by Gary Braver
“What happens when caregiver complaints over flashbacks force the FDA to put a hold on distribution? And while we scramble to figure out what to do, millions of victims begin to slip away again. Meanwhile lawsuits fall from the sky like hail, and GEM Tech stocks won’t be worth the paper they’re printed on.
“And what happens when outside medical studies conclude that GEM Tech clinicians cut corners and pulled strings to get FDA approval? GEM Tech and every one of us in this room would be litigational toast. And the only ones celebrating would be the lawyers and the competition.”
Jordan spoke up again. “Nick, for the sake of argument, let’s say that some of these flashbacks are the direct result of the drug. So what? The alternative is dementia and death. But if the flashbacks don’t intrude, don’t threaten anyone, why not live with them? Look at Louis Martinetti—his Mini-Mentals are over seventy percent. That to me is a miracle.”
More chants of “Hear, hear.”
“I say we vote to accept this report while initiating an aggressive demographic profiling of patients who may have such seizures. This way we determine susceptible target groups.”
“You mean we conduct a demographic screening after approval?” Nick asked.
“Yes,” Jordan said. “And that population with a propensity for flashback problems would be warned to avoid the drug, and at the same time GEM could offer a free test to screen for it.”
“But that’s putting the cart before the horse,” Nick said. “I think it makes better sense to make those determinations before we submit our application. Even if it takes a year or so, it’s to everybody’s advantage to determine which patients might be susceptible to these flashbacks. The alternative is a dangerous rush to market that is unacceptable to me.”
“The other option is a black box,” Paul Nadeau threw out.
Nick chuckled. A black box was the warning that the Food and Drug Administration required in a drug’s labeling—nothing a pharmaceutical company welcomed. “Sure: ‘If you don’t want your elderly patients to play Ding Dong School all day or attack the postman because he took your marbles, then this drug may not be for your dementia patient.’”
Nobody else found that amusing.
“What you are asking, Nick,” said Rubell, “is that we tell millions of people out there that they’ll have to let the fog close over them while we work out these little details. In my book there’s no crueler punishment—show them the light, then blow it out. We are simply not going to stop this train.”
“I agree,” said Jordan.
“Well, then,” Nick concluded, “I have to say that I cannot in clear conscience vote to allow this report to go to the FDA without a disclaimer statement. It’s a whitewash job that feeds false hope to sufferers and caregivers. And I refuse to contribute to the perception that we researchers are so embedded with GEM investors that we have collectively voted to look the other way.”
Hard eyes beamed at him, as heads bowed together in judgment. And for a second, Nick felt like the centerpiece of Leonardo’s The Last Supper.
“That being said, I will write my own letter of recommendation that the FDA postpone review until further tests are conducted.”
A gaping silence filled the room as the blank ballots were passed around. Two minutes later the count was made: twenty-two in favor, one opposed.
Nobody said anything to Nick as he left the room and took the elevator upstairs to his room.
74
TWO THOUSAND MILES AWAY JACK KORYAN lay in his bed thinking about his biological father’s remains lying in a grave somewhere in a Cranston, Rhode Island, cemetery.
75
A LITTLE AFTER NINE THAT SAME evening, Gavin Moy called Nick to join him at the bar downstairs. “I didn’t see you at dinner.” Moy was sitting alone in a private booth at the dimly lit rear of the room.
“I had room service.” Nick was tired and wanted to go back up to bed.
They shared a bowl of mixed nuts. “You ate all the almonds,” Moy said. “All you left me are friggin’ peanuts.”
Nick swirled the bowl with his fingers and pulled out an almond. “Here’s a friggin’ almond.”
Moy took it and popped it in his mouth and crunched it down. They sat quietly sipping their drinks for a few moments. Then Moy said, “I heard what happened this afternoon.”
“I said what I’ve said all along. No surprises.”
“Except that your dissenting report will be a major setback for us.”
“Just one voice in the wind. I doubt it.”
