Chapter 2Sunday, April 58:20 A.M."Okay, you'd better take it from here," Winston Bartlett declared to Kenji Noda over the roar of the engine. He had lifted his feet off the pedals and was unbuckling the cockpit seat belt. He liked having a turn piloting his McDonnell Douglas 520N helicopter on the commutes between his corporate headquarters inLower Manhattanand his medical research park in northernNew Jersey, but prudence dictated a more experienced hand on the collective during descent and landing. For that he had Noda, formerly of the Japanese Defense Forces. A tall, wiry man of few words, Noda was also his bodyguard, chauffeur, and curator of his museum‑qualitykatanasword collection.With the sharp, delicious aroma of the pine forest below wafting through the cabin, Noda quickly put aside the origami he'd been folding, to center his mind and slid around a special opening in the bulkhead. He strapped himself into the seat, then took the radio headphones. The sky was the purest blue, with not another craft in the visual perimeter. They were, after all, over a forest.AsBartlettsettled himself in the passenger compartment, he thought about where matters stood. There was the very real prospect he had rolled the dice one time too many. The daily blood tests at his clinic inNew Jerseywere showing he was disturbingly close to using up his nine lives.To look at him, though, you'd never suspect. At sixty‑seven he was still trim and athletic, confident even cocky, with a full head of steel dark hair and probing eyes that instantly appraised whatever they caught in their gaze. He played handball at a private health club near hisGramercyParkmansion for an hour every other morning and he routinely defeated men half his age, including Grant Hampton. Remaining a player in every sense of the term was the main reason he enjoyed flying his M‑D chopper, even though his license had been lapsed for eight years. It was the perfect embodiment of his lust for life. As he never failed to point out, his lifelong business success wasn't bad for aCityCollegegrad with a bachelor's degree in Oriental art history. He had gotten this far because he wanted success enough to make it happen.He'd started out inNew Yorkreal estate, but for the last twenty years he had concentrated on buying up small, under‑ priced medical‑device manufacturers with valuable patents and weak bottom lines. He dismantled some of the companies and sold off the pieces, always for more than he'd paid for the whole. Others he restructured with new management, and when a profitable turnaround was in sight, he took them public or sold them to a major player like Johnson & Johnson. The potential winners, though, the ones with promising pipelines of medical devices or drugs whose FDA approval was imminent, he relocated here at the BMD campus in northernNew Jersey.But competition was fierce, and the bigger players like Merck and J&J had limitless research capital. They could write off dead ends a lot easier. Thus it was that five years ago, when his pipeline was drying up, Winston Bartlett took the biggest gamble of his life. He acquired a cash‑strapped new start‑up called the Gerex Corporation, whose head scientist was at the cutting edge of stem cell research. Karl Van de Vliet, M.D., Ph.D., had just had his funding terminated and his laboratory atStanfordUniversityclosed after a political flap by right‑wingers.Bartletthad moved Van de Vliet here toNew Jerseyand poured millions into his stem cell efforts, bleeding BMD's working capital white and racking up 85 million in short‑term debt just to keep the rest of the company afloat. Now, though, the gamble was paying off. This month Gerex was winding up stage‑three clinical trials for the National Institutes of Health. These trials validated a revolutionary procedure that changed the rules of everything known about healing the human body. Already his CFO, Grant Hampton, was heading a negotiating team hammering out a deal with the British biotech conglomerate Cambridge Pharmaceuticals to sell them a 49 percent stake in Gerex. Over 650 million in cash and stock were on the table, and there were escalators, depending on the results of the trials now under way.The problem was,Cambridgehad only seen the financial and summaries of data from Gerex's successful clinical trials. They knew nothing about the fiasco of the Beta procedure."Karl called just before we left and said she's worse this morning,"Bartlettremarked to Noda. He was removing his aviator shades and there was deep frustration in his eyes. "God I feel so damned responsible. She was—""Having the Beta was Kristen's idea," Noda reminded him. "She wanted to do it."What he didn't say was on both their minds: what about Bartlett himself? After Kristen Starr had had the Beta, and it had seemed successful,Bartlettdecided to have it too. Now his daily blood tests here at the institute were showing that the telomerase enzyme was starting to metastasize and replicate in his bloodstream, just as it had in hers."Well,"Bartlettwent on, "Karl thinks he's got a new idea that might save us.Hamptonis supposed to be on the case this very morning." He stared out the chopper's window, down at the rooftops of his empire. At the north end of the industrial park was the main laboratory, where stents and titanium joint replacements were tested on animals—mostly sterile pigs, though some primate testing also was under way. The central area had two large manufacturing facilities where the more complex devices were made.The buildings were all white cinder block, except for the one they were hovering above now. It was at the far south end, a massive three‑story mansion nestled among ancient pines and reached by a long cobblestone driveway. Though it was actually the oldest building of the group by a hundred years, it was the latest acquisition for the complex. It fronted a beautiful ten‑acre lake, and had been a summerpalacioof a nineteenth‑century railroad baron. Around mid‑century it was turned into a luxury retirement home, complete with nursing services. Its ornate appointments reminded patients of the Frick Gallery, if one could imagine those marble halls teeming with wheelchairs and nurses.Bartlett had bought the defunct manufacturing complex next to it eighteen years earlier for the BMD industrial park, but it was only six years ago that the owners of the mansion, a group of squabbling heirs, finally relented and agreed to part with the property. It was now a flagship holding of BMD.He had an eye for design and he had loved remodeling the old mansion and making it into a modern clinic and research facility. He had renamed it the Dorian Institute and moved in Karl Van de Vliet and the research staff of the Gerex Corporation. He also had put a landing pad on the expansive roof, along with a stair leading down to an elevator that could take him directly to the laboratory in the basement.Kenji Noda settled the McDonnell Douglas onto the pad and cut the engines.Bartlettnever let himself worry about the noise. The patients in the clinical trials were here at no charge, so they really couldn't complain, particularly since they were now part of what was possibly turning out to be the greatest advance in the history of medicine. If your Alzheimer's had just been reversed at no charge, you weren't going to complain about a little hubbub on the roof."I'll wait here," Noda said opening the side door. His bald pate, reminiscent of an eighteenth‑century samurai, glistened in the early spring sun.Bartlettnodded, knowing that his pilot did not trust physicians and hospitals. Taking care of your body was your responsibility, Kenji Noda frequently declared and he trained his own daily. He ate no meat and drank gallons of green tea. When he practicedkendoswordplay, he had the reflexes of a man half his age. He never discussed why he had leftJapan, butBartlettassumed it was for reasons best left in the dark.Bartlettheaded down the metal stairs leading to the self‑ service elevator. This daily ordeal of flying out to give a blood sample and to see Kristen was increasingly unsettling. As he inserted his magnetic card into the elevator security box, he felt his hand shaking slightly.So close to the eternal dream of humankind. So close. How was it going to end?Sunday, April 58:38a.m."Dr. Vee, I'm feeling so much better, I can't tell you." Emma Rosen reached out and caught her physician by the collar of his lab coat, pulling him down and brazenly bussing his cheek. She'd been longing to do this for three weeks but hadn't mustered the nerve until now. "This morning I climbed the stairs to the third floor, twice, up and back without any chest pain. Oy, can you believe? It's a miracle."Karl Van de Vliet was a couple of inches over six feet, with a trim face and sandy hair that some older patients judged too long for a physician. His English normally was perfect, though sometimes he made a mistake when trying to sound too colloquial. But everyone, young and old adored his retiring Dutch manner and those deep blue eyes that carried some monumental sadness from the past. They also were sure he would soon be recognized worldwide as the miracle worker he was. The prospect of a Nobel didn't actually seem that far‑fetched."Emma, please, I begged you to rest." He sighed and checked the dancing electronic pens of her EKG. They were in the basement of the Dorian Institute. Upstairs, the "suites"—nobody called them rooms—were intended to invoke a spa more than a clinic, so most of the heavy‑duty diagnostic equipment was kept in a row of examining rooms down near the subterranean lab. "For another week at least. Why won't you listen? You've been a very naughty girl. I may have to tell your daughter."He glanced at the seventy‑three‑year‑old woman's readout one last time, made a quick note on his handheld computer, and then laid a thin hand across her brow for a fleeting, subjective temperature check.She's all but fully recovered, he told himself. It's truly astonishing.Five weeks earlier, she had come through the front door of the Dorian Institute in a wheelchair pushed by her youngest, a bottle blonde named Shelly. He took one look and scuttled the normal security precautions, the frisk for cameras and recording devices. Emma's low cardiac output had deteriorated to the point that her left leg below the knee was swollen to almost twice its normal size, owing to renal retention of fluid, and she was so short of breath she required oxygen. He hadn't wanted to complicate the clinical trials by taking on another patient at that late date, but she had been referred by a physician friend in the city, begging. How could he turn her away?He had removed a microscopic amount of bone marrow from her right ankle, extracted the stem cells, applied the hormonal signal that told them to develop into heart muscle, and then injected a thriving cell factory into her heart. Since stem cells could be made to ignore the body's rules to stop replicating after a certain number, they were able to reproduce forever, constantly renewing themselves. The only other cells with that immortal characteristic were cancer cells. In fact, it was as though