The Senator

Ah, Charles, McCready thought after Axford had gone. Doubting Charles.

He leaned far back in his chair and, as he often did, thought about his chief pet doctor. And why not? Their lives were tightly entwined, and would remain so as long as he remained ill.

Despite the fact that Charles was a doctor and an arrogant bastard to boot, McCready privately admitted to a soft spot in his head for his chief of research. Perhaps that was because there was no pretense about Charles. He made no bones about being a devout atheist and confirmed materialist who was constitutionally unable to accept anything that did not yield to the scientific method. If he couldn't observe it, qualify and quantify it, it didn't exist. Refreshingly free of bullshit, his Charles. Humans were nothing more than a conglomeration of cells and biochemical reactions to him. He had once told McCready that his dream was to reduce the human mind to its basic neurochemical reactions.

All fine and well when you had your health. But when you didn't, and when modern medicine failed you… then you looked for something more. You prayed, even when you didn't believe in prayer. You investigated faith healers even when you had no faith. The sneers and the derogatory remarks no longer came so easily. You looked under every rock and followed every trail to its inevitable phony end. And then sniffed out another one to follow.

Hopelessness was a bitch.

He had given up hope on current research into neuromuscular diseases—he couldn't trust it to go in the direction he needed. Thus the Foundation was born, with Charles Axford as its core. He had made Axford chief because he felt he owed him something.

Because the day he met Axford was the most traumatic day of his life. It had altered the course of his life, altered his perception of life, the world, the future. Because Charles Axford had been the first to know what was wrong with him.

All the other doctors before Charles had been wrong. To a man they had blamed his episodic fatigue on "overwork" and "stress." That was the new catchword in medicine: If you can't figure it out, it's stress.

McCready had bought that for a while. He had been working hard—he'd always worked hard—but he'd never felt so tired. He would get up in the morning a ball of fire and by midafternoon he was useless. He had stopped eating steak because it was too much work to chew it. His arm tired while shaving. Overwork and stress. He'd gone along with the diagnosis because time and again his physical examination, reflexes, blood tests, X rays, and cardiograms had come out completely normal. "You're the picture of health!" a respected internist had told him.

His first episode of double vision had sent him in a panic to the nearest neurologist who would give him the earliest appointment. That had been Charles Axford. He later learned that Axford had not squeezed him into that day's schedule out of doctorly concern for a patient in distress, but because his afternoon appointment book had been virtually bare.

McCready had found himself seated before a cool, aloof, thickly accented Britisher in a white coat who chain-smoked cigarettes in his chair on the far side of an old desk as he listened to McCready's symptoms. He asked a few questions, then said:

"You've got myasthenia gravis, a rapidly progressive case, and your life is going to be hell."

McCready still remembered the slow wave of shock that had passed through him by inches, front to back, like a storm front. All he could see was Aristotle Onassis fading away month after month, year after year. He managed to say, "Aren't you even going to examine me?"

"You mean tap your knees and shine lights in your eyes and all that rubbish? Not if I can bloody help it!"

"I insist! I'm paying for an examination and I demand one!"

Axford had sighed. "Very well." He came around and sat on the front edge of the desk. Holding out both his hands to McCready, he said, "Squeeze. Hard." After McCready had gripped them and squeezed, Axford said, "Again!" And then, "Again!"

And with each successive squeeze, McCready felt his grip grow weaker and weaker.

"Now rest up a bit," Axford had said. After smoking half another cigarette and further fouling the office air, he stuck out his hands again. "Once more now."

McCready squeezed with all he had, and, with no little satisfaction, saw Axford wince. After a brief rest his strength had returned.

"See," Axford said, wiping his hands on his lab coat. "Myasthenia gravis. But just to be absolutely sure, we'll do an EMG."

"What's that?"

"Nerve conduction study. Which in your case will show the classic decremental pattern."

"Where do I get this done?" He was suddenly desperate to have the diagnosis confirmed or denied.

"Lots of places. But my rig here in this office affords the most nutritional value."

McCready was baffled by this Brit. "I don't understand."

"The fee I'll charge you," Axford said with the barest hint of a smile, "will help keep food on my table."

