Tuesday, April 7
Ally steered her Toyota onto the ramp leading to the George Washington Bridge, the entryway to northern New Jersey. She was just finishing a phone call to Jennifer. She wanted her to take a look at the notes and blueprints for Bartlett's Gramercy Park project and scan them into their CAD program. After all the phone calls yesterday, she'd been too sidetracked to do it. Although Bartlett had declared he wasn't in any hurry, he had messengered a certified check to her office Monday afternoon. The project was a go. She wanted to get moving while everything was fresh in her mind.
Before leaving her apartment this morning, she'd downloaded a map from MapQuest and from it she had estimated that the drive up to the Dorian Institute would be approximately an hour-give or take. She had begun the trip early because her mother's mind had been lucid the previous evening and she was hoping that interlude might last into this morning.
Unfortunately, it had not.
Nina was sitting next to her now, in full makeup but completely unresponsive, seemingly in another world. When Ally arrived at the Riverside Drive apartment to pick her up, Maria-now silent and uneasy in the backseat, reading a Spanish novel-met her at the door with a troubled look and shook her head sadly.
"Miss Hampton, I know she was all right when you were here last night, but this morning… she may not recognize you. She'll most likely snap out of it and be okay later on, but right now she's just in a fog. It was all I could do to get her ready."
When Ally walked in, Nina was sitting in her favorite chair, dressed in her favorite black suit. Her makeup was perfect Thank you, Maria.
"Hey, sweetie, you look great."
Nina stared at her as though trying to place the face and said nothing. She just looked confused and very, very sad.
Dear God, Ally thought, this is the first time she's completely failed to recognize me.
It was so disheartening. Last night, when Ally had come up to discuss whether or not she still wanted to explore Dr. Van de Vliet's experimental treatment, Nina had been completely cognizant. Ally had tried to explain the concept of neural tissue regeneration using stem cells, which was difficult since she barely understood it herself.
"Mom," she had said "this might be something that could reverse some of the damage to your… memory. At least keep it from getting worse. I know it sounds scary but everybody says the conventional treatments for what you have don't work very well or very long."
"Then let's go out there and talk to him, honey. Just come in the morning and take me. By then I'll probably forget everything you've said tonight."
How prescient, Ally thought sadly. Now Nina was just gazing blankly ahead, silent. Does she remember anything from last night?
For that matter, what was Nina thinking now? Was she conscious of the fact she was losing her mind? And what about the ultimate question: do we want to live longer merely to be alive, or do we want to stay alive in order to do things? To be or to do? In her mother's case, she knew it was the latter. Nina had always been full of life, ambition, and projects. Would she want to go on living if none of those things were possible? You never know for sure about other people, even your own mother, but Ally suspected she would rather not live to see that day.
Now, though, was she even aware it was coming?
Ally thought back about the first signs. Nina hadn't yet turned sixtyfive when she abruptly started having trouble remembering little things. She began forgetting where she'd put items, and she gave up on remembering phone numbers and dates. Initially it had just seemed like a lot of "senior moments" run together, very puzzling.
But then it got worse. She'd always loved music, and she'd always played the piano. She loved Chopin, especially the nocturnes. By the time she was sixtysix, however, she was having trouble remembering the names of her favorite composers. She also completely gave up trying to play, either from memory or with the music. When getting dressed one day, she put on her blouse completely backwards. It was bad.
Ally had taken her to see four different specialists and they all had concluded that Nina Hampton suffered from what was known as familial earlyonset Alzheimer's. It was caused by a mutated gene and was extremely rare, representing only some 5 percent of all Alzheimer's cases.
There were two major drugs currently on the market, Exelon and Reminyl, that could relieve some of the symptoms of Alzheimer's by boosting the action of the brain chemical acetylcholine. However, Nina had not yet declined to the stage where doctors would prescribe those drugs. To resort to them was an admission you were at endgame, since they usually were effective only for a few months.
So the Dorian Institute might well be a long shot worth taking. Frankly, what's to lose?
