Weapon of Choice

by Patricia Gussin

  “Dr. L.” Eileen looked in. “Michelle Wallace is here. She has the report you requested.”

  “Send her in, please.” Laura had forgotten that she had asked her chief resident to research that new drug.

  Michelle glanced around Laura’s office, taking in all the family photos. Laura’s colleagues at the university and the hospital knew she had several kids, but for the most part, she’d kept her life compartmentalized. Career. Kids. Focus on one. Or the other. Fully. In real time. Do not take your career problems home. Do not take your kid problems to work. Usually, an effective policy. Not always.

  “You have such attractive kids,” Michelle gazed at Laura as if she were supernatural. “I just don’t think I could do it all.”

  Laura was always taken aback when female medical students considered career and kids incompatible. She’d had two little boys before she even started med school. For the moment, she stifled the career counseling impulse, took Michelle’s packet, and began perusing the pages. “So Keystone Pharma has a drug that outperforms methicillin and vancomycin. They’ve started phase three.”

  “Yes,” Michelle said, “They’ve completed phase two trials, so we know the drug is effective. Now they’re enrolling more patients to make sure that it’s safe.”

  “And is it?”

  “The study is double-blind, so no one knows. Unless the code has to be broken for some reason.”

  Laura was impressed. This girl knew her stuff, and Laura liked to give praise when praise was due.

  “Excellent, Michelle, and I appreciate the fine job you did in the O.R. today.”

  “I’m worried about the patient, Dr. Nelson.”

  “Why don’t you go check on him in the recovery area? Then check with Pathology, see what they’ve found. Just be sure to follow isolation protocol.”

  “Oh,” Michelle said on her way out the door, “did you know that the CEO of Keystone Pharma got the Nobel Peace Prize this year?”

  Indeed. Paul Parnell. Keystone Pharma was respected among pharmaceutical firms for good science, good medical community relations, and generous philanthropy. But their research director had not returned her call.

  CHAPTER FIVE

  MONDAY, NOVEMBER 25

  “No personal calls in the lab, isn’t that the rule?” Charles Scarlett addressed Stacy Jones as soon as she put down the phone. “Who were you talking to?” Charles knew he sounded pissy, but he could care less.

  On his way to the lab that morning, the boss had waylaid him in the hallway. Hadn’t even invited him into his office to inform him that Dr. Stacy Jones was being promoted to director, Experimental Staph Section. Just like the CDC—hell, the entire government for that matter. Promote women. Promote blacks. They got a double whammy with Jones, who was both a woman and black. “Colored,” his parents would call her.

  “Not a personal call,” Jones said, turning back her attention to her stack of petri dish cultures. “A friend in Tampa has a patient with probable HIV. Not that I’m an expert, but—”

  “We’re supposed to go through channels,” Charles said, “before we get involved.” He didn’t know whether Jones had been told about her promotion yet, and he wanted to get in his jibes, petty as they were, before she technically became his boss. Even when that happened, she wouldn’t be able to touch him. By the end of the week, he’ll have requested a transfer to anywhere she wasn’t.

  Jones seemed to ignore him. “Tampa isn’t San Francisco or D.C. or New York City,” she said, inspecting a plate under a scanning microscope. The exotic staph organisms that the lab handled were potentially lethal and access to their Center for Disease Control P3 Lab was restricted to scientists with doctoral degrees and intensive training in antimicrobial technique. “My friend Dr. Nelson doesn’t know whether her hospital ever has had a case. Well, you heard what I told her. Anything you’d have added?”

  Charles had to tread lightly. He couldn’t quite say, Put the poor bastard out of his misery and cremate the remains. Public correctness had been his watchword ever since Dr. Pierce had recruited him into The Order two years ago in Arlington. He had to remain non-confrontational even when The Order had openly advocated putting AIDS victims in “cities of refuge.”

  Not waiting for his reply, Jones continued from under the stainless steel containment hood. He could just make out what she said. “Something interesting going on with our flesh-eating AZ3510 series. Remember the fulminate growth we saw two days ago? Two days ago, I recultured the plate, and today there’s nothing. It must have burned itself out. Nothing left for antibiotic sensitivities, and I really wanted to try the paralexins series we got in from Keystone Pharma.” Jones recapped the petri dish and withdrew her head from under the protective hood. “That culture’s so virulent, burned itself out before I could replate it. Can you move these, please, from a forty-eight-hour to a twenty-four-hour schedule?”

