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Deadly Deceptions: A Medical Thriller
Deadly Deceptions: A Medical Thriller
Deadly Deceptions: A Medical Thriller
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Deadly Deceptions: A Medical Thriller

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Matt Radowski, a bright, young doctor, is on the fast career track at GenWorld Inc., the most successful biotechnology company in the world. His curiosity and intuition have served him well, and hes someone to watch.



But now that curiosity has uncovered a dark secret, and Matt is about to come face-to-face with powerful enemies who will stop at nothing to protect their investment. Quite by chance, hes discovered that someone has manipulated the registration data for the companys new blockbuster drug, Septicustat, and these changes make the drug appear to be much more than it is. His life changes in ways he could never have imagined as he considers the implications of that information. Matt must now make a decision that could endanger his reputation, his careerand even his life.



How far will these influential investors go to keep his discovery buried? And how far will this brave, young doctor go to ensure that the truth is known?



Deadly Deceptions takes the reader inside the fascinating world of drug development, biotechnology, science, and big money.

LanguageEnglish
PublisheriUniverse
Release dateNov 12, 2012
ISBN9781475956979
Deadly Deceptions: A Medical Thriller
Author

Henrik Sandvad Rasmussen

Dr. Henrik Sandvad Rasmussen received his medical and PhD degrees from University of Copenhagen in Denmark. After five years as a practising physician, Dr. Rasmussen left Denmark. He spent the next twenty-three years developing new drugs for pharmaceutical and biotechnology companies in Europe and in the United States. Now, Dr. Rasmussen runs his own medical and regulatory consulting company, based in Princeton, New Jersey. He, his wife, and their three children live in New Jersey, Maryland, and Utah.

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    Deadly Deceptions - Henrik Sandvad Rasmussen

    Prologue

    Jeff Diehlmann squeezed his daughter’s hand as the nurses prepared to take her down to the operating room.

    Hey, little flower, you’re gonna be okay. They’ll take out that little thing in your tummy that hurts and bingo! He tapped her nose. Good as new! The doc says you’ll be home in a couple of days.

    Nina was trying to look at her father but couldn’t focus on his face. The preop medication had started to work. Daddy, don’t go. I’m scared.

    Jeff bent down and kissed his six-year-old daughter on her forehead. He loved her more than words could describe. Nina was always happy, so full of energy, so inquisitive, so passionate. Picking her up at daycare after work, tired and dirty from eight hours on the building site, was the highlight of his day. Nina would hear his voice at the door, run toward him like a speeding train, and fling her arms around his legs. That was happiness.

    * * *

    Until twelve hours ago, life had been simple, if not easy. Raising a child was tougher than he’d ever imagined. When Carol died three years ago, Jeff hadn’t known if he was right to keep Nina. Carol’s parents wanted Nina to live with them, but they were in Pittsburgh, a six-hour drive from Jeff’s South Philadelphia row house. He’d never get to see his daughter. She would grow up not knowing who her dad was. That was not why he had decided to get kids.

    So far, he’d been glad about his decision. He’d done a good job as a single parent. Until today. Nina had gotten a stomachache at daycare, and when he got her home, he put her to bed. The pain got worse and worse. He took her temperature—it was a little high—and tried to get her to have some dinner. Finally, he called Dr. Tanello at his evening clinic. He told Jeff to bring her in.

    Dr. Tanello lifted Nina onto the examining table, felt her stomach, and asked her to show him where it hurt. She touched a spot to the right of her bellybutton. He palpated the area gently, and Nina howled with pain. Then he told Jeff he was going to admit Nina immediately to University Medical Center for some tests.

    That was three hours ago. When the test results came through, the doctors said Nina had appendicitis and that they were going to operate right away. Jeff’s heart sank, but they assured him that surgery for appendicitis was routine nowadays and that the risk was minimal. There is nothing to worry about, Jeff repeated to himself. Nothing to worry about.

