The Magic Bullet (19 page)

“Thank you.”

“So—what?—you furnish it totally through the Salvation Army or did you step up to Goodwill?”

“Actually, Dr. Shein—excuse me, Seth—I went to Ikea.”

“What’s wrong with you, Logan, losing your sense of humor?”

“He does that a lot,” piped up Reston. “Not one of his better traits.”

“I think,” said Sabrina evenly, “that we all are concerned to hear what you think of the proposal.”

Shein beamed her way. “See that. At least one person here’s got the balls to say it straight out.” Unbuttoning his coat, he tossed it on an empty chair. From the inside pocket of his rumpled tweed jacket he removed a folded copy of the protocol proposal. It appeared to have been well read. “You got something to drink in this place?”

“Please, Dr. Shein.”

Shein cast Logan a baleful glance. “Okay. It’s good. It’s very good.”

Logan could breathe again. He waited an instant. “You really think so?”

Shein looked from Reston to Sabrina, the pleasure—or was it just relief?—apparent on both faces. “Wait a minute. Not that I don’t got some serious criticism.”

And an instant later, as if rankled at having even briefly delivered unambiguous pleasure, he was into it: “I don’t like the drip. You gotta go with the bolus.”

“We of course gave that a lot of thought,” ventured Logan. “Why would you say—”

“Because taking risks is supposed to be your business,” he was cut off impatiently. “Not stupid risks, for Chrissakes, but, yeah, appropriate ones! Otherwise what kind of impact are you gonna make?”

“Very little,” said Reston, softly.

“Don’t just gimme the answer I wanna hear, Reston. Tell me something I don’t already know. Under the best of circumstances, what kinda toxicity you gonna get with this drug?”

Reston visibly reddened. “A lot.”

“Damn right. The stuff made your friend Tilley’s goddamn adrenal glands
fall
out! So why’re you pussyfooting around? The cancer’s gonna eventually kill ’em anyhow—why not hit the cancer cells
hard
and get out?”

“We were trying to minimize damage,” offered Logan. “We’d like to end up with a living patient.”

“Screw that. You do a trial like this, you face that there might be fatalities. Because basically what you’re doing is poisoning people within an inch of their lives. You can’t make omelettes without breaking eggs.”

There was a long silence in the room.

It was Sabrina who broke it. “Dr. Shein, we are talking about the therapeutic window, no? The dose that will be toxic to cancer cells but not toxic for healthy cells.”

He nodded. “You got it.”

“And this is a tiny, tiny margin … even for the best drugs.”

“The trick is finding it. That’s what separates great cancer docs from the chaff—the willingness to go right to the edge and not flinch. It’s a helluva lot easier saying it than doing it.”

Shein studied his listeners. Sabrina clearly had a handle on this; she’d go his way. So would Reston, if only to stay on his good side. But Logan seemed unconvinced.

“Listen,” he added, directing his words Logan’s way, “it’s not like I don’t understand the impulse. You give a patient an intravenous drip with a subtoxic dose and she’ll love you to pieces. She’ll tell everybody, ‘My doctor’s a genius, he’s giving me chemotherapy and there are almost no side effects!’ ” He paused meaningfully. “But you know what you’re doing? You’re killing that patient with kindness.”

He paused, as serious as Logan had ever seen him. “Your job is to come up with a treatment! Do that and—never mind if you’re a saint or an asshole—you’ll never have to worry about being popular again.”

Logan could not argue with any of it. The fact was, hearing the man lay it out so starkly, his respect for him only increased: the guy had not only a high-tech, microchip-driven brain but, just as vitally, old-fashioned brass balls to go with it.

Still, he hesitated—because he was also aware of something else. No matter how well intentioned Shein’s advice was, and no matter how ultimately sound, the senior man was in a no-lose position. Logan and the Compound J team could not proceed without his blessing. And yet, if things went wrong, he would not be the one to take the fall.

“How about the adrenal problem?” pressed Logan. “With the dosage you’re suggesting, every patient in this trial could have her adrenal glands”—he hesitated—“fall out. Like Tilley’s.”

Shein shrugged. “You’ll prophylax them with hydrocortisone. That’ll neutralize the toxic effects of the drug—provide the same hormone in pill form normally produced by the gland.”

Logan considered this. “But that could be just the beginning. I mean, that’s what we were trying to get at with our Informed Consent provision. Who knows how many other problems you’re going to have to fix along the way?” He paused. “Well, I guess those are bridges that have to get crossed.”

Shein smiled: he knew he had him. “Fortunately, you’ll have me to help devise solutions.”

“We can count on that?”

“Absolutely.” He stood up and reached for his coat. “By the way, when you rewrite the proposal, I want you to tone down that goddamn Informed Consent provision. You don’t have to go out of your way to imagine every possible side effect.”

“We just wanted to be candid. And responsible.”

“Listen, what you had there scared the hell outta
me
. The committee knows all that anyway.”

“I suppose you’re right.”

“Don’t forget, Logan, we’re all on the same side here.”

T
hat night, when Reston had gone, Logan produced a bottle of champagne of his own. Roederer Cristal—a hundred and forty bucks it had cost him.

Yet, though he’d planned this moment for weeks, it was astonishing how soon it began to feel like an anticlimax.

“Is there something wrong?” he asked Sabrina as they sipped their second glass. But, quietly exasperated, within he phrased it differently.
What the hell’s wrong now?

“I am just a little tired.”

He slipped his arm around her. “Get used to it. The
real
work hasn’t even started yet.”

“This Shein,” she said, with a forced smile, “he has the morals of a cabbage. But he is not dull.”

