Food and Drug Chapter 4
"Dr. Kenneth Lee is a snake," Emily waved a digital camera in Reid's face as he squeezed past her into the janitor's closet, mop-and-bucket combo in tow behind him.
"We've only been here for eight hours, and you already know that Dr. Kenneth Lee is a snake?" Reid asked, wiping his disinfectant-covered palms against his lab coat.
"Check out these photos of his office," Emily handed over the camera.
"Let's see here..." Reid scanned the image on the screen. "Dark depressing little room, government-issued IT-locked-down workstation, journal articles and bureaucratic forms on the desk, space-agey FDA logo on the wall, tissues that missed the trash can on the floor...Whoa, what's this?"
"A check for $50,000," Emily pointed out a small rectangular slip of paper on the seat cushion of the swivel chair, lying there as if it had been dropped when its owner had vacated the chair.
"Did you get a close-up?" Reid advanced to the next photo in the camera, then the next and the next and the next, "Ah, you did. A check for $50,000 from PhenoPharm to a 'Sandra Maynard' with an address in College Park, Maryland."
"Dr. Sandra Maynard," Emily said, "Anthropology professor at the University of Maryland...Wife of Dr. Kenneth Lee. I had Garcia look her up. I felt bad about calling Garcia in the middle of the night, but she was already awake. Apparently, some guy with a weird name had woken her up, demanding that she hack into the FDA purchasing database. Good thinking, Reid. If Lee, Ames, and Hawkins are working on something on the side, it might show up in their purchase orders. We, by which I mean you, can do a profile of their purchases to determine what they might be working on."
"Yes, that's exactly what I was thinking," Reid suppressed a sigh of relief and telepathically thanked Garcia for not broadcasting his actual plan. "Meanwhile, what should we conclude from this check, besides the fact that Dr. Kenneth Lee is a snake?"
"That's the problem," Emily said. "The check doesn't really help us, unless we can figure out what Lee is planning to do with the money. Maybe it's a gift from PhenoPharm for pushing the clinical trial through the FDA bureaucracy. Maybe it's something more sinister. Either way, there's no legitimate reason for an FDA administrator to accept money from a pharmaceutical company, is there?"
"No way that I'm familiar with," Reid replied. "Why don't we ask Garcia to do a thorough background check on Lee's wife? She could be a name on a check, or she could be directly involved in the..." he hesitated to call it a plot, then realized that he was huddled up with his partner-in-crime in a janitor's closet at 4:00 AM, "...plot," he finished.
"Good idea," Emily said, "That's another avenue of information for us. You know what we really need? We need some of those pills that my mother was taking. I searched all over her house, but I couldn't find the bottle anywhere."
"What about Isabella Torres, the other victim?" Reid asked. "Maybe we can get some pills from her. Did you get a chance to talk to her mother at the hospital?"
"Yeah, I did, but her mother was totally distraught," Emily replied. "It was all I could do to keep her calm for a few minutes to tell me that her daughter was participating in the clinical trial. I'm going to the hospital for morning rounds after my shift. Maybe I'll see her again, and I can ask her about the pills."
"I'm going to the hospital too," Reid said. "Wanna meet at the IHOP near there for breakfast? Say, around..." he checked his watch, "Quarter to six?"
"You should go home and get some sleep," Emily said, "We still have to check in at the office before our next shift."
"I will, after I go to the hospital," Reid said. "I had Garcia hack into the nurses' shift schedule. Hank doesn't work on Wednesdays. This might be my only chance to memorize the medical charts."
"You're still obsessed with getting your dirty little paws on my mother's medical chart?" Emily asked.
"On the charts, plural," Reid answered, "Hers and Isabella's. I want to compare them. There's something bugging me about the two of them, especially about their specific roles in the clinical trial."
"What do you mean?" Emily asked.
"The clinical trial is a double-pronged study," Reid explained. "One prong is to assess the efficacy of vorastatin as a cholesterol-lowering medication. That's what the drug was designed for, and that can be tested in a matter of months. The other prong is to assess the possibility of vorastatin as a prophylactic for Alzheimer's Disease. Certain other statins have been linked to Alzheimer's prevention, so every pharmaceutical company with a statin wants a piece of the Alzheimer's pie. That would take years to determine. The participants would have to continue taking vorastatin for years after they've already reaped the cholesterol-lowering benefits."
"Do you think that my mother's too old to take part in an extended study?" Emily asked.