    Jeff walked slowly behind the gurney carrying his daughter through the almost empty corridors of the hospital. He looked at his watch—11:15 p.m. They came to a set of double doors with a sign reading Operating Area—Authorized Personnel Only. As one of the nurses pushed Nina on through, the other led Jeff to an empty waiting area with plastic chairs and dog-eared magazines.

    One hour later, Dr. Harron, Nina’s surgeon, walked into the waiting area. She was tall and big-boned, and her young face looked tired.

    Mr. Diehlmann, everything went pretty well. Your daughter did have inflammation in her appendix, but I think we caught it in time. It was very lucky that you came in here so quickly.

    Jeff sensed something was wrong. "What does that mean, think you caught it in time? You don’t know?"

    Well, there was a small rupture of the appendix. We noticed when we got in there that some of the bowel content had leaked out into her stomach—into the peritoneal cavity, actually, which is the open space where the abdominal organs are lying.

    That’s bad?

    It’s a complication. The bowel contains a lot of bacteria, which normally isn’t a problem—in fact, they are healthy—as long as they stay inside the bowel. But they can infect other parts of the body if there is a rupture. As far as we can tell, only a tiny amount got out, and it shouldn’t have any consequences. We’ll put Nina on a strong antibiotic. That should take care of it. You go home and get some sleep.

    * * *

    The following morning, Jeff called in sick. Then he phoned Carol’s parents, explained what was happening, and went back to the hospital. Nina had developed a fever. The nurse told Jeff it was quite normal and that he shouldn’t worry. But he did. Later that day, Nina’s fever got worse, and she became increasingly confused. She didn’t know where she was. She asked for her mother, something she hadn’t done for the last year. Jeff did not know what to say. Then they moved her to the intensive care unit.

    Jeff was panicking.

    I’m sorry about this, Dr. Harron said, standing in the corridor outside Nina’s room. But Nina has developed an abdominal infection despite the antibiotics we instituted. Also, she has a slight case of septic shock, which is why we’ve moved her to the ICU.

    What’s that? Jeff asked.

    Septic shock is a complication that sometimes occurs after surgery, even minor surgery, Dr. Harron replied. In the past—even as recently as three years ago—there was no treatment for it. But now we’ve got a new drug in our arsenal. It’s called Septicustat. It has proven remarkably effective in the treatment of septic shock. With your permission, I would like to initiate treatment with Septicustat.

    Jeff stepped quickly aside as two orderlies wheeled an empty gurney quickly down the hall. Then he turned back to Dr. Harron.

    And that will take care of it? Nina will be fine?

    Well, all drugs have side effects, Mr. Diehlmann. Septicustat is well tolerated, but there is a risk, albeit very small, of developing bone marrow depression. This is a very rare complication. It has only been reported in a small number of patients. However, I, like most of my colleagues, believe that the benefits clearly outweigh the risk.

    Jeff stared at the young physician in her green surgical suit. She was a full three inches taller than him. What will happen if we don’t give her this drug? And what is this risk?

    You have to understand that all drugs have risks, Mr. Diehlmann. What we look at is whether the risk of not using the drug is greater than the risk of the side effects it might cause. Now, septic shock is a funny disease. I mean, it can start out as a simple infection, something that looks pretty easy to cure. But it doesn’t always respond to antibiotics. If it gets worse, it can be serious. A full-blown case of septic shock can damage the kidneys, the heart, the brain, and the lungs.

    Jeff couldn’t believe his ears. He was trembling and felt nauseated, faint, like something had hit him with a hammer. But you said taking out the appendix is a routine operation.

    Dr. Harron nodded. It is. But any surgery can have complications. In this case, the complications are septic shock. To get back to your question about the risk, before this new drug was developed, about half of the people who contracted a full-fledged case of septic shock would die.

    Die? Jeff interrupted, the nausea getting worse.

    Yes, Dr. Harron hurried on. But Nina’s case is at an early stage, so she would probably be okay without this new drug. Even so, her chances are clearly better with it.

