"In medicine there Is always something that can go wrong. Even the most innocuous procedure can end up being lethal if that's what the G.o.ds want that day." He looked at her intently and seemed to try to measure his words. "But I wouldn't recommend we proceed if I didn't feel that the potential benefits far outweigh the risks."

She listened wondering. Something in his voice is sounding cagey. What is he leaving out?

"I still want to think about it"

"Of course, but we can make some preparations in the meantime," Van de Vliet said turning back to Nina. "Mrs. Hampton, do you understand anything of what I've said? Nothing is risk free."

"Young man, if you'd lived as long as I have, and then felt it all slipping away, you'd be willing to take a chance with anything."

"Mrs. Hampton, Alzheimer's is one of the more promising areas of stem cell research. We've already had successes here. I truly think we can help you. In fact, Ellen can start your preliminaries right now, if you like. A lot of it you may have done before. For example, there's a game where you have to memorize the names of three unrelated objects, and you have to count backwards from one hundred by sevens. Finally there's a test where you copy sentences and symbols." He chuckled and there was a warmth but also a distant sadness. "Some days I'm not sure I could even do it all myself. In any case, it's not something you pa.s.s or fail. But if we do enter you into the trials, you'll have to stay here for the duration. That's absolutely essential. We'd also like a caregiver to be here with you, as long as it's necessary."

Ally looked at Maria. "Do you think you want to stay here with Mom?"

Maria's eyes were very sad "I could stay for a day or two. But ...

maybe we should talk."

"We can arrange for someone," Van de Vliet interjected "We routinely provide caregivers from our staff when called for. And because we're still in clinical trials, there is no charge."

Ally watched Nina brighten and turn to Maria. "You can bring some things from my closet when you go back. I want to start right away. I just know he can help me. I've got a feeling and you know my feelings are always right."

Ellen reached and took Nina's hand. "Come, dear, we have a special office where we handle all the paperwork for admissions. We can do the tests there."

Ally leaned over and kissed her mother. "I love you, Mom. And I love your spirit. You taught me how to be a fighter a long time ago. And I guess you're still teaching me."_

Tuesday, April 7

12:03 P.M.

_

Karl Van de Vliet watched the three women leave. Now he was alone with Alexa. So far, so good, he thought. With her mother checked in, we're partway there. Now what is it going to take to get her with the program? I'm not sensing commitment. She's asking too d.a.m.ned many questions.

It looks like we may have to go to Plan B tomorrow. Too bad.

After the door was closed, he turned back.

"Your mother is quite an inspiration," he said with a smile. "I'll need those tests to create a baseline, but already I can tell she'll almost certainly respond to the treatment. She fits our success profile. I'd say the odds are heavily on her side." Then he darkened his look, for effect. Better let her know I don't have to do this, he reasoned.

"The truth is, we already have enough data on Alzheimers that I don't really need any further clinical trials. I know the parameters of what the procedure can do and what it can't. But when Grant told me about his mother's condition, I saw no reason not to work her into the trials. We're winding down now and we have some empty beds."

"Don't think I'm not grateful," she said, "even though I may ask a lot of questions."

She got the message, he thought. Good.

"Alexa, I'm now going to tell you something I've never told anyone else," he went on, feeling a tinge of sadness arise in his chest. He hadn't planned to say this, but for some reason he now wanted to.

Perhaps because it was true. "My late wife, Camille, was a brilliant medical researcher. We worked together for many years, first at Johns Hopkins and then at Harvard. What took her from me was a heart condition very similar to your own. That was over a decade ago and I vowed I would dedicate my work to her. I wanted the final clinical trial in this program to be on a young person with advanced valvular stenosis, but I could never find a patient who matched that profile.

But you would be perfect." He looked carefully at her. It was all so true, which made this whole scene especially poignant.

"I'm sorry about your wife," Ally said. "I read in your--"

"You see, if I can succeed with you, it would almost seem as though I'd had a second chance to save her life. You bear such a striking likeness to her in several ways. You look something like her, but more importantly I sense that you share her indomitable will."

"So I'm not just another statistic to you?" She seemed to be trying to gauge the depth of his sincerity.

"No one here is a statistic, but you would definitely be someone special."

"I see," she said still sounding noncommittal.

Am I getting anywhere? he wondered Just press on. You've got to make this happen.

"All right, whatever you decide, we need to get some preliminaries out of the way. For one thing, we must have a complete new cardiology exam.

Nothing in the file you brought presents an obvious red flag, but still, it's essential that we have an up-to-the-minute stress test.

Toward that end I've taken the liberty of arranging for a checkup at the New York University Faculty Practice Radiology on East Thirty- fourth Street. Among other things, they can run a high-speed computed tomography screening using ultrafast X rays. Also, I'd like to see a phonocardiogram. A sonic a.n.a.lysis of 'murmurs' can tell us a lot about valve abnormalities. Regardless of what you decide to do here, it's a good idea for you to have this done regularly anyway."

"You've already scheduled tests?" Her tone of voice told him she was mildly taken aback at the presumption.

"It's just that the NYU Faculty Practice is sometimes difficult to get into on short notice. They can be booked for weeks in advance. But a cardiologist I know there, Lev Amram, has agreed to make room for you this afternoon. It's a professional courtesy. There'll be no charge.

After that, and a.s.suming you want to proceed, you should get a good night's rest and then come back here as early as possible tomorrow morning. You should pack for a three-week stay, though we'll provide you with pretty much everything you'll need here."

Just get her here.

"You know," she said, "I was actually hoping we could do this on an outpatient basis. I know you like to have your patients here for constant observation, but I run a business that needs me there every day."

"Alexa," he said, putting every last ounce of authority he had into his voice, "this is not a conventional procedure, and it's possible you might suddenly need special care of some kind. This is an experimental clinical trial, so we don't know what can happen. That's why I really must insist that you be here twenty-four hours a day." He looked at her with great tenderness. "We're talking about the possibility of completely repairing your heart. Surely you don't expect just to drop by now and then for that."

"All right, point taken," she said, "but--if we go forward with this-- I'll need to hire at least one temp to be at the office while I'm gone.

Somebody to at least handle the phone. That could take time."

"Surely someone there could manage to handle that," he said. She's getting resistant again, he told himself. Don't let that happen. "And there's also the matter of your mother. I think it would be wise for you to be nearby during the early stages of her procedure. When her mind starts climbing out of the abyss, it's important for a close family member to be there to provide a visual and emotional anchor. It truly can make all the difference. I fully expect that her functions of attention and recall will return to those normal for a woman her age, or quite possibly even better, but it will happen a lot quicker if you're here to help her, to remind her of things."

"This is a lot to digest." Ally turned and sat down in a chair. "All right, I might as well get the exam. It doesn't mean I've agreed to anything here."

He heard the ambivalence and knew he had no choice but to do what he was going to have to do tomorrow.

"I will proceed on the a.s.sumption that you'll be entering the program.

Truthfully, if you don't, a week from now your mother is going to be asking you why." He smiled. "In any case, we need to have those tests done in the city. Also some blood work here. We're affiliated with a lab. I want to check your T-cells and certain other markers, like C- reactive protein and h.o.m.ocystine. It's something you should do regularly anyway."

"All right, then," she said finally. "But after that, let me go see how Mom's doing. Then I'll arrange things with Maria somehow and drive back to the city."

"By the way, before I forget, we have to complete a formal application for your mother to admit her into the clinical trials, and we also need a signed liability waiver. I a.s.sume you have power of attorney for her by now. If you don't, then we may not legally be able to proceed."

"I have it."

"Then let's get started" he declared almost certain he had her.