I nodded. I’d heard the story from other members of the foundation. Hell, I’d spent hours on the phone with the representative from the clinic that made the donation. I obviously knew more about it than she thought. After taking a sip of tea, I said, “That’s why we now have the checks and balances. To be honest, there’s no way of knowing for certain if that clinic ever really donated the pellets or if they only claimed that they did. For your information, I’m the one who spearheaded the new facility. Now, donations are accepted, cataloged, and receipts are immediately issued. Everyone knows exactly what’s happening.” I tilted my head. “Unfortunately, there’s a lot of potential for abuse with so many volunteers. Believe it or not, I’m rather fond of what you’ve accomplished with the Harrington Society. I love that you got this all started while still in med school. And I do know what’s going on, both from you and the board. They report to me. They always have. Stewart’s never cared about the money the Harrington Society has cost; he truly never gave a damn about the foundation. However, he did like the publicity. And…” I leaned forward. “…he wasn’t happy when that was tarnished. Since that incident with the pellets, I’ve made sure nothing like that can happen again.”
“Vikki, I wasn’t implying…”
“Yes, you were, and I understand. I know I’m not a doctor, but I know my way around the world of money, taxes, and philanthropic organizations. I was thrown neck-deep into that muck over ten years ago. I think overall I’ve done damn well.”
Val reached for my hand. “Stop. Of course you’ve done well. You’re kick-ass. I’m in no way insinuating lack of knowledge or your ability to oversee. I just mean with everything happening with Stewart, well, I know you have other things to worry about than if a shipment of Adriamycin or a vial or two of powdered Cytoxan has gone missing.”
“Are those things missing?”
“No. They’re not. They’re just drugs that could be used, as an example.”
Pondering her choice of drugs, I watched my glass as the ice melted and floated near the top. “Theoretically,” I asked, “why would anyone take one of those drugs?”
Val leaned back and sighed. “Well, if we’re talking epidemic or pandemic proportions, it would take more than a vial or a shipment of twelve bottles. You see, Cytoxan is commonly used to treat breast cancer. Since it has a relatively short half-life, it’s transported in powder form. Before administering it to a patient, it’s made into a solution—a liquid.”
I rolled my eyes. “I may not have gone to college, but I know a solution is a liquid; thank you very much.”
“Well, it’s not the liquid that’s the issue. It’s the powder. It only takes a small amount of the powder to create the therapeutic dose. Yet, when in that form, this chemical is actually toxic. If that same small amount, or even less, of the powdered Cytoxan is absorbed through the skin, it can be toxic. In a very short amount of time the exposure would result in a dramatic decrease in white blood cells.” She nodded. “Which you know opens the floodgates for infection. Not just infection, like the flu or a cold: with exposure to this chemical a person’s immune system would shut down. It would be like HIV amplified. In only a matter of days, perhaps hours, sepsis could occur. Just imagine if enough was stockpiled? It could be released on an unsuspecting population, and they’d all be dead before anyone ever knew what happened.
“Adriamycin is known as the red devil. It’s a chemotherapy agent used to treat many kinds of cancer, including breast, lung, ovarian, and bladder. It’s commonly used as part of a three-part regimen. It’s administered over a period of time intravenously. It has serious side effects: low white and red blood cell count, low platelets, hair loss, and mouth sores. That’s when it’s given as directed. If it were to be absorbed through the skin or ingested at higher doses, those side effects would be amplified. The effects would be similar to the Cytoxan, but the symptoms would come on slower.”
“Wouldn’t people know that they were having symptoms?”
Val moved her head thoughtfully from side to side. “Probably. They’d know something was different, but they wouldn’t know the cause. I mean, a symptom like hair loss can be brought on by something as benign as a change in hormones. Honestly, most doctors wouldn’t take it seriously, taken by itself. Besides, it wouldn’t matter. By the time the drug’s in someone’s system, nothing could stop it.” She shrugged. “Adriamycin also has been shown to have a toxic effect on the heart muscle.”
“So it could cause a heart attack?” I asked.
“Essentially.”
“Damn, you’re like a doomsday postcard.”
Val laughed. “Hey! I’m not trying to predict doomsday. It’s just that one of my professors at Johns Hopkins was big on hematology and the lack of real knowledge on blood cancers. He sparked my interest.”
“Blood cancers, like the leukemia Stewart has.”
