Sunday, April 5
8:47a.m.
Winston Bartlett looked up to see Van de Vliet as he stepped off the elevator, and the sight heartened him as always. The Dutchman was a genius. If anyone could solve this damned mess, surely he was the one.
"First thing, Karl, how is she now?"
"I think you'd better go down and see for yourself," Van de Vliet said slowly. "As I told you on the phone, she still comes and goes. I think it's getting worse."
Bartlett felt a chill run through him. He had once cared for this woman as much as he was capable of caring for anybody, and what had happened was a damned shame. All he had intended was to give her something special, something no man had ever given a woman before.
"Will she know who I am? She still did yesterday."
"It depends," Van de Vliet replied. "Yesterday afternoon she was fully lucid, but then earlier this morning I got the impression she thinks she's in a different place and time. If I had to guess, I'd say she's regressing chronologically. I suppose that's logical, though nothing about this makes any sense."
Bartlett was following him back through the air lock and into the laboratory. The intensive-care area below was reachable only by a special elevator at the rear of the lab.
All these once-cocky people, Bartlett thought, were now scared to death. Van de Vliet and his research team might actually be criminally liable if the right prosecutor got hold of the case. At the very least they'd be facing an ethics fiasco.
But I'm the one who's about to be destroyed. In every sense.
It had all started when Karl Van de Vliet confided in him that there was an adjunct procedure arising out of stem cell research that might, might, offer the possibility of a radical new cosmetic breakthrough. Just a possibility. He called it the Beta, since it was highly experimental. He also wasn't sure it was reproducible. But he had inadvertently discovered it while testing the telomerase enzyme on his own skin over a decade ago.
At the time he was experimenting with topical treatments for pigment abnormalities, but the particular telomerase enzyme he was working with had had the unexpected effect of changing the texture of his skin, softening it and removing wrinkles, a change that subsequently seemed permanent.
The idea had lain dormant while they were preparing for the clinical trials. But then Bartlett'spetite amie, the cable TV personality Kristen Starr, had had a career crisis that she blamed on aging, and he came up with the idea of having her undergo the skin procedure.
In a mistake with unforeseen ramifications, she had then been made an official part of the NIH clinical trials. After she had gone for over a month without any side effects, Bartlett had elected to undergo the procedure himself.
Then it began in Kristen-what David had solemnly named the Syndrome. Van de Vliet had immediately (and illegally) terminated her from the clinical trials, removing her from the NIH database. She was now being kept on the floor below, in the subbasement intensive-care area.
As they stepped onto the elevator to go down, Bartlett found himself wondering how many of the staff here were aware of the real extent of the crisis. Van de Vliet had said that only three of the nurses knew about Kristen and the Syndrome. Fortunately, they all were trustworthy. Two had even been with him back at Stanford. They would never talk.
But what about the rest? They'd all fawned over Kristen, starstruck by her celebrity, and they'd spill the beans in a heartbeat if any of them found out. The story would be everywhere from Variety to the "Page Six" gossip column. It would certainly mean the financial ruin of Bartlett Medical Devices. If Gerex went under, everything else went with it.
On the other hand, he thought ruefully,what does it matter? If I end up like her, I won't even know it happened.
"W.B., the telomerase enzyme is completely out of control in her now," Van de Vliet continued. "First it metastasized through her skin and into her blood. Then it began directing its own synthesis. I've tried everything I know to arrest it, but nothing has worked. I still have a faint hope, though. If we can make some headway on your own situation. ." He paused and his voice trailed off. "In the meantime, though, I think it would definitely be wise to move her to another location. There are too many people here. The risk is enormous. Word is bound to get out sooner or later. You must have someplace. ."
"Of course." Bartlett nodded. "I'd rather have her in the city and closer to me anyway. But let me see if I can talk to her first. I need to try to make her understand."
Though it's probably too late for that, he told himself.
