Sarah Boseley was health editor of the Guardian for more than two decades until she left in July 2021 (hoping the pandemic was almost over) to write fiction instead of fact, or maybe a blend of the two. Her first novel, a literary thriller called The Cure, explores the world she has just left and still finds fascinating.
Sarah’s award-winning journalism covered global health, medicine and the occasional dodgy doctor. She has published one non-fiction book, The Shape We’re In; how junk food and diets are shortening our lives (Guardian Faber 2014).
sarahboseley1@gmail.com
Twitter: @sarahboseley
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The Cure
1. Tom
He wished he’d never met Luca Greco. Never heard the name. Maybe then at least one death might have been averted. Maybe. Most nights he dreamed about him. Papa Luca, his oddly muscular shoulders turning towards him, heavy grey locks snaking into his neck, and some sort of strange light behind his head, caught in the dawn creeping over the silent garden of the Palermo hospital. Eyes calm as a stagnant pond, a dark well of forgiveness.
Tom would wake to the electric brightness of his Bethnal Green bedsit, shaking with rage.
But they didn’t need to know any of that.
‘I’m not sure where this story starts,’ he said.
‘Start at the beginning,’ they said.
But where was that?
‘I don’t know how much you want from me,’ he said.
‘All of it,’ they said. ‘What you saw. What you did. What you thought.’
‘But it’s not about me,’ he said. ‘I was there and can tell you some of what happened, but I’d rather you didn’t ask for my personal opinions. Can we stick to the facts? The evidence? Isn’t that what we’re supposed to be doing here?’
The row of faces on the panel remained impassive.
Waiting.
‘Why don’t you address the basic questions people in your profession usually ask,’ they said eventually. ‘Who, what, where, why, when? Is that right?’
Yes, it was right. He smiled in spite of the humourless faces and the bleakness of the big white room, in the glass block above the lake. This collection of international worthies and clerks, assembled here to decide what occurred – and who was to blame – knew that much about his business. Probably from films and television. The trade, as he would call it, learned on the streets, by drinking in darkened pubs and knocking persuasively on reluctant doors. Not a profession. You didn’t need a qualification. He didn’t have a licence to practise.
He looked out of the window at the wind-whipped grey water below. A small crowd of people was huddled on the shore, watching a boat struggle. Its lone sailor was fighting the wind, trying to furl a sail that snarled like a raging animal.
He turned back to the room.
‘Who is Luca Greco?’ Tom asked aloud. His audience raised their pens as if poised to answer an exam question.
‘Professor Luca Greco was considered one of the best and brightest scientists of his generation,’ he began.
The whole world must know who Greco was now, he thought. It’s been in every newspaper and on every website in the world. Reams of it. Greco’s Italian-American heritage, the meteoric rise in the United States through the 70s and 80s of the young microbiologist from an immigrant family in Bensonhurst, Brooklyn. How medals and prizes tumbled into his path. How he just missed out on a Lasker award, and was tipped one day for a Nobel.
But a CV can’t tell you who somebody is. In Greco’s case, he wasn’t sure he knew. He tried the next question.
‘So, what happened?’
Ah, well that was just as hard.
He spread his pale hands on the desk. Thin fingers that his mother had hoped were those of a piano player.
He didn’t want to think about her. His head slipped to his hands. Nobody spoke. They were good at waiting. And then he began to talk, eyes half-shut.
‘I didn’t know anything about Greco until three years ago. I’m not a scientist, after all. I write about crime mostly. I’ve been called an ambulance-chaser, but I don’t do breaking news any more. My pieces are in-depth probes, investigations. I wouldn’t have touched science, but at the time, I could find nothing else to write about. Nothing else anyone was interested in.
‘I was at home, as we all were. Just trying to make a living.’
