"A proposal."
"Proposal? For what?"
"Actually, it"s a proposal for us to apply for an orphan grant."
Dennis coughed; beneath his black eyebrows his eyes opened.
Shane pressed on. "There"s a lung condition, a genetic mutation, called alpha-one ant.i.trypsin deficiency . . ."
"It"s a liver gene mutation," Anthony p.r.o.nounced robotically.
"Right, liver. There"s a high-potential cure using a protein we"ve already developed here."
Anthony shook his head firmly. "If a patient is alpha-one ant.i.trypsin deficient, they"ll develop emphysema. We"re focusing on that."
"Would you mind maybe having somebody read it? I"d love to know if I made any sense," he said, extending the folder.
"We only pursue drugs for immature populations when there is potential for significant scientific breakthrough. You said we already isolated this protein?"
"Doctor Acharn did."
"So what is the potential for discovery?"
Dennis shot Shane a look. "Our motto is, Profitable Biotechnology. You should read your coffee mugs."
"I thought it was, Where Science Is the Star?"
Anthony stared hard at him. Angrily he said, "We"re curing cancer here."
Shane felt his face flush.
"We"re going to take our people off of diseases that kill tens of millions of people a year to put them on one that affects almost no one? With no hope of discovering anything new?"
"I guess it"s called an orphan"-Shane smiled-"because it needs our help."
"It"s called an orphan," Anthony replied, "because it is unwanted."
He took up his laptop bag, turned to Dennis, nodded sharply, "Okay," and left. Shane was aware of a ball forming behind his Adam"s apple; his file stuck warmly in his hand.
Dennis"s black eyebrows curled. "What the h.e.l.l?"
"I know someone whose kid was born with this. I thought it would be respectful to have things thought through. I should have asked you how to handle it. That was bulls.h.i.t. I"m sorry."
Dennis"s face betrayed an almost parental frustration.
Shane left the conference room and walked down the hall. At the old elevator he turned. Dennis was still standing in the doorway; he had not taken his eyes off of him.
He sat across from Prajuk Acharn in a booth at a McDonald"s near Pinon Drive.
Shane swallowed his lunch uneasily; it did not escape him that the biotechnology which made replacing proteins possible also provided the food in front of him. Outside a smeared window, a teenaged employee waged a futile battle against freeway grime with a window mop.
"So," Prajuk grinned. "Anthony told you to p.i.s.s off."
"Right in front of Dennis too." He smiled. "Why are you laughing?"
"This thing is funny. Like watching someone walk into a door. Out of curiosity, what was this thing, your proposal, going to tell him?"
"A lot of it was a case study on Ceredase."
Prajuk chuckled. "This guy is top of his field in the world. He knows about Ceredase."
Shane frowned; the scent of grease and antiseptic became overwhelming. He pushed his tray away.
"Did he say anything at all?"
"He reminded me that we"re here to cure cancer. Dennis talked about money."
Prajuk leaned back into the stained red leather booth. "Make no mistake, they are the same thing. P and P took the company public because they wanted money. To cure cancer. There is relentless pressure on everyone to beat these Goldman Sachs a.n.a.lysts" calls, because we want money to solve for cancer. If Poulos never figures out how to end cancer, I think he will consider his life a failure. Anthony too. And to do this thing takes a great deal of f.u.c.king money."
It was amusing, Shane thought, to hear him curse in his high voice.
"Look," he continued, moving his fingers over his fries, "we take money from hedge funds, and college endowment fund managers, and police department pensions, and soccer moms with an E-Trade account, to pay for all of this research. But these investors are not in our stock to cure cancer, or teach the body how to live with it. They are in it for profits. If our stock goes down? They will not care that we might only be a year or two away, they will sell. And we have to make appropriate cuts in research. And so Anthony Leone will not approve anything that threatens us with a loss. Unless"-he raised his finger-"it leads to something new. Which this does not. Why didn"t you come to me?"
"I really thought he"d say yes."
"Even if he did, formal testing would take ten years. An infant with alpha-one ant.i.trypsin deficiency," he reminded Shane flatly, "does not have ten years. Or even three."
"Clinical trials are f.u.c.king immoral," Shane spat. "At Orco, they tested a leukemia drug, okay? Everyone in the test was going blastic, but half the people got a placebo. The drug pa.s.sed trials, Orco is making billions, half the test group was ignored. It"s barbaric."
"Testing without controls is more barbaric. Imagine if the half they gave that drug to died instantly?" Prajuk was watching him curiously. "You have to think clinically, Shane. Phase One of a trial involves a hundred people. It exists to determine side effects. This is urgently important. Ninety-nine percent of drugs are proven unsafe right there. Without controlled Phase One testing, we risk killing millions of people later. Those people in that trial you mention understand their risk. They volunteer to partic.i.p.ate to be part of finding a solution. One hundred voluntarily put themselves at risk to save millions. Those numbers are not barbaric, they are actually quite civilized."
"Thinking in numbers is immoral too."
"The dictatorship of numbers," Prajuk informed him, "is the process of history."
Shane shook the ice at the bottom of his cup. "I"m not going to stop. I"ll go to other drug companies."
Prajuk smiled wistfully and wiped ketchup from his lower lip with the back of his hand.
"What about you? It"s your discovery, your work, and it"s just sitting there. Doesn"t that bother the s.h.i.t out of you?"
