MFF Industries Boardroom - 07:15
Outside the large plateglass window Cloverfield was just beginning to emerge from its nightime slumber. Cars filtering through the streets of southside, the ferry making its morning foray lazily over the Deepwater River. Across the river the run down, brown brickwork of southside gave way to the sprawling cityline profile of Cloverfield's downtown core on northside. Perched atop a massive drumlin hill, six stories up in MFF Industries' powerplant, the city looked small.
Inside the boardroom the lights were dimmed. Outside the mountains obscured the rising sun such that the whole of the boardroom was illuminated solely by the light of the powerpoint projector and the city lights beyond with the effect of casting the whole of the room in a state of unnatural twilight. Figures in suits, men and women of serious disposition craned their necks, staring in rapt silence in the direction of the illuminated wall-screen, while an intern in heels stepped around refilling decanters of ice water before taking her place quietly in a corner out of sight. The words "Serenova Treatment - A Fresh Start to Mental Peace" illuminated the screen as a heading.
A presentation was in progress, the slides of the powerpoint shifted through initial preamble, talking mostly about something called 'Serenova', how it had passed initial animal and phase I human testing without serious consequences. How it made use of patented technology - held by a shell company owned by Lux (and built and initially tested by MFF's own R&D department) - designed to treat serious depressive disorders as well as anxiety and bi-polar issues. These and other things the figures watched in silence, occasionally nodding, occasionally shifting through their notes and papers or sipping from their coffee cups.
At the head of the room MFF Industries' CEO watched silently, less at the presentation than the people. Among those present he was one of the few aware of Lux Medical Technologies wasn't merely a strategic partner, but rather, wholly owned by MFF Industries - insulated from their activities by a slew of overseas shell companies that ultimately traced their way to a Panamanian Law Firm, whose partners were the listed owners of several private equity firms who collectively controlled Lux. Most even on MFF's board believed they were simply first in line to build the equipment for this treatment when the time came, and eager to be involved in buying up Lux shares during it's much anticipated Initial Public Offering.
"Off label treatment is very much on the table though." The knowing smile of the Lux presenter was cast in a gentle moonlit blue light to gentle applause as she yielded the floor to Dr. Pavinder Khadri, Lux's Chief Technical Officer. It was he who took up position to one side of the room, the pair of Lux presenters so far yielded the floor, taking their seats. There was ceremony and deference to it. Calculation too. An air of anticipation filled the boardroom. People leaned forward.
This was Lux's superstar, and the main event was about to begin.
"Now, what I'm sure most of you have been waiting to hear." The tone of the presentation immediately changed as Dr. Khadri advanced to the next slide. He was more animated than the others. Here was a man that enjoyed his work, and had news he was excited to share. "Most of the data-analysis from phase 2 trials is complete, but we are now very confident declaring our Phase II trials a resounding success."
Gentle applause from the board.
"A total of 957 patients completed the full study cycle - which is a very significant number for phase 2 trials, reflecting the excitement our product has generated from both patients and medical service providers. Our phase 2 results clearly show self-reported efficacy showing reductions in significant negative emotions and intrusive thoughts of 90% over benchmark treatments."
There was clapping around the boardroom as the screen flipped through the graphs from the study. A tepid smile tugged even at Mr. Foster's lips as he surveyed the table, the news drawing a few tepid claps from his own stoic hands.
"Double blinded assessment tools applied by our researchers overwhelming confirm these numbers.
A 67% improvement in the number of respondents showing positive response to Serenova over benchmark treatments, for the least severe symptoms. The reason this is lower, is self reports are always high. However, reduction of the most severe symptoms was higher still, scores show a 127% point improvement over benchmark treatments. Overall nearly 95% of those in the study group, showed
significant positive response to the Serenova treatment regime. These are unprecedented numbers in any study."
The room erupted clapping and smiles around the table. Executives were patting each other's backs, smiles ear to ear.
So much so that Dr. Khadri had to speak up to be heard even as the room began to die down. "
AND we have reason to expect there are synergistic effects when combined with existing medical interventions."
Renewed clapping and applause from the executive team, who rose from their seats. The only exceptions were the loan intern in the corner, who seemed to be hiding, and MFF's CEO, Mr. Foster, who remained seated presiding over the jubilant board room with an indulgent grin and a tepid set of claps.
At this point the boardroom opened to questions from those present for Dr. Khadri.
"How long does the full treatment program take?"
"Our study cycle is two years, but this would be ah... a recurring treatment. Once treatment is discontinued, resumption of negative symptoms typically occurs within one to two weeks."
"So we'd be looking at, indefinite continuation of the treatment?"
