Race Across the Sky (14 page)

“Are people upset?”

“People don't know yet. But relationships have”—Mack circled his hands—“reactions. If they succeed, other people feel they need one too. It's mimetic desire. If they fail, bad vibes invade our house. Look Caleb, if you feel the need for a one-on-one relationship, that's very cool. You can have that and still compete at a very high level. But not here.

“I like June. I love little Lily. But I don't care how good a runner you are. If you don't get it together, they're gone. I want you out training when June is in here. And in here when she's out.” He nodded his head. “I sent Annabelle packing when she was winning in every Fat Race in Colorado, because she was spending time with that mustached motherfucker bartender. And June isn't winning any races.”

Caleb's stomach clenched. If Mack expelled them, where would they go? He needed to keep them here, while he waited for Shane to tell them what to do. He would agree to anything for that.

Mack stared at him. “‘But where is what I started for so long ago? And why is it yet unfound?'”

Cowed, Caleb turned for the door. Then, his hand on the knob, he turned and said boldly, “She's in her room. Lily is.”

When Mack answered, his voice was gentle. “Okay, buddy. I'll do some work with her tonight.”

Caleb opened the door, moved straight outside, onto the dirt road, through the field's fallen leaves, into the unfriendly sky, and began to run, out and out, and out, and out.

• • • • • • • • • • • • 

A
t midnight, Shane sat in his cubicle, dimly aware of the cleaning lady behind him.

He had decided to open an orphanage. A well-managed operation, with the goal of placing just one orphan: a drug for alpha-one antitrypsin deficiency.

Since his revelation in Nicholas's room, Shane had been overwhelmed by thoughts of Lily. Sometimes in the whine of the refrigerator he heard the wheeze of her breathing. When his foot hurt after a run, he thought of her swollen feet. It was impossible to conceive of continuing to live his life any longer without doing all he could to help her.

So all week he had stayed late, researching orphan grants. It had been days since he had seen Janelle or Nicholas at night; even Stacey left the office before him, casting him an arched eyebrow.

He had begun crafting a formal proposal suggesting Helixia apply for one. He filled it with numbers, charts, examples, projections, all based on profit models he had read online. Slowly he was piecing together a sober argument to conduct trials on Prajuk's drug, which would switch on the gene in the fourteenth chromosome that ordered the liver to begin production of alpha-one antitrypsin.

Orphan grants excited him. Cystic fibrosis and Tourette's syndrome were currently being treated with biologics which had been produced under the Orphan Drug Act. One of the most profound examples was Ceredase.

In 1984, scientists at Genzyme had discovered a treatment for Gaucher's disease. But the small number of people suffering from the condition, a few hundred thousand, gave Genzyme no financial justification to spend eight hundred million dollars producing it. Instead, the company had applied for an orphan grant. The National Institute of Health paid for small clinical trials, did very well, and now Ceredase was earning a billion dollars a year.

A billion, Shane whistled. And Genzyme had been granted market exclusivity for a decade.

Only a fraction as many alpha-one antitrypsin deficiency patients existed as Gaucher's, but his math still worked; they could assume some small profit. If they won a grant.

He had not realized how much he enjoyed putting together a report; it felt good to be so lost in work. That weekend, Shane printed his proposal and showed it to Janelle over a glass of cabernet.

“I think you make a good argument,” she nodded.

“Thank you. So you'd product-manage this?”

“It doesn't matter what I'd do. The challenge is getting someone who matters to listen to you. You're a commercial specialist. I love you but that doesn't carry much weight with Science.”

“I'll send it to Anthony Leone.”

“Anthony won't read it.”

Shane frowned, swirling his glass. Anthony Leone was Helixia's Director of Science, and one of the three senior executives. He was moderately sized, balding, and tended unfortunately toward floral ties. Anthony had made his millions decades ago but worked six days a week; his belief in the company was unshakeable and inspiring to all of them.

“Why not?”

“Because who are you? The scientist who discovered this drug should have his name on it and present it personally. You need creds.”

“Prajuk won't do that.”

Janelle shrugged. “You might be kind of fucked otherwise.”

