Chromosome 6

CHAPTER 8

MARCH 5, 1997

10:00 A.M.

NEW YORK CITY

RAYMOND Lyons pulled up his cuff-linked sleeve and glanced at his wafer-thin Piaget watch. It was exactly ten o’clock. He was content. He liked to be punctual especially for business meetings, but he did not like to be early. As far as he was concerned being early reeked of desperation, and Raymond had a penchant for bargaining from a position of strength.

For the previous few minutes he’d been standing on the corner of Park Avenue and Seventy-eighth Street, waiting for the hour to arrive. Now that it had, he straightened his tie, adjusted his fedora, and started walking toward the entrance of 972 Park Avenue.

“I’m looking for Dr. Anderson’s office,” Raymond announced to the liveried doorman who’d opened the heavy wrought-iron and glass door.

“The doctor’s office has its own entrance,” the doorman replied. He reopened the door behind Raymond, stepped out onto the sidewalk and pointed south.

Raymond touched the tip of his hat in appreciation before moving down to this private entrance. A sign of engraved brass read: Please ring and then enter. Raymond did as he was told.

As the door closed behind him, Raymond was immediately pleased. The office looked and even smelled like money. It was sumptuously appointed with antiques and thick oriental carpets. The walls were covered with nineteenth-century art.

Raymond advanced to an elegant, boulle-work French desk. A well-dressed, matronly receptionist glanced up at him over her reading glasses. A nameplate sat on the desk facing Raymond. It said: Mrs. Arthur P. Auchincloss.

Raymond gave his name, being sure to emphasize the fact that he was a physician. He was well aware that some doctors’ receptionists could be uncomfortably imperious if they didn’t know a visitor was a member of the trade.

“The doctor is expecting you,” Mrs. Auchincloss said. Then she politely asked Raymond to wait in the waiting room.

“It’s a beautiful office,” Raymond said to make conversation.

“Indeed,” Mrs. Auchincloss said.

“Is it a large office?” Raymond asked.

“Yes, of course,” Mrs. Auchincloss said. “Dr. Anderson is a very busy man. We have four full examining rooms and an X-ray room.”

Raymond smiled. It wasn’t difficult for him to guess the astronomical overhead that Dr. Anderson had been duped into assuming by so-called productivity experts during the heyday of “fee-for-service” medicine. From Raymond’s point of view, Dr. Anderson was the perfect quarry as a potential partner. Although the doctor undoubtedly still had a small backlog of wealthy patients willing to pay cash to retain their old, comfortable relationship, Dr. Anderson had to have been being squeezed by managed care.

“I suppose that means a large staff,” Raymond said.

“We’re down to one nurse,” Mrs. Auchincloss said. “It’s hard to find appropriate help these days.”

Yeah, sure, Raymond mused. One nurse for four examining rooms unquestionably meant the doctor was struggling. But Raymond didn’t vocalize his thoughts. Instead he let his eyes roam around the carefully wallpapered walls and said: “I’ve always admired these old-school, Park Avenue offices. They are so civilized and serene. They can’t help but impart a feeling of trust.”

“I’m sure our patients feel the same way,” Mrs. Auchincloss said.

An interior door opened and a bejeweled, Gucci-draped, elderly woman stepped into the reception area. She was painfully thin and had suffered so many face-lifts that her mouth was drawn into a taut, unremitting smirk. Behind her was Dr. Waller Anderson.

Raymond’s and Waller’s eyes crossed for a fleeting moment as the doctor guided his patient to the receptionist and gave instructions of when he should see her next.

Raymond assessed the doctor. He was tall and had a refined look that Raymond sensed he possessed as well. But Waller wasn’t tanned. In fact, his complexion had a grayish cast, and he looked strained with sad eyes and hollow cheeks. As far as Raymond was concerned, hard times were written all over his face.

After warm goodbyes to his patient, Waller motioned Raymond to follow him. He led down a long corridor that gave access to the examining rooms. At the end he preceded Raymond into his private office, then closed the door after them.