They stepped off the elevator and entered a high-security area, a long hallway illuminated only with fluorescent bulbs. Using a magnetic card as a key, Bartlett opened the first door they came to. As always, he was dismayed by the sight.
For a moment he just stood looking at the thirty-two- year-old woman sitting up in a hospital bed, mutely watching a flickering TV screen showing the Cartoon Network. He had truly cared for her, perhaps even loved her for a time.
Then he walked over. "Kristy, honey, how're you feeling?"
She stared at him blankly. Kristen had been a vivacious blue-eyed blonde who’d had her own showbiz gossip show on the E! channel till it was canceled during a scheduling shake-up six months earlier. She had a nervous breakdown, declaring to Bartlett that her show had been canceled because she looked like a crone.
He’d told her it wasn't true, but if she was so distraught about her appearance, then maybe there was something he could do for her. Van de Vliet had once mentioned an experimental skin procedure. ..
Bartlett turned back to Van de Vliet, feeling the horror sinking in.
"Karl, goddamit, we've got to reverse this."
"Let's talk outside," Van de Vliet said.
Bartlett kissed Kristen's forehead in preparation for leaving. Her lifeless blue eyes flickered something. He thought it was a flash of some old anger.
Who could blame her? he told himself. But back then, who knew?
He'd wanted to give her a gift like none other. Not quite the Fountain of Youth, but maybe a cosmetic version. Her skin would begin to constantly renew itself.
And he'd been right. The promise of having her skin rejuvenated was just what she'd needed to get her self-confidence back.
For more than a month the miracle seemed to be working, and there were no side effects. Her skin was becoming noticeably softer and more supple. She was elated.
Screw NIH trials and the FDA, he then decided. It was working for Kristen. By God he would try it himself. He wasn't getting any younger.
But no sooner had he had the procedure too than Kristen started evidencing side effects. First it was little things, like lapses in short-term memory. Next, as it got progressively worse, she could no longer remember why she was at the institute. Then she couldn't recall her name, where she lived. And now. .
Could it be that God can't be cheated? And when it's tried, God brings down a terrible vengeance.
When they were outside in the hallway, he said, "I have a place on Park Avenue that's empty. At the moment. We used to spend weekends there and I can arrange for a full-time nursing staff, all of it." He paused. "Has anybody called here about her lately?"
"Just her mother, Katherine, who's getting pretty frantic."
"The woman is unbalanced. Certifiable. God help us if-"
"I told her to see what she could find out from Kristen's publicist."
"Good." Bartlett had told Kristen's midtown publicity agent, the nosy Arlene of Guys and Dolls, Inc., that Kristen had gone to a private spa in New Mexico to rethink her career and didn't want to be disturbed. She desired complete solitude. Any communication with her would have to be handled through his office.
He looked at Van de Vliet. "Karl, tell me how bad it is formenow."
"For you?" He hesitated. This was the question he'd been dreading. "The telomerase numbers from yesterday's blood sample are not encouraging. As I told you, your topical enzyme application has metastasized into your bloodstream and
started to replicate, just like it did in Kristen. We're seeing a process known as 'engraftment.' These special cells have learned to mimic any cell they come near. They become the tissue that those cells comprise and begin replacing the healthy tissue with new. In Kristen's case, we think it's now entered her brain and it seems to be supplanting her memory tissue with blanks. The same side effect could eventually evolve in you."
That doesn't begin to describe the real horror, Bartlett thought.It's too impossible to imagine.
"The only thing left is to find some way to cause your body to reject the enzyme," Van de Vliet said. "I'm optimistic that we might be able to grow some telomerase antibodies in another patient with your blood type, then culture enough of them to stop the Syndrome in its tracks. It's worth a try. Frankly, I can't think of anything else. But your blood type is AB, which is extremely rare. Also, the problem is that we'd possibly be putting that other person at severe risk too."
"Let's go back up to the lab," Bartlett said. "That idea of yours-Hampton thinks he's got somebody. A woman, in her late thirties." He put his hand on Van de Vliet's shoulder. "We're going to get her on board however we have to."
