“WELL, YOU GOT YOUR OUT-OF-COURT SETTLEMENT, and it cost me a friggin’ bundle,” said Gavin Moy.
“Two years from now, it’ll look like petty cash.” GEM Tech stocks that morning were up by twenty percent since last week over the rumors about the new Alzheimer’s drug. In a year Nick’s holdings would double several times over. And Jordan Carr would probably own an entire fleet of Ferraris.
It was a warm late October day, and Nick and Gavin were riding at thirty knots southward on Gavin’s boat in celebration of the settlement and Nick’s agreement to head up the clinical trials. When Gavin asked where he wanted to go, Nick said he had never been through the Cape Cod Canal. It would be the last run before Moy put the boat in dry dock.
A thirty-eight-foot Sea Ray sport cruiser with twin 350 horsepower Mer-Cruiser engines, the boat was long, sharp, and very fast; and it was named the
Pillman Express,
Moy’s punning homage to George Pullman, whose railroad car industry grew into a dynasty. Teddy drove while Nick and Gavin settled back at the stern.
According to Moy, Broadview Nursing Home had assumed full responsibility for negligence in the death of Edward Zuchowsky, while, behind the scenes, GEM Tech paid the lawyer fees and damages. The Zuchowsky family agreed to accept a settlement of $1.5 million as well as an apology from Broadview and a promise to upgrade the security system of Broadview and other homes in the network.
“So, to use your phrase, ‘God’s in His heaven, all’s right with the world, right?’”
“It’s actually Robert Browning.”
“Whatever. So how’s your colleague and former student doing?”
Nick let pass the sarcasm in Moy’s voice. “She’ll be relieved it’s all behind her.”
“Some things are better left forgotten,” Moy said.
“I guess.”
“By the way, we’re going to make an official announcement in a couple weeks—press release, video, you name it—the whole nine yards.”
Moy beamed at Nick as if he were Moses glimpsing the Promised Land. Nick nodded, thinking he would not spoil the moment by reminding him of the flashback issues that lay before them—the delusional seizures that had probably led to the killing of Eddie Zuchowsky and the death of one of Peter Habib’s patients, William Zett, on a playground slide.
No free lunch in pharmaceuticals. No magic bullet
—
or very few that don’t leave scars.
They had left Marina Bay at nine that Saturday morning, when the sea was like polished marble, and headed down the coast. A little before noon they passed through the canal and out into Buzzards Bay. They lunched at Woods Hole, then by two they headed deeper into the bay at Nick’s request.
On the right they passed Naushon and Pasque Islands and some of the others in the Elizabeth chain. Short of Cuttyhunk, Moy asked Teddy to turn the boat around because he wanted to catch the tide and the headwinds.
As they swung around, Nick nodded toward a low blue hump on the western horizon. “Isn’t that Homer’s Island?”
“Yup,” Moy said without even looking.
“You been out there recently?”
“Nope.” Then Moy waved at Teddy to head back.
Teddy leaned on the throttle, and the boat roared back up the ferryboat lane toward the canal which would take them back home.
“You remember that guy I was telling you about—the one who got caught out there in the jellies?”
“Yes, Jordan Carr told me something about it. In fact, I saw the blood workup.”
“Quite a coincidence.”
“I guess. What’s the name again?”
“Koryan. Jack Koryan.”
Moy shrugged. “Sounds like a countertop. How’s he doing?”
“Still comatose. It doesn’t look good.”
Moy nodded and raised his face to the sun and took a huge breath as if he were trying to drain the atmosphere. “Man oh man, it doesn’t get much better than this.”
“No, it doesn’t,” Nick said, thinking that maybe that was that about that.
But it wasn’t.
THREE WEEKS LATER IT WAS THE lead story. And René clicked up the volume as the Channel 8 anchor made the announcement:
“More good news in the fight against Alzheimer’s disease. At its annual meeting of shareholders, GEM Neurobiological Technologies announced some early successes in its trial use of Memorine, the lab’s revolutionary experimental drug for the treatment of various forms of dementia, including Alzheimer’s disease.”
The screen then showed a female reporter outside of Mass General Hospital. “Patients enrolled in GEM’s phase three clinical trials of the Memorine compound were diagnosed with early or mild forms of Alzheimer’s. And early reports have shown very promising results.
“Heading up the team of clinical physicians and researchers is Dr. Nicholas Mavros, neurologist at MGH.”
They shifted to Nick at his desk. “It’s very exciting to participate in this historic effort to develop a cure for Alzheimer’s. Until now there’s been no way to stop the decline in mental functions. And certainly nothing to reverse the disease’s progress. It’s still relatively early in the trials, but we’re seeing cognitive improvement in nearly forty percent of our trial patients.”
