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Authors: Daniel Kalla

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The last group of file folders she reached for contained the excluded patients—those people disqualified from the study after they had already been enrolled. There were over thirty such rejected patients. Though it was a large number, Jill wasn’t surprised. In a study as complex as hers, it was natural people would be disqualified or change their mind and drop out of the study after enrolling.

Jill separated the exclusions into two piles: eighteen from the treatment arm and fourteen from the control group. A few patients had been dropped
early on, but most had made it to at least the initial three-month reassessment phase. At the front of each file, a thick red stamp read exclusion. Underneath, scrawled in pen, was an explanation why a particular subject had been disqualified. Though she found some of the explanations flimsy, most patients appeared to have legitimate reasons for being dropped from the study.

She began flipping through the pages. After the first few files, Jill wondered if this review was the best use of her limited time but, a perfectionist by nature, she read on. After about fifteen files, she began to notice a trend in the data. The excluded patients did not seem to have the same outcomes as the included subjects.

Jill stacked the pile of excluded files back on her desk and turned to her computer. She reformatted the tables on the spreadsheet, inserting extra rows. Her mouth dry, Jill reached for the first file in the stack. She painstakingly transcribed all the data she had on that patient into her spreadsheet. Then she reached for the next file and repeated the step.

By the time she had typed in the data on the last of the thirty-two excluded patients, the daylight outside her window had faded to dusk and her stomach grumbled violently. Jill sat in the near dark, enshrouded by a sense of doom. The mouse’s pointer hovered over the icon, waiting to redraw the graph to now include the disqualified subjects. But Jill resisted tapping the button, already certain of what the new graph would reveal.

Time stood still.

Finger shaking, finally Jill clicked the button and watched as the graph popped onto the screen. While the two lines (the control and treatment group) still diverged over six months, they split from one another much more gradually; the statistical difference between them much less significant than it was before. Jill stared in horror at the newly calculated P value below the graph.

It’s all over!

Light from the overhead fixture suddenly flooded the room. Jill looked behind her to see Tyler standing by the light switch, eyeing his wife with concern. “Jill? You okay?”

She shook her head.

Tyler hurried across the room and knelt at her side. “What is it? Your parents?”

Jill pointed to the screen. “That.”

Tyler glanced from the screen back to her. “What is
that?

“It’s my ruin, Tyler.”

“What?”

“My study,” she choked out. “It’s a fraud.”

“What are you talking about?”

“The excluded patients! Once I put them back into the spreadsheet, my numbers don’t hold up. Look at the P value! I’ve lost the statistical significance between the two groups.”

Tyler squeezed her shoulder. “Slow down, Jill. You’re losing me.”

“There were thirty-two patients excluded after the fact from my study!” she said. “That’s a fair number, but not beyond expectation. But when I include the data I have on those subjects, my results don’t hold up.”

“So? They’re excluded patients. They shouldn’t be in the study.”

“That’s not the point. There is a trend here that is
anything
but random.”

Tyler shrugged. “I still don’t see it.”

“It’s right there in the graph!” Jill tapped the screen impatiently. “The subjects who were excluded from my study did not respond like the patients who were kept in. In the excluded group, the control subjects all did better than expected and the treated ones did worse.”

Tyler’s eyes widened and his jaw dropped a fraction. “Hold on, are you suggesting—”

She swallowed. “I think someone excluded subjects in order to make the study results look better.” She felt tears running down her cheeks. “I think I’ve just committed research fraud.”

“Jill, that’s ridiculous! How could you have? You obviously didn’t know about the exclusions until now,” he said. “It must be someone else inside—”

“It’s my lab, Tyler! My study. And I’ve already published the preliminary data in my grant renewal application. I swore to the validity of the results. Therefore,
I
am responsible.”

Tyler wrapped an arm around her and held her tightly against his chest. “But you’re the one who discovered it. There was no intent on your part. Now you just have to tell them.”

She buried her head in his shoulder. “Oh, Tyler. It’s too late.”

“No.”

“It’s over. I’m finished,” she said in a whisper.

“Come on, Jill. It just seems that way.”

“It
is
that way.”

He rubbed her back. “This is going to work out all right.”

The stifling dread began to relent, and she felt a glimmer of comfort in his arms.

Jill wanted to tell Tyler that she loved him. She wanted to tell him she was pregnant with his child. But her voice failed her. So she just clung tightly to him and buried her head deeper in his shoulder, wishing none of it was happening.

25

Lorna didn’t know whether the alcohol or the continuous storytelling was to blame, but Dot hit the wall during lunch. She had barely swallowed two bites of her frittata when her chin slumped to her chest and she dozed off in her seat, fork still in hand. Juanita had to practically carry the tiny woman off to her bedroom, which she did with an effortlessness that suggested she had done the same countless times before.

Pleasantly buzzed from her three prelunch drinks, Lorna worked the afternoon away on her laptop, typing new notes and reorganizing old ones. Everything had changed since her arrival at the Alfredson mansion. It now was a completely different story with more usable elements than Lorna had ever anticipated. The narrative was writing itself in her head, but she was desperate to tease out the rest of the family history from her great-aunt.

Consumed by her work, Lorna didn’t notice that the sun had lowered and the afternoon had given way to evening until she heard Dot’s clipped voice calling from downstairs. “Darling, dinner is on the table. And the wine has breathed so well that it’s
positively
panting now.”

“Damn it,” Lorna muttered to herself. She had hoped to speak to Juanita and convince her to keep the dinner as dry an affair as possible so that she didn’t lose Dot for another whole evening.

“Coming,” Lorna called, as she finished bulleting two quick notes. She saved the file, closed her laptop, and tucked it deep under the bed.

