The Plague Within (Brier Hospital Series)

by Lawrence Gold

  “You’re upset and frustrated. We’re suffering the consequences of success. PAT is going to do good things for many people. We should be proud.”

  “This was for him...for Ian, yet PAT has a life of its own and I’m not sure that it’s taking us in the right direction.”

  Greg sat at his desk, staring out the window in thought when Archie arrived.

  “I don’t mind telling you, your call really has me worried, Archie. Let’s go over to the conference table.” Greg indicated the round table in the corner of the room by a large bowed window.

  Archie dropped the large data file on the table. It landed with a thump. Next, Archie extracted his notes from a leather briefcase.

  “I thought I understood the difficulties of operating a complex business when I managed Wincott Enterprises, but that all seems like child’s play compared to running PAT. The science is as difficult and complex as are some of our prima donna researchers, and with the profusion of state and federal regulations, it’s surprising that we can get anything done.”

  “You’ve been at it only for a few years. I’ve lived with it my entire professional life.”

  “I’m almost afraid to ask, but what have you got?”

  “Let me offer an apology first. Andre Keller and I go back a long way, and here, as in the past, he’s a mixed blessing. He’s a brilliant investigator, but he defines, in part, why we need stringent control on research, and especially on trials that involve people.”

  “Now, you’re really getting me nervous.”

  “What I’ve discovered, that is, what Raymond Ames brought to my attention, is that Andre’s been playing fast and loose with his data. He did it when he was at Davis. We fought about it. I wrote it off as excessive exuberance in a dedicated investigator convinced of the truth he’d uncovered. It was wrong then, and I fear that it’s deadly wrong now.”

  Archie opened the data book and began citing the discrepancies in the data reports. He showed Greg the data that Andre ordered destroyed, especially the late adverse effects of the two drugs they had in Phase II study, PAT0035 and PAT0075.

  “This is not merely bad science, it’s criminal disregard for the potential adverse effect of investigative medications. His actions are unconscionable, and I’m afraid that the authorities will hold PAT responsible if anything happens to patients in the clinical trials.”

  Greg felt flushed and dizzy. Everything they’d worked for, their promise to Ian, their dead son, was in jeopardy.

  “My God, Archie. How could this have happened? We followed all the rules, all the guidelines.”

  “No, we haven’t. Someone above Andre should have signed off on the investigative protocol and analyzed all the data before authorizing human trials. I don’t know what possessed Andre when he decided to ignore the end of life mice data. It’s inexcusable.

  “A clever, unprincipled scientist working in his own small world can make things like this happen. Andre did so here. Hopefully, we can stop the trials before anyone’s hurt.”

  Greg studied Archie. “What should we do?”

  “I’d love to suspend that arrogant bastard right now, but I think it would be a mistake. This is his work, his doing, and I fear that we will need him before we’re done. He can’t know what we know and we’ve got to watch him.”

  Archie paused for a moment. “We have to stop all Phase II trials at once, call an emergency meeting of the board, notify the FDA, and get an immediate assessment of the status of patients already treated. We’ll need to deal directly with Andre. Another thing, one dose of PAT0075 is missing and Ray thinks Andre used it for his own purposes.”

  Greg held his head. “What next?”

  “Get Andre in here ASAP.”

  Chapter Thirty-Six

  Sandy Greer had been groping in the dark from bed when she finally reached the bathroom light switch, hesitated, and flipped it on. The fluorescent lights blinked on and nearly blinded her as she stood before the mirror. Her hand had not left her face as she continued to inspect it. In seconds, her eyes understood what her fingers foretold; she’d regressed to her age before receiving PAT0075.

  No, she stared and studied the mirror’s image. She looked even older.

  In shock, yet mesmerized by the reflection, Sandy continued to survey her face. The small coarse lines on her forehead had deepened, her eyelids drooped over her eyelashes, the slight bags below her eyes, now lapped into folds. Her skin was coarse with enlarged pores, streaks of tiny red blood vessels, and brown age-spots.

  When she lifted the third layer of what was once a single layer chin, the spell broke and she screamed, “Marty! Marty! Help me!”

