He leaned back into the sofa. "She has a genetic disorder. I searched it on my phone. It says there"s no treatment. June brought her there so Mack could cure her, he"s supposedly this healer? This whole thing is predicated on him being all-powerful. They all have stories about him healing their injuries and diseases"-Shane waved his arms-"with the laying on of his hands."
"Energy healing works," she informed him.
"If you"re Chinese."
She shook her head at his ignorance.
"But it"s not working for Lily. June and Caleb, they"ve lost faith in him. I need to find options. There has to be something in trials, don"t you think? If not from Helixia, then from someone?"
"There are trials going on for almost everything," she agreed.
"I need to find one to get this baby into. One as far from Colorado as possible."
Janelle considered this. "Talk to Dineesh. He"s our Director of Immunology. He"d know all the stuff that"s not public yet."
"Cool," Shane replied, pressing his eyes with the flats of his hands.
While Janelle slept, he"d lain on his side, staring at her stomach. Her body was making calculations and divisions beyond his understanding. The big questions about their son had already been decided: would he have an instinct for trigonometry? A wide Asian nose? Would he shoot with his left? But other decisions were ongoing. Every day, billions of Nicholas"s cells were splitting and dividing, agreeing on details without bothering to check with Shane.
And this was where things went wrong. Too much or too little of one protein in one cell, and their lives would all change forever. Written into the spiraling strands of Nicholas"s genetic code were secrets they would only learn by watching.
Shane"s knowledge of genetic prenatal disease, which he had picked up during his career selling these drugs, might have frightened him, but Shane felt no real fear for his unborn son. Things did not go wrong in his life. Only his brother had ever disturbed his confidence in the universe.
Stacey took him to his first meeting, where Dennis Adderberry greeted him warmly. He was introduced by conference call to his team of sales reps around the Northwest. They briefed him on the current state of the cancer drug Sorion. It was selling beautifully, though its chart seemed to have plateaued some years earlier. Dennis gave a cheery speech about the future. Afterward, Shane stayed behind to speak with him.
"The scientists who created this," he asked. "Do they still work here?"
"Most of them, sure."
"I"d love to talk with one of them. I like to have an idea of the thinking behind products, understand the pa.s.sion they have for it. I use that when I sell to doctors."
Dennis"s jet black eyebrows arched, and Shane sensed he had made an unorthodox request. "Well, you should talk to Prajuk Acharn. He led the team. I"m sure he"d tell you what you want to know, if you can get him to leave his lab."
So at lunch, Shane walked out into June"s early breeze, across a brick walkway to the concrete, five-story Research and Laboratory building. It reminded him of a Lego piece: blunt, flat, unadorned, ready to be transplanted like a gene onto another building.
When its industrial door closed behind him, all signs of day disappeared. There were no windows, and no reception area. A small sign directed him to Protein Chemistry. He turned left, facing a long straight corridor, and noticed a pungent chemical scent dominating the air. Though the corridor was empty, he could feel the presence of scientist specters. He walked past narrow offices adorned with names from every culture imaginable, until he found the nameplate for Dr. Prajuk Acharn.
His knock pushed the door open, revealing a slight man behind a small desk. He seemed to be in his early sixties. He wore a white shirt and a brown tie too thick for these times. He possessed a narrow face on the edge of delicacy, and his straight black hair was combed harshly to the left, though it faced a counterinsurgency along its part. He was glancing between an old PC on the side of his desk and a larger Mac monitor in front of him. His neck, Shane thought, must ache at night.
"Excuse me? Doctor Acharn?"
The scientist looked up at him.
"I"m Shane Oberest. I"m the new Director of Commercial on Sorion."
An empty swivel chair sat just out of reach, but Shane didn"t feel he should make a move for it just yet.
"I"m fairly sure I"ve never seen anyone from Commercial in this building, unless we"re in a Phase Three." Doctor Acharn"s voice was unexpectedly high-pitched, that particular nasal blend of Asia and California.
"Are you Korean?" Shane asked him impulsively.
"No, I"m from Khon Kaen."
"Really? I"d love to see the beaches."
"All American college students want to see the beaches. This thing has become some rite of pa.s.sage."
"It used to be Jamaica," Shane told him.
"A huge loss for the Jamaicans," Prajuk replied dryly.
Shane smiled and took a tentative step inside his office. "So, I just started on Sorion." He placed a thick purple-bound deck onto his desk. "They gave me this."
"They want you to learn about a biologic from a PowerPoint deck?"
Shane grinned. The doctor"s eyes brightened, and he knew he was in.
"I"d love to ask you a couple of questions really, really quick. Do you have a few minutes by any chance?"
"A few, sure."
