Kate smiled. "I watched the whole operation. Under x-ray guidance, Dr. Fielding threaded a tiny catheter into the tumor in Jeanette's brain. He then injected the tumor with a special virus, a recombinant strain of adenovirus that's had a specific gene from a herpes virus spliced into it."
"Wait. Doc, you injected herpes into this woman's brain?"
"Not the herpes virus per se," Fielding said. "Just a piece of it. You see, the altered adenovirus is called a vector virus. I'm oversimplifying, but let's just say it's attracted to dividing cells, and wild cell division is what makes a tumor a tumor. When the vector virus meets the tumor cells it does what all viruses do: it adds its own genetic material to the tumor's."
Kate said, "Think of the vector virus as a Trojan horse, but instead of Greeks it's carrying this tiny piece of a herpes virus—"
"Thymidine kinase gene H5010RSVTK, to be specific," Fielding added.
"—which gets incorporated into the tumor cells along with the virus's own genes. Now, there's no specific drug that will kill malignant glioma cells, but we do have medications that will kill viruses. And one of them, ganciclovir, kills by destroying a virus's thymidine kinase gene."
"Exactly," Fielding said. "And so, after injecting Jeanette's tumor with the virus and giving it time to combine with the tumor cells, we flooded Jeanette with high intravenous doses of ganciclovir."
"Which made a beeline for the tumor," Jack said, getting the picture now. "The herpes gene acts as a homing device for the gan-whatever guided missile."
Fielding laughed. "Homing device and guided missile—I like that. I'll have to remember it next time I'm explaining the protocol to a patient."
Kate said, "The ganciclovir not only kills the tagged virus, it kills any cell carrying the thymidine kinase gene. And since the tumor cells now carry that gene…"
"Blammo," Jack said, filled with wonder. "No more tumor. Sounds like science fiction. Or maybe horror fiction. What kind of mind dreams up something like this?"
"I wish mine had," Fielding said. "But I'm merely following in others' footsteps."
"But who volunteered to be the first patient to have a virus injected into his brain?"
"Someone with nothing to lose. But lots of lab animals paved the way."
"So Jeanette is cured."
"Not completely," Fielding said. "At least not yet. Malignant gliomas are tough, resilient tumors. Her last MRI showed a marked reduction in the tumor's size but she'll probably have to undergo another course of therapy to finish it off once and for all."
Kate turned in her seat and looked at Fielding. "And you still don't see any possible link between the protocol and Jeanette's personality changes?"
Fielding paused before answering. "Getting a reprieve from what is in a very real sense a death sentence has been known to cause enormous psychological turmoil."
Which isn't exactly answering the question, Jack thought, but maybe he's worried about a malpractice suit.
Kate had given him Holdstock's address but Jack hadn't had the faintest idea how to get there. He'd checked out a map before leaving tonight and had the route pictured in his head.
Night had settled in by the time he reached Astor Avenue. He slowed to a crawl, watching for a number.
"There it is," Kate said, pointing to a brick house ahead. "The lights are on. I know Jeanette's in there."
"Okay," Jack said, pulling into an empty spot half a block down. "Now that we're here, what do we do? How do we confirm she's there?"
He was mildly uncomfortable with the situation. Too ad lib. Normally he'd have checked out the house in advance and have a plan in place. And he never would have brought anyone else along. But this was Kate's gig. He was along for the ride and to provide some backup if necessary.
Kate said, "I looked through the living room window last time."
"That's a little risky, don't you think? A neighbor could report us as peepers."
"That would be catastrophic," Fielding said. "My entire career would be in jeopardy if I were even charged as a Peeping Tom."
Your career? Jack thought. If Jack got hauled in for anything—from shooting a crazy on a subway to littering—he could kiss his freedom bye-bye.
"Just a quick look," Kate said, opening her door. "I'll go myself. I've never heard of a woman being charged as a Peeping Tom."
No way Jack was letting Kate do it on her own. He got out on his side, and Fielding did the same. Career or not, curiosity must have got the better of him.