Did these elegantly clad folk on big salaries with second homes and lashings of vitamin D in mid-winter have any idea what that meant? What a struggle life became? Even crime seemed to have stopped. He’d heard the drug barons in the cities were having a hard time of it, with all the pubs and clubs shuttered and bolted and the dark streets peopled by memories, the ghosts of the hedonists we used to be. He was sure the criminal underworld was negotiating deals on Zoom, like everyone else. Delivering illicit goods in white vans, dropping packages on the doorstep and retreating to the street as some poor pale-faced addict with dangerously sweaty hands rushed to open the door.
Desperate times for all. He never did get around to writing that piece.
Dee kept asking when he was going to bring in some money. They’d had massive rows. She thought he too ought to get a courier’s job. He said no way was he going to stoop to delivering Amazon parcels. She said he’d better get used to not eating. It was about then she moved into the other bedroom.
He’d go for longer and longer walks. He would stay out all day long, until the light began to fade, brain beating with dull and useless thoughts. In the past, he used to stop and chat to people in the park whenever he went out for a breather. Good for ideas. Even tip-offs. There was a criminal lawyer who walked his bloodhound and a builder called Jed who knew a hell of a lot about the underworld. He thought Jed was exaggerating at first, but most of the stuff he told him checked out. Gave him a few stories. Names changed to protect his sources, of course. But now they all nervously stepped off the footpath when they saw him and hurried past, over the scrubby brown downtrodden grass full of dog piss. More frightened of this fast-spreading disease than gangsters. People were afraid of getting too close. He walked within spitting distance of one woman and she shrieked at him, quivering with skinny agitation: Keep back! I’m vulnerable!
Aren’t we all, love, he felt like saying. Aren’t we all.
After one of these lone walks, aware the bank balance was emptying faster than a bathtub, he decided he’d better up his game. Branch out. Think laterally to find a story people would actually read – or more to the point, editors might pay for.
He’d been listening to all the news bulletins, as he had since he was 15, but he was also spending hours and hours reading stuff online – some of it reliable and some probably not at all. And then up popped a thread about Greco.
‘The first mentions were fairly straight,’ he told the panel.
Look them in the eyes. You’ve done nothing wrong.
‘Eminent scientist investigates promising new drug compound. That sort of thing. Or it might have been a bit more sensational than that to pique my interest.
‘To be honest, given my lack of knowledge or concern about drug trials at the time, it was probably not until Greco did that TV interview in Italy that anything registered as a possible story.’
Carefully does it. He took a breath, staring through the windows at the collapsed sail like a piece of sodden newspaper in the water. No sign of the sailor. Probably he’d bailed out and got to land. It had started to rain and the crowd had dispersed. Show over.
‘It was late April,’ he said, ‘and everyone had seen those terrible pictures on TV of the wards overflowing with death in Europe. Overstretched medics giving interviews. Devastating stuff. You could tell they hadn’t slept for nights. They didn’t have enough of those spaceman suits to protect themselves against patients’ bodily fluids, they didn’t have enough beds and most of all, they had no treatment for those poor sods being admitted.
‘And then a while afterwards – maybe days, maybe weeks, I don’t remember – there was Greco on camera.’
Physically, he was an imposing man. Big shoulders like a wrestler, surprising in a man whose world was the lab, the ward and the classroom. Long hair and those hawk-like features. Introduced as an award-winning, world-leading scientist. But it wasn’t his build or his reputation that lingered in the mind afterwards. He had star quality. Sheer charisma. Stage presence. All the more unusual to Tom because he’d never seen or heard a scientist like that. The ones he’d seen were suits. Easy to ignore and easier to forget. Greco wasn’t.
And his words reverberated around the world. ‘I made a transcript. Do you have a copy?’ asked Tom.
They did.
‘Would you be so kind as to read it aloud to us, please?’ they said.
He shuffled a piece of paper from the folder in front of him.
Professor Greco, can you tell our viewers why you are running a trial of this compound in patients?
Because I believe it could be a cure.
(Sharp intake of breath from the woman interviewer.)
That’s a bold statement, professor. What grounds do you have for making it?