he had given Emma a new kind of cancer—one that produced cells as healthy as those in a newborn. Today she probably could have run up those stairs.Although his stem cell technology was going to create a new era in regenerative medicine, he had experienced his share of bumps in the road. Five years earlier,StanfordUniversityhad canceled his research project there since the work he had been doing involved the special stem cells in unused fertility‑clinic embryos. The university claimed there had been death threats to its president. The Board of Regents had finally decided with a sham show of remorse, to revoke his funding. They called him in one sunny afternoon in May and pulled the plug. He thanked them and tore up his contract. By that time he had already demonstrated that, using the right chemical signals, stem cells could be coaxed into becoming almost any organ. Inserted into the heart, they became new heart muscle, replacing scars; inserted into the brain, they became neural tissue. No way was he going to be stopped now. They didn't know what they were losing.What he needed was a "white knight." He did some poking around and came up with Winston Bartlett, then floated feelers toBartlett's people. What if, he proposed,Bartlettacquired the Gerex Corporation for BMD and made it a for‑profit business? No more public funding (and maddening administrative meddling). The research already completed was so close to a payoff, after years and years of grinding lab work and thousands of white mice, that the deal could be considered an investment where 95 percent of the seed money had already been supplied by taxpayers.Winston Bartlett had liked the sound of that, and Karl Van de Vliet had his white knight.Once his financing was secure, he decided to begin by solving the problem that had dogged him at Stanford. Since there would always be a distracting public‑relations problem hounding any researcher in the United States who made use of aborted embryos, even if it was to save lives, he was determined to find a less controversial way to trick Mother Nature and garner "pluripotent" stem cells, the name given those that could give rise to virtually any tissue type.He had. After he moved his research team into the Dorian Institute just over 4 1/2 years ago, he had perfected a way to use a human protein, an enzyme called telomerase, to make adult stem cells do most of the miracles once only thought possible with embryonic cells.The phase‑three clinical trials over the past seven months had proved conclusively that the technique worked. Adult stem cells, when treated with the telomerase enzyme to arrest the process of cell senescence, could indeed regenerate everything from the human brain to the human heart, from Parkinson's to acute myocardial infarction.Twenty‑three days from now, when the phase‑three clinical trials were formally scheduled to be completed, Karl Van de Vliet would have enough data for the National Institutes of Health to confirm one of the most important breakthroughs in the history of medicine.Unfortunately, however, there was that other bit of data that he would not be sharing with the NIH. The Beta.Thinking about that, his heart heavy, he turned back to the situation at hand."Emma, you're making wonderful progress," he continued on with the banter, "but don't push yourself too hard just yet."She laughed, sending lines across her forehead. Her voice was deep and rich, sultry in its own way. "When you get as old as I am, honey, you do anything you can get away with. What am I saving it for? I just might go toAtlantic Citynext week and pick up a sailor.""Well, then, I may have to have Shelly go along and keep an eye on you," he said with one last programmed smile. Then he checked his watch.Bartlettshould be arriving any minute now. Time to get Emma Rosen the hell out of here and back upstairs.He turned and signaled for Ellen O'Hara, the head nurse, to start removing the suction‑cup electrodes that had been stuck on Emma for her EKG. Ellen had been with him when he was at Stanford and her loyalty was unquestioned. She had made sure that the Beta disaster with Kristen hadn't become the gossip of the institute. Still, how much longer could it be kept quiet?ThenSandraHanes, the lively, dark‑haired woman in charge of the second floor for this shift, walked into the examination room. She knew nothing about Kristen."Perfect timing," he said. Then he drew her aside. "Keep an eye on Emma, will you? Try and keep her in her room and quiet as much as you can. The last blood work showed her white‑cell count over twelve K/CMM. It could mean there's some minimal rejection rearing its head. Probably nothing to worry about, but can you just keep her away from the stairs for godsake? I don't want her tiring herself out.""I'll tie her to the bed if I have to,"Sandraanswered. The clinical trials had required a mountain of paperwork, and her face was strained from working long shifts, including a lot of weekends, like this one. But he suspected she actually appreciated the overtime. She was forty‑five, divorced and putting a straight‑A daughter throughRutgers.She also was a first‑rate nurse, like all the others at the institute, and her loyalty couldn't be more secure. Still, he knew that she and all the other staffers were bursting to tell the world about the miracles they'd witnessed. That was whyBartletthad insisted on an ironclad nondisclosure agreement in the contract of every employee to be strictly enforced. (And to put teeth into the security, all employees were body‑searched for documents or cameras or tapes on the way in and out.) To violate it would be to open yourself to a life‑altering lawsuit. During World War II the claim had been that "loose lips sink ships." Here they would render you a pauper for life. Nobody dared even whisper about the spectacular success of the clinical trials.As the examining room emptied out, he checked his watch one more time. Winston Bartlett was due any minute now and he had nothing but bad news for the man.Trying to control his distress, he walked to the end of the hallway and prepared to enter the lab. Whereas the ground floor and the two above were for reception, common dining, and individual rooms, the basement contained the laboratory, his private office, the examination rooms, and an OR (never yet used, thankfully). There also was a sub‑basement, accessible only through an elevator in the lab or an alarmed set of fire stairs. It was an intensive‑care area, and it was where Kristen, the Beta casualty, was being kept.He zipped a magnetic card through the reader on the door and entered the air lock. The lab was maintained under positive pressure to keep out the slightest hint of any kind of contaminant. It was as sterile as a silicon chip factory.The room was dominated by a string of black slate workbenches, then rows and rows of metal shelves with tissue‑ containing vials of a highly volatile solvent cocktail he had engineered especially for this project, along with a computer network and a huge autoclave and several electron microscopes.He walked in and greeted his research team. He'd managed to keep the core group that had been closest to him at Stanford, four people who, he believed, were among the finest medical minds in the country. They were the renowned molecular biologistDavidHopkins, Ph.D., the strikingly beautiful and widely published endocrinologist Debra Connolly, M.D., and two younger staffers, a couple who'd met and married at his Stanford lab, Ed and Beth Sparks, both Ph.D.'s who'd done their postdoc under him. They all were here now in the wilds of northernNew Jerseybecause they knew they were making medical history.Davidwas waiting, his long shaggy forelock down over his brow as always. But his eyes told it all."Karl,Bartlett's blood work from yesterday just got faxed up from the lab atPrinceton. His enzyme level has increased another three point seven percent.""Damn." It was happening for sure. "Did you run—""The computer simulation? A one‑standard‑deviation estimate is that he's going to go critical sometime between seventeen and nineteen days.""The Syndrome." Van de Vliet sighed."Just like Kristen.""She faked us out. There were no side effects for weeks." Van de Vliet shook his head sadly as he set his handheld Palm computer onto a side table. Later he would transfer all the day’s patient data into the laboratory's server, the Hewlett‑ Packard they all affectionately called the Mothership. Then he began taking off his white coat."Bartlettlooks to be inevitable now."Davidexhaled in impotent despair. The frustration and the tension were getting to everybody. They all knew what was at stake. "It's in two and a half weeks, give or take."What had supposedly been a cosmetic procedure had gone horribly awry. Van de Vliet wondered if it wasn't the ultimate vengeance of the quest for something you shouldn't have."His AB blood type is so rare. If we'd just kept a sample before the procedure, we'd have something to work with now," Van de Vliet said sadly. "We still might be able to culture some antibodies."He hadn't told his research team yet about the other possible option—using somebody else as an AB blood‑type incubator.His last‑ditch idea was to find a patient with a blood type of AB positive and introduce a small quantity of the special Beta telomerase enzyme into them. The theory was that this might induce their body to produce compatible antibodies, which could then be extracted and cultured in the laboratory. If a sufficient quantity could be produced they could be injected intoBartlettand hopefully arrest the enzyme's pattern of entering the host's bloodstream and metastasizing into the more complex form that brought on the Syndrome. And if it did work, then there might even be some way to adapt the procedure to Kristen."Karl, if Cambridge Pharmaceuticals finds out about the Beta fiasco, how's it going to affect—""How do you think it's going to affect the sale? If this gets out, there'll be no sale. To anybody.Bartlettwill be ruined, and Gerex along with him. That's everybody here, in case you're counting." He turned and exited the lab, pushing pensively through the air lock, and then he walked slowly toward his office, collecting his thoughts. He was just passing the elevator when it opened.Sunday, April 58:47a.m.Winston Bartlett looked up to see Van de Vliet as he stepped off the elevator, and the sight heartened him as always. The Dutchman was a genius. If anyone could solve this damned mess, surely he was the one."First thing, Karl, how is she now?""I think you'd better go down and see for yourself," Van de Vliet said slowly. "As I told you on the phone, she still comes and goes. I think it's getting worse."Bartlettfelt a chill run through him. He had once cared for this woman as much as he was capable of caring for anybody, and what had happened was a damned shame. All he had intended was to give her something special, something no man had ever given a woman before."Will she know who I am? She still did yesterday.""It depends," Van de Vliet replied. "Yesterday afternoon she was fully lucid, but then earlier this morning I got the impression she