Michael Palmer - Fatal

"Sally," Ellen said finally, "you and I both know the power and influence of those pushing this thing, the deans of medical schools, professors of pediatrics, to say nothing of the President and his wife."

"Hey, wazzapnin'?"

Cheri Sanderson bounced into the room, a cup of coffee in one hand, a bulging leather portfolio in the other.

Five-three, if that, Cheri was a kinetic ball of energy and optimism.

"Ellen tells me the vote's going to be twenty-two to one," Sally said.

"What did you expect?" Cheri replied. "These people were hand-picked because they were going to vote yes. Hell, the pharmaceutical giants finance many of their labs. How would you expect them to vote? You've done great, Ellen. You stood your ground and presented our issues as well as anyone could have."

"Thanks. I'm a little disappointed I haven't had more of an impact, but like you said, the deck was stacked from the beginning. So, what's this news you have?"

Cheri paused dramatically.

"The news is, according to this press release from her office, the antichrist of sensible vaccine thought, Lynette Marquand herself, will be addressing the nation from the FDA on the day of the final panel debate on Omnivax."

"Nice timing," Ellen said. "The final vote is scheduled for two days after that meeting."

First Lady Lynette Marquand and Secretary of Health and Human Services Dr. Lara Bolton were the heavyweight champions of mass vaccinations. Four years ago, Lynette's husband, Jim, had narrowly won a bitter, hard-fought election. Now, with just a few months to go, he was in a dogfight again, neck and neck with the man he had beaten by only two points and just a dozen electoral votes.

One of his campaign promises — the one with the greatest likelihood of coming to fruition unscathed — was the development and distribution of a supervaccine. The vaccine, Omnivax, was to be given to infants early in life, and eventually mandated for everyone. Containing up to thirty different antigens — killed or modified viruses and bacteria — it would be given as a shot for now, and orally as soon as research, already well under way, permitted it. The immune systems of the recipients would learn to make antibodies against the various germs so that, should they encounter any of them in the future, their defenses would be primed and ready to fight them off. Editorials had equated Jim Marquand's bold pronouncement with the John Kennedy promise to put a man on the moon. Now, in this arena at least, he was looking good.

"What subtle timing," Ellen said. "Lynette Marquand is out stumping for her husband, who is getting boatloads of PAC money from the pharmaceutical industry."

"And like Cheri said, a lot of these doctors and professors on your panel owe their careers to vaccine research grants from various drug manufacturers," Sally added.

"So," Cheri asked, "do we have any bombshell Ellen can explode at that session? If Lynette's media people do their jobs as well as they have so far, there should be a gaggle and a half of reporters covering the show."

"I don't know what to say," Ellen replied. "Week after week, month after month, I've been searching for holes in what the committee is proposing, breaking down every component of Omnivax, looking for some kind of scientifically valid study that would confirm that one of the thirty vaccines was flawed — or even the opposite, if one of the components was flawless." She gestured to the graph behind Sally's desk. "I can't even find any hard data that prove vaccinations contribute to the increase in autism. Increased awareness, one expert tells me. Misdiagnosis, chimes in another. Environmental factors, pipes up someone else. Anecdotal, pooh-poohs a professor."

She calmed herself before continuing.

"When I first joined the committee, my teeth were bared and I was ready to chew them all apart for what they have and have not done. I still want to do that, believe me, I do. But there're so few scientific studies, even on our side. Nothing about this whole vaccination business is clear-cut except that we need to know more — much more. In the meantime, the other side is going to win this particular battle, and Omnivax is about to leap into our culture. You and Cheri and everyone associated with PAVE, including me, have got to resolve to keep on fighting for the scientific truth, whatever that is."

Sally looked clearly frustrated.

"All this time, all your studying, and you haven't turned up anything about any of the components of Omnivax?" she asked.

"I'm still working on it," Ellen replied. "Honest, I am."

She felt the chill in Sally's expression and hoped the woman couldn't tell that, in fact, she was holding back some information. She believed that neither Sally nor Cheri could be trusted to remain silent until Rudy Peterson's work on their behalf was further along, especially with Omnivax about to be approved. Rudy had been sifting through information on the supervaccine components for well over a year now without turning up anything damning. There was, however, clinical data on one of the components that he felt was limited in scope and obtained by research that was a decade old and possibly shaky in design. That component was Lasaject, a vaccine against the virus responsible for causing deadly Lassa fever.

Rudy was steadfast in maintaining that the data might still support the conclusions that the vaccine was safe. He needed more time — time during which the vaccine's manufacturer was unaware of his investigation.

Ellen felt certain that this wasn't the moment to tell the aggressive directors of PAVE that while there was no immediate chance of defeating Omnivax, there was lingering hope at least of denting it.

Look, officer, I don t want to be a pest, but this woman is really ill and she's running around the city somewhere, certain that some people are trying to kill her. Are you sure word is out?"

"Ma'am, I promise you. This is the fourth day you've called. Everyone here knows about Kathy Wilson. We have every car and every officer on the street looking out for her. We'll call you as soon as we find her."

Four days had passed since Kathy's call, and not another word from her until just now. When Nikki returned home from the office, there was a rambling message from her on their answering machine, but no hint on Caller ID as to the origin of the call. The disjointed, vitriolic message was terrifying as much for its tone as its content. Kathy Wilson was clearly insane.

Joe Keller continued to be as comforting as possible under the circumstances without being patronizing, as the police continued to be. He was, as Nikki would have expected, fascinated with the rapid development of what he assumed from her description were neurofibromas. Twice he began a tutorial teaching session with her on the differential diagnosis of the condition, but when it was apparent she was hearing only a fraction of what he was saying, he set his marker down.

Nikki paced restlessly about their two-bedroom flat, using a remote to change the five-disc CD player from Mahler to Carly Simon to Miles Davis to either of the two Bluegrass Ramblers CDs, and back. Every flat surface in the apartment seemed to hold a half-empty cup of tea or coffee. More than once she had to battle back the urge to go out and buy a pack of Merits — her brand when she quit smoking more than ten years ago. The living room was strewn with textbooks, each open to some aspect of either neurofibromas or acute paranoia. Outside, a steady rain had let up some, but the wind was howling.

Nikki flipped to the Mahler again — a powerful recording of his Symphony No. 7 — and then knelt down by one of her medical textbooks. Tuberous sclerosis, von Recklinghausen's disease, Sturge-Weber syndrome, von Hippel-Lindau Syndrome. The arcane collection of diseases that included neurofibromas were, for the most part, the result of genetic mutations on any one of several different chromosomes. All of them were accompanied by some sort of brain dysfunction, either by way of cancers or the actual growth of neurofibromas in the central nervous system. The best Nikki could come up with was that Kathy Wilson had some sort of variant of von Recklinghausen's disease, the most common of the conditions, reportedly occurring in one out of every 3,500 individuals. Von Recklinghausen's disease — outcome: fatal, sometimes within a few years from diagnosis. Treatment: none.