Ryland smiled sadly. “How could you know?” he said. “Maybe it’s better for the world that we didn’t do the right thing. But to be honest, if I could go back a week I would drive Vik and El to the FDA review panel myself.”

Lopez stared hard at Ryland. “How much of a risk could the aplastic anemia be to the MRGAS patients being treated with Oraloxin now?”

“It’s been tested in thousands of humans in clinical trials,” Ryland said.

“No bone marrow issues?” Lopez asked.

“Well … not until a few days ago. And that’s still unconfirmed.” Ryland looked down again. “Ellen heard from a Spanish investigator about a patient on Oraloxin whose white blood cell count dropped.”

Lopez’s eyes widened. “How could you not report that?”

Ryland held out his hands helplessly. “By the time we heard, the CDC had already found out that Oraloxin worked in the lab. We couldn’t have stopped its production if we tried.” He shook his head. His voice grew more self-assured. “Sixty years after its release, chloramphenicol is still one of the most widely used antibiotics in the world. It has the exact same rare side effect. If it had to be approved today, the FDA would laugh chloramphenicol out of the hearings.”

“That doesn’t make it right,” Lopez said with a slight edge.

“I’m not trying to justify what we did,” Ryland sighed. “But it seems to me that treating MRGAS victims with Oraloxin is less risky than the alternative. Besides, I think the bone marrow reaction is reversible if caught in time. The clinicians are checking patients’ blood counts daily, right?”

“I think so,” Lopez said in a calmer tone.

Ryland rubbed his eyes again and then looked at Kilburn. “Looking back, I think that Spanish study was the final straw for Ellen. Once the bone marrow reaction began to happen in humans …” His voice faded and he looked on the verge of tears.

The waitress finally arrived bearing their drinks. After she left, Cohen asked, “Neil, does anyone else at SeptoMed know about the bone marrow problem?”

He nodded. “A few of the other researchers in the lab, I’m not sure who else. I do know that Ellen told the VP of R-and-D, Luc Martineau.”

Kilburn’s eyes narrowed at the mention of Martineau. “What was his reaction?”

“I wasn’t there. Luc and I don’t exactly see eye to eye,” Ryland explained. “But according to El, Martineau supported our wait-and-see approach.”

Cohen nodded. “But he never spoke to you about it?”

“Just to tell me what ‘important work’ we were all doing on Oraloxin,” Ryland snorted. “Or some other line of crap.”

Cohen raised an eyebrow.

“Luc Martineau only sees what is important to Luc Martineau,” Ryland muttered.

Cohen nodded. “Neil, do you think he told anyone else at SeptoMed about the reaction?”