Finish Line

Blood clot.

Stroke.

Heart failure.

No…. no…. no… that couldn’t be right. James had spent the better part of four years working on the development of Rovanir, a new experimental drug to treat coronary heart disease. His parents had both been pharmacists before retiring a few years ago, so the industry had always had its claws in him.

Dinnertime conversations were often heated debates between his parents over which drug was best to treat whatever disease or why doctors actually sometimes didn’t know what they were talking about. James would sit, head turning back and forth, eager to catch every word of his parents’ arguments. So it was no surprise to anyone when, five years ago, he announced that he would be pursuing his Ph.D. in Drug Development.

Rovanir had come to James in a dream. His first year, he had scurried back and forth across campus, carrying scribbled notes with chemistry and physics equations. The dissertation lingered in the back of his mind, but at the time, it felt like a second-year problem. Then, when his second year rolled around, James had to go to his mentor, Dr. Presley’s, office empty-handed to tell her that he still didn’t know what he wanted to work on for his dissertation.

Nights at his parents’ house started to feel like what James thought wading through broken glass might, as his parents continued pestering him with questions about what the next steps in his program were.

“Well, why did you apply for a Ph.D. when you weren’t sure what you wanted to do?” His mother had asked him one night, while scrubbing a plate so hard, James thought it would surely shatter.

She had asked him this before, the most recent time being a few days before, but she never seemed quite satisfied with his answer. For someone who got her Ph.D. at just 25, the idea of not being absolutely sure about one’s next steps sounded indistinguishable from laziness.

“Because I want to help people, Mom. I’ve watched you and Dad help people get healthy my whole life. Just because I’m not sure what disease I want to work on doesn’t take away from that.”

A quiet “hmmph” from her told James that his answer still wasn’t good enough. That night, sleep came rather quickly, unlike most nights when he tossed and turned, thoughts of his next meeting with his mentor racing through his mind. As he slept, he dreamt of commercials. He had just started this strategy of tuning into whatever medicine commercials came on TV to get ideas on what to work on. One commercial for a heart disease medicine, some no-name drug with more side effects than benefits kept recurring in his dreams. “I can do better than that,” he had thought, but that night he dreamt of Rovanir and what he needed to do to make it happen. The next morning, he ran downstairs to his parents, who were drinking their morning coffee, exclaiming, “I got it! I got it!” His parents beamed at him, probing him with questions about his ideas. From then on, it became all he could focus on.

But Rovanir was supposed to work. He had missed holidays, birthdays, and a wedding, choosing to spend that time in the lab, perfecting his miracle drug. When the last of his colleagues and research assistants would leave, choosing to go to Lori’s for their post-work happy hours, James always stayed behind. Rovanir had passed through the first set of participant trials with flying colors, proving highly effective in reducing the risk of death in patients with heart disease.

He had hoped that the results of the most recent trial had been a fluke, just a bad batch of participants who had other health issues. But this most recent report from the current trials had just landed on his desk, confirming his worst fears. Three patients in the hospital from side effects that couldn’t have been from anything else. But that was impossible.

James sat back in his chair, rubbing his beard that had become scraggly after weeks of not having enough time to shave. If Rovanir had side effects at this stage, they’d have to pull the drug from the trials, go back to the development phase, and his dissertation would be back at square one. Four years of work and 60,000 words of his dissertation gone. He’d have to tell his labmates that there were issues with the drug. He’d have to tell them that the publications and conference presentations that they’d been waiting for wouldn’t happen. And it would have been all his fault. Well, mostly. Yes, while he worked in a team with one other Ph.D. student, who had started after him, and a few master’s students and full-time research assistants, he had been the one to propose the idea. And he had been the one to make a last-minute change to the drug’s composition before the trials started. Yes, everyone signed off on it, but he should have caught that there may have been a problem.

A knock on his door brought him out of his thoughts. He cleared his throat, though his voice still sounded strained when he managed to say, “Come in, it’s open.”

Alisa, the lab’s new administrative assistant, slid into his office, clutching a manila folder in her hands. James had fancied her since the moment he met her, really, but between managing patient calls and emails for the trials, he never had any time to make a move.

“Hey… James, you look… awful.” Her slight hesitation told him that awful was probably the nicest adjective she could find. She was right, he did look awful. Felt it too. He had spent the past few nights in the lab, opting to use the university gym to shower as opposed to going home. He didn’t have it in him to hear from his parents how proud they were of him and how close to finishing he was, not since he’d seen the first troubling reports.

“I have this new report for you from the hospital, this month’s trial results. And don’t forget, you have the grant meeting with Dr. Presley later this afternoon. Do you need anything?”

He shook his head, not quite able to meet Alisa’s gaze. She walked over to his desk and dropped the file before leaving. She’d seen him like this before; these days, he didn’t really have the energy for conversation. He grabbed the file, it felt heavy in his hands, as if it knew what was inside. He opened it, and there it sat, the words that he had been dreading seeing since he saw the first report.

Death.

Someone had died, from Rovanir, and it was his fault. He opened a drawer and shoved the file inside, not being able to bear its stare. He picked up another file on his desk, the patient recruitment list. This one felt much lighter in his hands.

He opened it to the first completed form. Scanning over the patient profile, he saw that this person was young, 25 years old, but had severe heart disease from some genetic condition. Under occupation, they had simply written, “Graduate student.”

James sighed, staring at the phone on his desk, his thumb wrinkling the edges of the participant recruitment forms. Over the past few weeks, interest in participating in the trial had skyrocketed, thanks to the help of their new summer interns. They had received over fifty emails and phone numbers of people in the community interested in learning about how they could sign up for a trial. James willed himself to look at the name on the form. Adrian Brosner. He didn’t know the kid, but somehow knowing the name made him feel worse about what he was about to do.

He picked up the phone and dialed the number slowly. A cheery voice on the other end answered almost immediately, “Hello?”

“Hello, Adrian. I’m James, calling about your interest in participating in our trial for Rovanir.” James twisted the phone cord between his fingers tightly, nearly snapping it in half.

“Do you have a few moments to talk about the trials and about Rovanir? I can assure you that it’s completely safe.”