Hypocrite's Isle

Fifteen

Gavin was standing outside the locked double doors of the microscopy suite in the medical school when Norman Singleton, the chief microscopy technician, arrived. ‘Samples for EM?’ he asked. ‘There’s a basket just round the corner. You can leave them there with a request form.’

‘No, I’m on the scrounge,’ said Gavin. ‘I need some polymyxin. I thought you guys might have some?’

‘You just might be in luck there,’ said Singleton, unlocking the doors and leading the way inside. Gavin followed him through the reception area and across a green-lit room where two electron microscopes sat like periscopes rising from their control desks.

‘Through here,’ said Singleton, leading the way into a smaller lab where two expensive-looking Zeiss light microscopes sat side by side on a bench, one with a conventional, tungsten light source attached, the other emitting a violet glow from the UV lamp secured to its base. ‘I used some recently for a nuclear prep I did for the Jackson group. Here we are,’ he said, opening a fridge door and taking out a small bottle. ‘polymyxin B. How much do you need?’

Gavin shrugged his shoulders. ‘Not sure to be quite honest. Depends if it works for what I have in mind.’

‘Why don’t you take the bottle?’ suggested Singleton. ‘We don’t use the stuff a lot. If I need it, I’ll get back to you.’

Gavin was whistling when he reached the lab. This drew a disapproving look from Tom Baxter and the comment, ‘God protect me from happy people. What have you got to be so cheerful about?’

‘Guess I’m just a happy-go-lucky sort of a guy,’ said Gavin.

Mary and Tom exchanged glances of exaggerated disbelief.

‘Or maybe...’ Gavin paused while he took out the cell preparation from the previous day from the fridge, ‘it’s just the prospect of biochemistry for the next six months that’s pushing me over the edge...’

The other two seemed more comfortable with this suggestion.

Gavin slipped the polymyxin B inside a plastic box in the fridge with his name scrawled in marker-pen on the lid and closed the door. Periodically throughout the day, when he had a lull in the biochemistry protocol he was following, he would gather things together for the evening’s work ahead. He had cell cultures of both tumour and normal cells growing in the incubator: he had Valdevan and polymyxin and he had a good supply of sterile glassware.

The excitement he felt at the prospect of stepping into the unknown caused several more outbreaks of whistling throughout the day, before night fell and people started to go home.

‘Going to be here long?’ asked Mary as she put on her coat.

‘Another hour or so,’ replied Gavin. ‘Everything takes so long with biochemistry.’

‘It’ll be worth it in the end.’

Tom had already left for a dental appointment. Frank Simmons was the next to leave at a quarter to six. ‘How’s it going?’ he asked as he came out his office with his coat on and carrying his briefcase.

‘No problems, pretty straightforward really. It’s just the waiting between reactions that’s the bummer...’

‘It was ever thus,’ smiled Simmons. ‘Take my advice and buy a book of crossword puzzles. You’ll get pretty good at them before the project’s over.’

Gavin smiled and felt a tingle of excitement as the door closed and he was finally alone in the lab. He brought out the drugs from the fridge and made up sterile solutions — seeing it as the first step on the road... to what? But this was why he’d gone into research. This was the tingle that said it was the best job in the world. Ultimately, it would be researchers who would uncover the secrets of life on earth. It would be they who’d uncover the meaning of it all — where we came from, where we were going and, even more importantly, why. As far as Gavin was concerned, every other job on the planet was just part of a network of service industries, required only to keep the machinery of discovery moving along.

There was a limit to how much he could do on this, his first evening. It was more a case of getting things up and running, but taking the first step of any journey was exciting. Before he could test the action of polymyxin on tumour cells he would need a supply of them, treated with Valdevan and displaying the characteristic membrane blips. This would take a couple of days, but they should be ready by the weekend when the lab would be quiet and he would have more time to experiment without anyone asking what he was doing. Everything was up and running by eight thirty. The Valdevan-treated cells had been placed in the incubator and a range of polymyxin solutions sat in the fridge.

He would have enough in the way of cell cultures for the initial experiments, but would have to order up some more from Trish for the next stage. The tumour cells, which he was also using for the biochemistry, would not pose a problem. Ordering up supplies of normal cells might raise an eyebrow or two when the monthly grant accounts came in, but he would cross that bridge when he came to it. In any case, he would have his results by then.

He called Caroline to ask how her exam had gone.

‘Okay, I think,’ she replied. ‘I must have taken in more than I thought.’

‘Look, I’m sort of assuming you’re going home this weekend?’ he added tentatively.

