Within minutes of reentering Shein’s lab the next morning, Logan crashed back to reality, the remarkable weekend light-years away. Posted on the bulletin board, his assigned task for the day was even more tedious than usual: “cell splitting”—a fancy name for garbage duty. Waiting in the tissue-culture hood, like so many filthy dishes piled up before a GI consigned to KP, were twelve flasks of overgrown cell cultures that had to be cleaned up. From sterilization to laying down new medium, it would take him, minimum, a half hour per flask.
Yet in contrast to what was in store later this morning, he almost welcomed the assignment. At noon Faith Byrne was due at the Outpatient Clinic for her weekly exam.
In the five days since he and Sabrina had come upon her creatinine problem in the reading room, they had kept it to themselves; and their preoccupation with the new compound had enabled them to effectively put off facing its implications. But this morning Byrne would have additional blood tests—and no longer could they avoid it: the results could jeopardize the future of the protocol.
“I just love watchin’ you work, Logan.”
He looked up from a flask into the amused eyes of Seth Shein.
“Right,” he said sourly, wishing that for once he could hit the guy with a decent comeback.
“Who says I don’t give my associates great job training? You could probably get work in a pet shop right now, cleaning out cages—”
“I’d take it, it probably beats this—”
“Or down in our very own animal theme park.”
“Downstairs.” He indicated with a nod. “Don’t you have some rabbits down there? I heard you shot up a dozen of them.”
“Oh, right.” As always with this guy, Logan was unsure how much to volunteer.
Shein smiled. “So you really did it—reconfigured the molecular structure in one weekend?”
“Yeah, I guess we did.”
He shook his head wonderingly. “Every experiment clicked? No screw-ups?”
“I don’t think so. We were pretty lucky.”
“Find any time to fuck her? Here in my lab?”
“Nope,” he noted, grateful it was the truth. “Sorry.”
“You should be.” Shein paused. “Well, I’m impressed.”
Then, as Shein turned away, “Listen, I was wondering if I could spring loose from here around noon. There’s something I want to check up on at the Outpatient Clinic.”
Shein stopped. “Oh, yes, that woman is coming in this morning, isn’t she?”
Logan looked at him uncertainly. “Mrs. Byrne.”
“Right, your best friend.” He paused. “Some sorta problem?”
“No. Just routine.” He had no idea if Shein bought it. “Dr. Como will be seeing her.”
“Good. No need for you to rush over there, then. I’ll expect you to finish your work here first.”
It was past twelve-thirty by the time Logan made it to the Outpatient Clinic. He had just settled into a chair in the physicians’ lounge when Sabrina walked in. Reading her face, he knew the news was not good.
“Logan, I have been looking for you.”
“You got the results of her blood work?”
She held aloft the computer printout. “Her creatinine is at two point zero.”
He closed his eyes and shook his head. “Well, there it is.” He looked up. “Does she know?”
“No. She is still in the examining room. I wished to talk first with you.”
“I think we’ve just got to be straight with her. At this point keeping her on the protocol will endanger her health.” Logan rose to his feet. “I’ll be glad to go in with you.”
“No, Logan,” said Sabrina, as he knew she would. “That could be more trouble for us all. By myself is best.”
“Of course,” he said, resuming his seat.
He was still sitting there fifteen minutes later when Sabrina returned, flushed. “Logan, you should come. This situation, it is impossible.”
“What?” he said, though he already had a pretty good idea what she meant.
“This woman, all she does is argue with me. Such anger.”
“Where is she?”
She nodded in the general direction of the examining room. “She wanted to make calls to her family.”
He exhaled deeply. “Look, Sabrina, maybe I shouldn’t get in the middle of this. My relationship with Faith Byrne—”
“Logan, please, she hates me now also. But this is a job that must be done.”
Reluctantly, he followed her down the corridor and into the examining room. Byrne was perched on the edge of the examining table in a hospital gown.
“Hello, Faith,” he began, as pleasantly as he could manage.
She made no response, just stared back defiantly.
“Dr. Como tells me you have some questions about your blood-test results.”
“Is that what she tells you? Well, I’m telling you your results are bullshit. I feel fine.”
He nodded. “I understand. We plan to run a second series of tests to check those results.” For the hundredth time, there came the bitter thought: Byrne should never have even gotten on this protocol! But now, suddenly, he was struck by a new one: Could it be—was it possible?—that Stillman also had known in advance about a looming creatinine crisis?
“You listen to me,” snapped Byrne. “I have been coming down here for almost three months and no one’s said a single word to me about this so-called problem until today.”
But, no, that made no sense: How could he have? There was nothing on her chart, nothing in her medical history…. Anyway, what about the other woman with the same problem …?
“Are you listening to me, Logan?”
“Of course.” The scowling face at once yanked him back to reality.
“You damn well better. ‘Cause you’re going to have to come up with something better than this before I let you kick me out of this protocol.”
Reflexively, Logan gave his best doctor’s smile. He hadn’t believed anything this woman might say or do could surprise him. But the suggestion that the test results had somehow been rigged as part of a personal vendetta left him at a loss. “Look,” he said, “perhaps I can give you a clearer idea of what the problem is. You see, the creatinine level—”
“I’m sorry, Faith, I got here as soon as I could.”
And there, stepping into the small room, not entirely to the doctors’ surprise, was Marion Winston.
“Ms. Winston,” said Logan, “I’m not sure you’re up to speed on what’s going on here—”
“I have some idea.”
“Perhaps, then, you can help Mrs. Byrne understand that, for all our past differences, we’re really all on the same side here.”
“Are we? Would you have called me—as Faith did?”
Logan intended his smile to be self-effacing. “Well, no. But actually, I’m glad you’re here. I know how much respect you have for the integrity of the Informed Consent Document.”
