The Portable Veblen

3 NEWS IS MARKETING

The year was starting well.

The week after Veblen said she would marry him, Paul Vreeland, MD, FAAN, FANA, FACNS (he loved the growing train following his name, all engines, no caboose) reported for the first full day of his trial at the veterans’ hospital known as Greenslopes. Climbing out of his car he stood in the morning chill, tasting the fragrance of his new domain.

The hospital was the centerpiece of this government compound, assigned to the task of supporting the spent men and women of the armed forces. The range of structures told of the ongoing demands on the military, from the dowdy Truman-era offices to the flat cold war bungalows and tin-can hangars to the striking prize-commissioned buildings of recent design. Gophers and moles had the run of the lawn, which was lumpy, riddled with loose mounds of soil. (Paul had recently spotted an excellent two-pronged gopher trap while shopping to eliminate squirrels, and thought he might recommend it to the groundskeeper.) And everywhere the grounds were paced by truculent crows. Two men in worn Windbreakers and baseball caps huddled in wheelchairs beside a Victorian-style cupola, which had been ceremoniously fenced in a pen and surrounded by rosebushes, and bore a plaque bearing the names of a select squadron of the national sacrifice.

Had he been born at another time, been drafted and required to serve, would he have mustered courage? In his lifetime, a man needed a test, and Paul thought: This one is mine. With a crooked smile he imagined the musical that would come of it. Greenslopes! The patients in their hospital gowns would come to life in their cots, and perform spirited ronds de jambe in the aisles.

Just then, a squirrel spiraled down the heavy trunk of the magnolia, nattering across the spotty lawn in fitful, myoclonic jerks. A trail of Fortuna cigarette boxes led his eye to three weary-looking women in white uniforms and blue hairnets lumped on a brick wall in smoke. Then an electric buzz drew his attention to the road, where an obese gentleman careened along in a wide, customized wheelchair, waving an orange flag on a bobbing wand. Along the sidewalk came a woman in a black tank top under her denim jacket, tattoos rising like thunderheads over the mountains of her breasts, carrying a ziplock bag packed with white-bread sandwiches. To lend some decorum to the tableau, Paul stood tall, dusted off his jacket, and turned to take the path from the lot to the main building as a limping janitor pushed a cart across the sidewalk at the drop-off circle.

A low band of cement-colored haze hung snugly over the peninsula. He was early, did not want to stand in front like a doorman; he changed direction, taking a path freshly decked with necky red cyclamen submerged in a carpet of woodchips.

For here he was, the man who would lead Hutmacher into a new era. Under his stewardship, the clinical trials program would surpass all expectations. Here at the VA, the new wing, filling daily with volunteers, would become a model of its kind. Physicians received Nobel prizes for innovations like his. They had body parts named after them, such as Kernohan’s notch and Bachmann’s bundle and the sphincter of Oddi. Not to mention the fissure of Rolando and the canal of Schlemm and the zonule of Zimm! Dr. Vreeland helped eradicate once and for all the effects of traumatic brain injury sustained in combat. Focal or diffuse, of no matter to Vreeland. Among the many types of experimental subjects, Vreeland popularized the use of the squirrel, as they tended to invade attics and make a nuisance and rile up generous-hearted women in their defense!

Heading back into the corporation yard, he passed an earthmover stuck like a mammoth in a lake of mud, and reflected on how until recently he’d been just as mired by the failure of his nerve. That is, until he met Cloris, at the start of a run of unprecedented luck.

There he was at work one ordinary afternoon last September, slumped in the elevator, his cart much like the janitor’s, thinking about how he’d run out of toilet paper that morning and how he’d have to stop to buy more on his way home, with no Veblen in his life, he had yet to meet her, when a tall, blond woman of around thirty-five tripped open the closing doors with her long striding legs and took her place at his side. It was a memory he’d committed to the permanent circuits. The way she leaned over, read his name on his lab coat, and made no foolish sentimental comments about the mixed specimens on his cart always struck him as proof of a giant leap in his sex appeal.

“Dr. Vreeland, why don’t you ask a resident to take your cart?”

He grinned, tossed off something about finding it difficult to delegate.

Her eyes gleamed with the thrill of discovery. “My father says, ‘If you want something done, ask a busy man.’” She had just visited a dear friend, very ill, maybe she should have a coffee before hitting the road, would he like to come tell her about his work? She was with Hutmacher Pharmaceuticals, and loved to keep abreast of the latest developments. He stood taller. At the next floor he jettisoned the cart.

“How long have you been here?” In the cafeteria they settled in plastic chairs.

“My third year. Are you a rep or something?” he asked with a mischievous poke, because industry reps were no longer allowed to do their repping at the School of Medicine, and he’d signed his share of SIIPs (Stanford Industry Interactions Policy), which covered gifts from the industry, access of sales and marketing reps to the campus, and other strategies of coercion the industry was apt to deploy.

“You could say that,” she responded. “You could say I’ve been repping for them since the day I was born.”

Moments later, when he realized over his plain black coffee that he was actually speaking to a Hutmacher, namesake of one of the largest pharmaceutical companies in the world, a modern empire, she a virtual princess, he gulped and scalded his esophagus, and worse, felt his testes shrivel to the size of garbanzo beans. To his shame, he really believed the wealthy were superior. In a Darwinian sense, they had to be. He could read the story of past conquests and brutal takeovers in her bone structure, her long arms and legs, her narrow shoulders, her high cheekbones and forehead, her elegant hands. The marriages that had led to her creation had been of alpha males and glorious females, and you wouldn’t find the peasant’s short calf or hunched trunk among them.

