"Prajuk, okay. It"s me." Shane started. "My friend Doctor Chin is here. We"re about to . . . can you please talk to him?"
He handed the phone to Wenceslas. While he took the call, Shane considered the lab, the lawyers, the hospital, the FDA, Helixia. The forces at play here were too large to fight.
Thirty minutes later, Wenceslas walked inside and sat down beside him.
"So?" Shane asked him pleadingly.
"So, I told Doctor Acharn that I would read the research on the Airifan trials. That"s the most that I can do, Shane. He"s going to send me everything he has on this protein and what you did with your mouse. I was going to ask you to give the vials to me, but he feels they need to be temperature stable right now." His eyes found Shane"s, and in them Shane could read different decisions being played out. "Promise you"ll wait until I go over this stuff. Promise me, Shane."
"I promise."
Janelle took Shane"s gla.s.s, swirled the wine roughly and drank.
"What do you think about this?" Wenceslas asked her.
"I think it needs FDA approval."
To Shane"s surprise, Wenceslas c.o.c.ked his head. "Why?"
She narrowed her eyes, confused.
"Unapproved medicines are given to children all the time."
"No, they"re not."
"I"m sure you know a few. Bear bile. Monkey claw?" He gave Janelle a knowing glance. "Chinatown doctors prescribe this stuff every day."
"That"s different. Those have been proven over centuries."
"I saw echinacea in your kitchen. Echinacea is unapproved by the FDA. More than a few physicians think it causes liver damage. But it"s on the shelf at every drug store, and in infant drops, by the way."
"Those are herbs. They"re natural."
"Our drug," Shane informed them enthusiastically, "is natural."
"Natural herbs are as powerful as pharmaceuticals," Wenceslas added. "Anyway, it"s not FDA approval I"m concerned with. There are thousands of drugs just like Shane"s that are available without FDA approval."
"Where do you buy them, back alleys?" Janelle asked.
"Walgreens."
She stared at Wenceslas in disbelief. "They sell unapproved drugs at major pharmacies?"
"Every day."
"Where"s the FDA in this?"
"Look, unapproved drugs are like illegal aliens. Does the government know about them? Sure. But there"s way too many to stop them all. Some of them work well. And some approved drugs are killers. That"s what I"m concerned about here. Knowing this will be safe. Safe and approved are two entirely different things."
"Read the Airifan research," Shane begged him.
Wenceslas stood. "You guys have been through a lot. Please rest. I"ll go over everything Doctor Acharn shares with me. I"m so sorry about your brother."
Janelle walked with him out to his car. Outside it was dark, and frigid. She couldn"t help but imagine Lily and Caleb running in weather like this.
"How is he doing?" Wenceslas asked her.
"Not good."
"Yeah, he doesn"t look good."
"He spent his life trying to get close to his brother, he would have done anything. This is so f.u.c.king rotten, Wen."
"Don"t let him give that baby this medicine."
"Oh," Janelle agreed, "don"t worry about that."
Over the next day Shane seemed to withdraw completely. He even turned down an invitation from Prajuk for a Chinatown lunch. Janelle knew Shane was not used to depending on other people"s permission to move forward. This had served him well in his youth; now it threatened to undo him.
He waited a week. On Friday, he called Wenceslas and attempted to communicate his agony.
"I"m at the point," Shane informed him, "where I"m going to give her the shot and let you call the cops."
"Okay. I"ll come by tomorrow morning. We"ll talk then."
Somehow he made it through the day. In the morning, Shane went downstairs, made coffee, and sat stubbornly by the front door. Around ten, when Janelle and June were taking the babies for a walk, Wenceslas knocked on the door. He wore stiff dark jeans and a blue sweater, and thicker eyegla.s.ses than was his wont.
"Come have a coffee," Shane told him.
They sat at the small wooden kitchen table, among chewed- up sippy cups, a parenting magazine, and a set of enormous plastic teething keys, while Shane prepared a press.
"So, I"ve spoken with Doctor Acharn three times," Wenceslas began. "He said he asked you to lunch?"
Shane said nothing.
"I"ve read the Airifan trials. They ran them on asthmatic children as young as six months old. In twelve- to twenty-four-month olds, there was a one point three percent incidence of liver damage. I have to say those are much better odds than a one-year-old child with alpha-one ant.i.trypsin deficiency has."
Shane watched him blankly. "So you"re going to call DCFS? The police? Just wondering who I can expect at my door? Because I"m giving her this medicine. I listen to her breathing all day and all night. I know why Caleb was desperate."
Wenceslas removed his gla.s.ses and rubbed his eyes with the backs of his hands. "I understand why you pursued this, Shane. I"m satisfied, with conditions."
Shane sat forward. "What conditions?"
"I need to be here when she gets it. I need to monitor Lily daily for a week. I"m not a pediatrician. Once we see if this is working, we"ll need to find someone sympathetic."
"Of course. Thank you, Wen."
"I can be here the rest of today."
"Today?"
"In fact," Wenceslas c.o.c.ked his head, "now would be good."
"But June and Janelle are out with . . ."
"You never hesitated this much pushing that Epherex s.h.i.t on me."
Shane pursed his lips, went to the refrigerator, and returned with a small opaque gla.s.s vial. Inside of it was Lily"s life, he thought, or nothing at all.
When they returned from their walk, Janelle put Nicholas upstairs, and June set Lily on the rug among the toys. She joined them around the dark dining room table. The room"s cream walls seemed to promise tenderness. There was only complete silence, save for the wheeze coming from Lily. June was the only one who had no idea what was about to happen.
