Informed Consent (2 page)

S
asha stared
at the electronic research database company’s sales representative and willed him to wrap it up already. She still wasn’t sure how he’d managed to worm his way onto her daily calendar, but he had. Her phone had beeped a reminder at her during her morning run and, sure enough, he’d arrived in her office with his rubber stress ball, fistful of free pens, and a laminated sheet listing all the new features of his company’s program.

“Do you have any questions?” he asked, giving her an encouraging smile.

How do you keep your teeth so white?
she wondered. But she didn’t think that’s what he had in mind.

“Does this plan include the practice guides and treatises?”

He bobbed his head. “Sure does.”

“Okay, well, I’ll hang on to this information and talk it over with—”

“Your partner. Of course.”

“Actually, no. I’ll talk it over with our legal assistant, er, our associate.” She kept forgetting that Naya had passed the bar exam while she’d been out on maternity leave. Naya was a full-fledged attorney now. But she still did the bulk of the legal research—which meant she called the shots on the electronic database. If Will wanted to research something, he’d head out to one of the law school libraries and hunt through the stacks.

The rep began packing up his materials into his logo-branded computer bag. “Oh. I guess that makes more sense. It’s just unusual for a firm to run that way.”

She smiled. “We’re an unusual firm, I guess.” At that moment, her calendar chimed.

“Looks like we finished just in time,” he joked. Then he shook her hand and let himself out.

He had no idea, she mused. If he thought McCandless & Volmer was unusual for consulting its employees on matters that involved them, it would probably blow his mind to know that her next meeting was with a pair of ravenous two-month olds.

As if on cue, Connelly swept into her office with Finn under one arm and Fiona under the other. Her twins squealed and gurgled when they saw her, and Finn gave her that smile that Connelly insisted was just gas.

“Hi.” Connelly handed over Fiona and let the hiking backpack that he used for a diaper bag fall to the floor. Then he aimed a kiss in the general direction of Sasha’s mouth.

“Hi, yourself, handsome.” She took a moment to smile at her husband before she got busy feeding Fiona, while he took care of diapering Finn with quick, practiced motions.

Feeding time, bath time, every time had become a ballet, a
pas de deux.
Fiona ate her fill, and Sasha handed her to Connelly for burping and diapering while she picked up Finn and fed him.

“How’s your morning going?” Connelly asked.

“So far, so good. Yours?”

“Great. I have a pan of lasagna in the works for tonight. I’m making an extra pan to freeze, too.” He grinned at her.

Connelly was still officially on the federal government payroll in his unofficial capacity, reporting to Hank Richardson and his shadow agency. But Hank called on Connelly only when he needed him, so the highly trained federal agent with the top-secret clearances and sniper-level marksmanship skills spent his days going to pediatrician appointments, feeding the cat, walking the dog, and whipping up elaborate meals from scratch. And he seemed to love it.

“Fantastic. I’ll pick up a bottle of red wine on my way home. I shouldn’t be too late.” She rubbed Finn’s back until he rewarded her with a burp, then folded up the burp cloth she’d taken care to throw over her shoulder and slid it into her desk drawer. She’d learned that particular lesson the hard way.

“Don’t bother stopping. I’ll get it when we come back this afternoon for their high tea feeding.”

She helped him gather the armloads of baby gear that were required for the shortest trip out of the house, then rocked the twins while he meticulously arranged the assorted baby gear so that it all fit in his backpack.

“See you later.” She kissed each baby on the head and then stretched on her toes to kiss their father goodbye.

“Oh. I almost forgot. I got a letter from the DNA registry,” Connelly said.

“And?”

He shook his head. “Dead end. No matches.”

She stared into his gray eyes, trying to get a read on his emotions. “I’m sorry, babe.”

He shrugged. “Like I said before, I’ve made my peace with never knowing who my father was. I’m just sorry Fiona and Finn will grow up with that question mark hanging over them.” His voice was casual, but his mouth was a hard line.