René could feel Nick’s restraint. Successful trial results were not officially made until the study was complete and findings were published in a reputable journal. But, of course, this was Gavin Moy’s ploy to start a Memorine fever.
Their faces strategically blocked, trial patients were shown doing puzzles, writing on pads, talking to nurses and aides. Many smiled and looked focused. There was tearful testimony from Christine Martinetti who told how her father was regaining his memory and coming back to his old self. “When we put him in the nursing home, he was confused and frightened. He got people mixed up. He couldn’t recognize family members. He struggled to do simple tasks like tie his shoes. Now it’s all beginning to come back.”
The camera shifted to Louis sitting in a chair with one foot on a stool as
he tied his shoes while chatting with an aide. He looked at the camera and waved with a big smile. And René felt a warm surge in her chest.
“He still has a way to go, but it’s a miracle what’s happening in him. A miracle.”
“And a miracle it seems to be,” the reporter continued. “We spoke to Mr. Martinetti briefly about the return of his memory.”
The camera closed in on Louis. He looked wonderful wearing a blue polo shirt and sitting at a table with his hands folded, his face squared in confidence. “Yes, I do feel things coming back to me, especially from way back.”
René’s eyes filled as she watched. She could not help but see her father.
“So, you’re remembering things that you had forgotten.”
“Yes, and I’m feeling more …”
There was a painful pause as he tried to come up with the word. Hating dead air, the interviewer began to talk, “Well, that’s wonderful—”
“Clearheaded. But sometimes the words take a while to come to me, but they do. Better than before.” Louis smiled at the camera and gave a two-finger salute just as they cut him off.
The scene shifted back to the reporter. “Located in Walden, Massachusetts, GEM Tech plans to develop Memorine as an orally available pill.”
On the screen were shots of the GEM complex, the camera panning the main building and surrounding complexes. “The president and CEO of GEM Tech is Dr. Gavin Moy.” Moy’s large, fleshy face filled the screen. “Dr. Moy, what do you see as your goals in these clinical trials?”
Moy adjusted his glasses. “Alzheimer’s disease is the most common and deadly form of dementia affecting people over age sixty-five. Some five million Americans are afflicted, and it’s the major reason why people are institutionalized in the United States. Left unchecked, there will be fifteen million cases in this country by 2025. And that’s what we’re trying to prevent here at GEM Tech. And every indication tells us that we’re heading that way.”
“So, when can we expect Memorine to become available?”
“Based on our great successes so far, we’re expecting to complete trials in nine months, maybe sooner if the FDA fast-tracks our application. We’re very hopeful.”
The camera switched to Nick’s video sequence of a blue brain heavily spotted with red blotches of plaque. As the video ran, the red began to recede and disappear. “What you’re seeing are time-lapsed MRI images showing the actual reversal of the damage in an Alzheimer’s patient’s brain …”
René watched, thinking that Gavin Moy was brilliant and slick as oil.
What he had done was turn a news announcement into a priceless promo for Memorine. And corporate protocol be damned because, no matter how premature the announcement, every prestigious journal in the world would want to publish the results, just as every neurologist would kill to get his or her name attached to the trials. And to potential investors the publicity was catnip. By tomorrow night GEM stocks would probably double again.
The camera closed in on the original patent framed and hanging on the wall of his office. “By the way,” the reporter said, “how did you discover that Memorine was so beneficial to the treatment of Alzheimer’s disease?”
Moy smiled. “Trade secret.”
Nick appeared on-screen again. “What makes Memorine so revolutionary?” the reporter asked him.
“We think that Memorine prompts an immune-system response that destroys amyloid plaques, one of the hallmarks of Alzheimer’s that contribute to brain cell degeneration. It also stimulates the regeneration of new cells in damaged areas.”
Back to the reporter. “According to GEM researchers, patients tested with Memorine experienced significantly better results than participants in the placebo group in measures of thinking and reasoning, day-to-day functioning, and behavior.
“But the drug did not help every individual who took it. At least not as yet.”
Back to Nick: “Some patients may take longer, depending on the stage of their diseases. It may be a genetic factor or a demographic one. That’s part of what we’ll try to determine in the trials. Also for whom it works best, et cetera.”
“Any side effects?”
“That’s part of what the trials will determine. Every drug including aspirin has side effects, some more measurable and adverse than others. But at the present time, there are no conclusive side effects to speak of.”
The report concluded with a shot in front of GEM Tech’s offices. “If approved by the FDA, all indications point to Memorine becoming one of the all-time blockbuster drugs with first-year U.S. sales of five billion dollars. Back to you, Liz.”
The final shot was of Louis Martinetti snapping a salute at the camera.
This is what it’s all about. Yes,
René thought.
Yes.
AND FOR ANOTHER ONE HUNDRED AND twenty-seven days Jack Koryan remained in a profound sleep.
