Introduction

"Fans of Michael Crichton will love this heart-pounding thriller." --Joseph Finder

In a Washington, D.C. research lab, a brilliant scientist is attacked by his own test subjects. At Columbia University, a talented biochemist is lured out of her apartment and never seen again. In the Justice Department's new Bioethics Committee, agent Les Mahler sees a sinister pattern emerging. . .

Zoe Kincaid is a petite college student whose rare genetic makeup may hold the key to a powerful medical breakthrough. When she is kidnapped, the very thing mankind has wanted since the dawn of time threatens to unleash our final destruction.

"A crackling good read. . .terrific and totally unexpected."--Michael Palmer

"A twisting, suspenseful thriller." --William Landay

Editorial Review

No editorial review at this time.

Excerpt

Zoe Kincaid wrenched the sweaty quilt off her legs and threw it to the floor. Adrenaline ample for a racehorse had been pumping through her since midnight, practically spinning her mind faster than the earth itself. For what felt like the hundredth time, she glanced at the orange numbers on her alarm clock: 7:59 a.m.

Sixty-one minutes.

She wasn’t sure if she was ready.

Her grandfather’s voice sprung to her mind: If there’s a job to be done, just do it. The first step was to get out of bed. Then, endure the next hour until her secret appointment with Dr. Carlyle. Together, at 9:00 a.m., they were going to reckon with the only enemy she feared: her own body. Time was short—though how short, it was impossible to know—and he was her last chance at a real diagnosis.

Light crept through her window like an intruder, dampening the clock’s glow. She winced when the numbers morphed to 8:00 a.m., just as a sledgehammer of high-pitched bells assaulted her ears, insolent in their cheerfulness. She tapped the alarm off. Then silence, except for the city noises seeping in from the street: cars speeding down Broadway, doors slamming, the occasional honk. Morning as usual for everyone else.

She looked around the room that had been her sanctuary for twenty years--at the oak desk where she had spelled her name for the first time; at the pink beanbag chair gathering dust in the corner; at the faded rainbow wallpaper she still loved. How simple it used to be to seek relief from her woes, in a lollipop or a Band-Aid or her mother’s arms. Today, not even the most elaborate fort of her childhood could shelter her from the doctor’s imminent news. With a shiver, she realized that one outcome was certain, no matter what he said: Later this morning, she would be returning home distraught--either vindicated but ill, or healthy but ruined. There was no other option.

Outside her bedroom, footsteps fell softly at first, and then louder, closer. She darted to her door and heard a slow shuffle marked by the regular plunk of a cane. Opening the door a crack, she peeked out to make sure no one else was around and whispered, “Gramps.”

In the hallway, he caught her eye and smiled. She beckoned for him to come in, to hurry. Her heart swelled as he tried to speed up. His arthritic grip on his cane tightened and he sank it into the carpet like an oar, pushing off. Despite the effort, his creased face betrayed no hint of strain. A narrowing of his eyes showed his acceptance of the challenge, offset by a slight grin that told Zoe he took pleasure in conquering it. Once an Olympian, always an Olympian. In 1948, he had broken the world record for running the 400-meter dash in 46.2 seconds. After aging out of the sport, he’d carried that determination into medicine, becoming a renowned physician who had never given up on a single patient for being too sick or not sick enough.

He was the only one who had not given up on her.

When he reached her, she put an arm around his thin waist and ushered him into her room, then closed the door.

“I was just coming to check you on,” he rasped, sinking onto her bed. “Are you all right? You look flushed.”

She shook her head, too tired to feign bravery. “I couldn’t sleep.”

“I’m not surprised.”

Her dainty brow creased. “What if it’s bad?” She looked into his watery blue eyes. “What if I’m dying?”

He shook his head. “Come here, darling.”

“Why could no one ever explain my seizures?” she demanded, standing. “Or why I look like this?”

“You’re small for your age.”

