Of Flesh and Blood (11 page)

Jill was weary from the politics of academia. These days, science was only a fraction of a scientist’s job. Medical research had become a business—awards and published papers its commodities. Jill knew how to play the game. She considered herself equal parts manager, writer, advocate, and publicist. And she was willing to fulfill any role needed. She had sacrificed far too much to see her work fall apart now.

With another pang of guilt, Jill thought of her mother, Angela, and how she had to put her law career on hold to care for her ailing husband. Alzheimer’s disease had made Jill’s father so unpredictable that it was impossible to leave him alone. Consequently, Angela had been forced to turn down the chance to become a district court judge—her lifelong career ambition. Instead she continued to practice law part time from her own home. Though dedicated to her husband, Angela exuded her resentment like steam seeping from a vent. Especially to her daughter.

Jill phoned often and returned to San Diego every few months to look after her father for weekend stints. She felt ashamed for not committing more time to her parents, but her work would not wait for anyone. Her study was too important. She had used that same rationalization to move her lab to Oakdale and drag her husband to the one hospital where he vowed to never work, because the Alfredson was the acknowledged leader in multiple sclerosis research and the destination of last hope for some of its victims.

People like Senator Calvin Wilder.

Jill could still picture the robust and charismatic forty-six-year-old senator from the news clips and advertisements two years earlier when he was
the front-runner for his party’s presidential nomination. Billed by some as the Republican JFK, the Washington State senator had been a shoo-in for one side or the other of the party’s presidential ticket when he pulled out unexpectedly in mid-campaign, citing “family issues.” Despite rumors about his health, Wilder’s handlers had done a good job at keeping the media at bay.

Stepping into the senator’s room, Jill was jarred by the sight of the former presidential front-runner sitting slightly stooped in his electric wheelchair. Wilder could walk short distances—though unsteadily and not without the aid of a cane—but he was forced to use the wheelchair much of the time. He had lost weight since the campaign, and the strong jawline that once made his face both handsome and authoritative now looked disproportionately oversized. Most noticeable was the change in his speech. His once deep silky timbre, the epitome of a leader’s voice, now often emerged as halting. Occasionally, he even stammered or slurred his words. But the man had lost none of his indescribable presence. Standing beside him, Jill felt as though she were in the shadow of authority.

Wilder flashed one of his winning smiles and extended a slightly shaky hand to Jill. “Hope you didn’t come so early on my ac-account, Dr. Laidlaw,” Wilder said.

Jill shook his hand and smiled back. “I try not to keep senators waiting.”

“You ought to.” He chuckled. “No one has more time on their hands than former politicians. . . .” He winked. “Except maybe the
current
vice president.”

With a polite laugh, she pulled up a wire chair and sat down across from Wilder.

He studied her face. “You worried at all about the Alfredson?”

She frowned. “Why would I be worried about the hospital?”

“A very interesting gov-governance structure,” he stuttered. “The board of directors are all descendants of Marshall Alfredson. The same folks own the land and buildings. The whole shootin’ match. You understand?”

Jill had no idea where the senator was going with this. She even wondered if the digression might be a medication side effect. “So basically the Alfred-son family still owns the hospital, right?” she said, trying to humor him.

Wilder nodded. “It’s a fairly unique setup among m-major academic hospitals.”

“And has been like that forever, probably,” Jill said lightly, hoping to be able to steer the conversation back to his condition.

“True. But aside from Catholic hospitals, which are all owned by that guy in Rome,” he chuckled, “most teaching hospitals are endowed by benefactors or charities. They are auto-auto . . .” He took a slow breath and tried again. “They are autonomous. They don’t have to answer to any one person or family.”

“Senator, I know practically nothing about hospital politics,” she said. “I am far more interested in MS and innovative treatment options.”

“I still have a few friends in high places,” Wilder went on, undeterred. “I hear an extraordinary meeting of the board has been called for the end of the month. Very hush-hush. Apparently, Alf-Alfredsons from all over the country will fly in for it.”

Jill forced a laugh. “You think they plan to raze the hospital and put up condos?”

