Last Shot

by Gregg Hurwitz

  Huang finally swept into view, wearing his knapsack, an accessory—like the Trek twenty-one-speed he “commuted” on—that Dolan had always thought an affectation of youthfulness. Dumping the knapsack onto his desk, Huang tugged his lab coat from his chair back and slipped into it, completing his transformation into authority figure. Sipping a Starbucks, he pulled himself to his monitor.

  Dolan stood, trying to override unease with indignation. Why shouldn’t he confront Huang? After all, wasn’t it Dolan’s company? Vector Biogenics wouldn’t exist were it not for him. As the father of the process and the senior scientist, wasn’t he entitled to a few simple information requests?

  He started for the door, muttering to himself, drawing curious gazes from the junior researchers. His resentment flared, putting an uncharacteristic conviction into his step. He gowned up and passed into the baking heat of the production room, a massive incubator where thousands of bottles rotated slowly on racks lining the walls. Made of polypropylene, a plastic on which cells readily grow, the roller bottles were filled with a red medium liquid. This growth fluid created a wet environment for the genetically altered smallpox to reproduce. In the batch currently spinning all around Dolan like living wallpaper, a mere three days into production, the virus had already swollen the cells and begun to bud out of them. A few more days and the production team could pour out the infected liquid and filter it. Once the Xedral was purified, it could be formulated, dispensed into vials, and freeze-dried, just like a standard vaccine. After that, just add purified water and inject.

  Dolan stepped into the airlock, then out into the test suite, the monkeys grunting and banging their cages in greeting. With relative ease, Dolan had designed a viral vector to “knock out” the AAT gene, so that Huang could create an animal test group that simulated humans with alpha-1 antitrypsin deficiency (destroying—especially when it came to genetics—was always easier than repairing). Rabbits, mice, pigs, and woodchucks had all come and gone before Huang hit upon cynomolgus macaque monkeys, whose clinical presentation of the deficiency was sufficiently comparable to that of humans to make them useful in determining the effectiveness of Lentidra and Xedral. Simple intravascular injections, like flu shots, were administered, and thirty-six hours later the test monkeys no longer had functioning AAT genes. Their livers started to shut down; they lost weight; their sclera yellowed. Dolan had created the problem to fix it. And fix it he had.

  How permanently his viral vectors could keep that fix in place was another question. The recovery of the monkeys had been staggering to witness. An added advantage in using higher animals was that the trials could continue longer; it wasn’t until the eighth month of L12-AAT’s second trial that Huang had caught the complications that had made the board pull Lentidra from development.

  Dolan arrived at Huang’s side, but the study director continued tapping at the keyboard, the monitor’s glow reflected back in his glasses. “Just a sec, D.”

  Waiting, Dolan offered a salute to Grizabella, and she bared her teeth kindly and returned the gesture. One of 128 composing the final longitudinal Xedral study, Grizabella was the gentlest and (on those rare occasions when Dolan ventured into the test-subject suite) his favorite. Huang had started with 130 macaques but lost two to simian hemorrhagic fever, which was common enough in monkeys imported from the Philippines and, thankfully, harmless to humans.

  Huang sent an e-mail with a flourish of his hand and spun on his chair to face Dolan. He flashed a boyish grin. “Herr Direktor.”

  “Chris, I took a spin through the preclinical reports you got me from the last Lentidra trial. I’m still having trouble reconciling the figures with the results. I’d like to take a look at the raw data.”

  “Again? We’ve gone around on this a few times now.”

  “And every time I found inconsistencies in what you submitted to me. I’d like all the raw data so I can rerun them myself. Top to bottom.”

  Huang blew out his cheeks. “Well, we’re focused on Xedral now, right? We’ve got a functional model, and we’re readying to hit market.”

  “Xedral’s more or less autopiloting to Phase Is next week.” Dolan set his fists on his hips, Superman style. “My work there is done.”

  “So don’t we need you to move on? Lentidra didn’t pan out.”

  “Exactly. But, you see, everything I oversaw on Lentidra did bear results—”

  “In a petri dish.”

