THREE ON THE EDGE

The human side of research medicine is the focus of this account of three patients participating in clinical trials of new drugs for the treatment of AIDS and cancer. In 1995 and 1996 science writer Kelly (co-author with Thomas Verny of The Secret Life of the Unborn Child, not reviewed) spent some 200 hours with Edward Sandisfield, Romy Hochman, and Julie Conte as they faced life-threatening diseases. Sandisfield, a middle-age gay man knowledgeable about AIDS and its treatment, was so desperate to win a place in the clinical trial at Bellevue of a new protease inhibitor, indivir, in combination with AZT and 3TC, that he was prepared to lie his way into the program if necessary. The Hochmans put their 14-year-old daughter with osteosarcoma (a form of bone cancer that frequently metastasizes to the lungs) into a clinical trial at NYU Medical Center to boost her chances of survival; however, Romy was randomized into the control group, receiving only standard treatment. Conte, a 34-year-old woman with breast cancer, was leery of joining a clinical trial testing a high-dose combination-drug therapy, but having already lost her mother and one sister to the disease, she entered the program at Fox Chase Cancer Center in Pennsylvania. Kelly stayed with his three subjects during exams, interviews, and treatment, observing them and talking to them about their experiences, their hopes, and their fears, and interviewing their families, friends, and doctors. Some conversations seem to be reported verbatim, at times giving the stories an up-close and personal feel. In each, Kelly inserts an essay on the disease and the treatment being tested. While the stories end with all three patients alive, an afterword reveals that by 1997 one had succumbed. Kelly’s discussion of the medicine is thorough, but the portraits of his subjects are uneven. Sandisfield’s story is the most complete and his character and his world the best delineated; by comparison, Conte’s story seems sketchy, and the teenager Hochman remains opaque.