Chapter Nine: Hell Hath No Fury
Posted on Thursday, 23 August 2007
Elizabeth sighed as she wearily opened her locker, massaging her neck with her free hand in a futile attempt to relax her tense muscles. Despite the lateness of the hour, and the knots of tension seizing her body, any feelings of fatigue that came from working consecutive shifts had been chased away by a more primal need: hunger. The grumbling sounds emanating from her abdomen were becoming embarrassingly louder, an acute reminder that her last proper meal had been the lunch she’d hastily consumed the previous day. With four hours remaining on her second shift, Elizabeth had finally succumbed to the pangs of hunger. Deciding that a fifteen-minute break was not entirely unwarranted, she had fled to the locker room with one objective in mind: finding food.
Glancing briefly at her watch, she uttered a small prayer as she rummaged through her locker. Beggars were definitely not choosers, and despite her cravings for a steaming bowl of lasagne and a relaxing shoulder rub, anything remotely edible would suffice. As her hope diminished, she was finally rewarded for her efforts with a long forgotten breakfast bar. Briefly contemplating the likelihood of finding something a little more appetising in Adam’s locker, her stomach protested loudly, overriding all deliberations. Ripping open the package, she contented herself with allowing her all too vivid imagination to conjure up the image of the hot meal she craved. She sniffed the air hesitantly as the tangy scent of tomatoes and mozzarella that suddenly seemed to linger in the air. Shaking her head, Elizabeth concluded that delusions brought on by extreme hunger and fatigue were the only explanations for her overactive senses.
Lost in deep contemplation of her mental decline, she was startled as a pair of hands carrying a sealed container suddenly materialised from behind her to wrap themselves around her waist. She recognised the smooth tapered fingers long before the familiar voice whispered in her ear. ‘I think you’ll enjoy this a lot more. That breakfast bar seems to have seen better days.’
She twirled around in confrontation. ‘Adam! What are you doing here?’
Adam frowned, the hint of a teasing twinkle in his eye. Straightening his tie with one hand, he brushed imaginary lint off his jacket as his chest swelled with mock pride. ‘Elizabeth Newgreen, the last time I checked I was an invaluable employee of this hospital.’
‘And the last time I checked, it was still Elizabeth Bennet,’ she responded, rolling her eyes. ‘Are you planning on making a habit of creeping up on me? Honestly, what are you doing here?’’
‘And that’s the way to thank your husband for rushing halfway across the city to get his beautiful wife her favourite meal?’ Adam replied petulantly, a frown creasing his brow. ‘Well, seeing I’m so unappreciated, maybe I’ll keep this for myself. Come to think of it, I am feeling rather peckish now, you know!’
‘Adam Joseph Newgreen, don’t even think about it,’ Elizabeth retorted, attempting to wrestle the container out of his hands, as he moved to unfasten the lid. Adam held the container out of her grasping reach, smiling teasingly. ‘Well?’
Elizabeth huffed. ‘Okay, I’m sorry! I’m just surprised. I thought you had surgery scheduled for this afternoon,’ she pouted, eyeing the container hungrily.
‘Cancelled,’ he responded, lowering her arms. He watched her tenderly as she took the lasagne gratefully, and, sitting down, attacked the contents with gusto. ‘Some patients just don’t know the meaning of the instruction ‘No food or water before surgery’.’
‘Don’t blame them. Starvation is a horrible thing,’ she murmured, scooping generous spoonfuls of pasta into her mouth. Adam chuckled, leaning his back against her open locker, gazing at her with a bemused expression. ‘So I can see.’
They sat in companionable silence, as Elizabeth quickly finished her meal.
‘That was wonderful,’ Elizabeth sighed appreciatively, closing the empty container and wiping her mouth on the paper napkin. Standing, she turned to her husband, tilting her face upright towards him. ‘Do I have any sauce on my mouth?’
‘Let me check,’ Adam replied in a low voice, as he gently cradled her face in his hands and studied her face intently. Dipping his face, he captured her lips with his own, moving slowly, languidly. At length, he pulled back, brushing a stray lock of hair off her flushed face as his hands settled upon her waist. ‘No, I can’t say that you do.’
‘Adam!’ Elizabeth admonished, casting a quick glance around the locker room. ‘I’m supposed to be working here, not making out with my husband in the locker room like a hormonally charged teenager!’
‘Just collecting my payment,’ Adam growled softly, his pupils dilating as his intense gaze lingered on her lips. ‘I have to say that I prefer this currency a lot better than dollars and cents! Especially when you are looking as sexy as you are now.’
Elizabeth laughed, her green eyes creased with amusement. ‘You’re the only man in the world who would think that scrubs on a tired dishevelled woman are sexy.’
‘It’s not the scrubs,’ Adam growled, bringing his face closer for more ‘payment’.
Beep! Beep! Beep!
Elizabeth sighed in frustration as her beeper rung out. ‘Back to reality!’ she groaned, attempting to wriggle her way out of her husbands’ embrace. She frowned as she examined the small screen. ‘It’s the ER. I should have known the department would implode the minute I took a break. I’ve got to go.’
‘Just one more minute,’ Adam implored gently, nuzzling at her neck.
Beep! Beep! Beep!
‘Adam, it’s probably an emergency!’ Elizabeth insisted, slapping away his roaming hands from her waist. ‘I’ll catch up with you at home.’
Adam groaned, as he ran his hand through his hair with barely concealed frustration. ‘Go, then. Break my heart,’ he pouted, grabbing at his chest mockingly.
Beep! Beep! Beep!
Pressing her soft lips onto the corner of his lips, Elizabeth smiled teasingly. Dropping her voice, she slowly ran her finger across his chest. ‘Its lucky for you then that even broken hearts keep beating.’
‘Cruel woman!’ he responded, a tender smile gracing his lips as he watched her walk briskly across the room and out the door.
Beep! Beep! Beep!
Elizabeth’s hand deftly shot out from under the covers, searching blindly for the offending alarm clock. Slapping the snooze button, she snuggled deeper into her bed, eyes closed tightly, desperately clinging to the dying vestiges of a hazy dream that had allowed her to once again hear a beloved voice and feel a beloved’s caress. As the minutes ticked, and the details faded back into the inaccessible abyss of her subconscious, Elizabeth finally gave up all attempts to sleep, and tossing the covers off her body, lay pensively staring at the ceiling.
The dreams, always sketchy, had almost disappeared in Africa. The gruelling workload and the distraction of beautiful scenery had helped. Being in Melbourne, in their home, the dreams returned and had been increasing in frequency. As much as she cherished reliving the precious sensations of being loved and protected once more, she dreaded the deep ache that was sure to linger in her chest when the reality of consciousness rudely intervened. Sighing shakily, Elizabeth examined the clock. One pm. In four hours, the eyes of two hundred colleagues would be sharply focused upon her; every ear listening to her every word. It was a sobering thought, but one that kept the threatening tears at bay.
