haveaname,justanumber—PF0231006—andthismade
it all the more enticing.
Therewereafewhoveringissues,includingthefactthat
thescientistsdidn’tyetknowthesafedose.Thedrugwas
only in a Phase I trial—that is, a trial designed to
determinethetoxicityofarangeofdoses,notwhether
thedrugworked.Furthermore,atestofthedrugagainst
her cancer cells in a petri dish showedno effect. But
Marcouxthoughtthatthesewerenotdecisiveobstacles,
justnegatives.Thecriticalproblemwasthattherulesof
the trial excluded Sara because of the pulmonary
embolismshehaddevelopedthatsummer.Toenroll,she
wouldneedtowaittwomonthsinordertogetfarenough
past theepisode.Inthemeantime, he suggestedtrying
another conventional chemotherapy, calledvinorelbine.
Sara began the treatment the Monday after Thanksgiving.
It’sworthpausing toconsiderwhathad justhappened.
Step by step, Sara ended up on a fourth round of
chemotherapy, one with a minuscule likelihood of
alteringthecourseofherdiseaseandagreatlikelihoodof
causing debilitating side effects. An opportunity to
prepare for the inevitable was forgone. And it all
happenedbecauseofanassuredlynormalcircumstance:a
patientandfamilyunreadytoconfronttherealityofher
disease.
I asked Marcoux what he hopes to accomplish for
terminallungcancerpatientswhentheyfirstcometosee
him.“I’mthinking,canIgetthemaprettygoodyearor
twoout ofthis?”he said.“Thosearemyexpectations.
Forme,thelongtailforapatientlikeheristhreetofour
years.”Butthisisnotwhatpeoplewanttohear.“They’re