She began down the stairs, but stopped on the landing to study the oil portraits that lined the wall. Marshall Alfredson stared down at her from the largest of the canvases at the top of the staircase. He wore a three-piece navy suit with his beloved pocket watch hanging prominently from his vest. Framed by a mop of red hair and muttonchops, his suspicious eyes and taut
expression seemed to challenge her from the wall. Accentuated by the sheer size of the canvas, Marshall struck Lorna as a larger-than-life character. She felt a real pang of empathy for Evan McGrath, imagining how daunting it must have been for him to have to confront her great-great-grandfather.

Lorna turned her attention to the smaller portrait of Olivia, hanging adjacent and just below Marshall’s. Though her complexion and hair color mirrored her father’s, she exuded gentle warmth that transcended her unsmiling pose. Her youthful face possessed timeless beauty. Lorna understood how easy it would have been for Evan to have fallen head over heels for the girl.


Dar
ling?” Dot called in a singsong voice from downstairs.

Lorna peeled her eyes from the portraits and headed down the rest of the stairs and into the dining room with its elegant wainscoting and coved ceiling.

Glass of red wine in hand, Dot again wore tiger-striped leggings, this time with a black blouse that was long enough to be a dress. She gave Lorna’s outfit—jeans with a gray sweatshirt—a quick once-over. “No need to dress up for dinner, darling.” She chortled. “We’re
hopelessly
informal here.”

Unperturbed, Lorna sat down across from her great-aunt.

“We really should have seafood after last night’s lamb.” Dot raised her glass. “But I felt like red again tonight, so I’m afraid you will have to make do with Juanita’s pot roast.”

“It smells delicious.”

“It’s generally edible,” Dot said louder than necessary, likely for Juanita’s benefit.

Lorna reached for her wineglass and took a small sip, enjoying the slight bite but determined not to let the alcohol impede her progress. “So did Evan marry that schoolteacher, Grace Hathaway?”

Dot sighed. “What say we let the nineteenth century rest in peace tonight?”

“You must find me exhausting.” Lorna laughed, feigning contrition. “It’s just that I have to leave early tomorrow to get back to teach a class in the afternoon. And you’ve left me on tenterhooks. It’s a real cliff-hanger. I just have to know how it all ends.”

Dot waved the compliment away as she took another sip of her wine. “We did spring from some
wonderfully
memorable ancestors. I’m merely a cipher.”

“Nonsense,” Lorna cooed. “Without you, this would be forgettable minutiae. You bring the Alfredsons and McGraths back to life.”

Dot lowered her glass. The vanity slid from her expression, and her eyelids narrowed warily. “I still don’t quite see why this matters so much to you.”

“It doesn’t really,” Lorna said lightly as she fingered the stem of her glass.

“Darling, am I
really
to understand that how Evan and Marshall managed their differences will impact your vote at the board meeting?”

Lorna pulled the glass from her lips and met her great-aunt’s stare. It was a precarious moment. She knew better than to overdo her answer; Dot was too sharp to be taken in. “I’ve already heard enough to make up my mind. At this point, I just want to know how it ended between these two men . . . and Olivia, of course.”

Dot viewed Lorna for several more seconds before her face relaxed. She lifted her glass again. “You asked me earlier how my father was related to Olivia.”

Lorna nodded.

“To be precise, Olivia wasn’t really my aunt.”

“No? What is the relation then?”

“Let’s not get ahead of our story.” Dot’s eyes lit mischievously. “On the tenth of August, 1896, Olivia gave birth to a boy—Arthur Marshall Grovenor Jr. Though from the day he was born, everyone came to know him as simply Junior.”

“Hold on.” Lorna sat up straighter. “Your father—Marshall’s son—was called Junior, too. Were there two of them in the family?”

Dot shook her head.

Lorna clutched the table in front of her. “Are you saying Junior was Marshall’s
and
Olivia’s son?” she said, aghast.


Please!
” Dot rolled her eyes. “You can safely accuse us Alfredsons of more than a few unsavory acts, but not
that
.”

“I don’t understand,” Lorna muttered.

Dot ignored her great-niece’s exasperation. “As was Junior’s lifelong tendency, he arrived early. Almost two months, apparently. But premature or not, he was born with the same solid constitution that would carry him through the next eighty-two years.” She sighed. “And how they fawned over him! Not only was he the apple of his parents’ eyes, but Junior was Marshall’s only grandchild.”

“But I thought you just said he was—”

“Ah, ah, ah.” Dot wagged a bony finger. “In good time.”

Aware that her great-aunt would not be rushed into her disclosure, Lorna folded her arms over her chest and leaned back in her seat.
Out with it, you old snake!

“Evan McGrath, of course, was still heartbroken over Olivia’s marriage.” Dot sighed. “But 1896 was a hectic year for the young surgeon, too. By early that autumn, the Alfredson Clinic was nearing completion. He was still the only doctor for the town of Oakdale. And yes, darling, he did marry Grace Hathaway.”

In those early days, Marshall and Evan faced daunting obstacles while establishing their new clinic. Together, they managed to overcome them all. But neither ever imagined how violently the winds of change would upend Marshall’s life in the spring of 1897.


The Alfredson: The First Hundred Years
by Gerald Fenton Naylor

Evan felt as though he had lived a second lifetime in the ten months since Virginia’s death. The clinic had risen rapidly from the muddy pit he had watched the crew dig. Despite his many differences with Marshall, Evan had to concede the lumber baron had erected a noble building that surpassed even his expectations.

The three-story redbrick building had a grand columned entrance with an esthetically pleasing façade that still conveyed a sense of healing and comfort. The spacious floors were flooded with natural light, providing ample room and privacy for staff and patients. The two operating theaters were the most modern and well designed Evan had ever seen. He considered the clinic’s layout superior to even the Morgan Clinic in San Francisco.

BOOK: Of Flesh and Blood
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