“But a big voice.”
“Then you might consider reevaluating the rush to market, because the drug is badly flawed.”
“Bullshit, it’s not flawed.”
“Gavin, the only thing worse than Alzheimer’s is experiencing the same horrible trauma over and over again. And that’s what this compound has done to many victims: It keeps sending them back to relive terrible events. And that’s worse than Alzheimer’s. That’s worse than death.”
Moy made a hissing sound and batted the air with his hand. “I heard your arguments. I just wish I could talk you around to our view. A letter from you could derail the train.”
“Sorry, Gavin, but I can’t.”
They sat in silence for a long moment sipping their drinks. Moy flagged the waiter for a refill and another bowl of nuts. Then out of his jacket pocket he removed a sheet of paper and handed it to Nick. It was a photocopy of the story of Jack Koryan emerging from his coma.
“What about it?”
“It’s our jellyfish,” Moy said. “You know who he is?”
Nick felt himself tighten. Jordan Carr had requisitioned a blood assay on the guy. He had also asked for a frozen sample of his blood to check how much toxin was still in his system. “Yes.”
“I understand he’s been complaining about bad dreams.”
The son of a bitch is baiting me. “Yes. He’s been having flashbacks.”
“Flashbacks,” Moy repeated. “Something about nightmares of violent confrontations of some sort.”
“That’s my understanding.” Nick kept his voice neutral.
Moy nodded, not taking his flat eyes off Nick’s face, and picked out a couple almonds and crunched them in his molars. “I’m just wondering if you think there’s anything to it.”
He’s playing tricks with me, Nick thought. Some kind of twisted blackmail thing. “It could be recollection; it could just be bad dreams. I’m not really certain. There’s no way to know.”
“It doesn’t bother you? You don’t see a problem here?”
“We’re talking about stuff in the subconscious mind—nothing one can substantiate.”
“Well, it seems we’ve both been wondering about this guy and what he remembers, and if that’s a problem.”
“I don’t believe it is. Besides, our interest in him was strictly scientific.”
“Of course,” Moy said, and he clinked Nick’s glass where it sat on the table. “And, frankly, I’m getting tired of this fucking ghost dance.”
Nick took a deep breath. “Me, too.” He checked his watch. “I’ve got to get up early tomorrow.”
“Oh, yeah, your sunrise safari.”
Nick had mentioned that he would be heading off to Bryce Canyon.
“You know that the forecast is for freezing rain in the mountains.”
“Cuts down on the crowd.”
Moy chuckled. “A crowd of one.”
Nick’s plan was to get up around four-thirty A.M. and make it to the canyon before sunrise. “You’re welcome to join me.”
Moy made a humpf. “The option of getting up in the cold and dark to drive twenty miles to watch the sun rise, or stay in bed. What we call your basic no-brainer.”
“How often does one get the chance to catch a sunrise on Bryce Canyon?”
“Almost as often as sleeping in. You can show me your pictures.”
Nick left thinking that maybe he was wrong. Maybe they were dancing with ghosts.
76
“MY GOD,” NICK WHISPERED TO HIMSELF as he looked down.
He was standing a few feet from the four-hundred-foot drop-off ledge that made up Inspiration Point at the southern rim of the canyon. The only sound was the rustling of chilled winds through the ponderosa pines and jagged sandstone promontories—a sound unchanged for a hundred million years.
Bryce Canyon gaped at Nick’s feet—a deep series of amphitheaters filled with thousands of limestone and sandstone spires, fins, and towers carved by wind and rain into whimsical shapes, creating a maze of ancient hoodoos. Overhead, the indigo vault was rapidly fading to an orange fire as the rising sun spread from the eastern horizon, bleaching out the last few stars. A crystalline quarter moon rocked in the northwest sky.
Nick inched closer to the drop-off for another shot.
