Final Venture

29

Very early the next morning, I packed a bag and called a cab.

'Where to?' asked the Indian driver.

'Logan Airport.'

The traffic wasn't too bad, and I checked over my shoulder all the way. I didn't think I was being followed, but I couldn't tell. We soon approached the airport. I was so tempted to direct the driver to International Departures and take the first flight to London. I would be safe in England; I wouldn't be much of a threat to anyone three thousand miles away.

I had two choices: either to run away and forget Revere, BioOne and Lisa, or to go underground and try to take the battle to the enemy, whoever they were. What I couldn't do was wander around Boston until someone shot me.

Long ago I had decided I couldn't run away from Lisa.

Besides, the Assistant DA had my passport.

So, I had the taxi-driver drop me off at Departures, and spent half an hour dodging round the airport, trying to make sure I wasn't being followed, before ending up at the Hertz office. There I rented a bland white Ford. I drove round Route 128 until I came to a rest stop, and pulled up in the parking lot. I hadn't seen anyone following me, and it was a couple of minutes before another car pulled off the highway, so I guessed I was safe.

I sat in the car and went through the four Alzheimer centres on my list. I pulled out my cell phone and managed to make appointments to see three of them.

The first clinician on my list was Dr Herman A. Netherbrook of one of the smaller universities that littered Boston. His office was on the campus in a medical research unit named after a now deceased Massachusetts politician.

Netherbrook was about sixty, grey and uninterested, with the weary cynicism that afflicts stale school teachers and, presumably, academics. He welcomed me politely into his small office, and procured me a mug of instant coffee. I gave him one of my cards.

'Now, who is it you are with, Mr Ayot? I don't quite follow.'

'Revere Partners is one of the investors in BioOne, who of course are conducting the trial of their neuroxil-5 drug for Alzheimer's disease. A trial in which you are participating, I believe?'

'Indeed we are. We were involved with the Phase Two trial, so it seemed natural to continue with the Phase Three trial as well. But I'm not sure I can talk to you about any of the commercial features of this work. You had better discuss that with Dr Enever himself.'

'It's the safety of the drug I'm concerned about.'

'Yes, you mentioned that on the telephone. But we monitor the patients very carefully in all the trials we do.'

'Of course. And have you encountered any adverse events?' I knew from my research on Alzheimer's that adverse events had to be reported as soon as they occurred.

Netherbrook looked me over carefully, as if deciding whether to answer my question. Finally he walked over to a filing cabinet, and pulled out a folder.

'Let me see. We have thirteen patients enrolled in the study. We have had two adverse events in the year or so the trial has been running. One patient had a heart attack, and another is showing signs of developing diabetes. But in a sample of elderly patients, that is only to be expected. And all of them have survived so far.'

Any examples of strokes?'

'Strokes?' He glanced at his file. 'No, none.'

'Nothing that you would consider suspicious or a cause for concern.'

'If I had a cause for concern, I would have notified BioOne immediately, wouldn't I?'

'Yes, of course, Dr Netherbrook. Thank you for your time.'

I left, feeling slightly foolish, and drove off to Springfield, in central Massachusetts. I hoped I was asking all the right questions. But if there had been no strokes amongst the patients enrolled, it was difficult to see how I could have missed anything.

There was a specialist Alzheimer's Research Clinic in Springfield. Dr Fuller turned out to be about thirty-two, blonde, with long eyelashes and very long legs. She seemed to me to be wasted on geriatrics, but perhaps if I were eighty I would disagree with that view. She had a soft southern accent, and purred quietly, rather than talked. I could scarcely make out what she was saying.

I did understand that one of her ten patients enrolled in the trial had suffered a mild stroke nine months after the trial had begun. Another had died from bronchial pneumonia, as old people sometimes do.

One stroke out of a total of twenty-three patients. That didn't prove anything.

Then on to Hartford and a Dr Pete Korninck. He was a genial man with a beard and iron-grey hair that curled over the tops of his ears. One of his sixteen patients had developed a liver complaint, and another had died of a heart attack.