Waller introduced himself cordially but with obvious reserve. He took Raymond’s hat and coat, which he carefully hung in a small closet.

“Coffee?” Waller asked.

“By all means,” Raymond said.

A few minutes later, both with coffee, and with Waller behind his desk and Raymond sitting in a chair in front, Raymond began his pitch.

“These are tough times to be practicing medicine,” Raymond said.

Waller made a sound that was akin to a laugh, but it was bereft of humor. Obviously he wasn’t amused.

“We can offer you an opportunity to significantly augment your income as well as provide a state-of-the-art service to select patients,” Raymond said. For the most part Raymond’s presentation was a practiced speech that he’d perfected over the years.

“Is there anything illegal about this?” Waller interjected. His tone was serious, almost irritable. “If there is, I’m not interested.”

“Nothing illegal,” Raymond assured him. “Just extremely confidential. From our phone call, you said you would be willing to keep this conversation just among you, me, and Dr. Daniel Levitz.”

“As long as my silence is not felonious in and of itself,” Waller said. “I will not be duped into being an accessory.”

“No need to worry,” Raymond said. He smiled. “But if you do decide to join our group, you will be asked to sign an affidavit concerning confidentiality. Only then will you be told the specific details.”

“I don’t have any trouble with signing an affidavit,” Waller said. “As long as I’m not breaking any law.”

“Well, then,” Raymond said. He put his coffee cup on the edge of Waller’s desk to free up his hands. He fervently believed that hand gestures were important for impact. He started by telling about his chance meeting seven years previously with Kevin Marshall who’d given a poorly attended presentation at a national meeting that dealt with homologous transposition of chromosome parts between cells.

“Homologous transposition?” Waller questioned. “What the devil is that?” Having been through medical school prior to the revolution in molecular biology, he was unfamiliar with the terms.

Raymond patiently explained and used for his example the short arms of chromosome 6.

“So this Kevin Marshall developed a way to take a piece of chromosome from one cell and exchange it for the same piece in the same location of another cell,” Waller said.

“Exactly,” Raymond said. “And for me it was like an epiphany. I immediately saw the clinical application. Suddenly it was potentially possible to create an immunological double of an individual. As I’m sure you are aware, the short arm of chromosome six contains the major histocompatibility complex.”

“Like an identical twin,” Waller said with growing interest.

“Even better than an identical twin,” Raymond said. “The immunological double is created in an appropriately sized animal species that can be sacrificed on demand. Few people would be able to have an identical twin sacrificed.”

“Why wasn’t this published?” Waller asked.

“Dr. Marshall fully intended to publish,” Raymond said. “But there were some minor details he wanted to work out before he did so. It was his department head that forced him to present at the meeting. Lucky for us!

“After hearing the talk, I approached him and convinced him to go private. It wasn’t easy, but what tipped the scales in our favor was that I promised him the lab of his dreams with no interference from academia. I assured him that he would be given any and every piece of equipment he wanted.”

“You had such a lab?” Waller asked.

“Not at the time,” Raymond admitted. “Once I had agreement from him, I approached an international biotechnology giant, which will go nameless until you agree to join our group. With some difficulty I sold them on the idea of creatively marketing this phenomenon.”

“And how is that done?” Waller asked.

Raymond moved forward in his chair and locked eyes with Waller. “For a price we create an immunological double for a client,” he said. “As you can well imagine, it is a significant price but not unreasonable for the peace of mind it affords. But how we really make money is that the client must pay a yearly tuition to maintain his double.”

“Sort of like an initiation fee and then dues,” Waller said.

“That’s another way to look at it,” Raymond agreed.

“How do I benefit?” Waller asked.

