Lethal Remedy (14 page)

"Yes. It was really bad. They tell me I almost died because it was some special infection that none of the usual antibiotics would help. I guess I owe my life to Dr. Ingersoll and that new medicine of his."

Rip Pearson frowned at the insistent buzz of his pager. He silenced the instrument, noted the number, and decided he'd return the call in a moment. He already had more on his plate than he could handle.

Rip sat like a penitent, across the desk from Ingersoll, who frowned at the interruption. "Sorry about that."

"Very well," the great man said. "Now are you clear on the things I want you to do while I'm in Germany?"

"Right." Bite your tongue, Rip. Don't scratch the scab from yesterday's argument. Just get through this meeting.

"Leave the big picture to me, Pearson. I promise that if you keep the Jandramycin study going, you'll get your share of the glory."

Or the blame when it comes out that your "wonder drug" had side effects that someone chose to hide.
"I know how you want the study run," Rip had said. "How long will you be gone?"

"Six days, I think. The conference is making the arrangements and covering all my travel expenses. First class all the way." Ingersoll rolled the words on his tongue and seemed to savor them as he would fine brandy. "An invitation to speak to an international meeting like this will mean a great deal of positive publicity for our work."

Yeah, and probably a hefty honorarium.
Rip knew that Jandra arranged the invitation to Ingersoll. Pharmaceutical companies could no longer offer honoraria directly to physicians for speaking. But there were ways around those rules. One was to pay the money to a sponsoring organization with the understanding it would be funneled to guest speakers. In the case of an international meeting like this one, it was even easier to find ways around the restrictions.

Ingersoll scanned the list in his hand, nodded with satisfaction, and shoved it into the pocket of his white coat. "Now I have to work on my presentations. Do you have any questions?"

Why should I? I've been doing the work on this study since day one. The only thing I don't know is why the drug I'm giving people may save their lives today and sentence them to a lifelong disease or even death in the future.
"No, sir. Have a safe trip."

A few minutes later, Rip was in the cubbyhole of the office assigned to him as a fellow. He checked his pager and dialed the number it displayed. "Dr. Pearson. You paged me?"

"Rip, this is Sara. We need to talk."

"Sure. Go ahead."

"No, I don't think this is something I want to go into over the phone. Can we get together? The sooner the better."

Sara sat on a rolling stool and Rip perched on the edge of the exam table. The door to the treatment room was closed. There were no doctors in the clinic. The nurses and administrative personnel were at lunch, returning phone calls, or otherwise occupied. "We should have some privacy here," Sara said. "Thanks for coming over."

"What's up that's so important?"

"Two things. As of this morning, I only had one to talk with you about, but the last patient I saw made the list longer. Do you remember a middle-aged lady named York? Pneumonia?"

"Sure. She was one of the first in the Jandramycin study. I think it was still EpAm848 then. What about her?"

"I saw her today. She's developed lupus."

She watched Rip's face as he connected the dots. It was almost immediate. "Another disease to add to the list. It's not a controlled study, but it's good enough for me. Jandramycin works to kill
Staph luciferus,
but a significant number of patients develop an autoimmune disorder within a matter of weeks."

"So the question remains: what do we do?"

"We've got to find out the exact mechanism of the drug. Then maybe we can figure out a way to block its ill effects."

Sara hesitated. "I don't want to sound stupid, but can't we just analyze some of it?"

"Sure," Rip said. "We could if we had a month or six weeks to determine the exact composition, synthesize the components, and get the proportions right, then do the lab experimentation to find out the true mechanism of action. Meanwhile, patients are dying all over the world."

"What's the count up to now?" Sara asked.

Rip pulled a wrinkled note from the pocket of his white coat. "The World Health Organization has identified over three thousand cases of
Staph luciferus
infection, all fatal except the patients treated here and the medical center in Germany that's also testing Jandramycin." He crumpled the note and tossed it into the wastebasket. "Sara, we've got to step up our search. Doctors around the world are clamoring for that drug. When it's released, thousands of patients will receive it. We have to find out how to save those patients without exposing them to a potentially fatal side effect of Jandramycin."

Sara took a deep breath. She dreaded reliving the experience, but she needed to tell Rip. "Our search may be putting us in danger, as well. You know that we confronted Jack about this, and he blew us off. Then I called Jandra but got nowhere."

"Right. But I may have thought of another way to get the information we need."

"Don't rush into it. I think I've already stirred up a hornet's nest. Last night, someone took a shot at me."

Rip rose and moved around the desk. She stood to meet him. He grasped her shoulders and said, "Are you okay? Did you call the police? What can we do to protect you?"

Sara didn't try to move his hands. "Yes, yes, and I don't know. But in the interim, we need to be careful who else knows about our efforts."

Rip relaxed his hold on her and moved back to his chair. "That's a pretty limited group so far. Besides you and me, there's Jack Ingersoll, and whoever you talked to at Jandra."

