Side Effects (20 page)

she asked.

"None."

Kate crossed to her desk, returned with a medication card similar to Ellen's, and slapped it down next to the other. "I think we should try one last time with our friends at the toxicology lab and their magic spectrophotometer.

Ellen's vitamins and these. If the reports come back negative, I shall put all my suspicions in the witch hunt file and turn my attention to other pursuits--like trying to regain some of the respect that was snatched away in the Bobby Geary disaster."

"Don't worry," Tom said, "you still have respect, admiration, and caring in a lot of places ... especially right here." He tapped himself on the breastbone with one finger.

"Thank you for saying that." "Whose pills are those other ones?" he asked.

"Huh?"

"The other card of pills, whose are they?"

"Oh. They're mine."

Friday 14 December

There was an air of excitement and anticipation throughout the usually staid medical suite of Vernon Drexler, MD. The matronly receptionist bustled about the empty waiting room, straightening the magazines and taking pains to see that the six-month-old issue of Practical Medical Science with Drexler's picture on the cover was displayed prominently enough to be impossible for Cyrus Redding to miss, even if he were ushered directly into the doctor's office.

In the small laboratory, the young technician replaced the spool of paper in the cardiograph machine and realigned the tubes, needle, and plastic sleeve she would use to draw blood from the arm of the man Drexler had described as one of the most influential if not one of the wealthiest in the country. Behind her desk, Lurleen Fiske, the intense, severe office manager, phoned the last of their patients and rescheduled him for another day. She had been with Drexler in 1967, when Cyrus Redding had made his first trip up from Kentucky. Nineteen sixty-seven. Fiske smiled wistfully. Their office in the Back Bay section of Boston had been little more than two large closets then, one for the doctor and one for herself. Now, Drexler owned the entire building.

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It was twelve-thirty. Redding's private 727 had probably touched down at Logan already. In precisely an hour, the woman knew, his limousine would glide to a stop in front of their brownstone. Redding, on foot if he could manage it, in his wheelchair if he could not, would be helped up the walk and before entering the building, would squint up at their office window, smile, and wave. His aide, for the last five or six years a silent, hard-looking man named Nunes, would be carrying a leather tote bag containing Redding's medicines and, invariably, a special, personal gift for each of those working in the office. On Redding's last visit, nearly a year before, his gift to her had been the diamond pendant--almost half a carat--now resting proudly on her chest. Of course, she realized, this day could prove an exception. Some sort of pressing situation had arisen requiring Redding to fly to Boston. He had called the office late on the previous afternoon inquiring as ' to whether, as long as he had to be in the city, he might be able to work in his annual checkup.

"Mrs. Fiske," Drexler called from his office, "I can't remember. Did you say Dr. Ferguson would be coming in with Mr. Redding, or did you say he wouldn't be?" "I said ""might," Doctor. Mr. Redding
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wasn't sure." The woman smiled lovingly and shook her head. Vernon Drexler may have been a renowned endocrinologist, and a leading expert on the neuromuscular disease myasthenia gravis, but for matters other than medicine, his mind was a sieve. She and his wife had spent many amusing evenings over the years imagining the Keystone Comedy that would result were they not available to orchestrate his movements from appointment to appointment, lecture to lecture.

The thought of Dr. Ferguson sent the office manager hurrying to the small, fire-resistant room housing their medical records; she returned to her desk with the man's file. John Ferguson, MD, afflicted, as was Cyrus Redding, with myasthenia, was a close friend of the tycoon. The two men usually arranged to have their checkups on the same day, and then for an hour or so they would meet with Dr. Drexler. Lurleen Fiske suspected, though Drexler had never made her party to their business, that the two men were in some way supporting his myasthenia research laboratory at the medical school.

"Mrs. Fiske," Drexler called out again, "perhaps you'd better get Dr. Ferguson's chart just in case."

"Yes, Doctor, I'll get it right away," she said, already flipping through the lengthy record to ensure that the laboratory reports and notes from his last visit were in place. Drexler was nervous. She could tell from his voice.