Meanwhile, he descended from a rough mix of Dutch farmers, Belgian carpet salesmen, Irish gamblers, and Presbyterian prigs, and he wondered what use she could possibly have for him.

“But as I said, I’m not here on business. I was visiting a sick friend.”

“I’m sorry,” Paul said.

“Thank you. Now more about you.”

“But—” He laughed at himself. “Shouldn’t you be skiing in Zermatt, or whatever heiresses are supposed to be doing?”

“That’s next January. Tell me about your work!”

Who had ever asked? The subject of his study was his gold reserve, burdening his heart. “Well, I’m working on traumatic brain injury. I’ve been developing a tool.”

“A tool? Tell me more,” said Cloris, with such prosperous vitality he felt all underfunded and desperate and teenaged again.

“To make it short: I’ve found a way medics on the line can take a proactive role in preventing permanent brain injury.”

“That’s terrific,” said Cloris. “How?”

“Well.” Was he pitching his tool? “You want me to tell you now?”

“Please!”

He nodded, and scalded another quadrant of his taste buds. “Let’s see. Where to start. The body’s response, you know, to just about any stimuli, is swelling—”

“I’ve noticed.”

His nostrils flared. “To injury. Like my burned tongue right now. The body swells.”

“Yes, it does, doesn’t it?”

“The blood rushes, it rushes to the — geez.” He laughed, looking down. “Okay. I have no idea what we’re talking about here.”

“Don’t stop.”

He cleared his throat. “So the brain. If the brain is injured and swells, the skull, I’m sure you know”—he made his hands look like a clamp—“holds it in, and—” His neck felt hot. “There’s pressure, lots of pressure.”

“I understand,” said Cloris.

“The pressure builds—”

“—and builds—”

“—cutting off circulation—”

“Oh, my.”

He bestowed a frank, open gaze upon her, and cleared his throat. “Anyway, the cells stop getting oxygen, which sets off a chain reaction called cell suicide, technically called apoptosis, but if a craniotomy — opening up the skull — can be performed immediately, releasing the pressure, to make room for the swelling”—Paul shifted in his seat—“then no more cell suicide, and under the right circumstances recovery is achievable, up to eighty, ninety percent.”

“So how could this be done?”

“Here’s the problem. Say you’re a medic in combat, and you need to get your injured troops to the closest field hospital, but for a thousand reasons, you can’t do it fast enough. This happens all the time. You’ve made your determination of brain injury—”

“How is that done?”

“Nonreactive pupils. Unconsciousness.”

“Sounds like me every morning.”

“Ah.” Paul felt a luxuriant warmth ripple down his thighs. “The point is, it’s not all that high-tech — craniotomies have been practiced for thousands of years. We see burr holes in the skulls of Egyptians, Sumerians, even the Neanderthals—”

“That was for a snack,” she said.

“The point being that long before there were hospital standards and antiseptics—”

“It could be done.”

“Right! And so in emergency situations, medics—”

“Could do just as good a job as the Neanderthals!”

Paul slapped his palms on the table. “Right. And here’s where my work comes in. I’ve devised an instrument that is safe, effective, essentially automatic, for the line medic to use right on the spot.”

“The Swiss Army knife of brain injury?”

“Yes.”

“Something every medic would carry?” she grasped, eagerly.

“That’s my hope.”

“Simple, easy to use?”

“Very.”

“How big is it?”

Paul held up his hands to indicate a tool of about eight inches.

Cloris raised her eyebrows, then entered text in her phone. “What’s it like? Tell me there’s something like it but not as good.”

He knew what she was getting at. The FDA would allow you to bypass a lot of time and red tape using the 510(k) exemption if a device was like something else already approved. “Between you and me, it’s unique. But you could easily say it’s like the Voltar pneumatic hole punch or Abata’s Cranio-locum.”

Her eyes sparkled and he felt wonderful. “Could it save the government money?”

“Oh my god, yes. And obviously, a lot of people’s lives would be much better.”

She leaned forward, to whisper. “What’s your contract situation?”

“I’m up for renewal at the end of the year,” whispered Paul, nervously rocking back in his chair.

“Has the Technology Transfer Office seen this yet?” she asked huskily.

“Funny you ask. I’m just finishing my report for them right now.”

“I see. Can I ask you something?”

“Ask away.”

“If I get back to you in a couple of days, will you let me take the first look?”

“Sure, but—”

“I think it’s a no-brainer.”

“Ouch.”

“What?”

“You said it’s a no-brainer.”

“I practiced that.”

They walked to the hospital lobby together, Paul carrying her tote bag to the door. She gave him a European-style kiss on his left cheek, and his catecholamines soared.

She called in two days, to inform him that Development at Hutmacher was very interested in his device. It seemed that Cloris Hutmacher was a scout for her family’s company, prowling med schools and biotech companies for the latest discoveries that exceeded her company’s resources to discover in their own labs. She could boast of finding a new drug for arthritis at UCLA, and another that blocked harmful proteins within cell walls at UC Santa Barbara, all on her own initiative. Of course, Paul’s device was a high risk Class III and would need to be tested in a clinical trial, but that was no obstacle at all. The VA center in Menlo Park was available as a testing site, and it was possible, in fact probable, that Paul could be the primary investigator in a trial there, making a niche for himself testing other patents relevant to the Department of Defense that were being licensed by Hutmacher. Hutmacher had numerous DOD contracts, she told him, and was dedicated to the men and women of the armed forces. He would be ideal.