'How about strokes?' I asked, knowing that if there had been any, he would probably have told me.

'None. At least not among the Alzheimer's patients.'

'OK.' I thought a moment. 'What do you mean by "the Alzheimer's patients"?'

'Well, we have some patients who suffer from multi-infarct dementia. That's a condition also known as "mini strokes". Small blood vessels in the brain can become blocked, causing areas of surrounding tissue to lose their blood supply. Over the years these can cause damage to the brain, which has similar effects to Alzheimer's. The two are often confused.'

'And these patients have "mini strokes" all the time?'

'Yes,' the bearded doctor replied. 'And sometimes they get big strokes.'

'Presumably you exclude these patients from your study?'

'Where we can, yes. But there's no doubt some of them creep in. You can only really identify Alzheimer's for sure after an autopsy'

'Have you had to reclassify any of your Alzheimer's patients in this way?'

'Yes, three.'

And you told BioOne this?'

'Of course.'

'Do you think there is anything significant about it?'

Korninck thought for a moment. 'It's impossible to say from my patients alone. There may be. But BioOne would be the only people to have enough information to be sure.'

I left Hartford, and drove east, stopping briefly for a cup of coffee and a burger. It had been a long day, with lots of driving, but I thought I might still have time to see the fourth clinic on the list, in Providence, Rhode Island.

Dr Catarro was unavailable, but his assistant Dr Palmer was. He agreed to meet me at seven fifteen at his office.

Dr Palmer was a dark thin man who could have been anywhere from twenty-five to forty. His young-looking face had lines that suggested a short life with a lot of worry, or a longer one with only an average amount. His voice, when he spoke, had the squeaky depth of a thirteen-year-old.

'Thank you for waiting for me, Dr Palmer.'

'Not at all,' he said. He looked tired.

'Hard day?'

'Since Dr Catarro passed away, every day has been a hard day'

I sat up in my chair. 'Dr Catarro passed away? What do you mean?'

'Oh, I'm sorry, I thought you knew,' Palmer replied. 'My colleague, Dr Catarro, died in a car accident last month. It was a terrible tragedy. We haven't found a replacement yet.'

'I'm sorry,' I said. 'What happened?'

'He was driving home late one night, and he hit a tree on a road near his house. He was only a mile away from home. They think he must have fallen asleep at the wheel. He left his wife and two girls.'

'How awful,' I said, lamely.

Palmer's eyes dropped downwards, recognizing the words and their inadequacy. Then he looked up. 'Now, how can I help you?'

'Oh, yes. I believe Dr Catarro was taking part in a clinical trial conducted by BioOne?'

'Yes, he was.'

'I wonder if I could ask you some questions about it?'

'I'm sorry. I won't be able to help. We discontinued the trial after Tony died. It was his baby really and I had too much other stuff to do.'

'Do you still have the records from the trial?'

Palmer shook his head. 'Well at least not easily available. I sent the file back to BioOne. We will have the information on each patient's file, but it won't be easy to collate.'

I was disappointed. 'Do you happen to know if there were any adverse events?'

'Yes, there were,' said Palmer. 'Tony was involved in a disagreement with BioOne over the reporting of adverse events. Strokes.'

'Strokes?'

'Yes. A number of our patients had strokes. A couple of them were fatal. BioOne had suggested that the patients concerned had been misdiagnosed as Alzheimer's patients, and really suffered all along from mini strokes. The autopsy showed the two who died definitely did have Alzheimer's. They had the neurofibrillary tangles that you only get with Alzheimer's disease.'

'Do you know how this disagreement was resolved?' I asked.

'It wasn't,' said Palmer. 'It's something I really need to follow up, but I just haven't had the time. It was one of the reasons I decided to drop the trial.'

'Thank you Dr Palmer, that was very interesting,' I said. I was just about to leave, when I asked him one more question.

'Oh, by the way, do you know where the accident happened?'

