Genesis

Chapter 21

May 9th

12:45 P.M.

As Aria approached the front entrance to the old, ramshackle OCME Forensic Pathology building, she had to pass under scaffolding, the presence of which was odd since there didn’t appear to be any construction going on. To Aria it was a curious New York phenomenon that she had noted since becoming a Manhattan resident. There was scaffolding spread all around most NYC neighborhoods, and it stayed up for years without any apparent rationale. Nobody seemed to question it. There was even semi-permanent scaffolding with electric lighting around the Plaza Hotel building with no apparent construction that she passed most mornings on her way to the Langone Medical Center.

Once inside she flashed her ID card to the receptionist, Marlene Wilson, who manned a high-topped counter and guarded entrance both into the identification area, where most visitors were directed to identify the dead, and into the building proper where the chief and deputy chief had their offices. Except for all the medical examiners and the Department of Toxicology, most other OCME functions had been moved to the much more palatial high-rise building at 421 East 26th Street. Hoping to avoid running into Dr. McGovern, Aria used the stairs rather than the elevator to get up to the second floor.

As she passed through the area charitably labeled lunch room with its sad Formica-topped card tables and molded plastic chairs, she tried to be as unobtrusive as possible since Dr. McGovern was a frequent visitor, particularly at lunchtime. Although the room was reasonably crowded, Dr. McGovern wasn’t one of the patrons, but Dr. Tad Muller, Aria’s resident colleague, was. Despite her efforts, he caught sight of her and called her over to his table. He was lunching with several of the mortuary techs. Reluctantly, she veered in his direction.

“Hey, Aria,” Tad said, leaning in her direction and speaking under his breath. “I’m glad I saw you. I wanted to warn you that Dr. McGovern is looking for you, and he’s not all that happy. He said you weren’t answering any texts or voice mail.”

“If you run into him, don’t tell him that you saw me,” Aria said. She briefly looked at the mortuary techs sitting with Tad, daring them to say anything as they had undoubtedly heard the exchange.

“He seemed pretty uptight,” Tad said in a more normal tone. “I’d recommend you call him. I know there are some interesting cases that came in during the morning that he wants us to observe.”

“I’m sure there are,” she said. “But I’m flat-out busy on the one that I actually did yesterday, rather than merely observe, and that promises to teach me more about forensics than standing around holding the dick I don’t have, watching a couple more autopsies.”

“I think you’re making a mistake,” he said, clearly offended.

“You’re entitled to your opinion.” She was tempted to add and you’re a hopeless ass-kisser, but she restrained herself. She glanced briefly again at the mortuary techs, whose bored expressions had changed to smirks. They at least seemed to have a sense of humor.

Once inside the residents’ office, which was again a charitable designation considering its size and décor, Aria took off her white coat, hung it over the back of the aged desk chair, and sat down in front of the monitor. A moment later she was on the internet. Her goal was to try to figure out which of the major ancestral DNA companies might be the best for finding Lover Boy now that Madison Bryant had made herself incapable of lending a hand. Deciding on which DNA company to use was going to be up to Madison, at least in the beginning.

From Aria’s reading she knew that Ancestry.com had the largest database, which might turn out to be a benefit since matches — people who shared segments of DNA of varying length with the dead fetus — were going to be what she needed. As she scrolled through the website, she saw that it was essentially divided into two parts. One part would help build a family tree through various and sundry records. Almost immediately Aria recognized that this service might provide information about Kera’s family but wouldn’t help with the father’s, so Aria avoided that selection and clicked on TAKE A DNA TEST AND UNCOVER YOUR ORIGINS. That got her to a page where she could click on WHAT YOUR RESULTS WILL INCLUDE. Clicking on this allowed her to scroll through ETHNICITY ESTIMATE, which she wasn’t particularly interested in, until she got to DNA MATCHES. This was what she needed, and the screen looked like the result some previous individual had obtained from Ancestry.com. It showed seventy-two matches with people who were either first or second cousins.