He had gotten up as planned, and made it out here in his rental in about half an hour, stopping for coffee and donuts at a gas station mini-mart. Of course, the roads were wide open with no one else on them. He had checked out of the hotel at four-thirty A.M., his rental packed to take him back to Salt Lake City for his afternoon flight back home—after this glorious pit stop, of course. The last couple days had been stormy, but today the clouds were breaking. And because of the nearly nine-thousand-foot elevation, the air was still chilled and the trails dusted with snow.
The most amazing thing was that nothing moved. He could see for over a hundred miles, and there was no motion but for the junipers and pines. Not even a falling stone. Given the hour and the frigid, windy conditions, not another hiker or tourist appeared to be within miles of the place. Nick’s rental was the only car in the parking lot. From his perch, not a road or car or building or urban light violated the primitive panorama. Not a single sign that this was the twenty-first century and not a sunrise during the Mesozoic age. In fact, this could very well be another planetscape—a vista on Mars, given the reddish stones. Yet the stunning lack of sound was a gratifying relief from the noisy, crowded conference rooms and dining halls.
Nick mounted the Nikon with the three-hundred-millimeter gun-barrel lens onto the tripod, attached a shutter release cable, and began taking shots of the predawn light glazing the towering fins rising from the canyon floor.
He would take maybe four or five shots, then move along the rim as the light changed. When the sunlight began slanting into the canyon, he switched to the two-and-a-quarter Mamiya 7 with the wide angle and headed for the very edge to shoot vistas. One must sustain a near-religious trust in the integrity of limestone, for he was at the very edge of a sheer drop-off, the sight of which sent electrical eddies up his legs.
He aimed at the sunrays gilding a row of rock blades.
Click click click.
Then back to the eighteen-millimeter wide angle.
Click click click.
The light was changing by the second. He shot off the rest of the roll and put in another, then moved up the rim. There he crouched down at the edge and shot down at the sunlight glancing off a clutch of sun-enameled fans of limestone. It was amazing how they resembled a colony of fire coral, but in monstrous proportions. Of course, despite the calcium carbonate structures and the fragile flamelike shapes, so-called fire corals are not true corals but rather a hydrozoa whose stinging cells are equipped with needlelike projections containing burning neurotoxins closely related to those of jellyfish.
Jellyfish.
Amazing how lines converge. Of all the people on the planet to meet up with Solakandji jellyfish, Jack Koryan. And what had brought them together was a confluence of seemingly random geophysical events—cool Pacific seas, warm Atlantic highs, errant Gulf Stream waters, a man on a swim in the right place at the right time.
The jellyfish effect.
Statisticians would put the odds at one in a million-except that this was not a statistically random convergence of the twain. Far from it. Nick didn’t know to what extent things connected, but when he got back to Boston he’d check. But it was amazing how the closer you looked at life, the fewer accidents there were. In fact, maybe there were no real accidents.
Oh, Jack Koryan, he thought. Poor Jack Koryan. You’ve got demons clawing at your brain, and you don’t know what to do. The sad thing is that nothing can be proven after all these years. And even if it came to that, how do you explain? It’s all so garbled by time. Even if you could explain, what can you do about it?
But maybe you should, Nick told himself. Maybe do the one decent thing that would free the guy. And isn’t that your playbill role out here: Dr. Ethics?
Deep down, Jack, we’re really not bad people, just humans in conflict—like the rest of the race. Except the stakes are higher.
Nick looked at the sun rising between a fissure in a hoodoo blade rising out of the chasm. A shaft of gold sent spikes in all directions like a crown of glory.
Sorry, Jack Koryan, for the long bad nights. But, I swear, when I get back I’ll open the door for you.
Nick moved to another outcropping of rock where he hung over the edge with the Nikon. He clicked off three shots. The light was rapidly shifting, shafts of gold shooting from the horizon through the cloud holes. He traced one to his right when he thought he spotted some movement on the higher ledge. He swung his camera around to zoom in on what appeared to be a clotted shadow among some pines just below where the rays lit the treetops.