  You black bitch. Trying to tell me how to run the lab? The two of them had M.D. degrees, but he also had a Ph.D. in genetics from Emory, and she had a master’s in Public Health from Harvard. A Ph.D. trumps a M.P.H. any day, but no, not here at the CDC. His father’s words reverberated in Charles’s head whenever he faced Stacy Jones: “Because you are white, you will always tell them what to do, no matter what.”

  The lab phone rang and Jones picked it up. “Sure,” she said. “Lunch? That’d be fine.”

  That would be the call, Charles thought. Stacy Jones, of African descent, a woman of color, about to be promoted ahead of him, a white male, of European descent, Southern aristocracy. At first he’d felt shame, then he thought about his Aryan Nation brothers in The Order. They talked and talked about something radical. A catalyst. Could this injustice be what they needed to fire them up? One of their own, passed over for a colored woman. Isn’t this what The Order had been warning the members about all this time? The Order had to do something to protect the future of white children. Something radical.

  Jones looked up at the wall clock. “I’ll put these cultures away,” she announced. “Stan Proctor asked me out to lunch. Imagine. Can you lock up the lab, Charles, when you leave?”

  His grimace was so taut that he had to consciously unlatch his jaws. Jones ordering him around enraged him—but what had she said just before that? About the AZ3510 culture? Ultravirulent? Flesh-eating?

  The introverted, wimpy, overweight offspring of a charming Southern socialite and a stalwart white supremacist lawyer, recognized the kernel of an opportunity. With just a little clandestine effort, Charles would have something special to share with The Order when the cell met next Wednesday night. This time he would have their attention.

  CHAPTER SIX

  MONDAY, NOVEMBER 25

  For his trip to Philly and after that to Clearwater, Victor Worth chose a camel-colored cashmere jacket, a pale green shirt, a multicolored striped tie, and tan wool slacks. In his breast pocket, he’d packed an extra monogrammed handkerchief. He wanted to look important when he presented himself to the big pharmaceutical company. Once he got to Florida later that day, he’d be overdressed, but he reasoned that wool would not wrinkle on the train ride from D.C. to Philadelphia.

  Victor had never considered himself an emotional man. But ever since he’d learned about Matthew in Cindy’s letter, just a month ago, he felt the yearning—unquestioning, with nothing held back—for a close father-son relationship. He knew it sounded trite, but a son brought meaning into his life. He and Matthew were a family. Even thinking the words son and family could bring tears to Victor’s eyes.

  The minute he was settled on the Metroliner from D.C. to Philly, Victor pulled out the letter handwritten on light-gray stationery from his all-but-forgotten college girlfriend.

  Victor, I have no way to know if you ever discovered this: you have a son.

  No, he had not.

  Matthew, a wonderful young man with your cobalt-blue eyes and your curly auburn hair. He’s thirty-two years old now. A college biology teacher, at least he was.

&nbs
p; Here the paper was marked by what probably were tearstains, blurring the blue ink.

  When I was told by my doctor six months ago that I have advanced ovarian cancer, Matthew left San Francisco and came to Clearwater to take care of me. He stayed with me through all my pain and anguish. What will happen to him now?

  Victor, I am begging you. Will you take him into your heart? Your life? He has no one. No other family. And his friends—I don’t know how to tell you. Our son, Matthew, is gay.

  Victor had to admit that this revelation hit him hard. He had a son, but he was homosexual?

  And although I’m a nurse, I don’t know for sure, but I’m worried that he’s ill, quite ill.

  When you receive this, I will already have passed. Matthew will be alone. I’ve never burdened you, but I am desperate. I have nowhere else to turn. You are an important scientist, not married—I do know that.

  That shocked Victor. He had never tried to find out what had happened to his girlfriend, the student nurse, Cindy. After he’d been emasculated, his testicles removed because of the cancer, he’d never looked back. Sex and women and love belonged to the past.