“Hey, don’t say that. We’ve only just gotten started searching for your dad. Maybe we should think about going to Vietnam in the spring, when the babies are a little older. Things have changed since the 80s. They may have better records than they did when you went looking for him.”

His cheek muscle twitched, and she thought he was about to reject the idea out of hand. But he paused and then said, “Maybe. I was also thinking we could ask Naya to do an online search. She’s pretty good at tracking down people who don’t want to be found.”

That wasn’t a half-bad idea. Assuming Naya had the time. “Good thinking.”

He smiled and planted another kiss near her ear. Then, as her intercom buzzed, he whisked the babies out of the office, intent on getting them home before they fell into their milk-induced slumber.

“Yes?” she said into the speaker as she smiled at her husband’s departing back.

“Sorry to bother you with the babies in there,” Caroline said apologetically, “but I have a Dr. Kayser on the line for you. He says it’s important.”

“It’s no bother—Connelly’s on his way out now. Go ahead and put the call through,” Sasha assured her secretary.

As Caroline transferred the call, Sasha wondered what Dr. Kayser needed. He’d been her grandmother’s physician when she’d been alive, and after her death, he’d helped Sasha with a case involving an elderly man who’d been improperly declared incapacitated. But it had been several years since she’d spoken to the geriatric doctor.

“Dr. Kayser, what a nice surprise,” she said when she heard him on the line.

“Well, you may not think so after I tell you what I want.” His voice boomed in her ear.

She sensed the joviality was forced, so she skipped the small talk. “What’s going on?”

“Do you know the assisted living facility in Oakland called Golden Village?”

“I don’t think so.”

“It’s one of those complexes that offers apartments and cottages for folks who are still able to live independently as well as nursing home care for those who can’t.”

“Okay, sure.” Her nana had lived in her Squirrel Hill apartment until she’d died, but many of her old friends and neighbors had moved into facilities like the one Dr. Kayser was describing.

“I have so many patients who live out there now, that I’ve started making house calls there at least once a week—saves them a trip.”

“A doctor who makes house calls? What year is it?”

He chuckled, but the laughter faded quickly. “Heh. In any event, several of my patients have finished out their lives in the locked dementia ward.”

“How sad.”

“It is,” he agreed. “Losing one’s mind … well, it’s an unpleasant end.”

She listened to him shuffle some papers and clear his throat. Finally, he continued, “I think there’s something untoward going on at Golden Village.”

“Untoward?”

“Yes. I—well, I don’t know exactly what’s going on. But I thought back to Jed Craybill and how you helped him, and I thought you might be able to help me, too. Are you free for lunch today, by chance?”

No, she thought, she most definitely was not. She’d taken to working through lunch at her desk, eating whatever salad or soup Jake’s had to offer. It was a bad habit, but it allowed her to eat dinner with Connelly and play with the babies before their bath time and bedtime. But she owed Dr. Kayser, even if he was too polite and well-bred to point it out.

“Yes,” she said, “let’s get lunch.”

T
he doorbell chimed
, once, then a second time, echoing through the quiet house and filling Leo with equal parts disbelief and irritation. He dried his hands on the dishtowel and hustled from the kitchen to the front of the house to answer the door before the caller could ring the bell again. The cat raced along beside him.

“This better not wake up the babies,” he hissed to Java.

The cat mewed his agreement.

Leo didn’t know what logistics were involved in getting one infant to nap, but getting two to nap at the same time required the alignment of the sun and the moon, a ton of luck, and the cooperation of family, friends, and delivery people who were willing to leave packages on the porch without ringing the doorbell. Whoever was out there better have a blasted good reason for being there.

He yanked the door open to find a skinny Asian kid shuffling his feet from side to side. The guy looked to be young, maybe twenty, and, if Leo were pressed to guess his ethnicity, he’d say Chinese. The kid was tall, almost as tall as Leo, but he rounded his bony shoulders forward and sort of stooped as if he were trying to take up no more space than was strictly necessary.

Leo took note of the guy’s stiff, ill-fitting suit and the long hair, swooping over his eyes, and tried to peg the nervous young man. Salesman? Volunteer for a political candidate? Census taker?