"I"d like to understand more than the numbers. Can I ask you about its genesis? You guys were looking for a cure for prostate cancer?"
"Oh, no. Is that what that deck says?"
He sat in the chair, as Prajuk shook his head. "This thing, "cure," is what they say for investors. We are not looking for a cure for cancer."
Shane frowned. "You"re not?"
"There is no such thing."
"If you don"t believe in curing cancer, then what do you want patients to do?"
"Live with it." Prajuk leaned back into his chair.
"Live with it?"
"Why not? Your body already lives with cancer every day. Stop anyone on the street at any time and screen them, and you"ll find some cancerous cells. So what? Your body absorbs them, most of the time. We place our bet on aiding the body"s natural processes to absorb these mutations before they grow large enough to interfere with life. We do not bombard it with radiations and chemicals. Attack the body, and it will attack back. That is what kills people."
"Well, the tumors kill people."
But Prajuk shook his head no. "Most cancer patients don"t die from cancer. They die from having their immune system and red blood cells obliterated by chemotherapy and radiation. They get pneumonia, infections; organ failure. With Sorion, we were not starting from a place of, how do we cure cancer? We were studying B and T cells, to understand how they function. Nothing in the body exists to do nothing."
"Except male nipples."
Doctor Acharn looked at him. A moment pa.s.sed.
"What we noticed was that cancerous cells produce an enzyme that healthy cells do not. This thing, a telomere, is an enzyme which prevents a cell from dividing. So it keeps growing, until it interferes with the body"s essential processes. If we could focus on inhibiting telomere production, we could stop this thing, tumors, from growing, without trying to kill them. Our idea is to keep this thing, tumors, at a size where the body can live with them. And manage cancer, the way you manage diabetes."
Shane blinked. "That"s a pretty radical notion."
"To doctors, maybe. But not to the body. B cells already produce a monoclonal antibody that targets telomeres and inhibits them. That is what our team discovered. The challenge is, the body does not produce enough of it. So obviously, if we could isolate these telomeres" antibodies, if we could reproduce them in the lab"-he opened his arms-"then we could have a drug that targets only the cells which produce telomeres and leaves the healthy cells alone. With healthy cells alive and functioning, there are none of the side effects to current chemotherapy treatment. No pneumonia, no hair loss, no weakness, the immune system is left whole. Only the tumorous cells are targeted."
Shane shook his head. Coming from Orco, a company that sold chemotherapy drugs, and then more drugs to address their side effects, this was a revelation. "I think I"m getting this. It"s enzyme profiling."
Doctor Acharn clapped his hands. This small gesture of joy seemed a complete breaking of his character. In his high-pitched voice he exclaimed, "Enzyme profiling. Yes. Definitely you are in Commercial for a reason."
"So, is that what Sorion is?"
"Yes. We cloned the gene that produces this antibody that attacks telomeres. We placed it on to an HIV virus, and introduced it back into the body. The virus carries the new cells through the body where . . ." He noticed the look on Shane"s face. "This thing is a disabled form of HIV. We are not injecting cancer patients with live AIDS-causing organisms."
"Okay, that"s good to hear."
"HIV is actually a wonderful vehicle for transporting genes through the body. What makes it so terrible to fight also makes it unstoppable in advancing good. Just because it is being used to destroy life does not mean it cannot be used to save it. Everything in nature is a tool, you know."
"I"m starting to understand that."
Doctor Acharn was watching him. "Now maybe you can help me understand something."
"Sure."
"This name "Sorion"? This thing sounds like a whale. What has this word got to do with telomeres?"
Shane grinned. "That"s actually in the PowerPoint."
He noticed several picture frames on the doctor"s desk, but their backs were to him. He wondered what they displayed.
"You should write a book, Doctor."
"I"m reading one."
Shane understood; he was talking about the human body. "How long have you worked here, Doctor Acharn?"
"A long time. I was employee number five."
"Really? So you know Steven Poulos?"
"My mentor."
Helixia had been founded by Steven Poulos and Walter Pietrowski, known to the biotech community ever since as P&P, in 1979. Poulos had been a young researcher at Stanford when he isolated and cloned a protein that replicated red blood cells. His lab a.s.sistant had been Prajuk Acharn. When a twenty-eight-year-old venture capital banker named Walter Pietrowski heard about this on the Palo Alto party circuit, he tracked him down. Two months later, they started Helixia as a research boutique.
In 1980, Genentech completed the biggest IPO in history, and Wall Street went insane for any biotech, boutique or otherwise. Eighteen months later, Pietrowski took Helixia public; anyone who stayed a year past that date was in this to save lives. Prajuk was one of them.
Now his eyes darted to one of his monitors. Shane watched his forehead wrinkle and stood up.
