When I stood up from the table, I felt like the snake that ate the pig. Probably looked like it too. My belly was so full I almost couldn’t breathe. While I was struggling through the last of my baked beans, Billie Ray emptied two full plates, ate all the bread on the table, guzzled a 32 ounce soft drink and went back for seconds. If I hadn’t been so uncomfortably full I would have given him a bad time about it, but as it was, I thought I was doing pretty well not to give it all back.
We looked like a group of comatose lemmings when we marched out of Bubba’s. We split up into three cars and convoyed back to Renken’s office. I was genuinely surprised to discover that he had moved from the 26th floor of the Texas Commerce Bank Building in downtown Houston to a heavily remodeled tire store in the middle of a little suburb of Houston called Humble. Humble, Texas. Now if that’s not an oxymoron, I never met one.
The garage doors had been replaced by cleverly designed inserts with crowned windows and decorative woodwork. The roof was covered with terra cotta tiles, and the building had been stuccoed to resemble something vaguely Tuscan, with a Southwestern accent. The space inside was also surprising. Just inside the doorway a tall water fountain cascaded into a pool of Mexican azulejos tiles. Skylights accented the entryway and ficus trees surrounded the fountain. Beyond the fountain, saltillo tiles paved the way to the interior where I was pleased to see indirect lighting, no fluorescent fixtures, expensive furnishings, fabric-covered walls, Berber carpets, Persian rugs and an impressive collection of paintings and art work adorning fabric covered walls. All in all, the effect was extremely tranquilizing.
“Peacifying, ain’t it?” Billy Ray seemed to swell with pride as we stood there surveying the interior landscape.
“Totally,” I said. “Who’s the designer?”
“I am,” he said.
My eyes must have given me away again. “You crochet butterflies on jock straps?” I asked?
Renken and James Karl were just coming up behind us. I thought Karl was going to hurt himself because he was gasping for breath. Valeriy, the Russian, was smiling because everyone else was laughing, but it was obvious that he didn’t understand the humor. So Tommy proceeded to explain it to him, whereupon he again smiled politely. A joke that has to be explained is never very funny in any language.
Renken led the way into the Board room, which looked as if it had been transplanted wholesale from somebody’s bank. Twenty feet of custom-carved walnut table stretched across an exquisite hand-woven rug. It was surrounded by more than a dozen tufted-leather wingback chairs, and a blown-glass center-piece, heaped with gladiolas. My favorite flowers. Purple and white.
When everyone had been seated, Renken’s secretary, a petite blonde named Candy with skin like the flesh of a MacIntosh apple [don’t they all?], rolled an English tea tray into the room. On top of the cart she had neatly organized tea and coffee cups, some maccaroons, and a small dish of antacid tablets. While she was rolling the tray into the room, Billy Ray unleashed a belch that hit the Richter Scale at about 4.3, and the uncontrolled laughter started again. Before we could recover from this event, Karl farted so hard he damned near got lift off and that brought the rest of the house down.
My god, I thought. It’s Blazing Saddles all over again.
After we caught our breath and Renken opened a window to clear the air, he sat back down and began his presentation. While Candy put his notebook computer on the table and bent over to plug it into the electrical outlet on the floor, Renken activated a projector screen that unrolled out of the ceiling at the far end of the Board room. He began talking while Candy got the computer running and focused the LCD projector on the screen.
“Thanks for coming to Texas,” he said to me. “The guys have been eager to meet you. I think you’re gonna be intrigued by what we’re going to show you.” He paused a second while maneuvering the mouse device on the table top so he could advance the next power point slide onto the screen.
“So, here’s the deal. About two months ago, Valeriy hosted a team of Russian doctors down in Atlanta while they conducted some clinical trials at CDCC. They brought a magic black box they claimed could cure hepatitis-C, and of course the CDCC guys thought they were full of crap.”
I turned to face Valeriy who was seated across the table. “What was your role?” I asked.
He hesitated a beat and then dialed in. “I speak the language,” he said. “I was trained in Vladivostok where I received my MD degree, then I studied physics in Moscow under a scholarship provided by the Russian Academy of Sciences.”
“Hell a’mighty!” said Tommy. “You must be about 75 years old by now, aren’t you?”
Valeriy simply smiled. Maybe he did not get the joke. Maybe he just had no sense of humor at all. Whatever. “When the Russian Academy requested permission to conduct jointly monitored trials at the CDCC, I was asked to translate and moderate the process.”
“You work for the government?” I asked.
“As a consultant,” he said. “I’ve been adjunct medical faculty at the Johns Hopkins Medical Research Center for the past 10 years.”
