Frameshift (UC), page 7
"That's only half as much as the M premium."
"Exactly. It's an incentive to have the test, see? We don't make
you take a genetic test, but if you decide to do so voluntarily, you can save a lot of money."
"That hardly seems fair."
Tiffany shrugged. "Lots of insurance companies do it this way now."
"But you're saying I can't get any health insurance because of my family history?"
"Right. Huntington's is just too costly, and your risk level, at fifty percent, is too high, to consider covering you at all. But if you take a test that proves you don't have the gene—"
"But I don't want to take the test."
"Well, this gets even more complicated." She sighed, trying to think of how best to explain it. "Last month, Governor Wilson signed a Senate bill into law. It comes into effect on January first—ten weeks from now. The new law says California health insurers will no longer be able to use genetic testing to discriminate against people who carry the gene for a disease but have no symptoms of it. In other words, we will no longer be able to consider merely having the gene for Huntington's or ALS or any other late-onset illnesses to be a preexisting condition in otherwise healthy people."
"Well, it isn't a preexisting condition."
"Politely, Mr. Tardivel, that's a matter of interpretation. The new California law is the first of its kind in the nation; in every other state, having bad genes does amount to a preexisting condition, even if you're asymptomatic. Even those few states that do have anti-genetic-discrimination laws—Florida, Ohio, Iowa, a couple of others—even they make exceptions for insurance companies, allowing them to use actuarial or claims experience in deciding whom to insure and what premiums to charge."
Pierre frowned. "But what you're saying is, because we're in California, if I wait until January first, you won't be able to reject me on the basis of my family history?"
"No, we'll still be able to do that—that's valid information that you're a high-risk candidate, and we're not obligated to give policies to high-risk people."
"Then what's the difference?"
"The difference is that genetic information supersedes family-history information. Do you see? If we have concrete genetic info, it takes precedence over anything we might infer from the medical histories of your parents or siblings. If you take the genetic test, then, under the new state law, we have to give you a policy regardless of its results related to Huntington's disease. Even if the test proves that you do have the Huntington's gene, we still have to insure you as long as you apply before you have any symptoms; we can't reject you or charge you a higher premium based on actual genetic information."
"Wait a minute—that's crazy. If I don't take the test, you've got a fifty-fifty shot that I'll end up making a lot of claims due to my Huntington's, and so you reject me because of my family history. But if I do take the test, and even if it's a hundred percent definite that I will get Huntington's and therefore make a lot of claims, you will insure me?"
"That's right, or at least it will be, after January first, because of the new law."
"But I don't want to take the Huntington's test."
"Really? I'd have thought you'd like to know."
"No. No, I don't. Hardly any Huntington's at-risks have taken the test. Most of us don't want to know for sure."
Tiffany shrugged a little. "Well, if you want to be insured, it's your only option. Look, why don't you fill out the forms today, but date them January—well, January second: the first business day in the new year. I'll call you up then, and you can let me know what you want to do. If you've already taken the test by that point, or are prepared to take it, I'll put the policy application in; if not, I'll just tear it up."
It was obvious that Tiffany simply didn't want to risk losing a sale, but, dammit, this had already taken far too much time; Pierre certainly didn't want to go through the same rigmarole again with somebody else. "I'd like to see some other plans before I make my decision," he said.
"Of course." She showed Pierre a variety of policies: the pre-dictable Silver and Bronze Plans, with progressively fewer benefits; a hospital-only plan; a drug-only plan; and so on. But Tiffany pressed hard for the Gold Plan, and Pierre finally agreed, telling himself he would have made exactly the same decision even if her blouse had been done up all the way.
"You won't regret your choice," said Tiffany. "You're not just buying health insurance—you're buying peace of mind." She got a form from her briefcase and handed it to Pierre. "If you could just fill this out—and don't forget to date it January second." She opened the left side of her jacket. There was a pocket inside the jacket, with a row of identical retractable ballpoint pens clipped to it. She extracted one, closed her jacket, and handed the pen to Pierre.