Paul thought he would be too, but when he brought it up with his mentor, Lewis Chaudhry, Chaudhry was flatly lacking in enthusiasm.

“This project is nowhere near ready for that, Paul. You have yet to do your randomized study, you’ve had no peer reviews, nothing! Are they planning to piggyback it on a 510(k)?”

GIFT BASKET

Paul admitted they were. “You know what an uphill battle it is to market anything. They’re saying it’s a major breakthrough and they can move it into practical application really fast. Isn’t that worth doing?”

Chaudhry stepped back with thinly disguised contempt. “So, Paul, how big was the gift basket?”

And Paul felt sorry for the stodgy old termagant and went directly to the Technology Transfer Office to work out the details. And when he met Cloris later that week, at the office of Hutmacher’s attorneys, Shrapnal and Boone, in Burlingame, and he was presented with a signing bonus in cash and stock options as well as a huge gift basket filled with bottles of champagne, fancy chocolates, aged wheels of French cheese, and even a sterling silver knife in a blue box from Tiffany & Co., Paul could see no reason not to own the moment.

Then, when Cloris invited him up to her place in Atherton, he wasn’t exactly surprised. He was easing into his new incarnation pretty suavely, he thought. As he followed her white Tesla Roadster up the hill, through the gate, to the house that had been built in the manner of a French château, sandstone covered with ivy, a front door thick and iron strapped, opening like a castle, he felt overwhelmed with fate and consequence. What if she fell in love with him? What if they married? What if the elder Hutmacher took him under his wing and told the world he was a visionary? What if he became president of the company after the old man was gone, and had a private jet? What if he and Cloris became goodwill ambassadors for UNICEF, distributing medical supplies throughout Africa, stopping in dusty towns to confer with Bono and Angelina Jolie? What if everyone from his hometown, Garberville, found out? What if the psycho-bitch mother of his high school girlfriend, Millie Cuthbertson, committed hara-kiri on a bamboo mat, and coyotes paraded her entrails down every street in town?

Cloris showed off her office with its high view of the peninsula, and he lingered to admire a wall of tightly framed photo ops, including, but not limited to Cloris and her father, Boris Hutmacher, with George H. W. Bush, Cloris and her father with Bill and Hillary, Cloris with George W. Bush, Cloris and her father with President Obama, Cloris with Mick Jagger, Cloris with the Dalai Lama, Cloris with the Pope, and…

“Where’s Cloris with god?”

She squeezed his arm.

Certificates of appreciation studded the walls, from charities and boards, medical, environmental, inner city, whippet societies. It seemed there wasn’t anyone Cloris couldn’t be appreciated by.

Just then, the monitor on the desk began to ring like a phone, and Cloris said, “It’s Morris calling. Our weekly Skype. Do you mind?”

“Who’s Morris?”

“My son.”

“I didn’t know you had a son.”

“Yes. Divorced three years ago. He’s eight.”

“Oh.”

“Don’t worry, this will only take a minute,” she said.

“Please, take as long as you want,” Paul said, and he went away to wait.

He let himself out the French doors onto a sweeping sandstone piazza, appointed with various clusters of wrought iron chairs, ceramic pots embossed with fleur-de-lis, and an inverted copper fountain that funneled into the earth. Across the lawn stood a rose arbor, its few leaves yellowed and spotted with black. From there, one could see up the coastal ranges north and south, the Dumbarton Bridge crossing the bay to Fremont, and the San Mateo Bridge beyond. For some reason, all he could think about at that moment was how he was going to tell his status-conscious friend Hans Borg about this. Maybe he’d be in a position to finagle some contracts for Hans, of course he would! He’d send his parents on the big trip they’d always wanted to take, and he’d hire a full-time caretaker to manage his brother, Justin, with an iron fist.

But they would never allow that. Deflated by the inescapable specter of his disabled brother, Paul wandered past the pool and pool house, admiring the château from every angle, until he found himself before a marble goddess skirted by camellia and heard Cloris’s voice through the windows. He could see her fine head before the large monitor in conversation with her son, who appeared to be slightly rotund, wearing a horizontally striped sweater that emphasized his girth. He had reddish hair and a galaxy of freckles, and his sniffles were amplified with sorrowful fidelity.

“I told you I don’t have time for this,” Cloris said.

The boy sobbed.

“Stop it,” Cloris hissed. “Are you trying to punish me? Because I don’t deserve it! I’m onto you and I won’t stand for it!”

Morris cried louder, and Paul stepped back, not wanting to believe his patroness was brutalizing her child. (Maybe the kid was a horrible brat and deserved it? Maybe Cloris, unlike his parents, knew how to exert some discipline?)

“Get me your father. Now!”

The boy disappeared from the screen and Paul leaned forward again, despite himself. A hard-jawed man in a black polo shirt with a sharp cleft between his eyes took the boy’s place.

“Cloris, what are you doing? He’s hurt!”

“Don’t expect me to fix it all from here. He wants to live with you, then be his father!”

“Cloris. Calm down. Morris, go upstairs while I talk to your mother.”

“Don’t let him leave. I don’t want to prolong this. Sit down, both of you!”

Cloris strained toward the screen, so that her nose might have sparked with static. “I want to tell you something, Morris. When my father asks me about his grandson, what am I supposed to say? Well, you know what, I say nothing! I change the subject! That’s because you let me down constantly. I would never tell him the things going on!”

“I didn’t mean to,” cried Morris.

“Stop it. Pull yourself together right now. You’re such a baby. You’ll have to earn my trust in the future, and it won’t be nice and easy, the way everything else comes for you.”