    Okay, Jeff nodded numbly, leaning back against the corridor wall. Go ahead. But Doc, he said and grabbed her hand, pleading, don’t let anything happen to her. She’s all I have. She’s my life.

    * * *

    Nina started Septicustat one hour later. Dr. Harron gave the first injection herself with Jeff watching. But things didn’t improve. On the contrary, they went from bad to worse. Later that evening, Nina started to bleed, first from her nose, then from the needle site in her right arm, and then from her vagina, her anus, and her nose. Needle-site red marks erupted on her skin, starting on the arms and then converged, like rivers of red tracks. Dr. Harron ordered tests and found that Nina’s platelets—the tiny blood components that help the blood coagulate—were dropping rapidly, an indication that her bone marrow had stopped producing them. Again Jeff was sent to a waiting area. The doctors and nurses infused bag after bag of blood platelets into Nina’s arm, but the faster the platelets went in, the faster they were destroyed. Nina’s body was rejecting the new platelets. And Nina continued to bleed. At seven o’clock the following morning, Nina’s heart gave up trying to pump the reduced amount of blood in her veins out to her oxygen-starved organs.

    This was every doctor’s nightmare: losing a child to complications from a simple procedure. For nearly an hour after cardiac arrest set in, Dr. Harron and her team tried CPR, and then injected atropine and epinephrine directly into the tissue of Nina’s exhausted heart in an attempt to shock it into beating again. Nothing worked. Nina Diehlmann, six years old, was declared dead at 7:50 a.m. on Wednesday, March 18, just forty-one hours after telling her daycare provider that her tummy hurt.

    * * *

    At 8:15, Dr. Harron walked into the waiting room to face Jeff. He could see what was coming, and his life stopped right there, right then. He sat as if paralyzed, his forearms pressing hard on the metal arms of his chair. When he moved his lips, not a sound came out.

    Later that day, Jeff Diehlmann went down to the basement of his house, put the barrel of a gun in his mouth, and pulled the trigger. Nina’s grandparents considered suing the hospital as well as the manufacturer of Septicustat, a biotech company named Genworld, but, after consulting a lawyer, they gave up the idea. According to the lawyer, they didn’t have a case. Septicustat had been approved by the Food and Drug Administration, a big clinical study had shown that it saved lives, and the surgeon had informed their son-in-law about the potential risks of the drug. He said he was sorry, but there was nothing he could do for them. No one among the manufacturer, the hospital, and the doctor was guilty of any wrongdoings. Or so he said!

    Chapter 1

    Paris, France, August 11, 1999

    Jennifer Bringles surveyed the small bar as she sipped her glass of Pomerol red wine. The bar was typical for the Latin Quarter—cozy, low-ceilinged, the air heavy with smoke. The place was full of local people laughing, chatting, and arguing as the piano player picked out a lazy love song, some Aznavour stuff. Jennifer reached for her pack of Marlboros, lit another cigarette, and exhaled with satisfaction. She was a long way from Charlotte, North Carolina, and she had every intention of keeping it that way.

    Paris suited her down to the ground. She liked her job at the US Embassy, and her blonde good looks, long legs, and soft Southern accent opened doors for her in both French and expatriate American circles. She didn’t spend her free time with her foreign affairs colleagues—the group was too small, too insular and too boring. She preferred the freedom of comparative anonymity—thus her presence in La Chatte Qui Chasse.

    Jennifer was watching two men embroiled in a typically Gallic debate, which sounded much more acrimonious than it probably was, when she saw the man walk through the door. He was tall, a couple of inches over six feet, with dark hair, a dark complexion, and a tan that definitely did not come from a bottle. He moved effortlessly, like a cat, with the confidence of someone who was aware of his good looks. His long, athletic legs were sheathed in tight black jeans. A gray Ralph Lauren T-shirt and brown leather jacket hung elegantly from his broad shoulders to his narrow hips. Something stirred in Jennifer’s belly, and she unconsciously bit her bottom lip. My God, she thought, this is one of the sexiest men I have ever seen.