Dr. Khadri smiled uncomfortably at the question. "We would be looking to pair the treatment with interventions targeted to reduce root causes of the negative symptoms. However, we expect the most common use of our treatment will be for depression, and having read some of our patient profiles it would be fair to say many of the root causes are not responsive to medical interventions."
One of the other Lux presenters spoke up. "So the answer to your question, for patients, is 'most likely'." Then to the rest of the board. "All chargeable of course."
This was exciting news. More clapping. Someone began hooting in the boardroom.
Lux's marketing officer spoke up at this point. The room being loud enough they had to shout to be heard. "We also have some confidential indications through our partners in the medical insurance sector!" The room began to grow still again by this fresh declaration. "Lux has a number of strategic partners, who are seeing the same data you are. Including Insurance Companies, and partner companies - employers - who are participating in study recruitment. Interest in our product coming to market has been high."
"How high?"
"We're being told that participating partners have seen radical improvements in workplace attendance, retention, productivity." The marketing representative declared, having to raise their voice again as people began standing up. The excitement was becoming infectious in the room. "They want to know how soon they can get this treatment on their workplace insurance plans!" People in the board were all rising to their feet. "We had a meeting just last week with insurance and industry partners about lobbying for expedited FDA approval!"
The room exploded. Clapping. Hooting. Senior executives elbowing one another. Bedlam had erupted. Announcements and news like this did not simply happen.
"And keep in mind people, the byproduct of this treatment is itself a revenue stream." Another of the Lux reps actually had to stand up on their chair and shout to make the last part heard.
And then, a sudden calming ran through the room. At first even those in attendance seemed confused as to where the sudden wave of silence was coming from but starting at the front of the table in ran down the whole length of it like a cold shudder. "Please, ladies, gentlemen." Mr. Foster's voice was eventually heard as one by one the table fell silent. His voice was neither loud nor harsh yet the very act of him speaking at all seemed to run through the room like a shudder. "We do have a meeting to finish, and I have an 8 o'clock. Dr. Khadri, please, finish your presentation."
The room settled into a more muted, quieter, more electric energy as people seated themselves. Serious faces resumed. People straightened suits and sat back down.
Dr. Khadri closed with some final remarks. "Obviously there are some caveats. Disclosures that must be made." He began running through a set of very standard conditions, warning common to such studies. Ending with one particular one that drew some raised eyebrows along the table. "Most significantly however, our study group did show a small, but statistically significant uptick in rate of suicide."
A chill descended over the room and as Dr. Khadri prepared to continue someone interrupted him. "That's... serious isn't it?"
Dr. Khadri shifted from foot to foot before the powerpoint screen, and adjusted his glasses. This was clearly a question he'd prepared for. "Any increase in suicide rate is taken very seriously. Yes." He prepared to resume his presentation when another person asked.
"Is this... likely to affect approval?"
Dr. Khadri looked annoyed, but responded. "That will depend on Phase III trials, however
as I was about to say, this was an expected outcome of the study in our original filings to the FDA. Previous treatments for these disorders have had similar side effects. Our treatment reduces intrusive negative emotions, allowing our patients to more calmly go about their lives. While these can have a very significant deleterious effect on patient well-being, they can also have a protective effect as in the case of inhibitory fears towards... say, suicide. Obviously this is serious, but what we're seeing is both expected and within limits the FDA has already approved for other treatments."
"How much leeway do we have on this?"
"Previous treatments accepted by the FDA that showed very significant positive benefits have typically seen approval so long total increase in suicide rate does not rise above 0.2%. Based on our effect sizes, so long as our efficacy data holds in Phase III we could reasonably expect the FDA to go as high as 0.5%, especially with strong backing from the insurance industry and major companies fighting to get us on their work plans. Remember too, Serenova is a procedure not a drug with complicated pharmacokinetics. Historically such treatments hold up much better in Phase III. Based on our previous animal testing, we expect most of our phase 2 results to hold up much better in phase 3 compared to industry standards."
"Do you have projections on what increases we might expect in Phase 3?"
"Based on post-hoc analysis, and going into patient records, we think some of the noted uptick is statistical anomaly from the randomization process. Our control group happened to show one fewer suicide than expected. Ours had one more. Post-hoc analysis of patient profiles suggest the study group did wind up with a higher relative risk index. This will all be controlled for in phase III. There's risk in such projections but controlling for these, we're projecting with 95% confidence we'll land between 0.05-0.25% increase. We are also hoping that, as follow up data continues, over time lifestyle improvements will push us back into net-positive territory but that hasn't manifested in the data yet."
Once things began to settle down there were congratulations to Dr. Khadri and the rest of Lux's technical team for the work they'd been doing. The conversation turned then to discussions of Lux's financial position and how much money they'd need to raise during an IPO offering to ensure they'd be able to complete phase 3 trials and bring the product to market, then the talk turned to contracts for MFF to build the facilities to actually build the treatment equipment.