“Stunted,” she corrected. “Thin and short doesn’t even cover it.” They stared at her reflection in the full-length mirror next to her bed. When he spotted the ugly purple bruise inside her elbow, a look of pain crossed his face, but he said nothing. She folded her arms. Gramps was unflinching around anyone’s wounds, except for hers.

Underneath her tank top and shorts—size double zero—was a slight rounding of her hips if she squinted. Besides two mosquito-bite breasts, her torso was a flat slab of skin and bone, her legs stick-like; she couldn’t gain weight, even eating a diet rich in butter, cheese, and whole milk. Yet her cheeks looked cherubic from a persistent layer of baby fat. With her fine blonde hair and freckled sloped nose, she looked on the wrong side of twelve, impossibly far from the woman with high cheekbones and full breasts she had yearned to become for a decade.

“At least you’re proportional,” he pointed out.

“To a ten-year-old boy. Why didn’t the growth hormone do anything? All those shots for nothing.” She turned away from the mirror to look at him.

He frowned. “That was unusual.”

“And why did I have so much trouble at school?” She crossed her bird-like arms.

“That’s a different issue, dear. Adjusting to college can be very trying. You were living away from home for the first time—”

“But what if some virus is killing off my brains?”

He ventured to smile. “You’re going to Northeastern. A very respectable university.”

“Not like it’s Harvard,” she declared, reddening at the thought of the professors who had ripped her apart like hyenas over prey, and with the same enthusiasm. Her flush deepened at the other, worse humiliation she’d suffered there, one too unbearable to relate to anyone, even Gramps. “Plus I only got in because of dad’s legacy. Anyway, that’s over.”

“For now,” he allowed.

“Whatever. The point is, I can feel something is really wrong. I don’t care if mom and dad are ignoring it.” She strained past the lump in her throat. “I just don’t want to die.”

He pulled her into a hug, and despite herself, she slackened against his arms. “I’ll tell you a secret,” he murmured. “Everyone is afraid to die. Every single person. And when it’s your own kid’s life at stake, you’re even more scared. That’s why your parents would rather act like everything is fine.”

“But you agree with me, don’t you? That’s why you haven’t said anything about giving me the blank check?” She didn’t add that the check was ripped up; that despite his generous offer, she couldn’t bring herself to take a penny from his savings, which her late grandmother’s illness had drained.

Silence for a moment, then: “Yes,” he said. “We can’t let them stop us.”

She pulled away from his embrace. “I don’t want to leave you, ever.”

“Death is inevitable, darling.” He looked her in the eye, but the warmth of his gaze did nothing to dull the sting of his words. “Mine before yours, I’m sure. But once you get to be my age, it’s not so tragic. I’ve had a long wonderful life—”

“Stop!” she cried, pressing her temples. “I hate talking about this.”

“It’s reality,” he said, clasping her delicate hands with his knobby ones. “We live, hopefully a nice long time, we get old, and then we die.”

“How are you not scared? I thought you just said everyone was.” Her heart pounded, the way it always did when she was forced to confront the idea of vanishing—poof—for all of eternity.

“I used to be, when I was your age,” he replied. “But eventually I realized there’s nothing you can do to escape it, and by the time it happens, you won’t even know. So the more time you spend thinking about it, the less you spend living.”

She relaxed slightly. He always made her feel safer around her worst fear, like an animal tamer caging a vicious beast.

“Are you afraid of anything?” she asked.

He looked away. The top of his head caught a ray of light and she could see purple veins snaking across his bare scalp. She glanced at the clock, It was already 8:25 a.m.

“That’s a yes,” she said impatiently. “What is it?”

“I’m afraid of lots of things,” he admitted. “I know you don’t want to think of me that way, but you’re old enough now to know your old Gramps isn’t superhuman.”

“Of what most?” she pressed, already conscious of the answer. But she needed to hear it from him, to know she wasn’t a hypochondriac.

