Part 14 (1/2)
”A proposal.”
”Proposal? For what?”
”Actually, it's a proposal for us to apply for an orphan grant.”
Dennis coughed; beneath his black eyebrows his eyes opened.
Shane pressed on. ”There's a lung condition, a genetic mutation, called alpha-one ant.i.trypsin deficiency . . .”
”It's a liver gene mutation,” Anthony p.r.o.nounced robotically.
”Right, liver. There's a high-potential cure using a protein we've already developed here.”
Anthony shook his head firmly. ”If a patient is alpha-one ant.i.trypsin deficient, they'll develop emphysema. We're focusing on that.”
”Would you mind maybe having somebody read it? I'd love to know if I made any sense,” he said, extending the folder.
”We only pursue drugs for immature populations when there is potential for significant scientific breakthrough. You said we already isolated this protein?”
”Doctor Acharn did.”
”So what is the potential for discovery?”
Dennis shot Shane a look. ”Our motto is, Profitable Biotechnology. You should read your coffee mugs.”
”I thought it was, Where Science Is the Star?”
Anthony stared hard at him. Angrily he said, ”We're curing cancer here.”
Shane felt his face flush.
”We're going to take our people off of diseases that kill tens of millions of people a year to put them on one that affects almost no one? With no hope of discovering anything new?”
”I guess it's called an orphan”-Shane smiled-”because it needs our help.”
”It's called an orphan,” Anthony replied, ”because it is unwanted.”
He took up his laptop bag, turned to Dennis, nodded sharply, ”Okay,” and left. Shane was aware of a ball forming behind his Adam's apple; his file stuck warmly in his hand.
Dennis's black eyebrows curled. ”What the h.e.l.l?”
”I know someone whose kid was born with this. I thought it would be respectful to have things thought through. I should have asked you how to handle it. That was bulls.h.i.+t. I'm sorry.”
Dennis's face betrayed an almost parental frustration.
Shane left the conference room and walked down the hall. At the old elevator he turned. Dennis was still standing in the doorway; he had not taken his eyes off of him.
He sat across from Prajuk Acharn in a booth at a McDonald's near Pinon Drive.
Shane swallowed his lunch uneasily; it did not escape him that the biotechnology which made replacing proteins possible also provided the food in front of him. Outside a smeared window, a teenaged employee waged a futile battle against freeway grime with a window mop.
”So,” Prajuk grinned. ”Anthony told you to p.i.s.s off.”
”Right in front of Dennis too.” He smiled. ”Why are you laughing?”
”This thing is funny. Like watching someone walk into a door. Out of curiosity, what was this thing, your proposal, going to tell him?”
”A lot of it was a case study on Ceredase.”
Prajuk chuckled. ”This guy is top of his field in the world. He knows about Ceredase.”
Shane frowned; the scent of grease and antiseptic became overwhelming. He pushed his tray away.
”Did he say anything at all?”
”He reminded me that we're here to cure cancer. Dennis talked about money.”
Prajuk leaned back into the stained red leather booth. ”Make no mistake, they are the same thing. P and P took the company public because they wanted money. To cure cancer. There is relentless pressure on everyone to beat these Goldman Sachs a.n.a.lysts' calls, because we want money to solve for cancer. If Poulos never figures out how to end cancer, I think he will consider his life a failure. Anthony too. And to do this thing takes a great deal of f.u.c.king money.”
It was amusing, Shane thought, to hear him curse in his high voice.
”Look,” he continued, moving his fingers over his fries, ”we take money from hedge funds, and college endowment fund managers, and police department pensions, and soccer moms with an E-Trade account, to pay for all of this research. But these investors are not in our stock to cure cancer, or teach the body how to live with it. They are in it for profits. If our stock goes down? They will not care that we might only be a year or two away, they will sell. And we have to make appropriate cuts in research. And so Anthony Leone will not approve anything that threatens us with a loss. Unless”-he raised his finger-”it leads to something new. Which this does not. Why didn't you come to me?”
”I really thought he'd say yes.”
”Even if he did, formal testing would take ten years. An infant with alpha-one ant.i.trypsin deficiency,” he reminded Shane flatly, ”does not have ten years. Or even three.”
”Clinical trials are f.u.c.king immoral,” Shane spat. ”At Orco, they tested a leukemia drug, okay? Everyone in the test was going blastic, but half the people got a placebo. The drug pa.s.sed trials, Orco is making billions, half the test group was ignored. It's barbaric.”
”Testing without controls is more barbaric. Imagine if the half they gave that drug to died instantly?” Prajuk was watching him curiously. ”You have to think clinically, Shane. Phase One of a trial involves a hundred people. It exists to determine side effects. This is urgently important. Ninety-nine percent of drugs are proven unsafe right there. Without controlled Phase One testing, we risk killing millions of people later. Those people in that trial you mention understand their risk. They volunteer to partic.i.p.ate to be part of finding a solution. One hundred voluntarily put themselves at risk to save millions. Those numbers are not barbaric, they are actually quite civilized.”
”Thinking in numbers is immoral too.”
”The dictators.h.i.+p of numbers,” Prajuk informed him, ”is the process of history.”
Shane shook the ice at the bottom of his cup. ”I'm not going to stop. I'll go to other drug companies.”
Prajuk smiled wistfully and wiped ketchup from his lower lip with the back of his hand.
”What about you? It's your discovery, your work, and it's just sitting there. Doesn't that bother the s.h.i.+t out of you?”
A knowing expression took over Prajuk's face. ”I wanted to study computer science my whole life. But once I experienced biomedicine I was seduced completely. I left Khon Kaen when I was eighteen, to attend MIT. Afterward, I went for graduate work at UCLA. It was difficult. Even though LA was closer to Thailand, I felt much more homesickness there. I felt better at Stanford, where I did my postdoctoral work for Steven Poulos. We spent uncountable hours side by side in his lab, as he finessed his enzyme into Sorion. Which enabled the company to go public and hire hundreds and later thousands more people. All of this is in some way my work, Shane.”