Forcing her tired body off the bed, she quickly showered and dressed, gazing wistfully at the woman who peered back at her in the mirror. The charcoal pencil skirt accentuated her curves, while the fitted burgundy shirt offered a mere glimpse of cleavage. With her curly locks tamed into a French twist, and a light application of mascara and lip-gloss, she looked both professional and collected. Elizabeth smiled faintly in satisfaction. She knew she would never be as giddily beautiful like Jane, but today, she felt she had scrubbed up rather prettily. Stepping into shoes with just enough heel to boost her height without sacrificing comfort, she grabbed her coat and bag and headed for Memorial.
‘Lizzy, wow!’ Charlotte breathed. ‘You look great!’
‘You should wear mascara more often, Lizzy,’ Marianne added approvingly. ‘It really shows off how gorgeous your eyes are.’
Elizabeth raised her hands to cool her flaming cheeks. ‘You two are very good for my ego,’ she replied, brushing aside their compliments. ‘Don’t get too used to this though. I’m not giving up my trousers and flats in a hurry. It’s just that I think presenting at the Departmental Seminar requires a bit of formality.’
Elizabeth had barely shrugged off her coat and scarf in the hospital foyer, before Charlotte and Marianne, returning from their lunch hour, had pounced upon her, showering her with compliments. Together, the three friends headed for the elevator.
‘You’re a bit early though Lizzy,’ Charlotte remarked, glancing at her watch. Her eyes narrowed in suspicion. ‘Three hours early to be precise.’
‘There’s a couple of patients that I wanted to check on before the seminar,’ Elizabeth replied coolly, eyes riveted on the elevator’s floor indicator.
‘Oh, before I forget, Dr Ferrars wanted you to page him the moment you came in,’ Marianne interjected. ‘He said it was really important that he speak to you.’
‘I hope nothing’s wrong,’ Elizabeth mused, chewing her lower lip in concern.
‘He probably just wants to thank you again for saving his behind last night.’ Charlotte snorted, as the lift doors opened to admit the trio. ‘I may have made him feel a little bit guilty for burdening you last night.’
‘Char!’ Elizabeth sighed, rolling her eyes skywards. ‘I can handle my own working schedule without your help, thanks Mum!’
‘Don’t get your knickers in a twist, it was all tongue-in-cheek’ Charlotte retorted, slapping her arm lightly. ‘Besides, Ferrars had little time today for self-recrimination. He’s been saddled with Dr Crady all day.’
Elizabeth faced her friend, brow arched. ‘And how did your precious Dr Crady fare on his first day at Memorial?’ she probed.
‘Lizzy, I can’t speak for anyone else, but I personally don’t think he’s going to have any trouble getting prompt assistance from us nurses,’ Marianne replied, her eyes clouding over as she sighed dreamily.
‘Actually, I found him a little aloof myself,’ Charlotte replied nonchalantly. ‘He hardly spoke two words when Ferrars introduced us this morning.’
Elizabeth smiled tightly. ‘So I take it you’re no longer his number one fan?’
‘Don’t be ridiculous, Lizzy!’ Charlotte exclaimed. ‘The guy may be a little on the quiet side, but it’s nothing that a tight set of buns can’t compensate for. It doesn’t change the fact that he is one gorgeous male specimen.’
‘Maybe he’s just shy,’ Marianne offered hopefully, as the elevator doors slid open at their designated floor and they stepped out into the cardiology ward. The conversation was abandoned as Charlotte and Marianne hurried to their stations, and Elizabeth stopped to check the patients’ board. Recalling Marianne’s request to page Dr Ferrars, she had barely picked up the phone when Dr Wentworth came rushing up towards her.
‘Bennet, it’s your lucky day today,’ he spoke hastily, pausing briefly to glance at her. ‘You look very nice.’
Elizabeth coloured, as she replaced the receiver. ‘Thanks, Rick. Exactly how is today my lucky day?
Dr Wentworth glanced at the clock. ‘I know you pulled a double shift overnight, but how soon do you think can you scrub in for theatre?’
‘Theatre?’ Elizabeth repeated, perplexed.
‘A thirty-four year old woman was presented to the ER this morning with symptoms of pulmonary venous congestion.’ Dr Wentworth explained hurriedly. ‘The findings from the echocardiogram are consistent with a large myxoma occluding the left atrium. We’re going in now to resect the tumour for biopsy. It’s invaluable to your training that you’re exposed to as many of these cardiac abnormalities as possible.’
‘But my presentation…’ Elizabeth began, bewildered.
‘Your presentation is hours away, Elizabeth,’ Dr Wentworth replied, waving away her objections. ‘Cardiac tumours, especially primary ones, are extremely rare. It may be a long while before you have the same opportunity arise. Technically, you’re not obliged to attend, as hospital policy does give residents the right to a full day off following double shifts. However, as your attending, I really believe it is in your best interests to at least observe the procedure. It’s your call.’
Elizabeth chewed her lip, mind racing. She was aware of the great honour that Dr Wentworth was paying her in insisting she scrub in for the surgery, and knew that her fellow residents would be clamouring to fill the position if the opportunity should arise. She nodded to herself, her mind made up in an instant.
‘Do I have time to page Dr Ferrars? He specifically requested….’
‘Dr Ferrars has already scrubbed in. I’m sure you can catch up with him after the surgery.’ Dr Wentworth interrupted smoothly, moving away from the central station. ‘Fifteen minutes, Bennet, and make your way to the Newgreen theatre.’
As Dr Wentworth retreated down the hallway, Elizabeth sighed deeply as she gathered her things. Thoughts of the presentation were temporarily pushed aside, replaced with excitement at the prospect of observing a rare cardiothoracic procedure. Nothing made her appreciate the wonder of anatomy more than the sight of a beating heart being stopped, manipulated and then restarted. She quickly penned a note for Charlotte explaining her whereabouts before running off towards the locker room. With her carefully selected clothing hastily removed, and replaced with her green surgical scrubs, Elizabeth had little time to notice that the tiny white sticker that had previously graced Adam’s locker was no longer there.
Life was unfair, William concluded bitterly. The exhilaration that had fuelled him in the morning had quickly dissipated when reality had seen fit to interrupt his fantasies. Expectations of examining patients and making deferential diagnoses lay tattered, buried under the enormous mountain of paperwork and clinical procedure training he had been subjected to. He knew that he had approached the day with the same naiveté with which he had begun his internship in London; automatically assuming he would be thrown headlong into actively practising medicine on real patients. The disappointment then had been as palpable as it was now, and he couldn’t erase the annoying voice of his pessimistic subconscious, that reminded him that had he wanted to be inundated with paperwork he could have saved himself the jetlag and remained as CEO of Darcy Pharmaceuticals. Sitting now, in the locker room, looking in despair at Memorial’s occupational health and safety charter, William attempted to reassure himself that interaction with patients would not be long in coming.
‘But, if only you had come to Memorial a week earlier!’ his pessimistic voice lamented. ‘Then you could have assisted with the tumour woman.’ Recollecting the events that unfolded earlier in the day, William snapped the charter shut in frustration. Just that morning, as Dr Ferrars had patiently guided him through the necessary protocols, Dr Wentworth had approached Dr Ferrars for a consult regarding a suspected cardiac tumour in a female patient. His excitement at being allowed to observed the echocardiogram with his mentor, and possibly observing the surgery, was quickly deflated when Dr Ferrars had handled him a pile of paperwork before walking away with Dr Wentworth. Naturally, William’s mood had turned sour from then on, and not even the open friendliness of the extremely pretty Nurse Crawford could restore his optimistic good humour.
