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Testing the Truth

Caskey's lab can look for inherited diseases or the damning sperm of marital infidelity.
Deron Neblett

We don't know for sure when our species developed language, but we can be sure that from that moment on, paternity was his word against hers. This uncertain he-said she-said state of affairs continued until the era of Ozzie & Harriet, when simple blood-type paternity testing was accepted. By the time of The Brady Bunch, blood-based paternity testing was refined to the point where 95 percent of men could be excluded as the father.

When the bizarre father figure Duckman debuted on the USA Network in 1994, "parenting" issues included a Pergonal- and Follistim-fueled spike in multiple births, talk of grandparents seeking legal custody of frozen eggs, and other sticky ethical issues, but getting to the genetic truth was much easier.

Caroline Caskey helped make it that way. She wasn't the first to offer DNA analyses when her fledgling Identigene firm received its first paternity test case in August 1994. But Caskey was the first to market that testing to the general public -- and that has made all the difference. Instead of a blood sample, her company collected cells with a buccal swab, between the cheek and gum. One pass with a swab might pick up a million cells, all riddled with DNA. Identigene promoted home collection tests at half the price of many blood-based tests. They settled questions and let the client decide how to deal with the answers.

"Who's the Father? 1-800-DNA-TYPE" billboards appeared in major cities. Even New York cabs carried the notorious ad, and Caskey began appearing on TV shows. "Some," she grins, "more proudly than others." Caskey, a 1992 graduate of Rice University's Jesse H. Jones Graduate School of Management and perhaps the only alum ever featured on Jenny Jones, has spread the word on tabloid TV and with more respectable media such as CNN, NPR and Time.

Paternity and fidelity concerns are the meat of bad TV, yet such questions aren't as squalid and far removed as they might seem at first. Researchers in genetic studies and tissue typing for organ donations find that plenty of folks aren't who they think they are. Different studies have found that from 5 percent to 20 percent of the population is wrong about their paternity. These studies aren't from contested paternity cases. The figures come from families who agree to genetic testing because they're concerned about muscular dystrophy, polycystic kidney disease or other proved or suspected inherited conditions; from people who didn't understand what research would uncover, or who understood but decided the health of future generations was more important than their reputation. In other words, they look more like you than like the half-wit trashy people of Maury Povich.

Health concerns, child support, restoring lost dauphins to their rightful position, just wanting to know for sure. Caskey understands the myriad reasons for calling Identigene and that the results of her DNA tests have inestimable implications, but she says her business is simply selling the truth.

"Once people have established the facts, they can move forward," she says. In addition to paternity testing, Identigene will find the facts on siblingship, twin testing (twins who look identical but may not be) and marital infidelity. The truth is out there, but it's impossible to predict how people will react to genetic truth. Caskey sticks with the facts because she grew up knowing the human genome could be mapped, but that the human heart may never be understood.

Caroline's father, Dr. Thomas Caskey, was the founder and longtime chair of the Human Genetics Department at Baylor and served as president of HUGO, the international organization formed to map the human genome. He most recently headed genetics research at Merck. Her mother, Peggy Pearce Caskey, founded Laboratories for Genetic Services Inc. It provides genetic lab services for doctors and hospitals nationwide and is right across the hall from Identigene's headquarters.

Caroline Caskey wasn't a high school science geek. Her undergraduate degree is in French (she attended her dad's alma mater, Duke), and she remembers being sort of an oddball among the finance-oriented students in her entrepreneur studies at Rice.

If she didn't exactly fit in as a grad student, the DNA findings of her company don't always match the outcome anticipated by clients, either. Caskey says none of the 25,000 analyses from her lab have ever been proved to be inaccurate. However, she recalls at least five cases where clients have, through desperation or ignorance, tried to alter reports. The forgeries were as obvious as absentee excuse notes signed "Epstein's mother," and they left Caskey shocked. The ever-optimistic, sunny blond remains disturbed, because altering those private test results was not a prosecutable offense.