Wilder stared back without smiling. “Don’t you think some HMOs or other health-care corporations might . . . might be interested in trading on the Alfredson name?”

Of course!
she thought, reddening at her obtuseness. The Alfredson effectively functioned as a public hospital, providing care regardless of the patients’ capacity to pay. But it was far better known worldwide from media coverage of the rich and famous who came for treatment of their exotic and deadly diseases. Jill suddenly saw Wilder’s point—a corporation could trade on the Alfredson name and reputation and charge its VIP clientele a small fortune. But no private-interest group would offer anything more than the legislated obligatory emergency care to uninsured patients or, even more alarming from Jill’s point of view, support the current research programs that cost the Alfredson millions every year.

“You don’t really think the Alfredson family would sell the hospital?” she asked quietly.

“I don’t know.” For a moment Wilder’s two eyes drifted apart but then they snapped back into alignment. “Isn’t your father-in-law the CEO?”

“Yes.”
But he would never discuss confidential hospital business with me
. “He’s pretty tight-lipped about administrative issues.”

“Still . . .,” Wilder encouraged.

“I’ll try anyway,” Jill said, as much to herself as the senator.

Wilder’s face relaxed into an asymmetrical smile. “I never used to gossip so much before. Wonder if I can bl-blame the MS for that, too? Hell, why not? I blame it for everything else.” He held open his quivering hands. “Dr. Laidlaw, I was hoping to find out a little about that study of yours that you mentioned the last time.”

“Of course, Senator.”

“I hate to waste your time, but do you mind walking me through the process again?”

“
Mind?
” she said. “I would never enroll you in a study unless you were fully aware of all the potential risks and benefits.”

His lopsided grin grew. “With that kind of thor-thoroughness, you will never become my aide, but I appreciate your approach, Dr. Laidlaw.”

Despite his physical disabilities, Wilder’s legendary charm continued to shine through. Jill saw why he had earned a reputation as a heartthrob among female voters. “If it’s all right with you, Senator, I’m going to start with the basics?”

He nodded. “Please.”

“All neurons, or nerve cells, in the body have a coating—like the rubber insulation around an electric wire—made out of a phospholipid called myelin,” Jill explained. “As you know, multiple sclerosis is an autoimmune disease. In other words, for reasons unknown the patient’s own immune system begins to misinterpret the myelin lining of their own nerve cells as foreign, like they were an invading germ. As a result, the white blood cells—the body’s natural defenders—are programmed to attack their own body’s myelin.”

“Like rats gnawing through a power cable,” Wilder offered.

“Not the prettiest analogy, but basically . . . yes.” Jill frowned. “As you know, people with milder disease have only one episode or a single nerve affected. Others have intermittent flare-ups, what we call the relapsing-and-remitting form of MS.” She held her palm out to him. “Unfortunately, Senator, you suffer from a type of MS that is progressive. The most severe form.”

“I never do th-things half-measure.” His engaging smile resurfaced.

“Traditionally, we’ve had limited treatment options,” Jill said. “At first, all we could do was treat symptoms. In the past ten or fifteen years, we have
been using interferons to try to modulate—in other words, switch off—the immune system’s self-attack.”

A fleeting look of bitterness crossed his face. “Interferons have never helped me.”

“I know.” Jill sat up straighter in her seat. “But my lab has taken a different approach. Rather than try to modulate the immune system—which is like slowing the leak without touching the flood—we’ve been looking for ways to stimulate repair of damaged neurons. To regenerate myelin and even replace the damaged cells.” She looked hard into his eyes. “In other words, we’re not trying to just slow the progression. We hope to reverse the course of the disease.”

“To turn back time.” Wilder lifted his hand and it banged into the handles of the wheelchair. “How does it work?”

“We grow stem cell cultures in the lab. These stem cells are very immature, what we call multipotent cells. That means they can differentiate—or turn into almost any type of cell: bone, muscle, skin, even brain tissue.” Jill nodded. “We’ve genetically engineered two enzymes that we introduce into these multipotent cells. Those enzymes steer the cells into growing brain cells like oligodendrocytes.”

