Informed consent (M/L ADULT) [COMPLETE]

Finished stories set in an alternate universe to that introduced in the show, or which alter events from the show significantly, but which include the Roswell characters. Aliens play a role in these fics. All complete stories on the main AU with Aliens board will eventually be moved here.

Moderators: Anniepoo98, Rowedog, ISLANDGIRL5, Itzstacie, truelovepooh, FSU/MSW-94, Hunter, Island Breeze, Forum Moderators

Locked
User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 2/15/2009

Post by greywolf » Mon Feb 16, 2009 3:38 pm

  • It had been two awareness-periods since she’d dreamed about Max and Izzy and – even though she knew they were figments of her imagination – she still hoped they’d walk in to this dream. About all the abyss was good for, Liz decided, was a quiet place for undisturbed introspection, and she’d had way too much of that. She was certainly better since she’d started dreaming of the two – she now at least had something to look forward to. It hadn’t been just the boredom, it had been the crushing loneliness. Even make-believe friends are better than emptiness – no doubt why little children tended to make up imaginary friends when they were in that period when they were more than babies but not yet really social animals. The brain needed stimulation – perhaps even a brain in a coma.

    She had come to accept that she was in a coma – it did make sense after all. At first – when she’d been all alone – she’d thought the abyss was hell. It seemed like years ago the first time she’d awakened to find herself in the abyss – could it really only be three or four months like Izzy and Max had told her? Had the moon orbited the Earth only four times while she’d been like this? It had seemed like an eternity before she started dreaming of Max and Izzy. Perhaps it was true – perhaps her subconscious mind was tapped in to some biological clock – counting her periods or something to keep track of the days. To her conscious mind the loneliness of the abyss had seemed an eternity.

    She looked out at the emptiness – it was getting smaller. That seemed a non sequitur – that an emptiness could get smaller – but somehow it was true. The abyss itself appeared endless – she could walk forever and experience nothing but inky blackness that seemed to retreat as she approached it – but the area in the center that surrounded her – the area that seemed real – moved with her, and that area was clearly shrinking. The first time she’d awakened to find herself here it had been wider – perhaps 25 paces in radius. Today it was scarcely 15. She wondered what would happen when she could no longer generate that bubble of awareness. Was that it? Was that the end of her sixteen plus years of life? Was that all that fate or God or the cosmos or whoever controlled such things had allotted Liz Parker? When her brain could no longer maintain that circle of awareness – was it all over? Somehow she knew that it would be.

    “God, where are they?” she asked aloud, hoping to feel them out in the abyss. She could feel them somehow, even before she could see them. Like the small child with an imaginary friend, she knew she needed them – somehow their presence helped her keep the darkness at bay – real or not. Of course she knew they weren’t real, but couldn’t stop herself from wishing they were – especially wishing Max was real. Introspection could be a bitch, and there was nothing worse than standing alone in an abyss, second-guessing your entire life. “But it’s more than just second guessing,” she told herself aloud – or was it aloud? Probably not – but she could dream she was saying it. “Admit it Liz, at least admit to yourself how badly you fouled up. Life never gives guarantees – even that you will live to see tomorrow. You did this to yourself – not the accident – that just happened – but the regrets.”

    She’d had time in the abyss to regret a lot of things but the thing she regretted most was Max – the real Max. Just once – back in middle school – she’d actually been tempted to do something to try to get past whatever caused his shyness. She had actually gone so far as to tell Maria that they ought to go ask the boys for a dance. She might have actually even done it if Maria had gone along….

    ‘No, don’t blame Maria,’ she thought to herself, ‘ … you certainly had other chances.’

    And she had. She’d seen the surreptitious glances – saw the longing in his eyes in his reflected in the laboratory glassware when he didn’t think she was watching him. It would have probably only taken a short conversation – an admission that she was as interested as he was – but it had never happened. The ‘Perfect Miss Parker’ was no more going to tell a boy that she was interested in him than …. Well, than the REAL Isabel Evans was going to fall in love with a nice guy who wasn’t one of the pretty people – someone like Alex.

    No, she had a lot of regrets in her life, not the least of which was that she’d never made that first step to reach out toward Max – to be something more than just a friend and lab partner. It might not have worked out – she had more than a small suspicion that was why she’d never done it – but at least she would know. Better to know disappointment than an eternity of regret.


    That was, she had little doubt, why the dreams of Max and his sister haunted her abyss. Even the story they told – being aliens – was no doubt her subconscious mind’s rationale for justifying why Max never took that first step. It was a stupid rationale – but she had none at all – just misplaced pride that said he had to make the first step. How things had changed. Now she looked forward to just dreaming about him, and even in the dream driving him away by telling him she knew he wasn’t real. But somehow, the dreams of Max and Izzy were as real as it was going to get.

    She made the decision finally – she’d treat them better – yes, they were only dreams, but they were also her only company. She’d held Max at arm’s length since third grade and what had it gotten her? She might as well enjoy the dream at least. It appeared to be a close to happiness as she was ever going to get.

    She felt them even before she saw or heard them – turning to face the part of the abyss that they were coming from.

    “Hi,” she said, “…glad to see you. It was getting sort of lonesome. What’s going on … back in the world?”

    “So you finally believe…?” started Izzy.

    “Not really I guess, but the two of you are the only act in town. I may as well be part of the play too. So what’s been going on?”

    “Max went to the podchamber…”

    “Izzy spent half the night dancing the night away with Alex. That’s why we’re late.”

    “Max, I apologized for that. It was just that – after the dance he took me to the Crashdown to share a Martian Blast Sunday – he was walking me home and we went by Jackson Street Park. We sat on the swing set like grade-schoolers and looked up at the sky – the night was so clear, and Alex knows all the constellations.”

    “That would be because I taught them to him. He needed to learn them for a science project in fifth grade,” said Liz.

    “Well, you did a fine job of teaching him,” said a smiling Izzy.



    It was some time later – Liz wasn’t sure just how much time, that was always difficult to determine in the abyss. They had started talking about what Max had found – she’d mentioned that the whole stasis chamber thing sort of made sense. She’d read a Scientific American magazine back in ninth grade that had talked about traversable wormholes.

    “Yeah,” Liz said, “…one of the possible things that would be a problem, according to that article, is the tidal forces. They wouldn’t be infinite – like dropping in to a black hole – but they might be high and any movement – like the heart pumping blood through a body – would really accentuate them. Chances are if you weren’t in something like a stasis field during a wormhole transition, it would tear your body apart, at least in a Schwartzchild wormhole.”