    The stranger went straight to the only vacant table in the bar and made a discreet gesture toward a waiter. His polite restraint told Jennifer that he certainly was not a Parisian and that he probably wasn’t even French. This was confirmed when the waiter finally came over. She could only hear fragments of the conversation, but to Jennifer’s linguistically trained ear, developed by seven years of working abroad, it was enough. His accent was unmistakably American. Jennifer continued to watch the man out of the corner of her eye. He was scanning the bar, and she knew what he was looking for. She should be sensible and leave now, she told herself. He was gorgeous, but she knew his type—a spoiled brat, full of himself, probably used to getting exactly what he wanted. Instead of leaving, however, she watched herself in mild amazement as she got up and walked toward his table.

    Bonsoir, she said. Mind if I sit down?

    Please, the man replied and gestured toward the empty chair. Irritatingly, he didn’t seem surprised at all.

    Jennifer tapped a cigarette out of her pack and slid it expectantly between her fingers. What’s a handsome American doing in a local bar in the Latin Quarter when he can’t even speak the language?

    Well—the man grinned—I guess I’m waiting for a beautiful American woman to turn up. His voice was deep, melodious, and slightly husky. He lifted his glass of Pernod, gestured a toast to her, and took a drink.

    Let me guess, Jennifer said. You’re either a businessman, a lawyer, or a doctor.

    Right, the man said, but which one?

    Jennifer lit her own cigarette, inhaled deeply before letting the smoke out, and then said, A doctor—probably a cardiologist or a lung specialist who is now going to lecture me about the dangers of smoking.

    The stranger smiled. A doctor, yes. A cardiologist or a lung man, no. I’m in research. But I still think you should stop smoking. Been in Paris long?

    Three years. Before that, Athens and Copenhagen. And you?

    I’m here at a medical conference. Going home tomorrow, though.

    Like Paris?

    Love it. All of it. The buildings, the boulevards, the art, the history, the food—even the bossiness of the French.

    I know what you mean. I like it, too. Seen anything else of Europe?

    London, Prague, Vienna, Rome, and Copenhagen, he counted off on his long, tapering fingers. Nothing in the US to compare with them. The closest we come is San Francisco, New York, Washington, and New Orleans.

    Your list doesn’t include Boston and Chicago. Why not?

    Too serious. I like a town where people can have a little fun.

    So they had put their mutual cards on the table, Jennifer thought. They were both intelligent and well traveled. Both professionals. Let the evening proceed.

    By the way, I’m Matt Radowski. And you’re…

    Jennifer brushed back a strand of ash-blonde hair. At least he pretended to be interested in her name. But if she knew his type; he would forget it by tomorrow. Jennifer, Jennifer Bringles, she said, extending her hand. I’m with the American Embassy here.

    As she held his gaze in hers, Jennifer saw that his eyes—brown, almost dark—had more gentleness than one would have thought from the rest of his appearance. Frankly, she wouldn’t have minded going straight to her place, but she was supposed to be a nice girl, and nice girls don’t make love to strangers—especially not nice girls who are foreign service officers. Anyway, the handsome young doctor didn’t seem to be in any great hurry.

    Two hours and three glasses of Pomerol later, Jennifer was growing restless. She had learned that Matt was intelligent and charming and liked to hear himself talk. She had learned he came from La Jolla, California, had gone to Stanford, where he played serious tennis, then studied medicine at the University of California at San Francisco. Now he was telling her why he had stopped practicing medicine and taken a job with a biotech company.

    You know, I think I always wanted to go into research. During med school, though, I changed specialties all the time. Actually, that’s pretty common. When you do psychiatry, you want to be a psychiatrist, when you do internal medicine, you want to be an internist, when you do surgery, you want to be a surgeon—

    And when you’re with women, you want to be a gynecologist? Jennifer interrupted.