“Of anything happening to you,” he said, looking at her. “Will you let me come with you?”

“No, I want to go alone.” It was a lie, but she could detect exhaustion in his face.

Before he could react, there was a hard double knock on the door. As her mother bustled in, Zoe spun around to open her dresser, hiding the bruise in the crook of her arm—evidence of the secret blood tests. Luckily there was no stamp of the MRI or x-ray.

Her mother’s wavy auburn hair fell over her shoulders, framing her smooth face. She was proud to still sometimes get carded, and insisted that Zoe’s youthfulness was a genetic blessing she would one day appreciate. “Dad! What are you two doing in here? I’ve been calling from downstairs. Breakfast is on the table.”

“Thank you, dear. I was just giving Zoe a little pep talk, that’s all.”

“A pep talk?” She hovered in the doorway. “For what?”

“An interview,” Zoe blurted over her shoulder, grabbing a pink collared shirt from the drawer. Then she turned around to face her mother, noticing how her fitted dress emphasized all her perfect curves. “Excuse me,” she said, stepping past her into the walk-in closet and closing the door. After putting on the shirt, black pants and flats—all purchased, to her chagrin, in the kid’s department at Macy’s--she inhaled a shaky breath. Half an hour, she thought. I can wait thirty more minutes.

She walked back out, stretching her lips into a carefree smile. But the characteristic dimple in her cheek, that barometer of sincerity, was missing. Her mother glanced at Gramps and then at her.

“If you’re too sick to stay in school, then why are you looking for a job?”

Zoe shrugged. “To keep me busy. It won’t be too demanding.”

“Who is going to hire a college dropout in this economy?”

Zoe looked at Gramps; from behind her mother’s back, he glanced at her bookshelf.

“A bookstore,” she replied. “A Barnes and Noble downtown. I’ve got to run.” She breezed past her with an air kiss, amazed at her own sangfroid.

Just as she reached the door, her mother’s manicured fingers clamped around her forearm. “A long-sleeved shirt, Zoe? In the middle of this heat wave?”

“It’s formal,” she snapped, wincing as her tight sleeve constricted around the bruise. She yanked her arm away.

“Good luck, darling,” Gramps called after her, though the forced lightness in his tone betrayed his worry. She wondered if her mother noticed.

She looked over her shoulder, compelled by some force within her that cried out not to leave him. His whiskered chin had sunk to his chest, helplessness incarnate.

“Bye,” she whispered, and hurried down the corkscrew wooden stairs. They lived in a rent-controlled duplex that cost the same paltry sum as when her parents had moved in two decades earlier, before the neighborhood became gentrified.

As she rushed toward the front door, a pile of mail on the counter caught her eye. One envelope had a blue circular logo next to the words Chase Bank. It was addressed to her father. Across the top, in bold capital letters, were the words: IMPORTANT—DO NOT DISCARD.

Zoe felt the blood drain from her face. She looked around, slipped the envelope into her purse, and ran out.

For a Monday morning in June, the streets of New York were bustling. Though Zoe had lived on the Upper West Side all her life, she had only recently begun to appreciate how Manhattan invigorated her. After living on the Northeastern campus for those eight stifling months, trapped in a slow-moving sea of popped collars and red sweatshirts, the caffeinated pulse of Manhattan made her eyes open wider and her heart beat faster.

Dr. Ray Carlyle, the city’s foremost medical geneticist, was located across Central Park on Fifth Avenue and Sixty-Eighth Street. She could make it there on foot if she scrambled.

Finding Dr. Carlyle had felt to Zoe like meeting the Wizard of Oz at the end of a yellow brick road paved by a sadist. The first brick was laid five years ago, when at age 14, she still had not gotten her period like all of her friends, nor sprouted breasts or grown an inch. When a prescription growth hormone failed to effect any change, her endocrinologist wrote off her condition as “idiopathic”—one with no known cause—and told her she might never bear children.

