Syndrome

Chapter 10

Monday, April 6

12:57 p.m.

Stone Aimes was floating through cyberspace, through the massive data pages of the National Institutes of Health. Since the Gerex Corporation had a complete clampdown on their clinical-trial results, he was attempting an end run. By going to the source, he was hoping he could find out whether or not Karl Van de Vliet's experiments with stem cell technology were succeeding.

He needed that information to finish his book, and he hoped that the remainder of the advance could be used to pay for his daughter Amy's private school in New York, if he got it in time. He was dreaming of a life in which she could come back to live with him at least part of the year. Sometimes, particularly days like this-Monday was his official day off-he couldn't avoid the fact he was incredibly lonely.

But first things first He had gone to the section that described the many and varied clinical trials the NIH had under way. Then he used "scrambled eggs," the entry protocol given to him by Dale Coverton, to circumvent security on the site and get him into the second-level NIH data files. He was hoping to find the names of patients who had gone through the Gerex stem cell procedure and could be interviewed.

It really wasn't all that difficult, or even-he told himself-unethical to get in this far. No big deal. Entry protocols were available to any high-level NIH employee who had the right security grade. Now he was poking through the reams of proprietary data that the Gerex Corporation had submitted to initiate the clinical trials.

It was one of the more ambitious studies he'd ever seen, not in numbers of patients necessarily but certainly in scope. They were indeed running stage-three clinical trials of their stem cell procedure on a variety of maladies. There was no double-blind placebo. You either were cured or you were not.

Jesus, it was incredible. They were shooting for nothing less than the unified field theory of medicine, aiming not just to patch some failing element of the human body but to regenerate entire organs. Among their stated objectives were building pancreatic islets, reconstructing the ventricles of the heart, reconstituting the damaged livers of individuals with advanced cirrhosis. They were also accepting patients with Alzheimer's and Parkinson's.

"Christ," he said, scrolling past page after page, "how come they're suddenly so secretive about this?"

If Van de Vliet had achieved results in just a fraction of those trials, it would herald the beginning of a new age in medicine.

The NIH monitor for the Gerex trials was Cheryl Gates, just as Dale had said. Her photo was featured along with the introductory description of the trials. Nice-looking, he thought, probably late thirties, dark hair, dark-rimmed glasses. She wasn't wearing much makeup in the photo, probably to emphasize how serious she was. Sooner or later, he told himself, he had to find a way to meet her. ..

He stared at his IBM Aptiva screen a moment longer, overwhelmed at what he was seeing, then got up and walked into the kitchen and made a peanut butter sandwich, whole wheat. It was a rehearsal for the possibly hard times to come. Then he retrieved a Brooklyn Lager from the fridge. It was his day off and the sun was over the yardarm.

He lived on the fourth floor of a brownstone in Yorkville, in New York's East Eighties. The apartment was small, but it was rent stabilized which meant he was paying well under market value-$1,128 a month on a place that probably could go for close to twice that on the open market. He'd lucked into it after he and Jane split-even though they weren't married they'd bought a condo in the West Fifties, and at the breakup they'd switched the mortgage to her name-but the problem now was, how was he going to pay even this piddling rent (not to mention child support for Amy) after he got fired from theSentinel? That day, he sensed was fast approaching. And if it happened before the book was finished he was just three months away from going back to freelancing. That was how long his "nest egg" would last.

Carrying the sandwich and beer, he walked back to his "office," a corner of the cramped living room that had an Early American desk, and sat down at the frayed chair in front of his IBM.

So here he was, past the first level of security of the NIH site, zeroed in on the Gerex clinical trials. Somewhere here had to be all the data about the patients who had been, and currently were, participating.

He moved on to the results section and opened the first page.Yes.

Then he looked more closely.

Hello, we've got a problem.The patient data he was looking at had only code numbers for names. The categories of trials also were just numbers. Without a key, there was no way to get a single patient name or differentiate Alzheimer's from fallen arches. Then he saw the notice at the top of the page: As part of the NIH policy on privacy, all patient data are aggregated and anonymous.

Shit.

This was as far as "scrambled eggs" would take him. He needed a higher security protocol to get into individual-case data. Dale either didn't have it or didn't dare give it out.

Well, he thought, at least I've got information on the structure of the clinical trials. I should print that before the system realizes it's been hacked. He clicked on the print icon.Let the games begin.

His real objective was to try to wangle an interview with Karl Van de Vliet, an interview that would have to be approved by Winston Bartlett. Maybe what could be gleaned from this level of the NIH site would be enough to bluff Bartlett into thinking he knew more than he really did. In truth, interviewing discharged patients would have meant anecdotal information, probably not rigorous enough for use in a definitive book. But at the moment, that would have been a start.

He lifted the first printed page and studied it.

Stone Aimes had seen enough clinical trials over the years to know that the data were reported according to an established schedule. Obviously, the schedule was always adapted to fit the nature of the trials under way, but studies that produce the kind of short-term results Gerex hinted at in their early press releases-before they clammed up-would probably have a tight reporting schedule, possibly even weekly.

