Hypocrite's Isle

Sixteen

Gavin reappeared in Frank Simmons’ office shortly after 4 p.m. He looked ashen.

‘What’s wrong?’

‘I can’t believe it. Grumman Schalk say we should forget the whole thing.’

Simmons’ mouth fell open. ‘You have to be joking.’

‘They say that it’s probably just a lab artefact and that there’s no way they’d ever consider putting Valdevan back into production. Apart from that, they say that treating patients with polymyxin would be a non-starter because of the toxicity. The bottom line is that I should forget the whole thing and “move on”.’

‘No way,’ exclaimed Simmons. ‘What the hell are they playing at? Didn’t you tell them that it would only be a low dose of polymyxin that would be required?’

Gavin nodded. ‘Several times. They didn’t seem to want to know.’

‘This is crazy.’

A knock came at the door and Jack Martin came in with the new term’s seminar schedule. ‘Long faces,’ he said as he laid a copy on Simmons’ desk.

‘Sit down and listen to this,’ said Simmons. ‘We’ve just had Grumman Schalk’s response to Gavin’s discovery.’

Gavin told him what the company had said.

‘You’re kidding,’ exclaimed Martin. ‘Ye gods, you’d think they’d be jumping down your throat to get something like this up and running.’

‘I just don’t get it,’ said Simmons, getting to his feet and looking as if he didn’t know what to do with his arms. ‘How can one of the biggest drug companies in the world not be interested in curing cancer?’

‘Who did you speak to at GS?’ Martin asked Gavin.

‘Max Ehrman.’

‘Then it wasn’t as if you were speaking to the office boy.’

The three men lapsed into silence before Martin suddenly said, ‘Wait a minute; how old is Valdevan?’

‘I don’t know, maybe something like twenty to twenty five years since it first hit the market. Why?’ said Simmons.

‘It’s out of patent!’ exclaimed Martin, as if he’d just solved a particularly difficult crossword clue. The others just looked at him.

‘I’m trying to think like a businessman,’ explained Martin. ‘Apart from the obvious difficulties of trying to reintroduce a product that’s already failed, the drug’s out of patent. That’s why they don’t want to hear anything about it. Any company could make it now. They’ve no longer got the monopoly on Valdevan. It’s anybody’s to manufacture!’

Simmons looked at him incredulously. ‘You’re saying that they’re not interested in a potential cure for cancer because they can’t make money out of it?’

‘That’s about the size of it.’

‘What about saving lives? Doesn’t that matter to them?’

There was another silence in the room.

‘I’ve heard some stories about drug companies, but this is outrageous. We can’t let them get away with this,’ said Simmons angrily. ‘For God’s sake, their whole business is curing disease.’

Martin shook his head indulgently. ‘No, Frank, their whole business is making money and keeping their shareholders happy, just like any other commercial concern.’

‘Then we’ll hunt around and get another company to make the stuff if it’s out of patent like you say.’

Martin looked doubtful. ‘It’s my bet that none of them will touch it. They’ve got too much to lose. Think about it. What do you think will happen to sales of their current chemotherapy drugs if you go wiping out cancer with a compound that anyone can make? They all stand to lose a bundle. Incurable disease and chronic illness are big earners for the pharmaceutical industry, much more so than any condition they can cure.’

‘Couldn’t we get the government to make the stuff?’ asked Gavin.

‘That might be your only hope,’ agreed Martin. ‘Why don’t you guys talk to Unived? They’re supposed to be the bridge in this university between academic discovery and the wicked world of commerce, but you’d better keep Graham informed of what you’re doing. That’s one loop he wouldn’t care to be left out of.’

‘Thanks, Jack,’ said Simmons. ‘We’ll do that.’

Martin left to continue his rounds with the seminar lists, Gavin returned to the lab and Simmons picked up the internal phone book.

‘Unived. How can I help?’ asked a pleasant female voice.

‘This is Dr Frank Simmons at the med school. I need to speak to someone about some work one of my postgraduate students has been doing.’

‘One moment. I’ll put you through to Mr Chalmers.’

A pause, then, ‘John Chalmers.’

‘Mr Chalmers? I’ll come straight to the point. I think one of my students has come up with a possible cure for cancer. Can we talk?’

There was another slight pause before the reply came. ‘You know, I think I’ve been waiting all my career for a call like this.’

A meeting was set up for the following morning.