He pressed down on the pen's button with his thumb, extending the point, and filled out the forms. When he was done, he handed the form back to her, and absently went to put the pen in his own breast pocket.
Tiffany pointed at it. "My pen… ?" she said.
Pierre smiled sheepishly and handed it back to her. "Sorry."
"So, I'll call you at the beginning of the year," she said. "But be careful between now and then—we wouldn't want anything to happen to you before you're insured."
"I still don't know if I'm going to take the test," he said.
She nodded. "It's up to you."
Pierre thought, It hardly seems that way, but decided not to argue the point further.
Chapter 10
Pierre had searched long and hard for an area to specialize in. His first instinct had been to do research directly into Huntington's disease, but ever since the Huntington's gene had been discovered, many scientists were concentrating on that. Naturally, Pierre hoped they would find a cure—and soon enough to help him, of course, if it turned out that he himself did have the disease. But Pierre also knew of the need for objectivity in science: he couldn't afford to piss away what time he might have left chasing slim leads that would probably amount to nothing-leads that someone without Huntington's would know enough to abandon, but that he, out of desperation, might devote far too much time to.
Pierre decided instead to concentrate on an area most other geneticists were by and large ignoring, in hopes that such territory would be more likely to yield a breakthrough that might indeed get him a Nobel Prize. He centered his research on the so-called junk DNA, or introns: the 90 percent of the human genome that did not code for protein synthesis.
Exactly what all that DNA did do no one was quite sure. Some parts seemed to be foreign sequences from viruses that had invaded the genome in the past; others were endlessly stuttering repeats—ironically, similar in structure to the very unusual gene that caused Huntington's; others still were deactivated leftovers from our evolutionary past. Most geneticists felt the Human Genome Project could be completed much more quickly if the junk nine-tenths were simply ignored. But Pierre harbored the suspicion that there was something significant coded in some as yet undeciphered way into that mess of nucleotides.
His new research assistant, a UCB grad student named Shari Cohen, did not agree.
Shari was tiny and always immaculately dressed, a porcelain doll with pale skin and lustrous black hair—and a giant diamond engagement ring. "Any luck at the library?" asked Pierre.
She shook her head. "No, and I've got to say this seems like a long shot, Pierre." She spoke with a Brooklyn accent. "After all, the genetic code is simple and well understood."
And so, indeed, it seemed to be. Four bases made up the rungs of the DNA ladder: adenine, cytosine, guanine, and thy-mine. Each of those was a letter in the genetic alphabet. In fact, they were usually referred to simply by their initial letters: A, C, G, and T. Those letters combined together to form the three-letter words of the genetic language.
"Well," said Pierre, "consider this: the genetic alphabet has four letters, and all its words are three letters long. So, how many possible words does the genetic language have?"
"Four to the third," said Shari, "which is sixty-four."
"Right," said Pierre. "Now, what do these sixty-four words actually do?"
"They specify the amino acids to be used in protein synthesis," replied Shari. "The word AAA specifies lysine, AAC specifies asparagine, and so on."
Pierre nodded. "And how many different amino acids are used in making proteins?"
"Twenty."
"But you said there are sixty-four words in the genetic vocabulary."
"Well, three of the words are punctuation marks."
"But even taking those into account, that still leaves sixty-one words to express only twenty concepts." He moved across the room and pointed to a wall chart labeled "The Genetic Code."
Shari came over to stand next to him. "Well, just as in English, the genetic language has synonyms." She pointed at the first box on the chart. "GCA, GCC, GCG, and GCT all specify the same amino acid, alanine."
"Right. But why do these synonyms exist? Why not just use twenty words, one for each amino?"
Shari shrugged. "It's probably a safety mechanism, to reduce the likelihood of transcription errors garbling the message."