“Can I help you?”

“Are you, uh, Leonard Connelly?”

“Depends who wants to know.” Leo didn’t know why he was even bothering to give the innocuous-looking guy a hard time. Habit, most likely.

The guy blinked rapidly, waiting for Leo to elaborate.

When he didn’t, he squeaked out an answer, “I’m a … messenger. There’s a gentleman in Maine who has information about your father.” He sing-songed the sentence in a rushed, high-pitched voice, as if he’d memorized the line and wanted to get it out of his mouth before he forgot it or screwed it up.

His father?

Leo’s pulse ticked up a notch and his mouth went dry. He forced himself to stay composed. He steadied his breathing and cleared his throat.

“My father?” He asked the question as if he were only mildly curious about the response.

“Yeah. The gentleman in Maine says he can put you in touch with your dad. Uh, if you want.”

The kid waited, looking at him with an expectant expression. Leo stepped out onto the porch and stood close to the messenger, deliberately crowding the kid just a bit.

“Who’s this gentleman?”

The boy tripped back a step, putting a little distance between him and Leo. “His name’s Mr. Wynn. Here—” He fumbled with gloved hands in his jacket pocket and pulled out a crumpled business envelope. He lunged forward and pressed the envelope into Leo’s hands. Then he turned and hurried down the stairs to the sidewalk.

Leo stood, oblivious to the cold wind swirling around his bare ankles, and watched the guy trot to the corner and cross the street. The kid craned his neck over his shoulder and saw Leo still standing on the porch. He broke into a full run.

Either by design or whim of the urban parking gods, his visitor hadn’t parked in sight of the house, so Leo couldn’t get a look at his vehicle. He almost started after the guy but remembered the two sleeping infants inside. After a moment, he turned and walked back into the house in a daze.

He lowered himself onto the leather couch and stared at the unaddressed envelope. After a moment, he slit the top open with his fingernail. He shook out a piece of lined loose-leaf paper.

Someone had printed in careful block letters a name and address of sorts:

B
eneath the address
, there was a single sentence printed in the same block lettering:

T
hat was it
. The note, such as it was, was unsigned. He turned the paper over in his hands taking care to touch it as little as possible. The reverse side was blank. He sat there for a long time, listening to the mantle clock’s gentle ticking, until Mocha wandered into the room and nudged his leg. He reached down with one hand and absentmindedly scratched the dog’s ears for a while.

Then, holding the paper by one corner, he headed to the office to make a photocopy.

His father was alive. After all this time, his father was alive, and Doug Wynn, whoever he was, might know where to find him.

T
he room began to tilt
. Greta Allstrom gripped the edge of the metal lab table and steadied herself. Heat crept from her hairline to her toes and her vision blurred and then faded, as the corners of the room grew dark. She focused on not panting, forcing herself to take deep, slow breaths until her heart rate slowed and her vision cleared.

When the moment of lightheadedness passed, she let go of the table and shook out her hands. Then she stood cautiously and walked slowly across the lab room to the metal filing cabinet where she stashed her handbag each day. She opened the bottom drawer and removed a spotted banana, an energy bar, and a bottle of water.

She wolfed down the bar and banana and tossed the wrapper and peel in the biohazardous waste bin that served as her trash can. Then she drank the lukewarm water in one long gulp and aimed the empty bottle at the recycling basket.

You can’t forget to eat,
she scolded herself as she hurried back to the table. Eating, while time-consuming and inefficient, was an unfortunate, but necessary, interruption to her work.

She traced the scar that lined her cheek, a reminder of the day last month that she’d passed out from hunger. She’d been about to make a breakthrough and had been working for more than forty-hours in an adrenaline- and caffeine-fueled session, when suddenly she’d grown dizzy. She’d hit her face on a stack of glass specimen slides as she collapsed and had awoken in a slick pool of blood. The resultant stitches and completion of the obligatory OSHA incident report had eaten up more time than a quick meal break would have.

