Ordinary Thunderstorms

39

BURTON KEEGAN POURED SOME more Scotch into Paul de Freitas’s glass.

“I really shouldn’t,” de Freitas said, “but I think I should.”

“You ready?”

“Let’s go for it.”

They were in Burton’s office on the top floor of his Netting Hill town house, under the eaves with a good view down dusky Ladbroke Grove. This was where he kept the scrambled phone line. Both men’s wives were downstairs in the kitchen clearing up the remains of supper.

Burton dialled Alfredo Rilke’s private number, feeling his mouth go dry, and his shoulders tighten. It never became any easier — there was always that element of apprehension, of the unforeseen, when you talked to Alfredo — even after ten years of experience of working with him, working with him closely. He was twenty seconds early from the appointed time to call.

“Burton,” Rilke said, “good to talk to you. How’s the weather in London?”

“Surprisingly good.” Burton felt his hands begin to sweat — banter was always a bad sign. “I’ve got Paul here with me. Can I put you on speaker?”

“Sure. Hi, Paul. How’s the beautiful Mrs de Freitas?”

“She’s excellent. How are you, Alfredo?”

Too familiar, thought Burton, anxiously.

“I’m still waiting, actually — waiting for news from you guys,” Rilke said, the tone of his voice changing. Burton made a zip-your-lip sign to de Freitas.

“We have a slight problem with Ingram,” Burton said. “He knows about my meeting with Philip Wang on that last day. I think he thinks he’s on to something.”

There was a long pause from Rilke and Burton began to massage his neck.

“Does he have any idea what was discussed at that meeting?” Rilke asked.

“No. I told him Philip was delighted, was pressing for accelerated approval from both agencies, US and UK.”

“I want you to be extremely nice to Ingram until this is all over. Got that?” There was real edge in his voice now. “What made him suspicious? Is it something you did?”

“I’m always extremely nice to him,” Burton said, not answering the question. “I just don’t think he likes me.”

“Then make him like you. Apologise, keep him sweet. What’s happening your end?”

“Things are good,” Burton said. “We have our guys talking up Zembla-4 to all the important people. We’re arguing compassionate use.”

“We’re confident we’ll get priority status,” de Freitas chipped in. “Did you see the latest WHO report on asthma? People need Zembla-4. Couldn’t be better timing.”

Burton was regretting pouring him that extra Scotch — you just didn’t become garrulous with Alfredo Rilke.

Burton jumped in. “We think the compassionate use, accelerated approval principle is unanswerable. Some of those AIDS drugs were approved in months, weeks.”

“What about post-marketing studies?” Rilke said. “Funded by us. You should have all that in place.”

“We have,” Burton lied. He forgot, very rarely, that Rilke knew more than anyone when it came to pharmaceuticals. He made a note on a pad: ‘post-marketing studies’. He should have thought of that himself. It was obvious — compassionate use, accelerated approval, licensee-funded post-marketing studies. It all fell into place — in theory.

“Children are dying,” de Freitas said, ignoring Burton’s finger held to his lips. “The data is enormous, exemplary, Alfredo, magnificent. Everything’s ready.”

Rilke was silent again. Then he said: “Run out the first advertorials next week.”

“Should I tell Ingram?”

“I’ll tell him.”

“What about the PDA?” Burton asked. “Are they happy with the European trials?”

“I think so,” Rilke said. “Our people are very close — close to people who are close to people: though nobody knows how close anyone else is to the other. The word is that they seem happy. So,” he paused. “Submit for approval, simultaneously, after the ads have run for a month.” Burton and de Freitas looked at each other, eyes wide. “Then we want the opinion pages.”

“Consider it done.” Burton saw the logic, clearly. “Everybody’s ready.” Announce the impending wonder drug, have people start talking about it, have journalists write articles about it, then asthmatics will start asking their doctors for it. There are millions upon millions of asthma sufferers out there — a powerful lobby, exerting a lot of pressure. Nobody will want to be seen dragging their feet, no bureaucratic impediments, niggling rules and regulations preventing relief from awful suffering, saving children’s lives.

“We’ll get right on to it,” Burton said. “Have a good even—”

“Just one thing.”

“Sure.”

“Did they ever find this Kindred guy? It’s the one factor that disturbs my peaceful sleep. He could ruin everything.”

“We’re closing in, is my latest report. He was seen in London a matter of days ago. We have a new description. A new name he’s been using. It’s just a matter of time.”

Now Rilke’s silence grew ominously long.

“This is just not good enough, Burton.”

The rebuke was devastating even though Rilke’s tone was mild. Burton felt the air leave his lungs and his guts contract. Somehow he managed to say, “I’m sorry. We just can’t explain how Kindred—”

“How many times do I have to ask for this? Prioritise it. Call your people.”