Simmons and Gavin drove over in Simmons’ car to the Unived offices on the university’s science campus at King’s Buildings. They made the journey in silence, in the aftermath of an early morning meeting with Graham Sutcliffe, who had appeared to be siding with Grumman Schalk. ‘It stands to reason that you can’t go injecting all sorts of failed rubbish and toxic compounds into people simply because you saw something in a test tube,’ he had maintained. ‘It’s far too early to go over the top about this. There are proper procedures to be followed, permissions to be obtained, trials to be set up.’

Simmons felt he couldn’t say what he really thought about Sutcliffe’s stance to a postgraduate student, and Gavin kept quiet for similar reasons of protocol, although he did permit himself the occasional sigh and shake of the head as thoughts of the meeting continued to prey on his mind.

John Chalmers, an overweight, avuncular man dressed in a smart suit and tie — in contrast to Gavin and Simmons in their denim jeans and open-necked shirts — welcomed them to his well-appointed office which, as Simmons noticed, was remarkably free of the clutter he was used to in his own office, and where venetian blinds offered striped shade from the morning sunshine. They were served coffee and Gavin was invited to tell all.

‘Sounds absolutely wonderful,’ said Chalmers. ‘A historic moment, you might say. But let me get this straight... neither of these drugs is new?’

‘They’ve both been around for a very long time,’ said Simmons. ‘It’s the way of using them that would be new, and the theory behind it.’

‘Mmm,’ said Chalmers. ‘So it’s not a new treatment we’d be selling... it’s a new technique... a new idea...’

‘We’re not interested in selling anything,’ said Simmons curtly. ‘We’d like to see the medics try this out as quickly as possible.’

‘Of course you would,’ said Chalmers, smiling indulgently as if the two men in front of him were babes in his particular wood. ‘But outside your ivory tower, chaps, things are different. Some of us have to live...’

‘In the real world. Yes, whatever that is,’ interrupted Simmons. ‘We just want this treatment to be given its chance.’

‘Of course, of course, I understand that,’ said Chalmers, holding up his hands. ‘But you must appreciate that it’s my job to protect the university’s financial interests in all of this. I would be failing in my job if I didn’t put certain safeguards in place. There are a lot of sharks out there.’

Simmons kept his tongue in check and Gavin managed to do the same, although the look in his eyes suggested it might be a close-run thing. ‘Of course,’ he said.

‘It seems to me that even if we have no right to patent any single component of the new treatment, there might well be a case for patenting the intellectual property — the idea if you like — but I’m no lawyer. I’ll have to pass this on to my colleagues, but I promise you I’ll do this as quickly as possible and get straight back to you. All right?’

‘I suppose it’ll have to be,’ said Simmons.

As they got into the car to drive back to the medical school, Simmons turned to Gavin and said, ‘Well done.’

‘What for?’

‘Not decking him.’

‘Only because I thought you were going to,’ said Gavin.

It brought the first and only laugh of the day.

It was Wednesday afternoon when Chalmers called back. ‘I’ve just had the report from our legal eagles. They think it might fly, but intellectual property is a tricky area. They’re going to have to refer the whole thing to specialist lawyers.’

‘Good,’ said Simmons. ‘How long will this take?’

‘Hard to say, but first things first, we need to get university approval for the application. Patent lawyers don’t come cheap. I’ll have to request the official go-ahead from Old College.’

‘Jesus,’ sighed Simmons. ‘And how long will that take?’

‘End of the week if I stress the urgency.’

‘I take it you heard that?’ Simmons asked Gavin who was sitting in his office. Gavin nodded. ‘Good to hear he’s going to stress the urgency,’ he said flatly.

‘Well, we’ll just have to grin and bear it. I suggest you go on with your experiments — establish the lowest doses possible of both drugs, and try to calculate the doses necessary to give to patients to achieve these levels. See what you can glean from old papers on polymyxin.’

‘Will do,’ said Gavin.

‘I’m going to try and persuade Graham to incorporate your stuff in the BBC programme. There’s nothing like a bit of publicity for concentrating people’s minds.’

It was late afternoon before Simmons could see Graham Sutcliffe, who had been acting as co-examiner in a PhD viva exam for one of the students downstairs. On hearing Simmons’ request he immediately voiced his reservations again, insisting that publicity would be premature and that proper procedures had to be followed.

Simmons listened politely until impatience overtook him and he interrupted. ‘I’m sorry, Graham, but you are missing the point here. Both Valdevan and polymyxin already have licences for human use — they’ve been through clinical trials and have been licensed for use both here and by the FDA in the USA. There is nothing to stop physicians trying this new treatment — if only they could get their hands on a supply of clinical grade Valdevan.’