He stared at the page for a moment, then lifted out another. He wasn't sure just yet what it all meant, but he might be able to infer something. He was still puzzling over the columns of numbers as the data finished printing.

What was it telling him?

He went back and clicked onstudy procedures. This section explained how the reporting was structured. He still held out hope that the names of the discharged patients in the clinical trials could be accessed somehow. In the past, when the FDA tested drugs, it often happened that the names of the participants were not revealed to the monitor, or to anybody. The policy was intended to preserve the privacy of study participants. But lately it had been under review. All that secrecy and non-accountability had permitted some spectacular fabrication of test data.

Surely the NIH had taken this into consideration by now and come up with a system whereby the identities of the participants could be checked and verified. That information had to be stored somewhere.

No such luck. It appeared the NIH had begun using a modified version of the new FDA sunshine policy. NIH clinical trials had a "one week of sunshine" provision, during which the suitability of test subjects could be evaluated by a review procedure. During that time, their real identity was in the database. But after that, the identity information of any patient actually selected for inclusion in the clinical trials was encoded-where thenceforth it could only be accessed through a lengthy legal process.

Screwed again.

At this late date, the Gerex Corporation surely was not going to be adding any new names and giving them that week of sunshine. According to press releases at the beginning of the clinical trials, when Gerex was a lot more communicative, at this date the entire study should be just days away from being wrapped up.

He went back to the patient files one last time, out of frustration. As he continued to scroll, he noticed that although the identities of patients and crucial personal data were encrypted, thedateson which they entered and finished the trials were all supplied.

Hmmm. It was actually more detailed than that. There were dates for when a patient entered each stage of the procedure: Screening, Initial Evaluation, Admitted into Program, Procedure Under Way, Procedure Monitoring, Results Evaluation, Patient Release, Patient Follow-up.

The time between screening and patient release averaged around five weeks, six weeks at most

Looking at the time-sequenced data, you couldn't avoid the conclusion that the clinical trials had been a spectacular success. No doubt the specific data would reveal whether there had been any adverse reactions, but as clinical trials go, these seemed to have been without major incident. He had a nose for trouble, and these looked as rigorous as clockwork. .

Hold on a second. . That’sodd.

What the data structure did not have was a category for Termination. Yet one of the patients had been listed with dates leading up to and including Procedure Under Way, but after that the patient was noted parenthetically as having been "terminated." That was all the information given.

What couldthatmean?

He leaned back with a sigh and pulled on his Brooklyn Lager. Okay, patients frequently got dropped from clinical trials because some underlying condition suddenly manifested itself and made them unsuitable trial subjects. In fact, that was preferable to keeping them in a study when they were no longer appropriate. But the thing about clinical trials was, there always had to be a compelling, fully explained reason for terminating a test subject. Otherwise you could just "terminate" non-responsive participants and skew the results. No reason was given here.

He thought again about the "one week of sunshine," and as a long shot checked to see if anyone had been admitted this week.

Nada, but again that was reasonable. The entire study was wrapping up.

Which meant, in short, that he had nothing to work with in terms of people. All he had were dates and encrypted names.

What now?

He finished the beer and was preparing to go off-line when a drop-down screen flickerednew data.

He was being directed to the new applicants' "sunshine" page.

He clicked back, then stared at the screen.

A name had appeared.

He couldn't believe his luck. For some unknown reason, they must still be adding new test subjects at this late date in the trials.

nina hampton.

Finally he had a name. This was an incredible stroke of. .

Wait. A second name was appearing now, the letters popping up one by one as they were being typed in.

He rolled the mouse to print, and felt his hopes surge.

Then his heart skipped a beat. The second name was. .alexa hampton.

Jesus, could it be?

No way. Too big a coincidence. Butwait, the other was Nina Hampton. Isn't that the name of her Brit mum? That unredeemable piece of work.

Impossible.

If it was the Ally Hampton he knew, she was a woman he still thought of every day. It went back to when they were both undergraduates. She was taking a degree in architecture at Columbia and he had just switched from premed to the Columbia School of Journalism.

Wasn't there a Cole Porter lyric about an affair being too hot not to cool down? They undoubtedly were in love, but they both were too strong-willed to cede an inch of personal turf. It was a combustible situation.

When they decided to go their own way, it was done under the agreement that they would make a clean break and never see each other again.Be adult and hold your head high and look to the future.No recriminations and no second thoughts. In respecting that agreement, he had gone out of his way not to keep track of her. He particularly didn't want to know if she'd gotten married had a family, any of it.

Thinking back now, he remembered that she had had some kind of heart condition. She refused to talk about it, and now he couldn't remember exactly what it was. But that could possibly explain her entry into the clinical trials, though it didn't clarify why she was only being added now, at the last minute.

If it was actually her.

And if so, how would he feel talking to her? He hoped time had mellowed her, though he somehow doubted it. Not Ally.

What an irony. If it was the same Alexa Hampton, she could end up being his entree into the secretive world of Winston Bartlett's Gerex Corporation. The trouble was, he wasn't sure he actually wanted to see her again. Even after all the years, the wounds still felt fresh.