Pierre waved at the chart. "But some aminos can be specified by as many as six different words, and others by only one. If synonyms protected against transcription errors, surely you'd want some for every word. Indeed, if you were designing a sixty-four-word code simply for redundancy, you might devote three words apiece to each of the twenty amino acids, and use the four remaining words for punctuation marks."
Shari shrugged. "I guess. But the DNA system wasn't designed; it evolved."
"True, true. Still, nature tends to come up with optimized solutions through trial and error. Like the double helix itself—remember how Crick and Watson knew they'd found the answer to how DNA was put together? It wasn't because their version was the only possible one. Rather, it was because it was the most beautiful one. Why would some aspects of DNA be absolutely elegant, while others, including something as important as the actual genetic code, be sloppy? My bet is that God or nature, or whatever it was that put DNA together, is no?sloppy."
"Meaning?" said Shari.
"Meaning maybe the choice of which synonym is used when specifying an amino acid actually encodes additional information."
Shari's delicate eyebrows went up. "Like, if we're an embryo, insert this amino, but if we've already been born, don't insert it!" She clapped her hands together. The mystery of how cells differentiated throughout the development of a fetus still hadn't been solved.
Pierre held up his hand. "It can't be anything as direct as that, or geneticists would have noticed it long ago. But the choices
of synonyms over a long stretch of DNA—be it in the active portions, or in the introns—might indeed be significant."
"Or," said Shari, now pouting slightly at having her idea rejected, "it might not."
Pierre smiled. "Sure. But let's find out, one way or the other."
* * *
A Sunday morning.
Molly Bond loved going over to San Francisco—loved its seafood restaurants, its neighborhoods, its hills, its cable cars, its architecture.
The street Molly was on was deserted; not surprising, given how early it was. Molly had come to San Francisco to attend the Unitarian fellowship there; she wasn't particularly religious, and had found the hypocrisy of most of the clergy she'd met in her life unbearable, but she did enjoy the Unitarian approach, and today's guest speaker—an expert on artificial intelligence— sounded fascinating.
Molly had parked a few blocks from the fellowship hall. The meeting didn't start until nine o'clock; she thought she might go into McDonald's for an Egg McMuffin beforehand—her one vice that she periodically but only halfheartedly tried to break was her fondness for fast food. As she headed along a steeply angled sidewalk approaching the restaurant, she noticed an old man up ahead at the side of the road in a black trench coat. The man was bent over, poking with a walking stick at something lying at the base of a tree.
Molly continued along, enjoying the crisp early-morning air. The sky was cloudless, a pristine bowl of blue arching over the stuccoed buildings.
She was now only a dozen paces or so from the man in black. His trench coat was an expensive London Fog model, and his black shoes had recently been polished. The man was eighty if he was a day, but tall for a man that age. He was wearing a navy blue watch cap that pressed his ears against his head. He also had the collar of his trench coat turned up, but his neck was thick, with loose folds of skin hanging from it. The old guy was too absorbed in what he was doing to notice her approach. Molly heard a small whimpering sound. She looked down and her mouth dropped in horror. The black-clad man was poking at a cat with his stick.
The cat had obviously been hit by a car and left to die. Its coat, mottled white, black, orange, and cream, was smeared down the entire left side with blood. It had clearly been hit some time ago—much of the blood had dried to a brown crust—but it was still oozing thick red liquid from one long cut. One of the cat's eyes had popped partway from its skull and was clouded over in tones of bluish gray.
"Hey!" Molly shouted at the man in black. "Are you crazy? Leave that poor thing alone!"
The man must have stumbled on the cat by accident, and had apparently been enjoying the pathetic cries it made each time he jabbed it with his stick. He turned to face Molly. She was disgusted to see that his ancient bone-white penis, erect, was protruding from his unzipped trousers, and that his other hand had been on it. "Blyat!" cried the man in an accented voice, his dark eyes narrowing to slits. "Blyat!"
"Get out of here!" Molly yelled. "I'm going to call the police!"
