The Devil's Landscape

Two

Sir Robert Dalrymple, secretary to the government’s bio-research grants committee, got to his feet and looked around the table, checking that all expected were present before calling the meeting to order.

‘Ladies and Gentlemen, thank you all for coming although I have to say that I am the bearer of not very encouraging news. I’m afraid the treasury has been even less generous than we anticipated this year.’

There were groans and looks of exasperation were exchanged, but Steven and Macmillan remained impassive: they had expected little else.

‘The chancellor has resolved to keep a tight rein on spending and research funding is to be no exception. You will be aware that major annual research council funding has already been frozen at its current level and we thought that supplementary funds might suffer a similar fate. Unfortunately, we have been cut by a further ten percent.’

‘But there’ll still be enough cash for Trident submarines and Middle Eastern wars,’ said Sir Nigel Carter, a distinguished-looking, white-haired man representing the interests of cancer research.

Dalrymple did not respond.

‘All that public posturing about how important health care is and in reality, our hands are being tied behind our backs,’ said the scientist representing genetic engineering interests, Sir Keith Walman.

Once again Dalrymple took it on the chin and said nothing, choosing neither to argue nor agree — a Whitehall speciality.

‘What will this mean in practice?’ asked Professor Simon Laing from the UK Stem Cell Research Monitor.

Dalrymple took a deep breath and made a weak joke about not shooting the messenger then paused as if about to announce the winner of an Oscar.

‘The committee has decided that Sci-Med’s request that the government actively engage with drug companies to introduce a vaccination programme for the general public to provide protection against agents likely to be used in biological attack... be declined.’

Macmillan nodded and exchanged a look with Steven who risked a small smile.

‘The application from Professor Dorothy Lindstrom for funding to continue and expand her work on epigenetic control mechanisms... has also been declined.’

‘Totally?’ exclaimed Lindstrom clearly taken aback.

‘I’m afraid so.’

‘What short-sighted stupidity. Unbelievable.’

Dalrymple seemed momentarily startled but decided to ignore Lindstrom’s outburst and continued. ‘The supplementary grant to cancer research will remain at its current level.’

Sir Nigel Carter nodded and accepted the decision without comment but Dorothy Lindstrom was reluctant to retire from the fray. ‘Why?’ she demanded.

Dalrymple recovered quickly from his obvious surprise. ‘I’m sure I need hardly remind you that cancer is a major killer in our country, Professor.’

‘It’s a major killer in every country,’ said Lindstrom. It has been for a very long time.’

‘Your point, Professor?’

‘Isn’t it about time they cured it rather than gobble up money sine diem?’

‘Oh, come on, Dorothy, you know it’s not that simple,’ protested Carter. ‘We have been making real progress.’

‘No, you haven’t,’ retorted Lindstrom, something that brought gasps from round the table.

Carter was becoming agitated. ‘The cancer figures are plain to see. People are living longer and longer. No one disputes that.’

‘People are living longer and longer with cancer,’ said Lindstrom. ‘You’re keeping people alive for longer and longer with cancer. Their quality of life can be poor to bloody awful but that doesn’t appear in your figures, does it? Quality of life never does. The bulk of your research is concerned with diagnosing the disease, telling us what causes it, screening for it, everything but curing it! You’ve got money streaming in from slick advertising which costs a bundle and makes people feel guilty if they don’t start shelling out on a monthly basis or running a marathon backwards dressed as a blooming kangaroo and you still want more!’

‘Professor Lindstrom, I know you are disappointed but I really must ask you to desist,’ Dalrymple intervened.

‘I’m not disappointed; I’m furious and I hoped I might be allowed to put my point of view,’ said Lindstrom.

‘You’ve certainly done that, Professor. We must move on.’

Dalrymple shuffled papers in front of him unnecessarily, still reeling from what had happened. ‘The committee has decided that funding for therapeutic genetic engineering be held at its current level.’

‘Why?’ interjected Lindstrom.

‘Really, Professor. This is completely unprecedented. The committee is under no obligation to explain its decisions to anyone... but I will tell you that it felt that the putative treatment of disease by genetic engineering techniques continue to be given a priority rating.’

‘A priority rating,’ repeated Lindstrom quietly. She took a moment before saying in deliberately controlled fashion. ‘Science discovered the gene for cystic fibrosis in 1979. Money poured in to fund a genetically engineered cure and here we are in 2014 no further forward apart from having a regiment of scientists on the CF payroll.’

‘That is monstrously unfair,’ said Walman. ‘The problems involved in inserting a replacement gene are enormous.’

‘That’s an excuse for failure not a claim for success,’ retorted Lindstrom. ‘You may never come up with a suitable vector.’

‘That’s not a reason for stopping trying,’ said Walman, clearly rattled.