thinks she's in a different place and time. If I had to guess, I'd say she's regressing chronologically. I suppose that's logical, though nothing about this makes any sense."Bartlettwas following him back through the air lock andinto the laboratory. The intensive‑care area below was reachable only by a special elevator at the rear of the lab.All these once‑cocky people, Bartlett thought, were now scared to death. Van de Vliet and his research team might actually be criminally liable if the right prosecutor got hold of the case. At the very least they'd be facing an ethics fiasco.But I'm the one who's about to be destroyed. In every sense.It had all started when Karl Van de Vliet confided in him that there was an adjunct procedure arising out of stem cell research that might, might, offer the possibility of a radical new cosmetic breakthrough. Just a possibility. He called it the Beta, since it was highly experimental. He also wasn't sure it was reproducible. But he had inadvertently discovered it while testing the telomerase enzyme on his own skin over a decade ago.At the time he was experimenting with topical treatments for pigment abnormalities, but the particular telomerase enzyme he was working with had had the unexpected effect of changing the texture of his skin, softening it and removing wrinkles, a change that subsequently seemed permanent.The idea had lain dormant while they were preparing for the clinical trials. But thenBartlett'spetite amie, the cable‑TV personality Kristen Starr, had had a career crisis that she blamed on aging, and he came up with the idea of having her undergo the skin procedure.In a mistake with unforeseen ramifications, she had then been made an official part of the NIH clinical trials. After she had gone for over a month without any side effects,Bartletthad elected to undergo the procedure himself.Then it began in Kristen—whatDavidhad solemnly named the Syndrome. Van de Vliet had immediately (and illegally) terminated her from the clinical trials, removing her from the NIH database. She was now being kept on the floor below, in the subbasement intensive‑care area.As they stepped onto the elevator to go down,Bartlettfound himself wondering how many of the staff here were aware of the real extent of the crisis. Van de Vliet had said that only three of the nurses knew about Kristen and the Syndrome. Fortunately, they all were trustworthy. Two had even been with him back at Stanford. They would never talk.But what about the rest? They'd all fawned over Kristen, starstruck by her celebrity, and they'd spill the beans in a heartbeat if any of them found out. The story would be everywhere from Variety to the "Page Six" gossip column. It would certainly mean the financial ruin of Bartlett Medical Devices. If Gerex went under, everything else went with it.On the other hand, he thought ruefully, what does it matter? If I end up like her, I won't even know it happened."W.B., the telomerase enzyme is completely out of control in her now," Van de Vliet continued. "First it metastasized through her skin and into her blood. Then it began directing its own synthesis. I've tried everything I know to arrest it, but nothing has worked. I still have a faint hope, though. If we can make some headway on your own situation . . ." He paused and his voice trailed off. "In the meantime, though, I think it would definitely be wise to move her to another location. There are too many people here. The risk is enormous. Word is bound to get out sooner or later. You must have someplace . . .""Of course."Bartlettnodded. "I'd rather have her in the city and closer to me anyway. But let me see if I can talk to her first. I need to try to make her understand."Though it's probably too late for that, he told himself.They stepped off the elevator and entered a high‑security area, a long hallway illuminated only with fluorescent bulbs. Using a magnetic card as a key,Bartlettopened the first door they came to. As always, he was dismayed by the sight.For a moment he just stood looking at the thirty‑two‑ year‑old woman sitting up in a hospital bed, mutely watching a flickering TV screen showing the Cartoon Network. He had truly cared for her, perhaps even loved her for a time.Then he walked over. "Kristy, honey, how're you feeling?"She stared at him blankly. Kristen had been a vivacious blue‑eyed blonde who’d had her own showbiz gossip show on the E! channel till it was canceled during a scheduling shake‑up six months earlier. She had a nervous breakdown, declaring toBartlettthat her show had been canceled because she looked like a crone.He’d told her it wasn't true, but if she was so distraught about her appearance, then maybe there was something he could do for her. Van de Vliet had once mentioned an experimental skin procedure. . . .Bartlettturned back to Van de Vliet, feeling the horror sinking in."Karl, goddamit, we've got to reverse this.""Let's talk outside," Van de Vliet said.Bartlettkissed Kristen's forehead in preparation for leaving. Her lifeless blue eyes flickered something. He thought it was a flash of some old anger.Who could blame her? he told himself. But back then, who knew?He'd wanted to give her a gift like none other. Not quite the Fountain of Youth, but maybe a cosmetic version. Her skin would begin to constantly renew itself.And he'd been right. The promise of having her skin rejuvenated was just what she'd needed to get her self‑confidence back.For more than a month the miracle seemed to be working, and there were no side effects. Her skin was becoming noticeably softer and more supple. She was elated.Screw NIH trials and the FDA, he then decided. It was working for Kristen. By God he would try it himself. He wasn't getting any younger.But no sooner had he had the procedure too than Kristen started evidencing side effects. First it was little things, like lapses in short‑term memory. Next, as it got progressively worse, she could no longer remember why she was at the institute. Then she couldn't recall her name, where she lived. And now . . .Could it be that God can't be cheated? And when it's tried, God brings down a terrible vengeance.When they were outside in the hallway, he said, "I have a place onPark Avenuethat's empty. At the moment. We used to spend weekends there and I can arrange for a full‑time nursing staff, all of it." He paused. "Has anybody called here about her lately?""Just her mother, Katherine, who's getting pretty frantic.""The woman is unbalanced. Certifiable. God help us if—""I told her to see what she could find out from Kristen's publicist.""Good."Bartletthad told Kristen's midtown publicity agent, the nosy Arlene of Guys and Dolls, Inc., that Kristen had gone to a private spa inNew Mexicoto rethink her career and didn't want to be disturbed. She desired complete solitude. Any communication with her would have to be handled through his office.He looked at Van de Vliet. "Karl, tell me how bad it is for me now.""For you?" He hesitated. This was the question he'd been dreading. "The telomerase numbers from yesterday's blood sample are not encouraging. As I told you, your topical enzyme application has metastasized into your bloodstream and started to replicate, just like it did in Kristen. We're seeing a process known as 'engraftment.' These special cells have learned to mimic any cell they come near. They become the tissue that those cells comprise and begin replacing the healthy tissue with new. In Kristen's case, we think it's now entered her brain and it seems to be supplanting her memory tissue with blanks. The same side effect could eventually evolve in you."That doesn't begin to describe the real horror,Bartlettthought. It's too impossible to imagine."The only thing left is to find some way to cause your body to reject the enzyme," Van de Vliet said. "I'm optimistic that we might be able to grow some telomerase antibodies in another patient with your blood type, then culture enough of them to stop the Syndrome in its tracks. It's worth a try. Frankly, I can't think of anything else. But your blood type is AB, which is extremely rare. Also, the problem is that we'd possibly be putting that other person at severe risk too.""Let's go back up to the lab,"Bartlettsaid. "That idea of yours—Hamptonthinks he's got somebody. A woman, in her late thirties." He put his hand on Van de Vliet's shoulder. "We're going to get her on board however we have to."Chapter 3Sunday, April 58:49a.m.Stone Aimes was staring at the e‑mail on the screen of his Compaq Armada and feeling an intense urge to put his fist through its twisted spiral crystals. What do you do when you've come up with an idea that could possibly save thousands of lives using simple Web‑based technology and then the piece gets spiked by your newspaper's owners at the very last minute because it exposes some important New York hospitals to unpleasant (but constructive) scrutiny?What it makes you want to do is tell everybody down on the third floor to stuff it and walk out and finish your book— undistracted by corporate ass‑covering BS ... or, unfortunately, by a paycheck.Around him the newsroom of the New York Sentinel, a weekly newspaper positioned editorially somewhere between the late, lamented New York Observer and the Village Voice, was in final Sunday countdown, with the Monday edition about to be put to bed. The technology was state of the art, and the room flickered with computer screens, blue pages that gave the tan walls an eerie cast. Composition, spell‑checking, everything, was done by thinking machines, and the reporters, thirteen on this floor, were mostly in their late twenties and early thirties and universally underpaid.The early morning room was bustling, though it felt to Stone like the end of time. Nobody was paying any attention to him but that was normal: everybody was doing their own thing. Besides, nobody else realized he'd just had a major piece killed at the last minute. Now he felt as though he were frozen in place: in this room, in this job, in this life.The book he had almost finished was going to change a lot of things. It would be the first major explication of stem cell technology for general readers. Stem cells were going to revolutionize everything we knew about medicine and the research was going further than anyone could have dreamed. The possibility of reversing organ degeneration, even extending life, was hovering right out there, just at humankind's fingertips. It cried out for a major book.He had read everything that had made its way into the medical journals, but the study that was furthest along was privately funded and now cloaked in secrecy. It was at the Gerex Corporation, whose head researcher was a Dutch genius named Karl Van de Vliet. The company had been bankrolled by the medical mogul Winston Bartlett after Van de Vliet lost his funding at Stanford.Winston Bartlett, of all people . . . but that was another story.Thirteen months earlier, the Gerex Corporation had trolled for volunteers on the National Institutes of Health Web site, referring to a pending "special study." The notice suggested the study might be using stem cell technology in some fashion. If that study