“What can I do?” sobbed the boy, whose cheeks glistened with tears.

Cloris bent, arms crossed over her chest, shouting at the screen. “Do you understand why you are in that school? You are in that school because my father went to that school and because he is on the board of directors of that school and you have every advantage in the world in that school! Do you know how bad it has to be for me to get a call from one of your teachers? You represent this family to the children of everyone who matters in Washington. And this is what happens?”

“Cloris, he’s in second grade.”

“And look at him. He’s at least ten pounds overweight. Morris, are you listening? You are fat. And do you know what that means? Nobody likes little fat boys. Morris? Stop eating junk food!”

“That’s more than enough,” said the boy’s father, and fearing that the conversation was coming to an end, Paul withdrew, in order to rush around the building to the expanse of sandstone, where he affected a casual stance until Cloris joined him again.

“There you are!”

“Nice view.”

“Now, where were we?”

“Everything okay with your son?” Paul asked, innocently.

“Oh. Fine. The long-distance thing isn’t easy,” said Cloris, and to stay on target for the future of his device, he pushed the scene he had witnessed from his mind.

He followed her inside and she brought them drinks on the couch, and shortly, one of her hands was on the cushion near his shoulder, then on his shoulder, finding its way like a garter snake to his ear. She had a thing for the little flange at the front of the ear called the tragus, and she pinched it at least six or seven times.

“You are a gorgeous man,” she said, embarrassing and thrilling him.

After a long session of making out (she tasted of vodka, and her mouth was surprisingly small, her tongue fast and flighty, putting him in mind of kissing a deer, for some reason), she threw herself back on the pillows and said, “I don’t have relationships anymore. But you’re hard to resist.”

“Then don’t,” Paul said, in motion toward her, fueled by instinct.

“I was a very decadent person in my twenties. You have no idea.”

He listened, with a hard tug in his groin.

“I had problems. And then, about five years ago, something shifted.”

“And what was that?”

“It coincided with my work for the company. I suddenly transferred all of that excitation into my professional life.”

“That’s a tragedy,” Paul said, grasping her fingers.

“So now, if I’m spending time with a man, which I’m not, I’m a nun these days, I’m impatient, I think about work, I double-task. I’ll be smiling and thinking about my toes and separating them to aerate them. And I’ll be thinking, there, that’s something I can accomplish until this is over.”

Paul cleared his throat. “Hmm.”

“Is that fair to the man?” she pressed.

“Depends on the man.” He laughed, as he only thought right, though he would never have taken her for a person with tinea pedis.

“Come here,” she said, pulling on his collar.

“I think you’re struggling,” Paul said, with renewed interest in kissing her.

“I am.”

“Maybe someone should help you with your struggle.”

He reached for her skirt, and under it, just long enough to feel that her inner thighs were cold, but with that she jumped up and laughed in an agitated and sophisticated manner, and said, “Come upstairs!” And he followed like a pup.

Her bedroom was vast, with a huge bed that she rolled over in order to rummage in a bedside drawer and retrieve a bronze pipe, tamping it expertly with pungent weed. She took a few long tokes and passed it to Paul, who was so surprised in a bad way that he shriveled. The scent of marijuana was his least favorite odor in the world. Even feces on a shoe smelled better than cannabis resin.

“No, really,” he said, when she pushed the smoking bowl toward him.

She indulged several more times, then flung herself back into the playpen of pillows, kicked off her shoes, sent them flying, and patted for Paul to lie next to her.

“He’s coming out next year,” she gasped.

“Who?”

“Morris,” said Cloris, exhaling loudly. “I have to figure out something fun to do with him. I never get it right. What did you like to do when you were eight?”

“I don’t know, the usual.”

“What’s the usual!” she said, hammering him with a pillow.

“Hey!”

He grabbed one from the multitude of bolsters and puffs at the head of the bed and socked her back.

“Paul!”

He drew himself up on his knees, and moved toward her, as she began to sniffle.

“How can I know the usual, I don’t live with my son, there is no usual.” She sniffed.

“Cloris? You okay?”

After a while she sat up, cross-legged, to dab her face with the sheet. “I get very emotional about him.”

“Why isn’t he with you?”

“That’s old school, Paul,” said Cloris. “We let Morris make his own decisions.”

“Mmm. Best.”

“Anyway, his father can’t have him in the spring and he’ll be here for a while.”

“That’s nice,” Paul said, worried he’d failed to keep things on track. The moment seemed to have passed. He gazed at her bare feet on the bed, wondering what grew between her toes, bound up by his desire to do the right thing in the presence of an heiress, whatever that might be.

“Were you a Boy Scout?” she asked.

“Definitely not.”

“A camp counselor somewhere? A coach?”

“No, no. Not me.”

“You seem like the kind of person boys would admire and imitate. Like my father.”

He tossed it off as if the compliment meant nothing to him, but he wanted to bury it, entomb it, make a shrine of it to worship at for the rest of his life.

“Come here,” she said, and then something happened — it was kind of like having sex with someone but not quite. It was a scratching, raging, rolling catfight of flesh and bone and disclaimer—we both know this doesn’t mean anything—until it was inexplicably over and he was almost heaved off the side of the bed. Then Cloris disappeared for about twenty minutes. Finally he wandered downstairs and bumped into her in the kitchen, dishing up bowls of spaghetti alle vongole, which they soon ate at a long table, discussing business as if nothing had happened. Driving back to his depressing condo just off El Camino in Mountain View later that night, he wondered if he’d just torched his whole career.

