Obsessed by G. H. Ephron Page B

assign half the patients to treatment, half get a sugar-pill. Even the doctors here won’t know what Uncle Jack is getting.”
    â€œAnd if he gets nothing?”
    I swallowed. “He’ll still be getting other treatment—something for the tremors, something for hallucinations.”
    Shands leaned back in his chair and tented his fingers. “There’s evidence that the treatment increases brain-cell membrane permeability,” he said, talking to his fingertips.
    â€œMeaning what exactly?” Annie asked.
    Couldn’t he just say it in English? I thought I caught the shadow of a smile on Philbrick’s face.
    Shands laced his fingers. “It may slow the progress of the disease, ameliorate the symptoms…perhaps more. Taken early enough, it may even provide a cure,” Shands explained, talking more slowly now. “That’s the hope. Of course, your uncle is already showing clear symptoms of dementia.” Annie flinched at the words. He plowed on. “The trials are designed to help us find out exactly what the treatment effects are.”
    I doubted Shands was making the impression on Annie that he usually made on patients’ family members. “And the drug he’d be taking?” she asked.
    â€œCimvicor,” Shands said. “It’s already FDA-approved for treatment of high cholesterol. Generally well tolerated. We’re administering it at a somewhat higher dosage. Of course, there may be side effects. In some, it can cause adverse reactions.”
    He handed Annie a piece of paper. I read over her shoulder. Though the risk of most of these nightmares was low, the list was daunting. Starting with dyspepsia and ringing of the ears, it moved on to photosensitivity, impaired vision, muscle weakness, and liver dysfunction. Doctors were required to disclose worst-case whenever discussing treatment. But even for me, it was impossible to know what to make of this laundry list of afflictions. Basically it was a big fat CYA, just in case anyone decided to sue.
    â€œWe’d like to put him on the treatment regimen and see how he responds. With permission of course. Then retest him every few weeks,” Shands said.
    â€œMore MRIs?” Annie groaned.
    â€œIt’s important to monitor his progress.”
    â€œIf it was me, I wouldn’t want to come back here. That’s for sure,” Annie said.
    â€œHe’ll probably have forgotten all about it by lunch time,” Shands said complacently.
    It wasn’t the right thing to say. “ I won’t have forgotten,” Annie said, her voice cold.
    Shands recoiled, blinked. “I’m sorry,” he said. For the first time, he seemed to really look at Annie and to take a moment to think before he spoke. “I realize that sometimes I sound insensitive. I don’t mean to. Maybe if I explain.” Now he lowered his voice and spoke as if he and Annie were the only ones in the room. “Medicine has been wonderful in helping people live their full allotment of years, but sadly deficient in attending to the quality of life during those last years. Over four million Americans suffer from dementia. We’re at the edge of a major breakthrough here.” There was a passion in his voice and his eyes were alive. “And while it’s true, your uncle only has a fifty percent chance of getting our new treatment, he has a one hundred percent chance of helping save countless others from this devastation, not to mention saving families from going through what you’re going through now.”
    Annie sat back, mollified. He slid some more papers across the table. “This is just the paperwork we need to start the process. Unfortunately, research entails a lot of bureaucracy.”
    Annie fingered the pages but she wasn’t reading. The shock of the diagnosis. The uncertainties of treatment. I knew what it was like. Shands held out a pen and Annie stared at it.
    â€œShe