Dawn.

Sipping coffee, Carl couldn’t remember the last time he had seen one. One he had woken up for, after actually going to bed, that is. The others had been part of a continuous flow, following dusk, following the long darkness of exam cramming, thesis writing, grant researching, midlife crisis despairing.

His coffee-making skills hadn’t quite adjusted to the new low-everything supplement-rich diet Rita had forced upon him, even before the crisis, after she had stared long and hard at his check-up exams. Just as love had forced Carl to marry her, despite his better instincts. A medical doctor either paid absolutely no attention to her family’s own health, too much of other peoples illnesses to fill up the day; or dedicated every instant of her off-hours with it, consumed by the guilt of prior neglect. A famous doctor meant all these truisms were multiplied, as many times as the perceived fame could justify. He was now the focal point of Doctor Rita Mendes’s medical attention. For Carl, one of those people who had tried to avoid disease by firmly ignoring it, there was little escape. Except things like strong coffee at dawn. And sneaking out before his caretaker finished her early morning emailing to Australia and Europe, and ran down with new ideas and recommendations. Or, more recently, with tiny speckles of doubt regarding her own health – nothing like a disease in the family to bring out the inner hypochondriac.

Campus was a slow fifteen-minute walk, a perk Carl had gladly learned to live with given his day was usually spent rushing from one room to the next. The early hour meant he could weave his way through the courtyards and parking lots in the glorious late spring air, slide in the Institute and hit the elevator before anyone could stop him for something. It tended to happen quite often.

On one of the fifth floor conference room tables Chandra had spread out the files from applicants to the brand new Ph.D. program the Institute and Hospital were spearheading with other institutions around campus. A full-fledged interdisciplinary effort, one that had needed many meetings to set up. Leading to a Selection Committee headed by the one individual that had sat on all of them without pissing off any of the Dozen Deans involved.

And now Carl contemplated the fruit of his labors in the form of hundreds of applications from young and eager graduate students moved by the campaign that he personally had made sure used all the current hot buzzwords. Chandra, the administrative assistant assigned to the project, and some of the junior committee members Carl had coaxed into helping out, had already set aside a neat pile of “no way” applicants, entitled to no more than a reasonably nice rejection letter Carl had drafted, on the brand new Program stationary. Still, this left at least a few hundred from all over the world to sieve through for a mere twelve openings. Prioritizing, choosing, not only for scientific instincts and readiness, but also for a diverse background, the ability to think outside whatever boxes they were in at the moment. Which meant asking the right questions at interviews over the phone, net and, ultimately, for about thirty finalists, in person. It would take a week to organize it all, and it took Carl most of the morning to begin organizing the organization. And he was already late.

On the way to the third floor Carl passed his small research lab, resisting the urge to step in, agonizing over two possible outcomes. One was that he would find no one at the bench. The other, much more depressing, was that he would, and promptly freeze, not knowing exactly what whoever was there could be doing, or how to ask without feeling stupid.

Outside his office the next task awaited. Ironic, really. Carl had spent the past few hours selecting future Ph.D. candidates; he was now called upon to arbitrate disputes involving current ones. In this case particularly unpleasant affairs, two students at odds with their supervisors. Would he be doing this in a few years, for some of the carefully selected candidates whose applications he would memorize before long? How sure could one be that the right person was being selected for the right project? One didn’t, which was why someone had invented advisory boards.

Predictably the other committee members simply refused to show up, citing bogus commitments off campus. That was why Carl, seasoned veteran of many arbitrations, had scheduled the session for his own office. At least here he had the specially designed chair Rita had given him for his birthday, thinking it was their anniversary (they were close). Sighing as he settled in, Carl picked up the files before asking the first plaintiff to enter. He didn’t bother telling either of them, but their cases were so clear his only wonder was why on earth someone hadn’t solved the mess yet. Because, he mentally answered his own query, very few wanted to be involved in any such messes.

The first student was, unfortunately for him, the latest victim of a supervisor that tended to hold on to her pupils for too long, getting them to do work well beyond their thesis project. The flip side was that students kept falling into the web, not because of any deception, but because the supervisor also published very well. Quid pro quo. The student knew this? Of course, too smart not to do some research before picking a lab. And Carl had been on the phone with his mentor, who personally cleared the two obvious options. Either the student stayed on longer and finished the paper he was working on as first author; or he wrapped up his thesis with what he had, and the next student would finish the paper and get the coveted first authorship. As always with children of privilege the decision wasn’t popular: the student wanted to finish and be guaranteed first authorship. Guarantees were for really bad sports personalities and political pundits, Carl replied. This was Science. To eat the cake one had to make it.

