Carol Davis lay on the examination table, her walker folded and resting against the far wall. The ultrasound operator stared at the screen. She reached out and twisted a dial on the console, then repositioned the probe on Carol Davis’ pelvis, pressing the probe in deeper, turning it left and right and rotating it.
“Oww!” Carol said, as the technician pushed again. The operator continued to stare at the screen. “What’s wrong?” Carol asked.
“Nothing,” the operator said. “Don’t move.” Holding the probe in place with one hand, the operator grabbed the phone with the other and punched in an extension. “You better come and see this,” the operator said. “I’m in exam room one.”
Carol craned her head around, trying to see the screen. “What is it?” she asked.
Just then another technician came into the room and walked to the screen. He looked down his nose through bifocals and squinted, then grabbed the probe and started running it across Carol Davis’ pelvis and thighs. Carol had been holding her head up trying to see the monitor, but the two technicians blocked her view. With a snort, she dropped her head back onto the pillow.
“Look at this,” the second technician said, moving out of the way and pointing at the monitor. Smiling gamely, Carol lifted her head again and looked at the console. A ghostly green-black image danced on the screen, a diffuse group of whitish blobs. “That’s your pelvis,” the tech said. “You can see some scarring here . . .” the tech pointed “. . . and here, but . . . .” The techs looked at each other.
“But what?” Carol said.
The first technician looked at Carol. “Your bones are healing themselves.”
—
Craig Marcus pulled up in front of a compact, neat house in Berkeley, California and saw three people—a woman, a man, and a teenage girl—standing in a tight circle, holding hands. Their heads were bent and their eyes were closed. The woman’s mouth was moving.
Marcus got out of his car and moved toward the group. He could hear the woman speaking: “Heavenly Father,” she said, “we thank thee for this miracle, and we thank thee for allowing me to stay with my husband and see my daughter grow. Amen.”
Marcus cleared his throat. “Excuse me, Mrs. Davis?”
Carol Davis opened her eyes and looked at Marcus. “Yes?” she said.
Marcus extended his hand. “I’m Craig Marcus. I’m a doctor at UCSF. I apologize for interrupting, but there’s something I need to talk to you about. It’s rather urgent. Is there someplace we could talk in private?”
Carol reached out and shook Marcus’ hand. “Oh, I don’t think so,” she said, smiling. “Anything you need to tell me you can say in front of my James and Julie. But I am surprised you heard so quickly. How did you get my name?”
Marcus shifted his weight from foot to foot. “Uh, well,” he said, “I got over here as soon as I could. You see, Mrs. Davis, I have some bad news about the blood transfusion you received during your recent surgery.”
“Bad news?” James said as he moved a step closer to Marcus. “Bad news?” James repeated, now eyeball to eyeball with him. “What is it? HIV? Hepatitis?” He turned to Carol and held his arms out to her. “Oh baby, there was something wrong with the blood.”
Carol listened, stunned, then folded into James’ arms, limp. She looked skyward, addressing the heavens. “Just can’t leave well enough alone can you? First I get TL and my bones go soft. Then it’s gone. Now this.” She looked at Marcus. “Is it AIDS?”
Marcus did not answer her immediately. “Excuse me,” he said. “Did you say your TL is gone?”
“Yeah,” James said. “She had late-stage TL. They had gone in to try and put some pins in her femur ‘cuz the TL was turning them to mush, but they said the bones were too far gone and they couldn’t use pins. But she was just pronounced virus free—just this morning, in fact, they told us, after they did an ultrasound to see how her pelvis looked and then tested her blood. They called it a ‘spontaneous remission’ because they said they didn’t know what else to call it. Her bones are already coming back. Apparently it’s quite a miracle.” He looked at the ground. “Or was,” he said.
Marcus felt behind himself for his car and managed to sit down on the hood. “How long ago was the surgery for her femur?”
Carol looked at James and together they did some quick mental figuring. “About two weeks,” she said.
Marcus began mumbling, thinking out loud. The Davises looked at each other, exchanging puzzled expressions. “Excuse me, Dr. Marcus, but the blood? You were saying?”
Marcus broke into a broad smile and jumped to his feet. “The blood was fine,” he said, “just fine. No HIV or hepatitis or anything like that.” He raced over to Carol and grabbed her wrist in a doctor’s characteristic grip to check her pulse. “How do you feel?” he asked. “Any fever, joint stiffness, anything like that?”