was what Stone Aimes thought it was, it would be the first to use stem cells in stage‑three clinical trials. Nobody else was even close.Karl Van de Vliet was the ball game. Unfortunately, however, his study was being held in an atmosphere of military‑like secrecy. Why? Even the identities of the participants in the trials were like a state secret. Since Winston Bartlett owned Gerex, it surely had been ordered by him. You had to wonder what that was all about.Whatever the reason, Stone Aimes knew that in order to finish his book with the latest information he had to get to Van de Vliet. ButBartletthad forbidden any interviews, and Gerex's clinic, called the Dorian Institute, was off‑limits to the public and reportedly guarded with serious security.But, he thought, perhaps he had just come up with an idea of how to get around that. . . .He stared a moment longer at the dim reflection coming back at him from the antiglare screen, which now informed him that his cover feature had been chopped. Truthfully, it was happening more and more; this was the third time in eight months that a major muckraking piece had been axed. Also, as he stared at it, the reflection told him he wasn't getting any younger. The hairline was no longer where it had been in his college photos—it was up about half an inch—and the blue eyes were sadder, the lines under them deeper.Still, the tousled brown hair was thick enough, the brow mostly wrinkle‑free, and he still had hope. He wasn't exactly young anymore, but neither was he "getting on." The "Willy Loman" years remained safely at bay. He was thirty‑nine and divorced, with an ex‑wife, Joyce, who had departed to be a garden designer in northernCalifornia, taking with her their daughter, Amy, on whom he doted. He had a one‑bedroom, rent‑controlled apartment in the East Nineties, on the top floor of a fashionable brownstone. He was socially unattached, as the expression goes, but he was so compulsive about finishing the book that he spent weekends hunched over his IBM Aptiva, nursing a six‑pack of Brooklyn Lager and writing deathless prose. The truth was he was lonely, but he didn't allow himself to think about it.He'd always vowed he'd amount to something by forty. And now it was as much for Amy as for himself. She lived with his ex‑wife nearEl Cerrito,California, and she meant the world to him. The mortifying part was, he was a week behind with this month's support check. And he knew Joyce needed the money. It made him feel like a callous deadbeat dad when the real culprit was an unlucky confluence of inescapable bills. He’d make it up next week, but he’d sworn he would never let this happen.That was why he had a larger game plan. Get out of this frigging day job and finish the book. The time for that plan to kick in was approaching at warp speed. This last insult was surely God's not‑so‑subtle way of informing him that his future was in the freelance world. Every day out there would be a gamble, but he could write anything he damn well pleased.There was a parable set down by the ancient Taoist philosopher Lao Tzu that Stone Aimes reflected on more and more these days. It was the story of two oxen: One was a ceremonial sacrificial ox who, for the year before he meets the axe, was feted with garlands of lotus flowers and plied with ox goodies. The other was a wild ox who had to scrounge in the forest for every scrap. But, the story went, on the day the ax was to drop, what wouldn't that ceremonial ox give to change places with that haggard struggling, underfed wild ox?That's the one he empathized with. The one who was out there, half starved but free.The Sentinel was an iron rice bowl that normally never let anybody go except for grossest incompetence or flagrant alcoholism. On the other hand getting ahead was all about office politics, kissing the managing editor's hindquarters, and copying him on every memo to anybody to make sure nobody else took credit for something you thought of.On the plus side, he knew he was a hell of a medical journalist. There was such a gap between medical research and what most people knew, the field cried out for a Stephen Hawking of health, a medical Carl Sagan. The way he saw it, there was room at the top and he was ready for a major career breakthrough. He had done premed atColumbiabefore switching to journalism, and these days he read the Journal of the American Medical Association from cover to cover, every issue, along with skimming the many other journals now on the web.The piece that just got cut was intended to show the world that investigative journalism was alive and well and trying to make a difference. He'd documented that hospital mistakes were actually the eighth leading cause of death in theUnited States. TheInstituteofMedicineestimated that medical errors caused between fifty and a hundred thousand deaths a year—rivaling the number from auto accidents or AIDS. (He'd gotten enough data to be able to quantify how many of those deaths were in leadingNew Yorkhospitals.) Yet there was no federal law requiring hospitals to report mistakes that caused serious injury or death to patients.The reason seemed to be that the medical lobby‑‑he'd named names—had successfully turned back all attempts by Congress to pass such a law, even though it was a formal recommendation by theInstituteofMedicine. The problem was, once you admitted you screwed up, you could get sued.So there was no formal accountability.But (and here was the constructive part) if patients' medical records were put on the Web—everything, even their medications—it could make a big dent in the all‑too‑frequent hospital medication foul‑ups. That alone could cut accidental hospital deaths in half.He'd pitched Jay Grimes, the managing editor, to let him do a five‑thousand‑word piece for the Sentinel. Jay had agreed and even promised him the front page. Jay liked him, but since all the real decisions were made by the owners, not‑so‑affectionately known as the Family, there wasn't much Jay could do to protect his people. Stone now realized that more than ever.The e‑mail on his Compaq's screen was from Jane Tully, who handled legal affairs for the paper. Apparently, Jay didn't have the balls to be the hatchet man, so he'd given the job to Jane, who could throw in a little legal mumbo jumbo for good measure. And she hadn't even had the courtesy to pick up the phone to do the deed. Instead, she'd sent a frigging e‑mail:See attached. Corporate says legal implications convey unacceptable risk. Consider an op‑ed piece. That way the liability will be all yours. Love and kisses.And of course, by "Corporate," she meant the Family (or, more likely, their running‑dog attorneys down onNassau Street).It was really too bad about Jane. She was a young‑looking thirty‑six and had her own legal practice with a large law firm in midtown, but she always dropped by before her Sunday brunch to answer any legal questions that might be pending before the Sentinel was put to bed. Stone knew pretty well how her mind worked. He should. Jane Tully was his former, very former, significant other.They d lived together for a year and a half onFirst Avenuein the East Sixties. But she was type A (tailored Armani suits and always on time) and he was a type B (elbow patches and home‑cooked pasta). The denouement had been seismic and full of acrimony and accusations.So was she killing this major piece out of spite? he wondered. Just to prove one last time who really had thecojones?Actually, it would have been nice to think so. That would put a human face on this gutless travesty. But the attached memo had enough legal jargon that another reason was immediately suggesting itself. The owners of the paper, the Family, the fucked‑up twins Harry and Bosco and their mother, Adeline, the heirs of Edward Jordan, actually were afraid of a lawsuit. The attachment had the fingerprints of the Family's attorneys all over it. Jane was just carrying out marching orders.And sure enough, there at the bottom was a second message, unsigned and not part of the original memo. She had written clearly ITMB.That was their old code for "I tried my best."Well, Jane baby, who the hell knows. Maybe you did.Damn, it wasn't supposed to be like this. He wasn't tryingto be a Carl Bernstein, for chrissake. For once, all he wanted was to report a story exactly the way it was, and then try to help. He ultimately wanted to fix, not fault.He hit a button and printed out a copy of everything, then minimized the screen, grabbed his jacket, and walked down the hall. Was this the moment to quit? It was, except he couldn't afford to. He'd never managed to put enough aside to take off a year and live on air and write and still get that fifteen‑hundred‑dollar check out to Joyce and Amy every first of the month.He got to the bank of elevators and pushed the button for the third floor and stepped on. The inspection sticker framed just above the controls actually told the whole saga of why his cover story about sloppy procedures inNew Yorkand national hospitals had been killed. The building was owned by Bartlett Enterprises, the real estate holding company of Winston Bartlett.The Sentinel held a very favorable lease, renewable for another ten years at only a 5 percent increase when it rolled over in seven months. TheJordanfamily had gotten it in the early 1990s, whenNew Yorkreal estate was still in the toilet from the stock market crash of '87, and for once Winston Bartlett really screwed up. Now it was about a fifth of the going price per square foot.So naturally he was about to do everything he could to break the lease. He was that kind of guy. TheJordanfamily, owners of the Sentinel, probably figured that a big lawsuit by the AMA or somebody would overtax their legal budget and giveBartletta shot at their soft underbelly. Thus no boats were to be rocked.The elevator chimed and he stepped off on three. This floor had subdued lighting and understated birch paneling, pale white, in the reception area. It was as though power didn't need to trumpet itself. Everybody knew who had itHe waved at Rhonda, the receptionist, and strode past. She glanced up, then said, "Does she know you're coming?"She knew full well he was headed down to see Jane. Unlike most organizations, which take Sunday off, this was always a big day for the Sentinel, with all hands on deck."Thought I'd give her a little surprise.""No kidding." She was reaching for the phone. "I think maybe I should—""Not necessary." He was charging down the hall, feeling knee‑deep in the thick beige carpet. "I've got a feeling she's expecting me."Jane's door was open and she was on the phone. But when she saw him, she said something abruptly and hung up. He strode through the door, then slammed it. The decor was bold primary colors, like her take on life. Explicit."Okay," he demanded, "what the hell's going on? How about the real story?""Love, you know you can't hang the Family out with that kind of liability," she declared, then got up and came around her desk and cracked open the door half a foot. "And you're the one person here I can't have a closed‑door meeting with. It'll just get people talking again."
8:20 A.M.