  When Marty rushed into the bright light, he stopped before her, stared, and rubbed his eyes in disbelief. “Sandy, what’s happening?”

  Marty’s pupils, first constricted by the light, suddenly dilated to encompass the sight—his wife had aged twenty years overnight. He had the urge to hold her, but felt, God forgive me, revulsion.

  He forced himself to embrace Sandy, but she fought his touch.

  “No, please Marty...don’t,” she sobbed, holding her face in trembling wrinkled hands.

  Marty picked up the phone. “I’m calling Dr. Lane.”

  The phone rang ten times before he heard, “Dr. Lane’s exchange. Can I help you?”

  “This is Marty Greer. My wife, Sandy, is Dr. Lane’s patient. We need to speak with her right away.”

  “Is this an emergency?”

  “Yes, it’s an emergency. Now can we talk with her?”

  “Dr. Lane left us strict instructions. We are to direct any emergency to the emergency room at Brier Hospital.”

  Marty fought to control his anger. “We don’t need the emergency room, we need Dr. Lane, and I mean we need her now.” He paused for a second, then added, “And you should know that I’m an attorney, so I suggest you get her on the line right now.”

  “Yes, sir. I’ll try her at home.”

  The phone switched to music, and then four minutes later the operator returned. “She’s not answering at home. I’ve paged her, but she hasn’t responded. That’s pretty unusual for Dr. Lane.”

  “Is there any other way to reach her?”

  “No sir. I’ll continue paging and trying her at home. Her office should open at nine, so I’ll try there as well.”

  “I’m sorry,” Marty said to the operator, “we’re upset.”

  He gave the exchange his home and cell number. “We’ll wait for her call.”

  Sandy returned to bed. She lay face down on her pillow with the sheet pulled over her head.

  Beth and Jack were holding each other in that serene contented moment of after making love. They never felt closer. Jack’s mind remained blank throughout, and only gradually did the world and its problems creep back into his consciousness.

  Beth had just left the bed to turn on the coffee maker when the doorbell rang.

  Jack’s stomach tightened.

  A quick glance through the peephole showed Harmony Lane, and when he opened the door she erupted, “Jack...Jack...I have to talk to you!”

  She was a mess. Her hair looked like she’d just got up, her makeup smeared, and her eyes red.

  Jack took her hand and walked her to the kitchen table. “What is it?”

  Beth stopped as she rounded the corner in her nightgown and entered the kitchen. When she saw Harmony, she froze in place. “Jack, what’s going on? Harmony, what’s wrong?”

  Jack turned to face Beth and gestured that he had no idea.

  Harmony sat at the table. Her frozen face stared with eyes fixed on the tabletop.

  “Jack...I...” she began sobbing, her shoulders rising as she gasped for breath trying to control the flood of emotion.

  Beth walked to her side and placed her arm on her shoulder. “It’s okay, Harmony. You’re with friends. What’s happened?”

  Harmony clenched Jack’s shirt as if it were a life preserver. “All I ever wanted to do was help my patients. You
know that, Jack. Sometimes you have to go the extra mile especially when nothing else works, right?”

  Jack unclenched her hand. “Harmony, for God’s sake, tell us what happened.”

  “They said you should never be your friend’s doctor, right, Jack? Zoe Sims was my best friend and she wanted me to be her doctor. So I agreed. We’d had such great success with the first experimental drug that she wanted to be in the new Phase II trial, so I agreed. Everyone said it was safe. Andre Keller’s data proved it was safe, that the worst that could happen is that it wouldn’t work, but Jack...something terrible has happened.”

  “What is it?” Beth cried. “Whatever it is, we can help. Harm, what is it?”

  “Nothing can help,” she paused looking toward heaven. “Zoe’s dead!”

  “Zoe?” Beth said.

  “My best friend, and my patient.”

  “My God,” Jack responded. “Dead? What happened? She was your friend, a young woman, Harmony. You must tell me what’s going on.”

  She began with a flat detached voice. “They found her, I mean they found Zoe’s body at the Rockridge Bart station.” She paused.

