" John, you're a hard man to track down. " Mark Wilcox pulled out his bottom desk drawer and rested a polished cordovan loafer there. He switched the phone to his other hand and began to doodle on a legal pad. "We need to talk about your malpractice case." "I'm sorry I haven't returned your calls. There's been a lot going on." "I'd love to hear about it. When can we-" "Just a second." There was a muffled exchange. "Sorry. I'm still in clinic and had to answer a question for my nurse. Can we meet this evening sometime? Come by my house and we can talk over coffee." Mark scanned through the possibilities. "I've got a better idea. I have to see a few more patients, then go by the hospital for a bit. Why don't you come by my office a little after six? If Sara Miles and Rip Pearson are free, we could all meet somewhere for dinner and pool information on the Jandramycin front."
He scrawled a note on the pad in front of him. "Del Frisco's has a private dining room. I can have my secretary reserve it for seven thirty. My treat." "I guess I could check with Sara and Rip." "That would be great. When you know for sure, call my office and Karla will take it from there." Mark smiled at the prospect of seeing Sara again, even if he did have to share her with others at dinner. This time, maybe their evening together wouldn't end when the meeting broke up.
"See you around six." Mark was smiling when he shrugged into his white coat and walked out of his office to see his next patient.
"Why the worried look?" Lillian Goodman pulled out a chair and joined Sara Miles in the clinic's break room. "Thinking about a patient," Sara said. She held her Diet Coke to her forehead and closed her eyes. "Why is it always the nice ones who have the complications?"
Lillian's first thought was John Ramsey. If she had anything to do with it, he wasn't going to be one of those nice ones who didn't do well on treatment. She made a mental note to ask Rip Pearson for more information on the Jandramycin late effects John had mentioned. "Which patient is this?" Lillian asked. "Chelsea Ferguson. She almost died from Staph luciferus sepsis, but we pulled her through with Jandramycin. Then she developed Guillain-Barre. We think the drug produces autoimmune disorders in some patients who receive it." No need to go to Rip. This was all the opportunity Lillian needed. "And now John is one of those patients. What can we do to protect him and the others from those side effects?" "We're checking into-Wait a second. Who's this 'we'?" "The other day I found John in a treatment room getting his IV meds. He told me that you, Rip, and another doctor were trying to solve the problem, hopefully before he gets one of those complications." Lillian sat up a bit straighter. "I'm inviting myself into the group." "But why-" "Because as a doctor, I'm dedicated to healing people, not making them worse, and I've contributed a couple of my patients to the Jandramycin study. So I feel an obligation to look out for them." She pushed back her chair. "And because, frankly, I'm growing fond of John. He's been through a lot, and I think right now he needs a friend. I've volunteered for the position."
John Ramsey rattled the knob of Mark Wilcox's office door, but it didn't budge. Repeated taps on the door brought no response. He had his cell phone out when he heard footsteps in the hall behind him.
"John, sorry to keep you waiting." Mark hurried up and pulled a set of keys from his pocket. "I got tied up at the hospital. Come on in."
When they were settled in Mark's office with soft drinks, John looked around at the office. Simple and functional, much like the one he'd had for years. "You seem to have a nice setup here." Mark leaned back and propped one foot on his desk drawer. "I like it. As I told you, I have a limited family practice but still manage to do a little law as well." "Do you think that as your medical practice gets more active, you'll do less law?" "I don't see that happening," Mark said. "Things have settled into a pattern, some medicine, some law, sometimes a combination of the two. For instance, I'm a consultant to the in-house counsel at one of the private hospitals in the city. The reason I was delayed was because he and I were meeting with the administrator and the chief of staff. There's a rather sticky problem with one of the physicians who has privileges there." "So what's new with my case?"