"Okay, you'd better take it from here," Winston Bartlett declared to Kenji Noda over the roar of the engine. He had lifted his feet off the pedals and was unbuckling the cockpit seat belt. He liked having a turn piloting his McDonnell Douglas 520N helicopter on the commutes between his corporate headquarters inLower Manhattanand his medical research park in northernNew Jersey, but prudence dictated a more experienced hand on the collective during descent and landing. For that he had Noda, formerly of the Japanese Defense Forces. A tall, wiry man of few words, Noda was also his bodyguard, chauffeur, and curator of his museum‑qualitykatanasword collection.
With the sharp, delicious aroma of the pine forest below wafting through the cabin, Noda quickly put aside the origami he'd been folding, to center his mind and slid around a special opening in the bulkhead. He strapped himself into the seat, then took the radio headphones. The sky was the purest blue, with not another craft in the visual perimeter. They were, after all, over a forest.
AsBartlettsettled himself in the passenger compartment, he thought about where matters stood. There was the very real prospect he had rolled the dice one time too many. The daily blood tests at his clinic inNew Jerseywere showing he was disturbingly close to using up his nine lives.
To look at him, though, you'd never suspect. At sixty‑seven he was still trim and athletic, confident even cocky, with a full head of steel dark hair and probing eyes that instantly appraised whatever they caught in their gaze. He played handball at a private health club near hisGramercyParkmansion for an hour every other morning and he routinely defeated men half his age, including Grant Hampton. Remaining a player in every sense of the term was the main reason he enjoyed flying his M‑D chopper, even though his license had been lapsed for eight years. It was the perfect embodiment of his lust for life. As he never failed to point out, his lifelong business success wasn't bad for aCityCollegegrad with a bachelor's degree in Oriental art history. He had gotten this far because he wanted success enough to make it happen.
He'd started out inNew Yorkreal estate, but for the last twenty years he had concentrated on buying up small, under‑ priced medical‑device manufacturers with valuable patents and weak bottom lines. He dismantled some of the companies and sold off the pieces, always for more than he'd paid for the whole. Others he restructured with new management, and when a profitable turnaround was in sight, he took them public or sold them to a major player like Johnson & Johnson. The potential winners, though, the ones with promising pipelines of medical devices or drugs whose FDA approval was imminent, he relocated here at the BMD campus in northernNew Jersey.
But competition was fierce, and the bigger players like Merck and J&J had limitless research capital. They could write off dead ends a lot easier. Thus it was that five years ago, when his pipeline was drying up, Winston Bartlett took the biggest gamble of his life. He acquired a cash‑strapped new start‑up called the Gerex Corporation, whose head scientist was at the cutting edge of stem cell research. Karl Van de Vliet, M.D., Ph.D., had just had his funding terminated and his laboratory atStanfordUniversityclosed after a political flap by right‑wingers.
Bartletthad moved Van de Vliet here toNew Jerseyand poured millions into his stem cell efforts, bleeding BMD's working capital white and racking up 85 million in short‑term debt just to keep the rest of the company afloat. Now, though, the gamble was paying off. This month Gerex was winding up stage‑three clinical trials for the National Institutes of Health. These trials validated a revolutionary procedure that changed the rules of everything known about healing the human body. Already his CFO, Grant Hampton, was heading a negotiating team hammering out a deal with the British biotech conglomerate Cambridge Pharmaceuticals to sell them a 49 percent stake in Gerex. Over 650 million in cash and stock were on the table, and there were escalators, depending on the results of the trials now under way.
The problem was,Cambridgehad only seen the financial and summaries of data from Gerex's successful clinical trials. They knew nothing about the fiasco of the Beta procedure.
"Karl called just before we left and said she's worse this morning,"Bartlettremarked to Noda. He was removing his aviator shades and there was deep frustration in his eyes. "God I feel so damned responsible. She was—"
"Having the Beta was Kristen's idea," Noda reminded him. "She wanted to do it."
What he didn't say was on both their minds: what about Bartlett himself? After Kristen Starr had had the Beta, and it had seemed successful,Bartlettdecided to have it too. Now his daily blood tests here at the institute were showing that the telomerase enzyme was starting to metastasize and replicate in his bloodstream, just as it had in hers.
"Well,"Bartlettwent on, "Karl thinks he's got a new idea that might save us.Hamptonis supposed to be on the case this very morning." He stared out the chopper's window, down at the rooftops of his empire. At the north end of the industrial park was the main laboratory, where stents and titanium joint replacements were tested on animals—mostly sterile pigs, though some primate testing also was under way. The central area had two large manufacturing facilities where the more complex devices were made.
The buildings were all white cinder block, except for the one they were hovering above now. It was at the far south end, a massive three‑story mansion nestled among ancient pines and reached by a long cobblestone driveway. Though it was actually the oldest building of the group by a hundred years, it was the latest acquisition for the complex. It fronted a beautiful ten‑acre lake, and had been a summerpalacioof a nineteenth‑century railroad baron. Around mid‑century it was turned into a luxury retirement home, complete with nursing services. Its ornate appointments reminded patients of the Frick Gallery, if one could imagine those marble halls teeming with wheelchairs and nurses.
Bartlett had bought the defunct manufacturing complex next to it eighteen years earlier for the BMD industrial park, but it was only six years ago that the owners of the mansion, a group of squabbling heirs, finally relented and agreed to part with the property. It was now a flagship holding of BMD.
He had an eye for design and he had loved remodeling the old mansion and making it into a modern clinic and research facility. He had renamed it the Dorian Institute and moved in Karl Van de Vliet and the research staff of the Gerex Corporation. He also had put a landing pad on the expansive roof, along with a stair leading down to an elevator that could take him directly to the laboratory in the basement.
Kenji Noda settled the McDonnell Douglas onto the pad and cut the engines.Bartlettnever let himself worry about the noise. The patients in the clinical trials were here at no charge, so they really couldn't complain, particularly since they were now part of what was possibly turning out to be the greatest advance in the history of medicine. If your Alzheimer's had just been reversed at no charge, you weren't going to complain about a little hubbub on the roof.
"I'll wait here," Noda said opening the side door. His bald pate, reminiscent of an eighteenth‑century samurai, glistened in the early spring sun.
Bartlettnodded, knowing that his pilot did not trust physicians and hospitals. Taking care of your body was your responsibility, Kenji Noda frequently declared and he trained his own daily. He ate no meat and drank gallons of green tea. When he practicedkendoswordplay, he had the reflexes of a man half his age. He never discussed why he had leftJapan, butBartlettassumed it was for reasons best left in the dark.
Bartlettheaded down the metal stairs leading to the self‑ service elevator. This daily ordeal of flying out to give a blood sample and to see Kristen was increasingly unsettling. As he inserted his magnetic card into the elevator security box, he felt his hand shaking slightly.
So close to the eternal dream of humankind. So close. How was it going to end?
Sunday, April 5
8:38a.m.
"Dr. Vee, I'm feeling so much better, I can't tell you." Emma Rosen reached out and caught her physician by the collar of his lab coat, pulling him down and brazenly bussing his cheek. She'd been longing to do this for three weeks but hadn't mustered the nerve until now. "This morning I climbed the stairs to the third floor, twice, up and back without any chest pain. Oy, can you believe? It's a miracle."
Karl Van de Vliet was a couple of inches over six feet, with a trim face and sandy hair that some older patients judged too long for a physician. His English normally was perfect, though sometimes he made a mistake when trying to sound too colloquial. But everyone, young and old adored his retiring Dutch manner and those deep blue eyes that carried some monumental sadness from the past. They also were sure he would soon be recognized worldwide as the miracle worker he was. The prospect of a Nobel didn't actually seem that far‑fetched.
"Emma, please, I begged you to rest." He sighed and checked the dancing electronic pens of her EKG. They were in the basement of the Dorian Institute. Upstairs, the "suites"—nobody called them rooms—were intended to invoke a spa more than a clinic, so most of the heavy‑duty diagnostic equipment was kept in a row of examining rooms down near the subterranean lab. "For another week at least. Why won't you listen? You've been a very naughty girl. I may have to tell your daughter."
He glanced at the seventy‑three‑year‑old woman's readout one last time, made a quick note on his handheld computer, and then laid a thin hand across her brow for a fleeting, subjective temperature check.
She's all but fully recovered, he told himself. It's truly astonishing.
Five weeks earlier, she had come through the front door of the Dorian Institute in a wheelchair pushed by her youngest, a bottle blonde named Shelly. He took one look and scuttled the normal security precautions, the frisk for cameras and recording devices. Emma's low cardiac output had deteriorated to the point that her left leg below the knee was swollen to almost twice its normal size, owing to renal retention of fluid, and she was so short of breath she required oxygen. He hadn't wanted to complicate the clinical trials by taking on another patient at that late date, but she had been referred by a physician friend in the city, begging. How could he turn her away?
He had removed a microscopic amount of bone marrow from her right ankle, extracted the stem cells, applied the hormonal signal that told them to develop into heart muscle, and then injected a thriving cell factory into her heart. Since stem cells could be made to ignore the body's rules to stop replicating after a certain number, they were able to reproduce forever, constantly renewing themselves. The only other cells with that immortal characteristic were cancer cells. In fact, it was as though he had given Emma a new kind of cancer—one that produced cells as healthy as those in a newborn. Today she probably could have run up those stairs.