“Myriad ways,” Raymond said. “I’ve constructed the business like a merchandizing pyramid. For every client you recruit, you get a percentage, not only of the initial price but each year from the tuition. On top of that, we will encourage you to recruit other physicians like yourself with collapsing patient bases but who still have a number of wealthy, health-conscious, cash-paying patients. With every successful physician recruitment, you get percentages from each of his recruitment efforts. For instance, if you choose to join, Dr. Levitz, who recommended you, will receive percentages from all your successes. You don’t have to be an accountant to understand that with a little effort you could be earning a substantial income. And as an added incentive, we can offer the payments offshore so they will accrue tax-free.”

“Why all the secrecy?” Waller asked.

“For obvious reasons as far as the offshore accounts are concerned,” Raymond said. “As for the whole program, there have been ethical issues that have been overlooked. Consequently, the biotechnology company that is making this all possible is paranoid about bad publicity. Frankly, the use of animals for transplantation offends some people, and we certainly do not want to be forced to deal with animal-rights zealots. Besides, this is an expensive operation and can be made available to only a few highly select people. That violates the concept of equality.”

“May I ask how many clients have taken advantage of this plan?”

“Laymen or physicians?” Raymond asked.

“Laymen,” Waller said.

“Around one hundred,” Raymond said.

“Has anybody had to utilize the resource?”

“As a matter of fact, four have,” Raymond said. “Two kidneys and two livers have been transplanted. All are doing superbly without medication and without any signs of rejection. And, I might add, there is a substantial additional charge for the harvest and transplantation, and the involved physicians get the same percentages of these fees.”

“How many physicians are involved?” Waller asked.

“Fewer than fifty,” Raymond said. “We started slowly on recruitment, but it is now speeding up.”

“How long has this program been going on?” Waller asked.

“About six years,” Raymond said. “It’s been a significant outlay of capital and a lot of effort, but it is now beginning to pay off handsomely. I should remind you that you will be getting in at a relatively early date, so the pyramid structure will benefit you greatly.”

“It sounds interesting,” Waller said. “God knows I could use some additional income with my falling patient base. I’ve got to do something before I lose this office.”

“It would be a pity,” Raymond agreed.

“Can I think about it for a day or so?” Waller asked.

Raymond stood up. Experience told him he’d made another score. “By all means,” he said graciously. “I’d also invite you to call Dr. Levitz. He’d recommended you highly, and he’s extraordinarily satisfied with the arrangements.”

Five minutes later Raymond exited onto the sidewalk and turned south down Park Avenue. His walk had an extra bounce to it. With the blue sky, the clear air, and the hint of spring, he felt on top of the world, especially with the pleasurable rush of adrenaline that a successful recruitment always gave him. Even the unpleasantness of the previous couple of days seemed insignificant. The future was bright and full of promise.

But then near disaster came out of nowhere. Distracted by his victory, Raymond almost stepped from the curb into the path of a speeding city bus. Wind from the hurling vehicle blew off his hat while filthy gutter water sprayed the front of his cashmere coat.

Raymond staggered back, dazed from his narrow escape from what might have been a horrible death. New York was a city of sudden extremes.

“You okay, buddy?” a passerby asked. He handed Raymond his dented fedora.

“I’m fine, thank you,” Raymond said. He looked down at the front of his coat and felt ill. The episode seemed metaphorical and brought back the anxiety he’d experienced over the unfortunate Franconi business. The muck reminded him of having to deal with Vinnie Dominick.

Feeling chastened, Raymond crossed the street with much more care. Life was full of dangers. As he walked toward Sixty-fourth Street, he began to worry about the other two transplant cases. He’d never considered the problem an autopsy posed to his program until the Franconi dilemma.

All at once, Raymond decided he’d better check the status of the other patients. There was no doubt in his mind that Taylor Cabot’s threat had been real. If one of the patients happened to be autopsied sometime in the future for whatever reason, and the media got hold of the results, it could spell disaster. GenSys would probably drop the whole operation.

Raymond quickened his pace. One patient lived in New Jersey, the other in Dallas. He thought he’d better get on the phone and talk with the recruiting doctors.