The Magic Bullet

PRAISE FOR
HARRY STEIN
AND
THE MAGIC BULLET

T
he first change was infinitesimal
—
a mutation in a single nucleotide of a single cell, deep within her right breast. It is impossible to say what caused it, or even if it was necessarily destined to have any impact. Still, from that moment on, that cell was unique among the several trillion in her body. She was seventeen years old
.

Over the next decade, the cell mutated several times. It began to behave autonomously, independent of the controls governing its neighbors. Its shape became slightly irregular. The structure of its nucleus changed. Its metabolism increased
.

Her career was going exceedingly well
.

Eight years later, the cell undergoes a sudden, dramatic change. The
DNA
within its unstable nucleus begins mutating hourly. All the cell’s energy is channeled into growth and reproduction. Normal signals directing it to stop are ignored. Immunological surveillance breaks down. Within a month, it has spawned close to a hundred daughter cells
.

Sometimes she thinks she is living a fantasy. Between her two young children, her work, and her husband, she jokes that she doesn’t have time for problems
.

It takes four years for the next great mutation. The malignant cells now number in the hundreds of thousands; but even if taken all together, are no larger than the head of a pin. Some, however, have already learned how to live outside the breast
.

One afternoon, doing laps in the White House pool, she feels a dull pain in her lower back. She ignores it; seemingly just a minor muscle spasm. The backache lasts twenty-four hours and disappears as suddenly as it arrived
.

D
aniel Logan lay, motionless, on a gurney in a dim cubicle off the emergency room in New York’s Claremont Hospital. He’d been this way for an hour—alone in the dark, seemingly forgotten by the nurses moving in the corridor just a few feet away. Occasionally, in his semiconsciousness, he could hear a faint rumble of thunder; evidence that the storm battering the city this Sunday evening had not abated. As far as the emergency room personnel were concerned, he might as well not even exist.

Dr. Logan smiled. Good, this is just what he’d hoped for when he heard the forecast en route to the hospital, that business would be slow. God knows he needed the rest! He hadn’t made it home from that damn party the night before until nearly dawn, and he’d had to report to the ER at noon; the senior resident in charge of a skeleton crew of one intern, a handful of nurses, and a half dozen support staff. More than ever, he appreciated the sweet truth behind that most cynical of medical maxims: Sickness takes a vacation during lousy weather.

But abruptly Logan sat up, roused by a commotion in the hallway. Swinging off the gurney to his feet, he poked his head into the corridor.

A pair of security men were restraining a large, unwieldy drunk.

“Hey, Doc,” called one of the security men, “want some action on this guy?”

“Gimme a sec.”

The Claremont emergency room was like many others in large city hospitals. Waiting patients could peer through a glass partition into the doctors’ station where, in turn,
the doctors and nurses could survey newcomers and assess which cases required immediate attention; meanwhile charting the heartbeats of those already under their care on a large EKG monitor suspended from the ceiling. Strolling over to the ER reception desk, Logan instinctively glanced up at the monitor. Nothing going on. Only one customer waited on the other side of the glass, a young Hispanic man staring blankly into the middle distance.

“What’s his problem?” Logan asked Nurse Clancy—known as Nurse Amazon, even to her face.

“The drip. Dr. Richman’s already taken a culture.”

“Good.”

She smirked. “Must be pretty bad to bring him out on a night like this.”

Trust me
, thought Logan, heading back down the corridor,
if you had green stuff coming out of your dick, you’d be in here too
.

The drunk was now sprawled out on the bed in a cubicle, held in check by four point restraints, one on each limb. Since the cubicle was designed to accommodate two people, one horizontal, the other vertical, Logan joined the group in the corridor peering within as a nurse drew a blood sample.

“You in, Doc?” asked an attendant named Ruben Perez.

“Wouldn’t miss it.” Looking the patient over, Logan tossed a quarter into the emesis is basin that was serving as the bank; there were already half a dozen others inside.

Logan prided himself on his skill at “Guess the Alcohol Level.” One early morning just the week before, a young Chinese man had been brought in appearing more inebriated than anyone they’d seen in months. The bids ranged from 400 milligrams per deciliter to 800; certain people would be
dead
at 700. Logan’s colleagues laughed when he came in at 275—until the fellow registered 295 on the computer. Logan alone had taken note of the key fact: Orientals invariably have a very low tolerance for alcohol.

Now Logan turned to Janice Richman, the young intern on duty. Shy and unassuming though she was, Richman
had crackerjack diagnostic skills; tonight he was liable to have some real competition. “Okay, Richman, you’re up.”

“Five twenty.”

Logan nodded. “Put me down for four thirty.”

Five minutes later, assorted medical personnel, more than half the staff on duty, crowded around the terminal as a nurse retrieved the winning number from the computer.

“Four thirty-five.”

“Dammit!” snapped Richman, to Logan’s amused surprise. She’d never before shown her competitive side.

“Logan,” exclaimed Ruben Perez, “you’re a medical animal!”

Logan laughed, pocketing the change. “Hey, everyone’s gotta have a specialty. I happen to be a drunkologist.”

He smiled at Richman. “Janice, will you keep an eye on things? I’m gonna grab a bite to eat.”

“Yeah, yeah,” she said, “go blow your winnings.”