Terminal (31 page)

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Authors: Robin Cook

BOOK: Terminal
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By the time they got back in the lab Janet found herself
becoming genuinely interested despite the day’s emotional traumas and her fatigue. Sean’s enthusiasm was infectious.

“What’s the next step with these medicines?” she asked.

“I’m not sure,” Sean admitted. “I suppose we should see what kind of reaction we get between the unknown antibody in the large vial and Helen Cabot’s tumor.”

Sean asked Janet to get out some scissors and a scalpel from a drawer near where she was standing. Sean took the cooler over to the sink, and after putting on a pair of latex rubber gloves, he lifted out the brain and rinsed it off. From beneath the sink he pulled out a cutting board. He put the brain on the board.

“I hope I don’t have trouble finding the tumor,” he said. “I’ve never tried to do anything like this before. Judging by the MRI we did in Boston, her largest tumor is in the left temporal lobe. That was the one they biopsied up there. I suppose that’s the one I should go after.” Sean oriented the brain so that he could determine the front from the back. Then he made several slices into the temporal lobe.

“I have an almost irresistible urge to joke about what I’m doing here,” he said.

“Please don’t,” Janet said. It was hard for her to deal with the fact that this was the brain of a person with whom she’d so recently related.

“Now this looks promising,” Sean said. He spread the edges of his most recent incision. At the base was a comparatively dense and more yellow-appearing tissue bearing tiny but visible cavities. “I think those spots might be areas where the tumor outgrew its own blood supply.”

Sean asked Janet to give him a hand, so she pulled on a pair of the rubber gloves and held the cut edges of the brain apart while Sean took a sample of the tumor with the scissors.

“Now we have to separate the cells,” he said, putting the sample in tissue culture medium, then adding enzymes. He put the flask in the incubator to give the enzymes a chance to work.

“Next we have to characterize this immunoglobulin,” he said, holding up the larger of the two vials of unknowns. “And
to do this we have a test called ELISA where we use commercially made antibodies to identify specific types of immunoglobulins.” He placed the large vial on the countertop and picked up a plastic plate that had ninety-six tiny circular wells. In each of the wells he put a different capture antibody and allowed it to bind. Then he blocked any remaining binding sites in the wells with bovine serum albumin. Next he put a small aliquot of the unknown in each of the wells.

“Now I have to figure out which antibody has reacted to the unknown,” he said, washing each of the wells to rid them of any of the unknown immunoglobulin that hadn’t reacted. “We do this by adding to each well the same antibody that was originally in the well, only this time tagged with a compound that’s enzymatically capable of yielding a colored reaction.” This last substance had the characteristic of turning a pale lavender.

The whole time Sean was doing this test, he kept up a running explanation for Janet. She’d heard of the test but had never seen it performed.

“Bingo!” Sean said when one of the many wells turned the appropriate color to match controls he’d set up in sixteen of the end wells. “The unknown is no longer an unknown. It’s a human immunoglobulin called IgGI.”

“How did Forbes make it?” Janet asked.

“That’s a good question,” Sean said. “I’d guess by monoclonal antibody technique. Although it is not out of the question to make it by recombinant DNA technology. The problem there is that it’s a big molecule.”

Janet had a vague idea of what Sean was talking about and had definitely become interested in the process of figuring out what these unknown medicines were, but suddenly her physical exhaustion could no longer be ignored. Glancing at her watch she could understand why. It was almost midnight.

Feeling ambivalent about interrupting Sean’s enthusiasm which she’d been trying hard to bolster, she reached out and grasped his arm. He was holding a Pasteur pipette. He’d started ELISA plates for the second unknown.

“Do you have any idea of the time?” she asked.

Sean glanced at his watch. “My word, time does fly when you’re having a good time.”

“I’ve got to work tomorrow,” she said. “I’ve got to get some sleep. I suppose I could go back to the apartment by myself.”

“Not at this hour,” Sean said. “Just let me finish what I’m doing here, then I want to run a quick immuno-fluorescence test to see the level of reaction between the IgGI and Helen’s tumor cells. I’ll use an automatic diluter. It will only take a few minutes.”