Although his stem cell technology was going to create a new era in regenerative medicine, he had experienced his share of bumps in the road. Five years earlier,StanfordUniversityhad canceled his research project there since the work he had been doing involved the special stem cells in unused fertility‑clinic embryos. The university claimed there had been death threats to its president. The Board of Regents had finally decided with a sham show of remorse, to revoke his funding. They called him in one sunny afternoon in May and pulled the plug. He thanked them and tore up his contract. By that time he had already demonstrated that, using the right chemical signals, stem cells could be coaxed into becoming almost any organ. Inserted into the heart, they became new heart muscle, replacing scars; inserted into the brain, they became neural tissue. No way was he going to be stopped now. They didn't know what they were losing.
What he needed was a "white knight." He did some poking around and came up with Winston Bartlett, then floated feelers toBartlett's people. What if, he proposed,Bartlettacquired the Gerex Corporation for BMD and made it a for‑profit business? No more public funding (and maddening administrative meddling). The research already completed was so close to a payoff, after years and years of grinding lab work and thousands of white mice, that the deal could be considered an investment where 95 percent of the seed money had already been supplied by taxpayers.
Winston Bartlett had liked the sound of that, and Karl Van de Vliet had his white knight.
Once his financing was secure, he decided to begin by solving the problem that had dogged him at Stanford. Since there would always be a distracting public‑relations problem hounding any researcher in the United States who made use of aborted embryos, even if it was to save lives, he was determined to find a less controversial way to trick Mother Nature and garner "pluripotent" stem cells, the name given those that could give rise to virtually any tissue type.
He had. After he moved his research team into the Dorian Institute just over 4 1/2 years ago, he had perfected a way to use a human protein, an enzyme called telomerase, to make adult stem cells do most of the miracles once only thought possible with embryonic cells.
The phase‑three clinical trials over the past seven months had proved conclusively that the technique worked. Adult stem cells, when treated with the telomerase enzyme to arrest the process of cell senescence, could indeed regenerate everything from the human brain to the human heart, from Parkinson's to acute myocardial infarction.
Twenty‑three days from now, when the phase‑three clinical trials were formally scheduled to be completed, Karl Van de Vliet would have enough data for the National Institutes of Health to confirm one of the most important breakthroughs in the history of medicine.
Unfortunately, however, there was that other bit of data that he would not be sharing with the NIH. The Beta.
Thinking about that, his heart heavy, he turned back to the situation at hand.
"Emma, you're making wonderful progress," he continued on with the banter, "but don't push yourself too hard just yet."
She laughed, sending lines across her forehead. Her voice was deep and rich, sultry in its own way. "When you get as old as I am, honey, you do anything you can get away with. What am I saving it for? I just might go toAtlantic Citynext week and pick up a sailor."
"Well, then, I may have to have Shelly go along and keep an eye on you," he said with one last programmed smile. Then he checked his watch.Bartlettshould be arriving any minute now. Time to get Emma Rosen the hell out of here and back upstairs.
He turned and signaled for Ellen O'Hara, the head nurse, to start removing the suction‑cup electrodes that had been stuck on Emma for her EKG. Ellen had been with him when he was at Stanford and her loyalty was unquestioned. She had made sure that the Beta disaster with Kristen hadn't become the gossip of the institute. Still, how much longer could it be kept quiet?
ThenSandraHanes, the lively, dark‑haired woman in charge of the second floor for this shift, walked into the examination room. She knew nothing about Kristen.
"Perfect timing," he said. Then he drew her aside. "Keep an eye on Emma, will you? Try and keep her in her room and quiet as much as you can. The last blood work showed her white‑cell count over twelve K/CMM. It could mean there's some minimal rejection rearing its head. Probably nothing to worry about, but can you just keep her away from the stairs for godsake? I don't want her tiring herself out."
"I'll tie her to the bed if I have to,"Sandraanswered. The clinical trials had required a mountain of paperwork, and her face was strained from working long shifts, including a lot of weekends, like this one. But he suspected she actually appreciated the overtime. She was forty‑five, divorced and putting a straight‑A daughter throughRutgers.
She also was a first‑rate nurse, like all the others at the institute, and her loyalty couldn't be more secure. Still, he knew that she and all the other staffers were bursting to tell the world about the miracles they'd witnessed. That was whyBartletthad insisted on an ironclad nondisclosure agreement in the contract of every employee to be strictly enforced. (And to put teeth into the security, all employees were body‑searched for documents or cameras or tapes on the way in and out.) To violate it would be to open yourself to a life‑altering lawsuit. During World War II the claim had been that "loose lips sink ships." Here they would render you a pauper for life. Nobody dared even whisper about the spectacular success of the clinical trials.
As the examining room emptied out, he checked his watch one more time. Winston Bartlett was due any minute now and he had nothing but bad news for the man.
Trying to control his distress, he walked to the end of the hallway and prepared to enter the lab. Whereas the ground floor and the two above were for reception, common dining, and individual rooms, the basement contained the laboratory, his private office, the examination rooms, and an OR (never yet used, thankfully). There also was a sub‑basement, accessible only through an elevator in the lab or an alarmed set of fire stairs. It was an intensive‑care area, and it was where Kristen, the Beta casualty, was being kept.
He zipped a magnetic card through the reader on the door and entered the air lock. The lab was maintained under positive pressure to keep out the slightest hint of any kind of contaminant. It was as sterile as a silicon chip factory.
The room was dominated by a string of black slate workbenches, then rows and rows of metal shelves with tissue‑ containing vials of a highly volatile solvent cocktail he had engineered especially for this project, along with a computer network and a huge autoclave and several electron microscopes.
He walked in and greeted his research team. He'd managed to keep the core group that had been closest to him at Stanford, four people who, he believed, were among the finest medical minds in the country. They were the renowned molecular biologistDavidHopkins, Ph.D., the strikingly beautiful and widely published endocrinologist Debra Connolly, M.D., and two younger staffers, a couple who'd met and married at his Stanford lab, Ed and Beth Sparks, both Ph.D.'s who'd done their postdoc under him. They all were here now in the wilds of northernNew Jerseybecause they knew they were making medical history.
Davidwas waiting, his long shaggy forelock down over his brow as always. But his eyes told it all.
"Karl,Bartlett's blood work from yesterday just got faxed up from the lab atPrinceton. His enzyme level has increased another three point seven percent."
"Damn." It was happening for sure. "Did you run—"
"The computer simulation? A one‑standard‑deviation estimate is that he's going to go critical sometime between seventeen and nineteen days."
"The Syndrome." Van de Vliet sighed.
"Just like Kristen."
"She faked us out. There were no side effects for weeks." Van de Vliet shook his head sadly as he set his handheld Palm computer onto a side table. Later he would transfer all the day’s patient data into the laboratory's server, the Hewlett‑ Packard they all affectionately called the Mothership. Then he began taking off his white coat.
"Bartlettlooks to be inevitable now."Davidexhaled in impotent despair. The frustration and the tension were getting to everybody. They all knew what was at stake. "It's in two and a half weeks, give or take."
What had supposedly been a cosmetic procedure had gone horribly awry. Van de Vliet wondered if it wasn't the ultimate vengeance of the quest for something you shouldn't have.
"His AB blood type is so rare. If we'd just kept a sample before the procedure, we'd have something to work with now," Van de Vliet said sadly. "We still might be able to culture some antibodies."
He hadn't told his research team yet about the other possible option—using somebody else as an AB blood‑type incubator.
His last‑ditch idea was to find a patient with a blood type of AB positive and introduce a small quantity of the special Beta telomerase enzyme into them. The theory was that this might induce their body to produce compatible antibodies, which could then be extracted and cultured in the laboratory. If a sufficient quantity could be produced they could be injected intoBartlettand hopefully arrest the enzyme's pattern of entering the host's bloodstream and metastasizing into the more complex form that brought on the Syndrome. And if it did work, then there might even be some way to adapt the procedure to Kristen.
"Karl, if Cambridge Pharmaceuticals finds out about the Beta fiasco, how's it going to affect—"
"How do you think it's going to affect the sale? If this gets out, there'll be no sale. To anybody.Bartlettwill be ruined, and Gerex along with him. That's everybody here, in case you're counting." He turned and exited the lab, pushing pensively through the air lock, and then he walked slowly toward his office, collecting his thoughts. He was just passing the elevator when it opened.
Sunday, April 5
8:47a.m.
Winston Bartlett looked up to see Van de Vliet as he stepped off the elevator, and the sight heartened him as always. The Dutchman was a genius. If anyone could solve this damned mess, surely he was the one.
"First thing, Karl, how is she now?"
"I think you'd better go down and see for yourself," Van de Vliet said slowly. "As I told you on the phone, she still comes and goes. I think it's getting worse."
Bartlettfelt a chill run through him. He had once cared for this woman as much as he was capable of caring for anybody, and what had happened was a damned shame. All he had intended was to give her something special, something no man had ever given a woman before.
"Will she know who I am? She still did yesterday."
"It depends," Van de Vliet replied. "Yesterday afternoon she was fully lucid, but then earlier this morning I got the impression she thinks she's in a different place and time. If I had to guess, I'd say she's regressing chronologically. I suppose that's logical, though nothing about this makes any sense."