"Not at all," Reid replied, "I think that Isabella Torres is too young to take part in such a study. Think about it this way. There's a drug group and a placebo group, and the researchers want to see fewer people develop Alzheimer's in the drug group. Let's say that 10% of the people in the placebo group develop Alzheimer's in five years, and 5% of the people in the drug group develop Alzheimer's in the same time period. In order for the study to be meaningful, a significant proportion of the participants need to develop Alzheimer's. They have to be old enough for disease onset. A 40-year-old, even if she were genetically predisposed for Alzheimer's, is very unlikely to develop it by age 45, but a 65-year-old, with or without a genetic predisposition, might very well develop it by age 70. For the Alzheimer's prevention aspect of the study, the ideal participant cohort would skew older, so the researchers could determine whether their drug made a difference in disease onset. The ideal participant would be someone like your mother, not someone like Isabella Torres."
"Well, we know that the UnSub wasn't interested in vorastatin, not for cholesterol reduction or Alzheimer's prevention," Emily said. "Maybe the ages of the participants don't matter to him."
"But the ages would matter to PhenoPharm," Reid argued. "The company, after spending millions of dollars on research and development, wouldn't want to jeopardize its clinical trial by recruiting unsuitable study participants. I doubt that the UnSub is operating with the knowledge and approval of PhenoPharm, regardless of how many $50,000-checks PhenoPharm hands out to Dr. Lee's wife. The UnSub probably recruited the younger participants for his own purposes and fed them the rogue agent instead of the medication. The younger participants are essentially useless for the Alzheimer's aspect of the study, unless PhenoPharm wants to follow them for the next 30 years. PhenoPharm might consider them legitimate participants if they have a family history of early-onset Alzheimer's, but it's extremely rare for Alzheimer's to develop in anyone under 50. All the younger participants, everyone under 45, is a potential target for the rogue agent."
"Then why would my mother have gotten the rogue agent as well?" Emily asked.
"Maybe there was a mix-up with the pills," Reid suggested. "Honestly, I don't know. It's one of the quadrillion things that we have yet to find out in this case. I'll ask Garcia to get us a list of study participants younger than 45. We can interview them and collect some of their pills for analysis."
"Hotch told us not to disrupt the clinical trial," Emily reminded Reid, "That includes interviewing the participants and collecting their pills."
"But we need a sample of the pills," Reid argued.
"We might be able to get them from Isabella Torres," Emily said. "Let me work on that before you go hunting down any other study participants to scare the crap out of them. We don't go against Hotch's rules, no matter what. It'll be armageddon if a single word of this leaks out into the media."
"Armageddon?" Reid rejected the idea at first, then remembered that he was taking on Big Brother and Big Pharma at the same time, "Yeah, you're right. It'll be armageddon."
"I'm always right," Emily nodded in agreement, "But where does that leave us?"
"That leaves us right where we started," Reid replied. "Dr. Kenneth Lee is a snake. Dr. Charlotte Ames and Dr. Stanley Hawkins may or may not be slithering limbless reptiles, but we can investigate their office tomorrow morning to find out. We can examine their scientific interests, starting with what they're reading at the moment."
"I peeked into their office already," Emily said. "It's very messy. There are piles and piles of papers all over the desk and the floor. All the papers are scientific publications. You can read them tomorrow."
"I can, and I will," Reid declared. "Ames and Hawkins are clearly keeping up to date with the scientific literature. Here's hoping that they're reading about topics that'll point us towards the agent," he crossed his fingers.
"I'm so glad I'm not you," Emily said.
"What?" Reid asked, "What's that supposed to mean?"
"What?" Emily stared in wide-eyed innocence, "I'd rather clean toilets than read scientific literature any day. That stuff is horribly written. I tried to read the abstract of one of the articles. It was totally incomprehensible. I'm not even talking about the biological concepts. I'm talking about the sentence structure and the way the words were randomly strung together with interesting choices of punctuation. Half the time, I couldn't even identify the verb in the sentence."
"I'm afraid that's nature of scientific literature, Emily," Reid explained. "Scientists don't always want other scientists to understand their experiments. What if the other scientists decided to try out the experiments and discovered that the results were not reproducible? That would throw doubt upon the discovery, and the next time the NIH hands out the federal tax dollars..." he rubbed his thumb and index finger together in the universal sign of greed.
"I don't want to know any more of this political crap," Emily batted away the greed sign. "For our next shift, we'll get our official work done first. Then, I'll snoop around Lee's office some more, while you speed-read the literature in the other office. We'll meet at IHOP for breakfast and share what we've discovered overnight. Sound like a plan?"