(And then he would meet Veblen a few weeks later, and would be so immediately bowled over by his feelings for the smart but spacey, undervalued woman with the handmade clothes and self-cut hair, who typed in the air and loved squirrels, that it would strike him as the closest call in his life.)

When he learned he was off to Washington, D.C., for an interview, his father said, “Terrific, Paul! You can go visit the Wall and see your uncle Richard’s name, can’t you?”

“Dad, I don’t think I’ll have time—”

“Wait a minute, wait a minute. It’s right in the middle of everything, outside, and you don’t have to pay admission or wait in line.”

“Dad, I’m going for an interview. They’re flying me out. If I have time I’ll go, of course. But—”

“Are you saying, Paul, that you’d go all the way to Washington and not visit Richard’s name?”

“I’ve visited it before, with you. I’ve seen it.”

“Oh, I see. You only need to see it once. Paul! Get your priorities straight!”

“Dad, I’ll go to the Wall if I can!” Paul barked back.

“It hurts me to think that we’ve only been there once. You could maybe take some flowers.”

“Do they do that there?”

“I don’t bloody hell care what they do there, you can take him some flowers. You can set them down under his regiment.”

“I’ll try.”

Soon enough he flew to Dulles, riding a cab past the gentle deciduous arms of eastern woodland fringing the highway. Rising into the powder-blue skies like holy temples were the strongholds of Northrop Grummon, BCF, Camber, Deltek, Juniper, Scitor, Vovici, Sybase, and Booz Allen Hamilton, while the gentle green grass and low trees waved around them, sprinkled with rusting conifers sick with disease. He heard the overture to a rock opera forming in his head, a rousing confluence of Carmina Burana and Tommy, and had a fleeting fantasy of supporting two careers with his boundless force.

He was taken to a building in Arlington, Virginia, a stone’s throw from the Pentagon, and those on the committee, some with their uniforms and Minotaur heads, jabbing their swollen thumbs through his documents, gave him the once over.

Present were Grandy Moy, Louise Gladtrip, and Stan Silverbutton, all from the National Institutes of Health (NIH); Vance Odenkirk, Willard Liu, and Horton DeWitt, all from the Department of Defense (DOD); John Williams, MD, National Naval Medical Center, Bethesda (NNMC); Lt. Col. Wade Dent, Walter Reed National Military Medical Center (WRNMMC); Brig. Gen. Nancy Bottomly; Reginald Kornfink, committee manager, DOD; Alfred Pesthorn and Cordelia Fleiss, FDA; Col. Bradley Richter, U.S. Army Medical Materiel Agency (USAMMA); and Ms. Cloris Hutmacher.

“Traumatic brain injury in combat has become the number one killer of our troops,” Paul began, gazing down the table. “It was the signature injury of the Iraqi and Afghani campaigns. Warfighter brain injury studies to date include a lot of hopeful breakthroughs on tissue regeneration, but none addresses the need for intervention on the spot, before the cascade of damage begins.”

A few of them actually yawned. He responded passionately:

“Let me get to the point. For the past year and a half I have performed a rigorous study of decompressive craniectomies on lab animals with a tool of my own invention, and I’m ready to translate my results to a Phase III trial—”

“We’ve got a few ‘animals’ for you,” one seasoned bureaucrat broke in, with a bitter snort.

“We’re getting an extended Doberman,” Kornfink said, drumming his pencil on the table.

“What’s that?”

“That’s what I wanted to know, but we’re getting one.”

“How extended is it?”

“I’ve heard of those.”

“I’ll let you know,” said Kornfink. “I’m breeding them. Shelley’s idea for my retirement.”

Suddenly the inert committee appeared to remember why they were there, and returned to Paul, as if nothing had happened.

“Dr. Vreeland, the Department of Defense will consider cooperating with the VA and the licensor to fund this study. How do you propose testing in field conditions?”

Paul said, “The VA in Menlo Park has several vacant buildings which we’ve submitted petitions to use to create field conditions with all relevant noise, light deprivation, smoke, and so on.”

He added, “We’ll also want to invite trained medics to test the procedure in simulated conditions, rather than MDs.” He cleared his throat, and pulled on his collar.

“This is something like a field trach, is that what you’re thinking?” asked Bradley Richter, a sinewy man with dark eyes and a pronounced underbite, reminding Paul of a sea angler with skills adapted to life in the dark deep.

“Yes, sir. Medics easily master tracheotomies in emergency situations. For testing we’d move from cadavers to live volunteers in these aforementioned conditions.”

“By volunteers, are we talking scores less than eight on the Glasgow Scale?”

“We’re looking at a number like that,” Paul said, having been warned by Cloris to keep this vague.

Cloris Hutmacher spoke up. “I’ve already met with Planning at the VA in Menlo Park and they’re ready to lease us Building 301, which is a fifteen-thousand-square-foot structure currently in disuse. Any of the WOO simulator systems would fit there.”

Richter took notes.

Paul cleared his throat. “If we succeed, which I believe we will—”

“People, this is huge,” said Cloris.

“Cloris has an eye for the huge,” pronounced Richter.

Cloris said, “It’s a cusp moment for all of us.”

Paul gazed around the oblong slab, at men and women who’d served the military and had undoubtedly been the trendsetters and thugs of their grade schools.