Bartlettwas following him back through the air lock and
into the laboratory. The intensive‑care area below was reachable only by a special elevator at the rear of the lab.
All these once‑cocky people, Bartlett thought, were now scared to death. Van de Vliet and his research team might actually be criminally liable if the right prosecutor got hold of the case. At the very least they'd be facing an ethics fiasco.
But I'm the one who's about to be destroyed. In every sense.
It had all started when Karl Van de Vliet confided in him that there was an adjunct procedure arising out of stem cell research that might, might, offer the possibility of a radical new cosmetic breakthrough. Just a possibility. He called it the Beta, since it was highly experimental. He also wasn't sure it was reproducible. But he had inadvertently discovered it while testing the telomerase enzyme on his own skin over a decade ago.
At the time he was experimenting with topical treatments for pigment abnormalities, but the particular telomerase enzyme he was working with had had the unexpected effect of changing the texture of his skin, softening it and removing wrinkles, a change that subsequently seemed permanent.
The idea had lain dormant while they were preparing for the clinical trials. But thenBartlett'spetite amie, the cable‑TV personality Kristen Starr, had had a career crisis that she blamed on aging, and he came up with the idea of having her undergo the skin procedure.
In a mistake with unforeseen ramifications, she had then been made an official part of the NIH clinical trials. After she had gone for over a month without any side effects,Bartletthad elected to undergo the procedure himself.
Then it began in Kristen—whatDavidhad solemnly named the Syndrome. Van de Vliet had immediately (and illegally) terminated her from the clinical trials, removing her from the NIH database. She was now being kept on the floor below, in the subbasement intensive‑care area.
As they stepped onto the elevator to go down,Bartlettfound himself wondering how many of the staff here were aware of the real extent of the crisis. Van de Vliet had said that only three of the nurses knew about Kristen and the Syndrome. Fortunately, they all were trustworthy. Two had even been with him back at Stanford. They would never talk.
But what about the rest? They'd all fawned over Kristen, starstruck by her celebrity, and they'd spill the beans in a heartbeat if any of them found out. The story would be everywhere from Variety to the "Page Six" gossip column. It would certainly mean the financial ruin of Bartlett Medical Devices. If Gerex went under, everything else went with it.
On the other hand, he thought ruefully, what does it matter? If I end up like her, I won't even know it happened.
"W.B., the telomerase enzyme is completely out of control in her now," Van de Vliet continued. "First it metastasized through her skin and into her blood. Then it began directing its own synthesis. I've tried everything I know to arrest it, but nothing has worked. I still have a faint hope, though. If we can make some headway on your own situation . . ." He paused and his voice trailed off. "In the meantime, though, I think it would definitely be wise to move her to another location. There are too many people here. The risk is enormous. Word is bound to get out sooner or later. You must have someplace . . ."
"Of course."Bartlettnodded. "I'd rather have her in the city and closer to me anyway. But let me see if I can talk to her first. I need to try to make her understand."
Though it's probably too late for that, he told himself.
They stepped off the elevator and entered a high‑security area, a long hallway illuminated only with fluorescent bulbs. Using a magnetic card as a key,Bartlettopened the first door they came to. As always, he was dismayed by the sight.
For a moment he just stood looking at the thirty‑two‑ year‑old woman sitting up in a hospital bed, mutely watching a flickering TV screen showing the Cartoon Network. He had truly cared for her, perhaps even loved her for a time.
Then he walked over. "Kristy, honey, how're you feeling?"
She stared at him blankly. Kristen had been a vivacious blue‑eyed blonde who’d had her own showbiz gossip show on the E! channel till it was canceled during a scheduling shake‑up six months earlier. She had a nervous breakdown, declaring toBartlettthat her show had been canceled because she looked like a crone.
He’d told her it wasn't true, but if she was so distraught about her appearance, then maybe there was something he could do for her. Van de Vliet had once mentioned an experimental skin procedure. . . .
Bartlettturned back to Van de Vliet, feeling the horror sinking in.
"Karl, goddamit, we've got to reverse this."
"Let's talk outside," Van de Vliet said.
Bartlettkissed Kristen's forehead in preparation for leaving. Her lifeless blue eyes flickered something. He thought it was a flash of some old anger.
Who could blame her? he told himself. But back then, who knew?
He'd wanted to give her a gift like none other. Not quite the Fountain of Youth, but maybe a cosmetic version. Her skin would begin to constantly renew itself.
And he'd been right. The promise of having her skin rejuvenated was just what she'd needed to get her self‑confidence back.
For more than a month the miracle seemed to be working, and there were no side effects. Her skin was becoming noticeably softer and more supple. She was elated.
Screw NIH trials and the FDA, he then decided. It was working for Kristen. By God he would try it himself. He wasn't getting any younger.
But no sooner had he had the procedure too than Kristen started evidencing side effects. First it was little things, like lapses in short‑term memory. Next, as it got progressively worse, she could no longer remember why she was at the institute. Then she couldn't recall her name, where she lived. And now . . .
Could it be that God can't be cheated? And when it's tried, God brings down a terrible vengeance.
When they were outside in the hallway, he said, "I have a place onPark Avenuethat's empty. At the moment. We used to spend weekends there and I can arrange for a full‑time nursing staff, all of it." He paused. "Has anybody called here about her lately?"
"Just her mother, Katherine, who's getting pretty frantic."
"The woman is unbalanced. Certifiable. God help us if—"
"I told her to see what she could find out from Kristen's publicist."
"Good."Bartletthad told Kristen's midtown publicity agent, the nosy Arlene of Guys and Dolls, Inc., that Kristen had gone to a private spa inNew Mexicoto rethink her career and didn't want to be disturbed. She desired complete solitude. Any communication with her would have to be handled through his office.
He looked at Van de Vliet. "Karl, tell me how bad it is for me now."
"For you?" He hesitated. This was the question he'd been dreading. "The telomerase numbers from yesterday's blood sample are not encouraging. As I told you, your topical enzyme application has metastasized into your bloodstream and started to replicate, just like it did in Kristen. We're seeing a process known as 'engraftment.' These special cells have learned to mimic any cell they come near. They become the tissue that those cells comprise and begin replacing the healthy tissue with new. In Kristen's case, we think it's now entered her brain and it seems to be supplanting her memory tissue with blanks. The same side effect could eventually evolve in you."
That doesn't begin to describe the real horror,Bartlettthought. It's too impossible to imagine.
"The only thing left is to find some way to cause your body to reject the enzyme," Van de Vliet said. "I'm optimistic that we might be able to grow some telomerase antibodies in another patient with your blood type, then culture enough of them to stop the Syndrome in its tracks. It's worth a try. Frankly, I can't think of anything else. But your blood type is AB, which is extremely rare. Also, the problem is that we'd possibly be putting that other person at severe risk too."
"Let's go back up to the lab,"Bartlettsaid. "That idea of yours—Hamptonthinks he's got somebody. A woman, in her late thirties." He put his hand on Van de Vliet's shoulder. "We're going to get her on board however we have to."
Chapter 3
Sunday, April 5
8:49a.m.
Stone Aimes was staring at the e‑mail on the screen of his Compaq Armada and feeling an intense urge to put his fist through its twisted spiral crystals. What do you do when you've come up with an idea that could possibly save thousands of lives using simple Web‑based technology and then the piece gets spiked by your newspaper's owners at the very last minute because it exposes some important New York hospitals to unpleasant (but constructive) scrutiny?
What it makes you want to do is tell everybody down on the third floor to stuff it and walk out and finish your book— undistracted by corporate ass‑covering BS ... or, unfortunately, by a paycheck.
Around him the newsroom of the New York Sentinel, a weekly newspaper positioned editorially somewhere between the late, lamented New York Observer and the Village Voice, was in final Sunday countdown, with the Monday edition about to be put to bed. The technology was state of the art, and the room flickered with computer screens, blue pages that gave the tan walls an eerie cast. Composition, spell‑checking, everything, was done by thinking machines, and the reporters, thirteen on this floor, were mostly in their late twenties and early thirties and universally underpaid.
The early morning room was bustling, though it felt to Stone like the end of time. Nobody was paying any attention to him but that was normal: everybody was doing their own thing. Besides, nobody else realized he'd just had a major piece killed at the last minute. Now he felt as though he were frozen in place: in this room, in this job, in this life.
The book he had almost finished was going to change a lot of things. It would be the first major explication of stem cell technology for general readers. Stem cells were going to revolutionize everything we knew about medicine and the research was going further than anyone could have dreamed. The possibility of reversing organ degeneration, even extending life, was hovering right out there, just at humankind's fingertips. It cried out for a major book.
He had read everything that had made its way into the medical journals, but the study that was furthest along was privately funded and now cloaked in secrecy. It was at the Gerex Corporation, whose head researcher was a Dutch genius named Karl Van de Vliet. The company had been bankrolled by the medical mogul Winston Bartlett after Van de Vliet lost his funding at Stanford.
Winston Bartlett, of all people . . . but that was another story.
Thirteen months earlier, the Gerex Corporation had trolled for volunteers on the National Institutes of Health Web site, referring to a pending "special study." The notice suggested the study might be using stem cell technology in some fashion. If that study was what Stone Aimes thought it was, it would be the first to use stem cells in stage‑three clinical trials. Nobody else was even close.