Janet reluctantly agreed. But she couldn’t sit on a stool any longer. Instead she dragged out an armchair from the glass-enclosed office. Less than half an hour later, Sean’s enthusiasm went up another notch. The ELISA test on the second unknown had identified three cytokines: interleukin-2, which as he explained to Janet was a T lymphocyte growth factor; tissue necrosis factor alpha, which was a stimulant for certain cells to kill foreign cells like cancer cells; and interferon gamma, which was a substance that seemed to help activate the entire immune system.

“Aren’t the T cells the ones that disappear in AIDS?” Janet asked. She was having progressive difficulty staying awake.

“Right on,” Sean said. He was now holding a number of slides on which he’d run fluorescence antibody tests at different dilutions of the unknown immunoglobulin. Slipping one of the very high dilution slides under the objective of the fluorescein scope, Sean put his eyes to the eyepiece.

“Wow!” he exclaimed. “The intensity of this reaction is unbelievable. Even at a one to ten thousand dilution this IgGI antibody reacts with the tumor four plus. Janet, come and take a look at this!”

When Janet didn’t respond, Sean looked up from the eye-pieces of the binocular scope. Janet was slouched in the chair. She’d fallen fast asleep.

Seeing Janet sleeping. Sean immediately felt guilty. He hadn’t considered how exhausted she must be. Standing up and stretching his tired arms, he stepped over to Janet and looked down at her. She seemed particularly angelic in her
repose. Her face was framed by her fine blond hair. Sean felt an urge to kiss her. Instead, he gently shook her shoulder.

“Come on,” he whispered. “Let’s get you to bed.”

Janet was already buckled in Sean’s car when her sleepy mind reminded her she’d brought her own car that morning. She mentioned it to Sean.

“Are you in any condition to drive?” Sean asked.

She nodded. “I want my car,” she said, leaving no room for discussion.

Sean pulled around to the hospital and let her out. Once she had her car started, he let her lead the way. And as they pulled out into the street, Sean was too intent on Janet to notice the dark green Mercedes which slowly began to follow them both without the benefit of its headlights.

7

March 6
Saturday, 4:45 A.M.

A
s soon as Sean’s eyes fluttered open, he was instantly awake. He couldn’t wait to get to the lab to unravel more of the medulloblastoma mystery cure. The little work that he’d been able to do the night before had merely whetted his appetite. Despite the early hour, he slipped out of bed, showered, and dressed.

When Sean was ready to leave for the lab he tiptoed back into the dark bedroom and gently nudged Janet. He knew she’d want to sleep until the last possible moment but there was something he wanted to tell her.

Janet rolled over and groaned: “Is it time to get up already?”

“No,” Sean whispered. “I’m off to the lab. You can go back to sleep for a few minutes. But I wanted to remind you to pack some things for our overnight trip to Naples. I want to leave this afternoon when you get off work.”

“Why do I have the feeling you have some ulterior motive in this?” Janet asked, rubbing her eyes. “What’s with Naples?”

“I’ll tell you on our way there,” Sean said. “If we leave from the Forbes we’ll beat the traffic out of Miami. Don’t pack a lot of stuff. All you’ll need is something for dinner tonight, a bathing suit, and jeans. One other thing,” Sean added, leaning over her.

Janet looked into his eyes.

“I want you to get some of Louis Martin’s medicine this morning,” he said.

Janet sat up. “Great!” she exclaimed sarcastically. “How do you expect me to do that? I told you how hard it was to get Helen’s samples.”

“Calm down,” Sean said. “Just give it a try. It could be important. You said that you thought the medicine all came from a single batch. I want to prove it’s impossible. I don’t need a lot, and just some from the larger vial. Even a few cc’s will do.”

“They control the medicine more carefully than a narcotic,” Janet complained.

“What about diluting it with saline?” Sean suggested. “You know, the old trick of putting water in your parents’ liquor bottles. They’re not going to know the concentration changed.”

Janet thought about the suggestion. “You think it could hurt the patient?”

“I can’t see how,” Sean said. “More than likely it’s designed with a wide safety margin.”

“All right, I’ll try,” Janet said with reluctance. She hated being deceptive and devious with Marjorie.

“That’s all I can ask,” Sean said. He kissed her on the forehead.

“Now I can’t get back to sleep,” she complained as Sean headed for the door.

“We’ll be sure to get lots of sleep over the weekend,” he promised.