  Please, dearest Victor, could you help him deal with losing me, help him get settled. He’ll have my house in Clearwater, but not much else. Please, Victor, help him. Please.

  Victor was still overcome by his reaction, which was immediate and intense. His son, straight or gay, was his son. All he could think of was “flesh of my flesh.” Where had that come from? The Bible?

  And now the fear of losing Matthew frightened Victor to the point of panic. He would do anything to keep Matthew alive. He had underestimated the stage of Matthew’s illness. He’d planned to convince his son during Thanksgiving weekend to move from the medical backwaters of Florida to D.C. with its sophisticated resources.

  Last time he’d seen his son in Clearwater, two weeks ago, Matthew had a hacking cough and a low-grade fever, but Victor needed to get back to D.C. so he’d left him. Each of the two times he’d seen Matthew, Victor had no choice but to leave Florida after a brief couple of days. He could not be away from the D.C. vicinity for more than seventy-two hours. Ever. But now, in retrospect, he realized he should have paid more attention to the purplish blotches on Matthew’s face that his son had found so embarrassing.

  Having spent his whole career in infectious disease research—the first nine on staphylococcus bacteria and the last nine on the cryptococcus fungus—Victor knew that Matthew was a victim of the HIV virus. Never in his career had he worked in virology research, but for the last few years, the entire infectious disease community had been focused in one way or another on HIV. Recently, even his own cryptococcus research had focused on opportunistic fungal infections in HIV-positive patients.

  No one had a cure for HIV/AIDS, though experts recommended AZT—zidovudine—in high doses. Nor was there a cure for Kaposi sarcoma, which Victor knew was the cause of the blemishes that Matthew thought were merely cosmetic. But there was a new cure for invasive staph infections, and that female doctor in Tampa emphasized that Matthew had a staph infection. That cure had come out of Victor’s lab at the NIAID division of the National Institutes of Health.

  The drug that resulted from his own research was being tested now in clinical trials by Keystone Pharma. Right now, at this very moment, some fortunate stranger suffering with virulent staph was getting an infusion of his drug, ticokellin. Matthew would have ticokellin by the end of the day. And that was why Victor was headed to Philadelphia on his way to Tampa to see his son.

  When the train arrived at 30th Street Station, Victor picked up his rental car and drove north out of Philadelphia toward Montgomery County. Fifty minutes later, he rushed through the glass doors of Keystone Pharma headquarters.

  “Dr. Norman Kantor, please,” he told the receptionist.

  “I’m sorry, sir, Dr. Kantor has retired,” the black female replied. Name tag: Marie. Pleasant smile.

  Victor thought he’d heard that on the professional grapevine, but Norman had never bothered to inform him directly.

  “Then I’ll see his replacement.”

  “Without an appointment, sir, I don’t believe that will be possible. But I will be glad to check with his assistant. Your name?”

  Victor also gave his title at the NIH. He and Dr. Kantor had been colleagues he stressed—worked on related research subjects.

  Marie dialed, explained into her headset. She smiled at Victor, “Dr. Minn will see you, sir. He’s our director of research.”

  A diminutive man in an oversized white lab coat appeared without delay. “Fred Minn,” he said, offering his hand to Victor. “We can talk in the conference room.”

  Victor followed the white lab coat. They entered a space about the size of a coatroom, to the left of the glass entrance doors. He’d expected to be ushered into the director’s office, offered a tour of the labs—the same courtesies he would show a visiting colleague. So far, Victor hadn’t even gotten past security.

  “I’m afraid that I’m having a very busy day, Dr. Worth. I don’t believe we had an appointment. So, what can I do for you?”

  You can give me a supply of ticokellin, he wanted to say, but he knew these industry scientists were political animals, so he methodically presented his case for a compassionate IND for Matthew. He peppered his request with tidbits of cutting-edge scientific insight about the virulence and resistance of Staph aureus. Victor was not some nobody off the street.

  Dr. Minn listened politely, apparently impressed with Victor’s research acumen, until Victor concluded.

  “Not possible,” he answered.

