Bad Medicine Page 4

  “Who’s that?”

  He looked up at me with a nasty grin. “Carolyn Gelman. A lot of us think she sabotaged her own freezer to gain sympathy and put the blame on Mark.”

  5

  I was pensive when I left Lowell’s office. I had a clear picture of how Gelman had earned the resentment of some of her colleagues. And she’d be understandably nervous about coming up for tenure under those conditions, especially at the same time as a powerhouse like Heller. But had she really unplugged her own freezer? It was possible, and Lowell seemed nearly convinced. I didn’t like him, but that didn’t mean he was wrong.

  Anna interrupted my speculation as I passed the reception desk. “Dr. Parker? You might be interested in this. It’s Dr. Gelman’s tenure seminar.”

  She handed me an announcement of a seminar at two o’clock that afternoon. Dr. Carolyn Gelman, speaking about “Combination Chemotherapy to Treat Drug-Resistant Cancers.”

  Gelman’s tenure seminar was something I most certainly wanted to hear. So why hadn’t Lowell brought it to my attention? Jerk.

  “It’ll be in the seventh-floor seminar room,” Anna said. “Shall I tell Dr. Lowell that you’ll be going? It would be a good chance for him to introduce you to the faculty.”

  “Thanks, Anna, I appreciate your bringing this to my attention. I’ll definitely go, but no need to bother Dr. Lowell. I don’t want to be a distraction, so I’ll just sneak in and sit in the back. There’ll be plenty of time for me to meet the faculty later.”

  ***

  I got to the seminar room a few minutes after two and took a seat in the back row. It looked like about two-thirds of what I guessed to be around fifty seats were occupied. Lowell was at the podium, just starting his introduction of the speaker, so my entrance was unnoticed.

  The introductions of speakers at tenure seminars were usually somewhat flashy. This was the candidate’s opportunity to impress the faculty who would be voting on their promotion, and whoever was introducing the candidate normally took the time to review their career and highlight their accomplishments in glowing terms. In other words, to help them put their best foot forward.

  Lowell was having none of that. He summarily noted that Gelman had received MD and PhD degrees from Yale, had done postgraduate work at the University of Wisconsin, and then joined BTI as an assistant professor. She’d come to MTRI three years ago and was now a candidate for tenure. Her work focused on combination chemotherapy for drug-resistant cancers, which she’d be talking about today.

  With that he stepped away from the podium, with no welcoming applause from either him or the audience. It was a cold introduction for a tenure candidate he obviously couldn’t care less about.

  Despite the chill in the room, Gelman looked calm and confident as she strode to the podium. A tall woman with shoulder-length black hair, she was dressed professionally in a light-gray jacket, cream-colored blouse, and dark-gray slacks. Ignoring the obvious hostility, she thanked Lowell for his very kind introduction and the audience for coming to her talk. Then she launched smoothly into a description of her research, using a PowerPoint presentation on her laptop via a ceiling-mounted LCD projector.

  She gave a good talk. She was a bit too rigid and formal, without any attempt at humor to engage the audience—but what else could she do, given the unmistakable air of hostility in the room? She started by reviewing the development of gene-targeted therapies and presented data from a number of studies showing their initial effectiveness, all too often followed by failure when cancers inevitably became resistant to the drugs. Then she focused on drugs that acted by inhibiting a class of enzymes called receptor tyrosine kinases, or RTKs. These were the most common anti-cancer drugs, which included Mark Heller’s aloxinor. As was the case for most RTK inhibitors, a high percentage of patients responded to aloxinor, but those responses typically lasted only a few months before the development of resistance led to relapse.

  Gelman then went on to explain that drug resistance could occur in a variety of different ways. Sometimes the RTK targeted by the drug mutated, making the drug no longer effective. One approach to dealing with this kind of drug resistance was to develop modified drugs that worked on the mutated target. This was sometimes successful and was, in fact, the approach that Heller was pursuing to fight resistance to aloxinor.