  “Which is why I want every piece of data since my vector crawled out of my petri dish and into your monkeys.”

  Huang laughed. “Fair enough. It’s a ton, though. I’ll need some time to pull it together.”

  “What’s the challenge? Attach it to an e-mail and click ‘send.’”

  Huang jigged the chair back and forth so it gave off little squeaks. “Look, the board’s been clear where we need to be putting our focus. Don’t you think—”

  “The board doesn’t want to burn resources chasing a failed model for the sake of the senior scientist’s ego. I get it.”

  A tension-releasing laugh. “You said it, not me.”

  “But you’ve got to remember, this company’s based on vision, not just corporate expediency. The upside to Lentidra—permanent transgene integration—is huge. It’s worth devoting a small percentage of our resources to backtracking and troubleshooting. I hate to sound like a commercial, but if I get a handle on the problem, I think I could engineer an alternate Lentidra design that would offer us the best of both worlds—the stability and safeness of Xedral with long-term genetic expression. If we nail it, who knows what the other applications will be?”

  “Okay. I’m with you. I’ll help. But we’re all working late. And early.” A gesture at the computer-screen clock. “We’ve still got limited time, and time—as our CEO is so good to remind me in our now daily meetings—is our most valuable capital. Based on what I’m getting from upstairs, obsolete vectors are not where our aim is right now. Our aim is the IPO. As soon as we get through the next few weeks, I’ll dig out all the old data. Then we’ll start breaking it down together in our copious spare time.” Huang offered a hand and a smile. “Deal?”

  Dolan did a quick translation: In his zeal to serve the board, Huang had put all his focus into Xedral, leaving the other data in sloppy condition. Though Dolan couldn’t relate to Huang’s lack of curiosity, he’d found it all too common in corporate researchers.

  Dolan returned the handshake but not the grin. When he turned, Grizabella extended her hand through the bars and slapped him a solemn five. He passed through the automated glass sliding doors into the hall, Dean Kagan’s pious oil portrait beaming down at him.

  Chapter 16

  Maintaining a disciplined stillness at the head of a preposterously long conference table, Dean Kagan held his executives’ pained attention a moment longer. The tip of his tongue poked into view, wetting his lips. “Permit me to list the excuses so we can skip the whining phase this morning. Consumers are pissed off about climbing prices. The AARP is on the warpath and has allies on the Hill. Canada’s undercutting our supply and pricing. The pipeline’s not what it was. Twenty-eight states and counting have passed legislation to regulate drug pricing. I know. Your job is not to reiterate the obvious but to come up with creative solutions. I’d like each and every one of you to hear me on this point.” A creaky shift forward and then a firm finger jabbed across the grain of the mahogany. “I’ll be pushing up daisies before I permit this company to backslide on its P&E multiple. I want blood from a stone. And I want it staining our next quarterly sales estimate. Booked sales will be up before the shareholders’ confab in November. I am not having another week’s golf at Wailea rained on by those Wharton clones from the pension funds.”

  Twenty faces stared back at him, male and female, black and white, doughy and chiseled, but attentive to a one. Dean scrutinized them, amused by himself, the market challenges, the tension in the room. His hair, silvered but as yet unthinned by age, was short and expertly styled. A fo
rty-five-hundred-dollar suit disguised his softening athlete’s build, enhancing his shoulders, firming his posture, creating a more tapered waist. Dean Kagan had never been forthcoming about his age, but an average of the conflicting public-record accounts put him at seventy-three.

  The air smelled of linseed oil and leather, still new-car strong though twenty-seven years of weekly 6:30 A.M. “stratcom” meetings had passed through the war room since it was constructed. The impressive plane of wood on which rested elbows, reports, and various mugs of designer coffee was Bolivian mahogany, acquired for a pretty penny before the import laws clamped down. The brass fittings of the cabinets were polished to a boot-camp gleam, and the window that stretched the length of the north wall, providing a twenty-six-story view of Westwood and the smog-shrouded Santa Monicas beyond, was spotless.