    It was, Liz told herself, only an academic discussion among friends. They had all sat on the ground to talk – starting out facing one another. She wasn’t entirely sure how she had wound up with her back against Max’s chest, both seated, but her sort of spooning against him. She wasn’t altogether sure when his arms had crept around her waist – or when she’d become aware of the warmth of his chest against her back. Somehow, it had just happened. But she wasn’t complaining. She knew it was only a dream – but she’d had a lot worse dreams than this one.

    Izzy looked at her brother and Liz – the two obviously enjoying the moment. Had the circumstances been different – and had Liz not been able to hear – she’d have probably teased her brother. ‘Get a room,’ she’d have said, and Max would have curled up and died in embarrassment. But circumstances weren’t different, and they were doing no more – and not much less – than she and Alex had done at the park.

    Besides, she wanted a favor from Liz, and if she slept in while Max got up at his normal time, she just might catch Liz in an early morning REM sleep. She needed to talk to her, girl-to-girl. She needed some advice, and Liz was the only one who really knew enough about the subject to have an informed opinion.

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 2/16/2009

Post by greywolf » Fri Feb 27, 2009 1:16 pm

As she felt the abyss reform around her Liz again felt the loneliness and emptiness. She was pretty sure that she would have no ‘visitors’ this time in the abyss – so far her subconscious seemed to send her the dreams of Izzy and Max only about every third time she managed to awake in the abyss, and since they’d been there last time, she figured this would be another time of loneliness, ugly introspection, and regrets – but she was wrong. The previous visit had left her with a curious sense of fulfillment – like she’d finally done something right. The memory of sitting there with her back against Max – with his arm around her waist … OK, so it WAS just a dream, but even its memory was pleasant.

She felt the presence before she saw it and was surprised to see Izzy stride out of the mists. Her face seemed so nervous and uncertain that despite knowing this was just a dream, the words left her mouth without conscious thought.

“Izzy, what’s wrong?”

“I needed to talk to you without my brother giving me a bad time about it, you know how brother’s are – well, I guess you don’t. Trust me, the teasing can be unceasing – especially with a topic like this.”

“A topic like – what?”

“Well, it’s about me and – Alex.”

OK so this was Izzy and not the real Isabel, Liz knew that. Even so, the goofy grin the girl had and the look in her eyes when she said his name almost made Liz giggle. “What about you and Alex?”

Izzy gave a deep sigh. “That’s just the point, what about me and Alex – I think I love him – maybe I have for years.”

“But you’ve only had one date.”

“Three-quarters of a date technically, but that’s in the real world. I’ve been sort of virtual-dating him for awhile – since middle school, actually.”

“Virtual-dating?”

“Yeah, like this, in his dreams – except of course his dreams are a whole lot more – normal.” She looked at Liz and winced, “Sorry – that didn’t come out just right. When I dreamwalk people who aren’t in comas their dreams are – well, like your dreams before the accident. But I can walk in to them and participate – or just observe – or if they are a dream about me, I can sort of ooze in to my dream-image and … participate.”

“What do you mean – participate – when it comes to Alex?”

Izzy’s face brightened at the sound of his name. “Well, mostly we just danced.”

“Danced?”

“Yeah, danced. It’s a long story. I started dreamwalking shortly after mom and dad adopted us – first with them – then with other people – classmates in school. I think it was sort of instinctive – a way to tell if they were a threat.”

“Sounds kind of paranoid….”

“Yeah I know. Max says our alien DNA must have come from a real rough neighborhood. That’s why he can heal people – at least if they are conscious enough that he can make a connection. I can too – a little bit, just like he can dreamwalk a little bit. Anyway, I started dreamwalking guys in our class in middle school. It isn't anything I wuld recommend to anyone who doesn't have a strong stomach though."

"What do you mean?"

"Middle school boys are the most hormone-driven animals you will ever see - no, fortunately for you you will never see them. If you remember I was...uh developing then," said Lizzy, waving her right hand in the vicinity of her upper torso."

"Yeah, you were about six months ahead of most of us..."

"Which every boy in class seemed to notice. You wouldn't believe the fantasies that some had in their dream-orb about girls in general and me in particular. The ....disgusting ... things some of them dreamed about ... well ... forcing us to do - even in their dreams they knew we wouldn't do it willingly, convinced that at sometime in the disgusting abuse we were going to become so enraptured in their ... prowess ... that we would become their love-slaves. Usually I'd take one look and leave and I never - ever - was even remotely interested in - participating. At least until I dreamwalked Alex. Alex was always a gentlemen, and his dreams were always consistent. He would be dancing with Isabel Evans - that was it - just dancing. Eventually I oozed into his dreams and danced with him. You may not believe this, Liz, but since that time, dancing with Alex has been the best thing in my life. At first it was just that he was so different from the hormone-driven immature guys in our class, but after awhile ...," Izzy's eyes rolled skyward and she blushed, "...I told myself that if he ever DID dream about me - that way - I'd participate anyway. " Izzy blushed again as she saw Liz smile at her. "Well honestly, Liz, it wasn't like I expected to ever have that experience for real - being an alien and all - and it was just a dream anyway."

"Well, I take it it finally happened?"

"No. Eventually I kind of came to the conclusion that Alex maybe wasn't interested in - girls. But I told myself that was OK, you know - he was still my friend, and I loved to dance with him. I told myself it was alright and I thought it was until - last night."

"Last night? What happened last night?"

"I came into the dream- orb and saw myself strapped onto this table - almost naked - my legs spread - groaning in pain Alex standing next to me...."

"Omigawd, Alex was assaulting you?"

"Hardly."

"You were having sex?"

"That would have occurred about nine months previously. I was having ... twins. Alex's twins. We were both wearing wedding rings - he was hovering over me so attentive and so loving and - I have to admit, I chickened out and didn't ooze into the dream until the second one was delivered, but then the nurse handed me the babies and I held them with Alex - I looked in to his eyes and God Liz - it was so wonderful how he looked back. I don't think he could ever believe until I really started dating him that we could ever really be more than friends who danced. he's loved me all along - just didn't think it could ever be ... and I love him so much, Liz."

"Well that's wonderful, Izzy. Why are you upset."

"Because he wants me to bear his children, Liz .... and I don't know if I can. I don't know how ... different ... we are. That's why I had to ask you - is it fair to him to let him think that may happen when it might not?"

"Izzy, I don't know. Maybe you should ask your mother. I mean she must have gone through it with your dad."

"Mom would be the LAST one I'd ask, Liz. I mean ... Max and I never even told her that we weren't from around here, and do you think that I want to remind her that she couldn't give daddy children? That they had to settle for a couple of weird kids like Max and me?"

"You should tell her - it wouldn't make any difference, and you aren't weird - just a little different."

