A Conversation With NELSON ERLICK

Q. What is the basic plot of THE XENO SOLUTION ?

A. The Xeno Solution is a two-edged sword: It could save millions of people... or decimate the world.

In The Xeno Solution , patients dying of kidney, liver, and heart diseases no longer have to wait for a donor organ from another person that may never come. Genetically-engineered pig organs are available for transplantation on demand, through a process called xenotransplantation . They've proved to be wildly successful, saving tens of thousands of lives - until the protagonist, Dr. Scott Merritt, a surgeon forced to retire from practice because of multiple sclerosis, discovers that this wildly successful process which has already saved tens of thousands of lives, may potentially cause a devastating epidemic. To expose the truth, he risks everything -- his new career, his life, the lives of his wife and children... unaware that the plague is already loose.

Q. What inspired you to write The Xeno Solution?

A. Back in 1995, I was Senior Research Analyst at an internationally-renowned medical think tank where I analyzed new, controversial medical technologies. My department was studying xenotransplantation , the process of transplanting organs (such as kidneys, livers, or hearts) from animals (primarily pigs) into desperately-ill people destined to die without a donated organ. This medical technology held the great promise of saving hundreds of thousands of people desperate for organ transplants every year. It also has the potential to ignite a deadly plague by inadvertently transferring animal retroviruses to people. ( Think HIV/AIDS and fears about the new Avian Flu! ) What a dilemma for both doctor and patient! I've observed this field for years... even predicted some recent developments... but the promise and perils still remain as great as ever. I had to write The Xeno Solution . This is the only medical technology which could save a patient but kill all of the patient's neighbors.

Q. You are a retired Podiatric surgeon and award-winning researcher, with an accomplished career behind you. What inspired you to become a novelist, and how has your medical career influenced your writing?

A. I've always wanted to be a novelist, but it took me 40-plus years to realize it. I've had a widely varied career: surgeon, medical technology analyst, designer of clinical study protocols, medical writer, medical director. My experiences have enabled me to analyze the intricacies of virtually any field of medicine or technology, as shown in my first novel, GermLine , which was lauded by intellectual giants in genetic research. I believe this also shows through my latest novel, The Xeno Solution .

Q. Is Dr. Scott Merritt, the central protagonist in the book, autobiographical, or based on a real person?

A. Scott's based on a compilation of people: a snapshot of me -- the "past" me, actually -- shortly after I had retired from surgical practice, blended with some elements of people I (have) know(n).

Q. How does the realistic potential for xenotransplantation play in the book?

A. The Xeno Solution is built on realistic potential. I've read hundreds of scientific and ethical publications. I was determined not to put a single word to paper unless I believed it was possible. In fact, the first draft of The Xeno Solution that I submitted to my editor included scientific advances in the field (such as specific "knockout" genes) and safety precautions (such as a national database) before they actually happened in the real world.

Q. Do you think that the scenario in the novel is something that could actually happen?

A. Fact #1: The great influenza plague that ravaged the US following World War I originated with a virus that jumped from animals (probably pigs) to people. The HIV/AIDS epidemic is a more recent example of animal viruses finding their way into human populations.

Fact #2: The Food and Drug Administration is so concerned with the risk from viruses jumping from animals to people in xenotransplantation that it has called for a national database to maintain specimens from animals and xenotransplant recipients for as long as 50 years, to monitor xenotransplant patients for life, and to check on health care providers and intimate contacts of patients for life.

Fact #3: We often hear about pharmaceutical companies conspiratorially covering up treatments that they know are dangerous. In reality, no company in its right mind develops a drug or treatment knowing it's unsafe. Facing staggering economic and legal consequences, drug companies freely choose to drop questionable drugs at the first sign of trouble. By law, they test treatments on thousands of patients, using statistics to prove that a drug is safe and effective. However, hidden dangers may only appear after the treatment is used on hundreds of thousands , even millions of patients. By then, the damage is done, and companies may be looking to find an answer -- or damage control.

Put the facts together, and the answer is a resounding "yes". Will it happen? Only hindsight will tell.

Q. Which writers have most inspired and / or influenced you?

A. They include (but certainly aren't limited to) Aldous Huxley, George Orwell, Kurt Vonnegut Jr., William Shakespeare, Frank Herbert, Stephen Donaldson, and Michael Crichton. In particular, I was enormously gratified to have both Kirkus Reviews and The Philadelphia Inquirer favorably compare my first novel, GermLine , with Michael Crichton.

Q. Why are your novels set in the Philadelphia area?

A. Yo, youse guys! I'm a native Philadelphian: born, raised, schooled (University of Pennsylvania, Drexel University, Pennsylvania College of Podiatric Medicine), practiced, and still work in the area. I know Philly. Plus Philadelphia is in the heart of the biotechnology corridor stretching from Boston to Baltimore. What place better to set The Xeno Solution ?

Q. During your career, have you ever unearthed the kind of damaging secret or potentially catastrophic information that is illustrated in the book?

A. As a Senior Research Analyst, I analyzed high-dose chemotherapy with bone marrow transplants for treating women with breast cancer. In the 1990s, this was supposedly the new panacea for various types of cancer. Except, the more I analyzed the studies, the poorer the results looked. Not only that, the research appeared to be poor quality. Women were dying with treatments that clearly did not work, but were being led to believe otherwise by leading investigators in the field. I was outraged! Years later, news headlines reported that a key doctor's cancer research was bogus. Shortly after, other studies corroborated what I'd said five years earlier. The Xeno Solution is based on a doctor discovering a comparable secret.

Q. The thesis in the book is, at its most basic, a tale of greed at any cost --   at the expense of both common sense and people's lives. During your career, did you find this to be the norm in both medicine and scientific research?   Does today's environment of bigger, faster, more mean that we're inevitably headed toward some kind of disaster?

A. Fortunately, I've seen very little pure greed. Unfortunately, I've encountered plenty of something far worse: ego. Greedy people make decisions based on remuneration; egotistical people make decisions based on their own infallibility, often intimidating those around them. That was my experience while analyzing medical literature on high-dose chemotherapy with bone marrow transplants for breast cancer. A greedy man won't run into an empty burning building if there's no profit. An egotistical one will if he's convinced he's impervious.

As to a disaster, "inevitable" isn't a word I'd care to use. With planning and foresight, we can usually avoid man-made disasters and minimize most of what Nature throws at us. What worries me is that there doesn't seem to be a lot of either long-term planning or foresight.

Q. Do you have an idea for your next novel?

A. Nearly half written, my next novel will take the reader beyond the confines of conventional medicine to the next evolutionary, revolutionary step in medical technology -- offering potential rewards and hazards that I believe have never been explored.