“This is clearly an opportunity of the highest order,” he heard himself declare. “To serve. My country.” He made methodical eye contact with each person present. “My father’s brother, PFC Richard Vreeland, Company C, Second Battalion Fifth Cavalry, First Cavalry Division, died of blast wounds to his head, chest, both legs, abdomen, and right hand in the ambush at Phu Ninh.” He had never mentioned his uncle’s annihilation to anyone before, and the expediency of doing it now shocked him, yet made him feel like maybe he could be a player after all. The room fell silent. “As soon as this meeting is over, I’m going to visit his name on the Wall. I want this as much for our country as I want it for him.”

A round of backslapping ensued. Cloris told him he was spectacular, and invited him to join some of the committee members for drinks. “Well, I’d like to, but I need to go by the Wall. My uncle,” he added.

“You really meant that?” An admiring glint flashed in her eyes. She was as thin as a whip.

“Of course I did.”

“Come with us now,” Cloris said. “Visit the Wall later.”

“But my flight leaves at nine.”

She whispered, “I won’t tell anyone you didn’t go to the Wall. Come on!”

They went to a noisy bar in Georgetown. Cloris spent her energy speaking closely into the large, open ear of Bradley Richter. Paul perspired heavily and drank too much. He didn’t end up visiting the Wall, but planned to tell his father he had. Or maybe not — maybe he’d tell his father he couldn’t, as he’d said all along. Well, it would make his father happy to think he’d tried. Throw the old man a bone. A cab returned him to Dulles within the hour, and he received the offer the next day by noon.

• • •

PAUL RETURNED from his tour of the VA grounds by nine A.M. In the lobby, an elfin woman in a yellow checkered skirt and a white blouse with a pin of a Scottish terrier on the collar stepped out and waved at him like a crossing guard.

“Dr. Vreeland!”

Susan Hinks had soft blond hair and cornflower blue eyes, a fine fuzz of blond on her cheeks, and an expression not of an embryo but of something quite fresh. A voyeur would know how to describe it. “Welcome. It’s great to meet you, Dr. Vreeland!” Her voice was charmingly nasal, with a mild midwestern twang, and her teeth were notably large and clean. “I’m your clinical coordinator and I’ll be providing support in all responsibilities related to the NIH and the DOD and Hutmacher. I’ll conduct follow-up evaluations, watch compliance with protocol, take care of the case reports. I’ll be your liaison with the Investigational Review Board, the IRB. We’ve been completely overwhelmed with volunteer applications — we’ve still got people calling and going around the usual channels to get in.”

Paul felt a surge of pride. “Seriously? Is this trial especially attractive for some reason?”

“Any trial is attractive,” Susan Hinks said. “They have to wait so long for treatment in the system. If they get into a trial, they get a lot of attention.”

He gave her a skeptical look.

“Are you trying to tell me these veterans are willing to get a hole punched in their skulls just to get a checkup?”

Unruffled, she said, “That’s the way it is, Dr. Vreeland. Let me show you what we’ve organized so far. I think you’ll be pleased.”

He’d recently reviewed the latest iteration of the World Medical Association’s policy statement, the Declaration of Helsinki, concerning the ethical principles for medical research involving human studies. Now he wanted to know: Had they followed the declaration to a T? Yes, Hinks told him. Had they filed all the paperwork disclosing his financial interest with Hutmacher?

“Form 3455, done.”

“Well! Great.” He followed her to the elevator, up a floor, down a corridor through some security doors that she opened with a code. A stooped man in a thin flannel shirt and jeans caked with cement pushed the blue button on a water cooler in the hallway; a woman in a butterscotch-colored sweater stood behind him. They eyed him timidly, and retreated to a room with a TV screen. “That’s the family room,” Hinks explained. “Since the volunteers began to arrive, we have some of the families spending all day here, thrilled to take part. Patriots to the bone.”

He winced at her word choice, while she opened a cabinet stocked with sterile aprons, masks, and gloves. “Here you go,” she said, and together they suited up.

The swinging doors let them through.

A gritty light touched on the ward, beds lined up military style. The cold echo of machinery bounced off the walls, along with the rhythmic hiss of chest cavities rising and falling on ventilators. A sharp whiff of ammonia penetrated his mask. Across the room, a nurse changed an IV bag, while an attendant mopped around a bed, gathering a pile of sheets bundled at the foot.

Paul grabbed the chart off the first footboard he came to. Flores, Daniel R. Injured by landmine, north of Kabul. He saw before him a twenty-four-year-old with a youthful hairline and an unblemished brow, missing the eyes, nose, and mouth beneath it. The roots of teeth poked from a band of purple tissue, and a breathing tube disappeared through a hole the size of a Life Saver, secured by a gasket. Where the boy’s arms had once been sprouted two fleshy buds, stippled with splinters of bone.

Paul looked at the chart attached to the next bed. Baker, Jeremiah J. Wounds suffered near Kandahar when his vehicle encountered an improvised explosive device. The young man’s eyes were open, and Paul bent over to make contact. The pupils were nonreactive. The eyes didn’t see.

“And we have wonderful volunteers who work with the families, a lot of attention, a lot of hope. It’s very uplifting.”

“There’s very little chance of—” He groped for ground.

“Dr. Vreeland, are you all right?”

Men missing parts of themselves forever, here to bolster his reputation and gain. Paul’s throat closed with shame.

“Who volunteered these volunteers?”

“Hartman is the CRO who recruits for us.”

“Could you tell me, what is a CRO?”

“Everything here has an acronym, you’ll get used to it. The CRO is the Contract Research Organization. They get volunteers and help us package our information for the FDA. Hartman is a little corporate but we’ve been very happy with them in clinic.”

