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"Harvard," he muses. "Such an elegant place, such elegant academics, such elegant science. And so distant from the rest of the world." He and his team, he says, will try to narrow that distance. "It's fair to say this [joint venture] is what now makes the work exciting to me -- the chance to palliate, to alleviate, or potentially to cure disease."
Though he, Seigel, and Gutierrez lobbied hard for this opportunity, Abel tries to shrug off credit, admitting only that he used his connections by calling researchers he knew at NCI. He says the hospital's willingness to spend money on technology and construction was a more important factor in bringing the vaccine trials here.
"All this helps people here, which is good," he says.
The first patient will begin to benefit as early as October 15, the doctors say. Temi Linzner might eventually qualify for the trials too, but she won't be the first in line. That honor will go to an as-yet-unnamed sufferer of a rare and deadly form of cancer known as mantle-cell lymphoma. The reason: Abel's colleague, Gutierrez, specialized in mantle-cell lymphoma at NCI and may help design the vaccine that researchers there will create. Linzner came close to entering a clinical trial earlier this year during two weeklong visits to one of the nation's most renowned private cancer clinics, M.D. Anderson Cancer Center in Houston, Texas. She received good advice, she says, but no treatment from a doctor who said he would not prescribe trial drugs because she wasn't his patient. She left the clinic in frustration.
Linzner has no such complaint about Abel. "I never feel rushed, not ever," she notes, describing a common complaint made by patients in community oncology centers. Nor does she have to suffer through long waits for an appointment. His office is extremely well organized, staffed by veteran nurses who have been with him for many years.
Her doctor is a formal man. He always addresses patients as Mr., Mrs., or Ms. The 62-year-old, balding Abel dresses meticulously: a lightly starched, long-sleeve dress shirt and crisply knotted tie under his doctor's smock. Linzner has never seen his cool professionalism waver. One time earlier this year when Linzner felt particularly demoralized, she told Abel she needed a hug. "He told me he didn't do hugs," she recalls with a grin. "But you won't find a doctor who cares more."
Linzner has completed her four-week therapy of one Rituxan injection per week. Today, two weeks after the last injection, the therapy seems to be working. For the first time in many months, she feels a spark of energy, and her cough is at least manageable. She has been feeling dizzy, though.
Linzner's 45-year-old daughter, Beth, slips quietly through the waiting room door, greeting her mother with a soft "hi." These days Beth spends as much time with her mom as possible, especially at medical appointments.
When a nurse calls her name, Linzner all but springs from her seat. Her daughter follows close behind as Linzner moves past the doctor's collection of framed posters, signed by Joan Sutherland and celebrating spectacular performances at the Metropolitan Opera. The pair enters a long hallway, where a nurse leads Linzner to the examining room. She offers a gown, but Linzner squashes the idea. "I don't do gowns," she says. "I'm not wearing a bra, so I can just slip off the jersey."
She sees Connie Wienants, Abel's top nurse, and the two share a quick, friendly hug.
The patient hoists herself onto the examination table, where she must wait for only a minute before Abel sweeps through the door in a dramatic rush, like a character appearing on stage in the Wagnerian operas he enjoys. Poised and trim, Abel appears to be curious about nearly everything.
"Did you hear about Deion Sanders?" he quickly asks. "He dropped the ball!" Abel is delighted by the lousy play the Washington Redskins' notoriously cocky cornerback committed the night before. Seems he doesn't like braggarts. "And so the mighty are humbled," he announces.
The obligatory chitchat completed, Abel gets down to business with a warm, encouraging smile. Earlier he fretted aloud that, even with the Rituxan, Linzner's chances of beating the disease are only about fifty-fifty.
Linzner has a form of non-Hodgkin's lymphoma. After exhausting the traditional prescriptions of chemotherapy and radiation earlier this year in treatments that shrank but failed to kill her tumors, and after returning without succor from M.D. Anderson, Linzner began the Rituxan. As Abel explains it, Rituxan binds itself to an antigen in the tumor cell. An antigen attracts or stimulates antibodies; the medicine can take advantage of that Achilles' heel in a tumor cell to kill it.
Though it is among a new generation of treatments, Rituxan already may be outdated. "What's coming up are antibodies that have radioactive properties," Abel reports. "Not only will they tag onto the tumor, but they will radiate nearby cells that could be infected."
Even if Rituxan is no longer the latest thing, Linzner is plenty encouraged by its results so far -- mostly because, unlike chemotherapy, it didn't nearly kill her. In fact she's feeling better and tells Abel so.