Four Months Later
“MEDS GAMA.”
Nurse Marcy Falco looked up from her chart to Constance Stone, who was tucking in the sheet at the bottom of the bed. “You say something?”
“N-no,” Nurse Stone gasped, here eyes bulging like hen’s eggs. “
He
did.”
“Omigod!”
Jack Koryan was staring at Marcy—eyes locked in purposeful focus, not floating around in their sockets or staring off in different directions. And his mouth was moving.
He repeated those syllables.
Over the six months, Jack Koryan had muttered a lot of nonsense, but this was the first time Marcy saw signs of a breakthrough. “Hi, Jack. My name is Marcy.” Then over her shoulder to Constance: “Get the others. They’ve gotta see this.”
But Constance was frozen in place, her eyes transfixed on a man who for the better half of a year had been a body connected to drips and Texas Catheters.
“Constance! Snap out of it. He’s trying to talk. Get the doctor.”
“Uh.” Constance said, but she was still unable to move.
“Meds Gama.”
“Jack! Jack. What did you say?”
“He’s waking up,” Constance gasped, as if just realizing it.
“Jack, say it again,” Marcy insisted.
And the same syllables scraped out.
“Something about his meds. ‘Meds karma’?” Constance asked.
“Would you
please
get me some help?
Now.”
And Constance bolted out the door. Marcy took Jack’s hand. “Jack? Jack, can you hear me?”
He looked at her, his eyes widening in fear.
“Good. Jack, my name is Marcy. I’m your nurse. I’m going to stay with
you,” she continued. In a strange environment with no frame of reverence, he could panic, maybe even relapse into the coma or, worse, go into cardiac arrest. “I’m not going to leave you. I know this is confusing to you, but you’re going to be okay. But I want you to talk to me, Jack. Do you understand? I want you to talk to me.”
His eyes closed again. Nothing.
Damn!
She squeezed his hand: “Jack, open your eyes again. Tell me what you said. Jack, answer me.”
Jack rolled his head and took a deep breath. But he did not open his eyes.
“Jack, squeeze my hand.” She raised her voice. “Jack, squeeze my hand.” And she felt his hand squeeze ever so slightly. “Good, Jack. Now open your eyes. I know you’re in there.”
Jack’s eyes slitted open.
“Hi. Can you see me?” she asked, hoping even after six months that he would be another of her “witchcraft” wake-up cases. Instantly she shifted into her clinical mode, carefully scrutinizing him for neurological responses. “Look at me, Jack.”
At that moment, several people burst into the room—two other nurses, another assistant, the nursing supervisor, and Dr. Clive Preston, director of the facility.
“His feet are moving,” one nurse said, and she pulled up the bedding to reveal the tennis shoes.
Greendale was aggressive with its physical therapy of coma patients—regularly exercising their limbs and digits, fixing their hands and feet in splints to prevent drop foot and hands freezing into claws. The shoes were intended to keep his toes pointing upward. Despite all that, two weeks in bed was like losing a year of muscular life. And six months of disuse had reduced Jack to scarecrow proportions.
Marcy removed his shoes. “Jack, can you wiggle your toes for me?”
Nothing. His eyes closed again.
“Then just move your feet a little.”
Still nothing.
“Jack.
Jack!
Listen: I want you to open your eyes for me. Please. Open your eyes.”
Jack’s eyelids fluttered slightly then opened partway. He rolled his head toward Marcy.
“Good. Can you hear me?” She lowered her face to his. His eyes were at half-mast, peering at her. But his tongue moved behind his teeth.
“Mmm.”
“What’s that?” She had to get him to track her with his eyes, to confirm that this wasn’t a false alarm.
Jack’s eyes widened and locked on to Marcy’s. And in a barely audible voice scraping through a larynx unused for months, Jack said, “You have big teeth.”
“I sure do.” Marcy’s white front teeth protruded slightly.
The paper skin around Jack’s eyes crinkled ever so slightly, and the muscles of his mouth expanded into a faint smile. Remarkably he was processing memory, even judging with humor. This was incredible. Also the fact that he had articulated his words so well. “Great. Now, Jack, please look at me.”
Jack’s eyes opened with gluey effort, his pupils large, parallel, and fixed on her face.
“Good. My name is Marcy. I want you to tell me your name. Understand?”
He looked down at his arm with the IV attached to the drip bags and catheter running to a bag hanging on the bed’s side and the wires connecting him to the monitors. In a breathy rasp, he said, “Where am I?”
“You’re at Greendale Rehabilitation Home in Cabot, Massachusetts.”
Jack rolled his head toward her, blinking against the lights at the circle of faces looking down at him. “Blurry.”
Marcy’s heart leapt up. Remarkably he was processing thought. “Yes, blurry. That’s from the ointment we put in your eyes. But can you see me okay?”