With an hour remaining before the Departmental Seminar, William’s coffee addiction reared its ugly head, demanding to be satisfied. He knew he would have to answer its call, for seminar rooms were enticingly dark and the speaker’s droll voices had the potential to lull even the most alert listener into sleep. Raising his nose at the tiny kitchenette with well-worn cups and instant coffee, he had retreated to the locker room, arm laden with manuals, to collect his jacket and mobile phone for a short sojourn to Meryton’s. He was in the process of carefully shrugging on his jacket, when his mobile phone erupted in loud peals. He examined the screen with a raised brow. Richard. He sat down on the island bench that ran in front of the lockers, his annoyance at the day projecting itself through the curt greeting.
‘What do you want now?’
‘Hello to you too, Fitz,’ Richard responded sarcastically. ‘I’m fine, thank you for asking.’
William breathed deeply in an attempt to bring his temper under regulation.
‘I’m sorry, Richard,’ he replied. ‘Today hasn’t been a good day.’
‘No need to take it out on one of only three people who know that William Crady is actually Fitzwilliam Darcy!’ Richard threatened mockingly. ‘Perhaps I should have some words with Professor Lucas?’
William rolled his eyes in annoyance. ‘I’m not in the mood, Richard, for your petty, empty threats. Why have you risen so early in the morning, and why are you annoying me?’
‘You’re assuming I went to bed since last night,’ Richard chuckled suggestively. ‘Maybe the woman of my dreams kept me up for a night of absolutely mind-blowing sex.’
William groaned loudly. ‘Richard, the woman of your dreams can’t be found anywhere but in your dreams. Why the hell are you calling me at 4am?’
‘Well, at least you’re not denying my studly ability to engage in an all-night sex romp,’ Richard chuckled again in amusement, before swallowing his mirth. ‘But you’re right. There is another reason for me being up at this ungodly hour. Do you recall the Japanese pharmaceuticals company that we were interested in acquiring a year ago?’
‘The company with the patent for the new arthritis drug?’ William responded immediately. ‘Shoji Technologies? What about them?’
‘Yes, Shoji Technologies.’ Richard affirmed briskly. ‘The executive assistant to the CEO contacted me yesterday, requesting a video-conference between you and the CEO, Mr Sawa, for today. Naturally, he was surprised when he I informed him that you would be unavailable for the next six month and had installed me as caretaker CEO.’
‘What did he want?’ William frowned, as he rose to pace the room.
‘I just finished the call ten minutes ago,’ Richard replied. ‘The short story is that Shoji Technologies is interested in re-negotiating.’
‘Why? They refused our last offer.’ William knotted his brow in confusion. His attempted acquisition of Shoji Technologies the previous year had left a bitter taste in his mouth. They had negotiated for months, scheduling late night meeting, tying up the legal departments resources, only to have the final offer rejected by the majority stockholder. The frustration that he had experienced over the whole affair had planted the first seeds of his acknowledged discontent at being Darcy Pharmaceutical’s CEO. ‘What has happened to bring about a re-negotiation?’
‘This should please you. Their major shareholder is two weeks away from filing for bankruptcy.’ Richard replied, his voice laden with irony.
William snorted, as he strode to the window that overlooked the park. ‘Then I don’t think Shoji Technologies are in the position to negotiate anything if their financial future is in such a shambles.’
‘Exactly. I know in this instance a hostile takeover seems an attractive proposition, but until I meet with the entire board, and ascertain exactly what shape the company is in, I don’t think its wise.’ Richard paused reflectively. ‘If we do decide that acquiring Shoji is a viable investment, then we are looking at obtaining stock at a much cheaper price than that which they rejected a year ago.’
‘If it was up to me, I would watch the company collapse with no little ill feeling,’ William responded curtly. ‘However, business is business, and if I can obtain their research and patents with little financial inconvenience, I am going to do it for my company.’
Richard laughed. ‘I guess the great Fitzwilliam Darcy doesn’t allow his notorious resentment to come between him and a great business opportunity.’
‘It’s called business acumen,’ William replied coolly. He paused hesitantly. ‘It’s going to be a lot of work. Do you feel you can handle something of this magnitude?’
‘I believe so,’ Richard replied nonchalantly. ‘I knew you would want to be informed; that’s why I’m keeping you in the loop. There is absolutely no need for you to concern yourself.’
‘Just be thorough in your dealings with Shoji’s CEO,’ William pressed, watching the sun cloaked by thick grey clouds. ‘Mr Sawa is as slippery as he is conniving. I would hate to be dragged back to deal with any potential fallout when I have only just put my foot in the door here at Memorial.’
‘Duly noted,’ Richard replied seriously. His tone turned playful a second later. ‘So why exactly hasn’t today been a good day?’
It was four o’clock before Elizabeth emerged from the Newgreen theatre, eyes glittering and face flushed. Although she had observed many a cardiothoracic procedure throughout her residency, Dr Wentworth had been accurate in his assertion that such surgery as the one she had just witnessed was incredibly rare. Despite the thrill of her observations, watching the tumour being carefully excised from deep within the atrial wall, Elizabeth could not eliminate the sympathy that she felt towards the patient, as she lay oblivious to her surrounds under carefully monitored anaesthesia. Histology had confirmed that the sample sent for analysis had been malignant, and Elizabeth knew that the patient would be subjected to debilitating bouts of chemotherapy and radiation in order to survive.
Jogging towards the elevator, her stomach clenched nervously with the realisation that in barely an hour she would be addressing the entire medical staff. And hour and she was undressed and her presentation was yet to be loaded onto the seminar rooms’ computerised projector. As she swiped her access key for entrance into the staff lounge and pushed open the door to the locker room, her mind was so busily engaged in practising her prepared speech that it took a moment before her eyes open wide as she finally registered the scene in front of her.
Adam’s locker was open.
Adam’s locker was filled with books and an elegant suit jacket.
Adam’s locker was evidently Adam’s locker no more.
When she had returned to Memorial the week before, she had been touched that her colleagues had kept Adam’s locker free, deftly steering new doctors into accepting the empty ones situated on the lower rows. For Elizabeth, it was as though they were paying silent homage to the amazing doctor he had been, the amazing man that had been snatched away in tragic circumstances. Now, with the establishment of a worthy memorial, the naming of the Adam Newgreen Memorial Theatre, she knew that it would be a matter of time before the locker was occupied once more. She had not anticipated that it would be so soon. Without warning, a strong familiar memory of Adam, their neighbouring lockers, and a container of cheesy lasagne suddenly flashed through her mind. Her breathing grew laboured, her eyes misty, as once again the finality of Adam’s death swept over her again and again. She tried to admonish herself for her unreasonable reaction to something she had known, had accepted, for over a year. As she stood silently, struggling with the pain coursing through her, she became aware of a deep voice, with an unmistakable accent, drifting from the opposite side of the room. Closing her eyes briefly, she steeled herself before turning to see the person she knew had taken Adam’s place.
