The Magic Bullet (24 page)

As they took their seats at the small wicker table, Logan noticed, with a rush of sympathy, that the worn suit jacket the other man wore didn’t quite match the pants.

“You want a drink?”

“Sure. Thanks.”

“Me too.” Coopersmith motioned for a waiter.

Coopersmith ordered a gin and tonic, Logan a beer.

They stared at one another for a long moment. Logan had no idea how to proceed and Coopersmith didn’t seem inclined to help.

“You come here a lot?” Logan finally spoke up, lamely.

“No.”

“Do you live in Richmond?”

“No.”

“Where?”

“Place called Hopewell. About twenty miles from here.”

“So what are you doing with yourself these days?”

“I’m getting by,” he said, with sudden, unmistakable rancor. “Don’t worry about me, I’m practicing medicine.”

“Where’s that?”

“At a clinic. In Petersburg. Why, you gonna check me out?”

Logan chose to ignore this. “I read your protocol. It was very impressive.”

The waiter brought the drinks, and they momentarily fell silent.

“You’re obviously a gifted researcher,” picked up Logan.

Incomprehensibly, Coopersmith snickered. “Maybe I’ll read yours sometime.” He tapped the side of his head and smiled. “Breast cancer. Smart. A glamour disease.”

Logan didn’t know whether to be amused or offended. The remark was obviously intended as a put-down, but the man making it was more worthy of pity than scorn. “That isn’t why we’re doing it.”

“No, of
course
not. Me—genius!—I go after prostate—try to get funding for that.”

This was the opening Logan had been looking for. “I heard it wasn’t lack of funding that got you in trouble.”

Spasmodically, Coopersmith’s head jerked left, then right. “Who said that?”

“Steven Locke. He said you faked your data.”

“Bullshit! They wouldn’t give me the resources I needed. The people. The money.”

“That doesn’t sound—”

“What am I supposed to do? There was too much damn data, I couldn’t monitor it all. But I’m a scientist! I didn’t
make up
anything!”

Logan nodded.
What was the point in arguing with the guy?

“The data was good data,” he insisted. “But they said it was uninterpretable.”

“Who’s that?”

“Larsen. Stillman. Kratsas. That whole bunch. They’re scum, they were against me from the start. What I’d give to ream out those fuckers!”

Logan stared at him.
That’s
why this guy had gotten him down here? “Look, Ray, I appreciate the warning, but it’s not news about these guys. They’re already making all the problems for us they can.”

“You don’t know what you’re talking about, you don’t know the half of it.”

“Really, I understand what you’re saying. But we’re not in the same position you were. There are three of us. And ours is just a mini-test—fifteen patients.”

“You’re such an arrogant SOB. You fit right in at that place!”

Logan was caught short by the savagery of the attack. “What’s that supposed to mean?” he snapped.

“Arrogant, complacent, and dumb as shit.” He shot him a malicious grin. “Bet you don’t like hearing that, do you?”

Logan glanced at his watch. “Look, I’ve gotta be getting back.”

“Before someone sees you with me?”

“Because I don’t think this is doing either of us any good.”

“It’s done me lots of good. I found out what disgusting little ass-kissers that place is turning out these days.”

Unsettling as this was, Logan found it useful too—even
reassuring. Who could doubt that this guy was wildly unstable? Or that—for all his accusations and complaints—that fact had been at the very heart of his problems?

“Wait a minute,” said Coopersmith with sudden contrition, “don’t go yet. I don’t get to talk serious science much anymore.”

“Sorry, I really can’t.”

“C’mon, just one more beer.”

Logan held up his glass, still more than half full. “No. I’ve got to drive back home.”

“You’re being careful?” The other’s sudden, strangled laugh caught him by surprise. “You’re such a fucking jerk, Logan!”

W
ell, the doctor said, in at least one sense she was already lucky. They wouldn’t have to put her under complete anesthetic for the biopsy. She’d get a local and be back home by afternoon
.