    He laughed. I think that would probably put me off women, Matt said. Anyway, I always found I returned to research. It never gets boring. You always feel that you’re on the verge of something great. Of course, that’s not the case. Most researchers never experience the great breakthrough. You walk through your professional life thinking you’re about to turn the corner, but before you do, it’s time to retire.

    I can’t believe medical practice could ever get boring, Jennifer said.

    Well, it does. Some specialties sooner than others, but even the so-called life-and-death specialties like trauma and acute care become routine. I spent three years doing trauma and emergency medicine at Cedars-Sinai in LA, and I can tell you that once you’ve seen a hundred road traffic accidents, shootings, muggings, or beatings, they all start to look alike. It gets routine.

    And you crave excitement? she asked softly, looking him straight in the eyes, feeling like she was drowning.

    Yes, I do. I need variety. He took the hand she had resting in her lap. Stimulation, too. I’m not particularly religious, and I’m not certain there’s an afterlife. So I figure I’d better get as much out of this life as possible.

    Jennifer appreciated his oblique approach, but her nose was out of joint. She would have taken him to bed after their first five minutes together—guys who looked this good didn’t come along every day. She decided to turn the tables and make him wait for it.

    So you left trauma because it was too boring, she mused, toying with her wine glass with her free hand. That’s the first time I’ve heard that one.

    Damned if he didn’t even grin at her. Clearly, he’d received her message—and took it in stride.

    Oh, that was only part of the reason, he continued. The other part is that as a young doc, you work your butt off. No spare time. No social life. And you don’t make that much money either. So when I got the chance for a job in biotech industry, where I could do research and make good money, travel, not work nights, I went for it. Why wouldn’t I?

    Do you ever miss practicing medicine?

    Jennifer thought she saw a flicker of doubt in his eyes, or maybe it was just wishful thinking.

    If everything else was equal, and I could make the same amount of money, I would probably go back. But I can’t, so it’s a nonissue.

    So he’s a bit lazy, pretty materialistic, and easily bored, Jennifer said to herself. But at least he is honest. And the sexual electricity was definitely there. Jennifer wanted him badly.

    She removed her hand from his and leaned back in her chair. Want a nightcap at my place?

    Matt Radowski slipped out of his pants and immersed himself in the burning hot water of the bathtub in his hotel room. It was six in the morning, and he had just returned from Jennifer’s tiny apartment on la rue Monge. Too bad he had a flight to catch. The night had been good. She was warm, passionate, uninhibited—he wondered if she owed that to her days in Copenhagen—and she obviously enjoyed sex. But then, didn’t they all? In his experience, women were as eager for sexual pleasure as men are reputed to be—most of them just didn’t like to show it.

    Matt gave a contented sigh, reached for the soap, and started to lather his neck and shoulders. He had time for six hours sleep before he’d have to pack and get to the airport. It had been a good trip, he thought. He had arrived at the hotel in Paris’s La Défense area three days ago to attend an international symposium on lung cancer, and over the last two days he had listened to numerous lectures on the progress made in the treatment of this insidious killer. But despite the new chemotherapy regimens, new surgical techniques, and increasingly sophisticated radiation schedules, the fact of the matter was that lung cancer eventually would kill you. Sometimes it just took its own sweet time to do so.

    Everything Matt had heard, in fact, confirmed that his company, Genworld, was on the right track with their radical new anticancer drug. Recent progress in the field of molecular biology had indicated that a number of patients with lung cancer, as well as some other cancer types, had a defect in the gene which codes for a process called apoptosis, or so-called programmed cell death. Apoptosis, which is part of the body’s natural defense against cancer, is a process by which very rapid cell growth, as seen in cancer, is being controlled. A defect in the gene coding for apoptosis impairs this mechanism, thereby creating a predisposition to cancer. By using DNA sequencing techniques, Genworld had identified the defect gene. Using molecular cloning, Genworld scientists had then repaired the defect and incorporated the repaired gene into a formulation that allowed reintroduction of the gene into cancer patients. The resulting drug was called Cancretol. Matt, who, as director of clinical cancer research, was in charge of the global development program for Cancretol, was currently shepherding it though the elaborate testing process dictated by the Food and Drug Administration.