‘Which Grumman Schalk have refused to provide.’

‘Exactly — and that’s why I’m asking you to include Gavin’s work in the television programme. We need to put pressure on the company. Public opinion can be a pretty strong weapon; it would level the playing field a bit.’

Sutcliffe appeared uncomfortable, but couldn’t think of a cogent argument against this. ‘I’m really not sure,’ was the best he could offer.

‘But you will consider it?’

‘We have until Thursday of next week before we have to agree the programme’s final format. I need hardly point out that if we were to incorporate Gavin’s work, someone else would have to stand down...’

‘How about Gerald Montague?’ said Simmons, almost immediately regretting letting his tongue run away with him.

Sutcliffe’s face darkened. ‘Gerald’s work on the temperature sensitive differences between tumour cells and healthy ones is showing great promise. Gerald Montague is a most distinguished researcher.’

Simmons remained silent.

‘I’ll let you know my decision.’

Simmons took this as his cue to leave. He stopped beside Gavin in the lab to say, ‘Graham will let us know about the TV programme,’ before going into his office and calling Jack Martin. ‘I need a beer.’

‘Drinking again?’ asked Jenny when her husband arrived home a little after seven.

‘Just the one, Constable...’

‘Lor luv us. Whatever’s going to become of me and the children?’ said Jenny, affecting a cockney flower-girl accent. ‘I take it Graham wasn’t too enthusiastic?’

‘He didn’t say no, but he would have liked to. I just don’t understand why everyone is being so negative about something that has the potential to be the first real breakthrough in years. It’s almost as if they see it as a threat.’

‘It is,’ said Jenny. ‘If you wipe out cancer, what are cancer researchers going to do? Thousands of people will be out of a job.’

Simmons, who obviously hadn’t looked at it in this way, stared at her for a moment before saying, ‘Jesus, I don’t even want to go there.’ He slumped down into a chair and held his head in his hands as he stared at the floor.

Jenny got up and stood behind him, massaging his shoulders. ‘Why don’t you take your shoes off and I’ll fix you a large whisky... which I bought instead of food for the children...’

Simmons put back his head and closed his eyes. ‘Time they were up chimneys anyway, earning their keep.’

‘How’s Gavin taking all this?’ asked Jenny, when they had finished their evening meal.

‘Pretty well, considering. He’s never exactly been a fan of the establishment, but I don’t think even he thought it could be this bad. He’s kept his cool this far, but he might snap if all this gets bogged down in the offices of patent lawyers.’

‘What about the TV programme?’

‘I might snap if they put in Gerald Montague’s crap instead of Gavin’s work. It’s our best chance of putting pressure on Grumman Schalk to start making Valdevan available again.’

‘What’s Montague’s stuff about anyway?’

‘He thinks tumour cells are more sensitive to heat than normal cells and has produced a million graphs and given a hundred seminars to show it.’

‘So, where’s he going with it?’

‘Nowhere, unless he intends dropping cancer patients in boiling water.’

‘But I take it no one will be pointing this out on the programme?’

‘You take it right,’ snorted Simmons. ‘His peers will nod sagely and pronounce the distinguished professor’s work to be extremely interesting.’

‘I hate to see you down like this.’

‘God, it’s ironic when you think about it. This is the sort of moment we’ve all been working towards for years. We could be on the very brink of a cure for cancer and we’re all at each other’s throats. Crazy.’

‘Let’s watch some shit television. It’ll take our minds off things.’

‘Look, Gavin,’ said Caroline. ‘I hate to say this, but maybe they’re right and maybe you are rushing things a bit? It doesn’t necessarily mean they’re dismissing the whole idea out of hand.’

They were talking at a table in Doctors. Gavin was rotating his beer glass constantly, in a nervous gesture which was beginning to annoy Caroline. She put her hand on his wrist to stop him.

‘You didn’t hear what Ehrman said.’

‘No, I didn’t — but if what Jack Martin says is true, about Valdevan being out of patent, Grumman Schalk are not in any position to have the final say anyway.’

‘Not on paper,’ agreed Gavin. ‘But he seemed pretty sure the other companies would toe the line, so it comes to the same thing in the end.’

‘A bit of publicity will soon put a stop to that.’

‘We’ll see.’

‘Cheer up, Gav. Nothing worthwhile ever comes easy, but when you publish your findings, the scientific and medical community will draw their own conclusions and start asking questions. A torrent of angry letters to the BMJ should help Valdevan make a comeback. And you could always canvass the support of the cancer charities.’

