Antoine Maurice Devine - The Official Site

The Cure Excerpt

The windows of Dr. Clouseau’s office revealed a beautiful summer day, evidenced by the diffused light that rent its way through the half-drawn blinds. The feeling of warmth from the August sun was in tune with his mood on this morning, a morning that was unlike the others that came before. Today was a special day. As he looked back from the view to rearrange the papers on his desk, he thought back to the years spent in this room in the Royal Victoria Hospital, and that now, today, the recognition he had sought so patiently, so diligently, had finally come.

Tonight there would be a celebration in his honor, for the publication of his work in the venerated New England Journal of Medicine. Twenty-five years of hard work in the quiet obscurity of Barrie, a small community outside Toronto, had put him in the limelight. His work in breast cancer research had uncovered a feasible cure, a process that will free thousands of women from the frightening ravages of this terrible disease. However, this achievement did not come without its costs. A marriage lost, a torn relationship with his best friend and closest colleague, alienation of countless research assistants and doctors. All in the singularly focused pursuit of one goal - to cure breast cancer for all time.

But before any celebrations, there were the daily responsibilities, like checking on the patients who were the subject of his tests. He assembled a top-notch group of assistants, but it pleases him to take a hands-on approach occasionally. Brave souls, his patients.

Terminally ill women with nothing to lose but their lives, and their pain. Every one of them, as brave as any soldier going into battle. In this case, the battle is against the insidious cell mutation that has caused them so much pain and suffering. These women, aged 60 and above, were surrendering their lives for future generations. All those people marching, walking, donating their time and so much of their money, have these brave women to thank for the generations that will be saved because of their sacrifices.

The process was long and arduous. At many times over the years, it was not certain that funding would continue when society sometimes lost hope, stemming the flow of financial support. Fortunately, organizations like the Jimmy V Foundation brought needed attention back to cancer research after the disappointments of the Seventies. Other processes were developed. Magic pills appeared that were purported to prevent the dread mutation from ever occurring, threatening to eliminate the need for his painstakingly discovered process.

One by one the new cures emerged. But every time, the new highly touted drug was proven to have limited effect, leaving his work, at least in his mind, as the one true path. As the preliminary results showed progress, the funding increased, the volunteers came, and the research assistants, eager to associate their names with his, signed up, each with nearly as much desire to sacrifice their lives to the work as the patients.

Then there were the review boards. The National Cancer Institute, the Office of Research & Integrity, peers at dozens of universities and research institutions worldwide - all excruciatingly scrutinizing his work, judging his results, evaluating the possibilities of his research and its effectiveness on the general population. Now, everyone, EVERYONE would want a piece of the man who cured cancer. Cancer - the most feared disease in humankind. This disease, so often undetectable to its carrier, would either quickly kill, or painfully devour its victim slowly. Even the most time-tested treatment, chemotherapy, brought additional pain with no assurance of success. But his results had survived all the rigorous scrutiny, and now, with the publication of his results in the Journal, the world could move on to other things. Women who developed breast cancer would know that they could be effectively treated, and forever cured by his process.

But for now, there was the daily ritual. Making the rounds, and visiting with the patients who had donated their bodies to science, putting their trust in him. First, Patient 10D, whose real name is Mrs. Clara Atkins. Mrs. Atkins lost her husband to a heart attack 10 years ago. Two years later, their only child was killed in an auto accident. She was only 23, her life barely begun. Mrs. Atkins, like many other participants in the clinical trial, had nothing to lose.

“Good Morning, Patient 10D,” Dr. Clouseau said jokingly.

“Oh, stop it,” Mrs. Atkins replied, chuckling at Dr. Clouseaus’ attempt at being impersonal. He had actually grown rather close to his patient group, even though he had seen many of them come and go, taken by the monster that quietly devoured them before he could complete his work. In fact, his staff speculated that they were the only people he was able to develop a relationship with, believing that the prospect of their all to imminent deaths made it easier for him to relate to them rather than to healthy people. Long term relationships were not his forte. Some reasoned that it was a God complex, and that rather than having a good bedside manner with his patients, he actually likened his patients to lab rats who could talk back.

“How are we doing this fine morning,” Dr. Clouseau inquired.

“I'm feeling better than ever,” Mrs. Atkins explained.“In fact, I haven’t felt this good in years.”

“I have good news for you. The cancer has not returned. The treatment was a complete success. You are totally free of its effects. You should be able to go home soon, and enjoy a much healthier life.”

Dr. Clouseau smiled down at her, watching her wrinkled face react to his prognosis.

“That is wonderful news,” Mrs. Atkins replied, though not as enthusiastically as he would have thought. Her smile seemed forced, and she cast her eyes toward the ceiling.

“Is something wrong? I would have thought that you would be overjoyed to hear that you can go home soon.”

“No, no, its wonderful news, doctor. It's just so unexpected. I guess I just have to let it sink in.”

“Well, I’ll leave you with your thoughts.”

He patted her shoulder before leaving her alone.

Mrs. Atkins confusing reaction was based on her expectations when she volunteered for the trial. When she entered the program, she was certain that she would not survive. She thought that by participating she could make a lasting contribution that would serve the next generation. What did she have to go back to now? No husband, no family. There were few friends, and no one thought she would make it, even though they would never say it. Now that she was cured, could she make a new life? That, she thought, might not be so easy at the age of 78. But realizing the miraculous second chance she had just been granted, she slowly began to consider what her new life might look like. She allowed herself to dream of the trip to Paris she had put off so many other times in her life, which brightened her mood.

After he left Mrs. Atkins to contemplate, Dr. Clouseau continued through the morning rounds, spending a little time with each patient. In the afternoon, he went over the charts with Sarah Hughes, his chief administrator, who was responsible for maintaining the records of all the work done in the hospital.

