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Clinical Trials


Carolina’s pen hit the ground with a thwack, the ink from inside spreading into a spatter of blue on the icy linoleum floor. 

“Tell me.” Joy set her pen on the table so as to better hear Carolina’s response. 


“I can’t fucking figure it out.” 

Joy stretched, throwing her arms up and over her head, the joints in her back snapping and popping. Joy waited for a quip from Carolina—“That’s bad for your joints, you know”—and upon hearing Carolina’s contradictory silence, peeked up from her microscope. Carolina’s crumpled form hunched over a swarm of papers scattered across the table. Her hair cascaded over the papers, the brown and blonde merging into frizzy ringlets. Joy cleared her throat. 

“You okay?” 

“Absolutely not.” Carolina’s forehead touched the paperwork sprawled across the desk with a soft thunk. “I’ve wasted years of my life. My research has been fucking pointless.” 

Her eyes met Joy’s, whose brown eyes examined Carolina with real human empathy—an unusual expression on Joy, and they both knew that. 

“I just don’t understand what I’m doing wrong.” Her voice cracked. Joy moved swiftly to Carolina’s side. She’d seen a lot of iterations of Carolina; crying Carolina was one of her least favorites. 

“Hey, hey…” She placed a gentle hand on Carolina’s shoulder. Her mind began to fill with thick clouds of frustration as she struggled to help Carolina. Joy took a deep breath and tried again.

“It’s not so bad. Look, you can—” 

“It’s okay.” Carolina’s voice was quieter. Softer. Defeated. She was shoving papers in her bag, letting them fold into clumps at the bottom of the biggest pocket, underneath all the neat folders that kept her paperwork in place, “It’s all pointless. Maybe I was too ambitious, or just too stupid.” She caught Joy’s gaze. Joy felt like she was watching an ASPCA commercial. “I have to go.” 

Carolina whisked herself out of the room, leaving a smell of vanilla and jasmine in her wake.



Joy loved coffee. 

She loved the way that it immediately put her body into motion. She loved the way that the coffee, always warm, paved a path down her sternum and into her chest. The lab was always cold, and coffee was her refuge. Her sanctuary. 

Her favorite drinks rotated through the years. Now, she’ll drink most any coffee put in front of her—often a regular brewed coffee, a special that Carolina liked to call “whatever’s in the machine today.” But in college, it was always flat whites. 

Grad-student Joy drank flat whites because flat whites never gave her the humiliating milk-foam mustache that lattes did. Joy drank flat whites because they made her feel like she was doing something, like she was drinking an actual coffee to give her energy to survive for the rest of the day. And so, even after she graduated, she found herself getting flat whites on days that were particularly difficult. 

And Joy met Carolina because Carolina made the epitome of a Perfect Flat White. 

“Ma’am?” Joy called out. A curly-haired barista, the only one behind the counter, perked up at hearing the call for attention, moving towards Joy as she wiped her hands on her apron. Her hair was pulled back into a ponytail with a bandana wrapped over the top, and rectangle glasses rested on the bridge of her nose. 

“Hi! How can I help you?” She offered Joy a warm smile. 

“Did you make this?” Joy gestured to the to-go cup in front of her. Carolina’s brow furrowed. 

“Yes,” The frizzy-haired barista paused. “What’s wrong with it? Would you like me to remake it for you?” She reached for the cup. Joy pulled it closer to her body. 

“No, absolutely not.” Joy squinted at Carolina. “It’s phenomenal. I haven’t had a flat white with foam like this in years. Where did you…?” Joy gestured vaguely to the espresso machine. 

“Here!” Carolina leaned on the counter. “I’ve been here for a few years now. I learn pretty quick.”


“Fascinating. How often do you work,” She read the barista’s nametag, decorated with faded looping letters. “Caroline?” 

“It’s Care-oh-lee-nah,” She sounded out with a smile, “And, for the most part, every morning.” 

Joy smiled back. 