‘Sounds like you’re planning to work,’ said Caroline, but not unkindly. ‘But yes, I think I will. I’ll be starting a new module next week so it’s probably a good time to go. How did it go this evening?’

‘Things are up and running but it’ll take a couple of days before the cells are ready to test. That’s what I’ll be doing at the weekend.’

‘God, it would be so fantastic if it worked.’

‘Fingers crossed.’

Gavin was in the lab by 6 a.m. on Saturday morning when he knew it would be quiet. Others — mainly grad students — would come in and out throughout the day to check on experiments and set up cultures, but that probably wouldn’t start happening until after ten. Student Saturdays usually started with hangovers. His heart was in his mouth when he took out the Valdevan cultures and examined them under the inverted microscope, but everything was fine. He could see the membrane blips.

It was time for the moment of truth. He took the polymyxin solution from the fridge and filled a small syringe, knowing exactly how much he was going to inject because he’d done the calculation in his head a hundred times since Wednesday. He pressed the plunger and rocked the tube gently to and fro before placing it back under the scope.

‘Sweet Jesus,’ he exclaimed as he watched the tumour cells rupture and die before his eyes. Within seconds he was left with little more than rafts of cell debris drifting across his field of view among the ghosts of the membranes which had once contained it. ‘I don’t believe it,’ he murmured. ‘Things this good don’t happen to me...’

Gavin controlled his impulse to get up and dance around the lab but recognised that he had only cleared the first hurdle. The Valdevan-treated cells were wonderfully sensitive to damage by polymyxin but the question now was, were they more sensitive than normal cells? If healthy cells should behave in the same way, there was nothing to get excited about and it would all be a wild goose chase, but polymyxin-based drugs had been used in the past to treat bacterial infections without any report of tissue damage, although they had shown other toxic side effects — the reason their use had largely been confined to topical application in modern times.

First, he would establish the minimum concentration of polymyxin necessary to kill tumour cells. He brought out another cell culture and this time injected it with a smaller dose — half the previous concentration, but the result was the same. Keeping a grip on his emotions was proving more and more difficult as he halved the concentration yet again and still saw immediate signs of cell death. Surely healthy cells could not possibly behave this way in the presence of so little drug?

Gavin couldn’t resist finding out any longer. He fetched one of the primary cell cultures from the incubator and injected it with the smallest dose of polymyxin he’d used so far. There was absolutely no reaction: the healthy cells remained completely unaffected.

He was aware of the thump of his heart as he doubled the concentration and got the same result. ‘Bingo!’ he exclaimed. There was a big difference between the sensitivity of tumour cells and normal ones. Right now, he could do what no one else in the world could do. He could specifically target and kill cancer cells.

He allowed himself to ponder this for more than a minute, savouring the moment and revelling in the feeling of achievement, before looking for reasons not to believe his results. He couldn’t think of any off-hand, although he did recognise that this was lab science and still might not translate into the treatment of patients, but this was a dream start.

He couldn’t resist carrying out one more ‘show-biz’ experiment before going back to the discipline of establishing the minimum dose of polymyxin necessary to kill cancer cells. This was to mix tumour and normal cells together in the same test tube and add polymyxin. It worked like a dream. The tumour cells with the membrane blips died: the healthy cells without the blips did not.

Gavin called Caroline on her mobile. ‘Where are you?’

‘Waverley station. Where are you?’

‘In the lab. It works! I can kill tumour cells without damaging healthy ones.’

‘Oh, Gavin, I’m so pleased for you. That is bloody brilliant,’ exclaimed Caroline. ‘I’m so sorry for ever doubting you.’

Gavin found himself competing with the station announcer who was announcing a London train departure. ‘It works like a dream!’ he shouted.

‘That’s absolutely wonderful, Gavin. I’m so glad for you. Call me later and tell me all about it. Oh, I’m so pleased for you, Gav. Got to run; my train’s leaving.’

‘Love you.’

‘Love you too.’

Gavin got up from his seat, clenched his fists together, looked up at the ceiling and yelled out, ‘Bloody brilliant!’

‘What is?’ asked Mary Hollis as she came in through the door.

Gavin was overcome by embarrassment. ‘I just got a good result,’ he stammered.

Mary looked puzzled. ‘Already? You only started the biochemistry on Monday.’

Gavin’s silence brought a suspicious look to Mary’s eyes. She saw the cell cultures sitting on Gavin’s bench. ‘You’re not still working on Valdevan, are you?’ she asked in disbelief.

