Richard Mabry - Lethal Remedy

Lillian Goodman settled into the chair in front of a computer terminal in the medical center library. She could have used her office for this, but this way she was away from any distractions. Her cell phone was silenced, her pager set to vibrate, and no one but her secretary knew where to find her. She was determined not to give up until she'd broken through some of the mystery that surrounded Jandramycin, the compound that began life as EpAm848. She decided that her first order of business would be to figure out what Jack Ingersoll's original area of research was when he stumbled onto his wonder drug. For instance, if the components were substances that might cause lysis of a cell wall, it was reasonable that they could be combined in such a way as to cause bacteria to swell and pop like balloons blown up too much. If they were involved in cell reproduction, the combination might act to keep bacteria from proliferating so their population would eventually decrease to zero.

The only clue she had was the original name given the experimental preparation: EpAm848. She decided to start with the number. That was fairly clear-cut, and surely Google would help her run down its meaning. She had second thoughts when she saw that entering "848" yielded almost eighty million results. Then she tried "compound 848."

Better-only three million. As she trolled through the answers, she discovered that Google put the most likely at the top of its list.

Good. After half an hour, Lillian was fairly certain that the number referred to R848, a compound associated with the immune response to harmful bacteria. Okay, immune response. That was a starting place.

She jotted a note on the pad beside the computer monitor. "Am" was more challenging. She dug deep, pounding the computer keys until her wrists were sore and her fingers stiff, but nothing seemed to click.

Then she decided that maybe it wasn't "Am" at all. Maybe the designation had been "AM"- two words, each beginning with one of those letters. That led to a different search. After an hour's digging into references, Lillian felt crosseyed. She stretched, moved around in her chair, and wondered if it was worth it. She dug into her purse, found a couple of Tylenols, and journeyed to the water fountain to combat the headache she was developing. Finally, she found an obscure reference in the Journal of Ethnopharmacology. It dealt with Chinese herbs, and stated that Astragalus membranaceus was thought to have "immunomodulating and immunorestorative effects." In other words, it affected the immune system of the person receiving it, helping throw offinfections. That had to be it. Two-thirds of the compound name, and both referred to the immune response to bacterial infection. She felt the flush of victory, but determined to make sure. Instead of searching for words that began with "Ep," Lillian tried the same tack that yielded her last positive result. She looked for two words that started with the letters E and P. This wasn't easy, and she was about to give up when she encountered Echinacea purpurea. She was aware that a number of homeopathic and herbal remedies contained Echinacea for its alleged ability to help cold sufferers throw offtheir infection.

Lillian plowed through reference after reference until, in one paper, she encountered the phrase: " Echinacea purpurea is known for its ability to kick-start the immune system." She also found that many people were highly allergic to this natural remedy, experiencing reactions ranging from rash and swollen tongue to anaphylaxis and death. Could this be the "unpleasant result" Ingersoll sloughed offduring their discussion? Lillian sat back and massaged her temples.

This might be the clue she and her colleagues had sought. Jandramycin, in its final form, acted to kick-start the patient's immune system to make antibodies specific for the invader, Staph luciferus. Such a targeted response would undoubtedly assure that everyone capable of mounting a normal immune response would be rid of the bacteria within a few days. And the autoimmune responses? If these only occurred in patients with an allergic background, maybe the drug had an additional action on their immune system, generating antibodies to the patient's own tissue. Nervous system, bone marrow, thyroid, kidney, blood vessels-any of these could be the target of the process. That could explain the autoimmune complications seen in allergic patients who'd received Jandramycin. It's all conjecture. And if it's true, what do we do to help those patients? She scooped her notebook into her backpack, stuffed her purse in after it, and hurried from the library.

She had to call John.

John opened the refrigerator and peered in, not really seeing the contents. He wasn't particularly hungry, but knew that he needed to eat. "Keep up your strength." He was startled when he realized the voice in his head that delivered the words wasn't Beth's. Instead, he heard Lillian Goodman. Did that mean Lillian was taking Beth's place?

Oh, please God, no. John loved Beth. He'd always love her. Was her memory fading already? He prayed that wasn't the case. He'd worked hard not to build what one popular book on the loss of a spouse called a "shrine to grief." He'd donated Beth's clothes to a shelter for battered women. Her books went to their church library. He'd cried while doing it, but John finally erased Beth's voice from her cell phone message, although now he wondered if that had been wise. But he knew he had to move on. He just wasn't ready for anyone to replace Beth in his life. The ringing phone startled John from his reverie. He closed the refrigerator door and hurried into the living room to catch the phone before the answering machine kicked in. He didn't bother with the caller ID. When loneliness had him in its grip, he was even glad to talk with telephone solicitors. "Dr. Ramsey." "John, this is Lillian. Did I catch you at a bad time?" He dropped into a chair and wondered if through some mind-reading magic Lillian knew he was wrestling at that moment with her role in his life. More than that, he felt guilty at the pleasure he felt when he recognized her voice. "No, I'm fine. Just browsing in the refrigerator." "Well, be sure to eat something. You have to keep up your strength." No doubt about it. The woman was a mind reader. "I will," John said. "But surely you didn't call to remind me to eat dinner. What's up?" "This may sound strange, but I need to ask you if you're allergic." "I don't understand what you mean. To medicines? To foods? What?" "Do you have hay fever?

Asthma? Eczema? That kind of allergy." "Oh, I see. Well, I was allergy tested several years ago. He said I was allergic to grasses, trees, and weeds. But I never got around to taking shots. I just treat the symptoms when they get bothersome." He frowned. "But why do you ask?"

"I think we need to talk," Lillian said. "Would it be okay if I came over?" "Sure. Why don't I order a pizza, and we can eat together? What do you like on yours?" "Just order what you usually get," she said.

"I'm sure it will be fine. Besides, after I tell you what I've learned, neither of us may have much of an appetite."

The call came through on his cell phone, not his landline, which was the way he'd set things up with his informant. Either way, there would be a record of the call, but this way there was no possibility that anyone could be listening in. At least, not without some sophisticated electronics. As for his office, it was swept for bugs once a week by a man he paid in cash out of his own pocket. Absolute security was impossible, but this would do. "So, who's still digging around looking for flaws in Jandramycin?" he asked. "Still Sara Miles and Rip Pearson, but-" Traffic noise in the background intensified for a moment, and the caller waited for it to die down. "Sorry. I stepped outside to get some privacy. Anyway, Miles and Pearson are the main ones, but I'm pretty sure there are a couple of others involved."