The second case was both much easier and much harder. Easier because, to stay on the dessert analogies, this student hadn’t even begun to gather ingredients for a cake, doodling with recipes without trying any of them. One of those fellows who thought coming to work and being in the program long enough entitled him to a thesis. Fine, credit could be transferred to another program, if that was the student’s wish. That way he wouldn’t be where he was. No closer to finishing, however. The student could sue, Carl thought out loud (litigation was clearly on the kid’s mind) but it would probably take longer than actually putting in the effort to finish his lab work. And he would lose. Not that Carl didn’t make a point of jotting down a scathing email to the idiot supervisor who had let this kid run amok, with copies to whatever thesis committee members had failed to monitor a damned thing. And, with that, it was time for lunch.

As he made a detour to the cafeteria for the usual, horrible, vegetable wrap that was the only thing the staff was allowed to sell him, Carl mapped out a safe route that would steer clear of both Rita’s permanent domains and those she had held momentarily, once her husband had begun his illustrious career as a patient. Whenever he was unlucky enough to wander into the wrong corridor Carl ran a serious risk of being kindly grabbed, fondled, probed, tested, quizzed. After an initial blunder that had left him undiagnosed for years, no doctor in that hospital wanted to have Professor Mendes (it was assumed she had taken his last name, until someone bothered to read his own badge) relapse on their watch. When she had looked at the fateful tests Rita had sadly shaken her head. Not because his case was hopeless (flash forward six years later, QED); but because, as she had put it “this is going to be the most famous tumor in town”. The one that had crept upon probably the third leading expert in Oncology anywhere, nesting straight in her back yard, renowned for, of all things, its cutting-edge early detection techniques. While Rita roamed the world, obliviously trumpeting her latest patented results. Colleagues and rivals were going to have a field day with this, she moaned. As usual, Carl had thought, not wholly without love, even when it was in him, it was about her.

Jared caught him as Carl was prodding through his wrap, sat down uninvited. There were two types of people in the accounting department: the ones carrying out their accounting in a well-calibrated neutral drone, and the few who took every single calculation personally. Jared belonged, unabashedly, to the second group. A former high-level bank employee, the move to health and science had awakened in Jared a new sense of purpose. In short: he cared. That was why Carl went to him first when he was trying to solve a particularly thorny issue in terms of allocating funds; but switched to one of his more boring colleagues to actually implement whatever solution Jared came up with. A proven strategy that didn’t exactly thrill Jared, and the price Carl paid was having his lunch highjacked every once in a while.

Predictably Jared zoomed in on the new Ph.D. program, specifically as to how expenses and potential profits would be divided among the several participating institutions. Jared had explained how it should be set up in terms of accounting minutiae, but wasn’t happy with the exact numbers, thought the Institution they both belonged to was being shortchanged. In a way that was his job, and Carl admired him for it. But he hated wasting energy explaining that the cents lost would be easily recaptured in, if nothing else, prestige and media attention. There were costs in running the program, but also benefits; did Jared think the Administrators would have agreed otherwise? At any rate Carl’s view of their dual-purpose employer that included both the Hospital and Research Institute was much less rosier than Jared’s. He had learned years ago that being a Public/Private enterprise usually meant that the “Private” part was called upon to divide whatever profits had been accrued, while the “Public” side sprang into action whenever Federal and State aid was needed to cover losses. Furthermore, Carl knew both those things could, and did, happen simultaneously. But, unless a masochistic streak was heating up, he avoided such musings around Jared, lest more depressing stories about evil corporate banking and the utter callousness of the “real world” finish ruining his lunch. The wrap was bad enough.

Carl shook Jared off where he usually did, at the coffee line. Jared couldn’t breathe properly without constant caffeine fixes, and Carl couldn’t be seen abusing his in public. On his way to conference room eight Carl tried hard to preview the Internal Review Board meeting, as he did for all of his appointments. As usual he came up blank. This was the killer committee, the one that could make lepers out of its members: the one every project had to come to for approval in terms of what was going to be done to what (or whom), how and when. Or if. The one that had to produce very clear and concise reports, either approving the research, not approving it, or, more frequently, listing pages of recommendations the research team would have to follow before re-submitting its proposal. It all sounded reasonable and precise. Except if Carl remembered who had been drafted into duty.

Bruno, the molecular biologist who could not understand why any permission was needed to do any experiment that would advance knowledge, no matter how controversial. Helen, the lawyer that cringed at any sort of animal experimentation. Chris, a medical doctor who usually sided with Helen not out of a deep love for lab animals, but because she wanted the committee to consider more trials with human patients (the only relevant ones, she claimed, neglecting her many cunningly indirect ties with pharmaceutical companies that sponsored such trials). Steve the publics’ advocate who always really understood twelve sides to any given dilemma. Dan the veterinarian who understood none, but never let pesky details separate him from an argument. And Carl, chairing. Just keeping them in their seats was hard work.