“No—anything but that. Get him an organ grinder and a little suit and he’d do handstands in the street.” He paused. “I only wish he’d stop making nasty cracks all the time.”

She looked at him closely. At the beginning his face had struck her merely as conventionally handsome; now she was equally taken by the deepening worry lines—evidence of what she knew to be character. “He doesn’t mean it. It is a sign he likes you.”

“Right. Much more of his friendship and I’ll put a gun to my head.”

For all his seeming self-assurance, Logan was, she’d come to know, deeply vulnerable; the product of an unsettled homelife she couldn’t pretend to understand. She sympathized with this—but it also left her ill at ease. Every bit as committed to career as he was, she’d long been equally disinclined to waste time and energy on complex romantic
entanglements. She cared for this guy—more than for anyone in a long time. But increasingly, she couldn’t help thinking he’d been right from the start: this confusion of the personal and professional could be a terrible mistake.

“I’m sorry, Logan,” she said, “this is a time we should be happy.”

“Who says I’m not happy?” He smiled. “Are you kidding? All I’d need to make my life
perfect
at this moment is a great Havana cigar!”

She laughed, but he knew he hadn’t begun to bridge the distance between them. “Look at it this way, Shein’s just my cross to bear. You’ve got Reston.”

Reston! He, of course, was the crux of the matter. Could she open up to Logan? More than once she’d come close. But always it came down to the same pragmatic question: What kind of havoc would that wreak? What mattered now—
all
that mattered—was the well-being of the protocol. And for the foreseeable future, that seemed to mean making the best of life with Reston.

“Well,” he suddenly spoke up, brightly enough that if she demurred it would come off as kidding around, “I think it’s time we did some real celebrating around here.” He nodded toward the bedroom.

“Not yet, Logan. This is so nice.”

Still, she was torn. For it was increasingly apparent the awkward personal situation might itself threaten the work. She simply could not trust Reston. Logan did, absolutely. As a result, she now sometimes found herself hesitant to confide in her lover/colleague even on scientific matters.

She reached for the champagne. “If I show you something,” she spoke up suddenly, “can we keep it just for ourselves?”

What now?
“Animal, vegetable, or mineral?”

“I’m serious, Logan. An article I found. About Nakano. Nothing so important—but I do not want John Reston involved.”

“Ahh.”
Christ, when’s she gonna get off this obsession with Reston?
“What the hell, I guess so. John doesn’t care about
any of the background stuff anyway. He thinks it’s all pointless.”

“This is a promise?”

“If you want.”

She rose, crossed the room, and retrieved a sheet of paper from her briefcase. “Here,” she said, handing it to him. “Not much—but it has some new details.”

It was a Xerox copy of a newspaper clipping, dated August 18, 1924, and a mere three paragraphs in length, from the German daily
Frankfurter Allgemeine Zeitung
. Studying it, Logan quickly understood it was a sort of social announcement. Dr. Mikio Nakano, associate director of the Medicinal Chemistry Division of the I. G. Farben Company, was to speak the following day at the Frankfurt League of War Wives. His subject:
I. G. Farben Wissenschaftler erzielen Fortschritte im Kampf gegen die Krankheiten der Menschheit
(Advances made by I. G. Farben scientists against human disease). The item identified the speaker as a native Japanese, formerly an assistant to the great Paul Ehrlich. His age was listed as thirty-four.

“Where did you get this?” asked Logan, looking up.

“I contacted all the important German chemical firms. I asked if they had any information on this man.”

“But I. G. Farben no longer exists.…”

As they both knew, the lesson left by the giant chemical firm about the potential misuses of science was among the most shockingly savage on record: having enthusiastically participated in the program of genocide instituted by the Third Reich—even to the point of operating a slave labor camp within Auschwitz—the company had been dismantled by the Allies immediately after the war, its directors convicted as war criminals.

“No. It came from one of the successor companies, Hoechst. It was in their files, all they had on this man.” She smiled. “I think the Germans do not throw much away.”

“So we were right about this guy—he was with Ehrlich.”

He looked at her. “You’re unbelievable, you know that?”

“No, just curious. Same as you. We still know very little of his work.”

But he could see she was her old self; her sense of intense preoccupation replaced, at least for the moment, by an openness appealing beyond description. “You’re also very beautiful,” he added, spontaneously. “I think you’ve definitely earned some more champagne.”

“No, thank you.” She took his hand and kissed it gently. “I think now is the time to do the rest of our celebrating.”

L
ogan was a bit shaky when he arrived at the hospital the next day for his morning rounds—and even less inclined than usual to deal with Rochelle Boudin.

Over the months, Rochelle had grown ever more difficult. Much as Logan prided himself on his skill with tough patients, with her it could be a physical effort to maintain his usual bedside manner of cheerful calm. Almost daily—even on those days when he was not charged with hospital duty—Logan received word Rochelle needed to see him. If it wasn’t about her dosing schedule, it might be the quality of the hospital food; or perhaps even a program on cancer research she’d seen the night before on PBS that she imagined had some bearing on her treatment.

Logan recognized, belatedly, that he’d help bring this on himself. Because he’d made an effort to show her special consideration at the start, she’d come to take it as her due; now feeling entitled to make demands she wouldn’t make on any other doctor at the ACF.

The truth, of course, was that what she mainly wanted was a friend—and never had it been more true than in recent weeks. Rochelle’s husband, Roger, who’d earlier made such a point of his devotion, had all but disappeared from view, and Logan noted that there was less and less conviction in her claim that he was just away on business.