Death Benefit (6 page)

Pia watched Rothman type away in front of her. The level of his concentration was truly remarkable. One minute he’d been talking with her, the next he was totally absorbed, as if she were no longer in his presence. Pia did not take any aspect of his behavior personally. After he’d confided about his Asperger’s, she’d read about the syndrome and guessed that many aspects of his personality were dictated by it, even ignoring her as he was doing at that moment. Instead of being annoyed, she thought about the content of the article she’d rewritten. It was about studies that Rothman had been doing involving salmonella typhi grown in outer space on the orbiting International Space Station. Rothman had found that growing the bacteria in a zero-gravity environment made it enormously more virulent than control bacteria grown back on earth. It was Rothman’s belief that the conditions in space somehow mimicked to a marked extent those present in the human ileum, triggering the bacteria to turn on the genes in the pathogenicity islands to produce effector proteins. Pia was one of the few people who knew that at that moment in the refrigerated storage facility inside the biosafety unit there were three strains of these enormously virulent, space-grown salmonella. She also knew that what Rothman wanted to do was to figure out how zero gravity caused these changes with the hope of learning how to turn them off, not only in space but in the human ileum as well.

Although Pia had learned to be patient in Rothman’s presence, she had her limits. After a few minutes had gone by Pia coughed lightly. She’d found by experience that coughing seemed to penetrate Rothman’s concentration more than anything else. Almost immediately he peered around the screen of his Mac and pushed a box of tissues in her direction. He had a phobia about people coughing in his presence. He was, after all, a firm believer in the “germ” theory. Pia took one of the obligatory tissues.

“Right. Miss Grazdani, for this month’s assignment . . .” He disappeared from her sight again. He resumed his two-finger typing but at least kept talking. She couldn’t see his face but she preferred it that way, which he did too as both had trouble maintaining eye contact not only with each other but with everyone else as well. “I want to move you over into our induced stem cell work. You’ve done a knockout job with salmonella, but it’s time you started in the other arena.”

A smile of anticipation appeared on Pia’s face. Rothman’s words were music to her ears.

“We’ve been making breakthrough discoveries of late involving organogenesis.”

Pia’s heart picked up speed. It was the first time Rothman had talked to her about his stem cell work. She knew what organogenesis meant as the word was self-explanatory. It was now the cutting edge of stem cell research. It was the last hurdle before creating organs that could be transplanted into patients—organs like hearts, lungs, and kidneys. It thrilled her to think that Rothman was making enormous leaps forward. And the idea that she would become part of the effort gave her chills down her spine.

“At this stage our biggest problem is that tissue culture techniques and fluids have not kept up with the breakthroughs that we’re making. Current tissue culture techniques were developed for sheets of cells, not solid organs. I’m sure you can gather what I mean. It relates to oxygenation and removing metabolic waste while maintaining acid base balance within extremely narrow parameters. It’s been basically a combination of pushing the limits of biochemistry and engineering. We have come up with some impressive hardware breakthroughs, but the involved fluids have not kept pace. The problem that is now holding us back is the acid base balance. My guess is that the pH is varying too much. We can’t figure out why. What I want you to do is to become a tissue culture fluid expert and figure out why we’re having this pH problem. Got it?”

“I think so,” Pia managed. She had learned that it was never a good ploy to question any of Rothman’s directives. Anything and everything could be discussed again, but not on the spur of the moment.

“Good! Get to it! And when I finish making these changes in the manuscript, I’ll see that Marsha gets you a copy for your final review. Now get out of here!”

Rothman’s typing picked up pace, a few keystrokes followed by several frantic deletions. Pia kept her seat despite Rothman’s final comment. She sensed that this was all the information she was going to get about her month’s elective at the moment, and it wasn’t much. Inwardly, she shuddered a little. She had expected to be working on some aspect of Rothman’s salmonella research as she’d done in the past. Tissue culture was a new discipline for her and what she was being tasked to do sounded like an entire Ph.D. project, not a month’s assignment. She was going to need a lot of help from Rothman and from the other technicians, especially Nina Brockhurst, whose job it was to take care of the physical plant of Rothman’s organ-growing experiments, which would include the baths. In the past Nina had openly resented Pia, claiming Rothman played favorites with her. Pia had taken the situation in stride as she knew there was always intrigue when people were forced to work together, especially when the boss’s signals were so hard to read.

