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Authors: Daniel Kalla

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Pinter’s smile grew wider but he said nothing. Jill focused back on the screen. She could not ignore the promise depicted in those diverging lines on the graph. The data had come from the same stem cell study in which Senator
Wilder was considering enrolling. Their first step on the road to publication was to analyze the subjects’ functional disability scores—their ability to perform simple tasks such as using a keyboard, grasping utensils, or pronouncing specific words—to compare before stem cell transplantation and every six months following.

Jill had heard anecdotes of patient improvement, some dramatic, within months of re-implantation. However, she knew better than to read much into those case reports. Placebo benefits and observer bias, where both the enrollees and researchers subjectively note improvement because they so desperately want to see positive results, were the rule in nonblinded studies. Most times, such outcomes could not be statistically validated or reproduced, which was the kiss of death for a major medical study.

The graphs facing Jill on the screen were objective measurements collected by “blinded” research assistants who were unaware of which patients had received stem cells. They meant so much more than the anecdotes. Aglow, Jill still tried to mask her exhilaration from Pinter. “It’s so early,” she said. “Why bother even running the data at this point?”

“ ’Cause of this.” He laughed.

Pinter clicked the mouse a few times and the data suddenly appeared in table format on the screen. Jill was so familiar with this type of table that she could mine it at a glance. Two numbers immediately popped out at her and sent her heart slamming. The first was the variance, the difference (in this case, improvement) in the scores between the groups. She saw that the treatment group had averaged a 38 percent improvement over the untreated group in neurological testing.
In only six months!
The number was staggering—higher than she had dared hope for. The second value, the P value, ratcheted her mood to near delirium. It was well under 0.05, the magic mark for the P value in any study. A low P value like that meant that the chance of improvement in the treatment group occurring randomly was almost nonexistent.

Unable to contain herself, Jill smiled from ear to ear. She laid a hand on Pinter’s shoulder. “Is this really right?” she asked, barely above a whisper.

Pinter shrugged. “I’m just the dumb monkey who plugs in the numbers.” His beaming face contradicted the modest words. “But I did plug ’em in right, if that’s what you’re asking.”

“Do you know what this means?” Jill said, as much to herself as Pinter.

“Yeah, I’ll still get paid next month.”

“You and me both. And everyone else in the lab.” She laughed. “Andrew, I could just kiss you right now.”

He tilted his head and touched a finger to his stubbly lip. “Oh, yeah? So what’s stopping you?”

She leaned her head in closer as if to kiss him, but pulled back at the last moment and punched him playfully on the shoulder. “Alimony payments.”

Andrew’s eyes lit with menace. “You only have to worry about those if you get caught.”

She giggled again, giddy with relief and thrilled by the implications of the early findings. Her grant renewal would be a slam dunk now. Suddenly, the likelihood of publication in one of the most prestigious journals, such as
Nature
or
Science
, loomed large in her mind. She sensed that big scientific accolades might greet such a landmark stem cell study, including major awards or prizes. Maybe even
the
prize.

Don’t get too far ahead of yourself, Jill!

But her silent reprimand did little good.

15

As her narration wore on, Dot visibly lost steam. Her usual animation—flying hands and exaggerated facial expressions—diminished until she sat slumped back in the chaise with her hands folded across her abdomen. A few times she lost her train of thought or used the wrong name.

Lorna worried that her great-aunt might soon pack it in as she had the day before. She dreaded another evening spent in the warm musty guest room with its unsavory history. Out of desperation, Lorna fell back to flattery. “Dot, it’s unbelievable the way you breathe life into Evan, Marshall, and these other historical characters. I feel as though I know them personally.”

Dot sat up straighter and ran her hand through her cropped white hair. “They were colorful people,
our
ancestors.”

“Technicolor, for 1895, I would say.” Lorna found it curious that Dot lumped Evan in with their ancestors but she kept the thought to herself. “I still don’t see how a vicious beating and a death threat led to an endowment for a hospital.”

“Come, now, darling.” Dot smiled humorously. “It’s a
positively
Alfred-son family trait to say one thing and do another.”

“Maybe, but I don’t see how that applies—”

“Take the upcoming board meeting, for example,” Dot said. “We speak in glowing terms about the little family hospital, but many of our
dear
relatives are perfectly prepared to sell off the Alfredson as though it were an old trailer that we could auction off on that eBay program.”

Lorna shrugged, careful not to show interest in present-day events. “I’m an academic. I don’t get too involved in the business side of the family.”

Dot stared at her for a long moment, and Lorna again spotted a disconcerting flicker of insight in the old woman’s eyes. “There is
no
Alfredson
family business,” Dot said. “The lumber business was sold off eons ago. Granted, a few of Marshall’s offspring have been prudent with their inheritance, but most have squandered it. All we have left of his legacy is our position at the Alfredson. And if not for the many strings Grandfather attached to the original endowment, we would have no say whatsoever in that, either.”

“Point well taken,” Lorna said, hoping to gently steer Dot back onto course. “Why did he attach those strings? Few hospitals are privately owned by families.”

Dot sighed heavily. “Sometimes I wonder if you’re hearing any of what I am trying to tell you, darling,” she said with more than a hint of annoyance. “Marshall Alfredson never had
any
interest in building or financing a hospital.”

Lorna held up her hands. “Then why, Dot? Why in God’s name did he go from trying to kill Evan McGrath to helping him realize his lifelong dream?”

Dot shook her head. “Marshall was a businessman, through and through. For him, everything in life had a price tag. The hospital was simply one more bargaining chip.”

“Bargaining for what? Surely he didn’t need to buy off Evan McGrath with a hospital? Sounds like Marshall was powerful enough to have just driven the man out of town, or worse, had he wanted.”

