The CRO came up with a novel concept: engage parents directly and run a clinic to administer the therapy. Kate and the trial’s lead investigator, Dr. John Helms, met with the CRO at length, searching for any alternatives. There were none. Kate urged Dr. Helms to move forward with the plan, and finally, he agreed.
They built a list of families within 100 miles of Jakarta that had any child on the autism spectrum. Kate booked an auditorium at one of the nicest hotels in town and invited the families to a presentation.
She wrote, re-wrote, and revised the trial booklet for days-on-end. Finally, Ben had barged into her office and said he would leave the trial if she didn’t just let it go; they were ready to recruit. Kate relented, the pamphlet went to the ethics committee, then the printer, and they prepared for the event.
When the day came, she stood by the door, ready to greet each family as they arrived. She wished her hands would stop sweating. She wiped them on her pants every few minutes. First impressions were everything. Confidence, trust, expertise.
She waited. Would they have enough booklets? They had 1,000 on hand, and although they had sent only 600 invitations, both parents could show up. Other families could show up — there was no reliable database or registry of affected families in Indonesia. What would they do? She told Ben to be ready to use the hotel copier just in case; he could prepare copies of the highlights while she talked.
Fifteen minutes past the hour. The first two mothers appeared. Kate dried her hand again before shaking vigorously and talking just a little too loud. “Great to have you here—thank you for coming—no, this is the place—take a seat, we’ll get started any moment—”
Thirty minutes past the hour.
An hour past the start time.
She circled the six mothers, making small talk. “I don’t know what happened—what day did you get the invitation?—no, we invited others—I think it must be a problem with the post…”
Finally, Kate led the six attendees to a small conference room in the hotel to make it less awkward for everyone. She gave a short presentation as one-by-one, each of the mothers begged off, saying they had children to pick up, jobs to get back to, and the like.
Downstairs, at the hotel bar, Dr. Helms got drunk as a skunk. When Kate joined him, the gray-haired man leaned close and said, “I told you it wouldn’t work. We’ll never recruit in this town, Kate. Why the hell— hey-ho, bar keep, yeah, over here, I’ll have another, uh-huh same thing, good man. What was I saying? Oh yes, we need to wrap it up, quickly, I’ve got an offer in Oxford. God I miss Oxford, it’s too blasted humid here, feels like a sauna all the time. And, I must admit, I did my best work there. Speaking of…” He leaned even closer. “I don’t want to jinx it by saying the words No. Bel. Prize. But… I’ve heard my name’s been submitted — this could be my year, Kate. Can’t wait to forget about this debacle. When will I learn? I guess I’ve got a soft heart when it comes to a good cause.”
Kate wanted to point out that his soft heart had certainly driven a hard bargain — three times her salary and his name first on any publication or patents — despite the fact that the entire study was based on her post-doctoral research, but she held her tongue and swallowed the last of her Chardonnay.
That night she called Martin. “I can’t—”
“Stop right there, Kate. You can do anything you set your mind to. You always have. There are 200 million people in Indonesia and almost seven billion people on this tiny planet. And as many as half of one percent could be somewhere on the autism spectrum — that’s 35 million people — the population of Texas. You’ve sent letters to 600 families. Don’t give up. I won’t let you. I’ll make a call tomorrow morning to Immari Research’s head of funding, they’ll continue funding you — whether that hack John Helms is on the study or not.”
The call reminded Kate of the night she had called him from San Francisco, when Martin had promised her Jakarta would be a great place to start over and to continue her research. Maybe he would be right after all.
The next morning, she walked into the lab and told Ben to order a lot more study booklets. And to find translators. They were going out to the villages. They would widen the net — and they wouldn’t wait for families to come to them. She fired the CRO. She ignored Dr. Helms protests.
Two weeks later, they loaded up three vans with four researchers, eight translators, and crate after crate of the trial books printed in five languages: Indonesian/Malay, Javanese, Sundanese, Madurese, and Betawi. Kate had agonized over the language choices as well: over 700 distinct languages were spoken throughout Indonesia, but in the end, she had chosen the five most commonly spoken in Jakarta and throughout the island of Java. She would be damned if her autism trial would fail due to a communication breakdown.
As with the hotel in downtown Jakarta, her preparations were an entirely wasted effort. Upon entering the first village, Kate and her team were amazed: there were no autistic children. The villagers weren’t interested in the booklets. The translators told her that no one had ever seen a child with these problems. It didn’t make any sense. There should have been at least two, maybe three potential participants in every village, possibly more.
At the next village, Kate noticed one of the translators, an older man, leaning against the van while the team and remaining translators went door-to-door.
“Hey, why aren’t you working?” Kate had asked.
The man shrugged. “Because it won’t make any difference.”
“The hell it won’t. Now you better—”
The man held up his hands. “I mean no offense, ma’am. I only mean you ask the wrong questions. And you ask the wrong people.”
Kate scrutinized the man. “Ok. Who would you ask? And what would you ask them?”
The man pushed off from the van and walked deeper into the village, past the nicer homes. On the outskirts, he knocked on the first door, and when a short woman answered, he spoke quickly, in a harsh tone, occasionally pointing at Kate. The scene made her cringe. She self-consciously pulled the lapels of her white coat together. She had agonized over her wardrobe as well, ultimately deciding that projecting a credible, clinical appearance was the order of the day. She could only imagine how she looked to the villagers, who were mostly dressed in clothes they had made themselves from scraps taken home from the sweatshops or the remains of partially-disintegrated hand-me-downs.