Chapter 50: A-Bio (5)
Lee Jun-Hyuk, the hospital director of Sunyoo Hospital, was having tea with Shim Sung-Yeol in his office.
To him, the hospital was a business. In that sense, Sunyoo Hospital was succeeding, and it was because of a rare genius scientist named Ryu Young-Joon. Succeeding in clinical trials was a bonus factor for hospitals. It made the hospital more famous by giving it the reputation that it was the first to cure a difficult disease. After succeeding in the glaucoma trial, Sunyoo Hospital received a lot of investments from several places, and it became the first place that patients with eye conditions came to.
“I’m glad the hospital is doing well,” Shim Sung-Yeol said.
“It’s all because you looked after us,” Professor Lee Jun-Hyuk said with a chuckle.
Shim Sung-Yeol had a political connection with Lee Jun-Hyuk for a long time.
Sunyoo Hospital was a huge university hospital; they didn’t just treat patients, but also conducted research and education. Despite their lack of significant results, Sunyoo University received 19.2 billion won in government funding in the last eight years as they were selected as a research-oriented hospital.
Behind their funding was Shim Sung-Yeol; he was one of the directors of the Sunyoo Social Welfare Foundation, which supported Sunyoo Hospital. It was a public interest foundation and was supporting Sunyoo Hospital, but Shim Sung-Yeol actually benefited more from it than them. It seemed obvious that it was going to be that way with the Alzheimer’s clinical trial as well.
Ring!
The office phone rang.
“Please excuse me.”Lee Jun-Hyuk picked up the phone.
“This is Lee Jun-Hyuk. Yes. Yes.”
He frowned a little.
“... Yes, I will be there right away.”
After hanging up the call, he glanced at Shim Sung-Yeol like there was a problem.
“What is it?” Shim Sung-Yeol asked.
“I think I might have to head out for a moment… But it’s nothing. The professor in charge of the clinical trial wants to see me for a little bit. I will be back soon.”
For some reason, Lee Jun-Hyuk looked like he was carrying a lot of worries as he quickly ran out of the office.
Shim Sung-Yeol just stared at the office door that Lee Jun-Hyuk closed on his way out.
* * *
“Was there any lobbying or request involved in Park Joo-Nam’s participation in the clinical trial as well? For example, an employee from the Stem Cells Department at A-Gen. Please be honest with me,” Young-Joon said.
“I do not know anything about that,” Koh In-Guk replied. “The only case where there was external pressure in the participant selection process was from Congressman Shim Sung-Yeol.”
“I am asking because I think that Shin Young-Yeon, a Scientist from A-Gen’s Stem Cell Department, knows Park Joo-Nam, the patient who was excluded.”
“I do not know. Park Joo-Nam only came with her husband to volunteer.”
“Hm.”
Young-Joon crossed his arms.
‘Does Shin Young-Yeon have nothing to do with it?’
Park Joo-Hyuk, who was beside him, said, “They could have just gone to the Stem Cell Department for the clinical trial, met Shin Young-Yeon, and she just brought them to you. Or they knew each other before, but she just told them how to volunteer.”
Young-Joon nodded his head.
“Maybe. I guess I was too sensitive.”
Click.
The conference room door opened, and a professor who looked like he was in his fifties or sixties appeared. It was Lee Jun-Hyuk, the hospital director.
“Why, Doctor Ryu, hello. Thank you for coming all the way here. You should have called us before.”
Lee Jun-Hyuk approached Young-Joon with a smile, acting like they were friendly.
“It is not that far. It’s ten minutes by car.”
“Haha, is it?”
“That was why I gave the clinical trial to this hospital, since it is convenient to provide fresh iPSCs or nerve cells and technical support. Do you know what I mean? It means that there is no reason for me to insist on this hospital as the investigation institution other than the fact that it is in a convenient location.”
“... I heard that you were angry about the patients being changed,” Lee Jun-Hyuk said as cold sweat dripped down his neck. “Did you know Park Soo-Nam?”
“It’s Park Joo-Nam.”
“Yes, Park Joo-Nam. Haha, my apologies. We must have made a mistake; we didn’t know that they were important to you… We will fix this right away.”
“Important to me?”
Young-Joon frowned.
“All those patients are important to me! What are you talking about? Do you think I am doing this because of some personal relationship? Selecting patients subjectively is data manipulation, you know that, right? I am bringing this up because I want this clinical study to be strictly controlled.”
Lee Jun-Hyuk looked like he realized he made a mistake, then tried to laugh it off.
“Now, now. Please relax, Doctor Ryu. Would it be such a big problem that one patient out of eight were switched? They are all Alzheimer’s patients after all.”
“I am the principal investigator, and the paper will have my name as the first author. The data that will be included in that will be manipulated. Even if you or Professor Koh are included as co-authors, the final responsibility comes down to me. Do you think I can relax?”