This compound is derived from a Chinese herb which has been used in traditional medicine for centuries and is very safe. We use a form of it today as a very effective drug against a common tropical disease. It’s tried and tested. It has also shown some anti-cancer properties. From my early lab work, I believe our formulation derived from the herb – you can’t just eat the plant – will have a powerful antiviral effect. It has the potential to stop this disease in its tracks.
Aren’t you worried about generating false hope?
I am confident that I am right.
That this could be a cure? Not just helpful but a cure?
That is what I said.
He looked up. One or two were nodding.
‘If I didn’t see the actual interview live at the time, I certainly saw the clips that ran on the TV news afterwards,’ he said. ‘But then it was then played down by the more staid and conventional kind of boffin – sorry, scientist. You know, asked onto the programme for so-called balance. Though that was the funny thing. I could see these other scientists were caught in a bind. Wriggling on a hook. They wanted to say Greco was wrong. But he had won awards they could only dream about. He had a history of conceiving the impossible and then proving it to be true. Most of these others were trudging along in their institutions, doing a solid job with no spectacular breakthroughs. Nothing that would go down in history. Nothing that would merit a statue in a city square.’
After that day, the newspapers and their websites ran reams of cautionary copy from that sort of establishment scientist. So dull that Tom would not have got past the first paragraph if he hadn’t had the flicker of an idea in his head. That sense of a story that flared instinctively in the gut after all the years he’d been doing the job. Excitement. And a hunger to find out more. And yes, of course, the hope of his name on a front-page story, maybe a picture byline, and a cheque big enough to allow him to pay the mortgage.
And get Dee off his back.
‘Obviously any newspaper would be desperate for stories about a potential cure,’ he said. ‘They’d all be dispatching staff reporters to talk to Greco. They didn’t need a freelance. I knew that.
‘But I thought I could do something different. Go at it from another angle. Human nature being what it is – and let me tell you if you write about crime, you learn a hell of a lot about perfidious human nature – other scientists would be on Greco’s case. Jealous. They’d try to rein him in. For sure. I re-ran those TV and radio interviews. They were trying to be neutral but they hated what he was saying.’
Tom remembered that moment of clarity, when he saw the story he could pitch as vividly as the mirthless faces in front of him. He would write about the naysayers. He would describe the scientific establishment’s bid to try to squash Greco that he was sure was coming. The wrecking ball of the scientific elite. He would chronicle the battle of the maverick genius against the dullards who wanted to stop him winning glory in his bid to save us all.
He was so excited he must have shouted at the screen.
He remembered the muffled thump of feet as Dee came downstairs and thrust open the door of his study. Her voice lowered the temperature below freezing.
‘What’s the noise? Are you watching the football or something?’
‘Dee, Dee. I’ve got this brilliant idea…’
‘Does it involve a white van?’
‘It’s a great story…’
‘You’ve said that so often before, Tom. We’re in a real financial hole. Can’t you go and get a proper job that pays decent money? Or has the going rate for freelance copy miraculously gone up?’
‘Don’t be like that. I know it’s been a bit rocky, but I’m doing all I can to get commissions and I really think I’m onto something now. Just have a little patience…’
‘Frankly, it’s run dry. The mortgage on this place and the bills are eating us alive. We’re going to have to take money out of the savings account this month and God knows, there’s only a few grand in there.’
‘But Dee…’
‘Honestly Tom, it’s about time you faced up to reality.’
She thumped the door closed and went and crashed about upstairs. She was no longer listening. They’d reached what might be called an impasse. Not a great place, looking back.
The panel needed to know none of this. They were barely human. Probably lived in a formaldehyde jar.
‘I did a Google search,’ he said in a low voice. One or two of his older listeners craned to hear. ‘These scientists who were casting doubt on Greco had impressive CVs. Very respectable. Heads of university departments, advisers to the government. Most seemed to have a multiplicity of roles.’
People like that wouldn’t have any trouble paying their bills, he thought bitterly. Out of expenses probably. With the rest of their dosh secure in a Swiss bank.