Ever since, she’d vowed to pay closer attention to her body’s needs and, so far, had avoided a repeat performance. She couldn’t afford to lose any more lab time. Not when she was
this
close to a breakthrough. Not when the Alpha Fund was waiting for a progress report.

She adjusted her safety goggles and peered into the microscope. She was scouring the blood smears on the slides for hypersegmented neutrophils. A normal mature neutrophil would typically have three or four segments, or nuclear lobes. If a cell contained six or more lobes, it fit the clinical definition of hypersegmentation, a symptom of coblamine, or Vitamin B12, deficiency. The samples she reviewed often contained as many as eight or even ten lobes.

She was counting under her breath and didn’t hear the door swing open, so she nearly knocked over her specimen when Troy Norman, one of her graduate students, coughed just over her left shoulder. She started and turned.

“So sorry, Dr. Allstrom. I didn’t mean to startle you.” He smiled sheepishly.

“You didn’t,” she lied even though he obviously had. “Do you have the samples?”

He nodded and passed her a soft-sided cooler bag, like the ones office workers use to keep their lunches chilled. Just knowing that now, at this moment, she held in her hands the tissue samples she needed to test her hypothesis filled her with a warm, pervasive sense of peace and calm.

“Do you need any help?” he asked with the eagerness of a puppy.

She didn’t. But she prided herself on being a mentor to the promising students who chose to commit to the grueling schedule she demanded. She’d think of some task that would engage him without endangering her work.

“Yes, please stay.”

He dragged a high metal stool across the floor and perched on it immediately, as if he feared she might change her mind if he took too long.

“What are you doing now?”

“I’m comparing the samples from the controls with the hyperhomocysteinemiac group who received the supplement.”

The supplement.
It sounded so innocuous, like an over-the-counter concoction of herbs that a person might buy at her local pharmacy, not quite believing it would work. But
this
supplement was a powerful blend of B-vitamins and fatty acids that were often deficient in dementia patients. The working hypothesis had long been that coblamine deficiency was responsible for demyelination of the myelin sheath and that the sheath could be repaired through nutrition, supplements, and perhaps, someday, prescription drugs. None of this was particularly cutting edge.

“And the tissues?” Norman asked. “We’ll thin-slice those to confirm that the supplement did help to regenerate the sheath?”

“We hope.”

“And then … the nano-robotics team can start its trials?”

“Soon. We just need a healthy control slice.”

The nano-robotics team,
there
was the cutting edge.

Greta had long suspected that the supplement would work better if it were delivered in massive quantities directly to a patient’s glial cells, where the myelin sheath was formed. But how to get it there? The answer had come to her on a rare evening off while she was watching
Innerspace
on late-night cable, marveling at how a movie about a miniaturized Dennis Quaid being trapped inside Martin Short had managed to net an Oscar. And then it hit her. A surgeon could insert a nano-robot into a patient’s body and, using a simple joystick, remotely guide the tiny robot to the glial cells, where it would coat the cells with her supplement. She’d been so excited that she’d headed straight into the lab at one o’clock in the morning to flesh out her idea without even bothering to change out of her pajamas first.

Nearly a year had passed since her brainstorm—a mere blip in time in the institutional research world, but to Greta it felt like an eternity. Each day that passed had seemed to her to be a failure, a missed opportunity. So she worked, harder, faster, committed to bringing her cure to fruition.

News of her work had spread through the scientific and technological communities, and she’d been offered a plum speaking engagement at a joint conference put on by MIT and Harvard. That had resulted in an infusion of cash from the Alpha Fund.

And now her borderline harebrained notion was
this close
to reality. If the brain tissue samples showed that the supplement had even a small positive effect, then the next stage—the nano-robotics phase—would go into production just as soon as she had a healthy brain tissue slice to use as the standard. She was convinced—certain to her core—that if her nano-robots became a reality, the horrifying specter of cognitive degeneration would someday be nothing more than a historical footnote. She prayed she was right. Otherwise the Faustian bargain she’d struck with the Alpha Fund had been for nothing.