“How can you call this trivial thing data manipulation? You are overreacting. Hahaha. We can just say that the person we randomly selected was Congressman Shim Sung-Yeol’s mother in the first place.”
“I’m saying that this kind of attitude is wrong.”
“Then what should we do now? Shin Mal-Ja, the congressman’s mother, is a clinical study participant that is already registered on our side. We can’t take her out now.”
“How old is she? I assume she is quite old as she is Congressman Shim Sung-Yeol’s mother.”
“She is eighty-three.”
“Then isn’t she included in the aged, eighty and over category, and classified as a separate age group in clinical trials?”
“There are a lot of places that do that, including the FDA in America. But since it’s a clinical study on Alzheimer’s, it would be good to obtain data on aged, eighty and over patients.”
“My point is that you did not use that classification of age when we got the permission to do the clinical trial.”
“We can revise something like that easily.”
“Revisions are something I should discuss with the doctor in charge and decide. According to the clinical study guidelines, she should have been excluded. Why are you trying to gather participants and then change the criteria?”
“Haha. Doctor Ryu, we won’t be able to do clinical trials if we are strict about every single thing.”
“Is that so?”
Young-Joon stared at Lee Jun-Hyuk.
“Then don’t do it.”
“...”
Lee Jun-Hyuk froze, and Koh In-Guk’s eyes widened.
“I guess it can’t be helped if you can’t manage something as small as that. If this hospital isn’t capable of that, I don’t want to conduct my clinical trial here. Stop the study. I will talk to the Ministry of Food and Drug Safety and the clinical trial evaluation committee. I will have to go through tedious paperwork again, but it doesn’t matter. I will transfer this to another institution and conduct it there.”
Lee Jun-Hyuk let out a sigh.
“Doctor Ryu, I will be frank. You shouldn’t go against politics if you want to run A-Bio. What are you going to do?”
“Who said I am going against them? I am only saying that we should keep principles and ethics.”
“I don’t understand why you are not cooperating with someone as huge as Congressman Shim Sung-Yeol when he is reaching out to you first. If you let this go just this one time, his mother becomes healthy, you get a supporter, and the congressman gets a young, talented individual and a new network. Everyone is happy, right? To be honest, it’s frustrating.”
“I hope you find another scientist like that. I’ll stop here. Please organize everything that was prepared here since I’ll be conducting the clinical study at another hospital.”
As Young-Joon was about to take his bag and leave, another person opened the door and came in. It was Shim Sung-Yeol. He slowly approached Young-Joon. Standing close, Young-Joon and Shim Sung-Yeol stared at each other.
Chuckle.
Shim Sung-Yeol laughed.
“It seems like you don’t like me, Doctor Ryu.”
Young-Joon didn’t reply.
“I want to be friends with you, but it’s not easy.”
“I am open to being friends personally, Congressman. But I will not help your political activities. And I will not ask you anything regarding research. You must remember that business is business in our relationship. Do you still want to be friends?”
“Why are you trying to distance yourself from politics so much? WIth your fame and reputation, it’s worth a shot to cooperate with me.”
“It would definitely be easier if I had someone like you backing me. It would be easy to get permissions for clinical trials, and my products would easily be given permission to commercialize.”
“That’s true, especially if you have someone who could use their power. They could discretely ease the restrictions on drug standards that congress develops.”
“That is why it has to be separate,” Young-Joon said.
“...”
“I also know what kind of position I am in among Korea’s scientific community. Of course, I’m not the first one, but I think I will make a huge step. I think I told you before, but science is independent and the study of objectivity.”
“Hm.”
“All drugs developed by scientists must obtain permission and regulation according to their level of side effects and efficacy. They cannot be loosened because someone is friends with someone. I know how pharmaceutical companies used to do things by the rule of thumb, and it’s not just in Korea. But I want to change that culture as much as I can. I want to make a culture where we prove development by data instead of lobbying. I hope you understand.”
“... Yes, of course,” Shim Sung-Yeol replied in a subdued voice. “Alright. I understand your ideology, Doctor Ryu. And I made a mistake with this Alzheimer’s clinical trial. I don’t know much about medicine and pharmaceuticals or clinical trials.”
Shim Sung-Yeol added, “Doctor Ryu, I didn’t want to break the law or research ethics or anything like that. I asked the director if there were any openings because I wanted to help my mother, and this is what happened.”
“So you’re saying that the director did this out of loyalty even though you didn’t ask him?”
“He knows how I think about my mother and how I take care of her. He just made a mistake while trying to help me out of pity.”
“See, this is why we must stay away from politics,” Young-Joon said.
“Yes, I understand. I guess this reaffirmed your beliefs,” Shim Sung-Yeol replied. “My mother will apply for phase two of the trial, and I will make sure that she is randomly selected. So please do not worry anymore and let’s conduct according to principles, like you want.”
“Yes, thank you.”
