A young junior resident in medicine, Michael Lewis, is asked by his attending physician, Dr. Peter Sharp, to go and see Mr. Pearsall, a fifty-five-year-old policeman with cancer of the esophagus, and get him to sign on to a promising clinical trial. Dr. Sharp tells him that Mr. Pearsall, who has been hospitalized repeatedly over the past year for treatment of his cancer, may well refuse the treatment out of hand. But the particular treatment protocol, Dr. Sharp tells him, is this patient’s only chance at survival—moreover it seems a real advance in the treatment of this form of cancer and may well result in saving countless lives. Michael goes into the hospital room and finds that Mr. Pearsall is sleeping. At first he feels a flash of impatience—it’s late in the day and he’s already put in twelve hours on this shift. As soon as he can consent Mr. Pearsall, he can go home. But as he looks at the sleeping man, noticing how wasted and pale he looks, his impatience subsides. Michael sits down: he’s been on his feet for hours. His gaze wanders to the pictures and cards on the bedside table. Wife, kids, and esophageal cancer: what rotten luck, he thinks. He closes his eyes briefly, reflecting on his amazing good fortune in being assigned to Dr. Sharp, a brilliant oncologist who is running a huge research protocol involving a new drug for just this kind of cancer. If Michael can impress Dr. Sharp, his career could really take off. Dr. Sharp reminds him a little of his own father, now dead—a brilliant geologist who had made major contributions to environmental science.
Mr. Pearsall coughs, and Michael opens his eyes to find that the patient is awake. He goes over to the bedside, introduces himself, explains the protocol, and tells Mr. Pearsall that he has a consent form for him to sign. Mr. Pearsall shakes his head. He won’t sign: he tells Michael he’s sick of tests, treatments, hospitalizations. Michael talks with him some more, persuasively, praising the study and ending with the very words he heard Dr. Sharp use, “It’s your only chance.” After more questions from Mr. Pearsall and vague promises or evasive replies on the part of Michael, Mr. Pearsall agrees. “You’re the first person here I can trust,” he says as he signs the document.
As Michael walks out of the hospital, he reflects on Protocol 907. He is uneasy. He knows that it’s too soon to determine whether or not patients will be