WHILE WAITING FOR KEVIN, Herb continued to craft text for their grant proposal. In such endeavors, he always used a number two wooden pencil capped with an oversized pink eraser and wrote on a yellow legal pad. He was holding the pencil by its point, bouncing the eraser up and down on his desk. A faint smile appeared as he thought about how obviously fundable the idea was, how the grant was writing itself. He hadn’t shown any of this text to Kevin yet. He wanted Kevin to design the study with a minimum of assistance and feel ownership of the effort. He’d sneak in these paragraphs, articulating the rationale and larger significance of their proposal, later.
Herb’s name would have to be listed as the principal investigator. His track record of publications was essential to getting them funded. Afterwards, he planned to recede into the background while Kevin ran the project and subsequently authored a paper describing the results. Herb was pleased by the personal closure his scheme entailed. He had become a wily mentor like the ones at the National Institutes of Health who had seduced him into a career of clinical research.
Herb had entered this pathway unintentionally. In 1968, after being deferred from military conscription for four years of medical school, three years of residency, and a year of pulmonary fellowship, he had run out of dodges. The army urgently needed doctors for its escalating war in Southeast Asia. Herb was newly married, and Cecilia wanted to get pregnant. He saw a flyer posted for a position at NIH, which was hiring young MDs to help conduct experimental treatment trials. Several perks came with the job—training in clinical research methods and another draft deferment. He applied immediately.
When Herb arrived in Washington DC, protests roiled the nation’s capital. College students wearing army fatigues manned barricades and cursed at police and National Guard troops. The kids were impassioned and cocky. They had just forced a sitting president to renounce his bid for re-election.
Cecilia was self-assured too—about her ability to handle the MBA program at Georgetown, pregnancy, and motherhood. Allison was born a few months after they arrived, an easy baby who slept through the night at six weeks and wasn’t prone to crying spells. They could take her with them anywhere—restaurants, parties, movies. Herb carried Allison on his back in public places and received smiles from passers-by instead of furtive, xenophobic glances.
It was also in Washington that he started jogging again. Out Embassy Row, through Rock Creek Park, up Connecticut Avenue past the Zoo, or to the Lincoln Memorial, through the middle of the Mall, and on to Congress. The exercise calmed him, reinforced his own nascent self-confidence.
Kevin came into Herb’s office holding a stapled, ten page document at arm’s length, as though unsure of its odor.
“It can’t be that bad,” Herb laughed.
“We’ll see,” Kevin replied.
While Herb read the draft and made notes in the margins, Kevin thought of the question he hadn’t asked yesterday.
Ten minutes later, Herb declared, “This is great! Besides a few typo corrections, all we need is to complete the analytic plan and justify the sample size. Then it’ll be ready to plug into our grant application.”
“Do you really think it has a chance of being funded?”
“More than a chance. I’ll be very, very surprised if it’s rejected.”
Kevin wasn’t convinced.
“There’s always luck involved,” Herb admitted. “We don’t know who will be on the study section panel or what their biases are. But even if it’s not funded on the first round, I’m sure a resubmission can address any criticisms raised.”
“You’ve been lucky, haven’t you?”
“Absolutely. My whole career was an accident. The only reason I went to NIH was to get out of the draft.”
“I don’t want to go to NIH.”
“You don’t have to go to NIH. There’s plenty of opportunity right here.”
“But I’m not lucky.”
“Look, I know you had a bad experience with Flagler, but this is clinical research, not a laboratory experiment where every possible variable is under your control. It’s about how patients react to a disease and respond to its treatment. Lots of uncertainty, many plausible interpretations of the data. You’re the kind of person who’s capable of dealing with the messiness and sorting it out.”
“So how did things work out so well for you?”
“Simply being in the right place at the right time, like you are now. When I showed up at NIH, the oncologists were investigating new chemotherapy regimens for children with leukemia, more toxic drug combinations than had ever been given before. The patients got so immune suppressed they were sitting ducks for opportunistic pneumonias like Pneumocystis. Serendipitously, the year I started, a company invented a flexible bronchoscope and wanted someone at NIH to try it out. There I was with the right training, the right patients, the right tool, and all these NIH microbiology and pathology labs happy to collaborate with me. A wide open road to success, and I took advantage of it. It wasn’t hard to publish a dozen articles during the two years I was there, which made me marketable enough to be offered this job.”
“Sounds too good to be true.”
“Perhaps, but let’s talk about how your stars are aligned. There are lots of GRID patients here, the disease isn’t going away any time soon, and no one understands it. That is a huge opportunity for someone with your skills and training. Not only will this grant be funded, you’ll be able to use the results to leverage bigger grants afterwards, which, by the way, should be more than enough to make the university change your academic appointment from temporary to permanent. If that’s what you really want.”
Kevin disliked being probed. Impulsively, he turned the tables.
“Herb, why did you choose me? Why not one of your pulmonary fellows?”
Taken aback, Herb said, “What? Am I pushing you? Isn’t this what you want? To figure out why people are dying from GRID and how to stop it?”
“Of course I do. But why choose me? Because I’m gay?”
Kevin tensed, expecting Herb to be defensive, if not hostile. Instead, Herb sighed, plopped his elbows on the desk, and rested his chin on intertwined fingers.
“I see,” Herb said, peering over his reading glasses. “Kevin, there are two reasons. One, it’s obvious you’re deeply disturbed by this disease. I can tell because I’ve been watching you since you were an intern. On the surface, you’re a lot like me—a relatively calm person in this madhouse of high-strung prima donnas. Anyway, that first case—I’d never seen you so upset. You may not realize it yet, but you need to figure GRID out. It’s going to haunt you until you do. And without that sort of passion, it’s hard to accomplish much as a clinical researcher. The second reason is you have the smarts and drive to pull it off. There isn’t anyone else here who has that combination of talent and motivation, which is why it has to be you.”
Kevin’s cheeks burned. He tried to maintain a skeptical expression.
“I’m not selfless,” Herb added. “Getting grants funded is good for my career too.”
Herb offered his hand. Kevin tentatively clasped it.