“I feel great for the most part,” Carol said. “Certainly better than if I was dead. What’s going on here, scaring us like that?”
Marcus dropped her wrist, then hugged her. Carol’s arms remained at her sides at first, but then, tentatively, she brought them up and patted Marcus on the back. Marcus grabbed her by the shoulders and held her at arms’ length, examining her. “Would you mind coming in for a blood test?” he asked.
“Another blood test?” Carol said, wrinkling her upper lip. “I have been tested to death, and I am not anxious to head back to some hospital.”
“I’ll send someone to your home,” Marcus said. “We just need a blood sample. That’s it. I promise.”
Carol looked at her husband and daughter, who nodded. “O.K., Dr. Marcus,” she said, “you can have a little blood, but that’s it.”
Marcus smiled and shook her hand. “Deal. Do you have time for me to ask you a few more questions?”
Carol thought for a moment, then nodded. “Let’s go in the house, though. The neighbors are watching.” She pointed toward the front door. “Julie honey,” she said, “bring Dr. Marcus a glass of lemonade.”
—
“Eureka!” Marcus called out as he threw open the lab doors and descended on Vincent and Ruth. They stared at him with blank expressions. “The stuff is too strong!”
“Wait a minute, back up there, Archimedes,” Ruth said. “What are you talking about?”
Marcus, panting, his face red, made a dash for the chalkboard, Ruth and Vincent on his heels. Marcus grabbed a piece of chalk and wrote “Jason” on the board, then tapped the chalk under the name. “The factor is in Jason’s blood, right?” Ruth and Vincent nodded. “And in his bloodstream it apparently had a cytotoxic effect on the virus cells in his system, sort of like super white blood cells attacking an infection.”
“That’s the theory anyway,” Vincent said. “So?”
Marcus wrote the word “mice” on the board and drew an arrow from Jason to the mice. “When we isolated the factor and injected it into the mice, it killed them, right?” More nodding. “But it’s not inherently fatal outside the host, it’s just too strong.”
“Too strong? The amounts we’re using are so miniscule, how is that possible? It’s far more likely that the mice died because they were allergic or because of type incompatibility,” Ruth said.
“No, no,” Marcus said. “When we extracted it from Jason’s blood and refined it, we also concentrated it. The mice O.D.’d on the cure!”
Vincent and Ruth looked at the board and looked at each other. “Maybe,” Vincent said. “Still just a hypothesis at this point.”
“Of course,” Marcus said, “but what we should have done was keep the dosage the same, in the same ratio as it exists in Kramer’s blood. For the mice, that would have been a very small amount—almost too little to inject. The lower dosage would have mitigated the adverse cytotoxic effects. We didn’t account for the concentrating effect of the refining process. There’s no way we could have known this without some real data from which we could extrapolate.”
“How’d you figure this out, Craig?” Ruth asked.
Marcus put his hands on his knees and inhaled, trying to catch his breath. “We had no way of knowing until I found Carol Davis,” he said.
“Who?” Vincent asked.
Marcus stood upright and drew another arrow from “Jason” down to the corner of the board and wrote “Carol Davis–Blood Recipient.” “Several weeks ago,” he said, “Jason donated blood at work. That blood went out into the world somewhere and Jason even forgot about it until I told him about the mice dying.”
“And so Jason thought his blood would kill whoever received it, right?” Ruth asked.
“Right, and so did I,” Marcus said. “We had to track down the recipients to warn them.”
“How’d you find out who it was?” Vincent asked. “That information is confidential.”
Marcus ran his tongue over his lips for a moment, then looked at Vincent and said, “The blood bank people understood our problem. I explained that it was a matter of life and death, and they worked with me.” Vincent opened his mouth as if to ask another question, but Marcus cut him off. “Anyway, when we found the recipient, I was expecting to find that she was already dead or that I was going to have to tell her she had received some bad blood that would probably kill her very soon.”
“And?” Ruth said.
“And instead, I found out she’d just come home from the hospital in complete remission from Stage IV TL.”
Vincent and Ruth stared at Marcus, initially not comprehending. Finally, Ruth’s eyebrows started moving up as her jaw began to drop. “The Kramer factor killed Triptovirus L outside the host!”