McCready fled Axford's office, fully convinced that the man was a lunatic. But second and third opinions, along with exhaustive testing, proved the Brit right. Senator James McCready had a particularly virulent case of myasthenia gravis, which he learned was an incurable neuromuscular disease caused by a deficiency of acetylcholine, the substance that transmits messages from nerve cells to muscle cells at their junction.

Out of a sense of loyalty, he returned to Axford for therapy. And, as he had long ago learned about such supposedly noble impulses, it was a wrong move. Axford's bedside manner embodied all the concern and personal warmth of the average cinder block. Axford didn't seem to care how the medications were affecting his patient—the muscle cramps, the twitching, the anxiety, and insomnia. He cared only about how they improved the responses on his damned EMG machine.

And McCready went the route—the whole route. He had his thymus removed, he was juiced up with drugs like neo-stigmine and Mestinon, then bloated up with cortisone. He went through plasmapheresis. All to no avail. His case progressed slowly but relentlessly no matter what Axford or anyone else did.

But he had never fully accepted his illness, not even to this day. He had fought it from the beginning and would keep on fighting it. He had plans for his life and his career that went beyond the Senate. Myasthenia gravis threatened to stop him. It wouldn't. He would find a way—over it, around it, or through it.

And toward that end, he began investigating Charles Axford years ago. He learned he'd been born into a working class family in London, and that he saw his parents and his home destroyed during the Blitz when the Paddington section had been heavily bombed. He proved brilliant in his studies, graduating from medical school in England at the top of his class; he was considered equally brilliant by anyone who knew him during his neurology residency here in Manhattan—admired by all but considered far too abrasive for anyone's comfort. After countless bids for research grants and fellowships had been turned down, he had reluctantly opened up a private practice, where he was quietly starving. Brilliant though he was in the science of medicine, he was virtually an idiot in the art of dealing with people.

To add to his problems, his wife had run off to "find" herself, leaving him with a chronically ill daughter.

Charles, of course, had never mentioned a word of his personal problems to the senator. McCready had ferreted them out through the contacts he still maintained with his publishing empire.

It became evident to McCready that the two men were made for each other: Axford was a whiz in neurology and McCready had a neuromuscular disease that was considered incurable at medicine's present state of knowledge; Axford was looking for a research post and McCready had more money than he could spend in many lifetimes—at last count his personal fortune had totaled somewhere in the neighborhood of 200 million dollars.

Two ideas were born then. The first was the seed of the Medical Guidelines bill. Doctors had explained to him over and over that myasthenia gravis was subtle and difficult to diagnose in the early stages. He didn't care. It should have been discovered years before he went to Axford. These doctors needed a lesson or two in humility. If they wouldn't do their jobs right, he'd show them how.

The second idea became reality sooner than the legislation: The McCready Foundation for Medical Research was begun, with Charles Axford, M.D., as its director. The setup was tax-advantaged and allowed McCready to direct the course of all research done. Axford seemed delighted—he was well paid and could follow his interests without having to deal too much with patients.

McCready had his first pet doctor. He too found the situation delightful.

With an influx of grants and donations, the Foundation grew until it presently provided inpatient as well as outpatient services and occupied its own building on Park Avenue in Manhattan, a former office building raised in the thirties that looked like a smaller version of Rockefeller Center. He had started off with one pet doctor; now he owned a whole stable of them. That was the only way to keep doctors in line: Own them. Make them dependent on you for their daily bread and they soon lose their maverick ways. They learn to toe the line like anybody else.

Axford still showed a lot of maverick tendencies, but McCready laid that off to the fact that he gave his research chief plenty of room. Someday he would yank on a few strings and see how the Brit danced. But not yet. Not while he needed Axford's research know-how.

That might not be much longer, though. Not if one tenth of what he had heard about this Bulmer character were true. After years of false leads, it was almost too much to hope for. But those stories…

His mouth went dry. If those stories were even half true…

And to think that Bulmer had been in his committee room only last month. He hadn't come across as a nut case then— anything but. But was it possible he had been sitting a few yards away from a cure and not known it?

He had to find out. He had to know! He didn't have much time!


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