notes, then continued. “As you know, about a week ago, a serious issue developed with our flagship product, Allurea. Allurea was launched just less than one year ago, and has already become the leading prescription anti-allergy drug in the country, if not the world. It has been safely used by millions of people across the planet, with absolutely no major problems or side effects. A safety profile unparalleled in the industry. Until last week.” He stopped for a moment, making sure his face was sculpted into what he hoped was a serious look. “After over three hundred days of zero complications from the use of Allurea, we suddenly saw ERs across the country being filled with hundreds, thousands of patients complaining of serious cardiac issues. All of whom had taken a morning dose of Allurea immediately prior to falling ill.”
McCarren picked up a clicker and brought up a slide on the screen behind him. “Here we have a list of just some of the actions Labarum took that day to address the crisis. Actions taken to find out exactly what went wrong, and to make sure that not a single additional person would risk taking the drug again until we understood how the world’s safest drug had suddenly turned so deadly. As you can see, we took this problem very seriously, and spared no expense or effort to control the crisis. Our first priority—our only priority that day—was to protect our customers. To protect the public, no matter what that cost. We immediately pulled the product off of every shelf—by the end of the day, every single bottle at the wholesale and retail level had been accounted for and locked down—and we flooded the airwaves with public safety messages asking for anyone possessing a bottle of Allurea to turn it in to their local pharmacy for a full refund, no questions asked. In addition, we sent company representatives to the homes of those who had fallen ill, to retrieve their bottles of Allurea for immediate analysis by our scientists. And, I might add, we would like to thank the great people at the Food and Drug Administration for signing off on a waiver that very morning, temporarily suspending the law that normally restricts pharmaceutical sales reps from taking physical possession of those bottles of pills. It took a lot of courage on their part, and for that we are forever grateful.”
His mouth had gone dry, so he paused to take another long sip of water, then looked up and started again. “For the past week we have been working literally night and day to discover what exactly happened that morning, why this perfectly safe drug had somehow turned into a killer. And yesterday we finally had a breakthrough.”
McCarren tapped his clicker and the slide changed, now showing a three dimensional molecular representation of the drug. “This is Allurea.” He clicked once more, and two molecules appeared, side by side. “And the one on the left, this is not Allurea. This is, however, what you might think of as the evil twin sister of Allurea. In scientific terms, it’s called the trans version of Allurea.”
Immediately hands shot into the air, and McCarren waved them down. “Hold on, hold on. We’ll get to the questions in just a moment. But first I need to explain where this second molecule came from, and why it’s such a problem.” He clicked to a slide showing the silhouette of two hands placed side by side. “Consider your hands for a moment. If you hold them out in front of you, in a way your two hands should be almost identical. Normally, you would have five fingers on each hand, and each respective finger should look almost exactly like its corresponding finger on the other hand. Same length, same shape. But, as you notice immediately when you try to put on a pair of gloves, your hands are not in fact identical. They are actually mirror images of each other—and if you placed a mirror on one side of either hand, it would reflect an image that looks almost exactly like your other hand.”
“And the thing is, molecules can be just like that.” He clicked, and a simplified picture of two small molecules popped up, each a mirror image of the other. “Louis Pasteur himself is the scientist who first discovered this property, way back in 1849 when he was working with the French wine industry. In scientific circles it is referred to as stereochemistry, and the ‘handedness’ of molecules is called chirality. Now, I could go more deeply into the science of all this, but there are just a few key things about all of this that matter to us today. First of all, the simplified molecular formulas for a left-handed molecule and a right-handed molecule are identical. That was part of the problem we had in isolating what went wrong—the normal methods for testing good Allurea produced exactly the same results as we got when we tested this new, evil version.”
“So what went wrong?” called a male voice from out in the audience.
