‘I set up a company. The company employs the pair of you to carry out your research. I’ll fund you. I’ll give you all the support you need. In return, I get to exploit your findings. We’ll push your discoveries so hard that they’re doing your Immune Reprogramming in every hospital from Tokyo to Toronto.’
‘Exploit my findings? You mean, like, commercially exploit?’
‘Yup.’
‘Patents, and royalties, and the stockmarket, and all that stuff?’
‘Exactly.’
‘Right. OK. I get you. No.’
‘No?’
‘No. I didn’t go into medicine to make money. If you have a discovery which benefits patients, you just have to put it out there. Let people use it for themselves. Not try to make a dollar every time somebody gets sick. I’m sorry. I don’t know what I’m going to do next, but not that. No way.’
She glanced across at her neighbour, asking for support. Kati gave it. ‘I agree. What we’re doing is for the good of humanity. It’s not for sale.’
‘You’re crazy, absolutely crazy,’ he said. This was the one sort of opposition he hadn’t expected, and for a moment he was utterly unsure of how to handle it. It was like a modern astronomer trying to argue with someone who thought the world was flat, that the sun orbited the earth, that the heavens were full of angels singing. ‘You’re making a mistake,’ he said lamely.
‘I appreciate all that you’ve done –’
‘Why should you?’ asked Kati. ‘He hasn’t done anything, except cut off your funding.’
‘But I think I should go. Really.’
The two women stood up, Cameron tall, skinny and evasive; Kati, with her halo of hair and her deep-brown spaniel eyes. They were getting up to go.
‘No. Stop. You’ve got to hear me out.’ His voice had a desperate edge, and he ordered himself to master it, adding more calmly, ‘Sit down, just listen to the arguments.’
The two women looked at each other, and, taking the lead, Cameron sat, followed by Kati. But it was edge-of-the-seat sitting, nothing more than a hair’s breadth away from leaving again. Anything Bryn said would have to be good.
With a hoarse voice, he spoke. ‘In the medical world, when it comes to choosing how to care for patients, what does it come down to really, truth or money?’
Cameron took a moment to absorb the question. Then, calmly, ‘It’s truth, of course. One bunch of scientists does its best to come up with solutions. Another bunch of scientists tests them out. They publish their results. And that’s it. Doctors adapt their treatments. Patient care improves. It’s that simple. It’s got nothing to do with money, whatever you might like to think.’
‘Really?’ asked Bryn. ‘Really? Then tell me, how much money do we spend on preventing disease, as opposed to treating? Two per cent of the total? Three per cent?’
Cameron laughed, a kind of snort as though dismissing the question. ‘Well, OK, we don’t spend anything like enough on prevention, it’s true. But –’
‘But what? What’s that statistic again?’ He appealed to Kati for help. ‘If you take Vitamin E, it reduces your risk of heart disease by … by how much?’
Kati pondered the question in silence. It was as though she had the answer at her fingertips but was wondering whether to release it. After a long pause, she made her decision and spoke. ‘There was a big study done recently,’ she said with a sigh. ‘Ninety thousand patients followed over two years. All taking Vitamin E. Heart attack risk was reduced by nearly half –’
‘Half!’ said Bryn.
‘But other studies have been done using bigger doses of the vitamin. Those studies suggest the real figure is more like three quarters.’
‘Exactly,’ said Bryn. ‘So there you go. If we wanted to, tomorrow, we could cut heart attack deaths by three quarters. Three quarters. With one simple little vitamin. So how come we don’t? How come people still die needlessly? Hundreds of thousands, every year. What’s stopping us?’
His question was greeted by silence. Pizza crust cooled on the melamine table, but at least up above, in the glassy heavens, the angels had stopped their singing. Cameron licked her lips which had gone dry. She was listening.
‘I’ll tell you how come,’ he continued. ‘There’s no damn money in it. Vitamins aren’t patented. Anyone can make ’em. The profit margins are no better than you get from selling potatoes. But – surprise, surprise – drugs aren’t like that. Profit margins can be ninety per cent or better. You know that. Annual revenues in the US cancer trade are a hundred billion dollars. Each year, every year. The heart disease business comes a good second. Who cares that we can prevent most of that disease? Who cares if people die? Why should some bloody little vitamin salesman be allowed to poop that party?’
The silence continued. Bryn wondered if he’d done enough, or gone too far. It was Kati who spoke next, and when she spoke, Bryn realised she’d become an ally.
‘It’s true. And it’s not just drugs. It’s surgery. It’s been estimated that eighty per cent of heart bypass operations are unnecessary, arguably nearly all of them.’
‘Right,’ agreed Bryn. ‘Absolutely right.’
‘And then there are the drugs which actually do you harm,’ continued Kati. ‘Cholesterol-lowering drugs which give you cancer. AIDS drugs that have been shown to shorten your life. Chemotherapy drugs which shrink tumours but have no impact whatsoever on life extension, though the doctors never tell you that.’
Cameron was very pale, and Kati too stopped, wondering if she’d pushed things too far. But again, when Cameron managed to find words, they were words of support. ‘Arthritis,’ she whispered. ‘My grandmom suffered really badly from arthritis. I was real mad when I found out in med school that standard drug treatment actually makes the illness worse.’
‘Exactly. My granddad, too. Good example,’ Bryn encouraged her.
‘Best-practice treatment of arthritis,’ said Cameron, ‘would be diet, plus allergy interventions, plus maybe some natural cartilage-builders.’
‘Right.’
‘But no drugs.’
‘Nope.’
‘So no profits from drugs.’
Silence.
‘Anti-depressants,’ said Kati sadly, after a while. ‘The best ones are all non-pharmaceutical, but no one uses them.’
Bryn nodded in agreement. ‘No one.’
‘No money in them, right?’
‘None at all.’
Silence.
Cameron looked out at the snow. As they had been speaking, a soft blanket had fallen, muffling the city. People and cars, when they appeared at all, moved slowly, treading cautiously, slowing right down at the bends. Then she brought her gaze back into the room, first down at her hands, then up, sadly, very sadly, to Bryn’s face. The white tabletop reflected chilly light on to the underside of her face, as though she too was wandering outside, lost in the moonlight and the snow.
‘Well, I guess this has been my night of lost illusions.’
‘It must be hard.’
‘You always do this when you invite a girl out to dinner?’
He smiled. ‘I’m sorry.’
‘So