But whatever the workload and her colleague’s demeanor, Pia knew she was going to find the month fascinating. Even if the fluid bath assignment wasn’t, on the face of it, very exciting in and of itself, it was still vital experience she would be gaining, learning the basic techniques for taking care of newly created organs, a key steppingstone in the journey from studying organogenesis in mice to studying it in people. Most important, the work was in the stem cell arena: the place she believed she really wanted to be.

Pia coughed again, this time into the tissue that she had in her hand. Rothman’s face reappeared around the side of his Mac. His expression was one of surprise that Pia was still there.

“I went to see the mother superior at the convent last night,” she said. “I told her about my not wanting to go to Africa.”

“Good,” Rothman said simply. His face disappeared. The typing recommenced.

“She was nice about it, but I could tell she was not happy.”

“That’s her problem, not yours. You’ll be doing a lot more of God’s work here in my lab than going to any godforsaken part of Africa.”

“She said she did not want to be repaid.”

“Good for her. So don’t.”

“I think I should. Are you still willing to cosign for a fifty-thousand-dollar loan?”

“I am, but I think you’re crazy. She doesn’t want to be repaid, or so she says. Save your money.”

“She used the word ‘betrayal,’ ” Pia said. She knew she was distorting the reason the mother superior had chosen to use the word, but the fact that she had used it at all still bothered Pia.

Rothman gave a short, mocking laugh. “Betrayal! She’s just trying to foist some Catholic guilt on you, Pia. For chrissake, pay her the money if you need to and be done with it. I’ll have Marsha take care of it with my bank. As a fourth-year medical student, I’m sure your credit is adequate. Remember, it’s your life, not the mother superior’s. Now, get out of here and get to work.”

Pia got up and left Rothman to his typing. Passing Marsha, she thought about hitting the library. Her initial plan was to read everything on tissue engineering that she could get her hands on. She had no doubt it was going to be an overwhelming amount of information.

 

 

H
aving loaded up on books and printouts from a Google search in the library, Pia spent the morning reading, sitting deep in concentration at a bench area outside her windowless office. She’d been vaguely aware of the maintenance man doing his thing, but she had ignored him until he came up behind her. Disregarding the fact that she had her iPod buds in her ears, he had the nerve to tap her on the shoulder.

“Pia, darling dear. Want to reconsider my pastrami offer? You won’t be disappointed.”

“Not on your life,” Pia said, with emphasis, hoping he’d get what she intended as a definitive message. He shrugged and smiled and gave a little silly wave as if Pia had been gracious rather than scathing. She was beginning to think that Vance was one of those men who reveled in rejection. Irritably, she repositioned her earplugs and went back to her reading. When she heard her name being called again, Pia was momentarily livid, wondering what she was going to have to do to get him to leave her alone. Tearing out her earpieces, she looked up to see Rothman’s assistant, Dr. Yamamoto, standing in front of her flanked by a young man and woman in newly laundered, dazzlingly white lab coats.

“Miss Grazdani,” Yamamoto said. He was a slight man with what appeared to be a kind of half-smile frozen on his face. “I would like to introduce our new students with us for the month.”

Dr. Yamamoto was often held up within the medical center as a perfect example of how opposites attract. He was well liked, soft-spoken, considerate and communicative, always encouraging people to address him as Junichi: the positive to Rothman’s negative. Also in contrast to Rothman, he was casually dressed as always, in a Hawaiian shirt beneath his wrinkled and not-too-clean lab coat. If there was one nod to his playful side, Yamamoto was said to be the originator of elaborate and brilliant practical jokes stemming from his graduate student days involving one particularly pompous medical student’s expensive fool’s errand to a “convention” in Geneva that never was. On the serious side, Dr. Yamamoto’s most important characteristic was his complete and total devotion to Rothman and Rothman’s work. What was accepted around the medical center was that Rothman was the brains and Yamamoto was the worker bee. They were yin and yang.