“You see,” added Sabrina reasonably, “this is set in the terms of the protocol. If a patient’s creatinine level rises above two point zero, then she must leave the protocol. It is too dangerous to continue.”
“No,” cut in Byrne, “you’ve got it backward. It’s too dangerous for me not to continue. I’m going to die if I don’t continue.”
Winston gave a decisive nod. “Frankly, I don’t know anything about this little experiment of yours. And frankly, I don’t really care. My concern is that you are attempting to break faith with this patient.” She turned directly to Logan. “Again. Only, this time you’ve got Dr. Como fronting for you.”
Astonished, Logan threw up his arms, looking toward Sabrina. Her mouth had literally fallen open.
“Not, I suppose, that I should be surprised,” continued Winston. “Given the nature of your relationship.”
“This is just completely uncalled for,” sputtered Logan.
Interrupting, Winston addressed herself directly to Sabrina. “I’d have thought that as a woman, you’d have a bit more understanding. Obviously, I was wrong.”
“This is not a question of men or women,” came the reply. “Why would you say this? What is gained?”
“No, you’re right, Doctor. It is about honesty. And competence.”
“You are the one who is not honest!” countered Sabrina; the very first time Logan had ever seen her so furious. “YOU! We are trying only to do what is best.”
“Look,” cut in Logan, “we are going to double-check the blood tests. We’ll triple-check them if you like. But the bottom line is that we cannot in good conscience continue to administer this drug to a patient who manifests this kind of reaction.”
He waited for a response. There was none.
“Now, Faith, as far as we’re concerned this examination is over. You may get dressed.”
Winston put a hand on the patient’s shoulder. “Go ahead,” she said gently. “You and I will talk in my office.”
As Byrne walked slowly toward the adjoining changing room, Winston, not unexpectedly, lingered behind.
“Are you waiting to have the last word?” asked Logan evenly.
“I just want you both to know that we are not going to let this stand. I’m not through with you.”
In an odd way, it was as if the pressure was off—at any rate, the pressure to be civil. Logan smiled. “You know, I’ve got an almost irresistible urge to tell you what I think of you—”
“Go ahead,” she replied too eagerly, chin forward. An invitation, it suddenly struck him, that could lead to a whole raft of new charges against him.
“But”—he turned to Sabrina, seemingly on the verge of an outburst of her own—“unfortunately, we’ve got better things to do.”
Arriving on campus the next morning, Logan was not surprised to find a note in his box instructing him to report to the office of Dr. Raymond Larsen.
“You’ve done it now, Logan,” began the head of the Department of Medicine. “I suppose I don’t have to tell you that.”
“How exactly do you mean, sir?” The fact that the senior man was so clearly enjoying this scene only reinforced his intention to play it as cool as humanly possible.
“I don’t appreciate that attitude, young man! Show me the respect of not insulting my intelligence!”
“Yessir. That wasn’t my intention, Dr. Larsen.”
“Let me come straight to the point. It has been five months since this protocol was approved, and I’ve heard nothing but bad news. Nothing! All you have established is that this drug is highly toxic.”
“I’m aware of that, sir. But it is still relatively early.”
“And,” he continued, brushing this aside, “it’s hard to imagine the reports of your personal conduct being any worse. You just do not seem to know how to get along with patients.”
Logan simply stared at him. This, from a man with the bedside manner of a serial killer. “Sir, I really don’t think that’s fair,” he replied. “Aside from Ms. Winston, with whom I’ve had a conflict almost from the start, there’s no one—”
“I am not interested in your opinion.”
“And I really don’t think the news on Compound J has been all that bad. Dr. Shein—”
“Or in his. Dr. Shein is not the principal investigator on this study, you are.”
“Of course. I’m just trying to point out that we haven’t done much worse than other protocols at a comparable stage. Even at the moment, we’re not the only trial of this kind that’s failed to show significant early results.”
Though he’d been careful not to name names, the implication could hardly have been any clearer. Immediately, the vein in the older man’s temple began to throb. “I should not have to remind you that you are not Dr. Stillman! Nor do you have the standing to speak in such a manner of Dr. Stillman’s work!”
“I was just trying to—”
“Dr. Stillman knows enough not to cavalierly place his patients in jeopardy. He has never once placed the reputation of this institution at risk! Which, young man, whether or not you are aware of it, is precisely what your conduct has done! Do you understand what I am telling you?”
Logan started to respond, then stopped himself. It was no good. This guy didn’t even know how to pretend to be interested in a dialogue. “Yessir, Dr. Larsen,” he said. “I’m sorry. What would you suggest we do now?”
“I don’t suggest anything. You will do the following. How many patients remain on this protocol?”
“With Mrs. Byrne off—I assume she is off …?” When the other only continued to stare at him, he pressed on. “That leaves thirteen.”
“And they are continuing to come here to be examined on a regular basis, are they?”
“Yessir.”
He leaned forward in his desk chair. “Dr. Logan, it is not within my authority to close down this protocol completely. But it is to take those steps necessary to safeguard the integrity of the Department of Medicine.” He paused. “I expect you to inform each of those patients, on her next visit to the ACF, of the extraordinary risks we now know to be associated with this compound. Each shall then be given the option of leaving the protocol.” He shook his head, as if in consternation. “And I wish I were in a position to offer each of them my personal apologies.”
Logan stood there, dumbstruck. In effect, he was killing the program. Was this the way it was going to end? Without his even making a coherent argument on its behalf?
But he also knew that words were not going to mean a thing. And none came.
“That will be all, Logan,” said Larsen suddenly, a military commander dismissing a contemptible underling. “Some of us do have work to do around here, you know.”