The following week, Shane sat nervously in his Sorion status meeting. A chart on the front page of their decks displayed its chemical compounds and genetic codes. Though he could not read it, Shane sensed its intrinsic majesty, similar to seeing a poem written in Mandarin.

Anthony was there, watching the team present an analysis of its generic competitors. Shane studied him surreptitiously. He seemed entirely focused, his hands rigid. He possessed the distant eyes of a mind on a different plane.

When the meeting adjourned, Anthony stood to leave. Dennis joined him by the conference room door. This was a study of biological opposites: tall, charismatic, silver-haired Dennis, and small, distant Anthony. Shane took a breath and walked toward them, clutching his carefully printed proposal.

“This is Shane Oberest,” Dennis explained kindly. “Shane's lighting Sorion on fire.”

“Hello,” Anthony muttered, exuding the air of a professor late to his next class.

Shane brightened. “Doctor Leone, I was wondering if you'd have time to read something.”

He was aware of Dennis looking at him and realized too late that he should have run this by him.

“What is this?” Anthony said, suddenly locking eyes with him.

“A proposal.”

“Proposal? For what?”

“Actually, it's a proposal for us to apply for an orphan grant.”

Dennis coughed; beneath his black eyebrows his eyes opened.

Shane pressed on. “There's a lung condition, a genetic mutation, called alpha-one antitrypsin deficiency . . .”

“It's a liver gene mutation,” Anthony pronounced robotically.

“Right, liver. There's a high-potential cure using a protein we've already developed here.”

Anthony shook his head firmly. “If a patient is alpha-one antitrypsin deficient, they'll develop emphysema. We're focusing on that.”

“Would you mind maybe having somebody read it? I'd love to know if I made any sense,” he said, extending the folder.

“We only pursue drugs for immature populations when there is potential for significant scientific breakthrough. You said we already isolated this protein?”

“Doctor Acharn did.”

“So what is the potential for discovery?”

Dennis shot Shane a look. “Our motto is, Profitable Biotechnology. You should read your coffee mugs.”

“I thought it was, Where Science Is the Star?”

Anthony stared hard at him. Angrily he said, “We're curing
cancer
here.”

Shane felt his face flush.

“We're going to take our people off of diseases that kill tens of millions of people a year to put them on one that affects almost no one? With no hope of discovering anything new?”

“I guess it's called an orphan”—Shane smiled—“because it needs our help.”

“It's called an orphan,” Anthony replied, “because it is unwanted.”

He took up his laptop bag, turned to Dennis, nodded sharply, “Okay,” and left. Shane was aware of a ball forming behind his Adam's apple; his file stuck warmly in his hand.

Dennis's black eyebrows curled. “What the hell?”

“I know someone whose kid was born with this. I thought it would be respectful to have things thought through. I should have asked you how to handle it. That was bullshit. I'm sorry.”

Dennis's face betrayed an almost parental frustration.

Shane left the conference room and walked down the hall. At the old elevator he turned. Dennis was still standing in the doorway; he had not taken his eyes off of him.

•   •   •   •   •   •   •

He sat across from Prajuk Acharn in a booth at a McDonald's near Pinon Drive.

Shane swallowed his lunch uneasily; it did not escape him that the biotechnology which made replacing proteins possible also provided the food in front of him. Outside a smeared window, a teenaged employee waged a futile battle against freeway grime with a window mop.

“So,” Prajuk grinned. “Anthony told you to piss off.”

“Right in front of Dennis too.” He smiled. “Why are you laughing?”

“This thing is funny. Like watching someone walk into a door. Out of curiosity, what was this thing, your proposal, going to tell him?”

“A lot of it was a case study on Ceredase.”

Prajuk chuckled. “This guy is top of his field in the world. He knows about Ceredase.”

Shane frowned; the scent of grease and antiseptic became overwhelming. He pushed his tray away.

“Did he say anything at all?”

“He reminded me that we're here to cure cancer. Dennis talked about money.”

Prajuk leaned back into the stained red leather booth. “Make no mistake, they are the same thing. P and P took the company public because they wanted money. To cure cancer. There is relentless pressure on everyone to beat these Goldman Sachs analysts' calls, because we want money to solve for cancer. If Poulos never figures out how to end cancer, I think he will consider his life a failure. Anthony too. And to do this thing takes a great deal of fucking money.”