He worried briefly about the hollow and ominous description of this corporate entity, and wanted to sputter Seropurulent!, which had been an ironic superlative they used in med school for terrible things that had to be overlooked. (By definition: a mixture of blood and pus.)

“Right. Okay. Have the cadavers arrived?”

“Yes, we have sixty-seven in the locker, and thirty-three arrive later this week. Would you like to see them?”

“No, that’s okay. I’ve seen plenty of cadavers.”

“Then let me show you our new MRI room.”

They went out through the ward on the other side, to a corridor, where Hinks took him into another room to see the sleek and massive multislice Somatom Definition Flash scanner.

“Excellent.” He reached out to pat it.

“Oh, Dr. Vreeland? Is this okay, we only have one technician authorized to operate this machine. So we’ll schedule together on that, okay?”

“Fine. Can we take a look at my office?” he asked.

“Of course, come this way.”

ARMORY SQUARE, 1865.

As they removed their gowns he peered back through the small window into the ward. The wounded forms in the cots looked no different from those he’d seen in photos of Civil War hospitals; he might as well have been peering through the window at Armory Square or Satterlee. The flag jutted from the wall. History repeats, repeats, repeats. By no means a rabid nationalist, as a schoolkid he’d nevertheless revered the custom of setting his hand on his heart and repeating the Pledge every morning, the ritualized blur of sounds. Antootherepublicforwitchitstands… These guys who really did stand for the country would never again stand for themselves.

Indivisible. As a kid he thought it was a stuttered invisible. And that it referred to the flag itself. Kids making pledges on misunderstandings. He’d thought it meant the flag flew invisibly over all.

• • •

THAT AFTERNOON Paul sat in his new office, fighting an unwelcome chill. The room was sensibly furnished with a teak desk and credenza, glass-fronted bookshelves that were empty except for the manuals for the computer and printer still packed in boxes on the floor, and a comfortable black leather chair that swiveled and reclined. Well, he’d reached a new high. He had brought his model schooner that he carried with him from desk to desk, and a picture of Veblen taken in San Francisco, which he removed from his briefcase and set on his bare desk. Her face was so trusting. He hoped he hadn’t upset some invisible balance by getting the squirrel trap, for he feared invisible balances lay like booby traps all around him. He loved to fall back into a warm evening in October when they’d pulled off Page Mill Road after a concert at the Almaden Winery and made love in the weeds, and her hair was full of burrs and she didn’t care. He thought at one point he’d been bitten by a snake, and he’d jumped up and she’d laughed. She was braver than he was!

All the more this past weekend, when he’d taken her up to the ski lodge at Tahoe to join Hans and the gang he used to hang with in the city — doctors, architects, financiers. He’d introduced her with satisfaction, and there were toasts to the engagement and plenty of lip service to what a hottie she was, but when they found out she wasn’t on a notable career path, they seemed unable to synthesize her into their social tableau, as if Paul had chosen a mail-order bride. Having Veblen along changed how he saw them; through the loud meals at a big table in which the conversation seemed all status and swag, Paul found himself hyperconscious of their crass concerns. There was Hans bragging about noteworthy CEOs he’d tweaked houses for, Tim the stockbroker gossiping about his favorite start-ups and upcoming IPOs, Daniel the city planner waxing about a welcome wave of demolition and gentrification south of Market, Lola and Jesse droning about furnishing their new place with everything high-end, until he thought if he heard the word high-end one more time he would retch. Hans’s wife, Uma, asked Veblen where she invested, and he heard her mumbling something about a checking account, to which Uma replied, “I’d be happy to review your portfolio and see if there’s anything I could suggest,” whereupon Veblen nodded and backed away, as if being cornered by a wolf.

By the time they said good-bye to everyone, he wondered if he’d ever want to see his old friends again, though Veblen remained cheerful all the way down from the mountains. To prove his loyalty to her, he made fun of Hans and Uma for buying their beautiful three-story Edwardian on Jackson Street in Pacific Heights, then duly gutting the place before moving in so that they had to stay nine months in an apartment, providing them with what could be considered a newlyweds’ adventure and many things to complain about, such as their unreliable contractor and the noisy tenants of the building they were renting in. Veblen appreciated that story, or his attitude about it anyway.

He also told her he saw his friends’ psychic wounds playing out in all this need for validation, and she seemed to like his analysis too.

True, there were things about Veblen that mystified him — her low-hanging job as a secretary, for one. (It wouldn’t seem right, after they married, for her to be a temp. He could support her then, she could look for real jobs, anything she wanted.) And her faith in people! She really believed they’d do their best.

Three large windows looked west to the coastal range, his new horizon. He sat back in his chair and closed his eyes and tried not to start rocking, his default when he was tense. He looked for that flat horizontal line he’d discovered whenever he was in a bad way as a child. With his eyes closed he contemplated the horizontal line as if it were a brilliant sunrise that would light up a terrific new day for him. His muscles relaxed. He brought air down to the bottom of his sternum. He visualized himself not as a weakling but as a dense little torpedo penetrating the bullshit of the world, and that always made him smile.

Good-bye to all he’d escaped. He’d never have fucking duck eggs again, with those bright yellow yolks, he’d have the regular, white, chicken kind, clean on the outside, not caked with green guano. He’d never have smelly beanbag chairs, or any kind of lumpy free-form thing splayed on the ground like a carcass. He’d have heat in his bathroom. He’d never run out of toilet paper, by god, and have to use fucking leaves. He’d have toilet paper stacked to the ceiling. He’d keep his place clean, without smoke or the creeping reek of bong juice. Unlike his parents, he’d never throw open-house parties in which guests could arrive any time of the day or night and stay for the rest of their lives. He wouldn’t have a guest room, period! He’d make barbed jokes about guests smelling like fish, so any potential guest would get paranoid. He’d never wear anything ethnic as long as he lived, he’d shop strictly at Brooks Brothers, down to his shorts. He’d invest in stocks and bonds and have a portfolio statement, not some sticky tie-dyed bag full of limp, resinous cash!

