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Authors: Robin Cook

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Nano (9 page)

BOOK: Nano
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“I’m sorry,” Whitney said. “That must be difficult. I applaud your persistence.”

“It’s not been easy.”

“Let’s go outside,” said Whitney suddenly. “It’s such a beautiful evening.” She stood up and walked out to join Berman and Pia.

For a few minutes George stayed where he was, now convinced that in all likelihood, Berman was probably sleeping with both Pia and Whitney Jones. He then berated himself for saying what he had to Whitney. Even without alcohol, George knew that social adeptness was not one of his strong points. Asking Whitney the question he had was exactly the kind of weak behavior Pia had tried to shake out of him, if not explicitly, then by example. George helped himself to some more wine and then headed outside to join the others. He was now plainly dizzy and had to move slower than normal, running his hand along the furniture to maintain his balance.

Outside, Berman was still showing off his telescope and had turned off the lights in the living room to help the viewing. Joining in, George found he was impressed again, in spite of himself. He had never seen the rings of Saturn, which were clearly visible. After viewing several more celestial objects, including a distant, sprial-shaped galaxy, George went and stood next to Pia. The alcohol had not only loosened his tongue but made him more demonstrative and even possessive.

“This has been lovely, really, but maybe we should head home,” George said out of the blue. He daringly slipped his arm around Pia’s waist. He was surprised when she didn’t make an effort to elude his grasp as she usually did. If Berman noticed, he didn’t give it away. Whitney on the other hand gave him a discreet thumbs-up.

“The evening is still young,” Berman said, hearing George’s comment.

“It is getting late,” agreed Pia. As far as she was concerned, they had already been there too long. “And I have a lot to do, as you know, Mr. Berman.”

“Zachary. My name is Zachary, or Zach.”

“Okay. Zachary. Thank you for a lovely dinner. And, Miss Jones, thank you, too.”

“Of course. Our pleasure.”

George stayed rooted to his spot next to Pia until she pulled away and headed for the door with Whitney. Berman waited for George, who was taking his time navigating the step up from the deck into the house and crossing the darkened living room.

“Will we be seeing you again?” Berman asked.

“You never know,” George said flippantly.

At the door, George gave Whitney a kiss on the cheek, and she said she was pleased to have met him. George shook hands with Berman and took Pia’s arm as they descended the stone stairs, pretending he was helping her. When they got to the car, both he and Pia looked back up at the house. Berman and Jones were standing at the door, waving.

“That was an odd evening and an odd couple,” said George. He climbed into the car and fell into the seat, leaning back against the headrest. He exhaled noisily as if he were exhausted.

“Are you drunk?” said Pia.

“Oh, absolutely. That was the only way I was going to get through the evening.”

“You were very . . .”

“. . . drunk, is what I was. Am. C’mon, Pia, we’re sitting in the car again. Let’s get out of here.”

11.

EN ROUTE TO PIA’S APARTMENT, BOULDER, COLORADO

MONDAY, APRIL 22, 2013, 10:45
P.M.

At first George kept quiet in the car. He felt very full, of food and wine, and the motion of the car was doing unpleasant things to his stomach. He put his left arm around Pia’s shoulders, and while she hadn’t drawn closer, she didn’t pull his arm away, either. The evening had definitely been taxing, and George was tired and reeling. He felt Berman had skillfully choreographed the event, keeping Pia to himself while allowing Whitney Jones to apply her considerable array of charms on him. He was again irritated at himself for what he’d said to Whitney. Guiltily he looked over at Pia, but she was concentrating on navigating the dark, twisting road. As usual, she looked beautiful. He wondered if Whitney was going to tell Berman what he had said. If she did and Berman told Pia, there was going to be hell to pay.

“What were you talking about with Berman?” George asked.

“When?”

“Most of the evening. It was obvious that he was dominating your attention.”

“Work stuff, mostly, except when he was trying to get me to talk about Rothman and my being kidnapped.”

“He tried to pull me into that.”

“I know. I heard and I have to commend you for not allowing it to happen. Thanks.”

“You’re welcome.”

“He did pay me some compliments about my immunology work vis-à-vis the microbivores.”

“That’s not surprising. It’s deserved, too.” George shook his head, trying to clear the cobwebs.