  However, Gelman was hoping to develop a more general strategy. Most RTKs converged on a small number of downstream targets within cancer cells. With that in mind, she had decided to approach the problem by combining inhibitors of these downstream targets with RTK inhibitors. Her hope was that inhibition of downstream targets would prevent development of resistance to the whole group of drugs that worked by RTK inhibition, not just to any one agent.

  It seemed like a plausible but chancy approach. It could pay off big, but it could just as easily flop. I wasn’t at all sure that it was a direction I myself would choose to try. Especially not before I had the job security that only came with tenure.

  However, the data she proceeded to show were impressive. Using aloxinor and one other common RTK inhibitor—retoramib—as models, she first tested the effectiveness of downstream inhibitors in preventing the development of resistance in cancer cells grown in culture dishes. The results were clear-cut: Her basic strategy worked, at least for cells outside the body.

  Studies in mice came next, and she showed the audience results that were really striking. A low, nontoxic dose of downstream inhibitors substantially interfered with the development of drug resistance in cancers in mice. Obviously not the perfect model for human cancers—there were many cancer treatments that looked promising in mice, but failed when they were tried in the clinic. But the results she had were certainly encouraging.

  And she wasn’t done yet. She went on to discuss the clinical trial that was now in progress. It was early days, but she already had some intriguing results to show. She’d established a nontoxic dose of downstream inhibitors, similar to the nontoxic dose in mice. Then she’d combined this with aloxinor and retoramib treatments. And at least early indications were that her protocol significantly delayed the emergence of resistant cancers. She concluded by appropriately acknowledging that these results, while encouraging, were still preliminary and the trial was continuing.

  It was an impressive talk, and I expected it to be followed by a round of enthusiastic applause. But not so. I was one of less than half the audience who clapped their hands, and most of the others who applauded at all made only perfunctory offerings. It had to be disappointing, even insulting, for the speaker. But Gelman maintained her rigid professionalism and said she would be happy to answer any questions.

  Only a few people raised their hands, and several got up to leave, purposely showing their lack of interest. Gelman pretended not to notice, instead calling on a man with his hand raised in the second row.

  “Yes, Mark?”

  So that was presumably Mark Heller. I was curious—would he be deliberately hostile?

  “Very nice talk, Carolyn. Your data look quite good. I was wondering, though, why you’ve chosen aloxinor for your clinical trial. As you know, my colleagues and I developed aloxinor relatively recently, and we’re also investigating approaches to overcome resistance. So I’m curious why you didn’t choose to work with any of the several other RTK inhibitors where more is known about resistance mechanisms.”

  Heller’s question was framed politely, but clearly designed to remind everyone that aloxinor was his drug. With the thinly veiled implication that Gelman was poaching on his territory.

  Gelman kept her cool. “We chose aloxinor because—to your credit, Mark—it’s one of the most effective drugs currently available. But resistance is still a problem, so we thought it would be an impactful example of us to start with. Of course, we’re testing our approach with another RTK inhibitor, retoramib, at the same time.”

  It was a good answer, but apparently not enough to satisfy a woman seated in the row behind Heller. She waved her hand, and Gelma
n recognized her. She didn’t mince words.

  “Aloxinor seems like an odd choice to me, Dr. Gelman. As you’re well aware, it was developed by Dr. Heller, our colleague. Although he may be too polite to say so, it seems to me that you’re stepping on his toes by choosing to work on it. Especially since some of his own current work concerns drug resistance as well.”

  I stared at the back of the woman’s head in surprise. She was out of line, her hostility abundantly clear. Gelman just stood there blinking for a moment. When she finally spoke, she managed it well.

  “I’m sorry you feel that way, Dr. Osborne, but I assure you that I’m in no way attempting to infringe on Mark’s work. There’s no dispute that aloxinor is his drug, and as I just said, it’s an excellent one. That’s why we’re trying to make it still better. As is Mark. We have a common goal here—beating cancer.”