One testee's attempt to avoid the truth was entirely a police matter. A child whose paternity was to be tested was kidnapped to prevent a sample from being taken. The biological father had merely stashed the child with a baby-sitter. The sitter saw TV coverage of the tot's disappearance and called the cops, who collected the unharmed child.

Along with the view of private lives afforded by paternity and other family relationships, Identigene also offers a sperm detection and marital infidelity test. Those services, Caskey concedes with a wry grin, are "not our most savory." As far as she knows, no parents have sent in their teenager's clothes to check up on them. She and her staff work in an environment where the daily mail includes panties sent by obsessed clients. This is serious business, answering what are often dark questions, in a joyless office tower midway between the Texas Medical Center and the Dome. However, in Caskey's 12th-floor suite, the spirit and enthusiasm resemble cheerleading camp, replete with handmade foam plastic projects, glitter paint and Day-Glo colors.

The staff has a lively, if not entirely intuitive, metaphor hanging from the ceiling in an open area between the sales staff and the office handling incoming cases. A band of lumpy Styrofoam asteroids dangle in an arc around a vivid Styrofoam earth detailed with gaudy green continents, tempera blue water and classic yellow happy faces. Mostly maintaining her poise, the president explains: "Those brown things represent the rocks, the obstacles we have to get past to get to a planet of happy people."

Identigene itself has had plenty to smile about. It has averaged quarterly growth of at least 25 percent since its meager origins as a two-person firm. When the company hit the 25,000-case mark, the whole crew celebrated with a workday at AstroWorld.

The privately held company has expanded to the UK, Canada, Mexico, Brazil, Peru, Japan, Korea and Turkey. Basically, wherever people have uncomfortable questions and access to overseas shipping, Caskey offers lab services. She's aiming for a planet full of happy people, remember?

Identigene has had to find innovative marketing messages to span the cultural divide. She first tried TV advertising. It won a slew of awards, including a Clio, but generated little business. So she turned to old-fashioned billboards and never looked back. Caskey put her faith in a Japanese firm for advertising in that country. The result is an ad image of two naked boys. Their backs are to the camera, but the children are obviously peeing. Caskey has no idea what it means, but it works.

Beyond marketing, her lab has some technical advantages. Identigene was the first U.S. lab to use the efficient polymerase chain reaction testing. Paternity test results are returned in three to five days for $475, plus collection fees for a legally binding test. For $1,500, Identigene will complete testing in one business day.

In contrast, competitor DNA Diagnostics Center in Ohio charges $475 for its "urgent five working day service" and $1,290 for three-day service. DNA Diagnostics doesn't do home collection, so clients must make an appointment to visit a draw site and pay $45 for that service.

It typically takes three hours to extract the DNA and eight to ten hours for the test, but Caskey's lab has found a way to step up the process. She dreams about a bio-electric computer chip that would cut test time by several orders of magnitude.

Caskey says Identigene does about 250 cases per week but has the capacity to do five times that volume. So she is focusing on business-to-business opportunities. "The sort of clients we have," Caskey says, "are expensive to go after and tend not to be repeat business." Identigene wants more account clients, companies that market and collect test specimens and use Identigene for the lab work. She also seeks more forensics traffic.

"England has one million DNA samples in a database," Caskey reports. "Car theft crimes are solved by DNA evidence in the UK." On the U.S. side of the Atlantic, she says, there is a tremendous backlog of DNA cases, including long-stored rape examination kits with evidence that still can be used to convict -- or to clear those wrongly convicted. "Barry Scheck has exonerated what," she asks, "almost 70 people? That's an area where Identigene might contribute."

Caroline Caskey is not daunted by the challenge of keeping a competitive edge in the genetics industry, the potential for ethical and political controversy, or the stream of heartbreaking cases coming through the lab. She's confident her company can continue to innovate and believes that the truth will set you free -- at least from nagging doubts. Caskey sees herself as selling picks and shovels in the biotech gold rush.


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