“He also told me that he wanted me to get back to work on the flagellum issue I told you about, which is really what I was hired to do.”

“Do you have any ideas for that?”

“I do. In fact, while I was talking to him, I gave it some more thought. I had the idea of programming the microbivores that are sent to deal with flagellated bacteria to roll their targets into a ball. You know what I mean?”

“Can’t say that I do.” George put his palm against his forehead. Its coolness felt good. He was beginning to get a headache.

“I’ve explained to you how the microbivores have specific binding sites for the bacteria they’re sent to deal with. My idea is to program the microbivores to roll the bacterium over and over a few times before bringing it into the digestion chamber. That way the flagellum would be wrapped around it and would get digested at the same time as the bacteria’s body. I think it is a masterful idea. My only worry is how much code it is going to take. What do you think?”

“Sounds good to me,” George said, but he was having trouble concentrating. What he really wanted to ask Pia was whether she’d had an affair with Berman, like Whitney suggested, but he didn’t dare.

“Berman seemed to think it was a good idea, but he’s not a scientist. His job is to get the funding, which he seems very capable of doing. I really don’t know how he does it. He hinted that he has found almost unlimited funding. It’s extraordinary.”

“You seemed to be getting on well with him.”

Pia glanced over at George, whose comment implied he was jealous.

“And you seemed to be getting on well with Ms. Jones. She’s very beautiful, isn’t she.”

“I guess so.”

“‘I guess so.’ George, she’s stunning! And you had her all to yourself.”

“I think Berman wanted her to sound me out,” said George, half to himself.

“What about?”

“About you and me. It would be unseemly for Berman to ask me directly. He strikes me as a guy who’s concerned about appearances, so he had his assistant ask me some questions.”

“It didn’t look like you minded being interrogated by her.”

“You’re right, I didn’t.” A thought passed through George’s mind. Was Pia even a tiny bit jealous?

“Did she ask you?”

“Not in so many words.”

“I hope you didn’t say very much, particularly anything personal.”

“Oh, no,” George lied. He was trying to remember what he did say, but it wasn’t easy. Whatever it was, he wished he hadn’t.

“He did apologize for that incident that I mentioned to you.”

“That’s nice. What did he say, exactly?”

“He said he was sorry. He said he’d been under a lot of pressure concluding the funding deal and had had way too much to drink. He said he wanted our relationship to start anew, since he appreciates my contribution to Nano.”

“Did you believe him?”

“So-so,” Pia said. “Not enough to see him socially without you around. But then he went on to say something I found really interesting, something I’d suspected.”

“Oh?” George questioned. He sat up straighter and struggled to clear his mind.

“He admitted that there’s a very specific personal reason he’s interested in medical nanotechnology in general, and microbivores in particular, and what’s driving him to raise the kind of money he has. He thinks that microbivores can possibly control or prevent or cure Alzheimer’s. His mother is struggling with the disease in a nearby assisted-living facility.”

“Very noble of him.”

Pia’s eyes left the road for a moment and darted over at George. “Are you being sarcastic?”

“I don’t know,” he admitted. “I had too much to drink.”

“At least it was good wine,” Pia said.

A few minutes later Pia pulled into her apartment complex’s parking area. She hopped out of the car and headed in, leaving George in her wake. The cool evening air was refreshing for George, so he made it last. Once back inside, he drank three full glasses of water and took a couple of ibuprofen tablets to preempt the headache that was sure to get worse.

When he walked back into the living room, Pia’s door was already closed. George could see the light was still on in her room. He sighed and started to undress, another uncomfortable night stretching out before him.

The door to Pia’s bedroom opened, and she stood in the doorway looking at George. “Thank you for being here so that I could see Berman’s house. I enjoyed it.”

“My pleasure.” George tried to make eye contact, but she looked away.

“Do you really have to leave tomorrow?”

“I do. I was only able to wrangle two days.”

After a pregnant pause, Pia’s eyes zeroed in and locked onto George’s for a fleeting moment.

“Why don’t you come in. I don’t think it’s fair to make you sleep on the couch again.” A second later she disappeared. George fumbled with his clothes half-on, half-off, trying to get to the doorway. He didn’t want her to change her mind. Now he truly wished he hadn’t drunk as much as he had.