He was conducting himself with proper decorum and professional detachment, but she could tell nonetheless. Once, years before, he had been ferried by helicopter to Onassis's yacht for a consultation on the man's already lost battle against myasthenia. That morning, he had calmly bid the office staff good day and then had strode out minus his medical bag, journal articles, and sport coat. Bedding's limousine, slowed by the snow-covered streets, arrived five minutes late. Lurleen Fiske joined the two other employees at the window. Across the room, Drexler, a tall, gaunt man in his midfifties, watched his staff pridefully.

"Look, look. There he is," the receptionist twittered.

"Is he walking?" Drexler wanted to see for himself, but was reluctant to disrupt the ritual that had developed over the years.

Lurleen Fiske craned her neck. "His wheelchair is out," she said, "but yes ... yes, he's taking a few st eps on his own. Another year, Dr. Drexler. You've done it again."

There was no mistaking the reverence in her voice.

In spite of himself, Drexler, too, was impressed. In sixty-seven he had predicted three years for Redding, four at the most. Now, after more than fifteen, the man was as strong as he had been at the start, if not stronger. You've done it again. Mrs. Fiske's praise echoed painfully in his thoughts. Myasthenia gravis, a progressive deterioration of the neuromuscular system. Cause: unknown. Prognosis: progressive weakness--especially with exertion--fatigue, difficulty in chewing, difficulty in breathing, and eventually, death from infection or respiratory failure. Treatment: stopgap even at its most sophisticated. Yet here were two men, Redding and John Ferguson, who had, in essence, arrested or at least markedly slowed the progress of their disease. And they had performed the minor miracles on their own. Though his staff thought otherwise, and neither patient would ever suggest so, they had received only peripheral, supportive help from him. They were certainly a pair of triumphs, but triumphs that continually underscored the futility of his own life's work.

From the hallway, Drexler heard the elevator clank open. For years, his two prize patients had been treating themselves with upwards of a dozen medications at once, most of them still untested outside the laboratory. For years he had dedicated his work to trying to ascertain which drug or combination of drugs was responsible for their remarkable results. The answer would likely provide a breakthrough of historic proportions. Perhaps this would be his year.

Redding, seated in an unmotorized wheelchair, waved his aide on ahead and then wheeled himself to the doorway.

Using the man's arm for some support, he pulled himself upright and took several rickety steps into the office.

"Thank you for seeing me on such short notice, Vernon," he said, extending his hand to give Drexler's a single, vigorous pump. "Mr. Nunes?" The aide, a sullen, swarthy man with the physique of an Olympic oarsman, slid the wheelchair into place for Redding to sit back down. Across the waiting room, Lurleen
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Fiske and the two other women beamed like proud grandmothers.

"You look wonderful, Cyrus," Drexler said. "Absolutely wonderful. Come on into my office."

"In a moment. First, I should like to wish your staff an early Merry Christmas. Mr. Nunes?" The expressionless Nunes produced three gifts of varying sizes from the leather bag slung over his shoulder, and

Redding presented them, one at a time, to the women, | who shook his hand self-consciously. Lurleen Fiske squeezed his shoulders and kissed him on the cheek.

"My limousine will go for Dr. Ferguson," Redding said, as he was wheeled into Drexler's office. "He will be here to share notes with the two of us, but not to be examined. He would rather keep the appointment he has for next month, if that is agreeable to you."

"Fine, fine," Drexler said.

The two men, Ferguson and Redding, had met perhaps a dozen years before in his waiting room and had developed an instant rapport. By their next appointment, Redding had asked that a half day be set aside for just the two of them. The request, supported as it was by the promise of substantial research funds, was, of course, granted.

Redding's bodyguard wheeled him into Drexler's office, set the bag of medications on the desk, and left to accompany the limousine to John Ferguson's house. Carefully, Redding arranged the vials and plastic containers on the blotter before Drexler. There were, all told, thirteen different preparations.