Already Aria was encouraged. If she could manage getting something like that, even one first or second cousin, she would be optimistic that the whole idea of finding Lover Boy would work. With a sense of building excitement, Aria scrolled down farther. All this was only going to cost a modest amount of money, which considering the implications, seemed to be quite a deal. Down near the bottom the screen read GET STARTED IN A FEW SIMPLE STEPS. The first thing she needed to do was to order a kit. The second thing was to activate the kit, whatever that meant, followed by providing a saliva sample. This was an issue that she had already considered since under the circumstances she would be unable to provide saliva for either Kera or the fetus. What Aria intended to do was contact the company and make sure that she could supply blood instead. Her research had suggested the blood would actually be better, anyway.

Aria’s eyes then shifted to the final step on the current screen she was looking at. It was then that her building excitement took a sudden nosedive. She read that in roughly six to eight weeks the results would be available.

“Six to eight weeks!” she said with utter disdain, slapping a hand to her forehead. “That’s a disaster.” She tipped back in her chair. She couldn’t believe it. She assumed that such DNA testing was all automated and done with microarray chips. Why would it take six to eight weeks? She was only going to be on her forensic rotation for another two to three weeks. Tipping forward again, she searched for a phone number to call the company. Although the website was generally rather well designed, finding a phone number to call was not easy and took persistence. When she finally got a customer service representative on the line, the woman wasn’t able to provide an explanation for the six- to eight-week wait other than suggesting it had to do with sheer volume. More to the point, the woman seemed to have no conception of the actual process, nor did she have the ability to connect Aria with anyone who might. Out of frustration, Aria ended up just disconnecting while the woman was in midsentence trying to extol her company’s level of service once the results had been obtained.

With rising frustration, she quickly checked the rest of the main ancestral DNA companies that she had read about the night before, namely Family Tree DNA, 23andMe, and MyHeritage. Although all three had slightly shorter estimated sample turnaround times than Ancestry, they were in the same ballpark, with the shortest being 23andMe, which estimated their results would be available online between three and five weeks. Still, that was much too long as far as Aria was concerned. She also tried calling these other companies, but the result was similar to her experience with Ancestry, namely that she only got to speak with a customer service representative who had little comprehension of the actual technological way the results were obtained. At the same time, all the representatives seemed to be reasonably conversant with the basic concepts of DNA science, including knowledge that their respective companies were relying on SNPs, or single-nucleotide polymorphisms, as the way that people’s DNA or genome were unique and relatives were varyingly similar, depending how close the relative was.

Aria rocked back again in her chair, wondering if she would have to give up this mini-crusade practically before she started it. As a soon-to-be senior, fourth-year pathology resident, she had too many other claims on her time than trying to figure out Kera Jacobsen’s fetus’s paternal family tree. Once she left the OCME rotation, which she considered almost a vacation, she would be back to working ten- to eleven-hour days with real responsibility. But the pause gave her an idea. Realizing that the ancestry DNA or genetic genealogy was a growing business as reflected in the long wait for samples to be analyzed, she reflected that there must be a lot of companies that were comparative start-ups, eager to get their firms in a competitive status with the big four, which were getting a lion’s share of the business.

Tipping forward yet again, Aria googled “ancestry DNA companies,” and as usual, Google came through. One website jumped out at her. It was a list of some thirty to forty testing companies. As quickly as she could, she started looking at all the websites, trying to find companies that were new to the game. After she found a handful of newbies, she started to locate them with the hopes of finding a relatively new company in the New York metropolitan area. After only fifteen minutes she hit gold. GenealogyDNA was fresh on the ancestral DNA scene and its home office was right there in Manhattan’s touristically trendy Meatpacking District on West 13th Street, which was a cab ride away. When Aria used Google Maps to locate the address, she was moderately taken aback from glancing at the photo. It was a six-story brick building devoid of any decorative elements but with a stylish boutique and a contemporary restaurant on the ground floor. The upper five floors were apparently recycled commercial space, which she assumed could be rented by a start-up for a decent rate in the near term, at least decent for Manhattan.

Going on the company’s website, which wasn’t as polished as those of the big four, she found another difference. The number to call for information was much easier to find, suggesting GenealogyDNA encouraged potential customers to call. And even more important from Aria’s point of view, there was a number to call for investment opportunities, meaning they were surely new to the game.