“The k-kind of cells that produce myelin, right?”

“Exactly!” Jill leaned closer, her voice warmed by her passion. “Now we harvest these newly grown nerve cells and inject them directly into your spinal tissue and brain stem. And we hope that the new cells will repair or replace the damaged ones.”

He raised an eyebrow. “You
hope?
”

“It’s worked well in the animal models,” she said. “And in our early human studies, we are seeing promising results.”

“What about the risks?”

“There are always those.” Jill nodded. “We have to give you immuno-suppressing drugs. So you’ll be at risk of infection, even cancer. And of course there are all the usual drug side effects.”

Wilder nodded, unperturbed. “These stem cells. Are they embryonic stem cells?”

Oh, not this!
Jill squeezed her leg in frustration. She knew where Wilder was heading. Many people, particularly on the religious right, but from
across the political spectrum, fundamentally opposed embryonic stem cell research because it involved the use of aborted fetuses and had a theoretical potential to lead to human cloning. That anti–stem cell lobby had hounded her from the outset, and she was fed up with having to defend her research to them.

“No,” she said. “We would harvest your stem cells from the lining of your nose. The olfactory neurosensory cells—the nerve cells responsible for smell.”

His features clouded. “But you do use embryonic stem cells in your research?”

She sighed. “I have. Yes.”

Wilder’s right hand trembled more noticeably. “I have always been opposed to embryonic stem cell research.”

“You’re not in the Senate anymore.” She pointed up and down, indicating his scooter. “Stem cells are the future of treatment for MS and all other degenerative neurological diseases. I don’t mean to sound fatalistic, but I don’t know of anything else that might offer you hope of reclaiming what you have already lost.”

“Lost?
Lost?
” He gaped at her. “This disease has
stolen
so much from me! I want my life back. I want to have another chance to make a diff-difference for people. To advocate for their hopes and interests. Maybe even a return to the Senate or . . .” He stopped short of mentioning another run at the presidency, but Jill inferred it from his tone. “But what would I have left, if I let this rotten disease steal my principles, too?”

The Alfredson Medical Center’s parking garage stood ten stories high and could have serviced a megamall somewhere in the suburbs. Tyler McGrath’s stomach flip-flopped as he wound his car around floor after floor. The evening before, he had stayed up late trying to fulfill his promise to share a birthday toast with his wife. Tyler ended up downing most of the bottle of wine and still nodded off before she returned. He woke fully dressed on the living room couch, draped by a blanket that Jill must have placed over him. Yet despite the hangover, he had shaken off his birthday blues. He even managed to drag himself out for an early morning jog, though the first few queasy blocks were touch-and-go. He arrived at the hospital revitalized and eager to start Keisha Berry and Nate Stafford on their new treatment protocols.

The mammoth lot, even the doctors’ parking area, was often completely full by eight
A.M
., so Tyler was lucky to find a spot on the eighth floor. The engine whined as he backed his new car into the lone spot. Though the six-month-old Japanese hybrid helped ease Tyler’s green conscience, the car had not won him over yet. It wasn’t nearly as versatile or peppy as his old SUV.

On his way to the stairwell, Tyler stopped for a moment to peer out of the opening between the concrete walls. Under the cloudless blue skies, the sprawling Alfredson Medical Center shone before him, a tasteful blend of sleek modern buildings and towers on the north side of the complex and, on the south, the older brick structures that possessed more character. There was living history in those buildings, and Tyler experienced an uncharacteristic wave of pride.

Maybe Dad’s right. Maybe it is more than just bricks and mortar
.

While his father’s words might have resonated more than he wanted to admit, he still had no interest in personally weaving the McGrath name any deeper into the fabric of the Alfredson’s history. What he wanted to do was help Nate, Keisha, and the other unlucky kids on the sixth-floor unit. The thought reminded him of another historical familial connection, though this one from his mother’s side. His maternal grandfather, Maarten Vanderhof, had almost single-handedly established the childhood cancer wards in the late fifties. Maarten was still a legend in pediatric oncology circles. So much so that Tyler was relieved not to share his surname. One medical dynasty was more than enough to shoulder.