Marcus folded his arms and smiled a satisfied smile. “Spontaneously, and completely.”
“Wait a minute,” Vincent said, “that’s pure conjecture at this point.”
“Any side effects?” Ruth said.
Marcus’ smile grew broader. “I asked her that. Only very minor ones. A bit of stiffness in her joints, a short-term low grade fever, a little fatigue.”
“You have absolutely no data to back up this hypothesis,” Vincent continued.
“She just happened to stumble on the right mixture,” Marcus said. “A pint of that stuff coursing through her veins, and she’s reborn. Who knows? Two pints of Jason’s blood might have killed her.”
“This is incredible!” Ruth said as she crossed the room, arms outstretched, and embraced Marcus.
Vincent watched them hug, then sneered. “If you go to Porter with this and you’re wrong—”
Marcus suddenly turned and stepped toward Vincent, but Ruth held him fast. “I’m not wrong, Vincent,” Marcus said.
“How do you know?” Vincent said. “There could be a dozen reasons for her remission.”
“A dozen reasons for a complete, spontaneous remission of Stage IV TL,” Marcus said, mocking him. “Yeah, right.”
“Just because her side effects mirrored those of your altered interferon doesn’t mean you’ve figured this out,” Vincent said. Marcus didn’t look up, and Vincent pressed his advantage. “You’re thinking that somehow Jason Kramer and his miracle blood are going to redeem your failed research on altered interferon, somehow maybe redeem you.” Vincent moved toward the door. “Funny, isn’t it, Craig?” he said. “You almost lost your career looking for the cure for cancer—and now nature drops something just as good right in your lap.” Vincent laughed and left the room.
Ruth and Marcus stood in silence for a moment, Ruth’s hands still around Marcus’ neck. “He’s right you know,” Marcus said. “That’s what this is all about: Redemption.”
Ruth put her hand on his cheek. “Craig, I don’t think—”
Marcus brushed her hand away and stepped out of her grasp. “No, I mean it. When I heard that lady tell me she was cured, with her husband and daughter gathered around her, praying and laughing, all I could think about was how good this was for me, how maybe I could undo that black mark from years ago, maybe regain part of who I had been, before Porter. I wasn’t happy for her at all.”
Ruth reached out and took his hands. “I don’t believe that, Craig, and besides, don’t let Vincent get to you. He’s just jealous that you were the one to discover this. Plus,” she said with a wink, “you knew that he was in the bottom half of his class at Yale, right?”
Marcus’ face remained clouded, but then the lines in his forehead softened and disappeared. “Thank you, Ruth,” he said. “You’re right. In fact, we should be celebrating!”
“You know what all good researchers keep in the fridge in the event of a huge breakthrough.”
Marcus smiled. “Dom Perignon?”
Ruth clicked her tongue and moved toward the refrigerator. “Please,” she said, “some of us are on a budget.” She opened the refrigerator door and pulled out a bottle of Cook’s champagne. “Domestic, but still quite good,” she said.
They moved to a table in the back of the lab, and Marcus began extracting the cork. “What do we do about Vincent?” he said, wrestling with the wire cage on the end of the bottle.
“What do you mean?” Ruth asked.
“Even though Jason is safely sequestered, I’m uncomfortable with Vincent’s knowing about these most recent findings. You saw his reaction, and you know his attitude. He’s a little wacky, and this is pretty valuable information.” The champagne popped open, and the cork whizzed across the room and crashed into a row of test tubes.
Ruth ducked and giggled. “Glasses,” she said, sitting up and looking around for suitable containers. Marcus grabbed two Styrofoam coffee cups off the counter and filled them with bubbly. “I wouldn’t worry about Vincent,” Ruth said. “He talks a good game, but when all is said and done I think he’ll honor the confidentiality agreement he signed.”
Marcus handed one of the cups to Ruth and lifted the other in a toast. “To Jason Kramer,” he said.
Ruth knocked her cup into Marcus’. “To the cure,” she said.
—
The Steinhardt Aquarium in Golden Gate Park was, as usual, bustling with tourists. It was penguin feeding time, and the benches in the amphitheater with an underwater view of the penguin habitat were packed. For now, though, the penguins waited, marching around the top edge of the tank like dwarf tuxedoed soldiers.
Marcus glanced at his watch, and then looked around. He jumped when he felt a hand on his shoulder. “Sorry I’m late,” Porter said from behind him.