“Are you ready for this evening doctor?” Her bright smile revealed how excited she felt about this momentous event.

“I think getting ready will be the toughest part. I’ve never been much for fancy, black-tie affairs, but I’m sure everyone at the hospital will enjoy the ceremony.”

Sarah laughed, sensing the thoughts going through the doctors' mind. She thought it would be a welcome change to see him in something other than the long white lab coat he wore every day.

Actually, his thoughts drifted back to the old days with Clarice, his former wife. She always liked all the fancy dinners, the retreats - all those things that go with being married to a successful doctor. She could not wait to get a new evening gown for every event, even though he always thought the dresses she already had were good enough. Still, she always looked stunning. Unfortunately, as time went on, she found herself competing with the research. It was a contest she could never win, and eventually decided she was not going to try anymore. One day, an otherwise uneventful one, he came home to find her things gone. She left a note simply saying she loved him dearly, and had tried as hard as she could to be the dedicated, sacrificing wife that many of his colleagues had, but the sadness she kept bottled up inside was more than she could bear. The last line read, “Be well, my love,” and was stained with what must have been a tear. Her ring sat on the table beside the letter, further confirmation that she was not coming back. He wished she could be here for this, to see the culmination of the work that stole him away from her.

“Have you finished the NCI submission package, Sarah?”

“Yes, doctor. It will be done in time for the overnight delivery pickup.”

The package contains the summaries of all the clinical test results, and more significantly, the details for new procedure that, with final approval of the National Cancer Institute, will be used by doctors worldwide to prevent the spread of breast cancer. All those years of dedication and perseverance reduced to a single envelope.

“So doctor, how do you feel about what you’ve accomplished,” Sarah inquired.

He thought for a moment.

“Sarah, it's hard to find the right words to describe how satisfying it feels to have finally discovered a procedure that really works. This will not please most of the drug companies however. They have spent untold billions trying to develop a drug that would stave off the onset of cancer or eliminate it once it appears.

Time and time again, we have seen announcements that a breakthrough had been reached, only to find out that the drug was not as effective as promised, or sometimes caused more problems than it was supposed to solve. They will see this procedure as a threat to their current efforts to sell a hopeful public on the latest miracle cure.

They will also see this development as a threat to their continued ability to attract investors. In fact, the many institutions that operate to find a cure on a non-profit basis may find it more difficult to raise funds. Don't get me wrong. If someone finds a way to prevent cancer from ever occurring, or can cure it with a noninvasive procedure, I'll be the first to raise a toast. But for now, the landscape of cancer research has been irrevocably altered, and nobody is going to change that.”

“It’s going to be a wonderful evening, doctor. We’ve all been working so hard. It will be nice to see some smiles around here.”

“I’m sure it will Sarah.”

As he turned and walked down the hall to another part of the hospital, he smiled to himself. In a separate wing of the facility, he sequestered a small number of patients for a separate study based on some recent discoveries. As far as the staff was concerned, these patients were part of the control group for the primary study. They received the same treatment, with one key exception. In place of the post-operative drug therapy, he used an untested combination of drugs that he stumbled upon out of sheer curiosity. New drugs were appearing on the market in rapid succession. While none of them proved to work as touted by the pharmaceutical industry, he wondered whether a combination of certain drugs might accomplish what an individual drug did not. He spent the last several years working quietly to formulate a multi-drug cocktail, with no success.

Recently, a new drug was released to the market that, based on its chemical composition, could provide the key. After months of secretly testing his reformulated cocktail on mice, he believed he had his answer. But he tortured himself over whether he should dare to try it on his patients. Doing so would violate countless ethical rules, and most certainly a few laws as well. Was it worth the risk? His white, furry subjects showed amazing progress, like nothing he had ever seen. But he knew the human experience could be vastly different, even deadly. What the public doesn’t realize is that many of these drugs contain chemicals that, in a different state, can literally tear a human body apart at the cellular level. While appreciating the potential success, he faced the greatest ethical dilemma of his career.

He also feared premature discovery of his tests. The drugs coming in for the trial were closely monitored, and anyone who paid attention to the orders might have suspected the purpose for some of them. However, Dorthea Hamilton, one of his most efficient staffers, only asked once about why a particular drug, one not normally used in post-surgical follow-up, was on his list. He came up with a plausible explanation, telling her that the drug was meant solely for mice, not people. That story satisfied her curiosity, and she never asked again.

It was times like these when he missed his old friend and colleague, Benjamin Calabresi. Ben would tell him to follow the rules, and do everything by the letter. He was one the most brilliant scientists he had ever known, but was not much of a risk taker. Dr. Clouseau believed that tough problems required bold solutions, and the occasional leap of faith. What if Marie and Pierre Curie had not stepped into the unknown to discover polonium and radium, ushering in the use of radiation and X-rays for medical science? They could not even see the particles they worked on, but they knew they were on the path to a historic discovery, and worked tirelessly to prove their theories. Modern chemotherapy would not exist without the incredible risks they embraced with the zeal of passionate explorers.

Even when they disagreed, which they did often, he always respected Ben’s opinions. What would he tell him now? He would probably point out all the risks, as he always did. In the end, Ben was at his best in the lab, and teaching. He just was not cut out for high-risk research, despite his brilliance.

He decided to try the drug cocktail, despite the potential for irreparable damage to the patients and his legacy. Fortunately, since he worked at a small hospital, away from the major research facilities, he could work with little outside influence, and avoid undue scrutiny. While it was true that he had siphoned funds from the primary clinical trial for this program, he deeply believed the outcome more than justified the fraud. When the time came to disclose the results, which would be very soon, the world was going to be a very different place. But for now, it would have to be one revelation at a time. He warmed at that thought as he swung open the doors to pay a visit to his special patients.

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