“Well, thank you, Carolina,” Joy responded, “And, in that case, I’ll see you tomorrow.” 


Being alone was much colder than Joy remembered. 

She tapped the screen of Carolina’s computer, waking it from sleep. 

Evaluating the Efficacy of Prototype Pollution-Related Disease-Preventing Drugs using a Preclinical Toxicokinetic Approach: The Clean Lungs Prototype Proposal 

Author: Dr. Carolina S. Garcia 

Abstract: Lung cancer numbers have been steadily climbing since the discovery of a microscopic mechanism by which minuscule pollutant particles have been found to trigger lung cancer in non-smokers. The Clean Lungs Prototype has had higher than average success rates in preclinical trials with mice to filter this mechanism through pharmacokinetic means. 


The rest of the page was a complete Investigational New Drug application for the prototype. Joy noticed a section of the table of contents highlighted in yellow with a large string of question marks, and she recognized the NOAEL acronym immediately—no-adverse-effect-level.

Joy glanced at the flurries of pages that adorned Carolina’s desk. Many near-identical graphs sat next to each other, each with a curve that swooped up from the inner left corner. Taking a closer look, Joy noticed Carolina’s loopy handwriting—NOAEL inconsistent. Joy checked the next graph—again, NOAEL inconsistent

Joy looked between the screen and the graphs and straightened her back, standing up and returning to her own computer. 

Carolina would figure it out when she came back. 

The rest of the first day without Carolina almost felt normal. Joy would find herself talking, questioning Carolina’s empty chair in front of her. It fascinated her that Carolina’s “contributions” to her research—her quiet mutters of “you’re dumb for that,” or the way that her eyebrows furrowed and always prefaced a gentle “…as long as you’re sure...”—helped her as much as they did. 

Joy stood up to disturb the silence of the lab. Her ID clattered to the floor, and Joy was reminded of how much she hated the way she looked in her ID photo. She scowled at the photo. ID Joy scowled right back. 

Joy remembered the first day in the lab when the photo was taken. Not a whole lot had changed since then. She had the same wire-rimmed round glasses, the same sharp brown eyes, the same short red hair. 

Her face, though, had changed. She’d become sharper with age, more poised. But, she remembered, this was the Joy that had met Carolina. The Joy who spoke with Carolina about all of her big ideas, her theories, and even all of her rambling about absolutely nothing. 

Joy stared at the paper in front of her. She asked it how it felt about her newest research. 


It remained silent. 


Joy had come to the café every morning since the first flat white. 

She came to learn that Carolina Garcia was a doctoral candidate for Preventative Medicine and Epidemiology. She didn’t have to work at the coffee shop anymore, as she student-taught, but she enjoyed the work. "And the regulars," she’d told Joy. 

“Carolina,” Joy began, leaning over the countertop of the café.


“Does your job permit you to wear jewelry? Rings?” she asked, glancing down at Carolina’s left hand. Carolina shook her head. 

“No, actually, food safety hazard.” She paused. “I don’t have any rings to wear, though, engagement or otherwise.” 

“Ah.” Joy felt a flutter of an unfamiliar feeling in her stomach. Like she couldn’t keep the blood from rushing to her cheeks, like her stomach was about to leap from her body over the counter and into Carolina’s welcoming arms. 

“Why do you ask?” Carolina leaned forward, bringing her face closer to Joy’s. 

“No reason.” Joy backtracked, “I just noticed you don't wear any.” 

Carolina hummed in response, moving back over to the espresso bar, and picking up the standard to-go cup that the café offered. She snatched a sharpie up from her apron and began scrawling on the cup while shots of espresso poured, slow and foamy, into the shot glass. Once they finished pulling, Carolina dumped them into the cup and swirled the milk in the pitcher. She poured the milk fast, then slow—forming a perfect, soft white dot in the middle of the foam. A perfect flat white, Joy noted. Carolina carefully snapped a lid over the top of the drink and handed it to Joy. 

“Your flat white.” She paused. “…and your barista’s phone number, if you were curious.” 