“No worries,” Marcus said, looking back. “The show’s about to start.” Marcus saw the Driver watching from several yards away in a dark corner of the aquarium.
Porter squeezed in beside Marcus, drawing an irate stare from the Japanese tourist sitting next to him. “Thanks for meeting me here,” Porter said. “I always prefer the anonymity of a public place.” He smiled. “And I like the penguins,” he said.
“This is fine. It’s certainly closer than driving up to Marin,” Marcus said. He looked at the tourist, who was still glowering at Porter. “Although,” Marcus said, “the matters I have to discuss are somewhat, uh, sensitive.”
“Oh, I’m sure the penguins are much more interesting to these folks than anything you and I have to discuss,” Porter said.
Just then the water in the tank came alive with zipping and darting black and white torpedoes. A moment later, attendants standing on the rim above dumped in hundreds of pieces of fish. Porter and Marcus watched the penguins zoom after the mackerel chunks and gulp them down, then dive after more. The crowd in the amphitheater laughed and pointed at the birds’ antics.
Marcus leaned over closer to Porter. “We’ve finished the tests on Carol Davis,” he said.
“Oh?” Porter said. “What did you find out?” The tourist next to Porter was now busy snapping photographs of the penguins.
“The most important thing we learned is that the Kramer factor is nowhere to be found in her system.”
“Meaning?”
“Meaning the body must treat it like any other pharmaceutical agent. The stuff circulates through the system, kills TL, and is flushed out by the excretory system. Like penicillin or Retrovir. We were hoping to find that the factor persisted in the recipient’s body for a while so we could study its longer term effects on the organs. We were also hoping to see if it produced a mutagenic effect on the recipient’s own interferon.”
“Sorry. I don’t follow,” Porter said, staring straight ahead, watching the penguins.
“Like a virus,” Marcus said. “When a virus invades a host’s body, it genetically alters the host’s own cells, turning them into little virus factories. We were hoping that Jason’s blood factor would produce a similar effect in Carol Davis’ interferon. If it did, two things would happen. First, we’d have another source of the factor to study, and second, it would mean Carol Davis would have immunity from another case of TL.”
Porter raised an eyebrow, but still did not turn his head toward Marcus.
“For example,” Marcus said, “once you have the chicken pox, and assuming you survive, you’re immune to it for the rest of your life. Your body produces antibodies to the virus that protect you from ever being infected by chicken pox again. That’s the way a vaccination works. The dead or weakened viruses produce an immune response, and antibodies are created that stay in your body the rest of your life. If Jason’s factor had caused Carol Davis’ system to create antibodies to TL, she’d effectively be immune. But because the Kramer factor is not a vaccine made from dead or weakened viruses, no antibodies are created.”
Porter turned to Marcus. “So Jason Kramer is the only one with that immunity, correct?”
“Apparently.”
“So if Carol Davis has a recurrence, or if TL mutates, she’ll need another dose. Like with the common cold. No vaccine for that because the virus mutates so frequently, and that’s why you catch a new cold every year—you have antibodies to the old virus, but not the new strain. Imagine what would happen if the chicken pox virus mutated dramatically enough to fool your antibodies—even if you had it before or had a shot, you could get it again. Same thing with TL, since it seems to like to mutate.”
Marcus looked down, thinking. After a moment he looked up at Porter. “Yes, but that stuff of Jason’s is pretty strong. I have to believe that it offers some kind of ongoing protection, that it did change Davis’ immune system such that she would kill even a mutated form of TL if she were exposed again. It’s like being reborn.”
Porter nodded, then reached into his inside jacket pocket and pulled out a legal size envelope. He handed it to Marcus.
“What’s this?” Marcus asked. Porter didn’t respond. Marcus opened the envelope and pulled out the single sheet of paper inside. He unfolded it and read:
Due to irreconcilable personality conflicts with Dr. Craig Marcus, I hereby tender my resignation as a consultant for Porter Pharmaceuticals. I cannot work in an environment that fosters such hostility and professional animosity. Dr. Marcus has demonstrated a complete lack of professionalism in almost all aspects of his research into, and study of, the Jason Kramer phenomenon. This resignation shall be effective immediately.