"Thanks for your time, Doctor. I do have more questions, things I can work into my sell."
"These things, e-mail them to me."
Prajuk extended a hand over his desk. As Shane leaned in, his forearm brushed a framed photograph and almost knocked it over. His face hardening, Prajuk reached out quickly to straighten it.
Helixia"s speed and intensity made Orco look archaic.
Shane felt as if he was constantly catching up. Dennis needed him to run a major annual sales conference on Sorion, for which he was vastly unprepared. He spent hours each day introducing himself to oncology practices. Each time he began to type "alpha-one ant.i.trypsin deficiency" into his computer or phone, his e-mail would sound, a text would come, someone would swing by his cubicle.
And as soon as his workday ended, Janelle would call him from the lobby to attend infant CPR cla.s.s or to hit Babies "R" Us to pick up some last remaining item. Per Janelle"s suggestion, he sent an e-mail to Doctor Dineesh Pawar asking for an appointment, but at the end of the week he had still not received a reply. On Thursday, he blocked off an hour in his calendar and drove to a nearby Peet"s to begin some focused research into Lily"s disease.
What he found saddened him. Lily"s lungs were hyperinflated. It wasn"t that they could not take a breath; it was that they could not exhale one. The air the baby inhaled became trapped inside of her, leaving only a sliver at the top for fresh oxygen. The remainder of her lungs were atrophying, unused, gray and shriveled; this produced the chronic wheeze and dry cough he had heard in her room. The condition was irreversible. It led to early onset emphysema, and an unhappy, short life. He quickly pushed the image out of his head, as if some form of transference could spread this disease to his own unmet baby.
For a decade he had wanted Caleb to leave Boulder, but felt selfish and childish each time he considered it. So his brother was living a different life than they all wanted him to, what was wrong with that? There had never been any concrete, objective reason to try to make him leave. Now, awful as it was, he had it. If he could find some test, some treatment, here.
It would take time, ma.s.sive amounts of time, to research this condition, contact specialists, learn things that weren"t to be found in online message boards and medical sites. In the car he punched his steering wheel. For a decade, Caleb had run beside strangers, knowing how much Shane would have given to have just thirty minutes with him. And after eleven years of total silence, Caleb had chosen this time, the busiest of Shane"s life, to reemerge? Rounding the Embarcadero toward home, he resolved to devote the rest of his night to e-mailing this Doctor Pawar, and tomorrow morning to personally introducing himself to everyone in Immunology.
He opened the front door to find Janelle on their couch, beads of sweat making their way down the smooth skin of her temples.
"Get the car," she whispered.
Shane ran for her blue gym bag and helped her out to the Civic. Her body felt foreign and awkward, this body he had known for years. At the street she tightened her jaw.
"Are you uncomfortable, or is it real pain?"
"I"m having contractions. Don"t be an a.s.shole."
These words, reverberating into the bones of his fully formed son, hurt him in a new and profound way. Shane brought the seat belt carefully over her belly and drove slowly over the huge hill of Mason Street as Janelle gripped his wrist.
At the hospital, a butch nurse laid Janelle on a cold metal table and attached a fetal monitor. The nurse gave it an odd look, tore the paper from the twitching needle, and walked away without a word. More time pa.s.sed than seemed necessary. Janelle expressed concern, but Shane inhaled easily; there was no problem, because in his life things did not go very wrong.
When the nurse returned, they were taken to a wide delivery room. An epidural was called for, and Shane ordered out of the room. He wandered to the lobby, looking out the window at its glimpse of the Pacific beyond. He called Fred and Julie, and Liu and Hua, whom he had to dissuade from coming immediately over. He considered finding the number of that copy store in Boulder, but he figured Caleb would ask for information about Lily"s illness, and Shane had no answer for his failure to obtain any. Tomorrow, he promised himself. He made his way back into the warm room where Janelle lay smiling. A nurse was pointing toward a monitor.
"That green light," she explained, "is his heartbeat."
And Shane was lost in a green bouncing haze. It seemed to him to possess personality, playfulness, eagerness to see him.
"Ready to meet your little boy?"
It was happening so quickly; he would have liked some time to inhale. The doctor instructed him to take Janelle"s leg. This he was unprepared for but he felt more connected now, touching his wife"s body, feeling the energy burning from it, as she pushed. And some time soon after, he saw Nicholas"s head appear facedown, covered in matted, thick black hair. He watched the doctor grasp his son"s shoulders and turn his body clockwise, and then in one seamless, sudden burst, this whole being was propelled into his life as if there had never been a moment without him.
Shane looked to Janelle, her arms outstretched for the writhing baby, and he began to laugh, and every other thought he had in the world was swept out, out into the endless ocean.
2.