‘I think Frank’s pinning all his hopes on this BBC TV programme, but you’re right; it wouldn’t do any harm to have a backup plan.’

‘From what you’ve said, the main objections are that Valdevan didn’t work the first time around and polymyxin is toxic. The first is irrelevant — you were the one who showed them exactly why Valdevan didn’t work — and, in any case, you’re not trying to use it to kill tumour cells. The second is probably not valid because of the reduced dosage you’d be using. Actually, maybe it would be useful to demonstrate that?’

‘How?’

‘Ask for volunteers to take a reduced dosage of polymyxin, measure their blood levels to see if they’re achieving the level you need, and monitor them for side-effects.’

‘Why the hell didn’t I think of that?’ exclaimed Gavin. ‘It wouldn’t be like trying out a new drug, so none of the legal restrictions would apply. If no one showed any ill effects, it would scupper any objections along those lines. Brilliant!’

Caroline made an all-in-a-day’s-work gesture and asked, ‘What kind of reduced dosage are we talking about here?’

‘The sums say that a quarter of the normal dose should give a high enough level to kill off damaged tumour cells.’

‘That’s a big reduction, so there shouldn’t really be a problem. Want me to ask my classmates?’

‘That’d be brilliant. I’ll talk to Frank about this in the morning.’

On Thursday morning Frank Simmons was called to Graham Sutcliffe’s office. He was surprised to meet Jack Martin on the way and learn that he’d also been summonsed.

Sutcliffe seemed in a good mood when they entered, and Liz served up coffee with a knowing smile on her lips.

‘I’ve had a call from Grumman Schalk,’ said Sutcliffe, sitting back in his chair and making a steeple with his fingers. ‘It’s good news: nothing in black and white yet, but it seems we’re almost certain to get the block grant.’

‘Congratulations,’ echoed Martin and Simmons.

‘Congratulations to all of us, I think. This means a considerable expansion for our department and, as I mentioned at the outset, justification for the creation of two new personal chairs...’ Sutcliffe paused to give his words time to take effect. ‘I have decided that you two should be the members of staff to benefit from this. I take it neither of you would have any objection to becoming Professors Simmons and Martin?’

‘None at all,’ said Jack Martin.

‘I’d be honoured,’ said Simmons. ‘But I think I would still like your assurance that we will have the chance to debate the conditions attached to the Grumman Schalk award.’

‘You have it, Frank,’ smiled Sutcliffe. ‘All I ask is that you do not dig your heels in on a matter of principle and refuse to budge, without looking at things in the wider context. Consider the advantages as well as the disadvantages.’

Simmons nodded.

‘I must ask you to keep this under your hats for the moment, just until the paperwork appears and it all becomes official.’

‘Of course.’

‘That was a surprise,’ said Jack Martin as he and Simmons walked back along the corridor. ‘I thought we were in for some kind of bollocking.’

‘It’s the squeaky wheel that gets the grease,’ said Simmons.

‘What’s that supposed to mean?’

‘He’s buying us off. We’re the only two to have raised any question about Grumman’s editorial control over what we publish in future. Now it’s a case of keep your mouths shut and you’ll both get personal chairs.’

Martin let out a long sigh. ‘I think that’s going a bit far, Frank. Graham’s right about viewing everything in context. The block grant money will make an enormous difference to this place, and we are probably the two most senior members of staff.’

‘Maybe.’

‘Heard anything back from Unived?’

‘Maybe tomorrow.’

Simmons closed the door of his office behind him a bit more roughly than he’d intended, but it reflected his mood. He’d just been told that he was about to be made a full professor and he felt bad. He was angry at feeling bad when he should be feeling good and thinking of celebration, but the suspicion that he was being bought off just wouldn’t go away. Maybe it was him? Maybe he expected too much of other people? Maybe this was just the way the world worked? This line of thought only evoked memories of Mary lecturing Gavin on the subject, which didn’t help. He was glad when a knock came at his door. He needed distraction.

Gavin told Simmons about Caroline’s suggestion.

‘Good idea. I don’t see anything wrong in principle,’ said Simmons. ‘Although we’ll probably have to pay for the polymyxin and to have the blood tests done. I think we should probably bring in the University Medical Centre on this. We’ll need them to administer the drug, and they’ll probably want disclaimers signed, but if the dose is to be a quarter of what patients have been given before, I don’t foresee any great difficulty. I’ll ask them if you like.’

‘Thanks, Frank. I’ll start asking around for volunteers.’