Then Nick picked up a throw rug in the shape of a yellow puppy. On the floor were crisscross lines where tape had been applied. “Her nephew did that.”
“What is it?” Jordan asked.
“A hopscotch grid,” Moy said.
“It was,” Nick said. “And she was pretty spry for her age. You would hear her singing and trying to hop about. We peeled the tape off when she took a fall.”
Jordan looked rattled. “But if she was happy, what’s the problem?”
“If Mary was your mother and you didn’t mind her playing with dolls and doing hopscotch, that wouldn’t be a problem. But if she’s doing it all day long, you may yearn for Alzheimer’s.
“The other thing is that she’d turn violent when it was time to take her antiseizure pills because she knew what they did. But it was the little blue pill that brought back her childhood.”
Nick held up a folder with a small stack of letters from family members. “These are requests from family members to withdraw their relatives from
Memorine. Mary’s daughter had threatened legal action if we refused. We complied, but not soon enough.”
“So you recommend we ask for an extension to work out these problems.”
“Yes.”
“We have a strategy meeting in June. We’ll work it out,” Moy said, and left the room. The others followed through the door. In the corridor Moy stayed back until he and Nick were alone. “You really believe they’re remembering that far back?”
“Yes. We’re rewiring areas in their hippocampus that’s sending them back.”
“How far?”
“Mary Curley’s daughter says she recalled events in the Ohio house where she was born—where they lived before the family moved east.”
“And how long ago was that?”
“Seventy-five years.”
Moy’s face appeared to shift slightly.
“She was less than three years old.”
Moy held Nick’s gaze for a moment until Nick felt something pass between them. Then Moy turned on his heel and left.
FIVE, SIX, SEVEN MORE DAYS PASSED, and Jack added another nine, twelve, and fourteen minutes to the time he could walk unassisted. Every day he made mincing little steps of progress.
According to the doctors, he had sustained no impairment to his thinking and reasoning skills, nor would he need speech therapy. So the rehab team focused on making him physically stronger and getting him to walk again. Thus his day was blocked out in sessions with the whirlpool, foot hydrotherapy, the rehab gym, and the physical therapist who had him keep active four or more hours a day.
His progress was considered remarkable by the staff, the result of his own determination to get back on his feet and out on his own. And they would hoot and high-five him and praise his strength of will. His recovery had pushed the envelope.
But it was more than strength of will and muscular reconditioning. Jack wanted out of Greendale. Call it bad karma or superstition or sour psychic residue. But the place was buggy with nightmares and bad flashes—so much so that he began to dread sleep for fear of being assaulted by grade-B horror flick snips. The nurses gave him different drugs that sometimes helped.
But the good news was that Vince had located a place to lease—a small Cape cottage he could have for the next nine months. And it was in Carleton, Jack’s hometown.
That was also the bad news, for it was near the old neighborhood where he and Beth had shared their home.
“HI, JACK. THIS IS DR. NICHOLAS MAVROS.”
A squarish middle-aged man with thick gray hair stood next to Marcy. In a black sport shirt and chinos, he didn’t look like a doctor—maybe because it was Saturday or because the docs here didn’t dress in white. The man had a wide, toothy smile and dark eyes that were hidden behind thick Coke-bottle glasses.
“Dr. Mavros assisted Dr. Heller when you were first brought to MGH.”
Mavros’s hand was meaty and cool. “Good to finally meet you awake. How you doing?”
“Better.”
“Good, good. You’re quite the Comeback Kid.” Mavros smiled broadly. “The PT reports say you’re progressing marvelously. And there’s no evidence of any neurological damage. In fact, quite the contrary. The memory centers of your brain are very active. Which is the most important thing, right?”
Jack nodded. Dr. Mavros’s large opaque eyes bore down on him. And though it was barely perceptible, Jack felt his innards tighten.
“You’re a medical wonder. And if you don’t mind, I’d like to run a functional MRI on you someday.”
Jack was not interested in more tests, and made a noncommittal nod.
“Do you recall anything about the actual accident—swimming, the jellyfish attack?”
“Not really. Just jumping into the water, some vague image of jellyfish, then I’m here.”
Mavros nodded woefully. “They got you pretty good.”
“I don’t recommend it.”
“I’ll say.” Mavros smiled brightly. Almost too brightly, as if trying to slide into the next question without notice. “And just out of curiosity, what were you doing out there on Homer’s Island? Seems like a rather remote place to be.”