“Yes, like that, as well as non-Hodgkin’s lymphoma, many other lymphomas, and even multiple myelomas. My professor would talk about the incidences of each etiology and how the CDC was watching for hot pockets.”
“Did they find any? Hot pockets?”
Despite missing my final, that year of advanced biology was kicking into gear. I’d always loved this kind of thing. I’d even been accepted into the University of Miami before my life took an abrupt turn. With either this kind of conversation or Stewart’s private shows as a potential use of my time, I much preferred sitting with Val and listening to her dire discussions.
“Vikki, I wasn’t implying…”
“Yes, you were, and I understand. I know I’m not a doctor, but I know my way around the world of money, taxes, and philanthropic organizations. I was thrown neck-deep into that muck over ten years ago. I think overall I’ve done damn well.”
Val reached for my hand. “Stop. Of course you’ve done well. You’re kick-ass. I’m in no way insinuating lack of knowledge or your ability to oversee. I just mean with everything happening with Stewart, well, I know you have other things to worry about than if a shipment of Adriamycin or a vial or two of powdered Cytoxan has gone missing.”
“Are those things missing?”
“No. They’re not. They’re just drugs that could be used, as an example.”
Pondering her choice of drugs, I watched my glass as the ice melted and floated near the top. “Theoretically,” I asked, “why would anyone take one of those drugs?”
Val leaned back and sighed. “Well, if we’re talking epidemic or pandemic proportions, it would take more than a vial or a shipment of twelve bottles. You see, Cytoxan is commonly used to treat breast cancer. Since it has a relatively short half-life, it’s transported in powder form. Before administering it to a patient, it’s made into a solution—a liquid.”
I rolled my eyes. “I may not have gone to college, but I know a solution is a liquid; thank you very much.”
“Well, it’s not the liquid that’s the issue. It’s the powder. It only takes a small amount of the powder to create the therapeutic dose. Yet, when in that form, this chemical is actually toxic. If that same small amount, or even less, of the powdered Cytoxan is absorbed through the skin, it can be toxic. In a very short amount of time the exposure would result in a dramatic decrease in white blood cells.” She nodded. “Which you know opens the floodgates for infection. Not just infection, like the flu or a cold: with exposure to this chemical a person’s immune system would shut down. It would be like HIV amplified. In only a matter of days, perhaps hours, sepsis could occur. Just imagine if enough was stockpiled? It could be released on an unsuspecting population, and they’d all be dead before anyone ever knew what happened.
“Adriamycin is known as the red devil. It’s a chemotherapy agent used to treat many kinds of cancer, including breast, lung, ovarian, and bladder. It’s commonly used as part of a three-part regimen. It’s administered over a period of time intravenously. It has serious side effects: low white and red blood cell count, low platelets, hair loss, and mouth sores. That’s when it’s given as directed. If it were to be absorbed through the skin or ingested at higher doses, those side effects would be amplified. The effects would be similar to the Cytoxan, but the symptoms would come on slower.”
“Wouldn’t people know that they were having symptoms?”
Val moved her head thoughtfully from side to side. “Probably. They’d know something was different, but they wouldn’t know the cause. I mean, a symptom like hair loss can be brought on by something as benign as a change in hormones. Honestly, most doctors wouldn’t take it seriously, taken by itself. Besides, it wouldn’t matter. By the time the drug’s in someone’s system, nothing could stop it.” She shrugged. “Adriamycin also has been shown to have a toxic effect on the heart muscle.”
“So it could cause a heart attack?” I asked.
“Essentially.”
“Damn, you’re like a doomsday postcard.”
Val laughed. “Hey! I’m not trying to predict doomsday. It’s just that one of my professors at Johns Hopkins was big on hematology and the lack of real knowledge on blood cancers. He sparked my interest.”
“Blood cancers, like the leukemia Stewart has.”
“Yes, like that, as well as non-Hodgkin’s lymphoma, many other lymphomas, and even multiple myelomas. My professor would talk about the incidences of each etiology and how the CDC was watching for hot pockets.”
“Did they find any? Hot pockets?”
Despite missing my final, that year of advanced biology was kicking into gear. I’d always loved this kind of thing. I’d even been accepted into the University of Miami before my life took an abrupt turn. With either this kind of conversation or Stewart’s private shows as a potential use of my time, I much preferred sitting with Val and listening to her dire discussions.