John asked. "I've been in touch with the attorney representing the plaintiff. Frankly, he's never handled a malpractice action, and I think he filed this as a favor to the guy who brought the suit. They move in the same society circles." Mark lifted his can of soda, found it empty, and put it down. "If it looks like we're going to trial, he'll probably turn it over to someone who does this kind of thing all the time." "If it comes to trial? So it may not?" "Filing the suit is only the first step in the dance. This is what I used to call an 'I'll get you for this' suit. From what I can tell, the son of the woman who died thinks everything around him should be perfect, and if it isn't, someone has to pay. Never mind that his mother refused to follow her own doctor's advice and wasn't taking her medications. Matter of fact, she was visiting the faculty clinic at the med school for a second opinion because her daughter insisted on it." Mark picked up a pen and began twirling it between his fingers. "The daughter, by the way, opposes this suit." John's heart hammered against his sweat-soaked shirt. "What happens now? Can you get the court to remove me from the suit? All I did was start an IV." "Not likely to happen. A suit like this is filed against every person and entity involved. The plaintiff- that is, the person who sues-could amend the suit, but I doubt that will happen while there's a possibility of getting something out of you. And the courts probably wouldn't allow it anyway. They prefer one trial for everyone." "And if it comes to trial?" "One thing they teach us in law school is to always try for a settlement, because there's really no way to predict what a jury will do. A trial is the last thing we want, and my goal is to avoid one." "Does this mean I might end up paying to settle a suit against me that has no merit?" Mark spread his hands. "I'm going to do my best for you, John. I'll let you know what happens. And I'll warn you, these things can drag out for months, sometimes a year or more." So there it was. John had come here hoping to hear good news, but there was none. Just like everything else that happened to him lately, the only thing to do was wait. John wondered how much more of this he could take. And as quickly as the thought flashed into his mind, the answer came. The same answer he and Beth had given each other when the tough times came over four decades of marriage. I don't know. But God's in control. Mark looked at his watch. "We've got a few minutes before it's time to head to the restaurant. May I ask you a question?" "Sure." "Is Sara Miles seeing anyone?" John ran that through his mind and came up blank. "I'm not sure I'd know if she were, but I've never heard her mention anyone. I think she's still hurting pretty badly from the loss of her baby and her divorce." "But that was… how long ago? A couple of years?"
"About that. But people heal at different rates. Why do you ask?" Mark cupped his chin in his hand for a moment. "You may recall that when I was in medical school, I was married." He held up a hand that bore no ring. "Now I'm not." "I didn't want to say anything, but yes, I noticed." "My wife died almost two years ago in a head-on crash with a driver who was going the wrong way on Central Expressway." "Mark, I had no idea," John said. "I've never even looked at another woman until I met Sara. And ever since then, I can't get her out of my mind." "So the fact that she was the target of a shooter-" "It almost killed me to hear about it. And if she feels about me the way I do about her, I don't plan to let her get away. I feel like this is a second chance for me. Maybe it's a second chance for both of us. And I'm not going to waste it."
Sara looked at her watch for what must have been the tenth time in the past half hour. Where was Rip? "We'll wait until everyone's here to order," Mark said. The waiter nodded, deposited drinks on the table, and walked away. The group sat in a small private dining room, centered at a table that would accommodate eight, with Mark and Sara on one side, John across from them. A fourth place setting marked the spot where Rip would sit. "I guess we'll wait until Rip gets here to start sharing information," Sara said, "but I'm sorry to say I don't know a lot more than I did when we met last." John fiddled with the silverware in front of him. "The same goes for me." "I have a few things to-" Mark stopped as Rip hurried into the room. "Sorry to be late. It appears that my attempts to find out more about Jandramycin stirred up a hornet's nest." He dropped into the vacant chair and drank deeply from the glass of iced water in front of him. Sara leaned across toward him. "What happened? Are you all right?" "Yes, but no thanks to whoever drove the SUV that sideswiped me and pushed me into a concrete abutment." Rip pulled a handkerchief from his pocket and wiped his brow. "My car will need some body work, but I managed to keep it under control. Otherwise, I'd have bounced out into the road and been broadsided by another vehicle." "Could it have been an accident?" John asked. "I saw the SUV in my rearview mirror just before he hit me. I'm pretty sure he was aiming right at me, trying to sideswipe my car." Mark leaned back in his chair. "So there've been attempts aimed at Sara and Rip. John, I guess you've been spared."
"Because I haven't been asking around. There's the difference." "So who have we asked?" Rip said. "Jack Ingersoll, Carter Resnick… "
"The higher-ups at Jandra," Sara added. "And, of course, there could be someone else who knows what we're doing, someone we don't even know about," Mark added. "What do we do about it?" Sara asked. Mark tented his fingers under his chin. "Rip, I suppose your accident was investigated by the police." "Yeah, they came out. Said they'd file a report, put out a bulletin to body shops. I don't look for anything to come of it, though." "And we know the shooting involving Sara was reported," Mark added. "I could talk with the police and try to tie those together, see if they're willing to investigate further." "But that's not likely. Right?" John said. "Not really," Mark replied.
"Forget it," Rip said. Mark nodded his agreement. "So I guess we either stop digging-" "Never!" both Sara and Rip answered in unison.