"Let's make this quick, people," Jack said as he caught up to Kate on the sidewalk. "One look, then back to the car to discuss our next move."
"I'll bet they're having that ceremony or séance or whatever it was I saw last night," Kate said.
When they reached the house Kate didn't break stride. She trucked right across the lawn toward the lighted window on the side. Jack slowed, letting Fielding go ahead of him. He brought up the rear, doing a three-sixty scan of the area. A few neighboring windows facing this way but no sign of anybody at them. All probably watching TV. Okay.
Kate reached the window, went up on tiptoe, and stared inside.
Jack heard her excited whisper: "There she is."
As Jack approached, Fielding came up behind Kate and peered over her shoulder. Jack saw him lean closer, then jerk back as if he'd received a shock.
"Oh, no!" he cried. Jack winced at the volume. "Oh, dear God, this is worse than I thought!"
He lurched away from the window just as Jack got there. Through the glass—thankfully it was down—Jack saw eight people sitting in a circle holding hands. And that was it. No one appeared to be speaking. The eight of them just sitting there with these goofy smiles on their faces. He was about to ask Kate which one was Jeanette but she'd slipped away.
"Dr. Fielding!" he heard her say. "Where are you going?"
Jack looked and spotted Fielding heading around the front of the house.
"Inside! I'm not leaving here until I find out what this is about!"
Kate followed Fielding and Jack followed Kate and the three of them wound up on the front steps. Jack went to grab Fielding to try to calm him down and find out what had set him off, but too late; he began pounding on the front door.
Kate looked at Jack and he jerked a thumb toward Fielding with a questioning look. She shrugged her shoulders, obviously as baffled as he.
"Take it easy, Doc," Jack said. "We don't need to wake up the whole borough."
Fielding looked as if he was about to speak when the door opened. A heavyset man with thinning blond hair and eyes too little for his face—his looks fit Kate's description of Terrence Holdstock—stood gaping at his three visitors.
"Why, Dr. Fielding. What a surprise!"
"What's going on here, Terrence?" Fielding said.
"Just a meeting. A support group, you might say."
"Support for what?"
"For the ordeal we've been through, and for the wonderful future that awaits us. All thanks to you, Dr. Fielding."
"Yes, well, I'm glad you feel that way, but how did you all meet? I have strict confidentiality procedures. If someone in my office—"
"Nothing like that, I assure you. We met quite by accident."
''''All of you?" Fielding took a step forward. "Look, may I come in? I'd like to—"
Holdstock didn't budge. "I'm afraid not, doctor. We're right in the middle of our meeting. Perhaps some other time."
"No, please, I must talk to you, all of you."
Holdstock shook his head. "We're fine, doctor. And getting better every day, thanks to you."
"I want to see Jeanette!" Kate said.
"She will be home later. As for now, please let us be."
So saying, Holdstock stepped back and closed the door.
"No!" Fielding cried.
He raised his hand to hammer the door again but Jack caught his wrist before he could land the first blow.
"I don't think that's going to get us anywhere."
Fielding resisted for a seco
nd, then dropped his arm. "I guess you're right."
"That's it?" Kate said. "We're giving up? Just like that?"
"We're regrouping," Jack said. "Holdstock has the law on his side at the moment. This is his house and he's invited a bunch of guests over to hold hands. He can have the local boys in blue haul us off for disturbing the peace here. So I say we go back to the car and settle down and let Dr. Fielding here tell us why he hasn't been straight with us."
Fielding stiffened.
Kate looked at Jack as if he were crazy.
"Look at him," Jack told her. "Look at his expression. And that conversation with Holdstock. Could you make sense of that?"
She turned back to Fielding and her eyes narrowed. "What aren't you telling us?"
Fielding's eyes were haunted. "I know those people in there. They're all my patients. Every single one of them!"
10
"Jeanette is not the first in my clinical trial to exhibit personality changes," Fielding said.
