That still didn’t justify burying data. But the more he talked about the miraculous results, the more she became self-conscious about raising niggling issues of policy regulations. Here was a celebrated senior neurologist sharing with her what might be the greatest breakthrough in medicine since penicillin, and two months on the job and little Polly Protocol was souring the air with fumes. “I can imagine.”
“In four months we’ll be submitting trial reports to the Institutional Review Board—all the data and documentation thus far, everything with all the Ts crossed and Is dotted as required by the FDA, to be followed by the necessary publications, which will no doubt make the press. This is going to be huge.”
“You’re talking as if you’re the principal investigator.”
“Actually, I’m one of them. A chief has yet to be named.”
The chief principal investigator on any clinical trial occupied a post heavy with responsibility and prestige, especially if the compound tested showed promise. That Jordan Carr was a prime candidate was evident. So was his yearning.
“So, what about Clara killing a man? How is that being explained?”
“That was unexpected, of course. And we’ll have to make the best of it. Thankfully, patient confidentiality protects us. Meanwhile, she’s at McLean for observation.”
She remembered Officier Menard’s question: Was she on any antipsychotic medication or other stuff that might have caused her violence? “So, what do we tell the police?”
“That there was a security breach and that it won’t happen again because new safeguards are in place.”
“I mean the murder.” He kept avoiding that fact.
“Simply that she was a woman suffering from dementia, that she just went berserk. And that’s not so far-fetched. These are crazy people, after all.”
René could hear her father’s voice. “Honey, I can feel it. I can feel the holes.”
The chilly touch of his words bothered her. “So you’re saying that Memoring—”
“Memorine,” he said, pronouncing it like a talisman. “Memorine—and file that away because it’s going to rock the world.”
“So you’re saying that Memorine did not cause her to attack the man.”
“That’s exactly what I’m saying.”
“But how do you know that if the drug’s been in its final phase of study for only six months?”
A smile spread across his face like a rainbow. “René, we’ve been running trials at Broadview and testing efficacy and safety for months, and there’ve been no adverse reactions whatsoever. The Clara Devine incident is an unrelated anomaly. Period.”
“She was sexually abused as a child.”
“Beg pardon?”
René did not want to violate the woman’s privacy, nor did she want to betray Cassandra Gould, but this was vital information. “A neighbor next door did things to her.” And she explained what she knew.
“How unfortunate, but what does that have to do with anything?”
She wasn’t sure if he was playing coy again or drawing her out. “Doctor, I’m saying that Clara Devine attacked the man because in her mind she was seeing her abuser. I’m just wondering if it had anything to do with this Memorine.”
Carr laid down his fork with a definitive snap. “Well, it didn’t.”
“But how can one be certain if the stuff’s improving memory?”
“Because half the people in your nursing homes are seeing dead people all the time. Their husbands are their baby brothers, their sisters are their kindergarten teachers. You spend your days on these wards, you should know that. Clara Devine was no different, except she’s had some kind of post-traumatic stress experience—which happens to people all the time. VA hospitals are full of them.”
“There’s also the matter of informed consent. Her sister had passed on power of attorney, which meant that Clara was a ward of the state. Essentially, nobody was watching out for her.”
Carr made another audible sigh. “And I suppose you’re going to quote the Nuremberg Code on the principles governing ethical experimentation on humans.”
“Actually, I was thinking of the Declaration of Helsinki.”
“Look, this is not some hideous conspiracy. We’re not conducting Josef Mengele experiments on the elderly, shooting them up with voodoo compounds. We’re bringing them back from a killer fog. You saw Clara Devine, and you’re going to see others in the next year. So, think of this as our apology for keeping you in the dark, as you said.”
She nodded, feeling as if she were being bought. “I’d like to know what other patients of mine are in these trials.”
“Of course, but you’ve got hundreds of patients, and I don’t know the overlap.”
“Dr. Carr, every clinical trial is bound by very detailed, very stringent protocols established well in advance. Were I to approach the Institutional Review Board and raise the question about their approval in advance of GEM Tech clinicians sequestering documentation of trial patients from the consulting pharmacist, what might be their reaction?”
For the first time that evening Jordan Carr’s face froze, his cheeks mottled with red as if he had been hit with a flash case of the hives. “Ms. Ballard, you’re very sharp and very responsible. I’ll make certain that you will have total access to all your patients enrolled, as soon as possible. But I ask that any indiscretion or irregularities you please overlook, okay? And I ask you because this is a turning point in the treatment of dementia, and any regulatory roadblock could be disastrous. Can’t you appreciate that?”
He was asking her to look the other way, and that made her very uncomfortable. And it wasn’t just being in complicity with regulatory violations. She didn’t like the power she suddenly possessed. One word from her and some very important people would end up on the proverbial red carpet and the trials of GEM Tech’s hot drug could be suspended. “Then I expect a full list of patients who are enrolled at Broadview and elsewhere.”
“Of course.”
“And full documentation of meds including Memorine, schedules, and nurses’ observations, et cetera.” If he proved as good as his word, she would not contact the IRB.
“Certainly. Absolutely.” The relief was clearly visible in his face.
The waiter came to clear the dishes. “Would you like to see the dessert tray?”
René shook her head.
Dr. Carr studied her face for a moment. “Irregularities aside, aren’t you impressed? A cure for Alzheimer’s?”
“If it’s the real thing, of course.” She could hear the forced brightness in her voice.
“Well, take my word for it, it’s the real thing.”
“And how long have these trials been going on?”
“The last phase for eight months. But we’ve known about the neurological benefits to dementia patients for years.”
She nodded, and felt something rip inside her heart.
14
JACK WAS AT THAT DOOR AGAIN.
The same brown stained wood-panel structure with the hanging herbs and tarnished brass knob. He had lost count how many times it had been. How many times he had grabbed the mouse and padded to the door through the sticky wet. Then how he had frozen again, knowing on some level that horrible things were happening out there, but also knowing he had to get out to Beth and the others.
Jack stared numbly at the doorknob as if something profound were about to occur. Then he heard a voice full of graveclass="underline" “Goddamn you, die.”
Then that horrible sound that pounded through his brain over and over again, every time he got here, every time he put his hand on the knob—a sound that set loose a flock of bats in his chest: The crack of iron against bonecap.