"I don't know, but even if it didn't make a difference to mom, how could I tell Alex that maybe he'll never have that dream?"

"You just tell him, Izzy. If he cares as much about you as you say, it won't matter. Even if you were both completely human, you might not be able to have children - 10% of couples can't, there aren't any guarantees for anyone. Besides, you MIGHT be able to have children. I suppose there's really only one way to find out."

"But that's just is, Liz, I DO know Alex now. He won't let that stop him and .... what if I can't have his children? Is that fair to him? I mean, Alex wouldn't back out once we were married - he just wouldn't. He'll be trapped. Would you want that if you were him- I mean we could have sex - that would work - but no kids?"

Liz thought only briefly - picturing herself briefly as the wife of a Max Evans who really was 'not from around here.' Would she want that - even if they could never have children together? "Izzy - trust me - if the person I loved were an alien - it really would make no difference at all. I'd marry him - and we'd just take our chances about the kids."

Izzy looked at Liz and noticed the coloring of her cheeks. "Why am I telling my secret sex fantasies, and you are the one who is blushing?"

"Shuttup, Izzy, OK? I can't even work up a good fantasy in here, and you've got the opportunity to have the real thing. The least you can do is let me imagine Max, a little bit here," she said with a laugh.

Izzy reached out and hugged liz. "You have no idea how badly I wish you could be my sister-in-law, Liz. I wish that for me, almost as much as I wish that for the two of you."
Last edited by greywolf on Fri Feb 27, 2009 6:43 pm, edited 1 time in total.

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 2/27/2009

Post by greywolf » Mon Mar 02, 2009 10:03 am

The smile on Isabel's face was a real one as she looked at her brother and his about to be bride. Nothing could really destroy the happiness she saw in both of their eyes - not the hopelessness of the situation Liz appeared to be in - not the fragility of Liz's dream-orb which was still slowly shrinking, despite their best efforts to keep Liz company and keep the dream of this abyss intact. As long as Liz was alive there was always hope. Max had been working in the pod-chamber on those damn stasis machines for months without the sort of breakthrough that was needed in finding whatever sort of power they required. Not even the fact that she was reasonably sure her new about-to-be sister-in-law didn't believe that this was real - none of that could subdue the joy that Isabel felt as she saw the sparkles in the eyes of her friend and her brother as they stood there together. No. the love they had come to share was all that Izzy wanted to think about right now. Besides - they needed this - both of them. They needed this moment of happiness to restore them to the sort of people they once were, and as she saw them look at each other with loving smiles, she knew that this ceremony was very real to both of them right now.

"In as much as you have both exchanged vows of love and fidelity, pledged your troth to one another for all eternity - forsaking all others, and have both indicated your desire to become man and wife, by the powers granted me by - uh -the owner of this realm," said Izzy, nodding at Liz who certainly did own this dream-orb - at least what there was of it, "I now pronounce you Elizabeth, and you Max, husband and wife." Before she could tell Max he could kiss the bride, that particular verse was already overtaken by events. She waited until the two came up for air, and then hugged her brother and her sister-in-law, the tears already rolling down her cheeks. "That was so beautiful. I wish mom and dad - and your folks too Liz - had been here to see it."
  • Three months earlier

    Doctor Taylor wasn't really irritated at the Parkers. In fact, she was very sympathetic. This happened all the time with the loved ones of people who had serious long-term problems. There was a real risk that they would become the victims, emotionally if not financially, of every quack or person with a personal cause out there. It was part of the desperation of such people that they wanted to believe so badly they lost a part of their normal skepticism about such things.

    "But you admit that it's not impossible..." said Jeff Parker.

    "In science we want to believe that nothing is impossible, although it's virtually IMPOSSIBLE to prove a negative, now that you mention it..."

    "But the person on TV said..."

    Doctor Emily Taylor held up her hand. Mr. Parker ... Mrs. Parker ... let me explain, OK?"

    The two looked at each other worriedly - Emily didn't blame either of them - there had been no real improvement in Liz's condition and even the REM sleep she had was getting fractionally less - but this was just upsetting them further and doing their daughter no good whatsoever. Finally the two seemed to come to some sort of mental agreement and sat back in her office chairs and nodded their approval.

    "First of all, I want you to understand, I'm a doctor and female. Like most doctors, I've certainly seen things in my training - ugly situations involving rape, incest, deformed fetuses .... pregnancies that were truly a threat to the mother - not just her changing her mind or deciding to do something after the fact that she was too lazy to prevent. And as a female I largely support the right of a woman - within certain limitations - to control what goes on in her own body."

    "What has THAT to do with embryonic stem cells in medicine?" asked a frustrated Jeff Parker.

    "Well, everything and nothing," said an equally frustrated Emily Taylor. "The whole embryonic stem cell issue is largely a red herring Mr. Parker. Somehow it has become a battleground in the culture war over abortion in this country - and it shouldn't be. Liz doesn't need any embryonic stem cells. She has stem cells of her own in her body - we do stem cell transplants all the time in medicine. We can even take somatic cells - adult cells from the body, and convert them back to stem cells if we want to.. That's how they made 'Dolly' that cloned sheep."

    "But on the program that actor said they could cure Parkinson's disease - other neurological illnesses."

    "And I'm sure he believes it - at least, he wants very much to believe it - but the truth is he is just being used. Like I said, Liz has her own stem cells. If there was something wrong with them - if they'd been replaced by leukemia or lymphoma cells - if they'd been destroyed by radiation or chemical poisons, she could benefit from stem cells. Best would still be her own stem cells. Some people now are saving the umbilical cord blood of their newborn children - it's rich in stem cells, and they are the same cells as the baby's own body - sometimes there is an identical twin - sometimes we use closely HLA matched donors. The closer the match, the better if we can't use the patient's own stem cells, but in Liz's case, the problem isn't a lack of stem cells, so giving her stem cells - embryonic or otherwise, isn't the answer."

    "But if embryonic stem cells made that - what do you call it? Reticular Activating System - in the first place. Why couldn't they do it again?"

    "It wasn't just that they were embryonic, Mr. Parker, it's that they were in an embryo - part of a whole organism. We could at least in theory do with Liz like they did with Dolly the sheep - we could clone her. People have actually done that with their pet dogs. But even if we could do that, it wouldn't be Liz - the body would be the same, but there would be no memory - nothing but a blank slate."

    "But why couldn't the stem cells just bridge the area that is damaged?"

