Fredric Stern - The Endorphin Conspiracy

Until Geoff came across the entry dated November 25, 2009. “Had another big problem in the O.R. today. It was finally my opportunity to do a case as the first surgeon, a simple burr hole in the skull to relieve a sub-dural hematoma, and I drilled right into the brain tissue. I felt awful, but Dr. Pederson, though he was angry at first, was very understanding. He took me to his office after the operation and let me know it was obvious I didn’t have the manual dexterity to be a surgeon. He said I had two choices: leave the program, something I could never do, or do medical neurosurgery (Is there such a thing?) and get involved part-time in an exciting research project he and Dr. Balassi had been working on jointly. Geoff worked with Balassi for a year, so I think I’ll take Pederson up on it.”

Geoff read on. January 10, 2010. “The project is exciting. It has to do with new endorphin analogs to be used for pain control in head injury patients. It’s all pretty hush-hush, though, and I was warned by Balassi not to talk about it with anyone. His assistant, Walter, keeps an eye on things constantly, and I catch him checking on me now and then. That guy gives me the creeps! It seems there’s a lot of industrial espionage going on in the biotechnology industry, and PETronics Corporation wants to be the first to hit the market with the new drug before anyone is even aware of the possibility. It’s great to be involved with something like this.

“January 19, 2010. Great news! We completed synthesis of an endorphin analog today, and according to Balassi, we were given the okay by the FDA for human trials. And guess what, little Howard Kapinsky from Queens is to be the one to administer this breakthrough drug!”

Geoff nodded his head in dismay, then continued reading. “It has to be given in a special way, since it would be broken down rapidly in the bloodstream, but I dare not mention it, even here. No one’s to know about any of this. PETronics Corporation is still paranoid about someone stealing their idea.”

“How’d you inject it, Kapinsky? How’d you inject it?” Geoff whispered as he bit his bottom lip and flipped forward searching for the answer.

“March 16, 2010. I’ve been very busy on the wards during the day and in the lab at night. Geoff and I have been at odds, and it’s very upsetting, more than he knows. I’ve come to a realization as to why there’s so much friction between us, but it’s difficult for me to write. I’ve told no one…” The entry trailed off at the bottom of the page.

“Come on, Kapinsky, get it out!” Geoff muttered in frustration. He turned the page.

“It’s, and this is difficult for me to admit even to myself in my own journal, that I’m attracted to him, that I’m… I’m…gay.”

No shit! Just like O’Malley said. Geoff read on.

“That’s right—gay. Besides my fantasies about Geoff, I had my first sexual relationship with another man last month. His name is Ricardo, a very hot Puerto Rican lab tech working with Balassi. It was very satisfying, much more so than it has ever been with a woman, though there haven’t been very many. No pressure, no expectations, nothing. It’s the best I’ve ever been treated, by man or woman. I’m worried, though, about people at work finding out. It probably wasn’t smart to get involved with someone at work. But it gave me pleasure. Something I haven’t had much of in my life.

“April 3, 2010. It was one of the worst days of my life. Dr. Balassi called me into his office and showed me photographs of me and Ricardo last night. My G-d, does Pederson know, too? Balassi wants to meet with me tomorrow. I’m scared shitless. My life could be ruined.”

“Son-of-a-bitch,” Geoff muttered. “One of the oldest tricks in the book.”

“April 4, 2010. Shock and surprise! I saw a side of Josef Balassi today I never dreamed existed. He was understanding and sensitive to my situation and promised not to tell Pederson or anyone else. He said my secret was safe with him. In fact, he said I could stay with the lab. Now that he knew something so intimate about me, he felt as though he could trust me more and would let me in on a new aspect of the project.”

“May 12, 2010. No entries for a while. Things have taken a turn. Walter’s peering at me strangely these days. He gives me the creeps. I think Balassi must have told him. I’m being blackmailed to remain with the project and do more than I want to, more than I should do as a physician. I don’t think Balassi would do it, but, G-d, if those photos get out about me, and my family found out, I don’t know what I’d do! Balassi’s not what I thought he was. I’ve totally fucked up my life.”

Geoff continued reading. He noted a definite change in the tone. Despondent was a good description. Kapinsky’s handwriting, normally akin to Chinese, had become total chicken-scratch, barely legible. Fortunately, Geoff was used to deciphering it in patient charts.

“May 25, 2010. I was told to inject a new compound today into a patient named Jesus Romero. Carried it out per instructions, but no effect noted yet. I think the stuff has a delayed reaction. The new analog they’re working on is going to be more immediate. I’ve had it with this! I didn’t spend my whole life training to become a slave! I’m going to do some snooping around on my own and see what’s really going on, what Balassi’s hiding.

“July 03, 2010. Snooped around Balassi’s desk after he left for dinner. The lab was empty. Found a list of what appears to be patient numbers under the heading Sigma Project. Balassi’s getting careless in his arrogance. There’s big time involvement here. Is this a James Bond movie or real life? Sometimes I think it’s all just a bad dream. How did I let myself get involved in all this? I must have been set up from the beginning. Shit, I’m scared!

“The numbers under the Sigma Project match patients I injected already in the NSICU. The other is a little girl who was just admitted a few days ago. I won’t do it even if he threatens to announce my secret on the reader board in Times Square!”

“Kapinsky, you coward, how could you?” Geoff swore under his breath.

“July 05, 2010. I tried to refuse, but Balassi brought Pederson in and showed the photographs to him right in front of me! I’ve never been so humiliated in my life. They forced me to carry it out. They said it was a newer analog and would bring her further out of her coma, that it wouldn’t cause any harm, that it was part of a classified experiment backed by the United States Government,that it would be tantamount to treason to refuse. Well, I could live with that, but I removed myself from the situation in a way they’d never know. I left it there at her bedside in a syringe marked “irrigation.” The nurse did the job for me without realizing it. My G-d, what have I become?”

When you have eliminated the impossible, whatever remains, however improbable, must be the truth.

Of course! The only way to reach the deep brain tissue was to deliver it directly , and the only way to do that and evade detection was to deliver it with an entry site that was already there: the ICP bolt!

Every one of those patients—Romero, the Rabbi, Jessica, DeFranco, Smithers—had ICP bolts drilled through their skulls that communicated directly with the space around the brain to measure the pressure in their heads and monitor their levels of injury. The lines were flushed daily. It was not a difficult chore to substitute the endorphin, or any substance for that matter, with the saline irrigation. The nurse on shift that night delivered the substance without knowing it when she irrigated the line.

Geoff resumed reading. “After she coded, they said it must have been too potent to inject directly into the brain. They would have to refine the analog further. I was instructed by Balassi to start raising the suspicion of a mercy killer on the loose and plant evidence to implicate Geoff. Tie it in with a drug problem. Balassi told me Geoff had had one in the past. I was supposed to accuse him of forging medication logs. At first I refused, then Walter—I hate that man—came to visit me at my apartment that night and…it was awful.”