    Cancretol had made it to late-stage clinical development, the so-called Phase 3 trials, for treatment of advanced lung and kidney cancer and was in earlier-stage development for a couple of other cancer types. It had sailed through testing on animals and passed both the Phase 1 trials, which used young, healthy volunteers, and the Phase 2 trials, which tested the drug on a small number of people suffering from lung and kidney cancer. The results were good. Cancretol seemed to kill the cancer cells. Also, the patients appeared to tolerate it well and to have fewer serious side effects than they would have had with traditional anticancer agents. Quite a few patients, however, did report flushing, heat sensations, and fever early on, but these usually disappeared with continued treatment.

    The only problem Matt was having with the Cancretol testing was that the side effects noted in Phase 2 testing and now cropping up among Phase 3 patients were so pronounced that the physician in charge, in many cases, could easily tell whether the patient was receiving Cancretol as opposed to a placebo. This, to some extent, defied the purpose of doing double-blind trials, in which the physician administering the study on the local level, the patient, and the drug manufacturer are not supposed to know whether the person is taking the actual drug or a dummy pill, a placebo. Double-blind trials ensure that any change that occurs in the progress of the disease is due to the drug, not to the patient’s (or the doctor’s) expectation that the drug would work. But there wasn’t a whole lot Matt could do about how obvious Cancretol’s side effects were, other than discuss the concern and clear it with the FDA, which he had done.

    If everything went well, Matt thought, they could complete the studies at the end of next year, break the blind, and see what the results were for those patients taking Cancretol. He couldn’t wait. If the studies were positive, the share price of Genworld—which was already the fastest growing and most successful of America’s burgeoning crop of biotechnology companies—would go through the roof. It would also be a major professional accomplishment for Matt to have brought the drug all the way through to FDA approval.

    Matt liked working in the biotech industry. There were always new ideas to pursue, the funding of the research was secured, and so far it had been quite easy to get the money needed for the trials. He found the environment stimulating—particularly the interactions with external physicians, many of whom were recognized experts and world leaders in cancer treatment. Also, from a financial point of view, he was significantly better off than he had been in clinical practice. His starting salary at Genworld three years ago had been $155,000, plus a bonus upon achievement of certain objectives and stock options in the company. The stock options, although still only paper money, were now worth approximately $400,000, thanks to the rapid appreciation of the company’s stock.

    * * *

    Matt toweled himself dry and slid naked between the sheets. Light was already seeping through the double curtains of his luxury room. It would be good to get home, even though Sandy wouldn’t be there.

    Jennifer had reminded him of Sandy, actually. She, too, was frankly sexual and unashamed of her desires. During their three years of marriage, Sandy had practically tackled him and dragged him into bed the minute he got back from a business trip. Now they were separated, and it looked like they would go ahead with the divorce.

    Matt had met Sandy four and a half years ago at Cedars-Sinai hospital in Los Angeles, where Sandy was working as a surgical nurse and Matt was doing his residency. She was short and slim with light red hair, lively gray-blue eyes, and an inexhaustible appetite for life. They had immediately clicked—he smiled at the memory of a hot and hurried half-hour together in an empty patient’s room—and a year later, they had married. They got on well together, in bed as well as out, although when Matt took the job at Genworld, things changed a little. He was working long hours, including some weekends and evenings, trying to make a name for himself among all the other talented young doctors and scientists on the staff. His efforts paid off in terms of promotions and raises, but they caused problems at home.

    Sandy hated having Matt gone so much of the time, and she often told him so. He tried to explain to her that he was doing it for them, so they’d be able to live well, but she just brushed him off. She’d rather live poor and be together, she said, than have lots of money and be apart so much of the time. Matt didn’t believe her. He continued to shine at work and had recently convinced Sandy to buy a bigger house, in La Jolla with a view of the Pacific, exercising some stock in Genworld for the down payment.