For a few minutes she stared at this second number while remembering how unproductive her calls to the other companies’ customer service personnel had been. She felt she needed to talk to someone a bit higher in the company’s hierarchy if she was going to have any luck circumventing this sample-processing delay. If she could manage to talk with one of the principals, she might have the best chance. But if that were to work, she needed a much more compelling story than trying to find the lover of a person who overdosed on opioids, as that was just too common and uninspiring. Aria knew enough about human foibles to know you had to offer something to get something.

Hoisting her feet onto the corner of her desk and crossing her legs in the process, which was Aria’s posture for serious thinking, she tried to put herself in the shoes of the people who had started GenealogyDNA. Although fully accepting she was laboring under stereotypes, she envisioned they were probably a group of relatively young, male, Silicon Valley — type computer techies, all of whom had been nerds in high school. Thinking along those terms, she tried to come up with something sexy, which she thought shouldn’t be too hard since the Kera story did involve consummated sex as evidenced by the existence of the fetus. But nothing came to mind that wasn’t overshadowed by the drug issue. That was when she had to abandon the overdose situation totally. In fact, she suddenly realized that whatever story she was going to come up with, it had to involve life, not death, meaning the father needed to be found to save the kid’s life. That was the kind of story that people could sink their teeth into, especially a young genetic genealogy company trying to make a go of it among giants.

All at once it came to her in a sudden burst of creative conceptualizing. It had to involve a child because kids always pulled on everyone’s heartstrings. By closing her eyes, she could envision a cherubic toddler with a rare disease, the kind of disease that spelled doom in most people’s minds. As a pathologist she thought immediately of an aggressive childhood leukemia, which heretofore was synonymous with death, yet against which great strides had been made of late.

“Perfect,” Aria said as she let her feet fall to the floor. Once again, she pulled herself up to the desk. All at once the whole story came to her. It involved a three-year-old boy conceived with donor sperm who was in a terminal state with advanced leukemia and who desperately needed a bone marrow transplant if he was to survive. Complicating the situation was the recent death of the mother days ago from a broken heart. Aria had to smile at herself for that last part, knowing she’d have to come up with something better, like an auto accident, while racing to the hospital. “Who could resist such a story?” she asked herself. And best of all, she imagined that the powers that be at GenealogyDNA would see the whole thing as a potential publicity gold mine even though Aria would have to remind them that because of HIPAA rules, they couldn’t be told the name of the stricken infant or the dead mother.

With significantly more confidence, Aria dialed the number on the GenealogyDNA website for those people interested in investment opportunities. When the phone was answered after the second ring, she was even more hopeful. When she’d called the other genetic DNA companies, the phone had had to ring ten or more times before being answered.

“GenealogyDNA,” a male voice said. “How can I be of service today?”

“My name is Dr. Aria Nichols, and I’m a senior resident in Pathology at New York University,” she said. As someone who wasn’t always glued to the truth starting in childhood, she knew from experience that if she was going to lie, it was best to at least start with the facts.

“And I am Vijay Srinivasan. How can I help you?”

“I’m calling about a major problem here at the Hassenfeld Children’s Hospital,” she said, quickly improvising. “I was hoping that GenealogyDNA might be able to help because genetic genealogy helped find the Golden State Killer. I assume you remember that story?”

“Most definitely,” Vijay said. “That was good PR for our business.”

“I can understand why,” Aria said. “We, too, need to find a missing man. What I’d like to do is speak with someone in your company’s hierarchy and not a customer service representative.”

“I am one of the founding partners,” he said.

“Well, that’s perfect,” Aria said. She hadn’t expected to hit pay dirt so quickly. “Before I start, I need to be certain you are aware of HIPAA rules that protect the confidentiality of patient information.”

“I understand about patient confidentiality,” Vijay said, “but I don’t know anything about HIPAA, per se. Is that an acronym?”

“It is indeed,” she said. “To tell you the truth, I always have to look up the actual name, but the long and short of it is that I will not be able to tell you any of the names of the people involved in our situation even though one is deceased. Nor will you be able to use the name of our institution if and when you wish to tout this endeavor for the benefit of your company. Is that understood?”

“I believe I understand,” Vijay said.

“Then let me tell you the gist of the problem,” Aria said. “We have a very sick toddler who was conceived with donor sperm and whose mother just passed away a few days ago. To make a long story short, we desperately would like to find the father to obtain some donor bone marrow. Has GenealogyDNA had any experience helping people who have been conceived with donor sperm find their genetic fathers?”

