The Plague Within (Brier Hospital Series)

by Lawrence Gold

  Ray approached, their faces separated by four inches.

  Andre had the urge to back away, but steeled himself and held his position.

  “Andre, you were one of the best, no maybe the best and most innovative researcher I’ve worked with, and I’ve worked with the best. I didn’t care that you were rude, self-centered, and inconsiderate. I didn’t even care about your self-involvement or your narcissism because of the promise of our research. I even thought, God forgive me, that beneath your malignant personality, you were a decent, but flawed, human being, but now all I see is evil.”

  “You can’t talk to me in this way. I won’t permit it.”

  “Andre, stop for a minute,” Archie said. “Although obsessive ambition may produce some of our greatest achievements, you can’t be so indifferent to the truth and to people you’ve hurt. That would make you a monster. I don’t see you as that monster, Andre.”

  Andre pulled a rolling laboratory stool before his desk, hung his head and held it between his two hands as if he was about to explode.

  “I don’t know what the future holds for any of us,” Archie said, “I only know that right now, we have to work together or other innocent people will die. Can you do this Andre? Can I count on you?”

  Andre looked up at Ray, and then at Archie—he nodded. “Yes.”

  Rachel Palmer was napping after lunch when the ringing phone startled her awake.

  “Rachel, it’s Dr. Lane.”

  “Harmony, how are you?”

  “More to the point,” Harmony said, “how are you?”

  “I’m doing great. Every day I get a little stronger. I know it’s going to take a while, but thanks to you, I’m better.”

  “Rachel, I’d like to see you in the office as soon as possible. Dr. Byrnes will be there as well.”

  Rachel trembled. “What’s wrong Harmony? Why as soon as possible?”

  “We’ve had some side effects in the clinical trials. It’s not with the preparation you received, but we’re being cautious. Can you come in this afternoon?”

  “You’re really scaring me now. Sure, I’ll be there. Should I worry?”

  “No, Rachel. I’ll do the worrying. See you at three.”

  Harmony invited Jack to her office.

  “I don’t know what to look for, Jack. Any ideas?” she asked.

  “All we can do is a clinical assessment and some lab tests. We don’t have any specific clinical or laboratory markers that would tell us how to monitor the aging process.”

  Rachel, Tom, and Maxine arrived shortly before three.

  When Harmony opened the door to let them in, Maxine remained seated in the waiting room. “This is your party, Tom. I’ll wait here.”

  They moved into Harmony’s office. “Tom took off from work. Tell me I’m being overanxious,” Rachel said. “Please.”

  “We’re just being cautious,” Jack said. “We have a big investment in you.”

  Harmony and Jack took turns examining Rachel. She looked so much better than at any time in the hospital that they’d never appreciate the subtle changes that might indicate future problems. They spent 45 minutes reassuring the Palmers, and arranged for routine blood tests.

  Back in Harmony’s consultation room, she turned to Rachel. “If it’s okay, we’d like to take a few pictures of you.”

  “Pictures?” Rachel said, alarmed again.

  “Yes, for your chart, and if you have one, we’d like a picture of you before you got sick.”

  “Why do you want pictures?”

  Harmony looked at Jack again. “We saw some physical changes in some patients taking the other experimental medication,” Jack said. “We don’t expect anything, but photographs will serve as points of references for any changes that might occur in the future.”

  “What kind of changes?” Tom asked.

  Harmony shook her head. “We can’t go into that now.”

  “What do you mean, you can’t go into it?”

  “Just that.”

  Harmony took several digital pictures, frontal and side views.

  As they were departing, Tom turned to her. “By physical changes, you were talking about side effects, weren’t you? What kinds of side effects of that new trial drug have you guys so concerned?”

  Harmony turned to Jack, staring into his eyes, a plea for guidance. “I’m sorry Tom, but the research study findings are not yet available for public disclosure.”

  They’re going to love that, Jack thought. They’ll be walking through a dark cave, never knowing if or when disaster will appear.