This morning, she knew, was going to be difficult. If Nina wanted to stay and checked in, there would surely be a pile of paperwork. Ally had had the foresight to acquire power of attorney for her mother three months earlier, and she'd brought along that document in case it might be needed. And Maria, the wonderful, ultimate caregiver, was there to help. The real challenge, however, might well be trying to help Nina understand what was going on and participate in the decision. This was the moment every child dreads, when you have to face, really face, a parent's mortality.
As the green forests of northern New Jersey began to envelop them, she slipped a CD of Bach partitas for unaccompanied violin into the CD player. She had loved to play them all her life, but now Dr. Ekelman had urged her to put her violin into storage. Hearing the violin now reminded her of the other purpose of the trip, the treatment decision she needed to make for herself.
In that regard one of the things that kept running through her mind was what Stone Aimes had said about the Gerex Corporation instituting a news blackout simultaneously with a patient being mysteriously dropped from the trials. Those concurrent facts did not need to be ominous, but they also could use an explanation.
What was she going to do? Was Van de Vliet's stem cell procedure on her heart really worth the risk? She honestly didn't know. Even though the violin had temporarily been taken away from her, she had hopes she could gradually get it back. There were other ways to try to strengthen a dysfunctional heart.
Well, she thought, wait and hear him out.
From the George Washington Bridge she had taken 14, which turned into 1208 and now the green forest held sway. It felt like she'd gone through a time warp, from the beginning of the twentyfirst century to the end of the eighteenth. Then finally, as the second partita was ending, the icycold Greenwood Lake came into view. It was associated with those long Finger Lakes gouged out by glaciers.
Driving past remnants of the last Ice Age, she reflected on how insignificant humans are in the scheme of things. Suddenly she thought of Aldous Huxley's novel After Many a Summer Dies the Swan, about a wealthy madman who'd discovered a way to prolong life by eating the entrails of prehistoric fish. Maybe it was seeing the lake that made her flash on that.
She was now on Greenwood Lake Road, which passed around the west side, and there were numbers on several gated driveways as she passed along. She suspected the place would be somewhere along the middle of the lakeshore, and she was right.
After a few miles she came to a discreet sign announcing the Dorian Institute, and a large iron gate that protected a paved roadway leading into a forest of trees. That was it: just forest, no hint of a building, though she saw signs of some kind of industrial park farther down the road. When she drove up to the gate, she realized there was a video camera and a twoway intercom.
When she reached out of the window and pushed the talk button, she heard "Good morning." And then the gates parted in the middle and slid back.
They must be expecting us, she thought, and drove through.
The road was cobblestone, or rough paving brick. It wound among the trees for approximately half a mile and then widened.
There, framed by the lake in the background, was a magnificent threestory building with eight Doric columns across the front in perfect Greek Revival style. There were windows at ground level, but they were heavily curtained.
Built of red brick, the building probably dated from the late nineteenth century, and it looked every bit like an Ivy League dormitory.
"Miss Hampton, I don't like the feeling I'm getting about this place," Maria said quietly. "It is very cold and formal from the outside, but inside I sense a place where there is bad magic. In the Dominican Republic, we call it Santeria. I can always tell these things."
Ally knew and respected Maria's sixth sense. But then Maria sometimes still acted like a freshly minted citizen just off a green card, and she had an innate suspicion of authority evoking buildings. Her aversion to the Dorian Institute might be nothing more than that.
On the other hand, Ally was having a bit of the same feeling. There was something formidable and foreboding about the place that seemed out of keeping with its supposedly benign purpose. She felt a moment of tightness in her chest.
There was a parking area off to the left, and she drove into the nearest slot and turned off her engine. This was the moment she'd been both anticipating and dreading. The clock on the dash read elevenfifteen; she was fifteen minutes ahead of the appointed hour.
"Okay, Mom, how do you feel?"
Nina turned and stared at her, uncertainty in her eyes. "Where are we, Ally? I don't recognize anything."
"This is the institute I told you about last night. Can you remember anything we talked about then?"
"This is the place you were… Didn't you say there's a doctor here who can do something for my… memory?"