12.

THE ENVIRONS OF NANO, LLC, BOULDER, COLORADO

TUESDAY, APRIL 23, 2013, 12:30
P.M.

It had not been the best morning for Pia. First she had to get up earlier than usual to take George down to the bus station to catch a bus to Denver Airport. She hated saying good-bye in general, especially with the potential for a scene since George had ended up wanting to drag it out, sitting in her car. She’d come to appreciate his visit, especially as it had allowed her to see Berman’s house and make sure he knew she had a boyfriend. But the previous night after they had gotten back from the dinner party and she had warmed up to him and wanted to have sex, he’d proved to be incapable with all the alcohol he had foolishly drunk. So she was glad he was leaving, but then couldn’t get him to get out of the car. She had been eager to get to work, looking forward to asking some of the programmers at Nano about the feasibility of her mechanical solution to the flagellum problem. When George finally did climb out of the VW, Pia had made sure to leave quickly, lest he return to ask her to promise yet again to be better about answering his communications and pressure her into making a commitment to come out to L.A.

As if saying good-bye to George wasn’t enough, Pia’s morning at work had been a disappointment. First she found out that none of the programmers associated with the microbivores project was available, at least until the following day and maybe not even for the rest of the week. Next, Mariel had the same chip on her shoulder that had epitomized her behavior on Monday. Pia had to work closely with her, and that was difficult when Mariel was in one of her passive-aggressive moods.

But the worst event of the morning was the sudden appearance of Berman in an uncharacteristically jovial and expansive mood. To Pia’s chagrin it seemed that the previous evening’s festivities had not dampened his interests in pursuing a social relationship. Pia had hoped to convey the proper message by showing up with a boyfriend, but it was apparently not to be. If anything, Berman had seemed emboldened, even in Mariel’s presence, making Pia wonder exactly what George had said to Whitney Jones during their conversations.

Berman had invited Pia to a festive dinner for the visiting Chinese delegation and maybe even a movie over the following weekend. On both accounts, Pia had begged off, saying she was going to be busy entertaining her houseguest, which, as it turned out, was not the right thing to say. Berman had responded with: “Didn’t he take an early flight to L.A. this morning?”

Pia had tried to cover her tracks as best she could. Berman had actually helped by finding enough humor in the situation to laugh. “You’ll have to come up with something better than that. And factor this into your thinking: I promise no repeat of my boorish behavior before my China trip. Scout’s honor.” He’d held up his three middle fingers in the form of a scout salute as convincing proof of his sincerity. “You don’t have to respond immediately,” he had added. “Think it over. I’d just like to show some appreciation for your contribution here at Nano. No strings attached.”

Pia had sheepishly agreed to think about the invitations but felt foolish not to have guessed that George couldn’t be trusted not to blab when he had too much to drink.

When noon had rolled around and Pia was able to clear her lab bench, she was relieved to leave and go out for a run. This was part of the new Pia, the Pia who had begun to embrace exercise and outdoor pursuits, as advocated by the company’s healthy-lifestyle policy. If employees exercised and didn’t smoke there was a significantly lower premium on health insurance.

As often as Pia was able, and weather permitting, she would change into her company running gear, most of it emblazoned with the Nano logo, and head out for an hour or so in the middle of the day. As a creature of habit, she always took the same unpaved public road up the mountain and away from the Nano complex.

Running helped Pia center herself. On this particular day she maintained a steady metronomic pace and focused on the physical acts of running and breathing. Her work, and the distinct and different social problems that Berman and George presented her, were forced to the back of her mind. Breathing in the crisp mountain air, she pushed herself to greater effort, reveling in the sensations coming from her quadriceps, hamstrings, and calves. The sun was out and felt strong against her face in the 5,000-foot-plus elevation.

The run was going particularly well, and Pia checked the running app on her iPhone, which was strapped to her upper right arm. The GPS was on, and the app marked her progress on the route, keeping logs of times and distances. As she passed a distinctive weathered pine tree, she saw that she was making great time. The activity calmed her. It was as if she didn’t have a care in the world.