“Why?” she asked, relieved. “I thought it would be a lot more complicated than that.”

Her questions, she recognized, standing back, always sounded weirdly dispassionate, as if this were happening to someone else. She figured it was probably her training as a reporter. But maybe it was just a defense
.

Well, came the explanation, during the preliminary exam the CAT scan had picked up a slightly enlarged lymph node near the spine, directly above the area of concern. They would be able to take a tissue sample from there instead of having to go into the bone; a far more dramatic procedure that would have required the participation of an orthopedic surgeon. In any case, soft tissue is always easier to work with than bone
—
easier to process and more readily converted into microscope slides
.

New questions came immediately to mind: Could an enlarged lymph node really be taken as a
positive
sign? Was the point here merely the ease of this procedure or her long-term health?

But this time she let them pass
.

There were three others in the room, in addition to her private physician: an anesthesiologist, his assistant, and a nurse. All seemed pleasant enough and she had been assured they were trustworthy. The room itself was in a secluded wing of the facility; she could hear none of the usual hospital noises in the corridor outside, not even the sound of footfalls
.

The first shot of Xylocaine, delivered with a small needle, was designed to anesthetize the skin. It made possible the second
—
a
three-inch needle from hell that went directly into the muscle
.

The talk in the room was about, of all things, TV. She admitted she had always been a big fan of medical shows
, St. Elsewhere
in particular, and wondered how accurate they thought it was. Not very, they said
—
except the nurse, who found the show’s depiction of doctor-nurse relations right on target. Which led to a discussion of differences in the way women and men see the world. And that, in turn, led her to her son and daughter
.

Anything but the matter at hand
.

She had to wait five minutes
—
to be certain the anesthetic had kicked in
—
before she was helped into the CAT scanner and carefully positioned by the doctors
.

She was aware that many other patients hated this enclosed cylinder, finding it claustrophobic. But she didn’t. “You know, I’m actually getting to like it in here,” she told them. “It’s like being in the womb.”

But now she had to stop talking: the procedure demanded absolute stillness
.

The screen the doctors watched so intently showed everything
—
her internal organs, her skeletal structure. But their total focus was on the long needle, moving slowly toward the node. It took several minutes for the needle to travel the six centimeters
.

“Got it,” said her personal physician softly
.

He pulled back on the syringe attached to the needle and sucked in a tiny bit of tissue. The sample they needed was no larger than the head of a pin
.

Five minutes later she was out of the machine and in bed. They made her stay there two hours for observation and would have kept her longer, if she’d let them. “Listen,” she insisted, “I got
lots
of better things to do.”

In fact, the anesthetic had done wonders for her disposition. She was in less pain than she’d been in weeks
.

The results would not be in for another twenty-four hours
.

L
ogan liked Faith Byrne the instant he met her.

“So, Doctor,” she greeted him as he walked into the examining room to conduct her exam, “who does a girl have to suck up to around here to get well?”

“You mean to get into the program?” He laughed. “I’m afraid sucking up won’t do it.”

“Ah. In other words, it’s you.”

This sixty-two-year-old widow from the Boston suburb of Brookline—slightly overweight, with lively blue eyes beneath a halo of white hair—was obviously going to keep him on his toes.

“All right, a
little
sucking up won’t hurt. But, sorry, I’m still going to have to do the exam.”

Still, from that moment on, Logan wanted her on the protocol. After all, where was it written that he shouldn’t look forward to seeing a patient?

What he appreciated about Byrne as much as her good humor was her directness—for in Logan’s experience, invariably it was patients’ reluctance to say what was on their minds that caused problems.

“I want to tell you it was my own decision to come down here and see you people,” she told him five minutes into their session. “My doctor wanted to give me the same old stuff. But I told him ‘no dice.’ ”

“Why’s that?” Logan asked.

“Look, I’m not an idiot, the cancer hasn’t hit my
brain
yet. I’ve read up on my chances.” She looked directly at the young doctor. “You’ll find I’m a strong, independent woman, not a babe in the woods.”