Gavin shrugged. ‘Just at evenings and weekends,’ he tried, with a mock apologetic look, and Mary smiled. ‘Gavin, you really are something else.’

‘I’m just curious.’

‘So what’s so “bloody brilliant” or shouldn’t I ask?’

Gavin looked at her for a moment as if undecided whether to say anything or not. ‘I think I know how to kill tumours without harming healthy tissue.’

This seemed a bit much for Mary who sank down into her seat. ‘Just like that,’ she said. ‘You’re telling me you can cure cancer?’

Gavin made a face. ‘Seems like it.’

‘Well, don’t keep me in suspense. Tell me!’

Gavin outlined what he had been doing and showed her the cultures he’d been looking at.

After a couple of minutes Mary looked up from the microscope and said, ‘I’d like to say something like, it’s far too soon to be sure, or you’re reading far too much into this, but I can’t. This is absolutely fantastic: there’s no other word for it. Does Frank know about this?’

‘Not yet, I wanted to be sure of my ground. ‘I’ve got a few more things to check out. I’ll speak to him first thing on Monday.’

‘You do realise that if this works in vivo, it’s going to be the biggest single advance in cancer treatment... ever?’

‘It may have crossed my mind,’ said Gavin.

‘Sorry,’ said Mary. ‘Of course you know it. What a bloody stupid thing to say.’

Gavin smiled affectionately at her. ‘Don’t apologise. You’re one of the good guys.’

‘The whole scientific world will be queuing up to be your friend,’ said Mary. ‘And Graham Sutcliffe will be leading the applause.’

Gavin laughed out loud at the notion. ‘That’ll be worth seeing on its own. So, why are you here this morning?’

‘I’m looking for a bit of peace and quiet to write up my paper. My flatmates had other ideas.’

‘I’ll only be here for another half hour and then I’ll leave you in peace,’ said Gavin.

‘I’m really pleased for you, Gavin.’

Gavin could see that she meant it. He smiled and nodded and then, after a moment’s hesitation, he went over to her and kissed her on the cheek. ‘Thanks for being so nice to me.’

Mary smiled at the clumsiness of the gesture.

Gavin finished establishing the minimum dose of polymyxin needed to kill tumour cells and cleared his bench. Life was good. It was to get even better on Sunday evening when Gavin met Caroline off the train and she told him that her mother had entered a period of remission. She had been in good form at the weekend and was almost back to being her old self. ‘God, it was so nice to hear her laugh again. She always could be so funny. She has a wicked tongue when she puts her mind to it.’

Caroline picked up on Gavin’s muted response and said, ‘All right, I know it’s just a pause in the nightmare and it will come back, but it was just so good to see her without that terrible barely suppressed bitterness for once. It seemed like... we were friends again.’

They went back to Gavin’s flat where he served up spaghetti bolognese and a bottle of Valpolicella he’d bought from Safeways.

‘Why don’t we get a flat together?’ asked Gavin when they had finished.

Caroline shook her head. ‘We’re fine the way we are. If we move in together we’ll have all the baggage that goes with that — laundry, bills, who does this, who does that — I don’t think I could cope with all that right now. Doesn’t mean to say I don’t love you.’

‘That’s all that matters.’

Frank Simmons noticed Mary and Gavin deep in conversation when he came into the lab. Both turned and said ‘Good morning’, before apparently having trouble suppressing laughter over something. He closed the door of his office, thinking that laughter was good in the lab. It was the pained silence that followed squabbles that was the enemy of progress. He sat down and started opening his mail when a knock came at the door and Gavin came in.

‘How was your weekend, Frank?’

‘Crap, if you must know. Our babysitter didn’t turn up on Friday night so Jenny was in a bad mood all day Saturday. We took the kids to a country park on Sunday and they squabbled all the way there and all the way back. Domestic bliss. How was yours?’

‘You can do what?’ exclaimed Simmons when Gavin told him about his weekend work.

‘I can kill cancer without damaging healthy tissue. All you have to do is pre-treat the tumours with Valdevan and this makes them hypersensitive to cationic detergent drugs like polymyxin.’ Gavin explained his rationale for trying this in the first place and his subsequent findings.

‘This is absolutely incredible,’ exclaimed Simmons. ‘If you’re right... and I’m not suggesting for a moment that you’re not... this is going to... Christ, I don’t know.’ He threw his hands in the air. ‘Revolutionise cancer treatment.’

‘Music to my ears,’ said Gavin. ‘I’m sorry I went behind your back to do the experiments. I just couldn’t let it go.’