A knowing expression took over Prajuk"s face. "I wanted to study computer science my whole life. But once I experienced biomedicine I was seduced completely. I left Khon Kaen when I was eighteen, to attend MIT. Afterward, I went for graduate work at UCLA. It was difficult. Even though LA was closer to Thailand, I felt much more homesickness there. I felt better at Stanford, where I did my postdoctoral work for Steven Poulos. We spent uncountable hours side by side in his lab, as he finessed his enzyme into Sorion. Which enabled the company to go public and hire hundreds and later thousands more people. All of this is in some way my work, Shane."
Shane watched the thin scientist, in his short-sleeved blue b.u.t.ton-down shirt.
"Let"s do it ourselves," Shane suggested.
Prajuk stopped moving.
"We"ll come in weekends. We"ll go back and find that door, and open it. No one will know."
"This is not a law firm. You cannot just come in on the weekend and use the company Xerox machines."
Shane"s eyes smiled.
"There is not a drop of saline that is not accounted for. And this thing, the lab, there are people in it around the clock. But also, I discovered this protein in Helixia"s employ. Any discoveries I make belong to them."
"But they don"t use it."
"So because you"re not using your car today, I can take it?"
"If a little girl was dying on the corner, you could G.o.dd.a.m.n take it. You"d be a criminal if you didn"t."
Prajuk"s eyes drifted down to his watch. "To manufacture a drug for the ten thousand people with alpha-one ant.i.trypsin deficiency would cost ten million dollars and take half a decade, Shane. This is not something we can do after hours."
"What if I didn"t want to help ten thousand people?"
Prajuk squinted, caught by surprise.
"What if I only wanted enough medicine for just one?" Shane looked across the table at this man he barely knew. He hesitated, breathless, and leaned forward onto the sticky Formica table. "What would that take?"
Prajuk crossed his small arms and stared out the window, at the haze of the industrial city. For a long time, only his little finger moved, unconsciously tapping on his tray.
In a much softer voice he answered, "Significantly less."
7.
When Caleb came downstairs at five a.m., there were bottles everywhere.
The house reeked of beer. Large bottles of Belhaven lay like unfinished books on the floor. Two mostly empty big bottles of Beam stood by an open Monopoly set. The old boom box was still on, its green light fluttering like the heart monitor of a dying man.
Three light-bearded kids wearing T-shirts were asleep on the floor. Caleb recognized one as a regular from the Rocking Horse; the others he"d never seen before. He walked to the kitchen and was pleased to find it tidy. As Happy Trails did not stock food, there had been nothing for the party to raid. He carefully opened the gla.s.s containers of amaranth, faro, spelt, buckwheat, barley, blue cornmeal, and wheat germ, took a measuring spoon from the drawer, and began sifting them into a large cast iron pot filled with soy milk.
From upstairs came the creak of floorboards. John, he guessed. The older John became, the more his energy seemed to concentrate in these earliest of hours. Anyone who was a.s.signed to prepare breakfast encountered John"s help bringing out bowls, replacing the grains, wiping down the countertop.
Then a sudden sound surprised him. Just beside the front door, the door to Mack"s room creaked open. Caleb stepped back into the shadows by the kitchen door. Rae, her hair loose from its familiar ponytail, closed the door behind her. Her full mouth was frowning, and her head hung limply from her shoulders. Her eyes seemed to be carrying black weights.
Caleb watched her move straight to the stairs and take them quickly.
At noon, he left O"Neil"s for his midday break and jogged steadily away from the shops.
Halloween themes had taken over the town. Orange and black banners hung from the streetlights advertising the upcoming parade, blocks of hay had been stacked along Broadway, and handmade posters for pumpkin coffees and beers hung in windows.
On Arapahoe he pivoted past the high school and took a quick turn down Nineteenth, a small street speckled with short trees and older single-story homes. By the doorway of a small apartment complex on Goss, he stopped and waited until June emerged, carrying her plastic bucket of supplies. She wore a soft turquoise fleece jacket and white running shoes, and when she saw him she skipped over the pavement and hugged him. They had arranged this a.s.signation with a whispered word during the group run the day before. He kissed her, she left her bucket and jacket in the doorway, and they started jogging west. Beside him she felt tiny but steadfast.
Soon they were out executing a good pace toward Flagstaff. They seemed to be struggling messily with the process of synching footsteps and heartbeats. Eventually, through a subtle progression, they found a rhythm and moved into a vast meadow.
"So, I really need to talk to you."
Caleb glanced at her and nodded.
She hesitated. "I"m worried."
"About Lily? Look, we . . ."
"About you."
He was surprised to see the look in her eyes.
"You asked your brother for help, and it"s been three months . . ."
"Three and a half," he mumbled.
"I haven"t seen my family in six years. They"ve never even met Lily. But I know if I asked them for help, they would be there. If they blew me off? I"d be crushed. Caleb, are you crushed?"
He smiled, looking out at the gray road, and the rolling green and brown brush. "I disappeared from Shane"s life a long time ago. Why should he jump just because I ask him to?"
"But he came out here, so we thought . . ."
"He must have seen something he didn"t like."
"It"s the way we live, or maybe Mack freaked him out. Or maybe me."
"I doubt that."
"I just, I wanted to tell you . . . I could see that he loves you."
Caleb felt that reach him with surprising force.
She touched his arm. "Ever since the Hardrock, I"ve been realizing how vulnerable we are on these mountains. I don"t want you to be distracted, by Shane, or us."
"I didn"t fall at Hardrock because of you, or my brother," he lied. "I fell because the trail was muddy."
"Rae"s been against Yosemite from the start. Maybe she"s right?"