William was oblivious to Elizabeth’s penetrating stare as he gazed out the window, deep in conversation with Richard. His first indication of another’s presence came from the almost inaudible gasp he heard behind him. He slowly turned his head in time to see a short woman, dressed in scrubs, turning away from where she had obviously been facing him, to open the locker neighbouring his with an almost angry determination. For a brief moment, he was filled with apprehension at the thought that the woman, whoever she was, had heard enough of his conversation with Richard to determine that Dr William Crady was more than just a mere resident cardiologist. With the amount of noise the woman was making, he quickly abandoned the notion that she could have been privy to his earlier conversation without gaining his attention. Her presence now, however, was a reminder that he would need to be more discrete when accepting calls at Memorial. He examined her flushed face for barely a few seconds before her profile was hidden from his gaze behind her open locker door, and silence was restored to the room.
‘and she rang the office trying to find a forwarding number,’ Richard continued, his voice snapping William to attention. ‘I take it Caroline has no idea that you’re in Australia.’
‘No.’ William responded curtly.
‘Afraid she’ll try and follow you down there, hey?’ Richard smirked
‘Yes’
‘What’s going on, Fitz?’ Richard responded with humour. ‘From since when does Fitzwilliam Darcy resort to monosyllables?’
Acutely aware of the woman’s presence, and the silence that carried his voice easily throughout the room, William slipped easily into French.
‘I can’t speak freely at the moment Richard,’ he replied, with the fluency of his French D’Arcy ancestors. ‘I’m in the process of preparing myself for a departmental seminar, and a woman has just entered the locker room.’
Richard whistled long and low. ‘You get to share a locker room with women? You lucky dog! Who is she? Is she beautiful?’
‘I don’t know or particularly care who she is, Richard.’ William replied coolly. ‘She’s in scrubs. Unlike some people who’ll chase after anything female, I actually have some standards.’
‘And they are way too high!’ Richard snorted.
‘On the contrary, Richard, it’s not my standards that are too high. Your standards are way too low.’ William retorted, distracted by the sound of a coughing fit emanating from the direction of the open locker. ‘I don’t know how many Australian women you have met in your life, but so far I haven’t found any of the women here to be anything but tolerable at best. And besides, I’ve told you before, I’m not here to have a love affair.’
‘You keep convincing yourself of that, Darcy-boy!’ Richard snorted sceptically. ‘I recommend you drop the French, unless you want them practically swooning at your feet.’
‘You’re wasting your time and mine.’ William replied in English, with palpable coldness. ‘I need to go. Call me if you have any news.’
As William switched his phone off and approached his open locker, Elizabeth could barely suppress her growing anger. Despite his attempts to mask the meaning of his words, Elizabeth had easily understood the uttered French, and they impressed her with the fullest belief of his arrogance and conceit. Grabbing her clothes and her USB, she slammed the door shut and, with a quick glance in his direction, turned on her heel, leaving behind, in her mind, a pretentious usurper rummaging through the locker of a doctor who had been ten times the man that Dr Crady could ever hope to be.
William observed Elizabeth as she marched out. For a brief moment, he had caught a glimpse of her fine green eyes, glittering with indescribable emotion. For a nanosecond, the expression seemed hauntingly familiar. Rejecting the notion quickly, he grabbed his own jacket and made his way to Meryton’s for an afternoon appointment with an espresso and the infamous Dr Bennet.
Twenty minutes later, Elizabeth was not surprised to find that she was the first person to arrive at the Bolte Seminar Room, home of the Memorial Departmental Seminar. Her heart thumped loudly as she turned on the lights, and examined the view of theatre from the stage lectern. As she busied herself loading up her presentation, staff from the hospital catering service slowly filed in, bearing covered platters of sandwiches, pastries and cold appetisers for the customary afternoon tea that would take place after her presentation. As the minutes slowly ticked by, and the room began to fill, Elizabeth’s nervousness increased.
‘Nervous?’
Elizabeth looked up into the smiling face of Professor Lucas.
‘A little,’ she replied flippantly.
‘Ah, well, you wouldn’t be human if the thought of addressing your colleagues for the first time didn’t affect you in some small way,’ Professor Lucas responded knowingly. ‘I’ll give you a tip to help with the stress….’
‘Imagine the crowd naked?’ came a familiar voice.
Elizabeth and Professor Lucas snapped their heads towards Charlotte as she ambled leisurely down the aisle.
‘Ah, I see the support group has arrived.’ Professor Lucas replied dryly. ‘Elizabeth, don’t listen to my daughter. Such reflections could create more trouble than ease I’m afraid.’
‘Is that the voice of experience, Dad?’ Charlotte enquired teasingly. Her father pointedly ignored her.
‘Just speak from the heart, Elizabeth. Believe in yourself and the audience will believe in you.’ Professor Lucas patted her arm in his usual fatherly manner. ‘Oh, and please try and avoid eye contact with that clown of a daughter of mine.’
Professor Lucas grinned in response to Charlotte’s declarations of familial oppression. ’As much as I would like to stay, I must speak with Dr Willoughby on a pressing issue. If you would excuse me, ladies.’
‘Yes, probably the pressing issue of seducing all available nurses in sight,’ Charlotte hissed, as Professor Lucas wandered off towards the tall young man who stood chatting comfortably with one of the new nurses.
‘Charlotte! Someone will hear you!’ Elizabeth exclaimed.
‘As if I care,’ Charlotte muttered darkly, sending lethal glares towards the couple.
‘Well, if you care about getting a decent seat you had better get moving,’ Elizabeth reminded her, as she examined the small laser pointer in her hand.
Forcing her eyes back to her friend, Charlotte smiled encouragingly, and enveloped her in a supporting embrace before quickly departing the stage for a suitable seat. Elizabeth breathed deeply, examining the faces scattered before her with apprehension. She was unperturbed by the fact that he was yet to arrive. He would be there; his planned introduction to the department by Professor Lucas guaranteed his presence. The presentation would be a success in every single way.
It was five minutes before the seminar was scheduled to appear that William finally entered the Bolte Seminar Room, Dr Ferrars and Dr Wentworth in tow. He had espied the two comfortably ensconced at the best table at Meryton’s, and they had invited him to join them for coffee. He had readily accepted, only to suffer through a detailed description of the amazing cardiothoracic surgery they had performed. His annoyance had increased at the knowledge that another resident cardiologist had been invited to observe the procedure. He schooled his features lest they betray is irritation, and when both men had politely inquired about the rest of his day, and it took every ounce of his civility to respond cordially.
Their appearance had immediately garnered considerable attention, and William found it amusing that a large proportion of the female staff suddenly found a pressing need to approach Dr Wentworth. William was subsequently introduced to so many new interns, doctors and nurses that he knew that he would never possibly remember their names. Slowly, the three men had made their way to the fifth row of seats. Having finally settled themselves into their preferred seats, Dr Ferrars quickly excused himself, and rushed down towards the stage where a young woman stood examining the lectern. At his approach, she smiled briefly, leaving her position on the stage to descend the steps and join him in the front aisle.