"Sounds like a plan!" Reid agreed, "I can't wait to start. The purchase orders, the scientific literature...They might all point us in the right direction. It's like interpolation. I've always enjoyed interpolation more than extrapolation. It's like a new profiling technique. Maybe I could write a book about it after this is all over. I could be like Dave, traveling the country on book tours."
"Yeah, you can leave on your book tour as soon as you come up with the magical elixir to get my mother out of suspended animation," Emily teased. "Maybe Hotch will get you a tour bus. You could be a rockstar, and I could be one of your groupies. I bet all the 13-year-old girls will be throwing themselves at you. Them, and the 50-year-old housewives."
"Why must you always present such dystopian visions of the future?" Reid shrank into a corner so he could wiggle his arm into a position to open the door. "Why can't this closet be bigger?" he complained.
"Because it's designed to store mops and buckets rather than overgrown humans?" Emily smirked.
"Go tell that to Hank," Reid pushed past Emily on his way out the door, "I'll assemble the trauma team to revive you afterwards."
"Can you believe that he cracked his knuckles at me?" Emily said, "It's not just you that he hates. He seems to hate everyone who gets anywhere near the charts. He's like a mother bear, and the charts are like his cubs."
"What a disturbing image," Reid commented, "Thanks, Emily. I'll be on my way back to lab now. I've still gotta put in some orders before I leave for IHOP."
"Will it be your head on a stick if Dr. Big Shot Researcher Guy fails to receive his reagents in a timely manner?" Emily asked.
"Naturally," Reid replied. "But try not to be such a chauvinist, Emily. It could also be Dr. Big Shot Researcher Gal who wants my head on a stick."
"Mmmmmmm, Reid brains for dinner," Emily giggled.
"Tell me, Emily," Reid asked curiously, "Is it really that much fun to make fun of me, or is it just the spice of life in the BAU?"
"Both," Emily replied. "See you at IHOP, Eyesore. Quarter to six?"
"Quarter to six," Reid waved and disappeared around the corner.
Emily waved back and sighed loudly, puffing out her cheeks and closing her eyes, as she leaned back against a shelf of paper towels and disinfectant bottles. She was dead tired, what with her day job, her night job, and her visits to the hospital. She supposed that she was lucky. With her day job, she was in the unique position of being able to acquire a night job and a faux persona to go along with it.
Elizabeth Prentiss was lucky as well. Other victims, such as Isabella Torres, did not have champions to help their cause when they were unable to help themselves. Elizabeth Prentiss had a daughter who could take swift decisive action in the face of a crisis. The daughter was clever and diligent in her quest to help her mother, but none of her actions assuaged her guilt. Through the years, Emily had allowed Elizabeth to assume all the responsibility for their shared genetic destiny, well or ill. Emily knew that she should have done more research, acquired more knowledge, asked more questions. Instead, she had chosen to ignore the problem. It was a bad habit of hers. Whenever Emily had an unthinkable thought, she would banish it, packing it into a box that joined a cohort of boxes in a growing strand. When the strand grew too long for the dimensions of the brain, it would break down the middle, and its ends would recruit additional boxes as its owner produced them. With four ends rather than two ends to recruit boxes, the strands would multiply faster, some of the longer ones repeating the cycle - breaking down the middle, two ends becoming four ends, recruiting an ever increasing number of boxes. Eventually, the strands would run out of room, and they would gather together to be packed into sheets. With their potency, the sheets would eat away at the brain until the brain was a sloppy spongy mass of holes. Someday, when Emily finally chose to open the boxes, she would discover that all the initially varied morsels of thought had been re-shaped into the same unfamiliar form, and even if they had not, her brain would have been so damaged by the potency of the sheets that she would not even recognize the contents in their original forms. In this way, her memory would fail, and she would never remember, as she did not now remember, some irrational throwaway comment that she had made, regarding someone else, someone that she did not recognize, producing a magical elixir to help another someone else, someone that she also did not recognize. All that remained would be the emotions that had survived the destruction of the intellect, but she would continue her habit of packing them into boxes, strands, and sheets. In time, even the emotions would vanish, and there would be nothing left to make Emily Emily.
Reid noticed a squeezing pain in his arm before he noticed the change in lighting in the dim janitor's closet. Fluorescent light flooded in from the bright hospital corridor outside, and Reid felt himself being locked in an iron grasp and wrenched bodily out of the closet, where he had been diligently memorizing the medical charts of Elizabeth Prentiss and Isabella Torres.