Chapter 3
Sunday, April 5
8:49a.m.
Stone Aimes was staring at the e-mail on the screen of his Compaq Armada and feeling an intense urge to put his fist through its twisted spiral crystals. What do you do when you've come up with an idea that could possibly save thousands of lives using simple Web-based technology and then the piece gets spiked by your newspaper's owners at the very last minute because it exposes some important New York hospitals to unpleasant (but constructive) scrutiny?
What it makes you want to do is tell everybody down on the third floor to stuff it and walk out and finish your book- undistracted by corporate ass-covering BS … or, unfortunately, by a paycheck.
Around him the newsroom of the New YorkSentinel, a weekly newspaper positioned editorially somewhere between the late, lamentedNew York Observerand theVillage Voice, was in final Sunday countdown, with the Monday edition about to be put to bed. The technology was state of the art, and the room flickered with computer screens, blue pages that gave the tan walls an eerie cast. Composition, spell-checking, everything, was done by thinking machines, and the reporters, thirteen on this floor, were mostly in their late twenties and early thirties and universally underpaid.
The early morning room was bustling, though it felt to Stone like the end of time. Nobody was paying any attention to him but that was normal: everybody was doing their own thing. Besides, nobody else realized he'd just had a major piece killed at the last minute. Now he felt as though he were frozen in place: in this room, in this job, in this life.
The book he had almost finished was going to change a lot of things. It would be the first major explication of stem cell technology for general readers. Stem cells were going to revolutionize everything we knew about medicine and the research was going further than anyone could have dreamed. The possibility of reversing organ degeneration, even extending life, was hovering right out there, just at humankind's fingertips. It cried out for a major book.
He had read everything that had made its way into the medical journals, but the study that was furthest along was privately funded and now cloaked in secrecy. It was at the Gerex Corporation, whose head researcher was a Dutch genius named Karl Van de Vliet. The company had been bankrolled by the medical mogul Winston Bartlett after Van de Vliet lost his funding at Stanford.
Winston Bartlett, of all people. . but that was another story.
Thirteen months earlier, the Gerex Corporation had trolled for volunteers on the National Institutes of Health Web site, referring to a pending "special study." The notice suggested the study might be using stem cell technology in some fashion. If that study was what Stone Aimes thought it was, it would be the first to use stem cells in stage-three clinical trials. Nobody else was even close.
Karl Van de Vliet was the ball game. Unfortunately, however, his study was being held in an atmosphere of military-like secrecy. Why? Even the identities of the participants in the trials were like a state secret. Since Winston Bartlett owned Gerex, it surely had been ordered by him. You had to wonder what that was all about.
Whatever the reason, Stone Aimes knew that in order to finish his book with the latest information he had to get to Van de Vliet. But Bartlett had forbidden any interviews, and Gerex's clinic, called the Dorian Institute, was off-limits to the public and reportedly guarded with serious security.
But, he thought, perhaps he had just come up with an idea of how to get around that. ..
He stared a moment longer at the dim reflection coming back at him from the antiglare screen, which now informed him that his cover feature had been chopped. Truthfully, it was happening more and more; this was the third time in eight months that a major muckraking piece had been axed. Also, as he stared at it, the reflection told him he wasn't getting any younger. The hairline was no longer where it had been in his college photos-it was up about half an inch-and the blue eyes were sadder, the lines under them deeper.
Still, the tousled brown hair was thick enough, the brow mostly wrinkle-free, and he still had hope. He wasn't exactly young anymore, but neither was he "getting on." The "Willy Loman" years remained safely at bay. He was thirty-nine and divorced, with an ex-wife, Joyce, who had departed to be a garden designer in northern California, taking with her their daughter, Amy, on whom he doted. He had a one-bedroom, rent-controlled apartment in the East Nineties, on the top floor of a fashionable brownstone. He was socially unattached, as the expression goes, but he was so compulsive about finishing the book that he spent weekends hunched over his IBM Aptiva, nursing a six-pack of Brooklyn Lager and writing deathless prose. The truth was he was lonely, but he didn't allow himself to think about it.