    "Because Liz isn't an embryo, Mr. Parker. Developmental biology isn't my specialty, but I know enough about it to at least give you an explanation. As the brain of the embryo develops, certain genes are activated in a certain sequence. Certain tissue is attracted to other tissue - certain transmitter substances are released - it's all a highly choreographed sort of procedure. Just tossing some stem cells in there - from whatever source - won't make that happen. Nerve tissue is some of the most specialized tissue in the body and has trouble regenerating, but it's not just that - if you transect a nerve it often has trouble getting back to the right place. If you cut a peripheral nerve - like in your arm, the surgeon will go back in and do microsurgery to sew the myelin sheath - the sort of insulation around the nerve - back into shape. If that's successful the nerve can slowly grow back maybe an inch a month, but even then there is no guarantee that the cut off end of the nerve fiber will find the right pathway. Inside the brain it is far more complicated than that, and we can't do microsurgery in the area of Liz's traumatic injury - it would kill her."

    "Then how will she EVER get any better," asked a tearful Nancy Parker, venting her fears and frustrations.

    "The situation with your daughter is like this, Mrs. Parker,” said Doctor Taylor, picking up a writing pad from the desk and making a quick drawing on it.
    "Nerve cells are very specialized – long and thin – with branches called dendrites that carry electrical impulses. This drawing really doesn’t do justice to the scale – the microscopic nerve cells that run your legs have their nucleus in your spinal cord, but the dendrites go all the way out to your toes. The ones in the brain aren’t quite that stretched out but because the nucleus is still so far from the dendrites and because the cells are so very specialized, when damage occurs it is very difficult for the nucleus to repair itself out on that long stalk. What happened to your daughter’s nerve cells in the brain was a combination of things – transverse axonal shear – direct impact and contusion – damage from the secondary swelling – even damage from the degradation products of cells that were killed outright in the accident. That left a few cells still functional – or she wouldn’t be here at all – some cells permanently destroyed – and the rest impaired. These impaired cells have damage to the dendrite and the myelin sheath that surrounds it at the molecular level – these things are mostly just a two molecule thick lipid membrane. If we had the ability to manipulate these molecules without disrupting the rest of your daughter’s brain to do it, we could restore these damaged areas to normal function. We don’t have that though. What we are doing is supporting her – letting her own healing processes work. Some of these she may be able to repair – others will eventually die of the damage they sustained. If she is able to repair enough of these cells, she may be able to regain consciousness – perhaps even have a fulfilling life. If not ……,” the doctor left the alternative unsaid. “I know there are a lot of people out there with there various causes, but fixing what is not broken won’t help – and like I said, if we could direct stem cells to replace these dead and damaged ones – like the embryo does – we wouldn’t use donor stem cells of any kind, we’d use Liz’s own stem cells. Unfortunately, that just isn’t possible. I’m not sure it ever will be, that’s a trememdously complex process with all sorts of feedback loops.”

    “Well what CAN we do?”

    “Well, since you asked – I don’t want to get your hopes up, but I’ve been in contact with a researcher in Chicago. He is doing clinical research on something called neurotrophins and in particular, something called brain-derived neurotrophic factor"






Last edited by greywolf on Mon Mar 02, 2009 11:04 pm, edited 1 time in total.

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 3/2/2009

Post by greywolf » Wed Mar 04, 2009 10:51 am

  • Ten weeks earlier

    Typically Liz would have to wait for at least a short period for her imagination to make Max and Isabel appear in the abyss, although once that happened they would generally stay with her until she could no longer keep the abyss stable – but not this time. She’d been in the abyss – she wasn’t altogether sure how long, but long enough to come to a decision – before they’d appeared. It had only been a few minutes at most – but it had been starting to get real interesting – when they had both dissolved out of the abyss leaving her there alone. Liz figured that she knew why that had happened. She was sure of it when Izzy reappeared in the abyss without Max.

    “So you get to play the Jiminy Cricket role Izzy?”

    “What do you mean?” asked Izzy, still somewhat bewildered by what had transpired.

    “You know – the voice of my conscience – like in Pinocchio.”

    “I’m not a prude, Liz. In fact, I’d always considered the ‘perfect Miss Parker’ to be somewhat of a prude herself – at least until two minutes ago. Do you want to explain to me just what is going on?”

    “Going on?” asked Liz, blushing in spite of herself.

    “Look, I thought it was sweet when we arrived for you to give Max a tender kiss – but pretty soon I was waiting for the break – wondering if either of you were going to be able to hold your breath much longer. Then I got the distinct impression that – tongue was involved. I mean, I’m glad you were happy to see Max, he’s missed you too, but – what’s going on, Liz? ”

    Liz waved her hand at the abyss. "It's this," she said, "... the darkness. It seems like I've been in here an eternity but I can still remember how it was at first. It was bigger then - at least the part I can see. I can still wander in it - probably forever - but the circle of vision I have in it - the part that seems real and not just a black fog - that's smaller. It has been getting smaller all along."

    Izzy nodded her head. It had been the elephant in the room for some time, and no one had addressed it. She and Max had talked to each other about discussing it with Liz and neither could bring themselves to do it. She wished now that they had. "Your dream-orb was never really normal since the accident. It has been getting smaller - not very much on the days we visit you but - well it corresponds to the REM sleep on your EEG according to Max. Your body has found it increasingly difficult to maintain even a level of consciousness that allows you to dream."

    "I think I knew that intuitively," said a somber faced Liz. "Well, before the two of you showed up, I got to thinking it over. I don't think I'm going to make it out of the coma - don't think I will ever get back to the real world. All those years of being 'the perfect Miss Parker,' preparing myself for the future - only to find out I won't have one. The prudishness too - you know I barely got to first base with anyone? I decided that - well, what I never allowed myself to do in the real world I at least was entitled to do in my dreams - especially since I won't have them all that much longer."

    "Oh God, Liz.... Don't say that. Especially don't say that around my brother. It would just crush him, Liz. He's working so hard - trying to find technology in the pod chamber that would let us keep you safe until there is a way to bring you back - and when he's not doing that, he's looking up stuff for my mom. Your doctor found a clinical research facility in Chicago that may be able to help and your insurance company is flying out a doctor and a lawyer to talk it over with your parents. Mom's going to be there to represent them and Max will be sort of her technical adviser."

    "If you say so, Izzy,” said Liz, not really believing a word of it. All this was, she was sure, was an internal debate with her own conscience, “But even if that's true, I don't see why you'd object to me - uh - getting closer to Max. When I think of the time I wasted when I HAD time..."