‘If I wavered at all, it was then,’ he said. ‘These scientists seemed to know what they were talking about. They were top of the ladder. If they talked about a need for caution, about a lack of evidence, well – maybe Greco was jumping the gun.’
He looked up at the faces defiantly.
‘But maybe that’s what you have to do to make anything happen in the scientific world. Like campaigners for – I don’t know – curbing greenhouse emissions who superglue themselves to traffic bollards and get themselves arrested so they can say their piece in court. Like terrorists who – next thing you know – are freedom fighters and presidents.
‘I scrolled through Google for anything on one of these sceptical boffins, a man called Bertrand. Prof John Bertrand. And I came across a Twitter link.
‘How can you live with yourself @Jbertrand? How many more have to die? Support @Greco #giveusthecure
‘It had 650 retweets and several thousand likes. I searched the Twitter hashtag and out surged a tsunami of praise for Greco and vitriol for his critics. Some of it sounded well-informed, like @scientificfraud who listed five retracted papers whose authors included one of the anti-Greco profs. And @moneytalks who claimed Bertrand and others were in the pay of Big Pharma. Easy accusation, I knew, but the tweet linked to a long list of declarations of consultancies and lectures paid for by drug companies.
‘I wasn’t a sap. I knew none of that was concrete evidence of any conspiracy against Greco. But it did mean I had a story.’
2. Jules
She was in California when the media interest began, she told them. She squared off the pen with the notepad they had put in front of her. Moved the pen to lie horizontally above the pad, then beside it, then on it, descending the page in little jumps as if down a ladder. Her neat hands worked seemingly uncontrolled by her brain. Her eyes fixed the panel with the fascination of a small creature confronting a cobra.
‘I’m a researcher in his department,’ she said. ‘Oh sorry – you already know that. Of course you do.’
They asked if she’d like some water.
Yes please. Oh yes, she would. Her mouth was as dry as Saharan sand.
Her hands took the glass to her mouth for a sip and then returned to the pen. Above, beside, above, below.
‘Yes, everybody in the department knew about the compound Professor Greco was investigating,’ she told them, staring at the pen without seeing it. ‘It wasn’t a secret. Quite the opposite. He used to talk all the time about… about a global catastrophe, a humanitarian emergency. He… he felt very strongly that we should be doing everything we could to find a treatment and we agreed with him – of course we did. How could we not feel the same way?
‘He was openly passionate, though, which is not so common in a scientist. He was a man of… of deeply held beliefs, which I suppose came from his background. He was working, as he saw it, for the betterment of humanity and just wanted to save lives. Others think that too, don’t get me wrong, but they don’t often speak out about it. The professor had great warmth and conveyed real conviction whenever he talked to us. I suppose it’s partly why people wanted to work for him.’
She prayed they would not ask about her personal feelings. She wasn’t at all sure she would be able to keep her voice steady.
‘He inspired people, you see. He would gather us all together every morning for a motivational talk, to urge us on, giving us the latest mortality data in the US and around the world. And we were trying. We really were. We pulled out all the stops, to the point of exhaustion. All holidays were cancelled, we were in at weekends and still in the lab after hours until late at night, every night. We almost slept standing up.’
‘Did that take a toll on family relationships?’ they asked.
‘Oh… well… yes, of course. It was pretty tough.’
Her cheeks started to burn. Move on and talk about the science. That’s what you’re here for.
‘We were testing lots of potential antiviral compounds, most of which proved ineffective. I was involved in the early lab work. Those are the first tests you do, to see whether the compound can inhibit the growth of the virus in a petri dish or test tube. It has to be done in very controlled, secure conditions, of course. The last thing you want is any kind of leak.
‘Anyway, after a lot of failures, this felt like a breakthrough. The herb extract showed strong antiviral activity. In other words, it stopped the virus replicating. I remember Professor Greco was really happy,’ she told them.