‘Elizabeth, you left the theatre before I could speak to you.’ Dr Ferrars admonished, wringing his hands nervously. ‘Didn’t any of the nurses tell you to page me?’
‘Of course they did, Edward,’ Elizabeth replied with a faint smile. ‘I intended to approach you after the surgery, but I guess I got preoccupied with last minute preparations for the seminar. There is nothing too serious, I hope?’
Dr Ferrars waved away her concern quickly. ‘No, not at all. There is something that I want to speak to you about, but it can wait until after your presentation. I know your stressed.’
‘If it’s the fact that Adam’s locker has been taken by another doctor, then, I already know.’ Elizabeth responded with forced calmness, dropping her eyes briefly. ‘I saw Dr Crady in the locker room earlier in the afternoon.’
Dr Ferrars sighed loudly, rubbing his eyes with the palms of his hands. ‘I’m sorry, Lizzy. I wanted to prepare you in advance.’
‘I appreciate your sensitivity, Edward.’ Elizabeth responded with warmth, touching his arm briefly. ‘Please, don’t make yourself uneasy over it. What’s done is done.’
‘If I could have convinced him to take a lower locker, I would have,’ Dr Ferrars continued earnestly. ‘But the man is over six foot at least, and Adam’s was the only one in the upper rows….’
‘Look, it was bound to happen sooner or later,’ she interrupted, toying with the pendant around her neck. ‘I never expected Adam’s locker to have been kept vacant for so long. I’ll admit I was pleasantly surprised to find it so when I returned, but it wasn’t going to remain so forever. Adam left very big shoes to fill, and it’s going to take more than his locker being taken by another doctor for us to forget everything he did here at Memorial.’
She smiled to lighten the mood. ‘Besides, we have the Adam Newgreen Theatre now. Which reminds me, today’s surgery was absolutely unbelievable…’
William observed the Dr Ferrars’ companion with interest. Her tanned face seemed to possess a coppery glow under the dim lights of the theatre, setting off the delicate features becomingly. She seemed familiar, but he knew that he would have remembered her had they been introduced, as his eyes swept over her curvy form shown to best advantage in a well fitting skirt. He could sense that she spoke energetically, although he could not detect the sound of her muted tones over the buzz of the audience, and he watched he as she frowned momentarily, and toyed with the chain that encircled her slender neck. As if aware of his attentions, she turned, scanning the audience before catching his interested gaze. Upon catching sight of her eyes, William instantly recognised her as the woman in scrubs from the locker room. Arching her brow slightly in response to his stare, she broke away from him gaze, and turned once more to face Dr Ferrars.
‘Who is that woman speaking with Dr Ferrars?’ William turned to Dr Wentworth.
Dr Wentworth turned his head towards the couple. ‘That, William, is the lady of the hour,’ he replied, nodding in her direction. ‘Dr Elizabeth Bennet.’
‘Dr Elizabeth Bennet,’ William repeated the name slowly. He had expected the much-praised Dr Bennet to be a lot older and experienced than the young woman standing before him. The prospect of having his attention engaged by this pretty woman for the remainder of the afternoon suddenly seemed like an interesting prospect. His contemplations were interrupted as Professor Lucas took to the stage. Playing with the lighting, he dimmed the room even further, and coughed hesitantly into the microphone. A lull descended on the audience, and Dr Ferrars, with a parting handshake, quickly made his way to occupy his seat to William’s right. Elizabeth sank down into the seat closest to the stage, breathing deeply.
‘Ladies and gentlemen, respected colleagues,’ Professor Lucas boomed. ‘It is my great pleasure to welcome you to the Memorial Departmental Seminar, and institution here at Melbourne Memorial. We regret the short notice of Dr Bertram’s unavailability this afternoon, and hope that you enjoy the alternate program that we have arranged for you. Today, I have great honour in introducing two members to the Memorial family. As many of you know, Memorial has recently been selected as a testing base for a new clinical trial testing the efficiency of a new ace-inhibitor. The developer of the drug, Darcy Pharmaceuticals, has sent Dr William Crady to supervise the trials for the next six months. He is a resident cardiologist that hails from Derbyshire in England. He obtained his medical degree from Cambridge and for the past three years has been involved in research and development at the Darcy Pharmaceuticals headquarters.’
Professor Lucas peered out into the audience, until he locked his gaze upon William. ‘I would like everyone to give Dr Crady a warm Memorial welcome. William, could you please stand up?’
William stood briefly, his features tinged with a rosy hue of embarrassment. He accepted the smattering of applause nonchalantly, before hastily sitting down.
‘Thank you, Dr Crady. I hope that your time at Memorial is both productive and enjoyable.’ Professor Lucas continued. ‘Secondly, I would like to welcome back our respected colleague and seminar presenter for today, Dr Elizabeth Bennet. For those of us who are unfamiliar with her history, Dr Bennet started at Memorial five years ago to begin her internship as the youngest doctor to have graduated medical school in Australia, aged eighteen. She is a gifted physician who has spent the past year in Africa volunteering for Sans Médecins Frontières, and has returned to finish her residency in cardiology. Please join me in welcoming Dr Elizabeth Bennet back to Memorial.’ At the thunderous applause, Elizabeth rose from the front row, her cheeks pink. She nimbly climbed onto the stage and occupied the now-vacated lectern. She clipped the portable microphone onto the front of her shirt. She breathed deeply.
‘Thank you Professor Lucas.’ Elizabeth’s clear voice rang clearly throughout the auditorium. ‘It’s great to be welcomed back here at Memorial, and a great honour to be sharing my experiences over the past year with you here today. The previous year in Africa has been one of both professional and personal enlightenment. The daily struggles that I personally witnessed on the continent in my role as medical volunteer for the MSF has given me a new appreciation of the amazing medical system existing here in Australia. Before I begin, I would like you, the audience, to check aside all your preconceived expectations of how this seminar will proceed. I want this to be an interactive discussion, and will encourage the sharing of ideas and the posing of questions as the presentation proceeds.’
Low murmurs of surprise swept over the audience at the unconventional approach. William fixed his gaze upon the stage, brow furrowed. Dr Bennets’ voice, clear and strong, seemed hauntingly familiar. Elizabeth paused momentarily to allow the noise to dissipate, before clicking on the lectern computer. The image of two women flashed on the giant projector screen above the stage.
‘Doctors, your expert opinion is required.’ Elizabeth gestured to the screen with the small laser pointer, as she moved to the front of the stage. ‘Here we have a photo of two Caucasian women, both in their mid thirties. Both live in Melbourne, and both are in desperate need of a lung transplant. A donor lung has become available. Which of the two deserves the donor lung?’
A hand shot up. ‘Yes, Dr Fischer?’
‘The one who is the most compatible should receive the organ.’ Dr Fischer replied confidently.
Murmurs of approval echoed out from the audience.
Elizabeth smiled. ‘As an Immunologist, Dr Fischer, I would expect no other answer from you. But what if both the patients were compatible?’
Another hand was raised. ‘Dr Kalitsis?’
‘You haven’t given us enough personal information about each patient.’ Dr Kalitsis responded.
‘And how would that influence the decision?’ Elizabeth prompted.