  “What happened?” Beth asked.

  “I’m telling it the best way I can. They found her and took her to the Oakland morgue. The medical examiner called me so I went there and Jack...” she began losing control again, sobbing. Harmony stood, placing her hands on her head, covering her ears. “It was Zoe, Jack, and it wasn’t Zoe.”

  “I don’t know what you mean.”

  Harmony’s eyes shifted in every direction, as though she were reliving it again. “It was Zoe, we know for sure it was Zoe, but she wasn’t thirty-four, she looked like she was seventy or eighty!”

  She started losing control of her body and began falling to her right. Jack was quick enough to grab her before she hit the floor. He carried her to the couch.

  Beth stood. “I’ll get a cold washcloth.”

  Suddenly, Harmony snapped into the upright position. “I did this to her. I killed my best friend. God will never forgive me. How could I be so stupid, so arrogant, and so irresponsible? Jack, you were right all along. Why didn’t I listen, Jack?”

  “Are you sure it was the experimental medication?”

  “It had to be. She was well except for the mild lupus. It happened within weeks of starting treatment. There’s no other explanation. I did it! I killed her!”

  Beth paled. “Sandy...Sandy Greer...did you give it to her?”

  Harmony’s head fell. She began weeping and choking, and then raised her eyes at Beth and nodded.

  Harmony looked down. “And Rachel Palmer, too.”

  Rachel and Sandy, what’s happened to them? Jack thought.

  Chapter Thirty-S even

  Jack’s mind had difficulty digesting Harmony’s words. How much damage had she done and how much more would be forthcoming?

  Sandy...

  Rachel....

  How many others in the clinical trial were similarly affected?

  “Who’s the primary investigator for the study, Harmony?”

  “Andre Keller at PAT, People for Alternative Treatment in Emeryville. He did all the work on these drugs. Nobody knows more than Andre.”

  Jack reached for a pad. “What’s his number? We need to call him now and get him to stop the clinical trials immediately.”

  Harmony looked at her watch. “My God, I haven’t talked to the service in hours. I wasn’t on call so I didn’t have my beeper. I’ve been driving around all night in a daze.”

  She dialed the service and heard, “Dr. Lane, we’ve been trying to reach you all night. Your patient, Sandy Greer, has been calling for hours. It’s some kind of emergency. I told them to go to the emergency room, but they refused. I also have an urgent call from Dr. Clarice Henson. She said she was the Oakland medical examiner. She needs you too. Shall I put you through to the Greers?”

  “Yes, of course, but give me Dr. Henson’s number first.”

  Before completing the first ring, Harmony heard, “Greer residence.”

  “Tom, it’s Harmony. What’s wrong?”

  “Where the hell have you been? We’ve been trying to get you for hours.” He choked on his words. “It’s Sandy...Sandy...she’s really sick. It looks like she’s aged overnight.”

  Harmony collapsed into the chair. “What do you mean?”

  “Her face, her skin...she looks like she’s in her 70s...overnight. We’re beside ourselves. You have to help...to do something.”

  “Come to Brier ER.”

  “What sense does that make? We need to see you.”

  “I’ll be there shortly.”

  Harmony dialed Clarice’s number.

  “Dr. Henson speaking.”

  “Clarice, it’s Harmony.”

  “Harmony, this can’t wait. Either you talk to me now or I’m bringing this to the DA.”

  “We may have another case.”

  “My God, Harmony, what’s going on?”

  “I’m on my way to Brier Emergency. Meet me there.”

  After Harmony replaced the phone receiver, she turned to Jack.

  He stared at her. “What do you mean another case?”

  Harmony’s lips trembled. She looked away. “It’s another case.”

  “Another case of what?” Jack shouted.

  Harmony wept. “One more victim of my stupidity and of PAT0075.”

  Harmony paused, and then gradually raised her eyes to meet Beth’s. “It’s Sandy.”

  “Oh, my God!” Beth said.

  Jack turned to Beth. “Go with Harmony to Brier. Give me Keller’s number. I’ll make the call and I’ll meet you at Brier.”