    "Look Liz, I know you don't believe in this and - well I like you Liz, I really really do like you, but - I love my brother, Liz. You think this is all a dream and to you I guess it really is - but to Max, Liz." Izzy sighed deeply. "He's loved you since the third grade, Liz. And I'm pretty sure he's lusted after you since puberty." Izzy flickered out of the abyss and returned almost immediately. "My brother isn't even asleep now," she said, trying not to giggle. "I bet that he's taking a cold shower - which won't be TOO suspicious to my folks - it's only about 1AM. The point is that what you do has real consequences in the real world, Liz. Maybe you think you are going to die anyway and so why not have a fling, but Max - Max'll take it seriously. He's loved you all this time without expecting that you would ever really be a couple - if you deepen that relationship and then when you do wake up - do have to confront the reality that you don't now believe you'll wish you hadn't done the things you did. It'll kill Max if you do that, Liz. It'll break his heart. You just can't toy with him like that. He can't just be an escape for you - an experience. If you are going to put him through that - it's got to be real."

    Liz looked at Izzy and sighed. Izzy, she knew, wasn't real - just the personification of her middle-class morality. The voice of 'the perfect Miss Parker incarnate. But that - she guessed - was OK. She was - after all - who she was, and a casual relationship like that - just for the experience - really wasn't her - even if she was dying. Her conscience was right - she should take it easy - let the relationship develop - and pray she had the time. What’s more – at least the fiction was a pleasant one. That the guy she’d always wanted DID care about her – had really always loved her. That dream would almost make dying at sixteen – or perhaps by now she was seventeen, she wasn’t sure – bearable. ‘You are what you are, Liz,’ she told herself. She smiled at Izzy – her very own Jiminy Cricket. “OK, if I was to promise to take it slow – promise on my honor to not do anything I would regret doing if I woke up tomorrow and were looking into Max’s eyes and he connected and healed me – if I do all that, do you think it just might be possible for me to make out a little bit with your brother?”

    Izzy giggled. “Well, since you put it like that, I suppose if I notice the two of you wanting to be alone, I COULD wander off into the mist. I can’t go too far, or Max will dissolve out of the orb – but I could wander around a little bit – see if I can figure out a way to break the news to Alex.”

    “You haven’t told him yet?”

    “It’s not as easy as all that.”

    ”You told me…”

    “You were in a coma. If you didn’t like it – who were you going to tell? If you woke up and told someone – who’d believe you? It’s a little different with Alex. Besides – don’t get me wrong Liz, I DO like you – but back then I didn’t even know you and if you freaked out – so what. I’ve been dancing with Alex in my dreams for years. If I were to lose him – I’m not sure I could take it.”

    As Liz listened to Izzy, she really wanted to believe – she really did. But she was still ‘Miss Scientist,’ even if she was no longer quite the ‘perfect Miss Parker’ she’d always been. Occam’s razor said that if there were two competing hypotheses, the more straightforward one was likely to be correct. The straightforward one was that she was in a coma and hallucinating. The alternate hypothesis – that she was being visited by two aliens – one of whom secretly had loved her since third grade – and who she secretly loved – was a whole lot more farfetched. No, this was all just a dream and if she had to make a deal with her conscience to let her make it a particularly pleasant one – she’d do it.



User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 3/2/2009

Post by greywolf » Fri Mar 06, 2009 2:13 pm

  • 9 weeks earlier:

    “How could you permit something like this? This is entirely unacceptable. I pay taxes to the library system, and when I need to use it – it’s entirely worthless.”

    “Well I’m sorry you feel that way, Mr. Parker,” said Ms. Kristofferson, Chief Librarian for the Chaves county library system. She sighed deeply. Some days were just like this…

    “I cannot believe that out of the seventeen books that are in your catalogue on this topic, there are only two on your shelves – and those in the children’s section!”

    Ms. Kristofferson put on her best professional face. The man was being a prick. It was in fact only her awareness of what was driving this – the tragedy that had happened to his daughter, that kept her from calling the Sheriff’s department and having the unruly and LOUD man removed from HER library. Parker had already worked his way through two junior librarians – leaving them in tears – and Ms. Kristofferson had had just about enough.

    “As Miss Abernathy told you …. as Mrs. Humboldt told you … the library works on a first come-first served basis for books that aren’t in the reference section. The books you have requested were all checked out – over two weeks ago – by someone else. If you put a hold on them the party who checked them out will not be able to renew them and they should be available to you in another two weeks.”

    “But that’s just NOT good enough,” complained Jeff Parker. In two weeks the new lawyer and medical consultant from the insurance company would be in town for the meeting. It would be held – at Diane Evans’s insistence – at her legal office. Jeff didn’t trust the insurance company at all after what they had already done and he had wanted to familiarize himself with everything he could about brain damage before the two showed up. But when he’d gone to the library to get books to read for background on physiology and coma and the like – damn near every one was gone – all checked out two weeks ago. Oh sure, he realized many of them would be right over his head but he wanted to do what he could to at least understand the situation. “Could you at least call the person who has these books checked out and make him bring back SOME of them?”

    “No we could not. Mr. Ev… that is, the patron who checked these books out followed the rules when he did so – and I might add, he did it quietly and politely. He apparently has a term paper or some such – even did several medline searches on the topic. I am not going to change established procedure because of one – NOISY – patron.”

    “Evans? MAX EVANS? He has all of these books?”

    A cross look came to the face of Ms. Kristofferson, irritated that she had been frustrated into giving a clue to the identity of the patron – a clear violation of a rule she herself had written. “The NAME of the patron is NONE of your business, Mr. Parker.”

    "But it is if it's Max Evans ... the boy is obsessed."

    Ms. Kristofferson looked at the man - his list of seventeen books - and shook her head. Obviously the vocabulary word for the day was 'irony.' She was tempted to tell him what she REALLY thought of all this - but then - his daughter had been in that terrible accident.

    "I'm sorry sir, but I lack the authority to change this policy. If you would like to show up at the next library board meeting - the second Tuesday each month, at 6PM - perhaps we can change the policy."

    "Forget it," said Jeff Parker. Diane Evans had said she wanted the boy at the meeting - that he understood more about biology than she did. He felt the same way toward his daughter. He really didn't want the boy there - feeding his obsession with Liz, but Liz had once told him that Max really did have an awful good appreciation of science. It probably made sense. And certainly, the boy appeared to be doing his homework.

    'You probably wouldn't have understood anything in the books anyway,' he told himself as he left the library.

Last edited by greywolf on Fri Mar 06, 2009 5:25 pm, edited 2 times in total.

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 3/7/2009

Post by greywolf » Sat Mar 07, 2009 1:00 am

  • Nine weeks earlier:

    Max struggled to disassemble the power lead – he assumed it was a power lead anyway – from the crystal to the stasis chamber. It was the final step of what had been a planned two day procedure that had actually taken closer to five days. Someone had REALLY not wanted anyone getting access to this part of the mechanism, and everything about it said that was to protect untutored hands from encountering lethal forces.