"What the hell is wrong with you?" Hank yelled in scarlet-faced rage at the cowering figure with the slack-jawed face. "I thought I made it clear that the medical charts were off limits! Are you a relative of the patients? Are you a relative of both Elizabeth Prentiss and Isabella Torres?"
"No?" Reid whimpered in the form of a question. "Uh, let me explain, Hank. I'm a family friend of Elizabeth Prentiss, and I'm a...uh...neurologist at Georgetown...at the School of Medicine..." he gave up when he realized that Hank could see through his pathetic lies. "Uh...I'll just leave then," he dumped the huge binders into Hank's hairy arms.
"I'd better not see you around here again!" Hank yelled at the figure departing in ignominious shame. "I don't know what kind of perverted sicko you are, but if I see you around here again, I'm going to snap you in half! I'm going to have your head on a stick!"
Reid directed his gaze downwards and pretended that the threats were directed at someone other than him as he scurried down the corridor into the stairwell. He wondered why Hank had shown up for work today. He supposed that Hank had switched shifts with one of the other nurses at the hospital. Apparently, the nurses' shift schedule was not a reliable method for avoiding Hank.
In the stairwell, Reid sat on the top step of the descending flight and texted Emily to meet him as soon as she was done with the doctors. He tapped his foot on a concrete step. He leaned his lead against a metal railing. It was quiet here, and the air was odorless, unlike the air of the hospital, which reeked of chemicals - disinfectants and medications and bodily fluids. Everything in the hospital, regardless of its simplicity or complexity, was reducible to chemicals, easy to understand when they were sealed up in reagent bottles, nearly impossible to understand when they were mixed up with millions of their cohorts in the bodies of living breathing humans.
The humans were part of the problem. If the chemicals were trapped inside other organisms, then the other organisms could be beheaded and their chemicals extracted for laboratory analysis. Chemicals in the human body were harder to access, especially the chemicals that made humans human, the ones that sequestered themselves within a round mineralized casing under a dome of hair, or no hair, whatever the case may be. The only method to get the chemicals was to saw through the skull and scoop out a sample of squishy gray goo. The only other method to get the chemicals, though far less satisfactory than the first, was to suck out a syringeful of cerebrospinal fluid from between the lumbar vertebrae of the spinal column, between L3 and L4 or L4 and L5.
"If only I had a CSF sample or two," Thumper fantasized, wrapping a pair of lab goggles, with elastic strap, around his furry head, "Then I could run a gel or a MALDI-TOF or a GC/MS to look for unusual components in the fluid bathing the brain. My life would be so much easier if I could get a CSF sample or two."
"Why don't you steal one?" Flower sidled up to Thumper with a conniving expression on his face.
"How would I steal a CSF sample?" Thumper nibbled at a blade of grass, ignoring the rules against eating in the lab. "I've been effectively banned from the fourth floor. Hank will snap me in half if I show my face there again."
"Bambi could steal one for you," Flower suggested, baring his teeth in an eager smile.
"You mean the next time someone comes to do a spinal tap on Bambi's mother, Bambi could steal the sample from under his nose?" Thumper considered, chewing with his mouth open. "But how would Bambi get a chance to do that? Someone would have to create a distraction, and as I said, I'm persona non grata on the fourth floor."
"I could create a distraction," Flower offered, sniffing at the air according to his skunkish instinct.
"What kind of distraction?" Thumper swallowed his last mouthful of sweet tender grass, his eyes and ears brightening at the selfless offer.
"You'll see!" Flower bounced towards a rabbit hole, "You'll see!" Flower wiggled down the dark opening.
"Flower!" Thumper hopped after the striped tail, "I wanna know about the distraction!"
"Don't like the taste of your own medicine, huh?" Flower poked his pointy snout out of the rabbit hole. "Thumper can't take his own medicine! Thumper can't take his own medicine!" Flower darted back into the hole and let fly a foul-smelling skunkish spray.
"Ewwwwwww!" Thumper rolled head over feet down a small fern-covered hill. "Flower, you've ruined my favorite hole!"
"Oh no, I've ruined Thumper's favorite hole!" Flower mocked the unhappy lagomorph. "Thumper can't take his own medicine! So, Thumper, you want my help or not?"
"Yes, Flower, I want your help," Thumper replied, donning an expression of false humility before his dastardly friend. "But just remember, Flower, Bambi is the one that you're really helping. That distraction had better be good...That distraction had better work. You just wait, Flower, I'm going to get you back..." Thumper waddled away on his hind legs, rubbing his front paws against each other and leaving a trail of bright white fur on the forest floor.