More than happy. The professor had been ecstatic, punching the air. He infected everyone in the room with his joy. And when most of them had leaked away, he had turned to her with his deep laugh and pulled her to him in a hug. Touch had become dangerous and strongly discouraged, but somehow the professor had always seemed above the rules. She remembered his solidity, the bulk of him, the warmth that seemed to flow from him down into her fingers and toes, the softness of his hands and the brief brush of his lips on the top of her head. And then he was gone. She heard his tenor voice singing a Puccini aria down the corridors as he made his way to the president’s office to tell her the news.
‘Yes, you could say he was excited,’ she told them. ‘You’re right – it’s not something you normally see in a scientist, but obviously we understood. The stakes were so high.’
Her knuckles showed white below the skin as she gripped the pen.
‘And yet…’ she said, hands pressing hard on the desktop, trying to force them to understand. ‘And yet this was still just a lab result. I must stress it was only a lab result. You can’t know whether a drug will work in human beings without running extensive human clinical trials.’
Her fingers skipped the pen up and down the notepad.
‘We did think about publishing the work as a pre-print. I’m sorry – should I explain that? It’s a phrase bandied about all over the place these days. Now that everybody seems to be an armchair scientist.
‘A pre-print is a scientific paper that hasn’t been peer-reviewed,’ she told them. ‘You write up the findings and then publish immediately online for the world to see. You don’t get it vetted by other scientists first.
‘Of course… it’s not a perfect system.’
How much should she say? Should she tell them about the petty jealousies? About envy? About the desire for fame? About the high career stakes? The linkage of names on scientific papers to university pay grades and funding? About the dark underbelly of what people assume is crystal-clean science?
‘There is always a danger,’ she said carefully, ‘of a bit of rivalry. The peer reviewers may be working on similar projects and hope to get their results out first.
‘Anyway, we didn’t publish at all. Because of the rapid spread of the disease, we decided – Professor Greco decided – to move on, rather than spend time writing up the results even for pre-print publication. We were working all the time with this sense of extreme urgency. And nobody expected any safety problems.’
‘Safety? What do you mean?’ they asked.
‘Oh – adverse events. Side-effects in layman’s language.’
Don’t talk down to them. Don’t talk down to them. Her department head had warned her several times. She felt her shirt dampen under her arms in the air-conditioned room. Closing her eyes, she imagined for an instant running through the cypress trees to Baker Beach, where the air was clean and fresh and her mind and body were synchronised in uncomplicated rhythm. She saw sunlight glinting on the toppling curve of a wave.
Opening them again, she saw the same stark square room in a businesslike building on a grey day in Europe.
She stifled a sigh.
‘What I meant was… was… that the herb has been used in medicines for hundreds of years,’ she said, ‘though not in this formulation that we’d put together in the lab. We were using an extract. Not the whole plant. Most medicines are originally from plants. Quinine for malaria comes from the bark of the cinchona tree, for instance. Digitalis to strengthen the heartbeat comes from foxgloves. But you can’t just swallow ground-up bark or petals. You have to find out which bit of the plant is the active substance – the bit that has the effect on the body. And then you have to synthesise it and turn it into a formulation with an exact dose you can swallow or inject so a drug company can mass-produce it.
‘One of the big attractions of this drug for the professor,’ she said, ‘was that it had been used in different formulations as a medicine before without side-effects and was likely to be safe. He looked at other possible drug compounds, but this one just ticked a lot of boxes before we even began.’
She saw nodding heads but couldn’t tell whether anybody understood. She flexed her left ankle, which tended to stiffen when she had to sit for a long time, ever since she broke it on a hill run. Zak had called out of the blue, irritable, wanting to see her. Wanting some sort of affirmation from her because his paintings weren’t selling. She’d been in too much of a hurry and hadn’t seen the crumbling edge of a crater. And then he’d been livid with repressed anger, that she had become the centre of attention, helicoptered off the hillside to hospital.