Joy took the third day without Carolina off, and she spent it scrubbing her hands. Joy loved washing her hands. It made her feel clean and crisp and all the good things that always got ruined by her experiments. Her mind wandered to her days in the neurology program, washing her hands as thoroughly and quickly as she could manage between dissections. Joy rubbed the suds up to her elbows, like she was taught to. Even though she always wore gloves, she could feel the sensation of formaldehyde on her hands. She didn’t remember exactly when it sunk in, but she could feel it. Ever-constant, ever-persistent. 

And no matter how much she scrubbed; it would not budge. 



“You think they’re clean yet?” Joy sat at one of the barstools in Carolina’s Café. Well, not Carolina’s, but it was and forever would be Carolina’s Café in Joy’s mind. 

Joy despised the fact that she was a regular at a coffee shop—she didn’t think it suited her disposition—and she hated when Carolina wasn’t working. She hated how the other baristas would chirp, “Hello, Miss Joy!” and give her a latte with whole milk. Joy didn’t order lattes from baristas. She ordered flat whites from Carolina, like the one she was holding now. 

“Oh, be quiet, Joy,” Carolina chided from under the laminated sign that read WASH YOUR HANDS! with a big yellow smiley face. 

“It’s this fucking caramel sauce. It won’t ever come off.” 

“I didn’t even know you sold caramel sauce,” Joy responded as Carolina wandered over. Joy noticed that she was shifty today—her flat white had a touch too much foam. 

“What’s wrong?” Joy asked. 

Carolina stood in front of Joy at the bar, wringing her apron in her hands to dry them off from the handwashing. Joy noticed a piece of caramel still stuck to Carolina’s hand. 

“I’m quitting,” Carolina blurted out. “I put in my two weeks today.” 

“What?” Joy couldn’t hide the disappointment in her voice. 

“I defended my thesis last week.” 

“You passed?” 


“Of course.” 

Joy offered Carolina a smile. 

“Well, if you’re ever looking for a job...” Joy lowered her voice. “I work for a privately funded lab. We’re hiring as far as I’m concerned.” 

Carolina raised her eyebrows. Joy continued. 

“It does get pretty lonely in there. There’s plenty of space for a second person to, perhaps, conduct preclinical research on a prototype preventative drug?” Joy leaned in closer to Carolina. “I even have some mice that you could borrow.” 

Carolina’s eyes narrowed, then widened. She grabbed a napkin from in front of Joy and scrawled her email across the top. 

“Email me,” she said with more urgency than Joy had heard before. “I’ll be able to do something? Like, actually help people?” 

Joy nodded. 

“That’s the idea.” 



On day four of Carolina’s leave, three mice died. Joy couldn’t figure out why. Maybe it was the way she fed them, or the way that they were living. Maybe they had just killed each other. It certainly wasn’t the drug. She went back to checking the tanks of the living mice, the ones that moved quickly and quietly across their cages. Out of the mice that lived, none of them had lung cancer despite their exposure to the pollutants. That should be enough. 

As Joy worked, she only thought of high school. It was easy to let her mind wander when Carolina wasn’t there to talk to her. Joy thought of her first “real” dissection in junior year biology, her calm and precise hand movements carefully taking apart the cat corpse. The other girls in her class crowded around her—they couldn’t stomach the dissection themselves. Joy held her head a little bit higher knowing that she could. 

Her college years were more difficult. She excelled in her classes until rejection letter after rejection letter from medical schools rolled in. It was always some bullshit excuse, too. We are thrilled by your application, but unfortunately lack space in our program for experimental research, or your transcripts reflect a well-rounded student, but your research goals do not align with the institution. 

After finding a privately funded lab, her research went swimmingly. She only used mice for her research—never rats and never rabbits. She felt for the creatures, though, and did her best not to kill them when she could. But, after all, she was after progress, and progress was not a victimless beast. She never named them--she felt it was the best mercy she could give. 