Then, ahead of her in the road, she saw a male figure lying facedown, legs straight and arms stuck out to the side, as if he had been crucified and tipped off the cross and onto the ground. He didn’t seem to be moving, and Pia’s pulse, which had been holding steady at a moderate rate, suddenly picked up speed. Her intuition told her the man was in trouble, and her first thought was whether she was up to lending a hand. She’d been through medical school, but as far as emergency medicine was concerned, her training only made her aware of what she didn’t know. How to actually be a doctor was learned in residency training, which Pia had yet to do. She knew all too well that there was a reason a trainee could not get a license to practice medicine until after some level of graduate medical education had been achieved.

Controlling her anxieties as best she could, Pia ran up and knelt beside the stricken individual, who was dressed in the same running gear she was. He was Asian. Quickly determining the man was seemingly not breathing and had no apparent pulse at the wrist, Pia maneuvered him over onto his back. She shook him forcibly, trying to rouse him. Leaning over him, she put her ear close to his mouth. Now she was certain. The man was not breathing! His mouth was partially open, and along his lips she saw a bit of foam, making her wonder if he’d had a seizure.

Wasting no time, as she knew time was critical, she again felt for a pulse and found none. With the flat of her hand she pounded the man’s chest several times. She had remembered that maneuver from a lecture. What she couldn’t remember was why it was done, but she did it anyway. She then reached for her phone to dial 911 in hopes of summoning help. Thanks to the GPS device in her phone, she could give very precise details of where she was located, which she did rapidly after telling the operator she’d come upon an unresponsive man who wasn’t breathing and had no pulse. Her final comment was that she had no idea how long the man had been lying next to the road.

After being reassured that an EMT vehicle was being dispatched, Pia started administering CPR. Her first priority was thirty chest compressions, using the heels of her intertwined hands. At least she could remember the outlines of the procedure. While she was doing it, she made certain that she was getting at least two inches of chest compression. It was not difficult. The man was lanky, perhaps in his forties, and seemed in good shape and hence was supple. The rationale she knew was to propel blood through the one-way valves of his heart and out into his system to keep the man’s brain alive until his heart could be restarted with a defibrillator.

After thirty compressions, Pia stopped. Quickly she pinched the man’s nose closed, fought successfully against her reluctance to seal her mouth over the victim’s, and forced her breath into the man. She saw that his chest rose appropriately. After two good breaths she returned to the chest compressions. Following thirty more, she broke off again to repeat the breathing. Before doing so, she quickly tried for a pulse at the man’s wrist. Unsuccessful at feeling a pulse, she pushed up the man’s sweatshirt sleeve on his right arm to check for a pulse in his ante cubicle fossa—his elbow. What she saw surprised her: the man was tattooed on his forearm with a series of numbers, reminding Pia of concentration camp victims of the Nazis. She tabled the thought and moved on quickly.

To her surprise, at the elbow she thought she felt a pulse. Encouraged, she then felt for the man’s carotid artery. Here there was a definite pulse! It was rapid and faint but definite, a good sign, provided the circulation was adequate to get oxygen to the brain. With her hand on his neck she noticed something else: the man’s skin seemed hot, but there was no perspiration on his forehead. The thought went through her mind that he might have been suffering from heat stroke despite the cool outdoor temperature.

Pia was confused by the conflicting range of symptoms. In addition to his problematic cardiac status, she saw what looked like urticaria, or hives, on his forearm. It was also apparent that he had vomited, because there was some vomitus on the ground next to him. And there was that foaming at the mouth she’d noticed initially. Pia worried that despite the thready pulse, the man might be about to die of shock, possibly septic shock, with his elevated temperature.

Pia again leaned over to recommence the breathing part of the CPR and suddenly felt resistance when she tried to blow into the man’s lungs. To her astonishment, the man spontaneously started breathing. He even coughed. Pia checked the pulse at the wrist. It was stronger. Then the man quickly woke up.

As if waking from a slumber, he gazed up at Pia with obvious surprise and gripped her by the arm, shaking her as if shocked she was there, and wanted to make sure she was real. He spoke quickly and excitedly in what Pia took to be Chinese. The man then pulled on Pia’s arm in an attempt to sit up, but only managed halfway before falling back. Pia was transfixed, as if she were confronting a ghost. It had been such a sharp recovery: one minute the man was dead, as far as she was able to determine; the next he was very much alive. His eyes were darting around. He seemed terrified.