The end of Dr. Khadri's presentation had taken some of the wind out of the room as discussions shifted then to Lux's financial position and what sort of assets they'd need to finish out phase III trials and bring the treatment to market. Some of the jubilant mood returned when the marketing team discussed projected market shares, with a potential client base of potentially 10 million within the US alone. This coupled with the revenue estimates that accompanied them restored smiles to everyones faces by the time the meeting was adjourned.
Mr. Foster was one exception, remaining much as he had throughout. A somewhat bemused figure presiding over the whole affair as he watched the presentation play out. The other was the intern, who'd remained stationary in the corner and looked by this point like she'd very much prefer being elsewhere, her fingers tapping against the cellphone in the waist pocket of her blazer.
Mr. Foster pulled out his pocketwatch as closing statements finished and people began standing up, shuffling papers and exchanging handshakes. He stood then, taking a position, sentinel-like then by the door, thanking everyone with a great smile, a firm handshake and a pat on the shoulder as they left through the door held open by the intern and a few jovial remarks as the room quickly emptied.
"You. Stay." Mr. Foster declared abruptly when it was just two left in the room and the intern was half-way out the door.
The intern froze in the doorway, like a gazelle having caught first sight of a predator in the distance, caught between fight and flight. Slowly, reluctantly, she stepped back into the room. Her shoulders tightened ever so slightly when Mr. Foster instructed her to close the door, but she did so.
Her shoulders half-relaxed when Mr. Foster began walking away from and not towards her. "Go on, have a seat. Just a friendly chat."
The intern, still wary, slowly seated herself - very uncomfortably - in the chair.
"Ms. Escriva was it?" Mr. Foster paused in front of the enormous plate glass window overlooking Cloverfield, planting his hands in his pockets, his back to the young woman. Beyond, the sun was just beginning to peak above the mountain tops and he became like a shadow against the backdrop of Cloverfield bathed in golden light, and he as a shadow looming before it.
"Yes sir." Ms. Escriva managed, unable to hide her surprise that he even remembered her name, much less her discomfort at being placed on the spot, or being alone in a room with the CEO of the company she interned for. This was the set up to the sort of horror stories that were plastered all over the internet. On the other hand there was an entire room, and probably 40ft of table between her and the man so long as he stayed over there.
"Look you're not in trouble - in fact, quite the opposite. I just like to take the measure of the people I work with. This company, more or less runs itself, and I just... keep an eye out for anything that looks out of place. Try and make sure I have the right people, in the right place. You know? Everyone else seemed happy, excited even, by what they were hearing in there: except you. You seemed troubled. Which tells me: you saw something that none of them did."
Ms. Escriva shifted uncomfortably in her chair, unsure if she should answer. She knew what she'd heard, but it was more what hadn't been said that troubled her. "I wouldn't say troubled sir. I'm just an intern - this is maybe a little be above me." She offered instead, unsure if some things were even safe to say out loud. If, perhaps, this wasn't some sort of trap.
Mr. Foster turned his head slightly, a perfect side-profile of a prominent jaw and chin set in shadow against Cloverfield beyond the plate glass. "Just an intern?!" A gentle belly laugh ran through the boardroom for a moment in a way that did absolutely nothing to alleviate the notion that this was, in fact, a trap. "Don't sell yourself short Alejandra. You don't mind if I call you Alejandra, do you? 'Just an intern.' You have a masters degree don't you?"
Alejandra Escriva did not move. She did not breathe. For a moment it was as though time itself stood still as she sat, fixed in her seat. She definitely wasn't okay with him calling her by her first name, and she definitely hadn't ever mentioned it to him, much less her degree. She could feel him watching her with one eye. He didn't move, a figure still as death itself in front of the window.
Should I leave? Was this... something I shouldn't have heardScenarios ran through her head like wildfire, until the thought came unbidden to her ringing crystal clear in her mind.
Is he going to kill me?Alejandra Escriva did not answer the question. She remained still as a ghost.
"We'll leave it at Ms. Escriva then." Mr. Foster laughed, nodding then as if apprehending her discomfort. "But I am curious. I have use for people who can see what others don't. Something troubled you in that meeting. I saw it. I'm curious what. Go on. No wrong opinions here, this is a safe space."
Alejandra shifted in her seat uncomfortably again before forcing herself to relax. "Okay. Okay." She said. "If I'm... honest. I may not be a medical expert, but.... this treatment is going to kill people."
"Ah." Mr. Foster nodded then, as if finally understanding the answer to some deep puzzle.
"And I'm no medical expert but I can do a little math..."
"And?"