  The solid-core oak door had been calibrated to bulletproof, as had been the door leading into the anteroom, one of many details put into effect by the same overpriced Beverly Hills firm that had sent contractors to secure the oil fields of Kirkuk. Stem-cell research that Beacon-Kagan sponsored on three continents had led to increased threats, but there’d be no shoot-em-ups here, nor at the Kagan estate, where the windows were tactical glass and Dean’s security adviser—who lived full-time in a guesthouse—was always within handgun range. The master suite even had a walk-in closet that converted to a safe room in case of burglary or attack. Dean had cut a swath through the world of international commerce over the past half century, and he wasn’t going down because some mouth-breathing crusader with a hair-trigger twitch couldn’t shake a fit of empathy over the treatment of his primate brethren.

  Beacon-Kagan had sprung up fast and hard in the late seventies, stealing talent from the universities and competing corporations and developing a slate of solid but unexceptional meds that kept the company reasonably profitable from the start. As it grew more innovative and reactive, it began to reap higher dividends. Beacon-Kagan had added its name to the roll of the Pharmaceutical Research and Manufacturers of America, at last muscling up to the table with Merck, Bristol-Myers Squibb, Pfizer, and its other better-regarded, higher-market-cap competitors. Over the past several decades, Dean had driven the company—and its stock—north with relentless focus and vigor, Beacon having long fallen out of the picture, slumped into his potatoes au gratin at a corporate luncheon in his fifty-ninth year with a blown aorta. Today Beacon-Kagan was poised not only to compete but to trailblaze.

  Dean punched an intercom button built into the desk. The door creaked open, and a nervous assistant stood in the gap, her hands clenched before a tasteful charcoal skirt.

  “My coffee,” Dean said.

  The assistant relayed the message to someone out of sight, and a demitasse, gold rimmed, appeared almost instantly through the gap. She delivered it to Dean and backed away, ready to respond if he chose to make eye contact.

  The leather chair cocked under his weight. “Now,” he said, with the relish of a football coach assigning a particularly grueling hitting drill, “let’s trot out the workhorses.”

  The senior VP of Sales and Marketing ruffled her notepad, then pulled off a stylish pair of glasses and set them on the table. Jane Bernard was a tenacious, steely woman with handsome features and a shell of coiffed gray hair. “Why don’t we begin with Midachol?”

  Dean tipped his head in a nod.

  They’d added their own statin to the cluster behind the counters and, with aggressive promotion, managed to squeak out an 11 percent market share to the tune of a billion and a half a year. To approve a new drug, the FDA demanded only that it be shown superior to a placebo, not to other drugs. In Beacon-Kagan-conducted trials, Midachol had beat a sugar pill at lowering cholesterol nine times out of ten.

  The young man across from her looked up from his BlackBerry and shot Jane a wink. In an approximation of an arranged marriage, he was engaged to her daughter, currently back east finishing a clinical social work degree at Smith. Chase Kagan returned to his e-mail, holding the wireless device in both hands like a GameBoy. His navy jacket hung over the back of his chair, freeing him to display the rich colors of his madras shirt. A knee, clad in artfully rumpled linen, was propped against the table’s lip. His eyes were small and pale, set in pouches of loose skin accented by lashes so light they disappeared unless the sun hit them. He carried an air of uninterest—not apathy but boredom, as if he knew all the answers before the questions had been asked. A precocious but well-earned affectation for a twenty-eight-year-old a few promotions out of B-school.

  Jane offered her future son-in-law a terse smile, folded her arms, and said, “We’ve stayed horizontal for June and July—”

  Dean said, “Lobby the panel, get them to change the parameters of high blood pressure. We already got one-forty over ninety moved to one-twenty over eighty, see if they’ll give us another adjustment. It’ll open up the market for everyone. Two of the panel members are our consultants—I’m sure the other fine M.D.’s are living subsidized lifestyles on someone else’s dime. Sandeep, put out a pigeon to our brothers-in-arms. We can play well with others at this stage, fight it out over market share later. What else?”

  “We need a more aggressive ad campaign,” Jane said. “We have to go up against the competition directly.”