In the split instant he depressed the shutter release halfway for autofocus, uncertain whether the shadow was an animal or a person, sudden movement from behind him sent a reflexive shudder through his body.
Before he knew it, a figure rushed out at him. In the instant before impact, it all became clear to Nick. But in a hideously telescoped moment he felt the wind punch out of his lungs, and his body was propelled off the rockface lip and into the abyss.
FROM A PERCH FIFTY YARDS TO the upper right, the only sound was a solitary note of recognition—a short “ahhh” escaping from Nick Mavros’s lungs as if he had found a misplaced key—then maybe ten seconds in real time the soft smack of his body against the rock rubble below … then some muffled afterechoes as he and his camera tumbled to their final resting place in the cretaceous layers of ancient seas.
It was done, and Dr. Jordan Carr signaled below to his accomplice to return to their car before day hikers began to show.
Jordan’s guess was that Nick would eventually be found by backpackers or park rangers—a battered thing in a red North Face parka and jeans. And, depending on how long it took to recover the body, the newspapers back home would run the sad obituary of Dr. Nicholas Mavros of Wellesley, Massachusetts, senior neurologist of MGH and chief principal investigator of clinical trials of the new experimental wonder cure for Alzheimer’s, who had apparently lost his footing during high winds on a slick and crumbly rim in Bryce Canyon National Park while alone on a photo hike. He had been in Utah attending a meeting of clinical physicians for blah blah blah, as Gavin Moy would so eloquently put it.
Jordan took a final glance into the abyss.
The only barrier between him and the Promised Land now lay below. And God’s in his heaven, and all’s right with the world.
77
SOLAKANDJI.
Jack had written the word on the back of René Ballard’s business card.
It was a warm afternoon, a fine day to be outside. And Jack’s rehab people were of the Kamikaze School of physical therapy, encouraging him to get out and walk twice a day.
The Robbins Memorial Library was no more than two miles from his house—maybe an hour’s walk at his rate with the cane. Located in the center of town on Massachusetts Avenue, the library was a beautiful Italian Renaissance building whose interior might have been one of the most stunning in the Northeast—high vaulted arches, Doric columns, carved marble niches, paintings, and multicolored marble floors. Beyond the rotunda was the reference room, where a bank of online computers stood against a wall. At this hour most students were in class, so there was no wait for a machine.
On Google, he came up with hundreds of hits for “Solakandji jellyfish.” He scrolled down the list, uncertain what he was looking for, but positive that this was preferable to laundry and housecleaning. Besides, he was curious about the little critters that had taken a half-year bite out of his life.
Some of the sites contained general info about jellyfish with sidebars about Solakandji; other sites were for naturalists, students of marine biology, and underwater photographers. Several explained treatments of jellyfish stings. Aunt Nancy had been right—vinegar, and don’t rub.
He clicked on a few sites that included color photographs of the animal. And there it was: Solakandji medusa—a smoky yellowish translucent mushroom with spaghetti tendrils. It looked so innocently pretty.
This highly venomous jellyfish is extremely hard to detect in the water …
… its tentacles can grow up to 2m long and are near invisible under water.
The Solakandji sting causes a rapid rise in blood pressure and a cerebral hemorrhage …There is currently no anti-venom available for the sting because scientists have struggled to capture enough of the jellyfish to develop an antidote …
Coelenterates have stinging cells called nematocysts, which are made of a spirally coiled thread with a barbed end. On contact, the thread is uncoiled and the barb delivers the toxic substance …
(St. Thomas, V.I.) By the time the emergency helicopter arrived, he was screaming in agony; a few hours later he was in a coma … died four days later …
There were similar news items about rare encounters in the Caribbean with swimmers and snorkelers, but none in North America. The news account of his own attack had apparently expired.
As he continued down the hit list, he found more technical sites cued by scientific terminology—“Coelenterate,” “envenomations”—and linked to lengthy abstruse articles for marine biologists and not the beachcomber or sport diver.