  Chapter Forty

  Zoe Sims’s death and Sandy Greer’s transformation had shattered Harmony’s psyche. She was intelligent and introspective and had forged an image of her role as a physician, and a sense of her goodness as a human being. Her fragmented ego—her honor, lay spread in confusion over the shriveled, now malformed image of herself.

  Nothing could undo the effects of what she’d done.

  When Harmony returned to the office, Shelley Stillwell tried her best. “Don’t do this to yourself. You don’t have an evil bone in your body.”

  “Good intentions are not enough. I was so damned smart. So sure that I knew better. I heard the words of caution a thousand times, but never listened. Look what I’ve done.” She held her face with her hands and wept.

  Shelley moved to Harmony, stroked her hair, and whispered, “Breathe it in. Accept what’s happened. Learn from it, but don’t let it destroy you. You have so much to give your patients, Harmony. All of us make mistakes.”

  “A mistake!” she cried, “Zoe was my friend and I killed her, and who knows what will happen to the others.”

  “Harmony, you acted on the information you had. The drug might not have worked…you knew that, but they assured you that it was safe. How did that happen? Who could have given you such guarantees? Are you so sure that Andre Keller told you everything?”

  The phone rang. Shelley picked up the receiver. “Dr. Lane’s office.” She listened for a moment. “Dr. Lane isn’t available at the moment. Can I take a message?” She turned to Harmony. “It’s Zoe’s parents, they’re in town.”

  At home that night, Harmony tried to sleep, but couldn’t. Her conscience had taken center stage and demanded an audience. She planned to meet Barbara and Ted Sims at the medical examiner’s office in downtown Oakland. She’d called Clarice Henson and asked if she could be there.

  Clarice tried to be kind. “You don’t have to put yourself through this.”

  “I need to see them.”

  As she dressed for the day, Harmony tried to imagine what she’d say, but everything sounded unreal, contrived, and self-serving.

  Barbara and Ted were waiting in front of Clarice’s office when Harmony arrived. She hadn’t seen them in several years and they looked much older than she remembered.

  Barbara embraced her. Both cried. “Harmony, darling.”

  Ted followed with a perfunctory embrace and they entered the office. Clarice introduced herself, and stood to leave. “I’ll leave you alone for a moment.”

  Harmony seated them in the medical examiner’s consultation room. “Would you like coffee?”

  Ted reddened. “What I’d like is a goddamn explanation.”

  Barbara grasped his hand then faced Harmony. “Coffee would be lovely,” Barbara’s voice had an uncharacteristic rancor.

  Ted nodded, but refused to look at Harmony.

  After returning with the coffee, Harmony moved the desk chair out from behind the desk to sit beside them. She’d place no physical barrier between them.

  “How could this have happened?” Barbara asked. “She was so young and so healthy, except for the mild lupus.”

  “I can’t begin to explain how devastated I was when Zoe died. I loved her. She was my best friend.”

  “I want to hear all about it...all about it,” Ted said, his voice cracking, “and then we want to see our baby.”

  Oh my God, thought Harmony. They
can’t see her. Impossible—I can’t let that happen.

  “That will be up to Dr. Henson, but I wouldn’t advise it.”

  Barbara and Ted stared at each other a moment, then Ted rose. “It’s obvious that you don’t want to tell us about Zoe’s death.” He paused and fixed Harmony in his gaze. “But understand this clearly, one way or the other, we’ll find out what happened.”

  Harmony gripped her chair. “No, you’re wrong, Ted, it’s that I must tell you, and tell you everything.” She wept.

  She regained control. “I’ll just lay it out for you as it happened. Just let me get through it, and then ask your questions.”

  “Treating patients with lupus, even in its mildest form, can be frustrating. Symptoms come and go, but patients live under the threat that the disease will change into a more severe form. That’s how it was with Zoe. When I met Dr. Keller and heard his research on treating patients with autoimmune diseases through People for Alternative Treatment, a company with the highest ethical standards, I became intrigued. I looked into the research study in detail and concluded that it was promising, and most importantly, I believed that the drugs involved were safe.”