Peeling off her dirty latex gloves, Joy left the room. 

Joy examined her coffee. She’d left it on the counter while she worked--its coldness seeped into Joy’s heart. 

It smelled like Carolina’s laugh. 



Carolina’s laugh was something that Joy admired.  

Joy found herself holding back emotions of any kind, for the most part, in exchange for professionalism. Carolina didn’t. 

Carolina laughed, high and loud, folding herself over with glee. True Carolina bliss. 

And Joy was elated that this laugh was taking place across from her at the table of an Italian restaurant. 

Joy had finally bit the bullet and shot Carolina a text: Hello. Are you busy next Friday? It was their first time spending time together outside of Carolina’s Café, and Joy had originally planned for it to be strictly business—getting Carolina into the lab. But, as the night progressed, it became clear to Joy that Carolina had interpreted the message as a date. 

Joy had been embarrassed, in her business casual attire, to see Carolina walking down the sidewalk in a cocktail dress and heels. Joy had never been on a date. She didn’t have a need for them or see herself equipped to handle the dating scene. 

Having a beautiful woman across the table from her, laughing at things that Joy didn’t mean to be funny—laughing with Joy—changed that perspective for her. 

“This has been really, really lovely, Joy.” Carolina caught Joy’s gaze. “Really. I mean it.” 

“I have to agree.” Joy responded, giving Carolina an encouraging smile. 

“I’d love to work with you.” 



Joy stared at the Investigational New Drug Application that she’d written for Carolina in her absence. 

Everything went swimmingly. The mice pharmacology and toxicology reports that she’d written, she thought, were strong. The only issue, and the only one that Joy could find, was the no-observed-adverse-effect-level. There were a handful of mice that died during the trials, and Carolina had logged the deaths as adverse effects. 

Joy looked at the mouse cages across the lab. She could admit that maybe they could take better care of the cages, or maybe the feeding habits were inconsistent. It couldn’t be Carolina, Joy thought. It simply couldn’t. It had to be the cages or the temperature in the lab or the food or something. Perhaps with more testing in clinical trials, the extenuating variant would become clear. But that’s what it was. Yes, that’s it. An extenuating variant, not related to the drug or its testing. 

Joy looked at the screen again. Carolina had finished most of the application and left blank the space where the NOAEL report should have been. She was sure Carolina’s drug was ready for clinical trials. Carolina had worked for years on this prototype, and Joy had seen how far it had come. 

Joy bit her lip. She typed NOAEL consistent in the highlighted space. 

Maybe Carolina just needed another push. Like the push that Joy gave her in the coffee shop that led to this. Yes, Carolina needed Joy’s help to succeed. Knowing that put a puff of pride in Joy’s chest as she sat up straighter. 

And she sent off the application. 


Immediately, Joy was filled with worry. What would happen if her clinical research proposal was denied? Would Carolina cry? Leave the lab? No, Joy wouldn’t let that happen. Carolina belonged with Joy; they were meant to work together. Would she be too sad to continue working with Joy? 

Or would she be angry? Carolina’s anger manifested as pure fury. Joy would rather be dead than face the brunt of it. Would she throw things at Joy across the lab, yelling about morals and how Joy was a terrible scientist? 

Her computer blipped, and after a week of silence, Joy almost didn’t recognize the sound. Thank God, she thought. Thank God, Thank God, Thank God. 


The next day found Carolina back at her grey desk chair with the navy-blue pad in the center that stopped her back from hurting so damn much. Joy sat on the matching red one that Carolina had gifted her for Christmas. 

“Wow, you look like shit.” Carolina let out an incredulous laugh. 

All red-eyes and tousled greasy hair, Joy was just happy to hear that laugh again. 

The seventh day let Joy find refuge in Carolina’s presence. She had gone back to her alma mater to talk to professors and students in her field, she explained to Joy, and Carolina said that she felt that her passion for research had finally returned. Carolina spent the rest of the day with her chair pulled up right up next to Joy’s, explaining to her the ins and outs of her new prototype. Joy tried her hardest to listen, but she found herself focusing on the way Carolina talked so passionately. So dutifully. She could almost kiss her for coming back. 