"Don't forget Mark Wilcox and John Ramsey. They were in our little session last night."

"I guess John's okay, but I don't know Mark Wilcox. For all we know, he's on the Jandra payroll."

Sara shook her head. "John brought him in, and I trust John's judgment. But I agree, we probably should be a little cautious around Mark in the future." She picked a pink message slip offher desk and began to fold and unfold it. "But you said you thought you had a way to find out the mode of action of Jandramycin. What's that?"

"Well, it may not be as great an idea as I thought, since your efforts got you shot at. Carter Resnick tells me he's become pretty good at hacking into computer systems. I was thinking about trying to wangle some cooperation from him."

"So you think he could get into the FDA's computer and access the new drug app for Jandramycin?"

"No, I think that information's fabricated. I was going to see if he could get the information from Jandra's system."

"Why wouldn't that be a good idea?" Sara asked.

"Resnick has been sort of off-again, on-again giving information to me. On the one hand, he seems anxious to take down Ingersoll. On the other, he guards the research data from his lab with a passion. I think young doctor Resnick has his own agenda. I don't know what it is, but in light of recent events I think I'd better be careful around him."

Sara leaned back. "I think we'd both better be careful around anyone else until this thing is settled."

S
ARA, THIS IS
M
ARK
W
ILCOX
." M
ARK BRACED HIS PHONE AGAINST HIS
shoulder and reached into his desk drawer for a fresh legal pad. He might be practicing medicine now, but old habits die hard. "Do you have a second to talk?"

"Just about that long. Your page caught me between my last clinic patient and afternoon hospital rounds. What's up?"

"I was wondering if you'd like to have dinner with me tonight. There's a great new restaurant I've heard about, and I'd love to take you there."

Mark wasn't sure how to interpret the silence that followed. Was Sara looking for a graceful way to say "No"? Of course she could be checking her schedule to see if she was free. He began to doodle on the legal pad.

"I . . . I'm not sure how good my company would be tonight."

"Tell you what. If you're a terrible dinner companion, we'll split the check. But I'm betting it will be an enjoyable evening for both of us. Goodness knows, I can use one, and I'll bet you can, too."

Another silence, but a shorter one this time. "Okay. But I have to go by and pick up a rental car after work, so maybe I should meet you there."

"Why a rental car?"

As Sara told him about the shooting the night before, Mark pressed harder with his pencil until it broke, sending splintered pieces flying offhis desk. "Are you all right? Did you call the police? And who would do something like this? Why?"

"I'm fine. The police came and took a report. And as for the who and why, I'm still working on that."

Mark was leaning back in his swivel chair. He came forward and his feet hit the floor with a dull thud. "Tell you what. Let me pick you up at the medical center. I'll take you to get your rental car. We can drop it offat your house and go to dinner together. How's that?"

He was getting used to the silences. Obviously, Sara was working on overload right now, and she was thinking through all her responses. Finally, she said, "I guess that would work. And I have to eat sometime. Can you pick me up at the plaza outside the Clinical Science Building about six? No, make that six thirty."

"Six thirty it is. I'll see you then. And in the meantime, be careful."

After he hung up, Mark tore the page offthe legal pad, crushed it into a tight ball, and slammed it into the wastebasket. He couldn't believe this was happening.

Lillian Goodman emerged from the treatment room into the hallway of the clinic and almost bowled over John Ramsey. "Oh, sorry," she said. "Afraid I was thinking about this last patient."

"No problem. I think about patients all the time. But it's good to have something to occupy my mind. Keeps me from feeling sorry for myself."

Lillian looked into John's eyes and read the sadness there. "Look, it's none of my business, but I'm a widow. I've been down the road you're walking. I know it seems like you're never going to get past what you're feeling now, but believe me, you will."

"I appreciate what you're saying, but I don't think I'll ever get over losing Beth."

"I didn't say 'Get over,'" Lillian said. "I said 'Get past.' When you lose a spouse, or any loved one, your world never gets back to where it was. But eventually you have to adjust to the new normal."

"I'm afraid I'm not doing very well at adjusting. I thought going back to work would help, and I guess it has, but still there are times when I feel overwhelmed with my sense of loss."

"And those times will continue to come. You can feel sorry for yourself. You can even cry. But the fact remains that you're still alive, and you ought to make good use of every day. Did it ever occur to you that maybe God left you here because there are some things God wants you to accomplish?"

"Beth told me that once. She said that when God said it was time for one of us to go, there was a reason, but we wouldn't have the chance to find out what it was until we got to heaven. I never paid a lot of attention to that. I just figured I'd go first, so I made all these plans to make sure she was cared for after I was gone. But now—"

Lillian looked at her watch. "I have patients, and you do, too. But I think it would do you good to talk some of this out. What say I buy you dinner? If not tonight, sometime soon. As I told you, I've been down this same road, and I remember how it helped to have someone to talk with about what I was feeling." She saw the look in his eyes and hastened to add, "Not a date. You're not ready, and if you were, it probably wouldn't be me. Just let me be a friend."