  She looked up at the Sims’s. Their faces betrayed nothing. She continued. “I saw this as a golden opportunity to help my patients by participating in a clinical trial. Thousands of trials are going on every day around the world. It was a chance to give my patients treatment that, because of bureaucratic delays, could be years away.”

  “Weren’t you concerned with the risk?” Barbara said.

  “Of course. For drugs like this to be ready for human trials, the drug company must prove them safe. The trial drug I gave to Zoe, called PAT0075, had no reported serious side effects so I felt that even if it didn’t work, it couldn’t do any harm.”

  Ted stared at Harmony. “Bullshit.”

  “I tried to talk Zoe out of the clinical trial, but you know her. Once she heard about the success we had with the first trial, she’d made up her mind. There was no stopping the girl.”

  Ted stared at her. “You’re blaming Zoe?”

  “Of course not. This was my doing.”

  Harmony paused to sip her coffee. “I followed her in the office regularly, doing tests as directed in the experimental protocol and everything had improved dramatically. Then came that phone call. I’ll never forget it or the image of Zoe in the morgue...it will be with me forever. You don’t have to see her. I’ve identified her. Don’t do that to yourself.”

  Ted grasped Barbara’s hand. “You still haven’t told us what happened to our girl.”

  “The first trial using PAT0035, an inactive virus, went smoothly and we haven’t seen adverse effects, yet. The second drug, the one that I gave to Zoe, was an active virus form of gene therapy designed to spread further and last longer. Initially, it produced miraculous beneficial effects, but later it caused rapid and uncontrolled aging.”

  She stared at them trying to gauge their status then continued, “Zoe, at age thirty-four, died of old age.”

  “What are you talking about?” shouted Ted. “Old age? Impossible!”

  Harmony felt their denial like a physical blow. “It’s complicated, and even the research people are unsure of what happened. Our cells have protective processes that keep them in a good state of repair. The virus interfered. It left the cells to age uncontrollably.”

  “Things like this shouldn’t happen. These medications clearly weren’t ready for human trials,” Ted said. “I promise you this; by the time I’m finished, we’ll know who’s responsible and who’s to pay.” He paused and looked at Barbara. “We’d like to see her now.”

  “Please don’t,” Harmony pleaded. “She doesn’t look like our Zoe. It’s better if you remember her as she was. Please trust me on this.”

  Ted stood and walked directly to Harmony, their faces separated by three inches. “Ask Dr. Henson to come back,” he said through gritted teeth.

  When Harmony returned with Clarice, Ted said, “We want to see our daughter.”

  Clarice looked at Barbara and Ted, and then turned to Harmony shaking her head. Harmony shook hers in return.

  “You have every right to see your daughter, but please don’t do it. I’ve been a medical examiner for a long time and I can tell you that on occasion, it’s best to retain the image of someone you love, rather than to see them as they appeared in death.”

  Barbara and Ted stared at each other.

  “I’m frightened,” Barbara said. “I don’t know if I can do it...see her that way?”

  Ted bit his lips, swallowing his own emotion; someone has to be strong.

  Ted took Barbara’s hand. “I hate it…putting you through this, but if we don’t see her, we’ll regret it...regret is the last thing we need.”

  Ted walked over to Barbara and they moved to Clarice. “Take us to our daughter.”

  As they entered the autopsy suite, Ted turned back to Harmony. Their eyes met and then Harmony followed. Clarice brought them to the stainless steel refrigeration unit. She approached the middle compartment then turned to Ted and Barbara who nodded. She opened the door, grasped the steel body tray, and pulled. The stainless steel wheels rattled against their runners as the tray slid into the open. She held the zipper slider and pulled it down with a single motion spreading the bag open.

  Barbara’s scream, then her sobbing would sear the moment forever, a hot iron into Harmony’s being.

  Chapter Forty-One

  When Greg returned from Brier Hospital, he sat with Amanda in their corporate offices.

  She grasped his hand. “You’re upset.”

  “Despite all our efforts, PAT may not survive.”