  Before Osborne could say anything else, Gelman recognized a white-haired man with his hand raised in the back of the room. “Dr. Carlson?”

  “Dr. Gelman, leaving aside the dubious ethics of your choosing to work on aloxinor, my question concerns the reproducibility and reliability of your results. You’ve shown us what would appear to be promising clinical data, but it seems very preliminary. Are there any confirmations of your observations? Otherwise, I would suggest that much of what you presented should be taken with a grain of salt, not viewed as serious science.”

  That was so insulting and inappropriate that I started to stand up to say something in Gelman’s defense. It was obvious that Carlson was simply out to embarrass her, with no intention of giving her a fair chance. But before I could say anything, Gelman lashed out.

  “You’re full of crap! My data are completely reliable, and I clearly pointed out that the clinical trial is still a work in progress. You’re just trying to throw up a smokescreen of bullshit to block my promotion. I can only hope that our colleagues are too smart to listen to you.”

  With that she turned and stomped out, using a door behind the podium to make an angry exit.

  I kept my seat as the audience filed out. At least some of them seemed to have the good sense to look embarrassed. Maybe even contrite.

  Not Carlson. It took some effort to contain myself when he walked past me, a self-satisfied look in his eyes. But now wasn’t the time to give him the chewing out he deserved. That would have to wait for the privacy of my office tomorrow morning.

  6

  The house that had been rented for me wouldn’t be ready for move-in until Friday—tomorrow afternoon—so I spent the night at the Old Village Inn in Ogunquit. The inn dated to the mid-nineteenth century and my room possessed the charm of that era, with a four-poster bed and an ocean-view balcony. The dining room was equally pleasant and featured an extensive selection of single malts—including my favorite, Oban. I celebrated my new job with a glass of scotch and an excellent grilled breast of duck. I was tempted by the baked stuffed lobster, but decided to save that for dinner tomorrow night with Karen, when she came up for the weekend.

  I took a walk down to the beach after dinner and then called Karen to check in on the day’s events. She seemed most interested in the fact that there was a security video of someone entering the institute at the time the freezer was sabotaged. If I sent it to her, she suggested, perhaps her folks at the Bureau could come up with some notion of the intruder’s general appearance.

  When I got to MTRI the next morning, Anna showed me into what was now my new director’s office. Bare and empty, except for the desk, conference table, and assorted chairs. Lowell had been good to his word—boxes and everything else was gone. The only thing left on the desk was a phone.

  “We have a new computer and printer for you,” Anna said. “I’ll have IT come set them up whenever you’re ready. And I have an assortment of desk supplies in a closet in the outer office. Maybe you can take a look and let me know what you need. Or what else I should order for you. Is there anything else you’d like me to get? I could bring in some plants, or maybe get some pictures to hang on the walls. You could use something in here to make it feel a bit more homey.”

  I looked around at the bare walls. “I guess it could use some decorating, but I didn’t bring anything. Not my first priority. Why don’t you have IT come and set up the computer, and while they’re doing that, you can bring me an assortment of desk supplies. Whatever you choose will be fine. And then I’d like to see Tom Carlson.”

  “Will do. When do you want me to try and get Dr. Carlson to come in? He keeps a pretty busy schedule, so he can be hard to get hold of.”

  “I want him here as soon as IT’s finished. Let’s say an hour. And you can tell him I don’t give a damn about his schedule.”

  She smiled. “You got it, boss.”

  Maybe I wasn’t the only one who thought Carlson was a pig.

  ***

  The IT guy was quick—it took less than half an hour to get my new computer set up and running. When he finished, I asked him to show me how to access the security camera recordings. He seemed surprised by the request, but dutifully pulled up the link. Once he left, I emailed the recording of the illicit entry to Karen. Then I began refreshing my memory of Carlson’s CV until Anna knocked on the door.

  “He’s here; shall I show him in?”

  I looked at my watch. He was five minutes late. “No, let him sit and stew for a bit. Give it ten minutes, then you can bring him.”