As Sean made his way out to his 4×4 there was only a slight hint of dawn in the eastern sky. To the west the stars twinkled as if it were still the middle of the night.

Pulling away from the curb, he was already preoccupied with the work ahead in the lab and oblivious to his surroundings. Once again he failed to notice the dark green Mercedes as it too pulled out into the light traffic several cars behind.

Inside the Mercedes Wayne Edwards was dialing his car phone, calling Sterling Rombauer at the Grand Bay Hotel in Coconut Grove.

A sleepy Sterling picked up on the third ring.

“He’s left the lair and is heading west,” Wayne said. “Presumably to Forbes.”

“Okay,” Sterling said. “Stay with him. I’ll join you. I was just informed a half an hour ago that the Sushita jet is winging south at this very moment.”

“Sounds like game time,” Wayne said.

“That’s my assumption,” Sterling said.

A
NNE
M
URPHY
was depressed again, Charles had come home, but he’d only stayed one night. And now that he was gone, the apartment seemed so lonely. He was such a pleasure to be with, so calm and so close to God. She was still in bed, wondering if she should get up, when the front door buzzer sounded.

Anne reached for her plaid robe and headed for the kitchen. She wasn’t expecting anyone, but then she hadn’t been expecting the two callers inquiring about Sean, either. She remembered her promise not to talk to any strangers about Sean or Oncogen.

“Who is it?” Anne asked, pressing the talk button of her intercom.

“Boston police,” a voice replied.

A shiver went down Anne’s spine as she buzzed the door open. She was sure this visit meant Sean had reverted to his old ways. After quickly brushing out her hair, she went to the door. A man and a woman were standing there, dressed in Boston police uniforms. Anne had never seen either of them before.

“Sorry to bother you, ma’am,” the female officer said. She held up her identification. “I’m Officer Hallihan and this is Officer Mercer.”

Anne was clutching the lapels of her robe, holding it closed. The police had come to the door a number of times when Sean had been a teenager. This visit brought back bad memories.

“What’s the problem?” Anne asked.

“Are you Anne Murphy, mother of Sean Murphy?” Officer Hallihan asked.

Anne nodded.

“We’re here at the request of the Miami police,” Officer Mercer said. “Do you know where your son Sean Murphy is currently?”

“He’s at the Forbes Cancer Center in Miami,” Anne said. “What’s happened?”

“We don’t know that,” Officer Hallihan said.

“Is he in trouble?” Anne asked, afraid to hear the answer.

“We really have no information,” Officer Hallihan said. “Do you have an address for him there?”

Anne went to the telephone table in the hall, copied down the address of the Forbes residence, and gave it to the police.

“Thank you, ma’am,” Hallihan said. “We appreciate your cooperation.”

Anne closed the door and leaned against it. In her heart, she knew that what she’d feared had happened: Miami had been the bad influence she’d suspected; Sean was in trouble again.

As soon as she thought she was composed enough, Anne called Brian at home.

“Sean’s in trouble again,” she blurted when Brian answered. Tears came as soon as she got the words out.

“Mom, try to control yourself,” Brian said.

“You have to do something,” Anne said between sobs.

Brian got his mother to calm down enough to tell him what had happened and what the police had said.

“It’s probably some traffic violation,” Brian said. “He probably drove over someone’s lawn, something like that.”

“I think it’s worse,” Anne sniffled. “I know it is. I can feel it. That boy will be the death of me.”

“How about if I come over?” Brian said. “I’ll make some calls in the meantime and check it out. I bet it’s something minor.”

“I hope so,” Anne said as she blew her nose.

While Anne waited for Brian to drive over from Marlborough Street, she dressed and began putting her hair up. Brian lived across the Charles River in Back Bay, and since it was
Saturday with no traffic, he was there in half an hour. When he buzzed to let her know he was on his way up, Anne was putting in the last of her hairpins.

“Before I left my apartment I put in a call to a lawyer colleague in Miami by the name of Kevin Porter,” Brian told his mother. “He works for a firm we do business with in the Miami area. I told him what had happened, and he said he had an in with the police and could find out what’s going on.”

“I know it’s bad,” Anne said.

“You don’t know it’s bad!” Brian said. “Now don’t get yourself all worked up. Remember last time you ended up in the hospital.”

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