“Yes, we have,” he said. “And we are proud of our record in that regard. I don’t know how much you know about ancestral DNA and how matches are found, but it is in this arena where our company excels. DNA matches are found by algorithms, and it is our belief that our algorithms are probably the best in the business. Did you know that the algorithms are proprietary in that each of the commercial DNA companies have their own?”

“I wasn’t aware of that,” Aria said.

“We not only get the most matches with a customer’s kit, but we get the least false-positive matches. We may be the new kids on the block, but we believe we have the best software, which is the reason we’ve been willing to challenge the established companies and have been able to find financing to do so.”

“How long has GenealogyDNA been in business?” she asked.

“Next month will be our first anniversary,” Vijay said. “If you are interested in investing, this might be the perfect time.”

“I’m more interested in solving this current problem,” Aria said. “But there is one other issue that I’d like to ask you about.”

“Please,” Vijay said. “This sounds like a situation that can be mutually beneficial.”

Such a comment was music to Aria’s ears. She needed GenealogyDNA to be selfishly interested on top of the Good Samaritan aspect, and it seemed that they were.

“To be entirely up front,” she said, “we already approached several of the more established ancestral DNA companies. I have to say that with none of them did I have the pleasure of talking with someone of your stature.”

“Thank you. You are too kind,” Vijay said.

“The other problem I encountered was an unacceptable delay in producing results,” Aria said. “With all of the companies it was weeks just to analyze the DNA samples whereas in our situation we are looking at days if we want to save the toddler’s life.”

“I’m not surprised,” Vijay said. “Processing time is another issue where GenealogyDNA has made a point to be competitive. Many of the established ancestral DNA companies outsource their analyses. We here at GenealogyDNA do not. We have our own lab to provide vertical integration, and we rent our high-density SNP microarrays so they can be upgraded as soon as newer arrays or chips are available. We intend to stay ahead of the curve.”

“You have a lab here in the city?” Aria asked. This was sounding better and better.

“No, not in the city,” he said. “Our lab is on Long Island, about an hour drive away.”

“So, you could get results faster than the weeks it takes in the other companies?”

“Absolutely,” Vijay said proudly. “If the DNA amplification goes smoothly, we could do it overnight in this type of emergency circumstance.”

“That’s fantastic,” she said, and meant it. “Now, there is one other issue. With the mother recently deceased, we obviously cannot use saliva as the other companies use. Would blood suffice?”

“Of course,” Vijay said. “Saliva has been used purely because of its ease for the customer, even though it creates an added problem of having to deal with the DNA of aural bacteria and fungi. It creates an extra step of isolating the human DNA. Using blood is far superior and will make the amplification process profoundly simpler.”

“This all sounds very encouraging,” Aria said. “Let me tell you a bit more of the circumstance that we are in. The child has an aggressive form of myelogenous leukemia, which has been resistant to any of the newer forms of treatment. A bone marrow transplant is the only hope and the father would be the best possible source. It is a crisis situation and only a matter of days or a week or two at most. Do you think you could help?”

“Most definitely,” he said. “There is no guarantee, of course, since it depends on at least some of the relatives of the father having contributed their DNA to the ancestral DNA pool and created family trees. But from purely an organizational standpoint, we can certainly produce the kits for the mother and the child on a timely basis. On top of that, for such a cause, I could have our in-house software people, including me, do the matching and try to construct a family tree for the ailing toddler. As an aside, do you have reason to believe the unknown father is from the NYC metropolitan area?”

“Yes,” Aria said. “I’m quite sure that he is.”

“That could possibly help,” Vijay said. “Sometimes talking people into sharing their genealogical information can be difficult and a face-to-face meeting can make the difference.”

“That’s good news,” she said. “When can we start?”

“When can you get us the blood samples?” Vijay said.

“How about this afternoon?” Aria said. “I can bring them to your office.”

“Fine,” he said. “I will be here all afternoon. When you come in, just ask the receptionist for me.”

“I’ll be there shortly,” Aria said, and disconnected. Before she pocketed her phone, she noticed she’d gotten three texts as well as two voice messages from Dr. Chet McGovern. She ignored them all.