Thursday, 3:15 p.m, Longwood Medical Area

Jake

I keep checking my iPhone, willing Harley to text me that the lab results are ready. I’m waiting in a Starbucks, nursing my third cup of coffee and trying not to freak out. The caffeine’s not helping.

Josh steps out of line to join me. “Almost five friggin’ bucks for a frackafuckachino, or whatever the hell this is,” he grumbles, holding up a coffee slush. “Can you believe that shit?”

I shrug, finding it hard to make small talk. What’s taking Harley so long?

Carp slurps his drink for a long minute, looking like he wants to say something but can’t find the words.

“Just tell me!” I finally snap.

“I, um…” He rocks back in his seat, avoiding eye contact. “I sort of called Jess this morning when you were asleep.”

My eyes must almost pop out of their sockets. “You what?”

“Jesus, Jake, she needed to know what’s going on, and if you weren’t gonna tell her –”

“What the hell, Carp,” I cut in, fists balling under the table. “You had no right to do that.”

“Yeah, well, I’m glad I did ‘cause get this: She texted me a few minutes ago to say she’s following a lead on Caulder.”

I jump up from my seat, so pissed off I feel like screaming. How could he be so stupid? The last thing I want is to drag Jess into this nightmare. “I don’t want her involved!” I hiss through clenched teeth. “Caulder is dangerous, goddamn it! Don’t you get that by now?”

“What I get,” Carp answers defiantly, “is that you need her help. She’s still your wife, for Chissakes! Okay, so you fucked up, big time. She’s so pissed she almost hung up on me. But when I told her what’s going on… hey, I’m not saying she’s forgiven you, but she understands you’re a victim here.”

“But after what I did…” I wipe my eyes with the back of my hand. “Why would she help me?”

“Because you’re in trouble. You need her, and she gets that now.”

“She does?” I sit down, feeling the anger seep out of me. Exhaustion rushes in to take its place. “But, how…?”

“That’s the thing. She did a web search and pulled up a photo of Caulder posted on a British gossip website.  Turns out Roy-boy was hanging with some billionaire Arab Sheik last week, right in New York City. Sheik's the wealthiest dude in the UAE, and guess what? Jess’s dad does some work in that part of the world, so she’s gonna give him a call, maybe dig up some dirt. I mean, this can’t be a coincidence, right?”

When I give him a blank stare, he slams his cup down on the table. “Didn't you listen to the news? Pulsar’s just been bought by a UAE-based pharmaceutical no one even heard of until today.”

“Yeah, I know,” I say. “I was watching CNN with you this morning.”

“And you don’t see the connection with Caulder?”

I bite down on the edges of my tongue, not wanting to go there. Because if Caulder’s involved with Saber Life Sciences…

Can’t be. That would be too big. Too terrifying.

Carp whistles before putting words to my thoughts. “I’ve got a bad feeling this aint just about you fucking his wife, Jake.”

*

We don’t say much on our walk over to Harley’s lab. Josh must realize I need time to collect my thoughts. Unfortunately, they aren't getting any clearer. If Caulder sabotaged the REST study, then why did Jean Clark die from an allergic reaction to latex? Caused by gloves I swear I never wore? It doesn't make any sense.

As soon as we step into her lab, Harley echoes my confusion. “I just don't understand this result,” she announces, fingers raking through color-streaked hair.

When I ask what’s wrong, she explains that early this morning, when she looked up the standard molecular weight of IgG, she discovered our antibody was heavier than expected.

Carpstein shrugs. “So what? How accurate is that SDS-PAGE thing anyway?”

“When I run it?” Harley’s nostrils flare. “You’d better believe it’s accurate. Anyway, I already ran the peptide fragments of each unknown through the mass spectrometer.  I’m comparing the peak lists with the Swiss-Prot and Genbank databases as we speak.”

“Then we’ll know soon?” I ask.

“Depends on how long it takes to get a few good hits. Who knows? It might only take a few more minutes. Here…” She walks over to her desktop computer, turning the screen to show us the streaming data.

“Sweet!” She points to a window where the data has frozen.  “Looks like we already have one likely ID.” She touches her fingertip to the screen, enlarging the result. “Hmm. Keratin 9. That must be from you, Jake.”

“One of my skin cells?”

“Hey, you’re the dermatologist, but if I’m not mistaken, that’s a structural protein in the stratum corneum, right?”

I nod. “So then it’s a contaminant.”

“Looks that way.”

“Which leaves us with only two more bands,” Josh notes.

Harley slowly shakes her head. “Some of the proteins may have been denatured during the extraction process. Let’s just see what else we get.”

Time slows to a painful crawl as we wait for the computer algorithm to identify the last two unknowns. When the results from the heaviest band finally come through, Harley points triumphantly to the screen.

“Huh! What did I tell you?” she announces, doing a little dance. “It’s IgE, not IgG. That makes perfect sense! Of course IgE is heavier, because it contains an extra constant-region domain.”

Carpstein turns to me and pulls a face. “Hey, can’t argue with that geek-speak.”

Harley whacks his arm. “There’s an extra component, bonehead! That’s all I’m saying. Think of a choo-choo train with one more caboose.”

“But that doesn’t make any sense,” I say. “According to the Pulsar specs, the neutralizing antibody should be IgG.”

“Yeah,” Carpstein chimes in. “Doesn’t IgE cause allergies? You know… like in asthma.”

As soon as the words leave his mouth, the room goes silent as we’re all struck with the same mind-blowing thought.

“Jake,” Carpstein finally says, sounding uncharacteristically subdued. “Didn’t that ME say they found elevated levels of anti-latex IgE in your patient’s blood?”

I nod numbly. Can’t be. Impossible.

Carp puts his hand on my shoulder and squeezes. Hard. “Son-of-a-bitch. That’s how he made it look like anaphylaxis. He switched syringes. Instead of injecting the reversal agent, you were shooting the fake evidence right into your patient’s bloodstream.”

Harley warns us not to jump to any conclusions. The analysis may be flawed, and besides, we still have one more unknown protein to identify.

But when that final ID comes through, less than five minutes later, there can be no doubt.

“Tryptase,” Harley whispers in disbelief. “With a 95% probability.”

IgE and tryptase: the same two markers of anaphylaxis that Roberts found in Jean Clark’s blood.

And just like that, the shocking truth crystallizes right in front of me.

Jean Clark was indeed murdered.

Roy Caulder is responsible.

He framed me for her death, using mind-blowing sophistication and ingenuity.

My friends and I just discovered his secret.

And finally, most chillingly…

The last person to possess this knowledge may have already paid for it with her life.

***

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