But the longer the status quo persisted, the more left behind she felt, especially when her high school peers began to revel in their nascent sexuality. The extent of Zoe’s own experimentation was listening to their gossip. Some of her friends even fell in love, and that was what hurt the most. More than breasts or height, she longed for movie-ending, Imax-sized love. She wasn’t sure where sex fit into her fantasy, though. She was ashamed to admit that she found it more embarrassing than erotic—all those bodily fluids and weird noises her friends spoke of with self-conscious laughter. Not that she had to worry. Guys only stared at her blankly, if at all.

During her lonely adolescence, Gramps had been a lighthouse of optimism. He told her the stories of his Olympic failures before winning the gold, and of his relentless courtship of her late grandmother, before he finally won her over, too. That he existed, that a man so tender and debonair could exist, powered her through those aching years.

Then one day near the end of high school, the road unexpectedly twisted. She suffered a seizure, and more than one top neurologist couldn’t pinpoint a cause. The seizures got out of control, until after months of trial and error, a rare combination of antiepileptic medications silenced them. As life settled into an uneasy routine until high school graduation, she tried to ignore the mysteries of her body as easily as everyone else did.

When the fall rolled around, she hadn’t felt ready to leave Gramps or her parents, and at the last minute deferred college for a year. She couldn’t really explain her attachment to home, when all her friends were desperate to move up and on. She just knew she strongly preferred to stay put, where she was comfortable and accepted. But once she finally started at Northeastern, with hundreds of new faces staring at her in dismay, she began to focus on her otherness once more.

On her first day in the dorm, her roommate asked what would become a common question around campus: “What are you, like, twelve? Some kid prodigy?”

It was almost easier to act the impostor than to explain the unexplainable.

With the same refrain constantly circling her, soon she found it was all she could focus on, even as her grades slipped. College had not just magnified her underlying sense of defectiveness, but lit it on fire. Then, two months ago, it burned her alive. All semester, she’d been working up the nerve to talk to her crush, a popular sophomore who played first violin in the school orchestra. Figuring they shared a love of music, she approached him at a frat party to ask him to a concert, the Boston Symphony Orchestra.

He took one look at her and raised an eyebrow. “Aren’t you a bit young for me?”

A brunette standing next to him smirked. “Maybe her babysitter’s off.”

Their drunken friends cracked up. The joke spread, innocuous teasing for everyone else, but a torch of humiliation for her. The following weekend, she showed up at her parents’ brownstone with two suitcases . They had no choice but to accept her decision to drop out, however disappointing.

At home with time to spare, her uneasiness morphed into an obsession, and then a quest, unceremoniously launched late one night in her bedroom with the Google search: “Undiagnosed Disease Help.”

That was how she found Dr. Carlyle, a legendary diagnostician in genetic disorders. He was a consultant to the National Institutes of Health’s Undiagnosed Diseases program, an arm of the federal government that aimed to tackle the cold cases of medicine, with a limited acceptance rate of 50 people per year. Though it seemed impossible to gain entry into such an exclusive program, Dr. Carlyle himself was right in New York City, with a private practice that accepted new patients. When Gramps corroborated his famed status, her excitement was propelled to stratospheric heights.

If there was anyone on Earth who could diagnose the mysterious, disparate problems she could only term her condition, Zoe felt certain that it would be him. But her parents hadn’t been quite as thrilled. Years ago, they had encouraged her to see plenty of specialists, then become wary after many futile visits; then accepting of the repeated diagnosis “idiopathic”; and finally, adamant that she accept it, too.

“Accept the things you cannot change,” her mother quoted from the Serenity Prayer with the regularity of rain.

And have the wisdom to know the difference, she always thought in response. But her father was convinced that her obsession with her health had become neurotic.

“Enough,” he had commanded. “You’re a perfectly capable young woman, and you’re just using these symptoms as an evasion.”

“That’s not—”

But he held up a hand.