  “Who’s stopping you?” Dean said. “Here’s what we do: Pick off the top dog. We run a quick trial comparing Midachol to Lipitor—twenty mgs of ours against ten mgs of theirs. We don’t have to disclose dosage—”

  “Better yet”—all heads swiveled to Diane Little, head of Legal—“nor do the guidelines specify how we need to administer. So for the Lipitor sample group, we can give the drugs other than as recommended—say, topically instead of orally.”

  Dean’s head panned the table. “What else? I want to hear those gears clanking, hamsters running on their wheels. Earn those stock options.”

  Jenner, Research, cleared his throat. “If we’re moving toward comparative branding, how about an obscure safety test? We’ll stress that Midachol usage doesn’t cause testicular cancer. Since the other companies haven’t tested for it, it buys us a ‘proven safer than’ tag in the commercial.”

  “We do, however, have some FDA complaints about the incomplete list of side effects on the current commercials. That we might need to address,” Little said. “We capped them at five seconds for a thirty-second spot, but we need at least ten.”

  “No,” Dean said. “I’m not paying two-fifty K per prime-time hit to air voice-over about burning urination and flatulence. Refer viewers to a Web site.”

  “We’ll hear about it from the FDA, Mr. Kagan.”

  “I’ve been hearing from the FDA for twenty years. What do we care about fines? We negotiate the levels of the fines every lobbying season. Now—do you know how many people the FDA employs to review industry ads for accuracy and balance, Ms. Little? Thirty. Thirty people for thirty-four thousand ads annually. They’re slow. By the time they send us a warning letter, the campaign’s run its course and the ads are off the air.”

  “And if we’re nailed?”

  “Our bottom line can handle a few nickels out and a page-twenty-seven mention in the Journal better than explosive diarrhea as declaimed by Mr. Moviephone. Next.”

  “We think you at least want to consider—”

  “Next. How are we looking in the ambulatory-suicide department?”

  “Strong,” said Patrick White, VP of Product Management. “We gained two on Prozac, nearly as much on Zoloft. But we’re losing the patent on Pastol next year, so we need some strategies for extending—”

  “Make it a weekly drug instead of a daily. Or change a molecule, have P&A pick a new name and color, and ram it through. There’s an idea—make it a suppository. Whatever. Pick us up a fresh twenty years on the patent. We’ll market it as improved, phase our users over to the new product, and discontinue the old model.”

  “We’ll also have to smear the old model before the generics get their hands on it,�
� Chase offered, his eyes still on the LED screen of his BlackBerry. “A few well-timed press releases about this side effect or that.”

  “There you go. I thought I was gonna have to send all you people to the remedial group.” Dean burned with pride, his mind feasting on the possibilities. “Thanks, Chase. Everybody: Ours is a highly creative business. Don’t come here needing to be reminded of that.”

  “If we start the process now,” White jumped in, “we’ll be in good position for the big holiday push. Advertise hard on Christmas depression—”

  “Make generalized depression a bit more generalized,” Jane interjected playfully.

  “—push the docs to prescribe away the blues. We do a mass sample mailing in November to get patients habituated, then we send the doctors free Christmas trees.”

  “You jackass.” A good-natured smile graced Dean’s lips. “These are doctors. Send dreidels.” He didn’t wait for the scattered laughter to die down. “I want a clean entry to prescribers. The repackaged Pastol has to be the New Best Thing for depression, and our data’s gotta support that.”

  Dean Kagan was in his element now. As the best and brightest argued over placebo bumps and cherry-picking test subjects, he leaned imperceptibly back and quit listening. The meeting had done what he loved—taken on a life of its own.

  “How’s Boneral?” he half heard someone ask. A fresh wave of laughter, though the quip had long worn thin.

  “Well,” Jane began, “our head-to-head campaign didn’t fare well. You’ll remember we had banners at NASCAR—‘Viterol: What Viagra Wants to Be When It Grows Up,’ ‘Viagra on Steroids’—that stuff, but it didn’t take. We need a face for the product.”