  “I don’t see why,” Amanda said. “We’re no worse off than we were before this whole gene therapy mess began.”

  “Those were simpler times. We owned and ran the company, so all we had to lose was our own time and money. PAT is publicly traded and any hint of a problem, especially a problem with a promising approach to treatment, can drop the bottom out of the stock. We’re already down 20 percent from our high for the year, and unchecked, we could wind up as a penny stock.”

  “It was Andre, wasn’t it?”

  “It was he and maybe it was us, too. I can’t deny the role that ambition played in our achievements, but blind ambition combined with an elitist attitude and poor operational control on our part was a formula for disaster. Archie says Andre is perhaps the most innovative researcher he’d ever seen, but he’s constantly infuriated by his disrespect for the rules. In research, when patients are involved, there’s no place for a shoot first, answer questions later, investigator.”

  Amanda twisted the hem of her skirt. “I can’t stand the thought that we’re responsible for what PAT0075 has done to those poor women. We must do something.”

  “I think Archie’s made headway with Andre. They’re going full-tilt at a solution. Proprietary concerns mean nothing here, and I’m supporting the search for an answer with everything in our arsenal.”

  Janet, Jack’s office manager, arranged for Sandy’s visits so she wouldn’t have to be in public view.

  Sandy wore a jacket with a high collar and covered her face with a scarf.

  Jack reached for Sandy’s shield, but she turned away. “I have to see what’s happening.”

  He peeled the scarf away and she turned aside so as not to meet Jack’s eyes.

  Nothing was frightening about the rather pleasant seventy-year-old face except when you realized that she was forty-four. Her wrinkles had thickened, her skin was more coarse, and its pores more obvious. The lids, drooping half-mast, weighed down by thick lid folds, yet her eyes remained bright and intensely blue. As Jack touched her face, examining its texture, she jerked away as if his hands had delivered an electric shock.

  When Jack finished his examination, she immediately replaced the scarf.

  After Sandy dressed, she and Marty returned to Jack’s consultation room. She sat head down while Marty stared
at Jack expectantly.

  “So far, Sandy, your tests show minor abnormalities, just the kind of changes we’d expect in the aged.”

  “Aged? I’m forty-four, Jack.”

  “I’m sorry. I want you to know what we know, what we understand.”

  “It’s okay, Jack,” Marty said. “We need the truth.”

  “It means that it’s not that you look old, Sandy, you are old by every measurement.”

  “You’re telling me. Every bone and joint aches.” She paused for a small smile.”Even my aches have aches.”

  Jack felt his eyes filling.

  “How long do I have?” she asked quietly.

  “I don’t know.”

  “What are they doing in the lab?” Marty asked.

  “They’re studying your cells in tissue culture and comparing it to the cells they saved before you received the PAT0075. Obviously, the goal is to restore your cells to, or as close to, their original status.”

  “Can they do this kind of work in weeks? I thought it took years.” She paused. “I don’t think I’d bet on it,” Sandy added, dry-eyed.

  Jack faced them. “I’m a born optimist, but it doesn’t look good.”

  As Beth walked Sandy and Marty back to their car, a group of demonstrators suddenly surrounded them wearing Evangelicals for Life tee shirts and chanting, “Choose life...choose life…choose life.”

  Sandy withered under their sneers and insults, and tried to cover her face. “Please,” she pleaded as she began sobbing.

  Marty pushed against the crowd. “Get the fuck away. All you bastards know is how to destroy. And, you call yourselves Christians?”

  A man in clerical garb stepped from the demonstrators. “Remember the Epistle of Paul, Galatians 6:7 Be not deceived; God is not mocked: for whatsoever a man soweth, that shall he also reap.”

  The man turned to face his followers then pointed toward Sandy. “She has broken God’s moral law. She used the stem cells of murdered babies. Look at her. The guilt of the murder will surely pollute this land and bring God’s wrath upon you. Remember Matthew 11:33 Either make the tree food, and his fruit good; or else make the tree corrupt, and his fruit corrupt: for the tree is known by his fruit.”