"We're both here now to just talk to him." She turned to the backseat. "Maria, can you get Mom's purse?"
She nodded, then reached hesitantly for the door. She was clearly reluctant to get out.
Ally walked around and opened the door for her mother.
"Okay, Mom, time to stretch your legs."
Ally held her hand and together they headed across the oval brick driveway. Birds were chirping around them and she could smell the scent of the lake, borne up the hill by a fresh wind. Then, through the trees, she saw two women walking up the trail that led down to the lake. They were, she assumed some of the patients.
They both looked to be in their early sixties, but also athletic and nimble. One was wearing Nikes and a pale green pantsuit. The other had on a blue dress and a white cap and Ally realized she must be a nurse. She'd been taking the other woman out for a stroll.
They were engrossed in conversation, but as they approached, the woman Ally had decided was on staff looked up and smiled a greeting.
"Can I help you?"
She introduced herself and Nina and Maria. The woman smiled again but didn't introduce herself in turn.
"We're here to see Dr. Van de Vliet," Ally went on, "about the trials. But we're a couple of minutes early and I was wondering if we could look around a bit first? I'm trying to understand what the institute is really like."
"Well, dear," the woman said, "even those of us who work here aren't allowed everywhere. You know, into the research lab in the basement. Some places here have to be completely hygienic. Of course, for patients who are in the recovery phase, strolling around outside is definitely recommended, as long as they're able. But that's getting way ahead of ourselves. First we'll have to check you in. There's a lot of paperwork for the clinical trials." She seemed puzzled. "They're almost over, you know. But come along and I'll let him know you're here. He's always down in the lab at this time of the morning. It's well after his rounds. They're so busy now."
Then she turned to the other woman. "Sophie, do you think you can find your way back to your room? It's number twoeighteen, on the second floor, remember?"
Sophie appeared to be pondering the question for a long moment before she huffed "Don't be silly. I know exactly where it is."
As she strode on ahead, the nurse watched her carefully, as though unsure what she might do next. She pushed a buzzer at the door and then a man in a white uniform opened it and let her in. Only after Sophie had disappeared through the doorway did the nurse turn back.
"I'm Elise Baker. Please forgive Sophie if she seems a little… confused. Her procedure is still under way."
"Her 'procedure'? What-"
"She was diagnosed with Parkinson's before she came here. She's improved an enormous amount, but we're not allowed to say so."
"Why is that?"
"We're in clinical trials. No one is allowed to discuss our results. Everyone here had to sign a secrecy agreement."
Now Maria was helping Nina up the steps. The porch, with its soaring white Doric columns, was definitely magisterial. The front door, however, was not wooden or decorative. It was solid steel, albeit painted white to blend in.
Elise walked to the door, which had a video camera mounted above it, and a split second later, it buzzed, signaling it was unlocked.
This is a lot of security, Ally thought, for a clinic doing research on cells. Are they worried about spies getting in, or patients getting out?
But the locked steel door was just the beginning of the security. Next they entered a small room just inside the door with an Xray machine to see into purses and parcels.
"The first floor is reception and dining," Elise explained as she swept through the metal detector. "There are rooms- we call them suites-upstairs for patients, and the research lab and offices are in the… lower area."
"What… what is all this security for?" Ally asked.
"The work here is highly proprietary. No one is allowed to bring in any kind of camera or recording equipment."
The guard dressed in white looked like a retired policeman, with perhaps a few too many jelly doughnuts over his career. He had a beefy red face and a hefty spare tire. But he was certainly alert to his responsibilities, eyeing the three newcomers with scarcely disguised suspicion.
In fact, Ally sensed a palpable paranoia in the air. Well, she told herself, medical research is a highstakes game. It's understandable they would be concerned about industrial espionage.
After the security check, they went through another steel door and entered the actual lobby. The first thing she noticed was a grand staircase leading up to the second floor, and then to the third. Off to the right was a modern elevator with a shiny steel door.
A number of patients were coming down the stairs and heading for a hallway leading to the back. They were mostly women, whose ages ranged anywhere from fortyfive to well beyond seventy.