‘Only that the woman whose family and society are impacted the most by her passing should receive the organ,’ offered Dr Kalitsis. ‘One of these woman may be a mother of four, who also happens to be the sole caregiver of her sick mother, whereas the other could be a single woman with no family.’
‘Interesting thought,’ Elizabeth nodded encouragingly. ‘But what would you say if I told you that the mother of four was a heavy smoker, and the single woman was not?’
Dr Kalitsis needed little time to give his answer. ‘Obviously, the woman who is going to adhere to the doctor’s post-operative requirements will be given the lung. If the mother of four insists she cannot quit her habit, then it would be pointless to provide her with a set of fresh lungs that will just be abused over time. The single woman should receive the organ.’
‘Very insightful, Dr Kalitsis,’ Elizabeth agreed, turning to the audience. ‘As doctors, there are so many decisions that need to be made in deciding to whom precious donor organs are given. Such decisions are made easier by the fact that there will always be one person who is more compatible for an organ than someone else. Let me then change this scenario a little. These two women are both infected with HIV. Which one deserves to be given anti-retroviral treatment?’
Elizabeth nodded at the raised hand before her. ‘Yes, Dr Elliot?’
‘Both women should receive the treatment, if neither woman shows hypersensitivity to the drugs,’ Dr Elliot added softly.
‘I see,’ Elizabeth responded. ‘What other impediments could possibly exist, apart from hypersensitivity, that could affect both these women receiving treatment.’
After a brief contemplative pause, Dr Ferrars raised his hand.
‘There should be no other impediment,’ he responded. ‘The drugs are easily available and are affordable. There is no decision to be made in that regard.’
Elizabeth smiled, cocking her head to the side, as her eyes moved past Dr Ferrars and skimmed over William’s face.
‘That is a very astute observation, Dr Ferrars,’ Elizabeth remarked, moving back to the lectern. ‘But what if, instead of discussing two Caucasian women living in Melbourne, with access to the best medical services, we changed our setting a little?’
With a tap on the console, the images of four ebony faces replaced the two white ones. Elizabeth slowly moved to the side of the stage.
‘I would like to introduce you to four of my patients from Kenya.’ Elizabeth declared. She pointed the laser at the first photograph depicting a middle-aged man with downcast eyes and gaunt cheeks. ‘Patient number one is a 34-year-old Kenyan male, Lahema, who contracted HIV while in heterosexual relationship with his sex-worker wife. She has since died of the disease, leaving him with three children, two of whom are HIV positive. He is the sole breadwinner of the family, and lives with in the Kibera slums of Nairobi.’
She aimed the laser beam at the neighbouring photo of an emaciated scarfed woman, her striking black eyes lowered in shyness.
‘Patient number two is Mbeke, a 27-year-old woman who caught the virus from her husband. As is the practise in her remote village, she was ‘inherited’ by her husbands’ brother upon her husbands’ death. Her brother-in-law regularly engages her in intercourse despite his knowledge of her HIV-positive status. She suspects that he too has the disease and is freely engaging in unprotected sex with other women in the village.’
Elizabeth paused before moving the laser beam onto the third photo, prompting hushed whispers as she focused on the small infants face.
‘Patient number three is Thabisa, the three-month-old baby daughter of a drug-addicted mother, who contracted the disease from infected syringes and did not discover she was HIV-positive until after she had passed on the disease to Thabisa and her husband. Thabisa is severely malnourished, and once her father dies, she will be one of the over one million AIDS orphans currently in Kenya.’
The laser beam was moved to the final photo, a young man whose face was marred by a deeply mournful expression.
‘Patient number four is Takalani. He is one of nine siblings, all of whom have perished from the AIDS epidemic. He lives with his elderly mother and blind father, alongside his thirty-two orphaned nephews and nieces. He is the sole breadwinner of this extended family, but was diagnosed with HIV a few months after the death of his last brother. He is unable to find work as the local community feels the entire family has been cursed.’
Elizabeth turned to face the audience once more.
‘I ask you again, as doctors, to make a decision,’ she repeated. ‘Who would you save? But before you answer that question, keep in mind. Only one of them will be given the opportunity to survive. You are not only choosing who will live. You are also choosing which three are to die.’
At the lengthy pause that ensued, Elizabeth looked straight towards William. Meeting his eye squarely, her next words were slow and deliberate.
‘These are the decisions that doctors are making everyday when it comes to the distribution of limited medical aid in Africa,’ she said, refusing to break her penetrating stare. ‘This is the reality. Contrary to popular opinion, there is more going on in Africa than merely visiting quaint little villages and going on safari.’
William blinked hard, dropping his gaze in confusion, as Elizabeth moved back to the lectern with satisfaction. Overwhelming disbelief simmered beneath his mask of impenetrable calm, battling for domination. His recognised his own words spoken back to him. The familiar eyes, the familiar voice, it all suddenly made sense, leading to one impossible conclusion. As much as he loathed admitting it, the girl who had raised his ire from the flight over was none other than his new colleague Dr Elizabeth Bennet. As he gazed at her with new eyes, he searched for any sign that could have betrayed her identity earlier. There were none. Her hair was perfected coiffed, and her clothes accentuated a body that had apparently been swamped in mismatched clothing. When he had asked her for her age, she had retorted that she was twenty-three. William mentally did the maths. Dr Elizabeth graduated medical school five years ago aged eighteen, hence she was twenty-three. William groaned imperceptibly, clenching his fist as he recalled his accusations that day. Naïve, idealistic, ignorant. That was what he had called her. Her voice rang out again, disrupting his reverie.
‘Unfortunately, for each of these four people there are a million more facing the same fate. For them there is no Medicare, no Pharmaceuticals Benefit Scheme, no welfare system to provide assistance.’ Elizabeth continued, waving her hand about emphatically, as she faced William’s direction. ‘A man I met recently suggested that poverty and foreign debt was to blame for the AIDS crisis in Africa. I ask, how is it possible to create a sustainable economy when the manpower necessary to build that economy itself is unavailable?’
William flinched as she clicked on the console, producing an image of tightly packed mud brick shanties stretching out into the horizon. A young girl, dressed provocatively, peered out from a dusty alleyway.
‘Meet the new generation of breadwinners. AIDS has driven a large percentage of Kenya's children into the labour market. It is estimated that there are 3.5 million working children in Kenya today, forced to head their households to take care of their orphaned siblings. They are vulnerable to exploitation and the worst forms of child labour.’ Elizabeth focused the laser beam on the young girl. ‘This is Luul, aged ten. When her parents died, she because the sole provider for her younger siblings. The only work available to her was prostitution. The level of prostitution in Kenya is high, even among girls as young as nine. It has been reported that the rate of HIV infection in girls and young women from fifteen to nineteen years old is about six times as high as that of their male counterparts in the most heavily affected regions.’
Elizabeth paused for dramatic effect. ‘Not surprisingly, one out of every five Kenyan girls reports that her first sexual experience is coerced or forced. Try convincing her that the state of the economy is to blame for her plight.’
Moving back to the lectern, she clicked the console again. An image of dusty children, with grimy torn clothes and no shoes, filled the screen, each clamouring for prime position in front of the camera, their little hands extended beseechingly towards the unseen photographer.