He'd always vowed he'd amount to something by forty. And now it was as much for Amy as for himself. She lived with his ex-wife near El Cerrito, California, and she meant the world to him. The mortifying part was, he was a week behind with this month's support check. And he knew Joyce needed the money. It made him feel like a callous deadbeat dad when the real culprit was an unlucky confluence of inescapable bills. He’d make it up next week, but he’d sworn he would never let this happen.
That was why he had a larger game plan. Get out of this frigging day job and finish the book. The time for that plan to kick in was approaching at warp speed. This last insult was surely God's not-so-subtle way of informing him that his future was in the freelance world. Every day out there would be a gamble, but he could write anything he damn well pleased.
There was a parable set down by the ancient Taoist philosopher Lao Tzu that Stone Aimes reflected on more and more these days. It was the story of two oxen: One was a ceremonial sacrificial ox who, for the year before he meets the axe, was feted with garlands of lotus flowers and plied with ox goodies. The other was a wild ox who had to scrounge in the forest for every scrap. But, the story went, on the day the ax was to drop, what wouldn't that ceremonial ox give to change places with that haggard struggling, underfed wild ox?
That's the one he empathized with. The one who was out there, half starved but free.
TheSentinelwas an iron rice bowl that normally never let anybody go except for grossest incompetence or flagrant alcoholism. On the other hand getting ahead was all about office politics, kissing the managing editor's hindquarters, and copying him on every memo to anybody to make sure nobody else took credit for something you thought of.
On the plus side, he knew he was a hell of a medical journalist. There was such a gap between medical research and what most people knew, the field cried out for a Stephen Hawking of health, a medical Carl Sagan. The way he saw it, there was room at the top and he was ready for a major career breakthrough. He had done premed at Columbia before switching to journalism, and these days he read theJournal of the American Medical Associationfrom cover to cover, every issue, along with skimming the many other journ
als now on the web.
The piece that just got cut was intended to show the world that investigative journalism was alive and well and trying to make a difference. He'd documented that hospital mistakes were actually the eighth leading cause of death in the United States. The Institute of Medicine estimated that medical errors caused between fifty and a hundred thousand deaths a year-rivaling the number from auto accidents or AIDS. (He'd gotten enough data to be able to quantify how many of those deaths were in leading New York hospitals.) Yet there was no federal law requiring hospitals to report mistakes that caused serious injury or death to patients.
The reason seemed to be that the medical lobby-he'd named names-had successfully turned back all attempts by Congress to pass such a law, even though it was a formal recommendation by the Institute of Medicine. The problem was, once you admitted you screwed up, you could get sued.
So there was no formal accountability.
But (and here was the constructive part) if patients' medical records were put on the Web-everything, even their medications-it could make a big dent in the all-too-frequent hospital medication foul-ups. That alone could cut accidental hospital deaths in half.
He'd pitched Jay Grimes, the managing editor, to let him do a five-thousand-word piece for theSentinel. Jay had agreed and even promised him the front page. Jay liked him, but since all the real decisions were made by the owners, not-so-affectionately known as the Family, there wasn't much Jay could do to protect his people. Stone now realized that more than ever.
The e-mail on his Compaq's screen was from Jane Tully, who handled legal affairs for the paper. Apparently, Jay didn't have the balls to be the hatchet man, so he'd given the job to Jane, who could throw in a little legal mumbo jumbo for good measure. And she hadn't even had the courtesy to pick up the phone to do the deed. Instead, she'd sent a frigging e-mail: See attached. Corporate says legal implications convey unacceptable risk. Consider an op-ed piece. That way the liability will be all yours. Love and kisses.
Syndrome Page 4