“And your specialty?”
“Nuclear medicine,” he said. No facial expression. No vocal inflection. It occurred to me that I’d hate to play poker against this guy. While he continued to answer my innocuous questions, I carefully examined his body language. His hands were laid on the table top, fingers neatly folded together. He was relaxed, open, not deliberately masking, which I thought was pretty remarkable. Total kinesthetic control. After working with expatriated Russian scientists for more than 15 years, I have come to consider myself something of an authority on their non-verbal body signals. As a class, Russian scientists are notorious for giving nothing away. Even if their lives depend on disclosing specific kinds of information, if you don’t ask for it, they will not volunteer it. It’s a most peculiar behavioral attribute, and one that I have observed in every Russian scientist or engineer I have ever dealt with. Someone has trained this guy, I thought. His body language is totally neutral all the time. I wondered what he was really doing here.
“So, what was the trial?” I asked.
Renken moved the next slide onto the screen.
“The Russians treated 14 patients with well-documented cases of advanced complications associated with chronic hepatitis-C.” The slide on the screen displayed a well-organized, easily readable matrix representing a database of clinical trial protocols and results. “All 14 patients exhibited the effects of long term complications, including things like cirrhotic livers, congestive heart disease, dementia, lupus, you name it.”
“I don’t know anything about hepatitis-C,” I said. “So what am I doing here?”
Dr. Bob chimed in for the first time. “Two months ago, during those trials, out of the 14 original participants, two died as the result of irreversible, long term respiratory complications. They were too far gone by the time we got our hands on them for the treatment to do any good.” He paused and helped himself to a sip from his water glass.
“I still don’t get it,” I said. “What am I missing?”
“hepatitis-C is incurable. No known treatment regimen has ever cured a single patient. The best we can do is to provide a variation on a cocktail of exotic, very expensive pharmaceuticals, but that doesn’t provide a cure.” There was a stark silence around the table. No one was laughing now.
“So what happened to the other 12?”
Dr. Bob looked first at Valeriy, then at Renken. To Tommy, the resident legal beagle, who simply raised his eyebrows.
“Cured,” he said quietly. “Totally, completely, absolutely cured.”
Renken changed the slide and began talking again. “If you look through this chart, you can see how the trials were conducted.” The next slide detailed the protocols used to govern the diagnosis, selection, testing, documentation and treatment of the test subjects. As I worked my way down through the list of bullet points, Dr. Bob connected the data points for me.
“All 14 subjects were selected from a test population of 140 possibles. All were carefully documented, long term patients at our clinic here in Houston. We picked the most advanced cases deliberately.we figured if their treatment modality could remediate any of these chronically ill patients back to health, it ought to work wonders for early stage acute cases.”
“As you can see, all 14 patients were subjected to the same test protocols.” He listed them for me on his fingers.
“First, we conducted a series of HCV antibody tests to detect the presence of antibodies in the blood. Positive readings from this test usually indicate that an HCV infection has occurred. However, this test makes no distinction between an acute or chronic infection, so we also conducted an enzyme immunoassay (EIA) test to detect the presence of any anti-HCV antibodies. We also conducted a supplemental test called the recombinant immunoblot assay (RIBA) to confirm the positive EIA test result.”
“So the test protocols have built-in redundancy?” I asked.
“Exactly. Next, we performed the standard HCV RIBA test, which is an additional test that detects antibodies to HCV in the patient’s blood stream. This test tells us whether the positive anti-body test result we got from the EIA was from an actual HCV infection or a false-positive.”
“The third set of tests involved testing for HCV genetic material (RNA) using a polymerase chain reaction (PCR) to detect the RNA of an active hepatitis-C infection. Usually, the RNA can be detected in a person’s blood within 1 to 2 weeks after exposure to the virus. HCV RNA testing may be done to confirm a positive result on an HCV antibody test, define the level of virus in the blood (called viral load), or predict the likelihood that a person with HCV will respond to medical treatment.”
The old tapes stored so many years ago during endless classes on organic chemistry and microbiology slowly began to grind inside my head. I recognized the words but couldn’t pull the information files up like I used to.
“We used another RNA test called genotyping to define the specific strain of hepatitis-C involved in each case of infection. This is important because it helps us decide which kind of treatment to employ.” He paused to take another drink of water. “HCV has 6 genotypes, and some are more responsive to treatment than others”.
“And then, as you can see, as the trials were administered, we supplemented the original tests with periodically repeated HCV quantitative and viral load tests. This data was accumulated during the test period and used to support the analytical review that we prepared for publication after the tests were concluded. ”
“Next slide? Right.”
