Logan was a bit shaky when he arrived at the hospital the next day for his morning rounds—and even less inclined than usual to deal with Rochelle Boudin.
Over the months, Rochelle had grown ever more difficult. Much as Logan prided himself on his skill with tough patients, with her it could be a physical effort to maintain his usual bedside manner of cheerful calm. Almost daily—even on those days when he was not charged with hospital duty—Logan received word Rochelle needed to see him. If it wasn’t about her dosing schedule, it might be the quality of the hospital food; or perhaps even a program on cancer research she’d seen the night before on PBS that she imagined had some bearing on her treatment.
Logan recognized, belatedly, that he’d help bring this on himself. Because he’d made an effort to show her special consideration at the start, she’d come to take it as her due; now feeling entitled to make demands she wouldn’t make on any other doctor at the ACF.
The truth, of course, was that what she mainly wanted was a friend—and never had it been more true than in recent weeks. Rochelle’s husband, Roger, who’d earlier made such a point of his devotion, had all but disappeared from view, and Logan noted that there was less and less conviction in her claim that he was just away on business.
Obviously, such a scenario is always poignant. A severe illness is the ultimate test of the human bond, tending to point up moral bankruptcy in loved ones nearly as often as character; and had it been someone else, someone less manipulative or even slightly more considerate of others, Logan might have found her circumstance more touching.
As it was, his dealings with Rochelle were governed only by a sense of obligation to the protocol of which she was a part. Which, finally—because the protocol in question was the volatile and unpredictable Larsen’s—was nothing more than a sense of obligation to his own future.
Now, as he scrubbed down, splashing cold water on his face to wash some of the bleariness from his eyes, he was suddenly aware of someone waiting off to the side. Nurse Lennox.
He turned and stared at her balefully. This woman was not in the business of giving him good news.
“What?”
“I hate to bother you with this, Doctor.”
“Boudin?”
She nodded. “She started asking for you yesterday afternoon, and began again as soon as she woke up this morning. Her latest white cell count is in.”
“Oh, God.” In general, he had no problem with the ethical guideline giving patients full access to their medical records. But Boudin made a habit of abusing it, seeking test results before they’d even been seen by her doctors, often interpreting them in ways that had only the most tenuous link to medical reality. “What is it?”
“Forty-two hundred. I have it right here.”
She handed Logan the sheet and he briefly studied it.
“So … I guess she wants to cut down on her dosage again, right?”
She nodded. “That’s what she wants, all right.”
“Jeez, what a pain …!”
“Good luck.”
“Yeah. I wish luck were all it took.”
Resignedly, he started moving down the corridor toward her room, the challenge at hand all too familiar: How to keep this conversation down to five or ten minutes? How to get through it with minimal emotional fallout?
“Dr. Logan?”
Logan was so preoccupied, he momentarily failed to respond to the voice addressing him from behind—or maybe it was just that it was so uncharacteristically moderate.
“Dr. Logan.”
He wheeled, and was startled to see … Stillman!
“D-Dr. Stillman,” he stammered, “I’m sorry, I didn’t hear you.”
The senior man approached him, hand extended, smiling. “No problem. I was just wondering if you might have a couple of minutes to talk.”
Logan hesitated. “Actually, I’m on my way to see a patient. But if it’ll only take—”
“Who?”
“Rochelle Boudin.”
“Lucky you. No, you’d better take care of it, you don’t want Larsen on your ass.” Another smile, this one full of comradely understanding. “Come see me in my office afterward.”
A moment later, stepping into Rochelle Boudin’s room, it was all he could do to mask his reaction—curiosity, tinged with anxiety—to what had just occurred.
“Good morning, Rochelle,” he said with brisk efficiency. “I’m told you want to see me.”
She was propped up in bed, Good Morning America showing on the mini-TV suspended at eye level. “Where were you yesterday?”
“Rochelle,” he said, with exaggerated patience, “you know I’m not on hospital duty Wednesdays, I’m in the Screening Clinic.”
“I mean yesterday evening. You used to come in the evenings.”
He couldn’t deny it. Earlier in his tenure at the ACF, he’d often spent time with patients after-hours; a bit of apple-polishing for higher-ups that could also actually be a nice change of pace. But since beginning work on the Compound J project, that had been out of the question. “Look, Rochelle, I’m sorry, it’s been a busy time.” He cleared his throat. “I’m told there’s something you want to discuss.”
“Have you seen my white cell count?”
“I have it right here.” He assumed his best sympathetic air. “I know it seems low. But I can assure you, we’re not close to the danger zone yet.”
In fact, after seven months of having her bone marrow pulverized by chemo, Boudin was holding up remarkably well.
“I want to cut the dose. I insist on it.”
