how do you wish me to”-he grappled for the word-“phrase this truth?” Seeley asked whether he had told the truth in his deposition. “Yes, of course.” Seeley had pushed the black binder containing Cordier's deposition across the table. “Then review this and make sure you stick to what you said.”
Now, at the courtroom lectern, taking Cordier through his qualifications as an expert witness-medical training in Toulouse, a pediatrics residency in Algiers, research at the Institut Pasteur in Paris, and seven years working in Africa for the United Nations AIDS agency-Seeley again worried about how the physician would tell the story of AIDS in Africa. Slow down, he wanted to say, think about your answers, or Thorpe will crush you.
At the edge of Seeley's vision, Fischler was conferring with Thorpe. Fischler rose. “May I approach sidebar, Your Honor?”
This was unexpected. Ordinarily Thorpe, as first chair, would be responsible for the leadoff witness. Thorpe remained at counsel's table, as gray and motionless as a gargoyle staring out at the proceedings.
The judge rolled her chair to the corner of the bench away from the jury. “So soon, Ms. Fischler?” There was amusement in her voice. “We haven't even heard a word of testimony.”
“Defendant is prepared to stipulate to Dr. Cordier's expertise in pediatric AIDS, Your Honor, but not in the demographics of AIDS. We're concerned that's where Mr. Seeley is going to take him.”
Farnsworth turned to Seeley.
“Defendant has Dr. Cordier's report and they've deposed him at length,” Seeley said. “They knew months ago what his testimony would be.”
“Until this morning,” Fischler said, “we didn't know he was going to be their lead witness.” She had wrestled her hair into a prim schoolteacher's bun for the trial, but still seemed discomposed. “This changes everything. His testimony's going to have a greater impact.”
That was why Fischler was in charge of Cordier. It was she who had deposed the physician. She had prepared herself for him, just as Thorpe had prepared for Steinhardt. Seeley was pleased at the unexpected windfall of his decision to put Cordier on first.
Judge Farnsworth said, “Mr. Seeley is right. You should have raised this before opening statements this morning. Now you're wasting the jury's time.” Any humor was gone from her voice. The judge was also telling the two lawyers that she didn't like being away from her jury for sidebar conferences. “On the other hand, Mr. Seeley, Ms. Fischler is entitled to know what you're trying to prove with Dr. Cordier's testimony.”
“Dr. Cordier's testimony will bear directly on the novelty of AV/AS.”
Farnsworth studied him for a moment. “I'm not sure I know how you plan to do that, but I'm confident Ms. Fischler will have an objection at the appropriate time if it turns out to be a problem.” She nodded for him to continue.
Seeley returned to the lectern and a quick back-and-forth with the witness established that Cordier practiced pediatrics at a clinic in Maseru, the capital of Lesotho, and that his practice consisted exclusively of treating HIV- positive children.
“And do these children respond well to treatment?”
“If we are able to get them antiretroviral therapy-yes, then their chances of survival are excellent.”
“And if you are not able to get them this therapy?”
“They will die of AIDS.”
“How many will die, say in Lesotho?”
“Today in Lesotho, we estimate that there are 22,000 children-infants, teenagers-who are HIV positive. Less than one in twenty of them will receive treatment.”
Seeley glanced over at the jury box. No one seemed to be having difficulty following Cordier's accented English.
“So you're saying, of these 22,000 children, roughly 21,000 will die?”
“That is correct.”
All of this was hearsay, and ungrounded in the witness's expertise, but Seeley was confident that Thorpe, with countless jury trials behind him, would not let Fischler object and risk the jury's ill will. “And, in your experience, are these numbers unique to Lesotho?” Fischler started to rise, but Thorpe's hand moved over hers.
“Unique? Yes, but only in how small the numbers are. There are approximately 230,000 HIV-positive children in South Africa, about 300,000 in Nigeria. In all of Africa, we estimate close to three million children are HIV positive.”
“And the survival rate without treatment is the same?”
“If we can treat them, perhaps 150,000 can be saved. But this is such a small number, no? The others, almost all of the three million, will die.”
Fischler was on her feet. “Objection, Your Honor. Relevance.”
Instinct told Seeley that he was at the edge of the judge's patience. “I can assure the court that Dr. Cordier's testimony will connect up.”
Farnsworth motioned the two lawyers to sidebar. “I still don't see how this relates to the novelty of AV/AS, Mr. Seeley.”
“Long-felt need, Judge.”
When a pressing problem, particularly of public health, has persisted for years, and finally one company comes up with a solution, that fact counts as evidence that the solution wasn't particularly obvious.
Fischler said, “I don't see how talking about numbers of victims makes that point.”
“I'm sure,” Judge Farnsworth said, watching Seeley over her half-frames, “that if Mr. Seeley doesn't very quickly connect up Dr. Cordier's testimony to his theory, you will renew your objection.”
When Seeley returned to him, Cordier seemed confused by the conversation between the judge and lawyers outside his hearing and the jury's. Television in Maseru, if the physician had the time to watch, probably had few courtroom dramas.
“In your clinic in Maseru, Dr. Cordier, why are you only able to get treatment to less than one in twenty of the children who need it?”
“There are three reasons-”
Anticipating that this was going to sound rehearsed to the jury, Seeley broke in. “Let's take them one at a time.”
“Expense, of course. We have succeeded in getting the price for antiretroviral treatments down to two hundred dollars a year, but many patients develop a resistance to these first-line cocktails, and we need second-line treatments like Atanazavir that can cost three to six thousand dollars a year. Remember, these are people who may earn less than a dollar a day. Foundations like the Gates Foundation help out. Also, many drug companies are lowering their prices, or licensing generics free-”
“So expense may soon disappear as a problem?” He and Cordier had spent time on this part of the testimony. It was important to Seeley that the jury not think that patents or high prices were the source of the problem. “If expense is not the major obstacle, what is?”
“Delivery. We don't have the facilities or the people or the equipment to make treatment available to every child who needs it. In climates like Lesotho, the most widely used booster drug, ritonavir, needs to be refrigerated. But who has a refrigerator?”
“You testified that there are three obstacles.”
Cordier closed his eyes and slumped into the wooden chair. For a moment, Seeley thought that, fatigued from his trip and Sunday's long preparation, the physician had fallen asleep. When, at last he opened his eyes, Seeley saw that the cause was not sleeplessness or overwork, but the exhausting futility of the conditions that he observed every day.
“It is the people themselves,” Cordier said. “They are distracted from their medical needs by poverty, by lack of education, but, most of all, by a struggle for daily survival that is so desperate, so consuming, that HIV treatment seems a luxury to them. I had a young patient, a fourteen-year-old girl, both of whose parents died of AIDS
…”
Seeley could picture Thorpe, at counsel's table behind him, restraining his second chair. Other than Cordier's voice, with its soft inflections, the courtroom was entirely still.
“This girl, barely a teenager, turned to prostitution to support her younger brothers and sisters. Of course, now she, too, is HIV positive, as her own child will be, when-and it is inevitable-she becomes pregnant. We have