Dr. Vincent Samuels
Marcus finished reading and put the letter in the envelope. He began to give it to Porter, but Porter held up his hand. “No, no, you keep it. I thought you’d like it for your little FDA scrapbook,” Porter said.
Marcus’ upper lip twitched, but he still managed a terse “Thanks,” to Porter. He stuffed the letter into his pocket. “Doesn’t this concern you?” Marcus asked.
“No. Why should it? Samuels signed the confidentiality agreement.”
“Yeah, well, I know how angry he was. I doubt that a contract will have much effect on him at this stage.”
Porter nodded. “If he chooses to disregard his contractual obligations, we’ll have to enforce the agreement in some other way, that’s all,” he said.
“Like you did with Gloria Buxton,” Marcus said.
Porter turned and locked eyes with Marcus. “Yes,” he said, his voice low and measured, “like Gloria Buxton.” Porter pressed his finger into Marcus’ chest. “A name you will never mention again.” Porter stared at him a moment longer, then stood and moved through the room, disappearing into the crowd.
Marcus watched him leave, then shivered, his hands and feet numb. He stared at the floor, until suddenly a Nikon camera was thrust into his field of vision. He looked up into the face of the tourist who had been sitting next to Porter. The tourist jabbed the camera at Marcus again and again, gesturing and speaking Japanese, then pointing at himself. Marcus smiled and took the camera. The tourist grinned and ran back to the penguin tank. He splayed himself up against the glass and beamed in Marcus’ direction. Marcus looked through the viewfinder and twisted the focus ring. The tourist’s image jumped into sharp clarity, but all the penguins were gone. He was standing against a huge empty tank of water. Marcus released the shutter and saw the flash light up the tourist’s eyes, turning them red. A moment later the tourist ran back and took the camera, still grinning and now apparently thanking Marcus. Marcus handed the camera back and nodded. He looked around to see if he could catch a parting glimpse of Porter or the Driver, but they were gone.
—
“Thanks for seeing me, Dr. Carnelli.”
Paul Carnelli extended his hand and gestured toward a chair. “Anything for a former student, Vincent,” he said. “Please, have a seat.”
Dr. Samuels moved across the room and sat down. He drummed his fingers on the arms of the chair and worried the knot in his tie. He shuffled his feet back and forth on the carpet.
“For heaven’s sake, Vincent, stop fidgeting. You act like this is the principal’s office and you’ve just been caught shooting spitballs,” Carnelli said.
Vincent tried to smile and grabbed the arms of the chair in defiance of his nerves. “Sorry,” he said, taking a deep breath. “Perhaps you’ve heard that I recently left the CDC and my consulting position with Porter Pharmaceuticals to hang out a shingle.”
Carnelli stuck out his lower lip and scratched his forehead, thinking, then shook his head. “No, I hadn’t heard that. What happened?”
“Not to sound trite, but let’s just say I had creative differences with Craig Marcus.”
“Craig Marcus!” Carnelli said, leaning back in his chair and putting his hands behind his head. “I haven’t heard much from old Marcus since that altered interferon debacle.” Carnelli looked off into the corner of the room, his eyes glazed, remembering. “He came here first before Porter picked him up. Thank heavens we didn’t hire him. All that baggage!” Carnelli’s eyes refocused. He looked at Vincent. “Brilliant researcher, though.”
Vincent cleared his throat. “Yes, uh, well anyway, I’m no longer with Porter and I wanted to visit with you about an opportunity that Amwell Pharmaceuticals may be interested in.”
Immediately, Carnelli leaned forward. “Hold on, Vincent,” he said. “We got scorched in court two years ago when we, according to the jury, ‘participated in and contributed to the breach of a non-compete agreement.’ Some little guy from Pfizer was in my office sitting right where you are, telling me he had the cure for cancer, and ten months later our insurance company was writing out a fifteen million dollar check.” He lowered his voice a notch and continued. “For obvious reasons, I’m still a little gun shy.”
Vincent did not respond. Instead, he reached into his pocket and pulled out a small insulated carrying case, which he sat on Carnelli’s desk. Carnelli’s left eyebrow arched up a bit as he leaned in and looked down at the package. Vincent opened the container and removed a vial of clear, light yellow, semi-viscous liquid. He held it up between thumb and index finger.
“It looks like plasma,” Carnelli said, squinting.
Vincent smiled. “What this is,” he said, “is the answer to your prayers.”