“You guys all seen this before?” I asked, looking around the table.
“No,” said Tom. “This is the first time any of us have seen it.”
Bob continued. “During the six weeks of the trial, each patient was tested and treated with identical doses and protocols. They did not meet or communicate with each other so they were not able to compare results. Blood samples were drawn each morning, delivered to the Russian doctors by 10:00 AM. We conducted our own tests on part of the samples but provided none of the test results to the Russian doctors. The only data we supplied was that we labeled each sample so their treatment program could be seamlessly administered to the right patient each afternoon.”
“Each afternoon, between 2:00 PM and 4:00 PM, each patient was infused with one liter of a standard saline solution supplied by the Russians. They used our saline solution drip bags. Each day, we tested one of the 14 bags at random to determine what pharmacological agents they were infusing into the patients. The state-of-the-art cocktail currently consists of a combination of some sort of interferon-based protein simulant and an anti-viral drug called ribavirin. Each of these is easily detected in qualitative analysis but we never discovered a single molecule of either of these substances in any of our saline tests.”
“In fact,” he said, “at no time did we detect anything in the saline bags except water and sodium chloride.”
The slide on the screen changed to display a chart that showed the final test results.
“As you can see,” he continued, “two patients expired before completing the tests, one in week four and the other in week five. Standardized quantitative viral loading analysis of blood samples taken post mortem from these two patients revealed that the levels of HCV present at the time they died were significantly lower than when the test first began.” He took another long drink from his water glass.
“So why did they die?” I asked.
“Because they were so close to death from complications resulting from long term infection that we were unable to save them,” Bob said.
I was watching Valeriy with my peripheral vision. He sat stock still, expressionless, immobile.
“Of the remaining twelve patients, using precisely the same diagnostic series throughout the course of the trials, ten were found to be completely free of HCV. The other two -next slide, please – presented vastly improved general physical conditions with more than 98% reduction in quantitative values.”
He stopped, removed his glasses and placed them lightly on the table in front of him.
“And that’s it?” I asked?
“Yes,” he said. “That’s it.”
“And you personally verified these results?”
“I managed the trials, with Valeriy’s able assistance.”
“And the research reports?”
“Ready to be submitted for peer review.”
I folded my hands in front of me. “So what’s the problem?”
Tommy piped up. “We elected not to submit the findings because we cannot describe what they did, how they did it, or explain why it worked.” He shoved a manila file folder towards me across the table. When I opened it, I saw it contained a copy of the final research report.
“A long way up the proverbial creek,” Renken said. “This thing is so hot we don’t dare publish the results until we can figure out how the hell they did it.”
“Valeriy,” I said, turning to look directly at him again, “what DO you know about their treatment protocols?”
He didn’t know, because he could not possibly have known, that I had been working with several different teams of Russian scientists and engineers for more than 15 years. As the strategic planner for Ashurst Technology Group, I had spent thousands of hours with them, studying their sciences, technologies and materials, learning to read their body language. So I was anxious to discover how transparent he was going to be.
“Not much,” he finally offered. He again folded his hands on the table. He did not look directly at me while he spoke. “When they came here in July, I helped them unpack and arrange their medical equipment in the lab space provided by the Center. They brought a collection of mostly standard items such as lab equipment, microscopes, centrifuges, and so on. They brought a computer system also.
Bob chimed in again. “They also brought a huge metallic case that remained closed while I was there. I was not permitted to handle it, so I have no idea what was in it.”
“How big was it?” I asked.
“Maybe one meter cubed.”
Bob answered again. “Very. It took four big guys and a piano dolly to move it.”
“Nothing special. Just standard plugs and extension cords.”
“So, let me see if I get this straight,” I said. “You gave them copies of your original diagnostic data. They got labeled blood samples every morning, brought bags of standard saline solution back to the clinic every afternoon. The Russian doctors infused the saline solution by IV, and once a week you conducted a standard battery of analytical tests on the blood samples. Anything else?”
Heads nodded sideways all around the table.
“And at the end of the day, when the trial was over, two died and ten were totally cured. The other two might as well have been totally cured. Right?”
Heads nodded yes.
“And you found nothing but saline in the water?”
‘Nothing,” said Dr. Bob. “Not a goddam thing.”
“Any ideas?” I scanned the room from face to face, saw that no one exhibited any masking postures, not even Valeriy.
“Well, I’ll be darned,” I said.
“Damn straight,” said Billy Ray.