"Hi Thumper!" Bambi poked his head up from between the branches of a tree.
"Emily!" Reid jolted awake, searching for his partner-in-crime in the empty stairwell, "Emily!" he stood up too quickly, almost tumbling down the stairs as his vision blacked out momentarily.
Seeing no sign of Emily, Reid opened the door to the fourth floor corridor, poked his head through, and glanced down the hallway towards Elizabeth's hospital room. He slinked back into the stairwell before Hank, who was lumbering down the hallway with a bedpan, could spot him and dump the contents over his head. He sat back down and considered the alternatives to stealing a CSF sample from under the nose of a medical practitioner. He considered the ideal protocol for such a operation. By the time Emily arrived in the stairwell, Reid had replayed his conversation with Morgan hundreds of times. He knew that he was not really conversing with Morgan, but with a figment of Morgan that existed in his own mind, spoke in his own voice, and expressed his own thoughts, all without him having to pack the thoughts into boxes or having to aggregate the boxes into strands and sheets. The cartoonish voices of Thumper and Flower sounded even more squeaky and ridiculous when they were sped up and dwelled upon in the light of consciousness.
"Reid, wake up!" Emily shook the hunched figure, who had dozed off again, dreaming of himself sitting in a stairwell, avoiding Hank, considering alternatives to stealing a CSF sample from under the nose of a medical practitioner.
"Huh? What? Oh, hey Emily, how's your mother?" Reid yawned and stretched his legs down the stairs.
"She's stable," Emily replied, "One of the doctors thinks that he's identified the seizures."
"Really? What kind of seizures are they?"
"Myoclonic jerks," Emily said, "Which are just involuntary muscle twitches, like hiccups, which are twitches of the diaphragm. The doctor thinks that my mother's heaves and twitches indicate a severe myoclonic episode, the most severe that he's ever seen. He said that myoclonic jerks are associated with a wide variety of neurological disorders, including Alzheimer's Disease."
"Myoclonic jerks...Myoclonic jerks..." Reid repeated to himself, searching his memory banks for information about the condition. Finding that he knew nothing about the condition beyond its role in causing hiccups, he furrowed his brow and deferred to his partner-in-crime, "Does this help the doctors make a diagnosis?"
"Not really," Emily sighed, "The condition is non-specific. The doctors told me not to expect a diagnosis any time soon."
"That's why we need to investigate this ourselves," Reid picked up the obvious segue. "I've got a plan for figuring out what's wrong with your mother. I'm going to need your help and Morgan's help as well."
"Morgan's help?" Emily raised her eyebrows. "Don't tell me that you want him sneaking around the FDA too!"
"We're not sneaking around the FDA, Emily," Reid corrected his colleague. "We're working there openly...Anyway, this has nothing to do with the FDA. I don't want to see Morgan at my day job everyday, then at my night job every night," he shuddered slightly, "Imagine Morgan in lab goggles," Emily shuddered with him. "Anyway, my plan is going to take place here at the hospital, not at the FDA. Let me explain..."
Emily followed Reid down the stairs as he explained the entire ill-advised operation, including the part where Flower would create a distraction while Bambi pocketed a CSF sample and passed it to Thumper, waiting with an ice bucket in the stairwell. Thumper, Bambi, and Flower were tremendously lucky today. Not only was the medical resident planning to collect a CSF sample when he arrived at 6:00 PM, but Hank's shift was also ending at 6:00 PM, allowing the three furry friends to carry out the covert operation without the worry of being snapped in half. Emily shook her head as she imagined the wild scheme playing out before her eyes. She couldn't believe what she was implicitly agreeing to do. The scheme, though hare-brained, did its part to soothe her guilty conscience. Finally, she could assume some responsibility for her mother's condition. She didn't have to leave everything up to the doctors. She could do something about it herself. She could be a good daughter, one of those rebellious teenage girls who painted their faces white and their facial features black, but who grew up to wash off their conforming non-conformity and conformed instead to an oppressive world order in which they were best friends with their own mothers. She neglected to remember that she was already assuming responsiblity with her covert operation at the FDA. She also neglected to remember that she was heaping responsibility upon someone else, who, although he did not know anything about myoclonic jerks and although his brain was not a perfect fount of all knowledge, still gave her hope with his irrepessible enthusiasm for the problem at hand.
Unfortunately, hope was not what Emily needed. What Emily needed was luck.
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