  When Jack heard Andre Keller’s voice, his recorded message, he pressed “O” for the operator. “This Dr. Byrnes from Brier Hospital, I need to reach Dr. Keller. It’s an emergency. If you can’t reach him, I need to speak with your CEO.”

  “One moment sir.”

  What a goddamn mess. How could this happen?

  Safeguards can’t protect us from the rogue researcher, the unethical doctor willing to take others’ lives into their own hands.

  Jack didn’t know Keller, but his perception of Harmony as a caring person, a good doc was shattered.

  After fifty seconds, the phone clicked. “Mr. Wincott’s office, Sally Majors speaking. Can I help you?”

  “This is Dr. Jack Byrnes from Brier Hospital. I have an emergency and need to speak with Mr. Wincott immediately.”

  “What is this regarding, sir?” she uttered officiously.

  “If I don’t have Mr. Wincott on the line in ten seconds, the next sound you’ll hear will be the police arriving.”

  “Greg Wincott here. Can I help you, Dr. Byrnes?”

  “I’m sorry sir, but I was unable to reach Andre Keller and I have something that requires immediate attention.”

  “Why he just joined me. He’s here. What is it?”

  “Two women on your Phase II study with PAT0075 have developed severe side effects, one, Zoe Sims, is dead. I don’t know what’s going on, or how many subjects have received the drug or are on schedule to receive it, but you must halt these trials at once.”

  “My God!” Greg said. “Who is the other patient?”

  “Sandy Greer. She’s on her way to Brier Emergency.”

  Jack heard Greg’s voice questioning Andre. “Do you know the names, Zoe Sims and Sandy Greer?”

  “Yes, of course, sir, we enrolled them in the PAT0075 study.”

  “Dr. Byrnes. I’ve halted the studies,” Greg said.

  “When did you stop the Phase II trials?”

  “We stopped the study a few days ago.”

  “Why were the study drugs withdrawn?”

  “I’m afraid I can’t get into that now. We have proprietary concerns.”

  “Proprietary concerns, my ass! I smell a cover-up.”

  Greg stopped to catch his breath and control his emotions. “I’d like to bring some of my best people to Brier.
We can help you assess this situation, and maybe we can be of assistance.”

  “We’re accepting help from all quarters, sir. I’ll have a conference room set aside.”

  After he hung up with Jack, Greg turned his attention back to Andre. I want a count on all the unused medication and all the patient data. You are to secure the experimental data at once.”

  Greg buzzed his secretary. “Get Dr. Archie Blake on the line ASAP.”

  Andre sneered at Greg. “I hope you know what you’re doing.”

  “For the first time in a while, I do.”

  Chapter Thirty-E ight

  Sandy and Marty Greer drove in silence to Brier Emergency. Sandy sat in silence, staring ahead.

  Marty glanced over at Sandy as light flickered over her pallid and wrinkled face.

  The ER had been busy all night, but it was calm as the day began. The morning shift had arrived and the smell of fresh brewed coffee filled the air. Brier’s emergency waiting room was empty.

  They sat before the registration clerk as Marty gave all the answers.

  “Age?” asked the clerk.

  Marty paused and studied Sandy.

  “Age?” She asked again.

  “Forty-four,” Marty replied.

  The clerk looked at Sandy and then at Marty. “Forty-four?”

  “Yes, dammit,” Marty exploded.

  The clerk paled. “I’m sorry, sir…”

  “No,” Marty said, “I apologize. It’s not your fault. Please, just finish up.”

  After they signed the insurance and permit forms, a nurse directed Sandy and Marty into an examining room. The room was small, closet-like, painted institutional pale green, and smelling of disinfectant. It contained an examining table with fresh paper, a cabinet with a variety of minor surgical supplies, a scale, blood pressure gauge, and a wall-mounted combination otoscope and ophthalmoscope. Moments later, a laboratory technician arrived to draw blood. “Dr. Byrnes and Dr. Lane will be here shortly.”

  Sandy had been unable to look at anyone. She kept her hands, her shield, over her face.