‘No, it isn’t,’ agreed Lindstrom. ‘But it is a reason for reconsidering priorities before they become traditions,’ she added with a glance towards Carter.

‘If I may be allowed to continue...’ said a clearly stressed Dalrymple, raising his voice to overcome the hubbub. ‘The committee has granted a ten percent increase to the stem cell research budget.’

‘Quite right too,’ said Lindstrom to Dalrymple’s obvious relief. ‘It’s our brightest hope.’

‘I’m glad you concur, Professor,’ said Dalrymple.

Simon Laing nodded his satisfaction. ‘Not as much as we’d hoped for, but in the circumstances, very welcome.’

Carter, still smarting from Lindstrom’s attack, said, ‘Perhaps Professor Lindstrom would be good enough to tell us why she considers her work more important than research into cancer and genetic engineering?’

Walman nodded his approval of the question.

‘Because it’s new and I know where I’m going with my research. Your people are going up side streets, around in circles, doing the same things over and over again because of a lack of vision. It’s fresh ideas you need not more cash.’

‘Whereas,’ said Walman angrily, ‘piddling around with what makes us happy, and what makes us sad is really important?’

‘It’s a start,’ said Lindstrom evenly, ‘but my research group have come a bit further than that. We accept we can’t make changes to the human genome when there are copies of it in nearly every cell in the body but it’s becoming clear that we can exercise control over it and we’re coming ever closer to learning how to turn genes on and off. We’re pretty sure we know why placebos work. It’s not magic; it’s the epigenome in action, the switchgear working. When one patient is given a drug and another a sugar pill and both get better it’s the belief that he had been given an appropriate drug that triggers the response in the placebo patient. It’s not a positive attitude in itself that helps patients deal with illness and overcome it, it’s the genetic switches that are thrown when a patient develops one. There’s a genetic reason why certain people have photographic memories and others not. There’s a genetic reason why some autistic savants can perform the most amazing calculations and others sit down and play a Beethoven sonata on the piano after hearing it for the first time. It’s all down to the switches and we are homing in on them. We may all have these abilities within us; it could just be a matter of learning how to throw the switches and in the right order.’

‘Or not,’ said Carter sourly.

‘Mind over matter,’ said Walman with a shrug of disbelief.

‘You’re right; it is mind over matter,’ said Lindstrom. ‘But what we have to do is translate the vagaries of mind into actual chemical reactions, identify them and simulate them.’

‘That does indeed sound an exciting prospect, Professor,’ said Dalrymple, attempting to mend fences. ‘I’m truly sorry that the committee could not see their way to offer support at this stage.’

‘No matter,’ said Lindstrom, getting up to leave, ‘I’m sure not all grant-funding bodies will be so short-sighted.’

‘Ouch,’ whispered Steven as this was taken to signal an end to the meeting.

‘Well, what do you think?’ asked Steven as he and Macmillan walked through to where coffee was being served.

‘She’s a formidable woman... but not exactly a sad loss to the Diplomatic Corps.’

‘Do you think she’ll find alternative funding?’

‘I suspect you’d have to be closer to finding these chemical switches before the pharma companies come on board, but it would be pretty wonderful if they could do it,’ said Macmillan. ‘Imagine being able to cure debilitating conditions through triggering a switch.’

‘I’m beginning to feel gutted she didn’t get support,’ said Steven.

‘Didn’t you say she had some?’

‘The drug company which paid for her relocation from the states gave her start-up money for the first year, but they would be counting on government cash appearing. I can’t see them picking up the tab much longer unless Lindstrom’s people were suddenly to hit the jackpot.’

‘How about the university helping out?’

‘No chance. Universities are like sponges. They would have been expecting grant money too so they could mop up a large chunk of it for providing accommodation and basic services. Now that there isn’t to be any... well, who knows?’

‘Life’s rich tapestry,’ sighed Macmillan. ‘Why don’t you see what the feeling is in the Lindstrom group? I noticed Dorothy wasn’t alone this morning.’

‘Good idea,’ said Steven, looking across the room to where Dorothy was making sure no one was left uncertain of her point of view. He saw the young man who had been sitting beside her earlier detach himself and head for the sandwich table. He walked over to create a chance meeting.

‘Steven Dunbar,’ he said with a smile.

‘Owen Barrowman.’

The pair shook hands.

‘Bad luck this morning,’ said Steven.

‘You too,’ replied Owen Barrowman, picking and choosing to fill his plate ‘I noticed you came up empty handed too.’

‘We’re used to it,’ replied Steven. ‘One day soon I might just buy a lance and start looking for windmills.’

Barrowman grinned and Steven added, ‘Happily, we weren’t looking for grant funding to continue our existence. We were trying to get the government to take public vaccination seriously. Your situation seems more precarious.’

