KEVIN SNEAKED INTO THE clinic building through a back entrance on Monday morning. When he was safe inside his office, he phoned his personal assistant, Freddy, who brought in an armload of mail, faxes, and phone messages. Kevin noticed the door had been left open. He stood up in alarm.
“No one’s out there,” Freddy reassured him.
“Not yet,” he said, closing the door.
Kevin had been flirting with fame since the summer of 1985 when reporters verified the rumor that Rock Hudson, icon of wholesome American masculinity and friend of President Reagan, was in Paris to get an experimental treatment for AIDS. Before the movie star was outed, the media had viewed AIDS as inconsequential, a fatal illness limited to social deviants. Afterwards, any change in the who, what, or how of the disease made national news, and Kevin had become popular as a source for expert comments.
However, once the AZT trial results made headlines, his celebrity became an affliction. The media wanted interviews in time to meet their deadlines, while the university’s public relations people insisted on controlling their access to him. Activists wanted any barrier to AZT availability eliminated immediately. They were under the delusion that Kevin had the power to make this happen. Worse, he was getting twenty or more phone calls a day from desperate patients, parents, siblings, and influential friends begging for the drug, which he had no means of obtaining.
On the other hand, grants and private donations to his program had tripled in the last year, and the money wasn’t likely to plateau soon. Kevin was able to recruit additional faculty. He had hired Freddy, a godsend who screened phone calls, took care of scheduling, and generally ran interference for him. Kevin also bought decent office furniture after a visiting congresswoman had looked at his scarred, institutional desk and chairs as though they were a homeless man’s bedroll and shopping cart.
The intercom on his desk buzzed. Kevin punched a button.
“Are you still meeting David at nine?” Freddy responded.
“I am.”
“It’s nine fifteen. Shall I send him in?”
“Yes, please. Thank you, Freddy.”
He heard tapping on his door. David Ross, a man in his mid-thirties with a thick black beard, wire-rim glasses, and a halo of tightly curled hair, took a tentative step into his office.
“Come on in. Making progress with the foscarnet protocol?”
Kevin had hired David directly from his fellowship at UCLA with the immunologist who in 1981 had discovered the key defect of AIDS—an absence of helper T cells. As soon as David joined the AIDS program at City Hospital, Kevin assigned him responsibility for treating the clinic’s retinitis patients and urged him to develop a research plan for this complication of AIDS, a condition caused by a normally innocuous microbe, cytomegalovirus, which could infect the eyes of people whose immune systems were too weak to restrain it. The disease inevitably led to blindness, if the person survived long enough. There was only one medication that could halt the retinal destruction, and it often caused severe blood toxicity. Kevin wanted David to test a promising experimental drug, foscarnet, which had a very different side effect profile. David promptly found a pharmacologist on the Hill with the equipment to measure concentrations of foscarnet in blood samples. Together, they were designing a protocol to give the medication in escalating doses to retinitis patients.
“I was in Angela’s lab,” said David excitedly. “We were talking about the case reports of seizures and cardiac arrests that have occurred in transplant patients treated with foscarnet. It’s going to be a major safety issue, right? Based on the drug’s molecular structure, it makes total sense it would bind serum calcium, doesn’t it? So that could be the mechanism by which it caused a seizure or a cardiac arrest, right?
David wasn’t even giving Kevin the time to agree with him.
“So I said, ‘Let’s get some plasma. You can draw my blood. We’ll spike it with the drug. If I’m right, the calcium will drop, won’t it?’ I mean, this won’t win a Nobel Prize, but nobody’s nailed down the toxicity mechanism. And if we know that, we can avoid killing people with the drug. Right? Right?”
David was now bouncing on the balls of his feet. Kevin instinctively shrank back, afraid David might be having a manic break. Then he grasped David’s perfect logic. He patted his protégé on the shoulder.
“Good job,” Kevin said. “Go for it.”
David gave a clipped shout “Yes!” and bounded out the door.