Kate bit back her anger. She sat half turned in the passenger seat as Jack slowly cruised the empty, tree-lined streets. Fielding was a dark blob in the rear, lit occasionally by a passing street lamp.
"What do you mean?"
She could feel her emotions running wild, tugging her in all directions. She wanted to charge back and drag Jeanette from that house; but she also wanted to hear what Fielding had to say. That might be more important right now.
"Over the past month or so I've had calls from the families of a number of patients in the study. They all complained of personality changes or strange behavior."
"Why didn't you say that when I called you this morning?"
"Because I didn't want you jumping to conclusions. And I couldn't handle a barrage of questions for which I had no answers."
"That's why the house call," Jack said, and Kate picked up on his tone… disdain or disappointment, or perhaps a little of both. "It wasn't for Jeanette's sake. It was for yours. There's been a screw-up somewhere and you're trying to cover your ass."
"I did it for many reasons," Fielding said. "I needed a first-hand look at this strange behavior that was being reported. I figured I'd start with Jeanette, then see if I could observe others. I never dreamed I'd find everyone in the trial in one room."
"Everyone?" Kate said. The night was warm but she drew her legs up under her to ward off a sudden chill.
Fielding was nodding. "All eight."
"What's the big deal about that?" Jack said. "They all went through the same thing, so—"
"They shouldn't know each other," Kate told him. "It's standard procedure in clinical trials to keep the patients anonymous. So, if they've never met during treatment and don't know each other's names, how did they get together?" She turned back to Fielding. "Any ideas?"
"Holdstock said by accident, but that's impossible. And how all eight recipients of the same vector strain managed to—"
"Same strain?" Kate exclaimed. "You mean they all were treated with the same virus?"
Fielding didn't reply.
Jack said, "I believe she asked you a question, doc."
"All right, yes," Fielding sighed. "Terrence Holdstock was the first, Jeanette the most recent."
Kate swallowed. She had an uneasy sense about where this was going. "What's different about that strain?"
"I have no idea."
"He's lying," Jack said.
"I am not!" Fielding sputtered.
"Trust me," Jack said, his eyes on the road, his voice flat. "He's lying."
How can he be so sure? Kate wondered. Or is he just guessing and trying to goad Fielding? Kate decided to weigh in with her own prod.
"One way to find out," she said. "Go to your medical center's practices and standards committee and ask for a full review."
"That won't be necessary," Fielding said quickly. "I've already reported it to the hospital board and to NIH."
"NIH?" Kate felt a wave of nausea. He wouldn't contact NIH unless it was something major. "Why?"
"That's the National Institutes of Health?" Jack said. "Down in DC?"
"Bethesda, actually," Fielding replied. "You see…" His voice shook and his words seemed to dry up. He wet his lips.
This is going to be bad, Kate thought. She gripped the edge of her seat, squeezing it. Oh, Lord, this is going to be terrible.
"You see," Fielding went on, "after connecting the complaints to the same vector strain, I took out the cultures and ran an analysis on the virus. It… it has mutated into two separate strains."
"Mutated?" Jack said. "Does that happen a lot?"
"No," Fielding replied. "That is, some viruses mutate frequently, but not adenoviruses. This was totally unexpected."
Kate closed her eyes. "Mutated how?"
"The original strain remained but the mutation had altered the thymidine kinase gene."
Kate groaned.
"That's bad?" Jack said.
She said, "It means the mutated strain was injected into the tumor along with the original vector virus. But without the thymidine kinase gene the mutation is immune to ganciclovir. The drug killed off the vector virus and the infected tumor cells—"
"But not the mutation," Jack said. "Oh, hell."
"Right. That means that Jeanette and the others have a mutant adenovirus running through their brains."
"Is it contagious?" Jack said.
"Yes and no," Fielding said. "Adenoviruses usually cause mild infections—pinkeye is a common one—but are caught only from people shedding the virus. These people are not shedding the virus."
Kate turned to Fielding. "We've got to do something!"
"I told you: I've contacted NIH and they in turn should be contacting Jeanette within a day or two."