“It’s all right,” Pia said, trying to calm him. She checked her watch, wondering just how long the man had been without breathing and heart action. She also worried when the EMTs would arrive, hoping they were close by.

The runner again tried to get up. When he again faltered, he spoke quickly—what was he trying to say? The two of them had no language in common, but Pia could tell by the man’s face that his terror was mounting, not lessening.

“It’s okay,” Pia repeated. “It’s okay. An ambulance is coming. Just try to lie still.” She knew it was common for people who’d just suffered a medical crisis to be anxious, but this was different. The man was trying to get up and leave. Who was he afraid would find him?

Pia’s fear was that the man would lapse back into cardiopulmonary arrest, as nothing had been done to alleviate what had caused his heart and breathing to stop in the first place. Yet the man seemed to become more alert as the few minutes passed. When the man heard the wail of the approaching ambulance’s sirens he looked even more scared, and started shaking his head. “No, no,” he said to Pia. They were his first English words. “Please.” He sat up, and this time didn’t fall back.

“It’s okay,” Pia repeated calmly while keeping her hand on the man’s shoulder. “It’s okay. It’s okay. You’ll be safe.”

The ambulance and a Boulder Police car came to a screeching halt, and two EMTs and a police officer hurried to the downed runner’s side. It was clear they were surprised to see the victim sitting up with his eyes darting about.

“I’m a doctor,” Pia announced hastily. “Maybe not a practicing doctor, but a doctor, nonetheless. I was running and I found him collapsed on the road, not breathing, and he had no pulse. I did CPR and got a thready pulse. Then he suddenly woke up. I thought he’d be in shock, but he suddenly seems pretty normal.”

The runner was clearly more agitated with the arrival of the policeman and the EMTs. He was talking loudly, gesticulating madly, and struggling to get to his feet. Pia kept her hand on his shoulder to keep him in a sitting position.

“Hey, sir, take it easy. What’s your problem?” said one of the EMTs.

“He doesn’t seem to speak much English, if any,” said Pia. “He’s very agitated.”

“I can see that,” said the EMT. “We can’t take him to the hospital if he doesn’t want to go. I mean, he looks normal.”

“He has to go. He wasn’t breathing for I don’t know how long. We have to check his brain function and try to figure out why his heart stopped. I’m telling you, when I first got here the man was dead as far as I could tell.”

“Bill’s right,” said the police officer, indicating the EMT. “If he refuses treatment . . .”

“I think he works at the same company as I do, Nano. You’ve heard of Nano, no doubt.”

“Obviously,” the policeman said.

“He’s wearing the same jogging clothes as I am, as you can see. We’re all given this equipment as employees of Nano.”

The EMT named Bill stepped forward with a blood-pressure cuff, but the runner yelled at him and tried to pull away from Pia’s grasp.

“We’re trying to help,” Pia said to the man. “We have to take you to the hospital.”

Pia had been kneeling by the man’s side and now stood up. With Pia’s restraining hand gone, the runner tried to stand, but his knees gave way. Some of the fight went out of him.

“I’ll come with you,” said Pia to the man, indicating herself and pointing to the ambulance and making driving motions. She pointed to the Nano logo on her sweatshirt and then to the one on his. It was the best she could do. The man nodded, as if comprehending. The EMTs then tried to get him onto the collapsed gurney, but the man refused. Instead they helped him first to his feet, something he insisted on, and then into the back of the ambulance. Inside the ambulance they secured him to the gurney. At that point he was no longer resisting, but Pia could see that the fear remained in his eyes. When one of the EMTs jumped out to get in the driver’s seat, Pia climbed in the back.

As the ambulance started and headed back down the mountain, Pia could see that the patient, although calmer than earlier, was still agitated. She wondered what he was so afraid of. She also wondered, if he worked at Nano, which wasn’t a given, what department he worked for. He didn’t look much like a scientist, but what did she know? Since he apparently could only speak a couple of words of English, he seemed like a stranger in a strange land. To try to calm him, she grasped his hand. He seemed grateful. He squeezed hers in return.

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