“Good question. Thanks.” McCarren once again brought up the slide with the two versions of the drug, side by side. “Without diving too deeply into the science—I’ll leave all that to the intrepid reporters from Scientific American and the New York Times—we have actual scientific names for the two Allureas. Good Allurea is called the ‘cis’ version, and evil Allurea is the ‘trans’ version. A mirror image of the first, but broken.”
“Why wasn’t this problem identified earlier on?” asked a red-headed female reporter from the Washington Post, seated on the second row. “I thought you guys were experts in the science of molecular design. Why didn’t you see the problem with the trans version popping up earlier in development?”
“Thank you, Erin,” McCarren answered with a tight nod. “As you noted, Labarum is one of the world’s top pioneers in the use of X-ray crystallography to design novel pharmaceuticals.” He swept his eyes across the entire room for a moment before continuing. “For those of you who are new to this science, X-ray crystallography is a scientific method used to determine the arrangement of atoms of a crystalline solid in three dimensional space, using the interatomic spacing of crystalline solids to establish a diffraction gradient for X-ray light, which has a wavelength of approximately one angstrom. Put another way, we shine a very precise light on a molecule and measure how the light scatters. The computers can then take these measurements and construct a 3D model of what the molecule actually looks like at the atomic level.” He nodded again to the Washington Post reporter. “As Erin has pointed out, Labarum leads the industry in this area, and X-ray crystallography was in fact instrumental in the development of Allurea. The problem we have here, however, is not something specific to the way we design drugs. If you remember the slide related to Pasteur’s discovery of stereochemistry …”
McCarren clicked back to that slide, showing two very simple chiral molecules side-by-side. “As you can see, this molecule is not very complicated, not complicated at all, so the differences between the two versions are pretty obvious. But in the case of Allurea …” He clicked back to the slide of ‘good’ Allurea and ‘evil’ Allurea. “Even if you know where to look for it, the difference is extremely obscure. And remember, X-ray crystallography is used to help design and construct molecules. It isn’t really all that useful in trying to predict where chirality might theoretically come into play. So, considering Erin, again …” McCarren pointed out the Washington Post reporter with a sly grin. “We can all see how beautiful that red hair looks, how perfectly it frames her
face, how parting her hair on the left side is absolutely exquisite. But, imagine for one moment that her hairstyle is flipped in some small way. Maybe something subtle, like her part is moved to the right. Or major, like flipping her hair from back to front. What impact would that have on Erin’s appearance? Can anyone even say for certain without first seeing it in person, or at least in your mind’s eye?” He paused as a small laugh coursed through the room. “And that’s the problem we faced with Allurea. Since our manufacturing process has only produced the cis version of the drug before last month, we never even considered the possibility of a trans version, or what impact that version might have on the drug’s safety profile. Questions? Yes. Grant Edam.”
A male reporter on the front row just to McCarren’s left stood up. “Grant Edam, New York Times. Two questions, Josh. First, I know we’re all going to have to Google all this as soon as we get back to the office—well, all of us except Steve.” He glanced over his shoulder, and the reporter from Scientific American waved back with a grin. “First off, how do you spell ‘sis’? Is it S-I-S, as in sister?”
“Good question, Grant. No, you’re close, but the word is spelled C-I-S. Sis with a C.”
“Great. Now the big question for you. Why did all this just pop up now, after several years of testing and sales? What changed in the formula or the manufacturing process to make the molecule start parting its hair on the right?”
McCarren ran a hand through his own hair, picking up on the reporter’s cue. “Right, that’s the elephant in the room, isn’t it? And I think I have a partial answer for you, although we’re not going to call the investigation completely finished until we’ve picked apart every possible angle on this.”
McCarren held up his clicker and advanced the PowerPoint presentation until he got to a slide detailing the manufacturing process for Allurea. “There are a number of different ways drugs are manufactured. Some drugs are simply substances that occur spontaneously in nature, such as aspirin. Some drugs are developed biologically. But most drugs, like Allurea, are assembled piece by piece from a number of smaller molecules. You might think of it like an organic chemistry version of Legos.