Who are these people? Ally wondered. They must have been sufferers of various kinds of debilitating afflictions, but now they were certainly ambulatory, if not downright sprightly. She wanted to talk to some of them, watching them moving along chatting and smiling, but this was not the moment.
"At eleventhirty we have meditation in the dining hall," Elise was saying as she led them through the lobby, "for those who care to participate, and after that a vegetarian lunch is served at twelvethirty sharp." Then she glanced back. "After you see Dr. Van de Vliet-and assuming you're admitted-there'll be an orientation and then you're welcome to begin participating fully in our activities."
"Actually," Ally said, "if people are well enough to be in 'activities,' why can't they be outpatients?"
"These clinical trials require twentyfourhour supervision," Elise explained, heading for the wide desk in the center of the room. "Now, if you would all sign in here at the desk, Ellen can take you downstairs to the medical reception."
A darkhaired woman smiled from behind the desk, then got up and came around. A signin book was there on a steel stand. Ally finally noticed that light classical music was wafting through the room, Tchaikovsky's Swan Lake suite.
"You must be Ms. Hampton," the woman said. "And this must be your mother. We were told to expect you."
She nodded a farewell to Elise, who said, "It was so nice to meet you. Good luck."
She then turned and headed for the back.
Ally signed all three of them in.
"Good," the woman said as she checked the information. "My name is Ellen O'Hara, by the way. I'm in charge of the nursing staff here. We're ready to go downstairs now."
Ellen O'Hara had a knowing, earnest face that fairly lit up when she smiled. She had short brown hair streaked with gray and was pleasantly fullfigured.
When they reached the elevator, she zipped a small plastic card through the reader on the wall and the doors slid open. As they emerged on the lower level, Ally realized they were in the precincts of a very sophisticated medical laboratory. Occupying most of the floor was a glassedin area, inside of which she could see three men and two women, all dressed in white. She also noticed rows of steel containers that seemed to be ovens or incubators of some kind as well as racks and racks of vials. At the far end of the laboratory, there was a blackboard on which one of the men was drawing something that looked like hexagonal molecules, linking them together.
"That's Dr. Van de Vliet," Ellen said pointing. "I'll let him know you're here. The laboratory is a special environment. The entrance there is actually an air lock. The air inside is filtered and kept under positive pressure."
She walked over to a communications module, buzzed then announced into the microphone, "Dr. Vee, your eleven thirty appointment is here."
He turned and stared in their direction, then smiled and waved. Next he walked to a microphone near the center of the room and clicked it on.
"I'll be with you in a minute. Can you please wait in the receiving room? And Ellen, can you start getting them ready?"
"Of course." She nodded then clicked off the microphone and turned. "Receiving is just down at the end of the hall. Next to his office. Please come with me."
She led them through a large wooden door, into a room with a retractable metal table covered in white paper and several chairs. It was a typical examination room, with a device on the wall to monitor blood pressure, a stethoscope, and other examination paraphernalia.
"If you'll kindly take a seat," Ellen said, "I'm sure he'll be here as soon as he can, in a few minutes at most. But while we wait, I need to take your temperature and blood pressure, and start a chart."
"Ally, where are we?" Nina asked. Her face was becoming alarmed, and Maria reached to comfort her. "Are we in a hospital somewhere?"
"Yes, Mom, it's actually the institute I told you about last night The doctor here wants to see if he can do anything to… help you."
"Oh," she said, "is he the one you told me about? I thought that was just a dream."
"No, he's real. Whether he can help you or not that part is what’s still a dream. But we're all praying."
She looked around at the pure white walls and wondered again what she was getting into. Meeting a new specialist in the sterile white cold of an examination room, could be frightening in itself. God, how many times before had she done this as she trudged through HMO hell? Maria was so unsettled she was deathly pale.
Ellen took their blood pressure and temperature, including Maria's, even though she protested mildly, half in Spanish-a sign of how unsettling it was to her. Ellen had only just finished putting all the numbers on clipboard charts for each of them when Karl Van de Vliet opened the door and strode in.