  Victor felt his face get hot—which meant his cheeks also were turning red. “I invented the prototype for that drug at the NIH. Norman Kantor as much as stole it from me. I demand that I leave with it!” Victor started to get up, not sure of his options. How could he convince this bureaucrat?

  “Calm down, Dr. Worth.” Minn gestured with his hands for Victor to sit down. “A few minutes ago, I had a similar conversation with Dr. Nelson in Tampa about the patient.”

  So she had called. Victor sat back down.

  “I told Dr. Nelson the same thing I’m telling you. Not good news for you. Not good news for Keystone Pharma.”

  Victor felt his body slump into the chair and the blood drain from his face.

  “This morning, we made the decision to stop the ticokellin clinical trials. Our CEO is meeting with financial analysts on Wall Street right now. By this afternoon, it’ll be public knowledge. A third case of aplastic anemia has been reported in the clinical trials. As a researcher yourself, you’ll understand.”

  “Ticokellin?” He paused briefly. “You used the butyl analog, didn’t you?”

  “Matter of fact, we did,” Minn’s eyebrows shot up. “Why do you ask?”

  “Why do I ask?” Victor’s voice rose. Kantor obviously had commercialized the wrong chemical analog. When his boss was leaving the NIH for a job in the pharma industry, Victor had argued with him. The butyl analog had a higher potential for toxicity. Granted, it was cheaper to synthesize the butyl analog and scale up to commercial quantities, but at the risk of more side effects such as severe anemia. The bottom line here: the bastard had deliberately sabotaged a lifesaving antibiotic so his corporate employer could save lots of money on manufacturing costs. Didn’t that make Kantor a murderer as surely as if he’d strangled all those potential patients with his own hands? Just as if he’d murdered Matthew with his own hands.

  “Just give me a supply.” Victor leaned closer to Dr. Minn. “Ticokellin showed efficacy in phase two, I’m willing to risk the chance of aplastic anemia. My son is immune compromised. He needs ticokellin. No paperwork, no record, no nothing. Just go into your lab and get me a twenty-one-day supply. That’s all I ask. No one will ever know. I will carry it on the plane and administer it myself. I’ll say nothing to Dr. Nelson or to anyone else. Please. I developed this drug. My son needs it. It’s only fair. Just give me a supply. Please!”<
br />
  “I’m sorry, Dr. Worth, I really am.” Dr. Minn got up, leaving Victor alone in the tiny room. As Minn disappeared through the security turnstile, Victor started to weep. It had come to this. A man who never had wept about his cancer, not even the emasculation, crying like a baby. Marie asked if she could call someone. A friend? A family member? Then she brought him a box of tissues. His handkerchief, and the spare, both tear-soaked, Marie’s fresh tissues wadded in his hand, Victor left for Tampa.

  At the Philadelphia airport, Victor rushed to find a pay phone near the boarding gate. His seventh call to a network of mutual colleagues hit pay dirt. Norman Kantor and his wife, Naomi, had retired to Longboat Key, Florida, to a condo on the Gulf of Mexico. How nice for Norman. No problem getting Norman’s phone number, it was listed.

  Victor’s watch said he had five minutes for a phone call before his plane left at two thirty p.m. Delta, nonstop to Tampa. Kantor was his last hope. A former vice president, Norman should have enough clout to prevail on the bureaucratic Minn. In fact, Victor was ready to bet that Kantor had squirreled away some of the drug. A common practice among researchers. One never knew when one might need the drug for personal reasons or for unsponsored research purposes. Not ethical, but—

  Victor heard Naomi’s voice on the Kantor message machine. Her voice was raspy as he’d remembered. “Leave a message. Norman or Naomi will call you back.”

  He asked that Norman call his office at NIH, leave a message where he could be reached. “As soon as possible, Norman, this is urgent!”

  Victor still had time to call Tampa City Hospital for information about Matthew. The last time he’d been told that Matthew was in the recovery room, listed in critical condition. No, Dr. Laura Nelson was unavailable—in a meeting. They informed Victor that Matthew was now in the surgical ICU, still listed as critical. That’s all the hospital could disclose. For more information, he’d have to talk to the patient’s doctor. Victor clanged the receiver into its hook and sprinted to the gate. He was the last passenger to board his Delta flight.