MARCO WAS ALREADY SETTING up gels in the laboratory before Kevin left for work. He took a break at noon, set down a stack of data printouts in his nook of a carrel, and had lunch—a thermos of strong coffee and a peanut butter and jelly sandwich. While eating, he gazed at the shelf of bound notebooks he had filled during his three years here. His heels bounced on the floor. He was so close to confirming a radical, new hypothesis, it was hard to stay calm.
Since moving to Berkeley, Marco had only chipped away at creating new knowledge. Once his current experiments were finished and the revised manuscript accepted for publication, his apprenticeship with Professor Goldstein would officially end. He would be promoted to full membership in the team attempting to create clones of genetically identical mice from stem cells. Everyone in the lab believed comparing clones of mice that had a single altered gene to clones of unaltered mice was going to become the gold standard for proving what any particular gene did, at least in mice. And because mouse and human genes were so similar, their experiments would create new paradigms for understanding human diseases.
His eyes strayed to a photo of Kevin with a turquoise lake and snowcapped mountains in the background. Kevin had a rare, contented smile. Marco’s neck muscles relaxed. He had taken the picture last summer in the high Sierras. They had backpacked for a week through alpine meadows dotted with marigold, paintbrush, and penstemon. Each morning they scrambled up boulder fields to find the loneliest outposts of life where only one or two flowers could survive. Marco took photos and kept a meticulous log. At their camp, Kevin gathered wood, made fires, and cooked. The modest effort required to survive in such an austere, exquisite place made him glow with satisfaction.
Marco’s attention wandered to the data printouts. He reached for a pencil but moved past it, picked up the telephone, and dialed Kevin’s pager.
After his morning clinic, Kevin boarded a shuttle to the Hill, the university complex of hospitals, health science schools, and research institutes towering over Golden Gate Park. As he entered a classroom, his pager vibrated and displayed the phone number of Marco’s lab. The instructor was explaining the difference between a t-test and a Chi-square test. Kevin wanted to hear this and made a mental note to call Marco later.
He had begun auditing this introductory biostatistics course once he accepted the handwriting on the wall. To have job security, he had to obtain grants. As a physician who didn’t perform expensive procedures like bronchoscopy, he had no other income-generating options. A grasp of the methods used in biostatistical analysis was one of the skills he needed to submit competitive proposals.
Yet Kevin was still ambivalent about research. Not only had he failed in Flagler’s lab, he had also been burned when he tried to publish a report of the first three Pneumocystis patients they had seen at City Hospital. Herb and he had hypothesized a combination of drug use and multiple bouts of syphilis and gonorrhea infection, features common to all their cases, might have irreversibly damaged the immune system. While typing his final draft, a phone call came from Atlanta. The CDC had investigated five Pneumocystis cases in Los Angeles, all in gay men with a history of many sexually transmitted infections. Their results would be published before Kevin could get his manuscript submitted. The CDC asked him to collaborate. They offered to include the details of his cases in their national dataset, for their statisticians to analyze. Eventually, his name would be on some papers, but not as first author.
He couldn’t have refused even if he wanted. Though he had been slapped in the face by fate, his mood soon improved. He was actually glad to not be alone in dealing with this disease. Nevertheless, the academic clock was ticking. He desperately needed funding, and a first-author publication would have been a foot in the door, giving him scientific credibility to grant review committees. He was back at square one.
Kevin’s pager buzzed again while he stood outside in the drizzle waiting for a shuttle bus. He saw Marco’s number, but there was no phone nearby. He couldn’t respond until he got to City Hospital.
Over the ocean, a dark curtain of rain was moving inland. Being exposed to inclement weather on the Hill, to forces beyond his control, evoked memories of his ward assignments in the university hospital across the street. He had hated those months, the arrogance of the attending physicians, the lack of resident autonomy, the ambience of social Darwinism. The approaching shuttle reminded him of the deliverance he had felt at moving on to rotations at the Veterans Administration and public hospitals where the mean-spirited competition that house staff exhibited on the Hill softened into collegiality. How strange life’s zigzags are, Kevin thought, as he compared those memories to his new appreciation of the Hill’s scientific resources.
He was still ahead of the storm sweeping across the city when he got off the shuttle. He walked toward his office in one of the original red-brick buildings constructed after the 1906 earthquake. Its bronze gargoyles, weathered green, were set against a blackening sky. He remembered he should check on his inpatients before meeting Herb at four-thirty. Kevin turned back and passed through motion-triggered, sliding-glass doors into the modern hospital. He had forgotten Marco’s page.