    Then, six months ago, Sandy told him she had met somebody else. At first Matt was shocked, outraged, and hurt. He knew Sandy loved him and he couldn’t understand how she could be unfaithful to him. Hard as it had been for him—women always seemed to throw themselves at doctors—he had been true to her. But when he eventually calmed down and listened to Sandy, he finally heard what she’d been saying for the past three years. She had been deeply lonely. There had been so many nights spent alone in front of the TV, so many weekends when she waited for Matt to come home so they could talk, walk, read, play tennis together, make love.

    Matt understood—and felt ashamed that he had driven away this wonderful woman. Putting aside his ego and wounded pride, he let Sandy go with as much good grace as he could muster. They agreed that Sandy would stay in their new house in La Jolla, and Matt moved to a condo in downtown San Diego. To his surprise, Matt soon realized that he enjoyed his newfound freedom. He had always loved women, and women certainly seemed to love him. He had received several more or less subtle propositions during his marriage to Sandy, and only by applying all his willpower had he been able to resist. But now he was free to pursue these opportunities, something he did without second thoughts.

    Sandy and Matt stayed in touch, talking on the phone or meeting for dinner—or more—at least once a week. When Sandy’s relationship with her new boyfriend ended, Matt was there to console her. But he didn’t want her back. Neither of them, in fact, wanted to try to put their marriage together again. During their separation they had grown in different directions, a process, Matt realized, that had begun when they were still married.

    All in all, despite the setback when Sandy left him, Matt had to admit he was a pretty happy guy.

    * * *

    He had traveled a strange road to get there, though. Matt was the son of a poor Ukrainian immigrant who had married an equally poor Polish immigrant. His early childhood had been a continuous struggle. He was born in Queens and spent the first three years of his life in a run-down one-bedroom apartment with his father, mother, and two older sisters. When the kids started tripping over drug addicts slumped on the staircase, Boris and Sophie Radowski took their scarce savings and moved the family out West, to a suburb of San Diego, where Boris got a job as a janitor in a country club in the posh neighborhood of La Jolla.

    It was here, in the lush surroundings of La Jolla Tennis and Country Club, that Matt first realized he wanted to be rich. Badly. Everything in the country club reeked of money, from the parking lot lined with Mercedes, BMWs, Jaguars, Ferraris, and Maseratis to the jewelry of the women and the Armani suits of the men. Matt loved walking around, picking up pieces of conversation, and listening to small talk about skiing in Aspen and Vail, shopping sprees in New York or Miami, cruises in the Caribbean, and tours of the great cultural cities of Europe: Vienna, Rome, London, Barcelona, Paris, Athens.

    All this was in marked contrast to his own life, though Matt’s family was doing a lot better than in Queens. They now lived in a two-bedroom apartment on the outskirts of San Diego, about three miles inland from the Pacific Ocean. Money continued to be scarce, however, and Matt couldn’t remember the family going on any vacations during the first ten years of his life, let alone a jaunt to Capri or Crete. Their biggest outing was the annual visit to Sea World, and even then, his father always complained about the entrance fee.

    Every chance he got, Matt tagged along when his father went to work so he could immerse himself in the imaginary world of the rich. And that was where he found entrance to the world he so desired. He started to play tennis. Matt was only four when he first picked up a racket. The little boy with the big racket immediately became a popular fixture at the club. People liked watching him chase after the balls, bounce them up and down or hit them off the backboard. It was soon obvious that the boy had talent, and when Matt turned seven, the head pro took him under his wing and started giving him free lessons. Tony Wise was famous for helping the younger kids at the club; he had lost his wife and his son, six, in a plane crash ten years ago. Tony took great delight in Matt and his obvious talent, and nurtured it in every way he could. When Matt was eight, he won his first tournament, a local junior competition in which he beat much older kids to win the twelve-and-under event.

    On the tennis court, Matt was ferocious. His mop of dark hair flying, he chased every ball, never gave his opponents any easy points, and hit every shot with tenacity. Even when

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