"Well, Doctor," he said, "here they are. Most of them you already know we have been taking. A couple of them you don't."

"Dr. Ferguson continues to follow exactly the same regimen as you?"

"As far as I know."

The endocrinologist made notes concerning each nedication. There were two highly experimental drugs >>

till far from human testing that he himself had only learned of in the past six or seven months. He bit back the urge, once again, to warn against the dangers of taking pharmaceuticals before they could be properly investigated, and simply recorded the chemical names and dosages.

Somehow, the two men were screening the drugs for side effects. They had let him know that much and no more. As far as Vernon Drexler, MD, was concerned, with a goodly proportion of his own research at stake, there was no point in pushing the matter.

"This one?" Drexler held up a half-filled bottle of clear, powder-filled gelatin capsules.

"From Podgorny, at the Institute for Metabolic Research, in Leningrad," Redding said simply. "He believes the theory behind the compound to be quite sound."

"Amazing," Drexler muttered. "Absolutely amazing." Rudy Podgorny was a giant in the field, but so inaccessible that it had been two years since he had met with him face to face. Redding's resourcefulness, the power of his money, was mind-boggling. "Well," he said when he had finished his tabulations, "these two preparations have finally had clinical evaluations. Both of them have been shown to be without significant effect. We can discuss my thoughts when Dr. Ferguson arrives, but I feel the data now are strong enough to recommend stopping them." Redding fingered the bottles. "One of these was your baby, yes?" The physician shrugged helplessly and nodded. "Yes," he said, "I am afraid I have hitched my wagon to a falling star." He failed in his attempt to keep an optimistic tone in his voice. Four years of work had, in essence, gone down the drain.

"Then you must strike out in other directions, eh?"

Just tell me, Drexler thought, tell me how in the hell you know the medications you are taking won't just kill you on the spot?

"Yes," he said, through a tight smile, "I suppose I must." The sleek, stretch limousine moved like a serpent through the light midafternoon traffic on the Southeast Expressway. In the front seat, Redding's portly driver chattered at the taciturn Nunes, whose contribution to the conversation was an occasional nod or monosyllable. In the rear, seated across from one another, surrounded on all sides by smoked glass, Redding and John Ferguson sipped brandy and reviewed the session they had just completed with Vernon Drexler.

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"I am sorry things have not been going well with you, John," Redding said. "Perhaps we should have stayed and let Drexler examine you."

"Nonsense. I have an appointment next month, and that will be quite time enough."

"Yes, I suppose so." There was little question in Redding's mind that Ferguson, perhaps eight years his senior, was failing. The man, never robust, had lost strength and weight. He could shuffle only a few dozen steps without exhaustion. His face was drawn and sallow, dominated by a mouth of full, perfect teeth that gave his every expression a cadaverous cast. Only his eyes, sparkling from within deep hollows like chips of aquamarine, reflected the immense drive and intellectual power that had marked the man's life.

Their collaboration, for that is what it quickly became, had begun on the day of their first meeting in Drexler's office. Ferguson, though still ambulatory with a cane, had the more advanced disease of the two. He was employed at the time as medical director of a state hospital outside of the city and was already taking two experimental drugs after testing them for a time on the patients of his facility. Within a year, Redding had begun locating new preparations, while Ferguson expanded his testing program to include them. Quickly, though, both men came to appreciate the need for a larger number of test subjects than could be supplied by Ferguson's hospital. Establishment of the Total Care Women's Health Center in Denver and, soon after, the Omnicenter in Boston, was the upshot of that need. Vernon Drexler continued as their physician, monitoring their progress and watching over their general states of health.

Redding's driver, still prattling cheerfully at Nunes, swung onto 95 North. Although they would eventually end up at John Ferguson's Newton home, his only other instruction had been for a steady one-hour drive.

"John," Redding said, setting his half-filled snifter in its holder on the bar, "how long has it been since you were at the Omnicenter?"

Ferguson laughed ruefully. "How long since I've been anyplace would be a better question. Two years, perhaps.