“Hi, Clara, how you doing today?” The feathery voice of Jordan Carr off camera.
“Fine,” Clara said, not looking up at the camera.
“Clara, look what I have here.”
Clara lowered her eyes into a shoebox. “See, a button, a hairbrush, and a lollypop.” She inspects them. “You can touch them. Go ahead.” She picks up each item, awkwardly running the brush through her hair. She inspects the button and puts it back, then picks up the lollypop and sniffs it. Carr puts the items back into the box and asks her about the puzzle she’s doing. For maybe a minute she picks up pieces and begins to try to find mates. She’s unsuccessful. Then the lidded shoebox appears. “Clara, remember this? This box?”
Clara looks at it blankly.
“Remember what’s inside?”
She continues to look at it blankly.
“What’s inside?”
“I don’t know,” she says and turns back to the puzzle.
“Remember the lollypop?”
“No,” she says, fingering the puzzle piece.
Carr pokes a few keys with a stylus. “Now this is Clara six months later.”
Clara is sitting at the same table. A wall clock behind her. Dr. Carr’s disembodied voice: “Good morning, Clara.”
“Good morning.” She smiles at the man beside the camera.
A shoebox slides into view. “I’m going to show you what’s inside, okay?”
“Okay.”
A hand opens the box and removes a spoon, a small Mr. Goodbar, and a pencil. Carr identifies each out loud, then puts them in the box and puts the lid back. “Now, do you remember what’s in the box, Clara?”
“Yes. A spoon, a Mr. Goodbar, a pencil.”
“Very good.” And Carr opens the box and removes each and replaces them. With the clock in constant view, he has her put together a child’s puzzle over the next fifteen minutes. She moves very slowly but manages to fit several pieces together. When time is up, the shoebox reappears. “Now, do you remember this shoebox?”
“Yes.”
“Do you remember what’s inside the box?”
Clara blinks at the box for a few seconds. She looks uncertain for a moment, then says, “Yes. Mr. Goodbar, a spoon, and a pencil.”
“Very good,” Carr says, and behind them the nursing staff cheers.
Carr laid the Palm Pilot on the table, the freeze frame of Clara smiling proudly.
The waiter delivered the food while René stared dumbly at the image of the woman smiling back at her. All she could think was, That could have been my father.
“SO WHAT DO YOU THINK?” Carr said, digging into his steak.
“Well, that’s incredible.” And for a second René wondered almost hopefully whether it had all been staged—that she wasn’t actually looking at Clara Devine but some imposter partaking in an elaborate conspiracy for whatever reasons—perhaps some security test gone awry.
“Even more remarkable, her cognitive test scores were double what she got before she was institutionalized and two to three times that of the placebo group—not to mention a five times response rate and enhanced ability to perform her activities of daily living. Six months before she took the drug, she could not dress herself or go to the bathroom alone. Now she’s undergone a clinical regeneration in twenty-four weeks at two ten-milligram dosages daily.”
“I’d very much like to see those results.”
“Of course.” Carr’s eyes beamed like a child sharing a secret.
“She was forgetting things from one moment to the next. It was like watching her being peeled away like an onion.” Cassandra Gould’s words buzzed in René’s brain.
And cutting across those her father’s plea: “Promise me … I don’t want to end up just some gaga thing attached to a diaper.”
Maybe Clara Devine was just some extraordinary anomaly. “Are there other test subjects?”
“Of course.”
“So why all the secrecy if it’s such a miracle drug?”
“It’s a blinded study to keep people unbiased.”
Clinical trials were blinded so that the people responsible for patients wouldn’t attribute any and every change to the drug being tested. And while in such studies the caregivers may not know which patients receive the active drug and which patients receive a placebo, they are made aware that patients are enrolled in a clinical study. “But why wasn’t I or my pharmacy informed?”
“Because technically the trial compound is not among the active meds supplied by CommCare, your pharmacy. The Memorine tablets came from GEM.”
“But these patients were on other meds that CommCare supplies.”
“Look, their medical charts were meticulously kept by the nursing staff.”
“You mean a separate and hidden set.”
“Yes, but the trial data wasn’t kept from those who need to know at the FDA.”
“That still doesn’t explain why there are no nurses’ reports of the trials in my records or the alleged improvement of patients’ behavior and functionality. Or why I wasn’t told.” Because her job centered mostly on paperwork, she had only minimal contact with nursing home residents—something she hoped to change as time passed. Therefore, she could not personally have witnessed any actual improvements in the behavior of these trial subjects. Nonetheless, nurses and other staffers at her homes often talked about patients’ health, behavior, affect, the funny things they may have said. Yet, remarkably, nobody had uttered a word about the extraordinary changes in Clara Devine or any other patients in these trials.
“Well, I’m telling you now.”
“But only because Clara Devine eloped and murdered someone.”
His face darkened. “That was unfortunate.”
“Doctor Carr, this isn’t a blinded study, it’s a concealed one.”
He stared at her for a moment, then shrugged. “If you wish.”
He was trying to disarm her with a concession because he knew that she could report him. As an employee of CommCare, she was an outsider to the nursing home and bound by state and FDA regulations. And they both knew that she could lose her job were she not to report a secret clinical trial. “Doctor, you’re not answering my question: Why was I kept in the dark?”
“It was nothing personal. Even the nursing staff didn’t know what the subjects were on, though they were aware they’d been enrolled in trial of a dementia drug.”
“That still doesn’t answer my question.”
He drained his wineglass. “Because GEM Tech did not want to risk the competition getting wind of what we have. Period.”
The we floated like a lazy feather in the air. “They’re really worried some other drug company’s going to whip up a me-too compound?”
“In a word, yes. They don’t want somebody else beating them to the market. You know what a rat race the pharmaceutical industry is. Somebody invents a Ford, and a Chevy is right on its bumper.” He lowered his voice to a conspiratorial whisper. “René, we’re talking about a supreme blockbuster drug here—a fifty-billion-dollar pill.”
The waiter arrived to clear their dishes. When he left, Carr said, “I know it’s premature, but the FDA is very excited about this, very. And I won’t be surprised if they fast-track its approval.”