“That’s the problem with you academics.” Dot flashed Lorna another knowing smile. “You never want to accept the simple answers, do you?”

“Hold on!” Lorna’s frustration with her great-aunt’s riddles suddenly vanished. “It had nothing to do with Evan, did it?” In her excitement, she rose from her seat. “Marshall was bargaining with his own daughter, wasn’t he?”

Dot smiled approvingly. “Yes, he was.”

“But back then, what kind of influence would a twenty-one-year-old girl have had on an overbearing father like Marshall?” Lorna asked. “Especially in light of her tryst with Evan.”

“Olivia was no shrinking violet,” Dot said. “She was a forward-thinking woman. A nineteenth-century feminist, of sorts.”

Lorna shook her head. “But even before Evan and Olivia were found out, Olivia couldn’t talk her father into the idea.”


Talk him into it?
” Dot threw up her hands. “
Gawd, no!
She would have had better luck talking him into wearing a ball gown to his men’s club! What Olivia did was trade on the one thing that mattered most to Marshall Alfredson.”

“The family name?” Lorna guessed.

“You really are catching on, darling.” Dot touched the side of her nose. “Back in those days there was something
even
more scandalous than a high-society lady having an affair with a married man.”

For Marshall, the new clinic was always an Alfredson family endeavor. He included Olivia in the planning from the outset.And her input proved invaluable.


The Alfredson: The First Hundred Years
by Gerald Fenton Naylor

Olivia hurled herself off her bed and scrambled on all fours until she found the pail near the bed. Just as the brim reached her mouth, she vomited violently into it.

Theodora Douglas watched Olivia with calm concern. “You sure you’re all right, child?” she asked.

Embarrassed, Olivia wiped the drool away from the corner of her lip. “It must have been something I ate at dinner.”

“And the four dinners before that one, too,” Theodora grunted as she walked over to pick up the bucket. “I best get you a clean one. Or maybe three or four of ’em.”

Theodora had been with the Alfredsons since Olivia was born. The skinny black maid with the pox scars, broad nose, and expressive brown eyes never seemed to age. No one knew exactly how old she was. As she had no family of her own, she lived in the servant quarters at the back of the coach house. A tireless worker, Theodora was afraid of no one, not even Marshall.

Theodora liked to pretend her commitment to the family was solely professional. Much as she maintained that Olivia was a continuous burden to her, she provided companionship and grudging guidance to the young woman. Olivia would trust her life in Theodora’s weathered hands. In Olivia’s mind, she already had, the moment she made Theodora the go-between in her clandestine correspondence with Evan McGrath. Every day,
the maid would stop by the Catholic hospital on Fifth Avenue to drop off or receive letters from Evan via the hospital’s black handyman, Moses Brown, who acted as Theodora’s counterpart in the letter exchange.

Ten days earlier, Theodora had brought home an unexpected and devastating letter. While Evan had reiterated his enduring love for Olivia, he insisted that they had to end their affair for their sake and those of their loved ones. “Being a surgeon,” he had written, “the only way I can possibly accomplish this is with one swift, deep, and complete cut. I could not bear it any other way.”

Olivia had cried for the better part of three days, reading the letter over and over. Then the vomiting set in. At first, she assumed it was merely part of her grief. But when her breasts swelled more and she passed through her seventh week without her monthly bleed, she realized that she was pregnant. Distraught, Olivia had written Evan three times begging him to reconsider his decision. In her most recent note, she pleaded for a meeting, although she could not bring herself to break the news of her pregnancy in a letter.

As Theodora reached to collect the bucket of vomit beside her, Olivia, still on her knees, grabbed for her arm. “Dora, are you certain there are no envelopes for me?” she gasped.

Theodora looked down at her and exhaled impatiently. “I may not be able to read, ma’am, but I am pretty sure even old Theodora remembers how to pick herself up an envelope.” She affected a Southern freedman accent, although she was born free in Massachusetts and had read every book in Olivia’s library.

“Stop it, Dora!” Olivia snapped, fighting back another wave of nausea. “I have to speak to Evan. It is imperative.”

“Child, you read his letter how many times? The doctor ain’t going to change his mind now. You just punishing yourself by drawing it out.”

“But he does not—” Olivia stopped herself.

Theodora’s face scrunched into a series of deep lines that hid the darker pigmentation of her pox scars. “Are you telling me your doctor friend doesn’t know about his own baby?” she said.

Olivia froze in mid-breath. “You know?” she whispered.

“ ’Course I know!” Theodora flicked a finger in the direction of the bucket. “What kind of imbecile you take me for?”

“I . . . I never thought . . .,” Olivia stammered, still stunned by the revelation.

“Doesn’t matter a rooster’s feather what old Theodora knows, but are you saying that your friend does not know about your condition?”

Olivia nodded, now warding off tears along with her nausea.

With surprising strength, Theodora pulled Olivia up to her feet. She guided her toward the desk in the room. “You get over there and you write him a letter and tell him,” she instructed. “I’ll take it to Moses straight away.”

Olivia frantically waved a hand in front of her. “Not like that, Dora! Not by sneaking him a letter. I will not tell him that way!”

Theodora’s stern expression relaxed into a sympathetic smile. She reached forward and brushed a few loose strands of Olivia’s hair away from her eyes. “Child, you do get yourself into some situations, don’t you?”

“Oh, Dora . . .” Olivia could no longer hold back the tears. She threw her arms around Theodora and buried her head in her shoulder, sobbing heavily.

Theodora rubbed Olivia’s back without saying a word.

After a minute or two, Olivia released Theodora and straightened up. She dried her eyes with her sleeves. She fixed the maid with a determined stare. “Tears will not solve anything,” she said, her voice gaining strength.

BOOK: Of Flesh and Blood
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