Death Benefit

22.

COLUMBIA UNIVERSITY MEDICAL CENTER NEW YORK CITY MARCH 4, 2011, 12:35 P.M.

The night before, Pia had taken the time to set the alarm that George had given her as well as her own cell phone and had awakened refreshed and ready to go at 6:30. She’d slept like a rock. First time in more than a week. After showering, Pia had taken a trip to the cafeteria and knocked on George’s door bearing a toasted bagel with cream cheese and a cup of coffee.

“Wow, this is a first,” George had said when he answered the door. “And you brought breakfast. Come in!”

“I’m just returning the favor. Or favors. But where were you yesterday and the day before? I was late both days, and yesterday I ended up scrubbing beakers for two hours as punishment.”

“Oh, I . . .”

“Doesn’t matter. I have some news.”

“Good news?”

“I think so.”

George had continued getting ready while Pia sat on his bed.

“Rothman wants me to work in his lab full-time when I graduate.”

George had come out of the bathroom holding his toothbrush. His mouth was agape and foaming.

“Can he do that?”

“I think around here, he can do pretty much whatever he wants. All he has to do is threaten to go to Harvard or Stanford.”

“So what did you say?”

“I didn’t say anything. For one thing, I was too stunned, and for another, he told me to think about it. But it’s a no-brainer. I’m going to say yes. I’ll talk to the dean about postponing my residency. I imagine I can still qualify as a Ph.D. student. But the important thing is to work in his lab. You can’t believe what’s happening in there. He’s going to become even more famous. I wouldn’t be surprised if he wins another Nobel.”

George had returned to the bathroom and stood in front of his mirror. He looked himself in the eye and bit his tongue.

“That’s great, Pia. Congratulations.” He had tried to sound convincing, but didn’t think he managed it.

“I thought you were going to give me one of your rants about Rothman.”

“Hey, if this is what you want to do, I think you should do it.” He bit his tongue again.

“My thoughts exactly. Come on, George! Hurry up, we’re going to be late.”

The early morning had been dark and a cold drizzle was in the air. March was not one of the best months in New York City. George and Pia had hurried to their assignments, talking about how their first days had gone.

“So what’s it like working with Will McKinley?”

“He’s a bit of an ass and into himself. Rothman thinks he’ll go into plastic surgery. Anyway, he’s holding his own since he’s smart enough. I do like Lesley.”

“I’m sure that Rothman’s comment was not meant as a compliment. I’ve heard he’s never said anything positive about anybody.”

Pia had merely raised her eyebrows without commenting.

“McKinley reckons he’s God’s gift to women. I’m sure you figured that out.”

Pia had shrugged, as if to say, “And?”

“Is he leaving you alone?”

“I can handle Will McKinley, believe me. He is quite cute though.”

George had caught up the stride after momentarily lagging behind Pia. He looked across at her. She was smiling, having a laugh at George’s expense. He couldn’t help but laugh along with her. Silently he chided himself for being such a wimp.

The morning passed uneventfully for the students. They spent their time on their respective projects in the organ bath unit. Pia also spent several more hours reading about pH buffers designed to be used for tissue culture. The maintenance man had still not finished in her office or in Rothman’s office either and wires still hung out of both ceilings. The electrical blueprints that had been in Pia’s cubbyhole were now in Rothman’s office. Pia had gone in to see if the worker was there as he wasn’t in her space. She wanted to give him an earful about the job not being done. But he wasn’t in there either, and after starting her reading, she forgot about him altogether.

As if taking a cue from jealous George, Will showed up and tried to engage Pia in small talk. Pia wasn’t sure if he was hitting on her or not but couldn’t have cared if he was. She answered his first few questions but then told him directly she wanted to concentrate on her reading. He took the hint and vanished.

At twelve thirty-five Rothman and Yamamoto appeared from the depths of the BSL-3. Pia couldn’t help but notice that they were acting out of character. They were actually talking excitedly to each other. Pia didn’t stare directly but watched out of the corner of her eye. The lab was quiet, which was why she had heard them emerge. It seemed that everybody was at lunch.

All at once Yamamoto came toward her as Rothman disappeared into his office but without shutting his door. Even that was out of the ordinary. Pia sensed that something was going on.

“Where are the other students?” Yamamoto asked when he reached Pia’s side. His voice had what Pia would have described as an anticipatory ring.

Pia looked up. “I believe in the organ bath unit,” she said.

“Good,” Yamamoto said. “I want you in there too. Rothman and I want to show you students something.”

Five minutes later all five people were in the organ bath room attired as per usual in caps, gowns, masks, and booties.

“Okay,” Rothman said, clasping his gloved hands together in excitement. After Pia’s surprising talk with him the previous evening and now his excited behavior, she felt she was seeing a side of Rothman that she never imagined existed. “Dr. Yamamoto and I want to show you something but in the strictest confidence. You will be here a month, Pia longer, but we would be very grateful if you could keep what you’re about to see to yourselves in that period and thereafter. Agreed?”

The three nodded their assent.

“Good. We don’t want anyone to get excited prematurely. The stakes here are very high.”

As he talked, Rothman edged toward the back of the room. Set in the wall was a door with another security pad like the one on the main door outside. Rothman shielded the code pad with his body, punched in a code, which Pia assumed was the same as for the other security doors, and pulled open the door. Dr. Yamamoto held it as Rothman stepped over the threshold, followed by the students. Yamamoto stepped in and closed the door behind him.

They were standing in a room that was maybe ten feet square, an identical but smaller version of the one they had just left. The five people made the room feel crowded. The same bluish light filled the room, which had its own HVAC system that hummed a little louder than its larger neighbor. The recessed ceiling light illuminated two carts like the ones they had been working with next door. They stood side by side, but only one was operating.

Rothman gestured toward the bath atop the one cart. It was similar to the ones out in the main room. In it was a kidney much larger than the mouse organs. Soon they learned that it was a human kidney, and like the human kidneys in the outer room, it had been made from Yamamoto’s fibroblasts. It was a pale color and appropriately kidney-shaped. The difference was that this organ had ports through the Plexiglas wall that were connected with Y connectors to the organ’s artery, vein, and ureter.

“What you’re looking at is what is going to be the world’s first human organ exoplant made from induced pluripotent cells. This morning we received official sanction from the FDA to go ahead and attach this organ to Dr. Yamamoto’s cannulated inguinal artery and vein. We will be allowing the organ to function as it would if it were transplanted into Dr. Yamamoto’s abdomen.”

“You’ve volunteered for this?” Will asked Yamamoto.

“Yes, of course,” Yamamoto said with enthusiasm. “It is a great honor for me.”

“When will you do it?” Pia asked. It seemed as if she was being overwhelmed on a daily basis in Rothman’s laboratory.

“As soon as we can schedule it with the surgery department. It will be done in one of the main operating rooms for safety’s sake. We’ll allow the organ to function for several hours while we monitor it carefully. It’s going to be a big day. A milestone really.”

But what Pia could see before her seemed like a destination in itself. The dreams inherent in what was growing next door were being made into a reality in this tiny secret chamber. Pia felt a sense of awe, that she was present at the creation of something immense and extraordinary. No one in the room was saying a word. Pia stared at the artificial kidney sitting in its nutrient solution, the blue light reflecting in the bath and flickering over her face. She had been working in Rothman’s cathedral but now she had seen the shrine. She knew that Rothman would have preferred the organ to be a pancreas, but she knew he knew that would not be far behind.

She could hardly wait to see that happen.