They had a few issues to entertain for the afternoon, to put it mildly. One had to do with the use of viral vectors for gene therapy in rats. Another with the Hospital possibly participating in a drug trial. The last for a new type of radiation therapy in animal models. All seemed benign, except when what exactly they implied was fully understood. The viral vectors were potentially dangerous, had previously caused serious issues at other facilities (issues the research team assured had been fixed, naturally), and project approval would imply a reshuffling of the already crowded high safety areas. Trials already underway for the drug to be tested were only marginally conclusive; and it had been approved to be marketed as a race-specific drug, not exactly a clean-cut issue in town, no matter what stance was decided upon. As for the novel radiation therapy, it was to be tested on a new type of animal model, just acquired when they had bought part of the animal facility from Children’s Hospital across the street. Monkeys. No matter what the rationale, Carl knew nobody but Bruno would ever perceive them as just extremely large and expensive lab rats.

That was, of course, exactly what Bruno did. He also approved the drug trials; race not a charged issue (or even an important one) in his world. Interestingly he was against the viral work, but Carl guessed why. Bruno had stakes in the high safety areas, didn’t want his time cut into. Helen and Chris, as expected, were aboard on the drug trials (though Helen clearly understood the issue was not pill-sized), on the fence for the viral work (the project was well-presented as especially relevant for juvenile genetically-based disorders, and children still trumped rats), adamant about returning the monkeys to Africa (they were actually Indian macaques). Steve and Dan reasoned, again as usual, for and against everything; Steve precise, Dan rambling.

Carl’s own thoughts had cleared during the morning walk. The viral work seemed important enough, but the researchers would have to start with a pilot study, both for safety reasons, and so as not to gum up already crowded areas. Same went for the monkey experiments except, having previously done only mouse work, the team would have to prove its expertise in primates a bit more thoroughly. Finally the drug trials. What was being asked was that they participate in ongoing trials, not take the lead. And Carl actually knew why they were being asked. Ten years earlier the hospital, represented by Carl himself, had overseen the reporting of the first complete animal safety trials for the very same drug, although in those days it wasn’t supposed to be race-specific (unless rats had the same issues as humans). But were the rewards enough for what was sure to be a controversial issue? Carl knew all science was also, in some way, a social construction, but this one was particularly social. His instinct told him to try something he never did. Approve the effort on clinical and scientific grounds (science was also about answering questions no one wanted answered), but kick the final decision upstairs, all the way to Administration Boards and Trustee Meetings. The ones he wasn’t privy to.

The problem was how to float these ideas to the other committee members, allow each to take them up as their own. Although he was always ready and willing to be surprised (one of his great qualities as chair), Carl did not believe in gradual consensus building, unless someone built it beforehand. But in conference room eight he was never sure of anything. Only that after four hours nothing remotely useful would come of any meeting. So, amidst all sorts of protests, he summed up where they were on each issue, and adjourned until the following week. Carl was careful to introduce discussions on all controversial proposals well before an official decision was due. If nothing else, it provided extra time for deliberations. Or to tire everyone out.

Before leaving for home he went back to the office. No real reason, mere habit. His next days would be spent interviewing potential Ph.D. candidates and getting ready for the annual retreat. In turn, that served as the starting point in preparing the annual report. Actually two reports: financial and scientific. Both to be evaluated publicly in the upcoming site visits by funding agencies and external advisory boards. Then there was the minor matter of securing finances to furnish and equip the new research wing. And thinking about what kind of scientists should be hired to occupy it.

Carl’s lab was closed, lightless. A perfect time to visit. Shadows fell on equipment with his name scribbled in fading tags, few clues as to what sort of science went on there. Carl sighed. He would have to at least manage a good spin for the annual report. Making a note to call a meeting with his lab manager and the two technicians, Carl was immediately confronted with the obvious. When could he schedule it? No matter. He would just march in tomorrow morning, when the lights were on and somebody was hopefully working. Just march in. Tomorrow.

Early evening had crept in with the wonderful pungency Carl associated with that time of year. Magnificence brought upon by a handful of blossoming trees in a parking lot, a true miracle. It had been a good day, only Jared to report on the ambush category. And Tamara, now hailing him from her car. But, miracles always coming in pairs, she had urgent babysitter issues to attend to, drove off while still trying to yell something Carl couldn’t quite make out. He would probably read about it when his insomnia reared its ugly head and condemned him to his usual one or two email hours, just after 3 AM.

