A cough. "But, uh, your team had no experience with gene transplantation."
"No. We considered sending her to another team."
"Why didn't you?"
"No one else would do the procedure."
"What did that tell you?"
Marsh sighed. "Have any of you seen a patient die of CTFD? Their kidneys necrose. Their livers shut down. Their bodies swell, turn a purple-gray color. They can't breathe. They're in agony. They take days to die. Should I have waited for that to happen to this lovely girl? I didn't think so."
There was another moment of silence at the table. The mood was distinctly disapproving. "Why is the family suing now?"
Marsh shook his head. "I haven't been able to speak to them."
"They have stated in court documents that they weren't informed."
"They were," Marsh said. "Look: we all hoped it would work. Everybody was optimistic. And parents can't really accept the truth - that a three percent success rate means ninety-seven percent of the patients die. Ninety-seven percent. It's almost certain death. They knew that, and when their hopes were dashed, they felt cheated. But we never misled them."
After Dr. Marshleft the room, the panel met in closed session. Of the seven members on the panel, six were outraged. They argued that Marsh was not telling the truth now, and had not told the truth before. They said he was reckless. They said that he gave genetics a bad name, which the field now had to overcome. They spoke of the Wild West, of his going off half-cocked.
They were clearly moving toward censure of Marsh, and recommending that he lose his license and his ability to apply for government grants.
The head of the panel, Rob Bellarmino, said nothing for a long time. Finally, he cleared his throat. "I can't help but reflect," he said, "that these arguments were exactly the same as those first voiced when Christiaan Barnard did the first heart transplant."
"But this isn't the first of anything - "
"Going off half-cocked. Not seeking proper authorization. Liable to lawsuits. Let me remind you," Bellarmino said, "what Barnard's original statistics were. His first seventeen patients died almost immediately. He was called a killer and a charlatan. But now, more than two thousand heart transplants are performed every year in this country. Most live five to fifteen years. Kidney transplants are routine. Lung and liver transplants that were considered outrageous a few years ago are accepted now. Every new therapy passes through a hazardous, pioneering stage. And we will always rely on courageous individuals, such as Dr. Marsh, to take risks."
"But so many rules were broken - "
"What would you do to Dr. Marsh?" Bellarmino said. "The man can't sleep at night. You see it in his face. His beloved patient died under his care. What greater punishment will you inflict? And who are you to tell him he did the wrong thing?"
"The ethics rules - "
"None of us looked in that little girl's eyes. None of us knew her life, her pain, her hopes. Marsh did. He knew her for years. Will we now stand in judgment of him?"
The room was quiet.
In the end, they voted to censure the University of Texas legal staff, with no penalty for Dr. Marsh. Bellarmino had turned them around, one of the panel said later. "It was classic Rob Bellarmino. Talking like a preacher, subtly invoking God, and somehow getting everyone to push the envelope, no matter who got hurt, no matter what happened. Rob can justify anything. He's brilliant at it."
But in fact, before the final vote was taken, Bellarmino had left the room, because he was late for his next meeting.
From the bioethicspanel meeting, Bellarmino returned to his lab, where he was meeting with one of his postdocs. The kid had come to him from Cornell Medical Center, where he had done remarkable work on the mechanisms that controlled chromatin formation.
Normally, the DNA of a cell was found inside the nucleus. Most people imagined DNA in the form of a double helix, the famous twisting staircase discovered by Watson and Crick. But that staircase was only one of three forms that DNA might take within the cell. DNA could also form a single strand, or a more condensed structure called a centromere. The particular form was dependent on the proteins associated with the DNA.
This was important because when DNA was compressed, its genes were unavailable to the cell. One way to control genes was to change the chromatin of various sections of DNA.
So, for example, when genes were injected into new cells, steps also had to be taken to keep the chromatin in an available form, through the use of added chemicals.
Bellarmino's new postdoc had done breakthrough research on methylation by certain proteins, and their effect on chromatin structure. The kid's paper, "Genome-Protein Accessibility Control and Adenine Methyltransferase," was a model of clear writing. It was bound to be important, and would make the kid's reputation.
Bellarmino was sitting in his office with the kid, who was looking eager as Bellarmino scanned the paper. "Excellent, just excellent." He tapped the paper. "I think this work does great credit to the lab. And of course to you."
"Thank you, Rob," the kid said.
"And you have the seven co-authors in place, and I am appropriately high on the list," Bellarmino said.
"Third," the kid said, "but if you felt second position was warranted - "
"Actually, I am remembering a conversation we had a few months back, in which we discussed possible methylation mechanisms, and I suggested to you - "
"Yes, I remember..."
"The very mechanisms you elucidate here. I feel rather strongly that I should be the lead author."