‘These are the orphaned street children that roam the streets of Nairobi, Kenya’s capital. They are known as the “chokora” or “scavengers”. Given that many AIDS orphans are out of school, and possess no other means for supporting themselves, the phenomenon of AIDS orphans roaming the streets has become yet another epidemic. The children forage the city's garbage dumps for food and withstand traumatizing abuse from the police and public alike. Many, simply to escape their pain, engage in sniffing glue or other hallucinogenic solvents, which impair judgment and yet again, make them more vulnerable.’ Elizabeth paused again, a wry smile tugging at her lips. ‘Once again, try telling them that the economy is to blame for their plight.’
Elizabeth clicked again. A close-up black and white image of a young teenager staring pensively into the camera covered the screen.
‘Adding to the daily battles that sufferers of AIDS and their orphaned offspring face, is the stigmatisation. Many of the uneducated and highly superstitious Kenyans believe that HIV is the result of black magic.’ Elizabeth flashed her beam at the young boy, her hand quivering slightly.
‘This is Isaiah Gakuyo. He was one of the first patients I met in Kenya. Not two months later, Isaiah was dead.’ Elizabeth’s voice broke, and, coughing lightly in an attempt to regain her composure, she continued. ‘Isaiah’s uncle stabbed him to death with a pitchfork once the disease had claimed his mother and grandmother and Isaiah’s diagnosis was confirmed. His uncle claimed at the trial that his nephew was possessed by evil spirits that needed to be exorcised only through death.’
Elizabeth paused as the audience absorbed her words under Isaiah’s watchful gaze.
‘Isaiah is the human face of suffering. His is the face of lost hope.’ Elizabeth’s words, softly spoken, were laced with compassion. ‘Isaiah is only one of 25 million African AIDS orphans. It’s easy to forget the problem, and label it an economic one, when you are studying statistics in a paper. But when you humanize it, that’s when it really drives home the urgency of the problem.’
William felt his face flush, and was relieved that the darkness of the auditorium kept his features hidden from view. The horror of the situation, visualised by Elizabeth’s clear photos was providing him with a different dimension to a problem he had only ever viewed with the analytical approach of an indifferent bystander. As a top executive, William had spent the past three years travelling extensively through Europe, Asia and the America’s to advance his professional agenda. Even his journey to Australia had been orchestrated to feed some personal need. Yet he had never even thought about travelling to Africa, never seriously considered living outside his comfort zone to mingle with the ‘uncivilised natives’ of the harsh continent. And yet he had offered his opinions on the situation so decidedly, so passionately, so…. ignorantly. His offensive had been the best form of defending his company.
’HIV runs a predictable course.’ Elizabeth continued, drawing up a flow diagram. ‘Victims die of opportunistic infections, such as tuberculosis, long before the onset of full-blown AIDS. Tragically, the life expectancy in Kenya is merely forty-six. Only fifty percent of the population will reach the age of forty.’
‘That is a shocking statistic, is it not?’ Elizabeth queried. ‘How about this: only seventy thousand of Kenya's estimated 2.2 million people living with HIV are able to afford treatment with anti-retroviral treatments. That is less than 3%. It’ s hardly surprising, given that in the past years, thirty-nine foreign drug companies went to court to challenge the African law that allowed the country to buy cheap, generic substitutes for patented AIDS drugs.’
William’s discomfort increased, as Elizabeth clicked the console to draw up an image of numerous pill bottles and scattered pills. He breathed deeply as a thorough examination of the photograph failed to reveal the distinctive packaging that characterised Darcy Pharmaceuticals products.
‘Many pharmaceutical companies unconditionally dropped the case under pressure from intense governmental and humanitarian lobbying. Many actually slashed the prices of AIDS drug cocktails.’ Elizabeth walked across the stage, keeping her eyes fixed on the crowd. ‘However, despite these price cuts, they remain too expensive for many African countries. In Kenya the minimum wage is less than one dollar a day, and the only solution lies in producing affordable generic versions of the required drugs. Research shows that when there is a generic alternative, there is an 82% drop in price for the drug, compared to the mere 9% drop for drugs with no generic counterpart.’
As a hand was waved in the audience, Elizabeth smiled. ‘I see someone has remembered that this is an interactive presentation. Yes, Dr Anderson?’
‘Dr Bennet, as a researcher in the Alzheimer’s laboratories here at the hospital, I know that the time and money spent on research and development is quite substantial. Don’t you think that companies have the right to protect the intellectual property through patents?’
‘On the contrary, I believe patents are generally necessary to stimulate research and development for new drugs.’ Elizabeth replied emphatically. ‘However, given the extent of the humanitarian crisis, I believe that protecting human life must take precedence over protecting intellectual property.’
‘But Dr Bennet, you yourself claim that strong patent protection necessary to stimulate research and development for new drugs.’ Dr Anderson persisted eagerly. ' How can this be achieved if you strip companies that have spent hundreds of millions of dollars, of their rights? What inducement do they have to continue research?’
‘Excuse my naiveté, but I always thought saving lives was a pretty big inducement.’ Elizabeth replied smilingly, as the audience tittered in response. ‘But in all seriousness, the patent system is only successful in the case of diseases that have a lucrative potential market in the industrialised world. Although pharmaceutical companies argue that their patents must be sacrosanct in developing countries for the sake of research and development the facts are that private sector research and development has long neglected the major killers of the developmental world. This is proven by the fact that there are no paediatric formulations of HIV drugs, because generally, children in the West do not suffer from this disease.’
William listened intently as the debate raged, his rising indignation reminding him that it had been her unfair generalisations regarding the pharmaceutical industry that had resulted in their in-flight altercation. Her words were a contradiction of everything his father had stood for. Raising his hand high, he waited as Elizabeth moved her eyes towards him, a small smirk gracing her lips.
‘Dr Crady, you have something to add?’
William nodded slightly. ‘Dr Bennet, in your estimation the entire pharmaceutical industry is either mercenary or deliberately neglecting the epidemics of the third world. That’s a pretty dangerous generalisation, don’t you think?’
William was disarmed by her radiance of her sudden smile directed at him.
‘Like lamb to a slaughter, Dr Crady.’
‘Well, Dr Crady, as Professor Lucas had informed us, you do come to Memorial with an extensive background in pharmaceutical research. Perhaps, with your intimate knowledge of the pharmaceuticals industry, you could provide us with the best answer to that question by answering a few of my own.’ Tucking an errant curl behind her ears, she posed her question with feigned ignorance. ‘Could you inform us, Dr Crady, as to how many drugs your employer has specifically developed in the last thirty years?’
William arched his brow questioningly. ‘I have only been with Darcy Pharmaceuticals for the last three years, Dr Bennet. Surely, you could not name how many bypasses the cardiology department at Memorial has performed over that same period?’
Elizabeth bowed her head in acknowledgement as the crowd laughed in amusement. As their mirth subsided, she raised her eyes to his once more.
‘Dr Crady, surely when a physician decides to follow a career in research and development, he puts a little time into researching his prospective employer.’ Elizabeth smiled with feigned sweetness. ‘At least that is how I know that over three thousand six hundred by-passes have been performed at Memorial since the procedure was established.’
