Acceptable Risk by Robin Cook

“It’s true,” Curt said. “Most of us are sleeping less than six hours a night.”

“There’s one thing that I haven’t started doing,” Edward said. “I’ve not yet contacted the people I know at the FDA. I want to start laying the groundwork to get Ultra at least considered for the expedited track. What we’ll do eventually is try the drug on severe depression as well as AIDS and maybe even terminal cancer patients.”

“Anything that saves time helps,” Stanton said. “I can’t stress that fact enough.”

“I think we get the message,” Edward said.

“Any better idea of Ultra’s mode of action?” Stanton asked.

Edward asked Gloria to tell Stanton what they’d just discovered.

“Just this morning we found low levels of a natural enzyme in the brains of rats that metabolize Ultra,” Gloria said.

“Is that supposed to excite me?” Stanton asked sarcastically.

“It should,” Edward said, “provided you remember anything from the four years you wasted at medical school.”

“It strongly suggests that Ultra could be a natural brain molecule, or at least structurally very close to a natural molecule,” Gloria said. “Additional support for this theory is the stability of the binding of Ultra to neuronal membranes. We’re beginning to think the situation could be somewhat akin to the relationship between morphine-like narcotics and the brain’s own endorphins.”

“In other words,” Edward said, “Ultra is a natural brain autocoid, or internal hormone.”

“But the levels are not the same throughout the brain,” Gloria said. “Our initial PET scans suggests Ultra concentrates in the brain stem, the midbrain, and the limbic system.”

“Ah, the limbic system,” Stanton said. His eyes lit up. “That I remember. That’s the part of the brain associated with the animal inside us and his basic drives: like rage, hunger, and sex. See, Edward, my medical education wasn’t a complete waste.”

“Gloria, tell him how we think it works,” Edward said, ignoring Stanton’s comment.

“We think it buffers the levels of the brain’s neurotransmitiers,” Gloria said. “Something similar to the way a buffer maintains the pH of an acid-base system.”

“In other words,” Edward said, “Ultra, or the natural molecule if it is different than Ultra, functions to stabilize emotion. At least that was its initial function. It was to bring emotion back from extremes created by a disturbing event like seeing a saber-tooth tiger in your cave. Whether the extreme emotion is fear or anger or whatever, Ultra buffers the neurotransmitters, allowing the animal or primitive human being to quickly return to normal to face the next challenge.”

“What do you mean by ‘initial function’?” Stanton asked.

“With our latest work we believe the function has evolved as the human brain has evolved,” Edward said. “Now we believe the function has gone from merely stabilizing emotion to bringing it more into the realm of voluntary control.”

Stanton’s eyes lit up again. “Wait a second,” he said as he struggled to understand. “Are you saying that if a depressed patient were to be given Ultra, all he’d have to do is desire not to be depressed?”

“That’s our current hypothesis,” Edward said. “The natural molecule exists in the brain in minute amounts but plays a major role in modulating emotion and mood.”

“My God!” Stanton said. “Ultra could be the drug of the century!”

“That’s why we’re working nonstop,” Edward said.

“What are you doing now?” Stanton asked.

“We’re doing everything,” Edward said. “We’re studying the molecule from every vantage point possible. Now that we know it binds to a receptor, we want to know the binding protein. We want to know the binding protein’s structure or structures since we suspect Ultra binds with different side chains in different circumstances.”

“When do you think we can start marketing in Europe and Japan?” Stanton asked.

“We’ll have some idea once we start clinical trials,” Edward said. “But that won’t happen until we get the IND from the FDA.”

“We’ve got to speed the process up somehow,” Stanton said. “This is crazy! We’ve got a billion-plus drug and we could go bankrupt.”

“Wait a second,” Edward said suddenly, drawing everyone’s attention. “I just got an idea. I just thought of a way to save some time. I’ll start taking the drug myself.”

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