    The power lead only had one connection – not two like the electrical connections from the solar cells. Those had been easy enough to puzzle out – they'd fed the incubators which appeared to have some sort of a spring-loaded interrupter relay. The incubators could come on only after the stasis field was no longer working – reasonable enough, Max supposed, since the stasis field wouldn't have let the incubators incubate anything anyway. But the switch or – it actually appeared to be some sort of a valve – between the crystal and the stasis field was still in the position he would have interpreted from the diagrams as being open.

    He was almost certain that meant the crystal was exhausted but this was the final test. Slowly - using all of his powers of molecular manipulation – Max was able to pry the conduit from the crystal out of the edge of the stasis chamber – half scared of what forces he might be unleashing as he did so. At last it was free – the conduit appearing to have a central hollow tube through which – he could only assume – the power would have flowed had the valve been open and the crystal charged. But nothing happened. Slowly he reached back to the valve/switch between the break he had made in the conduit and the crystal itself. He twisted it slowly at first, but as nothing seemed to happen eventually pushed it to the stops. Nothing happened. He sat back down with a sad resignation.

    He didn't have the knowledge to recreate the machines here, but he was pretty sure he understood them. The bulk of the machinery was electrical and used surprisingly little power. Even the lights in the chamber seemed to be overgrown light emitting diodes.

    Despite being buried in the rock, the pod chamber gave every indication of having been cobbled together from salvaged scraps of the ship itself. The crystal appeared to be some sort of a battery or storage unit for forces that he didn't understand – not anymore than he understood the stasis pods themselves, but it was pretty easy to see what had happened. Sometime ago the crystal had been exhausted and the incubators had turned on – trying to bring the embryos within to adulthood. But the incubators used electrical power – quite a bit of it – and as the embryos had become fetuses and then children – the solar panels hadn't been able to keep up with the need for electrical power. Eventually they too had defaulted – hatching the three of them to at least give them some sort of a chance, since the power was inadequate to take them to adulthood.

    Throughout his life people had said – not to his face of course, but occasionally to his parents – that only an inhuman monster would abandon two little kids in the wilderness- to die in the desert. Whoever had done this hadn't been human – that was obvious from the electrical connections. Someone had used molecular manipulation to flow the wires together rather than solder or screws.

    But Max wasn't at all sure he or she had been a monster. There had been a lot of thought put in to the setup here. The door – for instance – seemed to be salvaged from the airlock of the saucer itself, but a lot of thought had gone in to the mounting of the door. There was a hidden pad on the outside that responded not to pressure but rather to the presence of his hand – but on the inside, the door opened if anyone approached it. Whoever had put this place together knew that there were inadequate solar panels to bring three children to adulthood. The place was designed to let them out when the power could not sustain them and yes, it had been fortunate that mom and dad had found the two of them so quickly, but the fact was that Michael had survived for weeks on his own.

    Max wasn't the first person to wonder about why he had been placed on this Earth but his questions now were more practical than philosophical. He and Izzy and Michael had long debated this but five days of being surrounded by the alien machinery made him question it again. The survivor had gone to great lengths to insure the three of them a chance to survive and it couldn't have been easy. Why had that been done? If he could understand that, perhaps he could understand how he might help Liz.

    Were the three of them some sort of invasion of the Earth? If so, they must be a hell of a disappointment to whoever had put them there. Were they half-breeds – the offspring of unions between humans and aliens? Maybe, but if so, why had they been carried around in incubators rather than someone's womb?

    What he thought they were - most likely - was alien-human hybrids – artificially created, but if so – why? Were those creators benevolent? Their world was – apparently – a harsh one. Were they trying to share the DNA they evolved that gave them their powers with the people of Earth? Was sentient life in the galaxy so rare and precious that the people who had built the saucer wanted to protect sentient life wherever they found it? Were they seeking allies? Max wasn't sure he would ever know. But someone had crawled out of that crash and salvaged the three embryos and enough equipment to give them at least a fighting chance at survival – likely at considerable risk to themselves. Just why they'd done that, Max decided, he really didn't have a clue.

    Max sighed deeply and turned away from the alien equipment. He picked up the Medline article and started to read. At least this he could understand. In a couple weeks the doctor and lawyer from the insurance company would be in Roswell. He wanted to be ready.
Last edited by greywolf on Sat Mar 07, 2009 9:34 am, edited 2 times in total.

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 3/7/2009

Post by greywolf » Mon Mar 09, 2009 9:22 am

  • Six weeks ago

    Jeff Parker had been anxious for this day to come – but now that it was here he walked nervously into the room. The conference room in the law offices of Evans and Evans was not a large one – but there was no air of intimacy here. Jeff was too uncomfortable with the people here for that. With the exception of Nancy, Diane Evans was the only one here that he had any degree of trust in. Without her Liz would likely already have been warehoused in some nursing home with next to no prospect of ever returning to a normal life, even if she somehow did shake off the coma. Even though the woman was fighting this fight for her son as much as for Liz he and Nancy owed her -- owed her a lot. She was a fine woman and - it showed in the kindnesses that Isabel had shown Liz, she had certainly done her best to be a good mother and a good influence to the two foundlings she had raised. It was simply unfortunate that her efforts hadn't been nearly as successful for the troubled Max Evans as they were for the girl who even he and his wife were now calling Izzy.

    The boy himself - even there in the conference room miles from Liz's hospital bed - Jeff found difficult to look at. Max was sitting beside his mother with a calculator and stack of papers and books - looking at the doctor and the lawyer from the insurance company with an intensity that was somewhat frightening. Although, as he turned to look at the two new guys from Chicago, Jeff himself felt a sullen animosity fill him. These two were the representatives of the company that had tried to cheat his daughter. Perhaps in this case, thought Jeff, he would have to forgive the kid his obsessiveness.

    Finally the last person arrived - another person Jeff trusted, Doctor Taylor, making her apologies for being late - a patient - she was quick to reassure them not Liz - had experienced a treatment complication and that had delayed her. With the entry of the final person, Diane Evans stood up and introduced Emily Taylor, MD., to Fred Kramer, the lawyer, and Gregory Rothstein, M.D., medical consultant. Shortly, the meeting began.

    "Dr. Rothstein and I have come to discuss the treatment options for Miss Elizabeth Parker at the request of her own physician," said Kramer, nodding toward Emily Taylor, "...and we are operating in the capacity of representatives of the insurance agency funding her treatment. I should like to make clear, however, that we are NOT employees of the insurance company - we are in fact acting as agents of the Federal Court to assist in administering the affairs of the insurance company until such time the management can be reorganized since - virtually the entire senior leadership is now under indictment or have already entered guilty pleas as part of plea-bargaining to assist in the prosecution of those now under indictment."