Tamara’s untimely appearance had veered Carl slightly off his walking route, as he felt a gentlemanly urge to at least pretend to move towards her as she drove away. Perhaps that wasn’t a bad thing. Instead of cutting through campus Carl walked into town, taking the very long way home. He felt hungry for different smells, lights. Seeing people who were not interested (he hoped) in scheduling meetings. His phone beeped every once in a while, dutifully reminding Carl of other appointments, signaling the arrival of urgent messages. But, despite whatever frantic appeals were being made, the neighborhood committee was going to have to convene without him, thank Tamara. Let the Robinsons and Changs duke it out on such fascinating topics as the color of fences or the height of lawns or the style and number of Christmas decorations, or whatever it might be, without his mediation, for a change. Carl felt slightly worse about missing a Cheap Suitors rehearsal, but his folk revivalist band mates had actually called a meeting to organize appearances in the upcoming Summer Festivals, specifically to make sure enough slightly talented musicians would be available for every venue, so that the band sounded uniformly mediocre. Knowing that merry bunch, the Cheap Suitors would inconvenience the scheduling conundrums onto the one member who hadn’t deigned to show up. And Carl couldn’t help but smile as he sipped a guilty mocha in the bargain book section of Barnes & Noble. Had he attended, the end result would have been exactly the same. He walked on, until his phone finally gave up.

On the sidewalks people gathered idly. In front of a storefront, a street act, a bus stop. Gatherings that did not count as a meetings Carl thought, fondly. Passers-by coming together briefly, listening, seeing, smelling, moving on. What did they take away from those brief encounters? Carl couldn’t tell, and was slightly worried that he had thought about this at all. But he knew why these questions kept popping into his mind, especially when distracted. Not that Carl was too interested in the life experiences of a random crowd. Except these crowds he could get answers from. Awkwardly, perhaps; and they would be mostly useless answers. But better than his non-existent exchanges with the real quarry.

Carl never had wanted to know much about his illness. It was not just that he didn’t do disease well; he felt that the effort involved in researching the details and having an opinion wouldn’t be worth the stress of wrestling with all other opinions. With Rita. As his response to drunkenness in outings featuring the Cheap Suitors was utmost sobriety (someone had to settle the bills, match part-time musicians with the right cars), Carl’s answer to imminent demise had been eerie calm: he just wanted to be cured, not think – others could have those meetings without him. So he was patient for the duration. On the outside, at least. On the inside his mind had been in the same turmoil as his body. Wondering, not about drugs and surgery and radiation and survival rates and ranges of side effects that could curse his body with blandness. But on how it was that things like these happen. How cells wrecked havoc on a body that should be the full glorious sum of its parts.

Carl understood how his therapies were supposed to work. Cells too had meetings. Apparently some resulted in profound disagreements. But was there such a thing as a society of cells, and what rules did it follow? Was his whole body an entity, or a mere republic of organs, a confederacy of tissues? And, whatever the answer, how was cancer ever thought of as an appropriate thing for a body to promote, at the very least let happen, without warning?

Anthropocentrism, Carl sighed; cells didn’t follow the neat roles and behavior patterns assigned by entities actually made out of them. Entities too fond of clever, easy metaphors. Even if they did, Carl kept reminding himself that some of his own carefully prepared meetings with very sensible people had yielded stupendously appalling results. Perhaps it was unknowable, or perhaps just a question of complexity, of finding the right tools, computer programs, algorithms. Carl was not a defeatist – as a survivor he felt he wasn’t entitled. He firmly believed questions needed to be asked, hopefully at least half-answered. Just not by him. Carl had no idea how cells made decisions, as he lingered on a street corner.

It was their body. He just thought in it.

The street felt subtly different now, as if a switch had been flipped. Before he had zigzagged to avoid a crowd of mostly lone walkers, struggling to get to somewhere they wouldn’t be alone in. Now the evening sidewalk was filled with pairs, groups, families; people who walked to belong. Carl had entertained yet another forbidden notion: stopping for dinner at one of the taboo places, his former favorite Indian or Ethiopian. But that was when the street had been boiling over with many more like him. A new breed had since taken over, and was signaling all foreigners to leave.

Every day, as he arrived home, Carl remade an endless plan, a retirement of the mind; knowing what it really was, an utopist smokescreen. Something to think of and look forward to while his life was actually happening, one committee at a time. The real question was whether Carl was constantly appointed to these tasks because he was really good at it, and his input and efficiency extremely valued, or if he had fallen into them by default. Unable of doing anything else. Except meet. Without, he thought, actually meeting anybody. While his cells met secretly within.

Collapsing onto the sofa, clutching a dangerously full wine glass and praying to all available gods that Rita didn’t surprise him, Carl wondered how this day had become his day. He used to be indecisive on the topic of his career, his life. Now he wasn’t so sure. But it was late, he was too hungry, soon too woozy, the effort beyond him.

Carl fell asleep silently trying to name a committee that would make sense of it all.

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© 2011 João Ramalho-Santos

For MIR