Karl Van de Vliet was the ball game. Unfortunately, however, his study was being held in an atmosphere of military‑like secrecy. Why? Even the identities of the participants in the trials were like a state secret. Since Winston Bartlett owned Gerex, it surely had been ordered by him. You had to wonder what that was all about.
Whatever the reason, Stone Aimes knew that in order to finish his book with the latest information he had to get to Van de Vliet. ButBartletthad forbidden any interviews, and Gerex's clinic, called the Dorian Institute, was off‑limits to the public and reportedly guarded with serious security.
But, he thought, perhaps he had just come up with an idea of how to get around that. . . .
He stared a moment longer at the dim reflection coming back at him from the antiglare screen, which now informed him that his cover feature had been chopped. Truthfully, it was happening more and more; this was the third time in eight months that a major muckraking piece had been axed. Also, as he stared at it, the reflection told him he wasn't getting any younger. The hairline was no longer where it had been in his college photos—it was up about half an inch—and the blue eyes were sadder, the lines under them deeper.
Still, the tousled brown hair was thick enough, the brow mostly wrinkle‑free, and he still had hope. He wasn't exactly young anymore, but neither was he "getting on." The "Willy Loman" years remained safely at bay. He was thirty‑nine and divorced, with an ex‑wife, Joyce, who had departed to be a garden designer in northernCalifornia, taking with her their daughter, Amy, on whom he doted. He had a one‑bedroom, rent‑controlled apartment in the East Nineties, on the top floor of a fashionable brownstone. He was socially unattached, as the expression goes, but he was so compulsive about finishing the book that he spent weekends hunched over his IBM Aptiva, nursing a six‑pack of Brooklyn Lager and writing deathless prose. The truth was he was lonely, but he didn't allow himself to think about it.
He'd always vowed he'd amount to something by forty. And now it was as much for Amy as for himself. She lived with his ex‑wife nearEl Cerrito,California, and she meant the world to him. The mortifying part was, he was a week behind with this month's support check. And he knew Joyce needed the money. It made him feel like a callous deadbeat dad when the real culprit was an unlucky confluence of inescapable bills. He’d make it up next week, but he’d sworn he would never let this happen.
That was why he had a larger game plan. Get out of this frigging day job and finish the book. The time for that plan to kick in was approaching at warp speed. This last insult was surely God's not‑so‑subtle way of informing him that his future was in the freelance world. Every day out there would be a gamble, but he could write anything he damn well pleased.
There was a parable set down by the ancient Taoist philosopher Lao Tzu that Stone Aimes reflected on more and more these days. It was the story of two oxen: One was a ceremonial sacrificial ox who, for the year before he meets the axe, was feted with garlands of lotus flowers and plied with ox goodies. The other was a wild ox who had to scrounge in the forest for every scrap. But, the story went, on the day the ax was to drop, what wouldn't that ceremonial ox give to change places with that haggard struggling, underfed wild ox?
That's the one he empathized with. The one who was out there, half starved but free.
The Sentinel was an iron rice bowl that normally never let anybody go except for grossest incompetence or flagrant alcoholism. On the other hand getting ahead was all about office politics, kissing the managing editor's hindquarters, and copying him on every memo to anybody to make sure nobody else took credit for something you thought of.
On the plus side, he knew he was a hell of a medical journalist. There was such a gap between medical research and what most people knew, the field cried out for a Stephen Hawking of health, a medical Carl Sagan. The way he saw it, there was room at the top and he was ready for a major career breakthrough. He had done premed atColumbiabefore switching to journalism, and these days he read the Journal of the American Medical Association from cover to cover, every issue, along with skimming the many other journals now on the web.
The piece that just got cut was intended to show the world that investigative journalism was alive and well and trying to make a difference. He'd documented that hospital mistakes were actually the eighth leading cause of death in theUnited States. TheInstituteofMedicineestimated that medical errors caused between fifty and a hundred thousand deaths a year—rivaling the number from auto accidents or AIDS. (He'd gotten enough data to be able to quantify how many of those deaths were in leadingNew Yorkhospitals.) Yet there was no federal law requiring hospitals to report mistakes that caused serious injury or death to patients.
The reason seemed to be that the medical lobby‑‑he'd named names—had successfully turned back all attempts by Congress to pass such a law, even though it was a formal recommendation by theInstituteofMedicine. The problem was, once you admitted you screwed up, you could get sued.
So there was no formal accountability.
But (and here was the constructive part) if patients' medical records were put on the Web—everything, even their medications—it could make a big dent in the all‑too‑frequent hospital medication foul‑ups. That alone could cut accidental hospital deaths in half.
He'd pitched Jay Grimes, the managing editor, to let him do a five‑thousand‑word piece for the Sentinel. Jay had agreed and even promised him the front page. Jay liked him, but since all the real decisions were made by the owners, not‑so‑affectionately known as the Family, there wasn't much Jay could do to protect his people. Stone now realized that more than ever.
The e‑mail on his Compaq's screen was from Jane Tully, who handled legal affairs for the paper. Apparently, Jay didn't have the balls to be the hatchet man, so he'd given the job to Jane, who could throw in a little legal mumbo jumbo for good measure. And she hadn't even had the courtesy to pick up the phone to do the deed. Instead, she'd sent a frigging e‑mail:See attached. Corporate says legal implications convey unacceptable risk. Consider an op‑ed piece. That way the liability will be all yours. Love and kisses.
And of course, by "Corporate," she meant the Family (or, more likely, their running‑dog attorneys down onNassau Street).
It was really too bad about Jane. She was a young‑looking thirty‑six and had her own legal practice with a large law firm in midtown, but she always dropped by before her Sunday brunch to answer any legal questions that might be pending before the Sentinel was put to bed. Stone knew pretty well how her mind worked. He should. Jane Tully was his former, very former, significant other.
They d lived together for a year and a half onFirst Avenuein the East Sixties. But she was type A (tailored Armani suits and always on time) and he was a type B (elbow patches and home‑cooked pasta). The denouement had been seismic and full of acrimony and accusations.
So was she killing this major piece out of spite? he wondered. Just to prove one last time who really had thecojones?
Actually, it would have been nice to think so. That would put a human face on this gutless travesty. But the attached memo had enough legal jargon that another reason was immediately suggesting itself. The owners of the paper, the Family, the fucked‑up twins Harry and Bosco and their mother, Adeline, the heirs of Edward Jordan, actually were afraid of a lawsuit. The attachment had the fingerprints of the Family's attorneys all over it. Jane was just carrying out marching orders.
And sure enough, there at the bottom was a second message, unsigned and not part of the original memo. She had written clearly ITMB.
That was their old code for "I tried my best."
Well, Jane baby, who the hell knows. Maybe you did.
Damn, it wasn't supposed to be like this. He wasn't trying
to be a Carl Bernstein, for chrissake. For once, all he wanted was to report a story exactly the way it was, and then try to help. He ultimately wanted to fix, not fault.
He hit a button and printed out a copy of everything, then minimized the screen, grabbed his jacket, and walked down the hall. Was this the moment to quit? It was, except he couldn't afford to. He'd never managed to put enough aside to take off a year and live on air and write and still get that fifteen‑hundred‑dollar check out to Joyce and Amy every first of the month.
He got to the bank of elevators and pushed the button for the third floor and stepped on. The inspection sticker framed just above the controls actually told the whole saga of why his cover story about sloppy procedures inNew Yorkand national hospitals had been killed. The building was owned by Bartlett Enterprises, the real estate holding company of Winston Bartlett.
The Sentinel held a very favorable lease, renewable for another ten years at only a 5 percent increase when it rolled over in seven months. TheJordanfamily had gotten it in the early 1990s, whenNew Yorkreal estate was still in the toilet from the stock market crash of '87, and for once Winston Bartlett really screwed up. Now it was about a fifth of the going price per square foot.
So naturally he was about to do everything he could to break the lease. He was that kind of guy. TheJordanfamily, owners of the Sentinel, probably figured that a big lawsuit by the AMA or somebody would overtax their legal budget and giveBartletta shot at their soft underbelly. Thus no boats were to be rocked.
The elevator chimed and he stepped off on three. This floor had subdued lighting and understated birch paneling, pale white, in the reception area. It was as though power didn't need to trumpet itself. Everybody knew who had it
He waved at Rhonda, the receptionist, and strode past. She glanced up, then said, "Does she know you're coming?"
She knew full well he was headed down to see Jane. Unlike most organizations, which take Sunday off, this was always a big day for the Sentinel, with all hands on deck.
"Thought I'd give her a little surprise."
"No kidding." She was reaching for the phone. "I think maybe I should—"
"Not necessary." He was charging down the hall, feeling knee‑deep in the thick beige carpet. "I've got a feeling she's expecting me."
Jane's door was open and she was on the phone. But when she saw him, she said something abruptly and hung up. He strode through the door, then slammed it. The decor was bold primary colors, like her take on life. Explicit.
"Okay," he demanded, "what the hell's going on? How about the real story?"
"Love, you know you can't hang the Family out with that kind of liability," she declared, then got up and came around her desk and cracked open the door half a foot. "And you're the one person here I can't have a closed‑door meeting with. It'll just get people talking again."