“Perhaps you know Lesley Wong and William McKinley,” Yamamoto said.

“Like the president,” the young man said. “But call me Will.”

Will stepped forward, a big smile on his face, hand outstretched. Columbia University Medical School had about 640 students spread over four years of training. In general the first two years were primarily spent absorbing the science of medicine with progressively more and more time creatively devoted to introducing students to patients. The third year was the principal clinical year with the major attention devoted to internal medicine and surgery. The fourth year was mostly rotations in various clinical subspecialties combined with electives according to each student’s personal interests. At Columbia the emphasis was on academic medicine. Lesley and Will were fourth-year students in Pia’s class. Both thought they had a new interest in research, which was why they had been assigned to spend a month in Rothman’s lab.

Pia took Will’s outstretched hand and stood up.

“Pia. Grazdani.” She noticed that Will was tall, even a little taller than George, who was above average. Like George, Will had blond, unruly hair.

“You’re George’s friend, right?” Will said.

“George? Yes, of course.”

“Love George, great guy. I often play b-ball with him.”

“I’m Lesley Wong,” the woman said, shaking Pia’s hand in turn.

For a moment there was an awkward silence. Pia briefly eyed the two students, realizing they had to be the students Rothman had briefly mentioned the day before and then never brought up again. He had said something about tasking her to come up with something for them to do, as if she wasn’t going to be busy enough. One way or another it was going to be a burden of sorts.

Lesley and Will eyed Pia back. For their part, they weren’t terribly excited about meeting her either. For them, finding out they had been assigned to Rothman’s lab was the equivalent to being sent someplace in Dante’s inferno. Rothman had the reputation of destroying every student’s sense of self-confidence by making them feel stupid, which they invariably were in comparison to Rothman’s encyclopedic knowledge. And they had heard about Pia as well. She too was known as being over-the-top smart and also strangely detached and had taken an early interest in research in addition to the regular curriculum. For most people being a medical student was demanding enough. Except for being tight with George Wilson, who was one of the more popular students in the class, a mark in her favor, Pia never had had the time or inclination to be particularly friendly with many of her classmates. And all that was on top of the gossip that she and Rothman had something going since she was the only person in the entire medical center that he got along with except for Dr. Yamamoto.

Lesley looked over at Will, but he was staring at Pia. When they’d received their assignment, Lesley had told Will that she’d sat next to Pia in a lab every day for a month the first year but she was sure Pia wouldn’t remember. Lesley hadn’t made up her mind if Pia was extremely focused on her work or just plain rude, although she thought it was the former. As for Will, he was excited to be finally matched with Pia—he’d wanted to be for three and a half years. He’d been sure to introduce himself to every woman in the student body he deemed attractive, but this was the closest he’d come to her.

“Okay. Introductions done,” Yamamoto said. It hadn’t been quite as awkward as he feared, and he was relieved. He could get down to business.

“If it’s okay, we can go to my office. I’d like you to come as well, Pia. There are a couple of things we need to talk over and then we can all go take a look at the organ baths with Dr. Rothman.”

Yamamoto beamed a smile and walked away, the two new students padding closely after him. Pia brought up the rear, reluctant to be leaving her reading but excited at the same time. Even though she had been working there for years, she had never seen the organ baths. Although she had spent more actual time with Dr. Yamamoto than she had with Rothman, she didn’t feel she knew him as well. In her mind he was more complicated than Rothman. She thought of him as a kindly man but knew that in his own way, he was just as demanding as the chief. He suffered fools no more gladly, but his reprimands and corrections were delivered more politely and at lower volume. Pia had gathered from experience that the quieter Yamamoto spoke, the more important it was to listen.