‘Shortly after that, I was moved onto other research,’ she went on. ‘My expertise was in the lab anyway, not with patients in the clinic. But that means I can’t tell you what was happening at that stage with Professor Greco’s project. Greco’s baby, we called it, among ourselves. Or Baby G.’
She tried not to smile. Baby G. One of the lab staff had been a real comedian. He did a rap around the workbenches about eating babies. It was black and tasteless and she didn’t at all approve, but in their almost out-of-body exhaustion, they had laughed. A refrain wormed through her head.
Baby G chopped up with glee,
a nose for you and an ear for me.
She dug her nails into her left palm to kill the looming hysterical giggle.
‘The only thing I did hear, which may seem odd to you but is perfectly normal for someone like the professor, is that he took a large dose of the compound himself,’ she said with barely a quiver in her voice. ‘Effectively he enrolled himself in a one-man safety trial. As what we call a healthy volunteer. As far as I know, he had no ill-effects. That’s what he told everybody.’
To be more specific, and she had no intention at all of recounting this, that is what he had told her.
He’d come to her office as she was packing her laptop and her running shoes into her big battered rucksack to go home at the end of a long day. Greco sat on the desk, excited as a child who knows Christmas is coming. She was surprised because she was no longer part of his team, but they were the last people in the building. Just like Zak, she thought, he wanted applause.
His smile lit the room like a 100W bulb.
‘It’s going to work, Jules,’ he said to her. ‘It’s going to work. Believe me.’
She shook her head anxiously. She wasn’t his mother. She shouldn’t have to warn him not to get into trouble.
‘You mustn’t say that. We don’t even know it’s safe yet.’
‘Ah, but I do,’ he said.
The compound had been turned into pills by then. He’d taken three times the dose they were going to trial for several days.
‘You’re crazy,’ she had told him. He’d laughed and touched her arm.
‘I’ve never felt better,’ he’d said. ‘We’re going to save so many lives.’
As he’d walked away, he took the light and warmth with him.
‘I don’t know who else was given the drug at that stage,’ she told the watching faces. ‘I’m sure it was all done properly.’
Her hands sought the water and she drank in gulps.
‘I had to take some time off,’ she said. ‘Just a few weeks. For personal reasons. I’m sure the same thing was happening to lots of people at that time.’
She looked down at the notepad, surprised to see it was blank.
‘My relationship broke up,’ she said, slowly drawing a running shoe on the paper and beginning to shade it in, so that she didn’t have to look up.
‘My partner left me and I was having to sell the apartment. I’m not looking for sympathy – I’m just telling you because I think it’s relevant to what happened next.’
She’d been called into the president’s office – the head of the university. A couple of other professors from the department were with her – Vogel, who always walked past her as if she didn’t exist, and Fitzpatrick, whom she didn’t know well but who was said to be smarting after being overlooked for promotion.
The president turned on her the moment she was inside the door.
‘Did you see Professor Greco’s interview on the television?’ she asked.
‘You mean the comments he made on the news?’
‘Yes, yes.’
‘I did. Not live, of course, but I saw what they ran later on the bulletins. They were making a lot of it. You couldn’t really miss it.’
‘No. Quite. That’s exactly it.’
‘Exactly what?’
She hadn’t meant to be rude. This was the president, after all. But she couldn’t see what she was driving at. If you’d worked with the professor, you weren’t easily surprised by the things he said and did. Vogel took over. He was fingering the bow tie he always wore, twisting it this way and that. He peered at her over the top of his little round glasses.
‘As you know, Luca Greco is in Italy where he is trialling his antiviral compound in a hospital with which he has personal connections,’ Vogel had said.
He made it sound sleazy.
‘He’s running a trial in the US too,’ she said.
‘Yes he is, though very small scale. Clearly he has gone to Italy because he wants to recruit a lot more patients. Numbers are soaring there, as you will be aware. We think that Professor Greco could do with some help. To cut straight to the chase, we wondered whether you might be willing and available to join him.’