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
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
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
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
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.