"Even 0.05% of 10 million patients is... 50,000 people. Dead people." Alejandra blurted out. "That's a lot."
Mr. Foster nodded, his shoulders sinking. "I suppose it is, isn't it? It really is." He nodded again as though processing what she'd just said, pushing off the window and shuffling from foot to foot as though thinking before heading to the far end of the board table and seating himself at one of the chairs there. "That's kind of one of the problems with the sort of work Lux does, isn't it? You can treat symptoms but, what can we really do when the disease is out there right? When the problem is just... people's lives. We can't really cure Southside, can we?" He looked up at her, offering a tepid smile and a helpless shrug.
"I suppose not sir." Alejandra wasn't sure where the conversation was going, but she did relax then. As though a great weight had been lifted from her shoulders.
Mr. Foster looked down at the conference room table somberly, as though searching for answers in its polished surface. Then he looked up and smiled a smile of pearly white teeth as though a solution had just presented itself to him. It was this moment that Alejandra Escriva realized she was actually in the middle of a pitch meeting. "But... what if we could?"
Despite herself, despite the uncertainty of what was going on and her skepticism about this man, her boss, Alejandra felt the tuggings of a genuine, curious smile here. "I'm not sure I follow sir."
"I'm talking about making differences here. Instead of standing around, holding doors, filling glasses and running coffees - is that what you went to school for? No of course it wasn't."
Alejandra laughed here, having the sense that this private meeting had just taken a different, altogether sillier turn. "I'm still not sure I follow."
Mr. Foster sat on the edge of the boardroom table and checked his pocketwatch and grinned. "You know what, let's put a pin in this for now. My 8 o'clock is about to start."
Ms Escriva started to stand up.
"No no. Stick around. You might find this interesting." He said, leaning over the table to the teleconference interface and keying the intercom button. "Is my 8'o clock out there?"
The disembodied voice of his executive assistant, Mrs. Weathers rang back over the intercom. "He is sir."
"Send him in."
The man that entered was a very different contrast to Mr Foster. Alejandra realized as she stood at the man's entrance that she was actually taller than Mr Foster himself.
Ryan Jackson was a different story. Well over six foot. Broad shouldered, barely chested. The man was practically poured into his suit. "Mr Foster." The two men shook hands, and with a nod from Mr Foster, Alejandra was obliged to do the same.
"This is Ms Escriva, she'll be auditing this meeting." Mr Foster declared.
"Is she cleared for this?"
"I cleared her." Mr Foster shot Alejandra an impish grin and gestured for them both to sit. "What news Ryan? Its been awhile."
"I just got out of a meeting with PRA's business liaison office. There's a couple of STG notices they handed out, I'd say these ones could be serious."
"What do you need from me Ryan?" Mr Foster spread his hands magnanimously as he seated himself last.
"For starters? A review of our site security contracts, and we need eyes on your boy Gideon."
"He's not really my boy."
"What he is is a problem. The PRA's flagging every corporate security rep in the region, Hollow's gearing up, they're concerned about corporate back-channels into Northside."
"Of course they are."
Jackson tossed a file of documents on the table in front of Foster. "The word terrorism is getting bandied about. My backchannels are telling me PRA's getting warnings from on high something going on."
Mr Foster glanced at the pages, his eyes skimming over them. "Troublesome."
"And that's not all." He set down another set of papers. "PRA's tracking reports of missing persons. Weird shit's making its way down from the mountains."
Mr. Foster looked at the new document briefly before sliding it back towards Jackson. "And that is precisely what I pay you to deal with. Look into it. Take the girl, show her the ropes."
Jackson's eyes fell upon Alejandra sitting, sheepishly across from him. "I don't need a partner."
Mr. Foster shrugged. "Well, I say: it is time that you do."
Jackson glanced at Alejandra again, and bit his lip. It was apparent there was some mental calculus going on there as to whether this was a battle worth fighting or not and from the way his shoulders slumped he decided, ultimately, it was not. "Fine. I'll show her around. I am
not taking a partner, just so we're clear."
Mr. Foster removed the notice about Hollow from the pile of documents, leaving the rest for Jackson to retrieve. "Great! Southside can take care of itself - we need to be sure this isn't something
else. In the mean time you can leave this on my desk. I'll deal with it." And Jackson could say anything further Mr Foster reached into his pocket and pulled out his pocket watch. "Regrettably, I have an 8:30, so let me know if you need anything. I have the utmost faith in both of you."
Abruptly the man stood up and headed towards the door pausing only briefly before he closed it behind himself. "Oh and Ms. Escriva. Congratulations on your promotion. We'll settle the paperwork when you get back."
Ryan Jackson and Alejandra Escriva both looked at one another just before the door closed, both wearing the same expression that wordlessly communicated the same message: what the hell just happened?
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