"It"s time," Shane told her evenly, "to talk about why you all went through all of this." He placed the small vial on the table. "This is a drug that a very famous biochemist developed for alpha-one ant.i.trypsin deficiency."
Wenceslas told her. "I"ve looked at their data, I"ve spoken with experts in your daughter"s condition. And I agree this is a treatment worth trying. I"m here to monitor everything."
June was nodding. "Mack said it would be toxic."
"It"s not a pharmaceutical drug," Shane explained. "It"s natural. It comes from the body. There"s nothing artificial in here. It may not work, okay? It may not. But it"s not toxic."
He leaned in closer. "But something could still happen. Lily could have some kind of allergic response. We"ve never tested this exact drug on a baby. Her liver could react in some unforeseen way to the protein, and liver damage is not reversible. We estimate a one point eight percent chance of a problem."
June had gone paler than he had ever seen her. She stared at the vial between his thumb and ring finger. "The doctor told me she only has a small chance of living past three years old," she nodded, almost to herself.
"That is the current statistic," Wenceslas agreed quietly. He pa.s.sed her the vial, and she handled it nervously.
"How long does it take to work?"
"We don"t know," Shane told her. "A week, a year? It took around a day in our mouse."
"Can I see the mouse?"
"Sure. You guys should have it, actually."
"If something happens to the mouse, we"ll know to call you."
"His name is Thailand."
"Tell me what happens if . . ." June trailed off, looked down at Lily and hugged her close. Her voice broke a bit. "If something goes wrong."
"We"ll get her right to the ER," Wenceslas answered. "I"ll bring the rest of the vials, and we"ll tell them everything."
"Can they just give the drug to her there, in the ER?"
Wenceslas shook his head and gave her a small, resigned smile. "We can"t walk into a hospital with a vial of a homemade biotechnology drug developed in an unlicensed lab and ask them to help us inject it into a child. Should we stop?"
"And do what?" June gestured to her daughter. "She"s dying. She"s dying."
Wenceslas nodded. "I think she is."
"Caleb knew it. That"s why he needed to bring her to you. He gave everything for this."
Shane laid his open hand onto the table. "Caleb can"t be the reason you do this." He squinted, looking as deeply into her eyes as he could. "This can"t be a memorial to him. It has to be because you believe it"s right for Lily. You"re her mom. It"s your call. Not ours. Not his."
Shane turned to Janelle. He knew she was struggling, wanting to tell them all not to do it. But by the set of her jaw, he saw that she would defer, as they all would, to June.
Shane went to the bathroom and returned with a paper bag. He placed a box of alcohol wipes and an Elmo Band-Aid onto the coffee table. Janelle and Wenceslas watched as he arranged them like sacrament. Outside a family ran laughing past their bay window.
Shane held out a packaged syringe to June. "Do you know how to use one of these?"
"I sure don"t."
Wenceslas explained, "Better learn now. If this works, you"ll need to do this every six months. You clean the side of her belly with rubbing alcohol. Let it dry. Pinch her fat between your fingers, three inches from her belly b.u.t.ton. Very easy. Push the needle in straight. And press. When you remove it, push the plunger and it will click shut. I"ll write Shane a prescription for the syringes."
June lifted Lily onto the table, facing her. She raised her yellow play shirt and touched her warm, thin stomach. June looked shaky. She"s not going to make it, Shane saw.
"I love you, baby girl," June whispered into her ear.
Lily seemed to sense something then and squirmed away. June opened the wipe. The antiseptic smell reminded Shane of imminent pain. And then she took up the syringe, pushed it into the top of the vial, and pulled the plunger up, sucking in the opaque liquid of Prajuk"s genius.
Her hand hovered over her baby. Tears began to roll along her cheeks. n.o.body moved.
Janelle whispered. "This is enough for now."
And June pushed it through.
Lily frowned, and then tears burst from her betrayed eyes, and she howled. June withdrew the needle, laid it on the table beside the discarded wipe, and it was done.
Instantly a trembling began in Shane"s fingers. It moved up his arms, as if he were suffering the physical reaction they all half-expected in Lily. He moved his hands to his lap so that no one would see. Wenceslas was looking at him. Then Janelle. He could not control it as it moved to his shoulders. Oh, Jesus, he screamed inside his head, what had he just done? He stood and walked into the kitchen.
Janelle followed him. "What?" she asked angrily.
He could not reply. He stared out the back window onto the alley. It took everything he had to remain upright.
"You can"t," she frowned, "be thinking this now."
Shane shook his head back and forth.
"If you had any doubt, you should never have let her do it."
"I don"t," he replied far too weakly.
Fed up, Janelle went back to the living room. He could hear them talking with voices reserved for waiting rooms. A hot flush burrowed its way into his temples. His chest tightened. He grabbed the countertop, squeezed, pulled deep breaths. It was not enough. A cool tingling shot down his left arm.
He waited to hear the screaming from the other room when the bruising of Lily"s soft stomach appeared, and turned a wretched black. When her eyes began to yellow. When her body began to convulse.
Shane searched out some neutral object, the toaster, the window. Anything to focus on. It was no good; every nerve in his world tensed. Taking breaths became harder. He thought he might pa.s.s out.
The window of time Prajuk had set for a toxic reaction was twenty-four hours after injection. Shane could not fathom surviving this amount of time. Twenty-three and a half hours? How would he get through the next two seconds? The knowledge that Caleb had walked into his house and never come back, and that the same thing could happen to this baby and that it was too late to do anything at all about it enveloped and demolished him.