‘You’re right,’ agreed Barrowman. ‘We were all hoping for government money. Everything depended on it. Jobs, careers, degrees, mortgage payments, you name it.’

‘For what it’s worth, I’m truly sorry you drew a blank. It sounds like a really exciting field to be in right now.’

‘If only the suits could see that too. I don’t think anyone saw a complete turn-down coming, least of all, Dorothy. I thought someone with her credentials was a cert for funding.’

‘Have you been with her long?’

‘I joined her group when she returned to the UK from the states. I did my PhD on epigenetics at Edinburgh and was looking around for a post-doc position, which would allow me to continue my own research interest but without much success when I read that Dorothy had moved into the field and was looking for people to join her. It sounded just right for me.’

‘For her too I should think,’ said Steven. ‘PhDs in epigenetics can’t be too thick on the ground.’

Barrowman grinned. ‘Yeah, well I guess it looked like working both ways. I thought I’d landed on my feet: now I find it was my backside.’

‘You said, continue your research?’

‘Most advertised post-doc positions are to work on specific projects, which is fair enough, but I was hoping for one that would allow me to continue what I’d started during the last year of my PhD project. My old PhD supervisor got me a small grant for six months to tide me over until Dorothy arrived from the states.’

‘So, what are you studying?’

‘Genetic and biochemical patterns in psychopathic killers.’

‘Are you serious?’

‘Absolutely.’

Steven was taken aback. ‘How on earth do you do that?’

‘I got the university to approach high security prisons and prison hospitals across the country with a view to me interviewing selected prisoners — those convicted of murder while classed as criminally insane — hoping to recruit them as volunteers in my project. They would have to provide lab samples for analysis.’

‘And they agreed?’

Barrowman smiled. ‘It took a while to get through all the red tape but, in the end, all the prisons agreed although not all prisoners did, but I’ve managed to get a reasonable number to provide blood, buccal swabs etc.’

‘I take it Professor Lindstrom was happy for you to continue this line of research?’

‘I wouldn’t say she was over the moon but she wanted someone to bring her new people up to speed in the latest epigenetic techniques. It’s worked out well.’

‘Dorothy’s goal is to understand everything connected with human behaviour.’

‘Is that your goal too?’

‘I’m more specific,’ said Barrowman. ‘I’d like to find a cure for psychotic behaviour.’

‘That’s a pretty high bar too,’ Steven pointed out. ‘I’m impressed. Seriously, this field is just too important to be ignored. It can only be a matter of time before support appears.’

‘I hope you’re right, but I’m beginning to suspect that the people Dorothy upset in the past might be thinking it’s payback time. She’s not the easiest person to get along with.’

‘We should keep in touch, maybe have a beer some time,’ said Steven. ‘I’d like to know more about your work.’

The two men exchanged contact details.

Steven and Macmillan walked back across Green Park.

‘You two seemed to get on,’ said Macmillan.

He’s gutted that the group didn’t get funding when he’d gambled that they would. He’s at that time in his career when he needs to get a few good publications out there to establish himself as a researcher and start thinking about a lectureship somewhere. I think he’s worried that there might be some kind of vendetta against Dorothy.

‘Mm,’ said Macmillan non-committally. ‘I’m having lunch with a couple of ministers tomorrow. I’ll see what I can find out.’

‘Good, we agreed to keep in touch.’

It was just after six in the evening when Steven got back to Marlborough Court to find that Tally hadn’t yet arrived home. He made himself coffee and stood at the window, catching glimpses of the Thames river traffic through the gap in the buildings across the street while he considered the events of the day. He was feeling numb and wondering why this should be when the sound of Tally coming in broke his train of thought.

‘Well, how did it go?’ she asked, dumping her bag on a chair and shrugging off her coat. ‘Is HMG going to take up the challenge and offer the public protection at last?’

Steven shook his head. ‘They turned us down.’

‘I’m sorry,’ said Tally coming over to wrap her arms round him. ‘How do you feel about that?’

‘It’s what we expected.’

‘That’s not what I asked.’

‘No,’ agreed Steven, ‘Defence against biological attack should be a priority and here I am neither pissed off nor angry that the government is still sitting on its hands over it. Why’s that?’

Tally looked up at him, mildly amused. ‘Because... you don’t know what to do about it anymore than they do. If you did you’d be absolutely furious. Instead you probably just feel numb.’

Steven smiled, appreciating the fact that Tally had hit the nail on the head. He squeezed the hand resting on his shoulder. ‘I think I’m more concerned about someone else being turned down for funding.’

‘Really? Who?’

Steven told her about the Lindstrom group and their failure to attract government support.

‘Well, I suppose there’s only a limited amount of money to go around.’