  There was no denying that Carlson had an impressive record. Now in his mid-sixties, some fifteen years my senior, he could claim responsibility for the development of nearly half a dozen useful drugs. He was a member of several prestigious societies, including the National Academy of Medicine, and had a consistent record of winning large research grants, as well as substantial contracts for drug development from pharmaceutical companies. Not only was he the best-funded faculty member at MTRI, but he also had the largest research group, with almost thirty postdoctoral researchers. Even with his funding, I couldn’t figure out how he could afford that much salary money. It would be interesting to see how he did it; presumably, many of his postdocs had their own fellowships. I was going to start looking at their funding sources when there was another knock on the door and Anna showed Carlson in.

  He came through the door with a big smile and an outstretched hand. “Dr. Parker, it’s a pleasure to welcome you here. And an honor for me to greet you on the first day of your new job. I think I can speak for all the faculty in wishing you the very best here at MTRI.”

  I stayed seated behind my desk as he crossed the room and stood in front of me. He was about my height—just under six feet—but with a potbelly that I’d managed to avoid. At least so far.

  Ignoring his still-offered hand, I nodded toward an uncomfortable-looking wooden chair I’d placed in front of the desk for the occasion. “Take a seat, Carlson.”

  His smile faded as he realized that I hadn’t asked him here for a social call. I stared at him without speaking until he became visibly uncomfortable. Finally, he broke the silence. “Is there something you wanted to talk with me about?”

  “I was at Carolyn Gelman’s seminar yesterday. I saw you there, too.”

  His smile returned. “Ah, yes. Typical shabby performance from her. I’m glad you had a chance to hear for yourself; she’s a problem we need you to deal with.”

  I’d been about to lay into him, but maybe I could learn something first. I changed tactics. “I’m aware that there’s a problem. What do you need from me?” I asked.

  “Isn’t it obvious? We have two candidates coming up for tenure, her and Mark Heller. Mark’s fantastic while Gelman’s a loser. As our new director, we need you to follow the lead of the faculty and make a clear recommendation for Mark and against Gelman.”

  “You’re aware that there’s no reason they couldn’t both get tenure, aren’t you? It doesn’t need to be a competition.”

  “Of course, I’m aware. Do I look like this is my first tenure case? But Gelman doesn’t deserve it, a
nd we don’t want her here in a permanent position.”

  I nodded. “I see. Has the MTRI faculty voted on this yet? I didn’t see that in the record.”

  “Not yet. We’ve known Lowell was leaving, so we thought it would be best to wait until the new director was on board and could participate in the deliberations.” He smiled. “Now that you’re here, I’ve taken the liberty of scheduling a meeting for early next week. I’m sure it’s on your calendar.”

  How presumptuous could the guy get? But I refrained from comment. “Good, I’ll look forward to it. But you already think that most of the faculty share your opinion of Gelman?”

  “Absolutely. She’s a very difficult woman. Not at all popular. The fact is, most of us can’t wait to get rid of her.”

  “Difficult? How so?”

  He snorted derisively. “In all the ways you can imagine. Arrogant, only interested in her own research, refuses to work with anyone else’s students, won’t serve on committees. Need I go on?”

  “No, I’ve got the picture. But how about her science? The fact that she’s not a good colleague isn’t really a basis for denying tenure. Although it’s certainly something that I can talk to her about.”

  “Her science? You said you were at her seminar. It’s derivative third-rate garbage. I don’t even trust what she presents as being true.”

  I’d gotten some useful information, but now he’d opened the door to the point of this meeting. Time to get back to it.

  I gave him a cold hard stare. “I heard her seminar. I thought she presented some good work. And I also heard your question. It was disgustingly unprofessional. Rude and totally out of place. I want to be clear that I will not tolerate that sort of abusive conduct, from you or anyone else at MTRI. I expect faculty members to treat each other professionally, as colleagues. If anyone can’t behave appropriately, they’d do well to look for another position.”