Simmons waved away the apology with a hand gesture. ‘In this case, the end has justified any means used to achieve it. Who have you told about this, Gavin?’

‘You, Mary, my girlfriend Caroline, that’s about it.’

Simmons nodded. He was finding it difficult to keep his emotions in check. He wanted to dance around the lab.

‘What happens now?’ asked Gavin.

‘That’s just what I’m wondering,’ said Simmons, tapping the end of his pen on his desk. ‘My instinct is to tell Grumman Schalk that their drug, Valdevan, can be a wonder drug after all. What do you think?’

‘Seems only fair.’

‘Hang on a minute though,’ said Simmons, remembering something. ‘I don’t think you can give patients polymyxin-based drugs any more. They were very toxic as I remember...’

‘I checked up on that,’ said Gavin. ‘They were used to treat bacterial infections when they first came out and you’re right, they did prove to be very toxic, but the level of the drug needed to kill the tumours is way below the dose needed to kill bacteria. I think there’s a good chance that patients won’t experience any side-effects at all.’

‘You seem to have thought of everything,’ smiled Simmons. ‘So who’s going to tell the company, me or you? I take that back; it should be you. Give Max Ehrman a call. Bloody hell, this is going to be the mother and father of all phone calls.’

‘Thanks, Frank.’

‘Gavin? What a pleasant surprise. What can I do for you? More Valdevan?’

‘Actually, no, I have some news for you, Professor.’

‘Max, please.’

‘Max, I think it might be possible to use Valdevan after all.’

‘I’m sorry? Use Valdevan? For what?’

‘To treat cancer, just as you guys hoped all these years ago.’

‘Are you kidding? It didn’t work then and it doesn’t work now, and you were instrumental in showing us why not.’

‘I know, but we can exploit the membrane damage it causes in tumour cells.’ Gavin went on to explain his findings.

Ehrman seemed stunned. The silence seemed to go on for ever.

‘Max?’

‘I’m still here. Well, you’ve really given me something to think about, Gavin. I think I’d like to get back to you later if that’s all right. I need to discuss this with my colleagues. But congratulations on an intriguing piece of work.’

Gavin felt deflated. He’d expected a bit more enthusiasm from Ehrman, but told himself that this would probably come later when the company had had time to digest what he’d discovered. Frank Simmons wasn’t in his office when Gavin went to tell him about the call, but he returned shortly afterwards with Graham Sutcliffe in tow. ‘I thought you should tell Graham about your discovery,’ said Simmons. ‘It’s going to affect everyone.’

‘Sure,’ said Gavin, noting again the coldness in Sutcliffe’s eyes, although he was affecting a smile.

The three men sat in Simmons’ office while once more Gavin went through his work. Simmons looked to Sutcliffe for a response when he was finished.

‘Well, I must say, this is all very interesting,’ said Sutcliffe, giving the impression that he didn’t know quite what to say and needed time to get his thoughts in order — not that this stopped him talking. ‘Of course, I need hardly say... I must advise caution at this stage. These are lab results... and as such, are a world away from the human situation... or even animal trials... and as you yourselves say, they are also based on two drugs, one of which has already failed and another which has proved to be highly toxic...’

‘This is a brilliant finding,’ said Simmons.

‘It’s very encouraging,’ conceded Sutcliffe.

Gavin watched and listened to the verbal battle without contributing to it. Frank kept trying to ignite the flames of enthusiasm in Sutcliffe, while Sutcliffe kept dousing the fire with negativity.

‘This is the sort of thing that should be in your BBC programme. This is real breakthrough material,’ said Simmons, still trying to persuade Sutcliffe.

‘I take it you have informed Grumman Schalk?’ Sutcliffe asked Gavin.

‘I’ve just spoken to Professor Ehrman. He’s going to confer with his colleagues and get back to me.’

‘Let’s wait for that then, shall we?’

Seeing that Gavin was looking a bit down when Sutcliffe left the room, Simmons said, ‘The professor comes from a background where showing any kind of emotion is a no-no.’

‘Public school tosser,’ said Gavin.

‘Not exactly what I meant,’ said Simmons. ‘But perhaps something along those lines.

‘Don’t let it get to you, Gavin. Both Valdevan and the polymyxin drugs have already been through the trials and licensing process. They don’t need to go through it again to be used together or consecutively. It just needs Grumman Schalk to put Valdevan back into production and then the medics can try it out.’

Gavin cheered up noticeably.

‘Let me know when Max has been back in touch.’