Logan smiled. “I wouldn’t guess many people think otherwise.”

“And”—she smiled back—“I’ve always got plenty to say.”

In fact, during the initial session in the examining room, Logan learned more about Faith Byrne than he knew about some people he’d known all his life. He discovered that her husband, Ben, a salesman, had died of heart disease almost five years before; and that, though they’d had their problems—“Who doesn’t?”—the marriage had been a good one. Still, it was only since his death, working as a part-time copy editor at a local weekly newspaper, that she felt she’d really come into her own. She had two daughters. One, a married schoolteacher, lived in Minneapolis. The other, a social worker, was gay and lived in New York.

“Actually, if you want to know the truth,” she confided, “I prefer the woman Ellen lives with to my son-in-law. If I’m ever gonna be a grandma, I really think it’ll be Ellen and Francine who make it happen, not Joyce and Ron out in Minnesota.”

Fortunately, Logan was equally intrigued by the particulars of Byrne’s disease. The physical manifestation of her malignancy was unusual: hundreds of tiny pink nodules cutting an angry swath across the chest wall and extending around to the back, scattered tumors having reappeared at precisely the spot where she’d had a mastectomy some fifteen years ago.

“I look at it,” she observed during the exam, “and it just seems unstoppable. When I get depressed, I feel like running out and trying every kind of acne cream I can find.”

Though in that sense the case was atypical, the young doctor saw this as no impediment to her inclusion in the trial. The key fact was that Byrne’s malignancy had not yet invaded vital viscera. Too, she had been exposed to only minimal levels of adjuvant therapy; and that had been quite a while back, at the time of her mastectomy.

Then there was something else: Faith was an irresistible
chance to stick it to Stillman. For he found in her paperwork that this patient had had the chance to go with the senior man’s protocol—and rejected it.

“Why’s that?” he soon felt comfortable enough to ask. For a patient seeking innovative treatment to turn down a doctor with Stillman’s reputation was almost unheard of.

“
Why?
You’re kidding me, right? I
met
the guy. Call me weird, but I like to feel I’m gonna get more consideration than a slab of beef.”

Despite himself, Logan burst out laughing.

“I don’t think you’re supposed to do that, Doctor. He’s a colleague.”

“You’re right. Sorry.”

“But I guess you can’t help yourself—you’ve met him too.”

The exam was all but over. “Well,” he pronounced, “I’ll want to look more closely at your case. And naturally talk it over with my colleagues. But I think I can tell you I’ll probably have good news for you.”

She beamed. “Good. I knew this was going to work out.”

Logan felt a momentary twinge of unease.
Was she expecting too much? Did she fully grasp how remote were the chances of success of such an experimental trial? Had he, in brief, been as straight with her as the other way around?

“Faith,” he gently launched into his standard litany, “it’s important that you know exactly what you’d be getting into. This is an unproven drug and there’s a real possibility of side effects. I want you to read the Informed Consent forms very carefully. And talk it over with your doctor. And come back to me with any questions you have.”

“Of course, of course.” Nodding briskly, still smiling, she rose to her feet. “Just do me a favor. Tell your colleagues not to worry, we’re all going to have a wonderful relationship.”

* * *

When she was formally accepted five days later, Faith became the eighth woman attached on the protocol. A half dozen other likely prospects waited to be seen. Having begun in February, by now—the first week in April—the patient accrual process could be judged a success.

The time had arrived to begin administering the drug.

By custom and simple fairness, patients in such a test receive treatment in the order in which they’ve signed up. That meant Judith Novick leading off.

Logan was keenly aware this was not ideal. The progress of the early patients—and especially that of the first—would be watched closely by their more senior colleagues; and of all the patients on their growing roster, Judith was in the worst shape.

But, given the range of considerations involved, he kept his misgivings to himself.

It was Reston, at a meeting one rainy Sunday morning at Logan’s place, who raised the issue. “Look,” he said, “this is something we’ve been avoiding. But I say we launch this thing with someone else.”