COLUMBIA UNIVERSITY MEDICAL CENTER NEW YORK CITY MARCH 1, 2011, 1:15 P.M.
Having loaded up on books and printouts from a Google search in the library, Pia spent the morning reading, sitting deep in concentration at a bench area outside her windowless office. She’d been vaguely aware of the maintenance man doing his thing, but she had ignored him until he came up behind her. Disregarding the fact that she had her iPod buds in her ears, he had the nerve to tap her on the shoulder.
“Pia, darling dear. Want to reconsider my pastrami offer? You won’t be disappointed.”
“Not on your life,” Pia said, with emphasis, hoping he’d get what she intended as a definitive message. He shrugged and smiled and gave a little silly wave as if Pia had been gracious rather than scathing. She was beginning to think that Vance was one of those men who reveled in rejection. Irritably, she repositioned her earplugs and went back to her reading. When she heard her name being called again, Pia was momentarily livid, wondering what she was going to have to do to get him to leave her alone. Tearing out her earpieces, she looked up to see Rothman’s assistant, Dr. Yamamoto, standing in front of her flanked by a young man and woman in newly laundered, dazzlingly white lab coats.
“Miss Grazdani,” Yamamoto said. He was a slight man with what appeared to be a kind of half-smile frozen on his face. “I would like to introduce our new students with us for the month.”
Dr. Yamamoto was often held up within the medical center as a perfect example of how opposites attract. He was well liked, soft-spoken, considerate and communicative, always encouraging people to address him as Junichi: the positive to Rothman’s negative. Also in contrast to Rothman, he was casually dressed as always, in a Hawaiian shirt beneath his wrinkled and not-too-clean lab coat. If there was one nod to his playful side, Yamamoto was said to be the originator of elaborate and brilliant practical jokes stemming from his graduate student days involving one particularly pompous medical student’s expensive fool’s errand to a “convention” in Geneva that never was. On the serious side, Dr. Yamamoto’s most important characteristic was his complete and total devotion to Rothman and Rothman’s work. What was accepted around the medical center was that Rothman was the brains and Yamamoto was the worker bee. They were yin and yang.
“Perhaps you know Lesley Wong and William McKinley,” Yamamoto said.
“Like the president,” the young man said. “But call me Will.”
Will stepped forward, a big smile on his face, hand outstretched. Columbia University Medical School had about 640 students spread over four years of training. In general the first two years were primarily spent absorbing the science of medicine with progressively more and more time creatively devoted to introducing students to patients. The third year was the principal clinical year with the major attention devoted to internal medicine and surgery. The fourth year was mostly rotations in various clinical subspecialties combined with electives according to each student’s personal interests. At Columbia the emphasis was on academic medicine. Lesley and Will were fourth-year students in Pia’s class. Both thought they had a new interest in research, which was why they had been assigned to spend a month in Rothman’s lab.
Pia took Will’s outstretched hand and stood up.
“Pia. Grazdani.” She noticed that Will was tall, even a little taller than George, who was above average. Like George, Will had blond, unruly hair.
“You’re George’s friend, right?” Will said.
“George? Yes, of course.”
“Love George, great guy. I often play b-ball with him.”
“I’m Lesley Wong,” the woman said, shaking Pia’s hand in turn.
For a moment there was an awkward silence. Pia briefly eyed the two students, realizing they had to be the students Rothman had briefly mentioned the day before and then never brought up again. He had said something about tasking her to come up with something for them to do, as if she wasn’t going to be busy enough. One way or another it was going to be a burden of sorts.
Lesley and Will eyed Pia back. For their part, they weren’t terribly excited about meeting her either. For them, finding out they had been assigned to Rothman’s lab was the equivalent to being sent someplace in Dante’s inferno. Rothman had the reputation of destroying every student’s sense of self-confidence by making them feel stupid, which they invariably were in comparison to Rothman’s encyclopedic knowledge. And they had heard about Pia as well. She too was known as being over-the-top smart and also strangely detached and had taken an early interest in research in addition to the regular curriculum. For most people being a medical student was demanding enough. Except for being tight with George Wilson, who was one of the more popular students in the class, a mark in her favor, Pia never had had the time or inclination to be particularly friendly with many of her classmates. And all that was on top of the gossip that she and Rothman had something going since she was the only person in the entire medical center that he got along with except for Dr. Yamamoto.
Lesley looked over at Will, but he was staring at Pia. When they’d received their assignment, Lesley had told Will that she’d sat next to Pia in a lab every day for a month the first year but she was sure Pia wouldn’t remember. Lesley hadn’t made up her mind if Pia was extremely focused on her work or just plain rude, although she thought it was the former. As for Will, he was excited to be finally matched with Pia-he’d wanted to be for three and a half years. He’d been sure to introduce himself to every woman in the student body he deemed attractive, but this was the closest he’d come to her.
“Okay. Introductions done,” Yamamoto said. It hadn’t been quite as awkward as he feared, and he was relieved. He could get down to business.
“If it’s okay, we can go to my office. I’d like you to come as well, Pia. There are a couple of things we need to talk over and then we can all go take a look at the organ baths with Dr. Rothman.”
Yamamoto beamed a smile and walked away, the two new students padding closely after him. Pia brought up the rear, reluctant to be leaving her reading but excited at the same time. Even though she had been working there for years, she had never seen the organ baths. Although she had spent more actual time with Dr. Yamamoto than she had with Rothman, she didn’t feel she knew him as well. In her mind he was more complicated than Rothman. She thought of him as a kindly man but knew that in his own way, he was just as demanding as the chief. He suffered fools no more gladly, but his reprimands and corrections were delivered more politely and at lower volume. Pia had gathered from experience that the quieter Yamamoto spoke, the more important it was to listen.
“Okay, guys, find a seat.”
The condition of Yamamoto’s office in comparison with Rothman’s was as different as the men’s personalities. Yamamoto’s looked like a typhoon had passed through it. Books, journals, files, documents, papers lay everywhere, including on each of the two seats in front of the desk. Visitors took it on faith that Yamamoto actually had a desk as every square inch was under paper, including a mountain of academic journals positioned so that a curious passerby couldn’t see whether the doctor was sitting behind his desk or not.
“Just move those papers,” Yamamoto said, as Pia and Lesley Wong gathered them up from the chairs but searched in vain for a free surface on which to put them down. Yamamoto gestured to the floor, a suggestion the women took. He leaned his posterior against the front of the desk and folded his arms. “You could get a chair from the lab,” he suggested to Will.
“No problem,” Will said. “I’ll stand.”
“I thought it appropriate for us to do a small review and go over some introductory material so you people can better appreciate what you’re about to see,” Yamamoto said. “You are in for a treat today. I’ve gotten special dispensation from Dr. Rothman to show you our organ bath program, which has been kept a secret of sorts up until now. It couldn’t have been kept a complete secret as there are too many people working here, and we’re here in a very public medical center. Since the professor and I are close to publication, secrecy is no longer the issue it was since the university has already seen to it that the appropriate patents have been applied for. At the same time, we would prefer that you keep what you see today to yourselves. Deal?”
All three students nodded.
“All right, let’s start at the beginning. But I don’t want to make this a boring monologue so help me out! Somebody tell me what a stem cell is.”
The three students eyed one another. Will spoke up. “In simple terms it’s an undifferentiated immature cell that has the potential of becoming a differentiated mature cell.”
“Right on,” Yamamoto said. “An example is a bone marrow stem that can become an adult blood cell. These cells are often called adult stem cells. What’s a pluripotent stem cell?”
Lesley spoke up: “A stem cell that can turn into any of the three hundred or so types of cells that make up