"Or be careful," Mark said. "You started to tell us what you've found," Sara said. "What was that?" "One of the guys in my law school class ended up at the FDA. He sort of owes me-I coached him through his last year-so I gave him a call. Could he get a copy of Jandra's NDA for Jandramycin? No way. Apparently they've pulled some strings with the FDA and gotten it not only fast-tracked but protected from everyone but the small group that's due to review it." "Makes no difference," Rip said. "The mechanism of action they quote for the drug is probably cell wall destruction, and we know that's just a smokescreen. We need the real mechanism if we're going to figure out how to block the late complications." Mark nodded. "And we can't get that from Jandra." "Never going to happen," Rip said. "Or from the investigators," Mark concluded. "And I understand that we don't have time to analyze the compound we have on hand, then do the animal experimentation to show its mechanism of action," Sara said. Mark shook his head. "I believe we've tried every legal means available to get the information we need." As she pondered that last phrase, Sara decided that maybe it was time to think outside the box. She had a couple of ideas- but she decided she'd better keep them to herself for now.
Mark signed the bill, retrieved his American Express card, and closed the folder. "Thank you all for coming." John dropped his napkin beside his empty coffee cup. "Thanks for dinner. It was good to throw around some ideas and share information, but I'm afraid we're no closer to a solution of our problem than we were before we started."
One by one, the group pushed back their chairs and stood. Rip declined a ride with John, saying that although his car looked terrible it was still drivable. "I'll call my insurance company in the morning and see about getting a rental while mine's in the shop." Mark was happy to see that Sara was the last in the group to move toward the door. He touched her on the shoulder. "I was wondering if you might like to go somewhere for a-I was about to say a drink, then I remembered-for another cup of coffee? We haven't really had a chance to talk with each other tonight." He could see Sara consider the offer. Her frown told him the answer before she spoke. "Mark, I like you. Under more normal circumstances, I'd say yes. But I'm really in turmoil about this whole Jandramycin thing. Until it's settled, I'm not ready for any kind of a relationship. For now, can we just stay friends?" She smiled, obviously trying to take the sting out of her response. "Sure.
I understand." He fell in step beside her. "Any more strange noises in your house?" He knew it was a low blow to remind her of what her exhusband did to torment her after he left her. During Mark's classical education he'd memorized the oft-misquoted words of John Lyly, Renaissance poet and playwright: "The rules of fair play do not apply in love and war." On rare occasion, he'd applied that strategy in the courtroom. After all, weren't most legal battles a form of war?
But he'd never had occasion to use it with respect to love… until now.
Sara turned on the living room lights and double-locked the front door behind her. She wondered why she'd turned down Mark's invitation to extend the evening. Did she sense a danger in letting him get too close to her? Was there something about him that triggered her response? Something John said about Mark tickled at the edge of her memory-something about his consulting for pharmaceutical companies.
Could one of those be Jandra? She dropped her purse on the entryway table, wincing at the muted clunk it made. She unzipped it and pulled out the revolver. A Taurus Ultra-Lite-one pound of metal that could be either a harmless paperweight or an engine of death. Sara made sure that the safety was on before she swung the cylinder open and dumped the bullets into her palm. She admired the way the copper noses shone in the light from the table lamp. She tried to visualize one of them ripping through flesh, putting an end to a human life. Finally, Sara carefully reinserted the bullets one by one. She clicked the cylinder into place with an empty chamber under the hammer, re-engaged the safety, and dropped the gun into her purse. It was ready. Was she? She wouldn't know the answer until the situation arose. And she prayed that it never would. At her computer, Sara logged on to PubMed. In the search box, she entered Jandramycin, and was surprised to find no hits. Then it dawned on her. She was looking for preliminary work, and the name, Jandramycin, had been applied only recently. She searched her memory in vain for the initial designation of the compound. She dialed Rip Pearson's home number. "Rip, hope I didn't wake you." "Not at all. I was about to sink into a hot bath. That collision shook me up a bit more than I initially thought, and I'm getting a little sore.
What's up?" "What was it you called Jandramycin before Jandra applied that name?" "EpAm848. Does that help?" "It may. Enjoy that hot soak."
She rang offbefore he could ask more questions. This might be a total waste of time, but she had to try it. Back at her computer, she opened the PubMed search box, typed in "EpAm848," then hit "enter." There were only four citations, three of them papers with Jack as a co-author along with Bob Wolfe and some others whom she took to be Jandra research staff. She struck pay dirt with the fourth. It was a preliminary report detailing the design of a study to investigate a potential new antibiotic. She ignored the abstract that followed. It contained nothing she didn't already know. Instead, Sara found a slip of paper and wrote down the names of the authors: Gruber H., Rohde H.