“Rochelle, you know perfectly well that according to the terms of the protocol—”
“I’m so sick already,” she interrupted, “why can’t you just give me a break …?”
“Please, Rochelle, you know that I—all of us—have only your best interest at heart.”
“Do you?” she asked, suddenly girlish. “Sometimes I can’t tell.”
“Listen, have you given any thought to what we talked about the last time?”
The reference was to the implanting in her upper chest of a subclavian intravenous line. As often happened with long-term chemo patients, the veins closest to the surface had narrowed and virtually disappeared from sight, making the insertion of an intravenous drip a dicey and sometimes painful procedure. Such a line would make it as easy as inserting a plug into a socket.
“I don’t know,” she said. “Would it hurt?”
“Rochelle, we’ve been through this. Any pain would be minimal. The surgeon can do it in fifteen minutes, with a local anesthetic. When you’re finished with chemo, it’s just as easily removed.”
“Do you think I should?”
Under other circumstances, it might have been a reasonable question. Now it merely annoyed him. “Yes, I certainly do.”
“Then I will. If you say so.”
“Good, I think that’s the right decision. I’ll have the surgeon, Dr. Dawkins, come by.” Logan glanced at his watch. “Listen, Rochelle, I’ve got a very busy morning. Perhaps you can take this up with one of the other doctors.”
“I don’t want to talk about it with anyone else.”
“Well, I’m sorry, I really do have to go.” And he turned, heading for the door.
“Will you be back to see me later?”
But he pretended not to hear, not stopping until he reached Stillman’s office.
“How’d it go?” asked the senior man, as unsettlingly pleasant as before.
Logan shook his head. “The woman’s a nightmare.”
Stillman laughed. “Well, sit down, relax.” He indicated the chair facing his desk. “Who knows, maybe we can arrange it so you don’t have to do that sort of thing anymore.”
Logan sat down and returned his smile. What the hell was this about? “That would be nice.”
“I haven’t seen much of you lately. What have you been up to?”
Logan offered a stiff shrug. “Nothing much. This and that.”
“This and that? Sounds like you could put your time to better use.” He paused, leaning forward. “No sense beating around the bush. I’d like you to join my team.”
“Your clinical research team?” Logan was stunned. “Really?”
“That drug I talked about to you and what’s his name about …?”
“John Reston.”
He nodded. “… I’m almost ready to bring it to trial. We’re putting together the protocol right now, and I’m going to have to beef up on support staff.”
“My God! That’s incredible.”
If Stillman had sensed there was less than full enthusiasm in his tone, he didn’t let on. “I know I don’t have to try and sell you on this, Logan,” he said. “But I can tell you this could be a big drug. And big for everyone close to it.”
“It’s incredibly flattering. Thank you.”
Stillman waved this away. “Forget that, I want you because you’re good. I’ve seen your work in the Clinic and on the inpatient wards. Patient accrual is going to be a very important aspect of this trial.”
He waited for a response. When Logan merely nodded, he pressed on. “Needless to say, assuming things work out satisfactorily, at the end you’ll get your name on the paper.” He laughed. “Not as a lead researcher, but it’ll be there somewhere.”
Logan knew how unusual such an offer was. He appreciated what, under other circumstances, it would mean to his career.
He also knew that he had to find a reason not to accept.
Logan nodded again, then decided to take the risk. “Sir, could you possibly tell me a bit more about the drug?”
Such a question from a junior researcher might have been seen as highly presumptuous. But Stillman, utterly confident, took it with good grace. “Well, as I told you before, it’s an anti-growth factor strategy. I’m really not ready to go into more detail than that.”
Still not ready, Logan wondered, with the thing almost set to go before the Review Board? Something odd was going on here. “Sir, it’s just that, well, if I’m going to commit to work on the project, I’d really love to know just a little more about it.”
“You would, huh?” Stillman leaned back in his chair. “Well, start by knowing this. This is the sexiest drug to come down through the pipeline in a while. It’s new and it’s different and the press is going to eat it up.”
“That’s great.”
“And,” he added, “you’d be a fucking fool not to leap at this chance.”
Suddenly, sitting there, it hit him, a gut feeling so powerful he’d have bet his life on it: Stillman had zero faith in this drug! It was just another variation of the same old stuff. That’s why he wouldn’t come clean.
This protocol posed no threat at all to Compound J. Stillman was thinking only short term—the hype, and the funding it would bring in.
“Can I just think about it a little while?” Logan waffled. “I mean, it’s such a huge decision.”
Stillman’s eyes flickered with annoyance, but he held it in check. “Certainly,” he said. “Of course.” He got to his feet and extended his hand. “Like I tell people, that’s one of the things I like about you, Logan. Not an impetuous bone in your body.”