• • •

LATER IN THE DAY, there was a knock on his office door.

“Come in!”

Through the door came a short young guy with a goatee and heavily framed glasses. He wore baggy shorts revealing thick, shapeless legs.

“James Shalev,” he said, shaking Paul’s hand. He had a nickel slot between his incisors, which gave him the uncanny appearance of vulnerability and viciousness combined. “Welcome to Greenslopes. I do the VA newsletter and PR, and when you’ve had a chance to settle in, I’d like to do a profile. Mind if I take a quick shot now?”

Paul blinked in the flash.

Shalev took the extra chair and opened his satchel, to present Paul with a short stack of past newsletters. “Here’s what I do. It’s actually considered one of the best hospital newsletters in the country.”

“Yes, it’s impressive,” Paul said.

“We’ve won the Aster four times in the last seven years, honoring excellence in medical marketing. Look, each issue has a theme and variations, but it takes a careful reading to detect it.”

“News is marketing?”

Shalev blinked, as if Paul had just emerged from an ancient pod. “Yes, it is.”

The cover story was about the art exhibition in the lobby, and went on to list the names of the local artists who had contributed. On the inside page was an article on the free shuttle bus that operated continuously between Greenslopes and the Palo Alto Caltrain station. There was a picture of the little shuttle bus. The next page had a continuing feature called “Meet Our Specialists.” This month’s specialist was Dr. Burt Wallman, a psychiatrist who specialized in suicide prevention. Paul restlessly flipped through the pages, not able to detect a theme.

He noted the headline WIDOWS, WIDOWERS HONORED WITH DAFFODILS. It seemed the Daffodil Society of Greenslopes gave symbolic daffodils to the families of vets.

“Did you see it?” asked Shalev.

“See what?”

“You’re picking something up. Try to say what it is.”

“Man’s inhumanity to man?”

“Close. This month’s theme is regeneration, starting over, springtime.”

Paul said, “Why did you write this? As one of the leading clinical trials hospitals for veterans, Greenslopes is proud of the wonderful relationship it has forged with widows… ?”

“Nothing wrong with it, is there? Here’s your dependent clause headed by your subordinating conjunction—”

“It implies that the clinical trials create widows.”

Shalev said, “The people in your trial, they’re either brain damaged or brain dead, aren’t they? But nobody stops hoping.”

“Nobody ever said this was about a cure.”

“Have you talked to any of the families?” Shalev prodded.

“What do they think?”

Shalev gathered the pile into his case. “Someone they love is laid out before them, trapped in an endless sleep. You ever loved someone in a coma?”

Paul shook his head.

“From what I’ve seen, when someone you love is in a coma, you simply want to believe. As long as they’re alive, there’s hope.” He snapped the latches on his satchel, and adjusted his glasses. “We had a trial in here last year with big funding, they extracted the essence of a tumor, gave it a whirl in a centrifuge, then injected a concentrated dose back into the patient.”

“Immune therapy, very cutting edge,” Paul said.

“The volunteers went extinct in a matter of weeks. But research-wise, hey, it was a big success. Doctors high-fiving each other all over the place.”

To extract more of Paul’s essence, they made plans to meet again. And after Shalev left him, Paul gauged he’d been spending too much time in the lab. Bedside manners had never been his strong suit. Maybe he could delegate them.

But the greats knew how to handle their patients. Look at the superstar neurologist Oliver Sacks. Patients adored him, stayed in touch for the rest of their lives. Paul recalled an interview in which Sacks said he loved to find the potential in people who “weren’t thought to have any.” That noble sentiment had haunted him since. Surely his commitment to medicine showed that he cared in his own way. Was it his job to deal with magical thinking too?

• • •

AND THEN TO TASSO STREET. Veblen had that tendency to try to coax some desired outcome from anything he told her, her face as bright as a daffodil, overpowering him with good cheer. She met him at the door and gave him a kiss. “So, how’d it go?”

“We’ll see,” he said.

“How’s your assistant? What’s she like?”

“Seems efficient.” He went to wash his hands in the sink. His lifelong habit, on the hour. Wash hands. Wash off the world.

“Everything all right?”

Paul grabbed a dish towel and twisted it. “It’s probably not fair to hate her for saying ‘in clinic,’ is it? ‘I’ll see you in clinic.’”

“She dropped the article? What a bitch.”

“Yeah. It sounds clammy and invasive, like she’s breathing on my genitals.”

Veblen backed off, took two beers from the refrigerator, popped the caps. “She’d better not.”

“Thanks.” Bottoms up. The beer tasted bitter, and landed heavily in his gut. “It’s a lot to absorb. They’ve had a big response to our call for volunteers.”

“That’s great, Paul. See? You deserve it.”

“The question remains, what ‘it’ is I deserve.” He sighed. “All these caring families are hanging around. It feels like a lot of pressure. I hope I know what I’m doing.”

“That must be unnerving. Take one day at a time,” Veblen said. “No one expects you to undo the damage of the military industrial complex overnight.”

“Ha!” He snorted. “Are you sure?” He finished his bottle. The foam bubbled on his lips, tickling like root beer and first kisses.