It was amusing, Shane thought, to hear him curse in his high voice.

“Look,” he continued, moving his fingers over his fries, “we take money from hedge funds, and college endowment fund managers, and police department pensions, and soccer moms with an E-Trade account, to pay for all of this research. But these investors are not in our stock to cure cancer, or teach the body how to live with it. They are in it for profits. If our stock goes down? They will not care that we might only be a year or two away, they will sell. And we have to make appropriate cuts in research. And so Anthony Leone will not approve anything that threatens us with a loss. Unless”—he raised his finger—“it leads to something new. Which this does not. Why didn't you come to me?”

“I really thought he'd say yes.”

“Even if he did, formal testing would take ten years. An infant with alpha-one antitrypsin deficiency,” he reminded Shane flatly, “does not have ten years. Or even three.”

“Clinical trials are fucking immoral,” Shane spat. “At Orco, they tested a leukemia drug, okay? Everyone in the test was going blastic, but half the people got a placebo. The drug passed trials, Orco is making billions, half the test group was ignored. It's barbaric.”

“Testing without controls is more barbaric. Imagine if the half they gave that drug to died instantly?” Prajuk was watching him curiously. “You have to think clinically, Shane. Phase One of a trial involves a hundred people. It exists to determine side effects. This is urgently important. Ninety-nine percent of drugs are proven unsafe right there. Without controlled Phase One testing, we risk killing millions of people later. Those people in that trial you mention understand their risk. They volunteer to participate to be part of finding a solution. One hundred voluntarily put themselves at risk to save millions. Those numbers are not barbaric, they are actually quite civilized.”

“Thinking in numbers is immoral too.”

“The dictatorship of numbers,” Prajuk informed him, “is the process of history.”

Shane shook the ice at the bottom of his cup. “I'm not going to stop. I'll go to other drug companies.”

Prajuk smiled wistfully and wiped ketchup from his lower lip with the back of his hand.

“What about you? It's your discovery, your work, and it's just
sitting
there. Doesn't that bother the shit out of you?”

A knowing expression took over Prajuk's face. “I wanted to study computer science my whole life. But once I experienced biomedicine I was seduced completely. I left Khon Kaen when I was eighteen, to attend MIT. Afterward, I went for graduate work at UCLA. It was difficult. Even though LA was closer to Thailand, I felt much more homesickness there. I felt better at Stanford, where I did my postdoctoral work for Steven Poulos. We spent uncountable hours side by side in his lab, as he finessed his enzyme into Sorion. Which enabled the company to go public and hire hundreds and later thousands more people. All of this is in some way my work, Shane.”

Shane watched the thin scientist, in his short-sleeved blue button-down shirt.

“Let's do it ourselves,” Shane suggested.

Prajuk stopped moving.

“We'll come in weekends. We'll go back and find that door, and open it. No one will know.”

“This is not a law firm. You cannot just come in on the weekend and use the company Xerox machines.”

Shane's eyes smiled.

“There is not a drop of saline that is not accounted for. And this thing, the lab, there are people in it around the clock. But also, I discovered this protein in Helixia's employ. Any discoveries I make belong to them.”

“But they don't use it.”

“So because you're not using your car today, I can take it?”

“If a little girl was dying on the corner, you could goddamn take it. You'd be a criminal if you didn't.”

Prajuk's eyes drifted down to his watch. “To manufacture a drug for the ten thousand people with alpha-one antitrypsin deficiency would cost ten million dollars and take half a decade, Shane. This is not something we can do after hours.”

“What if I didn't want to help ten thousand people?”

Prajuk squinted, caught by surprise.

“What if I only wanted enough medicine for just one?” Shane looked across the table at this man he barely knew. He hesitated, breathless, and leaned forward onto the sticky Formica table. “What would that take?”

Prajuk crossed his small arms and stared out the window, at the haze of the industrial city. For a long time, only his little finger moved, unconsciously tapping on his tray.

In a much softer voice he answered, “Significantly less.”