    "They ought to be prosecuting the owners of that company as well as the management," opined Jeff Parker instantly. The wince on Diane Evans' face his first clue that he'd somehow stepped in it.

    "That would prove difficult," said Fred Kramer, smiling slightly. "There are almost a half million total owners - including your wife, your daughter, and yourself."

    Diane's voice was less sarcastic. "Your insurance company is a mutual insurance fund, Jeff. The policyholders are the owners."

    "That's right," said Fred Kramer, nodding his head. "All of those proxie statements - annual meeting announcements you were getting for all these years - that was your opportunity to decide who the management would be - what policies would be enforced. Like most policyholders, you really didn't participate."

    "I was busy running my business," said Jeff. "I didn't have time to sort through all that literature - to tell what it was saying. I am not responsible for the policies that the management put in place. "I didn't vote for any of them."

    "But by not voting, you made it relatively easy for them to stay in control. Like all of the half-million policyholders, you gave the management your money - in premiums. Many also gave their proxies - just allowing the board of directors to manage the company any way they pleased. The management pleased to give extravagant executive compensation and enact senior management bonuses that caused unreasonably high management costs and they encouraged fraudulent handling of the more expensive cases - such as that of your daughter Elizabeth - to be able to offset the expense for their own excessive compensation. But it was you, Mr. Parker, and the half million other policyholder owners that let them do that by giving them money and power and then no meaningful supervision. But that's not what we are here to discuss, are we? What we are here to discuss is Doctor Taylor's request that we approve an experimental treatment of your daughter at the neurological institute in Chicago. Regretfully, I fear our answer will be no," said Kramer.

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 3/9/2009

Post by greywolf » Wed Mar 11, 2009 9:50 am

  • “But she has a right to whatever treatment might help her,” said Nancy Parker.

    Mr. Kramer winced, then replied. “No, Mrs Parker – she doesn’t. She has a right to the benefits provided for in the contract. That contract was based upon the actuarial probabilities – the premium was set to allow ALL policyholders to receive the covered services and to provide for the administrative expenses needed to run the company and maintain adequate reserves. The insurance business is among the most highly regulated. These rates and services were looked at by insurance commissioners in every state where the company does business and were all judged to be basically fair. Where the administrators cheated the policyholders was trying to short-change those with expensive treatments – like your daughter Liz – to cover their own excessive salaries and bonuses. They apparently hoped that by cheating these few highly expensive cases they would be able to do business as usual, since they would be irritating only a small fraction of their total policyholders. For a number of years, it appears that their ploy in fact worked.”

    “But why won’t you allow Liz the treatment she needs?” asked Jeff.

    “Mr. Parker, I’m sincerely sorry for your daughter’s accident, but as I said. Insurance companies do not make money. The premium amount would have had to be higher to cover higher levels of care, and that is always a trade-off. The policy you purchased is, in fact, a very good one. It funds a whole range of benefits – practically anything other than experimental procedures – for an entire year, before the acute treatment benefits are used up, and even then it reverts to long-term care at a lesser level. Out of a half-million policy-holders, we will have perhaps only one or two annually who have claims as expensive as your daughter. Generally, the policyholder either has much less costly illnesses or injuries or has such devastating medical problems they do not survive them. The premiums are based upon these assumptions. Liz alone has substantially pulled down the company’s reserves, which I might add were not exactly where they should have been due to the excessive salaries of some of the senior officers. But the system has worked as insurance is designed to work, the premiums were pooled and they covered not only the routine care for hundreds of thousands of people, but also the covered care for the few – like your daughter – who required massively expensive treatment. On any given week since her accident, the cost of her care has exceeded the total premium payments that you have paid for her – your wife and yourself – and all of your employees. But giving your daughter money for treatment that is NOT covered by the policy – that is not even yet approved by the FDA – that takes money away from all the other policy holders – money that will be necessary to fund THEIR care. An insurance company – any insurance company – is little more than a bookie – or if you prefer, the whole thing is a lottery – one you hope you lose. Unfortunately, your daughter is one of the ‘big winners’ in this game. But even for her, there are limits as to what we can pay.”


    “But then why did you even bother to come here?”” asked Jeff.

    “Well,” said Kramer, “… that would be due in large part to Ms. Evans here. We wanted to assure her that we would be fully funding your daughter’s care – exactly as the policy calls for. We wanted to assure her that the court – and those of us appointed by the court – are going to great lengths to correct the mess she discovered. We wanted her to realize that we aren’t the bad guys here – that everything we discover gets handed over to the federal prosecutor and those of us appointed by the court are being as open and honest and fair about our duties as we know how. We wanted her – and you and your wife – to understand that the denial is based on the legal contract – not just the one that you signed, Mr. Parker, but the ones that were signed with the other half-million policyholders. We bear your daughter no ill will at all, in fact, as the basis for uncovering the wrong-doing, we owe a huge debt of gratitude to you and Ms. Evans for what you have done for those other half-million policyholders who were also being cheated. But legally, we can’t really give your daughter more than she is entitled to under the policy. Even if Dr. Rothstein and I agreed to that, the court simply wouldn’t let us.”

    The Roswell people at the table sat in stunned silence. There seemed to be nothing to say, and Jeff looked at his wife and saw the same despair in her eyes he felt himself.

    Suddenly the silence was broken by the voice of Max Evans. “Mr. Kramer, what if I could show you a revenue neutral way to give Liz this chance?”

    Jeff’s first impulse was to be angry about the boy giving Nancy false hope that would almost certainly be dashed – but as his eyes saw the boy – saw the tears trickling down his cheeks – he decided to listen to what Max had to say. It wasn’t like things could get much worse.

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 3/11/2009

Post by greywolf » Thu Mar 12, 2009 8:39 am

  • Greg Rothstein, M.D., looked at the teenager with sympathy. The girl obviously meant a lot to him, and it gave him no pleasure to destroy the boys hope. But he also needed to understand reality.

    “Son, I’m sorry, but I really don’t think you have done your homework on this,” said Doctor Rothstein. “I know about this – I’m a neurologist, and I toured the facility about eight months ago. The Chicago Neurological institute gets neurotrophins that are produced by human diploid cells culture treated with a bioengineered neurotrophin inducer similar to one of those that occurs in human embryological development. The inducer is grown in DNA-modified e. coli and extracted, purified, and then used on the human diploid cells. Then they are grown, the neurotrophin extracted and purified. Both processes are rather enormously tedious and expensive and we don’t have the technology to make either of them cheaper right now – probably won’t for fifty years or so. They then use a rather massive dosage of these neurotrophins to ‘shock’ the patient’s cells – the ones that are damaged but not yet dead – to stimulate those cells repair processes.”