‘Mm,’ said Steven thoughtfully. ‘Trouble is I’m not entirely convinced that was the reason.’ He told Tally about his conversation with Barrowman.

‘I suppose you take on the establishment at your peril,’ said Tally, ‘but didn’t you say Dorothy Lindstrom had been a darling of the media?’

‘There’s a world of difference between that and being embraced by academe,’ said Steven. ‘Anyone who crosses their invisible line and strays into what might be considered show-business can be in for a very hard time indeed.’

‘Something you don’t realise until the knife goes into your back,’ smiled Tally.

Steven told her about the opinions Dorothy had expressed at the meeting about the direction of current research funding.

‘Wow.’

‘Wow indeed, but not entirely without foundation,’ said Steven quietly.

‘Maybe... but I mean...’

‘Not the wisest thing to come out with?’

‘Quite, I mean you’ve got to play the game, haven’t you?’

‘Maybe it should depend on how clean the game is,’ said Steven.

‘You don’t think it is?’

‘People are people. Human nature rules at whatever level of society you’re in.’

‘Not a happy thought if you really believe that the research grants system is corrupt. Do you?’

Steven shook his head. ‘No,’ he conceded. ‘Well, not at the level of cash exchanging hands in brown paper bags, but it’s not above having an old boys’ network who scratch each other’s backs. As to whether it extends to standing in the way of first rate research in order to settle old scores... who knows? John is going to try and find out at one of his lunches.’

Tally smiled. ‘Where the real truth leaks out.’

Steven nodded and asked, ‘How was your day?’

‘Life is good,’ replied Tally. ‘I am practicing medicine instead of spending my time arguing about targets and filling in forms.’

‘Being a consultant suits you.’

‘Nothing to do with that,’ said Tally. ‘We’re well funded and well managed. I now work in a proper hospital instead of being treated as a form-filling, box-ticking piece in a board game for third rate politicians and mediocre managers. It’s all about choice for patients, my backside. It’s all about money. Period.’

Steven smiled. He was used to hearing Tally sound off about the shortcomings of the National Health Service He was even pleased that her promotion and move had apparently done little to blunt her views, but felt obliged to point out what John Macmillan had said about special funding for Great Ormond Street.

‘I suppose,’ Tally conceded. ‘Maybe I should keep my mouth shut, smile sweetly and be terribly sympathetic to medics less fortunate than myself.’

‘Well, I was wondering how long it would be before the establishment gets to you and bends you to its will. You’ll be co-opted on to one committee after another until you can’t say a word without offending someone you shouldn’t.’

‘Aint gonna happen.’

‘Mm, maybe we should go out to eat before you start wearing a bow tie and playing golf,’ said Steven.

‘Maybe we should go out to eat before I pour the contents of this kettle over your head?’

The food at the Jade Garden Chinese restaurant was as good as it always was. Steven had been a regular there since joining Sci Med; Tally had only been there twice before — with Steven when she’d come to visit — but it was now a favourite haunt for them both.

‘Will John continue to lobby on mass vaccination?’ asked Tally after they’d placed their order.

‘I’m sure he will,’ said Steven, ‘but I think we’re both resigned to failure until...’

‘Until what?’

‘Until something actually happens... either by deliberate attack or through some awful epidemic arriving on our shores through chance or circumstance.’

Tally ended the ensuing pause. ‘Would you like to hear a happy story?’ she asked.

‘You bet. Have you got one?’

‘One of my patients, a little blind girl; is going to get her sight back.’

‘Surgery?’

Tally shook her head. ‘Stem cells. Isn’t that just brilliant?’

‘Now that is a happy story.’

‘Stem cell technology is just so exciting. It’s going to bring about such a revolution in medicine.’

‘Even if it’s a bit of embarrassment to science,’ said Steven.

Tally raised an eye.

‘Science doesn’t really understand how stem cells do what they do.’

‘As a clinician, I must say I don’t really care. It’s then end result I’m interested in. What’s their problem anyway?’

‘Differentiation,’ said Steven, ‘the holy grail of biology. How do absolutely identical cells in terms of their DNA diverge to become limbs and organs which are totally different from each other? Science doesn’t know but stem cells do. If we put them in the right place they’ll do the job for us.’

‘And that’s all I care about,’ said Tally. ‘If stem cells can make my patient see again, they can keep their secret.’

Steven nodded. ‘Actually,’ he said thoughtfully, ‘they may not be keeping their secret that much longer.’ He told Tally about Dorothy Lindstrom’s claims for epigenetics. ‘It makes so much sense,’ he added. ‘The DNA can’t change so it must be the switchgear that does the trick.’

Tally made thoughtful imaginary circles on her napkin with her forefinger. Eventually she looked up and said, ‘You know, there are times when I think we know so much and then, quite suddenly, I feel like we know nothing at all.’

‘Join the club.’