“As a condition of living at home until you sort this out, you’re going to a therapist, but no more doctors.”

It was 8:49 a.m. Zoe cringed as she hurried through Central Park, recalling the memory of her father’s piercing eyes, his shame at her for being a college dropout. A warm summer rain pelted the grass under her feet, turning the dirt soggy. She squished across the lawn, not caring as the soil muddied her pants and slid between her toes. The only thing that mattered was Dr. Carlyle’s diagnosis. After that—

Time ceased. Her whole life, every desolate and bewildering moment, was compressing down to this one hour, this 9 a.m. appointment. The magnitude of it flattened her focus to a point, and beyond that, the future skewed like light through a prism, breaking off into infinite directions.

But one thing was real, regardless of how the morning’s events would play out: inside her purse was the envelope that could ruin her. Inside was her parents’ credit card bill--a sum total of over $10,000 for her recent full body x-ray, MRI, tissue analysis, and genetic screening. Their family’s Scrooge-like health insurance plan had denied coverage for the tests after she had already gotten them, so she had no choice but to charge the card. Would she face her parents with remorseful trepidation or calm conviction when they opened the bill?

She let out a nervous breath as she stepped from the mushy lawn to the wet concrete of the sidewalk. As Dr. Carlyle’s nondescript office building came into view, she worried for the first time if she could have been wrong about her own motives. What if, as her parents believed, she was using her health obsession to conceal some more profound psychological distress?

No. She shook her head defiantly, whipping her wet blonde hair against her cheek. The rain was pounding the ground with increasing intensity, and passersby scrambled under the awnings of the nearest buildings. Already drenched, she stopped and turned her face to the sky. The warm drops felt like tears that wouldn’t come -- tears for herself, for her parents, and for the river of betrayal that separated them.

Since stealing the credit card, her first morally questionable act, her idea of growing up had taken on a new meaning--not the reckless fun of unsupervised independence, but quite the opposite -- a crushing responsibility for every choice she would ever make. Was this what it really meant to get older?

Every step in her soaked pants felt leaden as she crossed the final block to Dr. Carlyle’s clinic, to answers. She squinted at the slick asphalt of Fifth Avenue, which glowed red in the taillights of passing cars. Maybe she was searching for a neatness that didn’t exist, but she was counting on one explanation to tie everything together, from her size, to her seizures, to her inability to fit in. There can be a simple answer to a complicated problem, she reassured herself. Newton proved that three times over.

As she walked up to the clinic’s door, the sound of the rain drowned out the world, leaving her worst fear the loudest noise. What if there is a simple answer—but it’s a death sentence? The door stood inches away, grey as the sky. A gold plaque next to it read: Dr. Ray Carlyle, M.D.

She froze. This is happening, she thought.

It wasn’t too late to turn back, go home and admit her mistake, and work tirelessly to pay back every penny. She could return to Harvard next semester and get on with her life, without ever learning the results of the tests. Ignorance, bliss. Throw in some drinking and drugs to dull her unease, and she might almost feel like everyone else. It would be so much easier than hearing Dr. Carlyle speak words like “survival rate” or “terminal.”

Her head throbbed at the base of her skull as she considered which choice would be the true evasion. She looked back at the road, at the cars splashing by, and beyond the trees, at the glistening path home.

A vibration near her elbow startled her: the appointment reminder on her cell phone. It was 9:00 a.m.

If there’s a job to be done, just do it.

She pushed open the door and walked inside. view abbreviated excerpt only...

Discussion Questions

1) Do you feel it would be a blessing or a curse not to age (or both)?

2) Do you think that a drug that could stop aging would be a boon or a danger for individuals? What about for society at large?

3) If you had a choice about whether to accept a dose of a drug that could freeze your biological age exactly where it is, would you take it? Why or why not?

4) Do you believe, like a certain character in the book, that death is a natural and desirable end that humans should not try to postpone or avoid?

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