"Well, guess it would help to talk. And dinner tonight sounds fine. Why don't we touch base after our last patients?" John turned away, then looked back over his shoulder, to add, "Thanks for the offer. I could use a friend right now."

Jack Ingersoll closed the last suitcase. Six days in Germany, presenting his paper at a prestigious international meeting, speaking at lunches and dinners where physicians would hang on his every word, all of it first class and paid for by Jandra. His allotted two pieces of luggage bulged, and he'd already thought of a few other things he might need. No matter. He'd buy it there in Europe. If Jandramycin did well, he need never worry about money again.

His cell phone startled him out of his thoughts. As he pulled it from his pocket, he ran through the short list of people who had the number. Who could be calling? Resnick? No, Ingersoll was sure the detailed instructions for projects he'd left would keep Resnick safely tucked away in the lab for the duration of this trip. Pearson? Just the opposite of Resnick, who'd probably never had an original thought in his life, Pearson was competent to handle any question or problem that might come up.

He looked at the caller ID. "Private Number." No help there. He punched the button to answer. "Dr. Ingersoll."

"Jack, this is Bob Wolfe. All packed for Germany?"

"Just finishing, Bob. My flight leaves in the morning. I assume you're about to be on your way as well."

"I'll have to pack tonight—my duties keep me pretty busy around here, you know—but I look forward to seeing you and hearing your presentation."

Your duties keep you busy. Sure they do. You cull through a mound of data your researchers accumulate and cherry-pick the best projects so you can take credit for them. Oh, well
. . . "What can I do for you, Bob?"

"It's what I can do for you," Wolfe said. "I can warn you that a Dr. Sara Miles from your institution called Jandra trying to get information about alleged late effects from Jandramycin. I tried to reassure her, suggested she talk with you, but she was quite persistent. She even called Dr. Patel's office."

Jack felt his intestines knotting. "I trust she didn't get through to Patel."

"No, but the news got to him anyway, and I got called in for a rap on the knuckles by Patel, Lindberg, and the head corporate attorney, a guy named Berman."

"Sorry to hear that. Let me assure you that I—"

"No assurances necessary, Jack, because we all know how important it is that Jandramycin move forward and do well, with no hint of any adverse effects to our miracle drug. And we all know the consequences of any information to the contrary being circulated."

"Of course, and—"

"That's why I wanted to call you and—oh, by the way, I'm recording this conversation. I know you won't mind. I called to ask you the same question Berman asked me in Patel's office. Just for the record, you understand."

"Uh, sure. What's the question?"

"Are you prepared to state that you are unaware of any side effects from Jandramycin such as the ones mentioned by Dr. Miles?"

There was a long moment of silence.

"I need a yes or no answer," Wolfe said. "Please respond, Dr. Ingersoll. Do you understand the question?"

A recorded conversation, a loaded question, and his name tagged to his response. Ingersoll knew he was trapped. "I understand the question."

"And your answer, Dr. Ingersoll?"

"Yes, I'm prepared to state that I know of no such effects."

The chuckle on the other end of the line must have been similar to the serpent's response when Eve took a bite from the apple. "That's all I need, Jack. See you in Frankfurt."

Ingersoll hung up the phone and slumped onto his bed, almost knocking a suitcase onto the floor. He loosened his tie and tugged at his collar, but still couldn't get enough air. His good mood of ten minutes ago was gone. Right now, he needed time to think. That, and a stiffdrink.

"I'm sorry it took so long to get the rental car," Sara said. "That's going to make us late for dinner."

"No problem." Mark Wilcox wheeled his BMW into the parking lot of the restaurant and hurried around to open Sara's door. The parking valet hustled up, and Mark tossed him the keys.

Inside the restaurant, the maitre d' greeted Mark as though he were a long-lost cousin. "Dr. Wilcox, so glad to have you with us this evening."

"Thanks, Hugo. I hope you have a nice table for us."

"Of course. Right this way."

As they wove through the crowded room, Mark watched Sara out of the corner of his eye. Even though this restaurant had only been open for a few weeks, it had already become an "in" spot. He was glad he'd come by here earlier and introduced himself to the maitre d, slipping the man a twenty-dollar bill instead of a calling card. Yes, Hugo, the table had better be good and the service fantastic. After that, Mark figured it was up to him.

The spot to which Hugo showed them was perfect, a halfround booth toward the rear, where they could see everything and everyone without sacrificing their own privacy. The maitre d' presented menus with the flourish of a magician producing a silver dollar out of midair and padded away.

"Mark, this is so nice. Do you come here often?"

"First time," Mark said.

"But the maitre d'—"

"When I was practicing law, I defended his brother." Mark had spent some time trying to come up with an explanation other than "I came by earlier and greased his palm." He hoped this one would suffice.