“Oh, and I brought you this.” Carolina pulled out a small to-go cup. “I stopped by on the way back. They even let me go behind the bar to make it, since I worked there for so long.” 

“You spoil me.” Joy smiled at Carolina and took the beverage from her. “I have something for you, too.”  

Joy had prepared for this. When she got the email saying that the application had been approved, that the Clean Lungs Prototype would be moving into clinical trials, she had printed out the email and put it in an envelope. She’d written Carolina in big, loopy letters on the front. 

Carolina gave Joy a playfully skeptical look and opened the letter. Joy eagerly and patiently waited for Carolina to realize what it was. Joy watched Carolina’s expression change from confusion to shock, and then from shock to breathless panic. 

“You submitted the application?” 

“I did.” 

“No, Joy, no. Why the fuck would you do that? No. No, no, no!” Carolina stood up and put her hand in her hair. 

“It’s okay,” Joy began, vastly unprepared for Carolina’s reaction and standing up with her. 

“This isn’t right. It’s not ready.” Carolina shook her head solemnly after a moment of silence. “It’s just not ready” 

“But we’ll figure it out,” Joy reached for Carolina’s hands and took them in her own. “You and me. We’ll figure it out and you’ll become world-renowned for this, and

“I don’t want to be world-renowned, Joy,” Carolina spat. “I just…” She closed her eyes and took a deep breath. “I just want to help people.” 

She stood up, putting her papers neatly in the folders in her bag. “This was a mistake.” 

“The prototype?” 

“Coming back.” Carolina slung her messenger bag over her shoulder and took a deep breath. “I got a job offer. A teaching position. It’d be with disease prevention,” she said, her voice even and low. “And I think that it aligns more with my research goals than being here.” 

“What?” Joy felt a heavy weight in her throat move and settle deep into the pit of her stomach. Like she’d swallowed lead. “Who? An offer? What are you talking about?” 

“I went in for an interview, and they really liked me, and...” Carolina glanced towards Joy, “I’d be actually helping people, Joy. I’d be coordinating events and speeches and research that would actually help people,” she paused. “You should be happy for me.” 

“How am I supposed to be happy for you when you’ve just told me that you’re leaving again? I mean, you just got back, for Christ’s sake.” 

“I’m sorry, Joy. I’m really, really sorry.” 

Carolina’s brown eyes examined Joy’s with real human empathy--an emotion that Joy infrequently received, and they both knew that. 

Joy began to panic. 

“No, no, this is all wrong,” Joy sputtered, eyes filling with hot tears of frustration. “The application was approved. I did it so you would stay, I approved it for you, for us—” 

“For you, Joy.” Carolina interrupted. “For you. It was never for me, it was never for us. It was for you.” 

“You’re wrong,” Joy responded quietly. Carolina scoffed, shaking her head and turning her back on Joy to leave. 

 “I love you,” Joy blurted, and while it was a last-ditch effort to keep Carolina from leaving again, it wasn’t untrue. 

Carolina froze. She inhaled, then exhaled, then put her head in her hands. 

 “I love you too, Joy. I’m sorry.” 

And then she was gone. 

In Carolina’s wake, Joy observed the flat white that Carolina had brought in. It was perfect. The drink had been made so recently that in the cold air of the lab, little swirls of steam rose up from the white to-go cup that housed the hot liquid. 

Joy loved coffee. But Joy loved Carolina much, much more. 

  • Betty Duplantis is a senior in the English program. She loves video games, Sad Park, her animals, Dante's Divine Comedy, and her education. On chilly days, she can be found on long walks in the woods with her loving partner, Moe. She'd like to thank Professor Vogrin for making her the writer she is today. 

    Her favorite place is Ely, Minnesota, where she hopes to do writing groups during rainy summers for the rest of her life. 

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