“We used to rent a place out there.”
“We?”
“My family.”
“Your family … ,” Mavros repeated, leaving an inviting gap for Jack to fill in.
“A vacation rental.”
“I see. Were you staying there at the time of the jellyfish attack?”
Outside thunder cracked. Jack had already tired of the line of questioning. “Just wanted to see the old place.”
“I see.”
But it was clear that the good doctor didn’t see.
“Do you remember how old you were when you first started going out there?”
Jack shook his head. “I was a baby.”
“Do you remember the name of your first-grade teacher?”
“My first-grade teacher? I already had memory tests.”
“Just checking.” And Mavros flashed a thousand-watt smile.
“Miss Van Zandt.”
The doctor jotted that down on his pad, and Jack wondered how he’d check for accuracy.
“What were your adoptive parents’ names?”
Jack told him.
“Do your remember your biological parents?”
“No. My father died when I was six months old, my mother when I was two.”
“So you don’t remember them.”
Jack felt himself slump. “No.”
The doctor looked at his notepad. “The nurses say that you’ve complained of bad dreams, which is consistent with the reports while you were in the coma. Do you remember anything about those dreams—any specifics?”
“Nothing very clear.”
“Can you characterize them in any way?”
“Disturbing.”
“Disturbing?”
“Violent. Images of someone getting hurt.” Jack felt his heart rate notch upward.
“Can you see who it is? Who’s involved, or how they’re—”
Jack cut him off. “No, and I’d rather end the questions, if you don’t mind. I’m very tired.”
“Of course. I understand, and I’m sorry about this.” Then his face brightened again. “But thank you. And you should know that we’re delighted with your progress.”
Jack nodded. He was drowsy all of a sudden, as if he’d been drugged.
Before the doctor left he said, “I hope I didn’t upset you with my queries. It’s just a routine thing, you understand.”
“No problem.” Jack closed his eyes.
“Just one more, if you don’t mind. One of those standard memory test things.”
Jack opened his eyes.
“Your biological mother. What was her maiden name?”
“Sarkisian.”
Mavros looked at him for a protracted moment. Then he nodded.
But he did not ask to spell it, nor did he write it down on his pad. He just stared at Jack without expression, then thanked him and left the room, leaving Jack thinking that this was the third person in a week who wanted to know his mother’s maiden name.
“WE HAVE A PROBLEM,” MARK THOMPSON announced.
Of the thirteen chairs around the huge shiny cherrywood conference table in the boardroom of GEM Tech, six were occupied. Five men and one woman: Gavin Moy; legal counsel Mortimer Coleman; marketing director Marilyn Pierce; medical director Mark Thompson; principal investigator for the clinical sites in Connecticut Zachary Mello; and Jordan Carr. Conspicuously absent was Dr. Nicholas Mavros.
“Peter Habib has gotten Nick thinking there’s a causality between these so-called flashback seizures and Memorine. Since the suicide-ruled death of one of his patients, he is asking for an immediate review of clinical protocol.”
“Even before Utah?” Moy asked.
“Even before Utah.”
“What about Nick?”
“He’s more open-minded but he’s susceptible. Apparently Peter has forwarded him data.”
“Wasn’t it Peter who first raised a flag?”
“Yes. And now he wants to alert the agency.”
“What about Nick?”
“I think he’s willing to wait until Utah. But the point is that he’s losing his proper vision on this project,” Thompson continued. “And frankly that makes him something of a liability for this trial and this organization.”
“If you’re suggesting we replace him as chief PI, that’s not going to happen,” Gavin Moy declared. “That’ll only invite the press to ask why, raising the kind of speculations we don’t need.”
Mort Coleman agreed. “Axing Nick because we don’t like his position on the drug’s efficacy is not the way to go. He’s an iconic figure in the medical community and is identified with these trials and GEM Tech. That would be counterproductive.”
Marilyn Pierce cut in. “Not to mention how the FDA would react once Nick began talking to the press about his termination. That’s not a viable option.”
“But there is a viable option,” Moy said. “Hiring an independent clinical research organization. Not only is that the most legitimate way to go, but I’m betting it’ll get Nick to come around.”
“Come around to what?”
“To stop suggesting that we ask the FDA for a friggin’ two-year extension.”
“Christ, is that what he’s doing?”