    “But the point is, it works,” said Max. “The recovery rate of coma patients with this treatment is significantly better than without it.”

    Doctor Rothstein gave Max an indulgent smile. “Son, you have to understand that when a medical journal says ‘significantly,’ they mean that in statistical terms. They compare treated patients to untreated patients, and if the treated have a greater cure rate that is unlikely to have happened by chance, that is statistically significant. In this case though…” Rothstein appeared to give a deep sigh, and then looked sadly at the Parkers and Max. “In this case, after this long in this degree of coma from any cause – well the statistics say that there is about two chances in a thousand of Miss Parker.
    The procedure used at the Institute does cause a statistically significant increase in recovery. Best estimate for effect of treatment is a three-fold increase in recovery, but son that only brings the chance up to six in a thousand. And unfortunately, that’s only part of the story. Miss Parker's particular injuries – well RAS trauma is rare, but there is some evidence that her likelihood of recovery, with or without Institute treatment, is even less than the average. As much as I would like to see the young lady cured, I don’t see how it could ever be cost-effective from the insurance company’s standpoint, to spend such a huge amount for a treatment so unlikely to make any real difference in her outcome. It would seem to me it would be far cheaper just to leave her in the rehab hospital for the next three months – give her that chance – then send her to a less expensive semi-skilled nursing home facility. I’m sorry, but that’s just how it works out.”

User avatar
greywolf
Roswell Fanatic
Posts: 1999
Joined: Wed May 24, 2006 12:08 am

Re: Informed consent AU M/L ADULT 3/12/2009

Post by greywolf » Fri Mar 13, 2009 3:04 pm

  • Max's eyes held tears, but he wasn't totally without hope. He'd come to terms with just how poor the odds were that Liz would regain consciousness during the studying he had done at the library and at the pod-chamber. But he'd remembered something a former lab-partner had once told him.

    He had always admired Liz's attitude, even if he privately believed that his powers to manipulate matter gave him an intuitive edge in some types of science - like chemistry. Liz really never gave up. She'd develop plans and implement the one she thought most likely to solve the problem and push it until there was either success or failure. He'd decided to do the same. He'd racked his brain and could only come up with one. It wasn't quite the longshot that Dr. Rothstein thought. It actually had a probability of success of almost 10%.

    Doctor Rothstein had accurately quoted the long-term success of the institute's work - but in reading the details he had seen an opportunity. The initial 'shock' to the cells that Doctor Rothstein had described stimulated all the living cells - even those too damaged to ever survive. For a few minutes many of the patients - almost 10% - briefly awakened, even if they were destined to quickly go back into their coma. If he could be there then - Max reasoned - he could seize that window of opportunity to connect with her and heal her in the few minutes before she lapsed back into unconsciousness. But what he needed to do first was to get them to agree to treat Liz. That, as it turned out, was simply a matter of math.

    "Actually Dr. Rothstein," said Max, I AM familiar with the work at the institute. They too are aware of the prohibitive nature of the cost of treating everyone considering the modest salvage rate. They have actually been doing a concurrent study about a screening process. It will be published in next months Medical Economics. I have talked to the author and he was kind enough to fax me the galley proofs for the article. What they do is to give a small IV test dose of radio-isotope labeled neurotrophins to the patient and then do PET scans at 24 and 48 hours after injection. Then they assess for uptake of the labeled neurotrophin at the injury site. If the uptake is above a certain level, it's quite likely there are enough stunned by viable cells there to benefit from the full treatment. If there isn't - well the full course of treatment is probably going to be ineffective. The test is expensive - but nowhere near the cost of the large doses of neurotrophins used for actual treatment. It's predictive value positive for treatment success in their study is only about 70%, but it's predictive value negative is quite good - in excess of 99%."

    Dr. Rothstein took the papers and read through them rapidly, before setting them down and looking at Max with an arched eyebrow. "I'm afraid I made a serious mistake with the comment about you not doing your homework, young man. It would appear that I'm the one that hasn't done his homework. But I'm not sure how this changes anything in terms of your coverage," he continued, looking back toward Kramer.

    "But the point is," continued Max, "... for a relatively small amount you could find out with reasonable certainty if Liz could be healed. It would cost less than the cost of a month of her current therapy."

    "But if she couldn't - which is still the most probable outcome, the company would be no better off than we are," said Kramer.

    Max looked across the table at him. "I thought you said that insurance companies were like bookies, Mr. Kramer. Change the contract. As it now stands you have a certainty that you will be paying for Liz to be in the rehab hospital for three months and a 99 plus percent chance of having to pay for Liz to spend the rest of her life in the nursing home. In six weeks she'll be seventeen. Even in a nursing home her life expectancy is - what - another forty years? I read that medical care costs are going up almost 15% per year. That means that her last year of care alone will cost the company 1.15 to the 39th power times what it does now. That's about...," Max worked furiously with his calculator and then looked up, "...that last year alone will cost you sixty-eight times what it will cost the first year. If you could agree to use some of the money that you would otherwise spend on her expensive care now to get her to Chicago - to do the screening test - the money you can likely save if she is a candidate for treatment will more than offset what the treatment would cost. It would be bad business for your company to NOT pay for her treatment. You said the company's reserves are low anyway - this would give you a chance to improve them."

    Kramer shook his head and smiled. "Whatever the decision, kid, I don't think I'd want to play poker with you. Let me get our actuarial people to cranking the numbers. The doc and I will stay over and talk to the accountants. If it pencils out, I'll need to get permission from the judge that is overseeing me. If he OK's it, then Mr. and Mrs. Parker will have to agree. But let's meet back here tomorrow, and see what we come up with."

    As they were driving back to their hotel, Dr. Rothstein turned to Kramer. "You think the idea the kid has will actually pencil out?"

    "Yeah. We'll MAKE it pencil out somehow, although I don't believe the 15% annual increase is going to last for forty years. But if the Parker's are willing to use some of the first year money to go for that test, I'll see to it that the girl at least gets a chance. Hell, I wouldn't want that young man upset with me, you can tell he's heartbroken about the girl."

    "I thought lawyers were supposed to be all business - no place for a heart in the field of law." said Rothstein with a smile.

    "Hell, some lawyer got the drunk off, lawyers from the company were putting the girl's parents through hell - it's probably time the legal profession cut these people a little slack. Besides, if it wasn't for the Evans kid's mom, the company management would still be screwing over people like these and stealing the policyholders blind - rather than looking at jail time."

    "Is that what you are going to tell the judge?"

    "If I have to - you damn right," said Kramer.

Locked