He closed out the NIH file and opened People Search, which he often used to look up phone numbers. He started with New York State as a criterion. The names Alexa and Nina undoubtedly belonged to women, so they might be listed merely by their initials. But start with Alexa and be optimistic.

He got lucky. Three names and phone numbers popped up.

One was in Manhattan, and Ally was a dyed-in-the-wool New Yorker, but he wasn't sure he was psychologically prepared to speak to her. That number he decided to save for last, though it was by far the most plausible.

The next Alexa Hampton lived in Syracuse, with area code 315. He was still shook up as he dialed the number.

"Yeah, who's this?"

Sure didn't sound like Ally. But he was playing this straight. As a reporter he always started a conversation by identifying himself, so naturally he answered, "Stone Aimes, New YorkSentinel."

"The fuck you want?" came the voice. It was female but it definitely was not ladylike. "I don't need any newspapers."

Whoa, thatdefinitelydidn't sound like Ally. She was direct but she didn't talk like a sailor.

"Sorry, ma'am. I have a few questions about your participation in some clinical trials. Sorry to bother you, but I have a deadline. Shouldn't take a minute."

"You a fucking reporter?"

"I'm doing a story on the Gerex Corporation. Are you-?"

"Thewhatcorporation? The fuck you talking about?"

"Seems like I'm calling the wrong number. I'm very sorry and I apologize."

"Listen, if you're some kind of weirdo, I'm going to call the cops and have this call traced."

"I said I apologize." He hung up and thought about another beer. This was beginning to feel like the moment.

But he resisted the urge and called the next number. Come on. Be the right one and don't be Ally.

This one had a 516 area code. That meant Long Island.

"Hello," came a rusty old voice that had to be in its seventies. It sounded over-smoked and just hanging on. Again definitely not the Ally he knew.

"Hello, ma'am," he said "I'm sorry to bother you, but-"

"Are you trying to sell me something, young man," the woman asked. "It's not going to do you much good. I live on a Social Security check, and it's all I can do to make ends meet as is. You sound nice, but-"

"No, ma'am, I'm a newspaper reporter. I'm doing a story on … I just wanted to follow up on your admission to the clinical trials for the Gerex Corporation." He felt a surge of hope. It wasn't Ally, but she did sound like a woman who might well be a candidate for medical treatment. "Do you know what day you plan to start?"

"What on earth are you talking about?" she asked. "Young man, it's ill manners to start asking a body silly questions, no matter how nice you might be otherwise. I've never heard of this, whatever you called it, corporation." Click.

She sure didn't sound like a patient. Or maybe she was too far gone to even know if she was a patient or not. In any case, this was not a promising lead.

Okay, he thought,go with the one you should have in the first place.

Blast. He wanted this to be the one, but he just didn't want it to be Ally. Or maybe he did.

He took a deep breath and punched in the last number, which had a Manhattan area code, 212. The phone at the other end rang five times and then an answering machine came on. At this hour, she would most likely be at work.

"Hello, this is Alexa Hampton. I'm sorry I can't come to the phone now, but if you'll leave your name and number, I'll get back to you as soon as possible. If you're calling about design work, the number of CitiSpace is 212-555-8597."

He felt his heart flip, then sink. It was Ally. It was a voice he had heard for years in his reveries-or were they the nightmares of roads not taken?

She still might not be the new patient in the clinical trials, but at least he knew he could reach her.

The sound of her voice. After all this time he didn't realize it would still affect him the way it did.

So, he thought, clearing his head,she's running a design business now. He wondered how that had happened. The last time he saw her, she was a single-minded student of architecture. Intensely focused.

No message. Don't leave a message. It probably would freak her out.Actually, it might freak them both out.

Assuming she was the new patient, how the hell did Ally get involved with Winston Bartlett? It probably would have something to do with that heart condition she didn't like to talk about.

He clicked off the phone and settled it onto the desk. Then he glanced again at the computer screen and decided to go back to the NIH files. The other woman, Nina, he would look up later. Ally's Brit mum must be getting on by now, but still it was hard to imagine anything being wrong with her; as he remembered Nina, the woman was well nigh indestructible.

When he got back to the NIH Web site and went to the "sunshine" page, it was again blank. The two new names, Nina Hampton and Alexa Hampton, were not there anymore. They must have been entered immediately into the clinical trials. But why now? If Van de Vliet kept to the original schedule, the trials would be over in a matter of days.

Maybe, he thought, this was a momentary screw-up. I just happened to be at the right place at the right fleeting moment, when somebody, somewhere, was entering those names. Maybe some NIH bureaucrat hit the wrong key on a keyboard someplace in Maryland.

But it was the break he'd been waiting for.

He turned off the IBM and headed for the fridge and another Brooklyn Lager. Ally, Ally, Ally. Can it be you?This is so weird.

Worse than that, it was painful. There was that immortal line fromCasablanca: "Of all the gin joints in all… she walks into mine."

Why you, dear God?

Coming back, he sat down, took a long hit on the icy bottle, and reached for the phone.