The audience murmured again.
William met her gaze, chin held high. ‘Over four hundred new drugs have received ethics approval for distribution and production,’ he replied with concealed pride.
‘Four hundred,’ Elizabeth repeated slowly. ‘That is a large number is it not, Dr Crady?’
‘Darcy Pharmaceuticals is one of the largest drug development companies in the world.’ William affirmed smugly.
‘I see.’ Elizabeth’s smile was replaced with confused bewilderment. ‘Dr Crady, could you inform us as to how many of those four hundred drugs were developed specifically to deal with the tropical diseases that are the main killers of the developing world?’
William furrowed his brow, a deep sense of foreboding settled in the pit of his stomach. ‘I couldn’t specifically say.’
‘Half perhaps?’ Elizabeth prompted. At his silence, she continued. ‘A quarter perhaps?’ William remained silent. ‘How about ten percent, Dr Crady?’
‘I don’t have those figures committed to memory, Dr Bennet.’ William replied coldly.
‘Well, allow me to refresh your memory. Of the more than thirteen hundred drugs developed between 1975-1999 by the world’s major drug companies, only thirteen were for the treatment of tropical diseases. That’s 1%, Dr Crady. In fact, it has been over 30 years since the last significant tuberculosis drug was developed. The simple truth is, it’s not from lack of need, it’s due to lack of a lucrative market.’
As his silence stretched out, Elizabeth stoically continued.
‘So theoretically, out of your 400 approved drugs, the likelihood is that only 4 have been produced for diseases limited to developed nations.’ Elizabeth shook her head in mock sympathy. ‘It is fortunate for them that an independent, not-for-profit Drugs for Neglected Diseases Initiative aims to develop new, improved and field-relevant drugs for neglected diseases, such as malaria, leishmaniasis, human African trypanosomiasis, and chagas disease. Hopefully such gaping holes in research can be plugged before long.’
William sat silently defeated. He found an unlikely champion in the persistent Dr Anderson, who once again raised his hands.
‘Just for the record, from my own personal experience in the industry, I don’t believe that all pharmaceutical companies have that mentality, Dr Bennet,’ he insisted. ‘It’s only logical that researchers tackle the diseases that are prevalent in their own backyard before they try and save the rest of the world.’
William nodded approvingly. Elizabeth caught his motion and turned to him once again.
‘I see Dr Crady and Dr Anderson are in agreement. Well, Dr Crady, I am yet to answer the question you posed earlier. I’m prepared to do that now by sharing a little story with you. Malaria and African sleeping sickness remain the leading causes of morbidity and mortality in Africa. Once upon a time, Novartis Pharmaceuticals discontinued the production of Elfornithine, an effective and safe treatment for malaria and sleeping sickness because it was not considered profitable. Doctors continued to prescribe the drug Melarsoprol instead, despite the fact that it killed one in every twenty patients, and despite the fact it was a derivative of arsenic. Then, two years later, Elfornithine reappeared, remarketed under the new brand name Vaniqa. And do you know why?’
At the ensuing pause, Elizabeth folded her arms over her ample chest.
‘Research indicated that it eliminated women’s facial hair!’ Elizabeth announced dramatically, smiling condescendingly. ’The new cosmetic use triggered re-production, Dr Crady, and not the death of millions of the worlds’ poorest people. If that isn’t the definition of mercenary and neglectful, then what is?’
She turned pointedly away, as Professor Lucas coughed slightly, but not before delivering her parting barb. ‘I guess Pharmaceutical companies would rather treat a bald American than a dying African.’
A buzz of voices and laughter erupted throughout the lecture theatre, as Elizabeth returned to the lectern.
Dr Wentworth waved his hand. ‘Dr Bennet, what solutions are necessary to the African dilemma?’
Elizabeth smiled ‘Well, there are several…’
For the remainder of the seminar, William sat motionless, his mind in turmoil and his indignation rising. She was clever. She had not once mentioned Darcy Pharmaceuticals but her meaning had been clear. He was barely aware of the concluding comments and the violent bursts of applause that ensued. In the fog surrounding his senses, he could see the many colleagues who approached her with congratulations and hearty handshakes. He was faintly aware of a glass of juice being thrust in his hand as Professor Lucas paraded him around the room, introducing him to several colleagues. His lips moved but his mind wandered over to the accusations, to the statistics that he himself could not deny. If Darcy Pharmaceuticals had produced four drugs to combat tropical diseases, he could not even recall their names. The hypertension meds, chemotherapy drugs and autoimmune steroids he could recall with ease, but just four drugs that had the potential to save millions a year, no.
William was so swept away in his thoughts that he was unaware that Professor Lucas had deftly steered him towards Elizabeth Bennet. The triumph swimming in her green eyes as they locked gazes jolted him. He looked at her grimly.
‘Elizabeth, I don’t believe you have been properly introduced to Dr Crady.’ Professor Lucas said lightly, noticing the rising tension existing between the two doctors.
‘Actually, Dr Crady and I have already met, Prof’, she responded, her gaze unflinching. ‘We shared a flight a couple of weeks ago.’
‘That’s quite a co-incidence!’ Professor Lucas mused. ‘I hope it was a pleasant flight.’
William finally found his voice. ‘On the contrary, I found the last leg to be quite tiresome.’
Elizabeth’s lip curled in smile that did not reach her eyes. ‘Yes, quite.’
William clenched his jaw. ‘That was a very poignant speech, Dr Bennet,’ he muttered. Turning to Professor Lucas, he raised his brow haughtily. ‘ Professor Lucas, its quite ironic that a person in such passionate opposition to the pharmaceutical industry could bear to receive her wages from a hospital partly-owned by one. Some might think that is rather hypocritical.’
Elizabeth dropped her gaze as Professor Lucas frowned slightly.
‘Actually, Dr Crady, Dr Bennet has instructed our accountants to deposit her wages into the Drugs for Neglected Diseases Initiative,’ he answered coolly. ‘We are proud to have a doctor who is so ready to practise what she preaches. It’s a wonderful quality is it not, Dr Crady?’
William remained silent, his face heightened with colour, his hands gripping his glass so tightly. Elizabeth looked past his face, and could see Charlotte gesturing for her attention. She directed a smile towards both men.
‘If you excuse me, Professor Lucas, I must speak to Charlotte. Thank you once more for this opportunity, and for your faith in me.’ Elizabeth kissed his wrinkled cheek quickly. Turning to William, her smile was decidedly cold. ‘Dr Crady.’
William breathed deeply, his senses suddenly filled with the sweet scent of vanilla and honeysuckle that emanated from her body. He looked at her, his face blank, as she moved towards the young nurse he had met that morning. She stopped suddenly and swivelled slowly to face him once more. ‘Dr Crady?’
Her next words, uttered in perfect French, drained his face of all colour.
‘I am fully aware that you are a man with high standards. I hope that during the remainder of your stay, you will find everything to be a little more tolerable.’
She turned on her heel and rushed to Charlotte, smiling in satisfaction, as she left a confused Professor Lucas and a stricken Dr William Crady.
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© 2007 Copyright held by the author.