They said their goodbyes. Burton felt nauseous. He knew his hands would shake if he held them out.

“Why’s he so obsessed with Kindred?” de Freitas asked, oblivious, with all the confidence of the nearly drunk. “What can he do to us? It’s all too late now, isn’t it?” He put on a bad cockney accent: “Kindred is toast, mate.”

“Yeah,” Burton said vaguely. But he was thinking: that’s the first time in ten years I’ve heard Alfredo Rilke sound worried. That was serious. “I’ll see you downstairs, Paul,” he said. “Take the Scotch with you.”

De Freitas left and Burton thought back to that afternoon’s meeting with Philip Wang…Nice, mild, clever, plump Philip Wang in a shivering incoherent rage, his voice shrill, threatening to bring everything down on their heads — the deaths of children, cover-up, manipulation of research data. The trials would end, he’d go to the FDA himself, he didn’t care. Philip Wang’s fury as he had listed the abuses was almost as if it were driven by the death of one of his own children. Burton had stalled, but it was alarmingly clear to him that Philip Wang had independently figured out almost everything that had gone on in the Zembla trials — indeed, he was even impressed by Wang’s detective powers, in an unhappy, panicky way, feelings that he managed quickly to control.

Philip had said that it was certain aspects in the ‘adverse event reports’ that had first alerted him: compulsory reports that logged patients dropping out of the trials because of certain seemingly mild side effects: shortness of breath, temporary fever. This appeared odd to him — Zembla-4 being so benign — so he had decided to investigate further, personally, and when he had visited the four hospitals and looked through the clinical records in detail he had discovered to his intense shock that of the several dozen drop-outs (perfectly normal figures in a trial of this size) fourteen had later died in intensive care.

“Those deaths were unrelated to Zembla-4,” Keegan had said at once. “They were very, very sick children in the first place, remember. We’ve treated thousands of children with Zembla-4 over the last three years. There is no statistical significance.”

“I know what’s happening,” Philip had said. “This is Taldurene all over again.”

“Those Taldurene deaths are still disputed,” Keegan said, hoping he sounded convincing. He knew the case — everybody in the Pharma world knew the case: five out of fifteen patients had died from renal failure in a particular phase-three Taldurene trial — everyone assumed that, because the patients already had hepatitis, the deaths were nothing to do with the drug they were testing. Turned out they were wrong.

Wang would not be appeased, reminding Keegan that the de Vere Wing children’s trials had not been his idea. “It’s not just children who suffer from asthma,” he said, “I wanted across-the-board population studies. I’m not developing a drug that’s just for children.”

“And you got them. The Italian and Mexican trials are exactly that,” Keegan said. “We just thought that in the UK we might—”

“You just thought you’d go flat out for accelerated approval, priority status of Zembla-4. Choose a niche group — children. Show genuine medical need. What can the PDA do? I know how it works.”

“I’m surprised you’re so cynical, Philip.”

Wang had lost it again at that stage and had begun to detail, very skilfully, the components of the cover-up, explaining how parents, nurses and doctors in the de Vere wings could never have made the connections, how they would think, even in the face of these rare individual deaths, these particular family tragedies, that nothing was untoward. The de Vere staff were just administering, supervising and supplying data. Calenture-Deutz was analysing, collating and categorising it. A very sick child became ill and was logged as a drop-out from the trial, not a death. The deaths were part of any hospital’s inevitable, grim body-count. The trials continued unaffected.

“What were the signs?” Wang had taunted him. “What gave you those four or five days’ notice? Something was telling you. How could you move them out of the de Vere wings so quickly? That’s what I want to know. What was Zembla-4 doing to them?”

“I haven’t a clue what you’re talking about,” Keegan had said. However, he had conceded that there might have been some bureaucratic foul-up and feigned his own quiet outrage.

“Look, I’m as unhappy as you, Philip. We’ll investigate, we’ll triple-check again, we’ll get to the bottom of this…Everything goes on hold from this second, everything, until we discover what’s happening…” He had spoken on, continuing to reassure, praise, to promise retribution if there had been any sign of manipulation until he saw Philip calm down, somewhat mollified. They had left each other, not exactly as firm friends once again, but with a handshake at the door.

He had called Rilke immediately Philip had left. Rilke had listened and had told him, quietly, emphatically, what had to be done, now, with no delay — who to call and what precise words to use.

Burton now experienced a sense of deja vu as he picked up the scrambled phone and punched out the number.

“Hi,” he said to the woman who answered, “I’d like to speak to Major Tim Delaporte, please…Yes, I know it’s late but he’ll want to talk to me…My name’s Mr Apache. Thank you so much.”