Shim Sung-Yeol smiled, patted Lee Jun-Hyuk on the shoulder and left. Young-Joon stared at him as he walked toward the door.
Something that happened at Lab Six at A-Gen came to mind. Even then, Shim Sung-Yeol was shut down when he tried to get Young-Joon on his side. He also apologized and left, just like he was doing now. But unlike the last time, this might sour their relationship a little.
‘He might become an enemy, but I can’t help that.’
Lee Jun-Hyuk approached Young-Joon and said, “Well, it’s a bummer, but I guess it’s done. Then, we’ll just continue with the patient that was originally selected, yes?”
“What?” Young-Joon replied. “We will continue with the patients that were originally selected, but I cannot trust you anymore. We will continue this trial at a different institution. Thank you for your hard work.”
“...”
“Let’s go, Joo-Hyuk.”
“Wait!”
Lee Jun-Hyuk urgently grabbed Young-Joon’s arm.
“S-Sir, wait. We wrote a contract to hold the clinical trial here and everything. You can’t do this…”
“The primary investigator said he was going to resign, too,” Young-Joon said.
Lee Jun-Hyuk turned to Koh In-Guk in surprise. Koh In-Guk confirmed it with a serious face.
“I will resign. My pride has been hurt too much over this incident, and I feel ashamed at the work I am doing here.”
“...”
“Goodbye. I won’t be giving clinical trials to Sunyoo Hospital anymore.”
Young-Joon said goodbye to Lee Jun-Hyuk and left with Park Joo-Hyuk.
On the way back to A-Gen, Park Joo-Hyuk glanced at Young-Joon, who was lost in thought. His hands were trembling lightly.
“Hey. You went in there like a bulldozer, but… You overdid it, didn’t you?”
“...”
“You did good.”
“Thanks.”
“Hey, but I have something to ask you.”
“Why did you bring me? You can take care of it by yourself.”
“Just in case we fought about legal problems.”
“So I was your law robot.”
“And I need someone to stop me if I get too heated.”
* * *
Young-Joon called the Stem Cells Department and talked with Shin Young-Yeon on the phone. She actually had no relationship with the old couple. All she did was tell them how to apply and fill out their application form. She also said that she told them multiple times that they could not be selected. They only came to Young-Joon after they were absurdly removed from the trial afterward even though they were selected as participants.
—I did not break research ethics! How could I dare to come see you if I did that? You have no compromise about that.
“Right?
—Of course. At A-Gen, your personality and attitude toward research is like what you’d see in textbooks. If I got the participants selected by lobbying, it would be suicide to come see you.
“Alright. Could you please give me the couple’s contact information?”
—Contact information?
“Yes. I want to visit them.”
Young-Joon got their contact information and made time on his weekend to go to the old couple’s house. There were rows of worn-out, ragged houses in the suburb. The old, dark streets and dirty roads reminded him of his parents’ house in Daejeon. Young-Joon brought them to an apartment he got near Jungyoon University, and they were going to move in soon, but they still lived there.
“...”
Kang Hyuk-Soo, who was standing in the living room, which also was the kitchen, looked very disheartened.
“Sorry, I don’t have anything to offer you…”
Kang Hyuk-Soo handed Young-Joon a glass of water.
“Your wife will be able to participate in the clinical trial.”
Kang Hyuk-Soo’s face lit up when he heard Young-Joon.
“Thank you!”
“There is no need to thank me. I didn’t do anything. She was randomly selected.”
“Still, thank you.”
“But the clinical trial investigation institution will change, so it will take longer than planned.”
“... Is that so?”
“Don’t worry too much. She will get better quickly when the treatment starts. But I think it will be hard for you to take care of her alone until then, so why don’t you get a caregiver?”
“I did look into it. The hospital said that without a professional caregiver, it’s easy for people with Alzheimer’s as advanced as her to get sepsis or something, and they said that she had to be admitted into a nursing home to be properly taken care of.”
“Is that so?”
“Yes, but it was too expensive. I live paycheck to paycheck from my job as a taxi driver. How could I afford something like that? Even the health insurance doesn’t work because of something about my wife.”
“... I would like to help you, but large sums of money or valuables should not be exchanged between clinical trial personnel.”
“Haha, it’s alright. I did not tell you so that you could help me. I’m just grateful that you developed a drug like that.”
Young-Joon grinned. “She will get better, I promise. Don’t worry about the selection process and have hope.
“Yes, thank you. Thank you so much.”
Young-Joon left the house as the old man bowed to him multiple times. He stopped in front of Kang Hyuk-Soo’s front door. After checking that he went back inside, Young-Joon slipped a little envelope in his mailbox. It was some money for him to be able to use a professional caregiver or go into a nursing home until the clinical trial.
It was funny and bitter, but one of the most powerful disease suppressors in the world was money. In the bounds of science, that determined treatment and survival.