“Mmmm.”
“Can you tell me your name?”
“Jack Koryan.”
“Great. That’s great.” Because Jack was her patient, the others let Marcy maintain a running monologue to keep Jack awake and to assess any neurological dysfunction. Nearly glowing with pride, she had him wiggle his toes, his fingers, blink one eye, then the next, tell her his full name, to repeat words after her. But what she dreaded telling him was that he had missed the last half year of his life.
“Hi, Jack, my name is Clive Preston. I’m the director here at Greendale.”
Marcy nodded for Dr. Preston to continue. “You had a swimming accident and were unconscious for a while. You’re getting better, but you have to stay awake and keep talking to us. Okay?”
“How long?”
Marcy felt her insides clutch. The shock could be traumatic, maybe even bring on a relapse.
“How long?” Preston asked.
Before he could answer, Marcy cut in. “Jack, the important thing is for you to talk to us.” She took his hand. It wasn’t supposed to happen this way. Patients never just snapped out of deep comas; they emerged gradually, over days—enough time to call in relatives and friends to be there when they woke up. Jack had emerged from a profound coma lasting over six months and was suddenly demanding answers.
His eyes scanned the faces. “How long?”
Marcy wished Beth or Vince were there. The shock could send him into a panic. “Jack, I want to run a few tests on you. I want you to count to ten, okay?”
He closed his eyes for a long moment. But instead of mouthing numbers, he said, “Honesty is the best therapy.”
The words sent a cold ripple through Marcy. Her slogan. What she had said to Beth—but
Jesus!
That was months ago! “Well, now, you’ve been listening.”
“What’s … date?”
Dr. Preston pushed forward. “Jack, I know how confusing this all is, but we’d like you to just answer a few simple questions, okay?”
Jack closed his eyes again and rocked his head slowly from side to side.
“Jack, don’t go back to sleep,” Marcy said. “Please open your eyes.”
“Dreaming,” he whispered.
“What’s that?”
“Dream.”
“No, you’re not dreaming, Jack.”
“Jack, tell me your name again.”
“Jack Koryan.” Then his eyes widened as something passed through him. “What’s date?”
Marcy glanced at the others who looked like wax images of themselves hanging over the bed.
A groan rose from Jack’s throat. “Whatsa date?” he repeated.
Dr. Preston shot a hard look to Marcy, then nodded. He was deferring to her and her baseline policy. To stall him until Beth and Vince arrived would not work. It could even cause him trauma. “Jack,” Marcy finally said, “you had an accident swimming and you’ve been in a coma. You’ve been asleep. Do you understand me?”
And in slow deliberate breath he asked, “How … long?”
“Jack, can you tell me where you live? What town you live in.”
“
How
long?”
To deflect the question would only make him more agitated. But to tell him the truth could be worse.
God, let me do the right thing,
Marcy prayed. “Six months.”
Jack looked at her blankly as he processed her words.
“You had a swimming accident off a beach on Homer’s Island—know where that is?”
Jack nodded.
“Good. Well, you blacked out in the water.” And she told him how he was brought from a hospital on Cape Cod to MGH to here. She narrated the details slowly and deliberately for him to absorb, repeating herself, asking him if he was following her, trying not to get him too upset or excited. She left out the jellyfish. There was no point adding to the shock. When she finished, he looked down at his left hand. For a moment Marcy thought he was trying to make sense of the IV connection. But he was inspecting his fingers.
“Beth?”
“Beth is on her way in. We just called her. Now, I want you to do me a favor. I want you to wiggle your toes.”
“Beth.” He repeated her name again as if testing his memory.
“Yes, we just talked to her, and she’s coming in to see you.”
“Still my wife?”
“Now, Jack, I want you to wiggle your toes for me, okay?”
“Still my wife?”
Marcy knew what he was asking. “I’m sorry, Jack,” she said, and shook her head. Gently she gently stroked his hand. Two months ago Beth moved to McAllen, Texas, to remarry.
Jack closed his eyes, and in a matter of moments his eyeballs began to flutter.
“Jack!” She had to keep him talking. “Jack.” Suddenly his face appeared to reshape itself. The skin across his forehead smoothed out, blanking the frown and scowl lines at the corners of his eyes; his lips began to move as if he were having a private conversation within. Then he made a sweet smile. And before they knew it his mouth opened.
“He’s saying something.”
Marcy lowered her ear to his mouth. “I think he’s singing.”
And in fluttery breaths she heard: “You are my sunshine, my only sunshine.”
But what sent a bolt of recognition through her was Jack’s voice: He was singing in the high, thin, honeyed pitch of a woman.
The next moment Jack let out a raspy sigh and sank into sleep, leaving the others wondering what the hell had just passed through their patient.