"I mean now!"
"What do you suggest?"
"Find a way to kill the mutation!"
"I've already begun testing various virucidal agents against it. I'm confident we can find an effective cure."
"But in the meantime," Kate said, "what about other complications?" She envisioned the viral particles invading Jeanette's neurons, multiplying inside, then rupturing the cell membranes and moving onto other cells, their numbers growing exponentially. "What about meningitis? Encephalitis? What about an abscess eroding into an artery and hemorrhaging? She could die, Dr. Fielding!"
"I'm working as fast as I can," he said. "But even if I had a cure in my pocket right now, it might not help us."
"What are you talking about?"
"Consider: why am I here instead of home? Because Jeanette refused to come in to be checked. How do we cure a patient who refuses treatment?"
Kate's stomach knotted as she remembered Jeanette's words this morning: Why would I want to see Dr. Fielding? I'm fine. Never felt better…
"It's a gray zone," Fielding was saying. "If the patients aren't complaining, if they deny anything's wrong and don't want treatment… you can see the problem, can't you."
Yes, she could.
A wave of fatigue swept over her, leaving her chilled and achy.
Fielding said, "I'll keep testing the mutation while we wait to hear from NIH. I'm sure a call from them will convince Jeanette and the others how serious this is and that they all need help."
But as far as Kate was concerned, Jeanette already did want help—she'd told Kate so this morning. Pleaded with her for help. And Kate was darn well going to see that she got it.
THURSDAY
1
"Easy, Joe."
Stan Kozlowski had watched his brother becoming more and more agitated as he tore though the morning papers at their tiny kitchen table. By unspoken agreement they'd decided to eat breakfast at their pad this morning. Joe's outburst at Moishe's yesterday had drawn too much attention. They'd been just two of the regulars, Stan and Joe, no last names. Now Joe had no doubt become the regular with the scarred hand who'd gone into a screaming rage about blowing somebody off the face of the earth. With outstanding federal and state arrest warrants on each of
them, discretion said to lay low.
"Nothing!" Joe said, tossing the News onto the floor where it landed in a heap next to the similarly discarded Post and Newsday. "You'd think one of the assholes on that subway car would have gotten a good enough look at their fucking Savior to give some kind of description. What about your Times there? Anything?"
"Lots of psychobabble about the personality types of the two shooters." With one man dead and the other missing, Stan was amazed at the bull these "experts" could sling without speaking word one to either man. "But if you mean anything like a police artist sketch, no."
"Shit!" He leaped up from his chair and gave the papers on the floor a vicious kick, sending them into fluttering flight against the far wall. Which wasn't very far at all. "It's him, I tell you. This Savior is our guy!"
Stan wasn't going to say, Easy, Joe, again. He'd already said it too often since yesterday morning.
"I know you want it to be him, Joe, but—"
"Oh, it's not just want, Stan. I can taste him. I can smell his stinkl My palm started to itch the minute I read about that tiny .45. He's our guy, Stan. He's the reason we're living in this shit hole. He's our fuckin' guy!"
Shit hole is right, Stan thought as he surveyed their crummy one-bedroom apartment.
How the mighty had fallen: from Upper East Side condo owners to fugitive Alphabet City renters—literally overnight.
All because of "our guy."
Whoever he was he'd come out of nowhere. And he came smart and tough. Whether he had a personal grudge or was hired for the job, who knew? Stan figured he was hired. A pro. Just like the two of them.
Fires and explosions—the Kozlowski brothers' specialties. All thanks to the U.S. Army and a tour in Nam.
Stan hadn't wanted to go to Nam, and if he'd stayed in college the war would have been over by graduation day. But when he'd flunked out in year one the draft board wasted no time scooping him up. Over in the provinces Stan learned all about C-4, became a gonzo expert at blowing up Charlie's booby-traps with the white clay-like substance. And he brought all that training home with him. He finished college after the war but the economy sucked then, so he'd gone into a business of his own, taking in Joe in as a partner, teaching him all he knew.