'Yeah, on a little road near Dighton. It's about twenty miles away. Why do you ask?'

'Just curious.'

I was very curious. It was too much of a coincidence that Dr Catarro had died in the middle of asking questions about BioOne. Car accidents could be faked.

I checked Information for the number and address of a Dr Catarro in Dighton. There was one.

I drove straight there. I didn't feel good about barging in on a widow, but I had no choice.

I found the white-painted clapboard house and rang the bell. Mrs Catarro came to the door. She was small and blonde. Her face was carefully made up, but very fragile. I heard a television in the background.

'Yes?' she asked.

'Mrs Catarro, my name is Simon Ayot. I'd like to ask you a couple of questions about your husband.'

She looked at me doubtfully, but the smart suit, friendly smile, and English accent seemed to do the trick.

'Very well, come in.'

She led me into a living room. A girl of about fourteen was sprawled on the floor in front of a sitcom.

'Can you turn it off for a moment, honey?' Mrs Catarro asked.

The girl made a face. Mrs Catarro snapped. 'Brette, I said turn the TV off!' It was almost a shout. The girl grumpily did as she was told, and left the room, throwing me an angry glance.

The woman sat down on the sofa. 'I'm sorry about that. My patience is not what it used to be. Teenage girls, you know.'

I knew very little about teenage girls, but I smiled and nodded, and sat down.

'Were you a friend of Tony's?' she asked.

'No, I wasn't,' I replied. 'But I'm interested in a project he was working on before he died.'

'Well then you should talk to Vic Palmer at the clinic.'

'I have, Mrs Catarro. And he was quite helpful. But I wonder if I could ask you a couple of things, too?'

'You can try,' she said. 'But I don't have any medical training. I doubt if I can help.'

'Do you know if your husband was worried about the neuroxil-5 trial he was working on before he died?'

She thought for a moment. 'Yes, he was, as a matter of fact,' she said. 'He used to talk about that a lot. It made him quite upset.'

'Did he say what the problem was?'

'Yes, he did. As I recall, four of his patients had suffered strokes after taking the drug, and the company that made it, what was it, Bio something or other?'

'BioOne.'

'That's right, BioOne, didn't seem to care at all. It was doing all it could to hide the results, or confuse them, Tony said. He was worried that patients were dying unnecessarily all over the country. He had two who died in his clinic alone.'

'I see. And what was he going to do about it?'

'Talk to the company first. And then go to the Federal Authorities.'

'But it never came to that?'

Mrs Catarro looked at me suspiciously. Her thoughts were following mine. Her brow furrowed, her jaw tightened. 'You don't think…'

I decided not to alarm her. Not when I had no more than guesses to go on.

'It was a car accident, wasn't it Mrs Catarro? I'm sure the police investigated it thoroughly'

'Yes,' she said. She looked as though she was about to cry.

'Thanks very much. If you do think of anything more to do with the trial, do give me a ring.'

I pulled out a card, scribbled in my cell phone number, and handed it to her.

She glanced at it. 'Oh, Revere Partners. You'll have known poor Frank Cook, then?'

'Yes,' I paused. 'Yes I did. You heard about his death?'

'I couldn't miss it.' She nodded towards the television set.

'Did you know him?'

'Yes. Well, Tony knew him better. He'd known him for years. In fact we saw him at some friends' house just before Tony's accident. Come to think of it, just before Frank was murdered.'

I froze. 'Did your husband talk to Frank about the clinical trial?' I asked.

She thought a bit. 'I think he did. In fact I think they had a long conversation about it. Frank was involved in it in some way. The same as you, I assume.'

I nodded. 'That's right, Mrs Catarro. Thank you very much.'

'Are you sure that Tony wasn't…'

She was adding two and two and I could see she couldn't avoid reaching four.

I sighed. 'I don't know, Mrs Catarro. But that's what I'm trying to find out.'

I left her on her doorstep, her fragile face looking as though it was on the verge of shattering.