“Yes.” Moy poured himself some coffee from the decanter. “So what we do is consult an expert clinical research organization. We submit them all the clinical data, have them go through each case report, put them on spreadsheets, blah blah blah, and determine any problems and if so whether they fall within the projected end points of the target population blah blah blah.”
“But that could still take months,” Jordan said.
“Not if we make it worth their while,” Moy said. “But Nick’s right. It’s better safe than sorry.”
Coleman agreed. “We don’t want to explode onto the market only to discover that we’ve got a billion dollars’ worth of lawsuits dogging us like with Fen-Phen or Vioxx or those rotavirus vaccines that got yanked.”
“And what if this CRO determines there’s a … correlation?” Jordan could hardly word that possibility.
“If that’s the case, then we have to determine that segment of the population for whom these side effects can’t be eliminated. But, at least, usage of the drug can be screened and made available only to people not susceptible, who meet specific eligibility criteria—or under conditions where the benefits may outweigh the risks. That’s what warning labels are for.”
“Even in the worst-case scenario, say thirty percent are risk cases, seventy percent of the market is still blockbuster proportions.”
“I think the CRO option makes sense,” Jordan said. And the others agreed.
Moy named the Klander Group, a New York organization GEM had used in the past. Moy also was good friends with Allen Klander. All agreed. “Good, that settles it,” Moy said.
Before they headed for lunch, Jordan pulled something out of his briefcase. “I assume you’re aware of this news item.” He handed Moy a photocopy of the
Boston Globe
article as well as copies to the others. The headline read: “Jellyfish Coma Victim Recovers After Nearly Seven Months.”
A 33-year-old Carleton man who had spent six months in a “persistent vegetative state” recently regained consciousness at the Greendale Rehabilitation Center in Cabot, Mass … .
“Is this a problem?” asked Marilyn Pierce.
“Is what a problem?”
“The article goes on to say that the guy returned from the coma with memory powers that baffle his doctors. Some sharp-eyed neuro-pharm person from another lab might find a connection to the Solakankji jellyfish and scramble to come up with a competing compound for treating dementia, you know, tweak the molecule a little and get their own patent.”
“Hardly,” Coleman said. “We’ve got the patent for the parent compound, plus patents on sixteen molecular ‘for use’ variations. Nobody else is even close, unless they’ve got a variant synthesis we haven’t thought of.”
Coleman was right. Those patents represented proprietary as well as legal rights to scientific property. For another company to develop a competing compound, it would have to be an ingenious and unforeseen molecular variation that also demonstrated pharmacological uses in combating Alzheimer’s or other forms of dementia—a process of biochemical identification, extensive three-phase testing of animals and humans, and the implementation and organization of the R&D required to launch a decade-long process. Even if some little-known lab could secretly put together a competing drug, there’d be a leak—if nothing else, word filtering down from the FDA, one of the many Alzheimer’s associations, or employees in the very tight and incestuous pharmaceutical industry.
“Someone would have to make a connection between the jellyfish and the guy’s enhanced memory,” said Thompson. “And there’s no way anybody would. You just have a miraculous recovery. And sometimes that happens.”
“Not a problem.” And Moy slipped the article into his folder.
But Jordan thought that he detected a lingering concern in Gavin’s face.
Whatever, they would take the CRO route. And if all went well, they’d go to market before anybody else. Thanks to marketing, Memorine was not just a household term already; it had become to the needy an incantation.
GAVIN MOY SAT ALONE AT THE head of the table after the others had left. From outside he could hear the sounds of jets on their approach to Logan Airport over Boston Harbor.
His eye fell on the newspaper article again.
Jack Koryan.
It sounded French or maybe even Irish (like one of his neighbors at Bayside, a guy whose face was the map of County Cork—named Kevin Lorian).
Maybe even Israeli—à la Moshe Dayan. Possibly Arabic, a variation of
Koran.
Whatever, the guy had been sent into a coma for nearly seven months.
Moy had wondered at the odds of a casual tourist on Homer’s Island getting stung by Solakandji. Those things don’t come around but once in a blue moon—could be decades between occurrences. An absolute rarity.
But who was this Jack Koryan? And what the hell was he doing out there taking a swim with a storm brewing?
A simple statistical coincidence. Nothing more, nothing less.
Maybe Mark Thompson was right. Maybe the real problem was Nick Mavros.