The man snapped "Blyat" at her once more, then hobbled away. Molly thought about going after him and detaining him until the police could arrive, but the very last thing in the world she wanted to do was touch the vile character. She loomed in to look at the cat. It was in terrible shape; she wished she knew a way to put it quickly out of its misery, but anything she might try would probably just torture the poor creature more. "There, there," she said in soothing tones. "He's gone. He won't bother you anymore." The cat moved slightly. Its breathing was ragged.
Molly looked around; there was a pay phone at the end of the block. She hurried over to it, called directory assistance, and asked for the SPCA emergency number. She then dialed that. "There's a cat dying at the side of the road," she said. She craned her neck to see the street signs. "It's just off the sidewalk on Por-tola Drive, a half block up from the corner of Swanson. I think it was hit by a car, perhaps an hour or two ago… No, I'll stay with the animal, thanks. Thanks ever so—and please hurry."
She sat cross-legged on the sidewalk next to the cat, wishing she could find it in her heart to stroke the poor animal's fur, but it was too disgusting to touch. She looked down the street, furious and distraught. The black-clad old man was gone.
Chapter 11
Three weeks later.
Pierre sat in his lab, looking at his watch. Shari had said she might be late getting back from lunch, but it was now 14:45, and a three-hour lunch seemed excessive even by West Coast standards. Perhaps he'd been crazy hiring someone who was just about to get married. She'd have a million things to do before the wedding, after all, and…
The door to the lab opened, and Shari walked in. Her eyes were bloodshot and although she'd obviously taken a moment to attempt to fix her makeup, she'd clearly been crying a lot.
"Shari!" said Pierre, rising to his feet and moving over to her. "What's wrong?"
She glanced at Pierre, her lower lip trembling. Pierre couldn't remember the last time he'd seen someone look so sad. Her voice was low and quavering. "Howard and I broke up." Tears were welling again at the corners of her eyes.
"Oh, Shari," said Pierre. "I'm so sorry." He hadn't known her that long and wasn't sure if he should pry—and yet, she probably needed somebody to talk to. Everything had been fine before she left for lunch; Pierre's might very well be the only friendly face she'd seen since whatever had happened.
"Did you—did you have a fight?"
Tears rolled slowly down Shari's cheeks. She shook her head.
Pierre was at a loss. He thought about drawing her close to him, trying to comfort her, but he was her employer—he couldn't do that. Finally he settled on, "It must hurt."
She nodded almost imperceptibly. Pierre led her over to a lab stool. She sat on it, placing her hands in her lap. Pierre noticed the engagement ring was gone. "Everything was going so well," she said, her voice full of anguish. She was quiet for a long time. Again, Pierre thought about reaching out to her—a hand on her shoulder, say. He hated to see anyone in such pain. "But—but my parents came over from Poland after World War II, and Howard's parents are from the Balkans."
Pierre looked at her, not understanding.
"Don't you see?" she said, sniffing. "We're both Ashkenazi."
Pierre lifted his shoulders slightly, helpless.
"Eastern European Jews," said Shari. "We had to go for counseling."
Pierre didn't really know much about Judaism, although there were lots of English-speaking Jews in Montreal. "Yes?"
"For Tay-Sachs," said Shari, sounding almost angry that it had to be spelled out.
"Oh," said Pierre very softly, understanding at last. Tay-Sachs was a genetic disease that resulted in a failure to produce the enzyme hexosaminidase-A, which, in turn, caused a fatty substance to accumulate in the nerve cells of the brain. Unlike Huntington's, Tay-Sachs manifested itself in infancy, causing blindness, dementia, convulsions, extensive paralysis, and death—usually by the age of four. It was almost exclusively found among Jews of Eastern European extraction. Four percent of American Jews descended from there carried the gene— but, again unlike Huntington's, the Tay-Sachs gene was recessive, meaning a child had to receive genes from both parents to get the disease. If both the father and the mother carried the gene, any child of theirs had a 25 percent chance of having Tay-Sachs.
