Strong Medicine

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Strong Medicine Page 7

by Arthur Hailey


  “If you pick up one of the pamphlets at that booth, as some of you may have already, you’ll find it describes the use of Lotromycin by my husband. He’s an M.D.—an internist. My husband has had excellent experience with that drug and with some others. He has also had bad experience with drugs, and with detail people who deceived him by describing those drugs falsely. He is not alone. Other doctors—far too many, as I know from reports made to me—have shared the same experience. It is a side to this business which can and should be changed.”

  Aware that she was reaching rugged ground, Celia faced the audience squarely and chose her words with care.

  “As a result of my husband’s experiences as a physician, he tells me he has mentally divided the detail men who call on him into three groups—first, those who give him honest information about their companies’ drugs, including adverse side effects; second, those who are uninformed and fail to advise him properly about the drugs they are promoting; and third, those who will tell him anything, even lie, to have him prescribe what they are selling.

  “I would like to say that the first of those three groups—the detail people who are informed and honest—is the largest, and that the other two are small. Unfortunately that isn’t true. The second and third groups are far larger than the first. What it adds up to is that the quality of detailing, in terms of full and accurate information, is poor, and that applies to all companies in the pharmaceutical business, including ours.”

  Celia could now see signs of consternation, not only among executives at the front, but back beyond them. Amid a series of groans someone called out, “Hey, what is this?”

  She had anticipated the reaction and accepted it as part of a calculated risk. As she continued, her voice was strong and clear.

  “I am sure you are asking yourself two questions. One: ‘How does she know all that stuff, and can she prove it?’ The second: ‘Why bring it up now, at a time when we’re happy and cozy and don’t want to hear unpleasant things?’”

  Again a voice from the audience. “You’re damn right we’re asking!”

  “So you should!” Celia shot back. “And you’re entitled to an answer, which I’ll give.”

  “Better make it good!”

  Something else Celia had gambled on today was that whatever the reaction to her speech, she would be allowed to finish. It seemed to be happening. Despite frowns of displeasure in the executive rows, no one was rising to use authority and cut her off.

  “One reason I know what I’m talking about,” Celia declared, “is that I used to be a member of that second group—the uninformed. That’s because, when I went out selling drugs to doctors, I was inadequately trained. In fact, I was scarcely trained at all. Concerning that, let me tell you a story.”

  She described the encounter—which she had related to Andrew on their honeymoon—with the North Platte physician who had accused her of having “inadequate knowledge” and ordered her brusquely from his office. Celia told the story well and there was a return to silence as the audience listened. Here and there she saw nods and heard murmurs of agreement. Celia suspected that many in the hall had had similar bruising experiences.

  “The doctor was right,” she continued. “I didn’t have the knowledge to discuss drugs with highly qualified physicians, even though I should have been given it before I went out selling.”

  She reached behind her to a table and held up a file.

  “I mentioned reports from doctors about false information given by detail people. In the nearly four years I have been selling for Felding-Roth I have kept a record of those reports, and it is here. Let me quote examples.”

  Celia pulled a sheet from the file. “As you know, we have a prescription product called Pernaltone. It is an excellent drug in the treatment of hypertension and one of Felding-Roth’s good sellers. But it should never be used by patients with rheumatic disease or diabetes. To do so is dangerous; warnings to that effect are in the literature. And yet … four doctors in New Jersey, two others in Nebraska, were assured by detail men from this company that Pernaltone was safe for all patients, including those with the diseases mentioned. I have the doctors’ names if you wish to see them. Of course, those are just the doctors I know about. Obviously there are more, perhaps many more.

  “Two of those doctors I spoke of, who were given that misinformation, checked it out and found it to be in error. Two others accepted it in good faith and prescribed Pernaltone for hypertensive patients who were also diabetic. Several of those patients became extremely ill, one of them close to death, though he eventually recovered.”

  Celia whisked another paper from her file. “A competitor of ours has an antibiotic, Chloromycetin, again a first-rate drug, but for serious infections only, since its possible side effects include damaging, even fatal, blood disorders. Yet—and again I have dates, names, places—the other company’s detail men have assured doctors the drug is harmless …”

  Celia finished with Chloromycetin, then continued, “Now to come back to Felding-Roth …”

  As she talked, the damning evidence mounted.

  “I could go on,” Celia said after a while, “but I won’t because my file is here for anyone in this company to examine. I will answer that second question, though: Why did I bring this up today?

  “I brought it up because I could not get attention any other way. I have tried since last year to have someone at headquarters listen to me and go through my file. No one would. I had the strong impression that what I had accumulated was simply bad news that nobody wanted to hear.”

  Now Celia looked down directly at the two executive rows. “It may be said that what I have done today is headstrong, even foolish. Perhaps it is. But I would like to say that I have done it out of deep conviction and caring—for this company, our industry, and the reputation of both.

  “That reputation is being tarnished, yet we are doing little or nothing about it. As most of us know, there are hearings being held at present in the U.S. Congress about the pharmaceutical industry. Those hearings are antagonistic to us, yet few in the industry appear to be taking them seriously. But they are serious. Already the press is giving prominence to criticisms; soon there will be a public outcry for reform. I believe that unless we do something ourselves to improve our sales practices and reputation we shall have it done for us by government—in a way that none of us will like and that will be harmful to us all.

  “Finally, for all these reasons I urge that our own company take the lead—first in establishing a detailing code of ethics, second in setting up a training and retraining program for us detail people. I have put together my own ideas for such a program.” Celia paused and smiled. “If anyone is interested, they too are in my file.”

  She concluded, “Thank you, and good afternoon.”

  As Celia gathered up her papers and moved to leave the speakers’ platform, there was some feeble handclapping, though it ceased almost at once, with few in the audience seeming inclined to join in. Clearly, most were taking their cue from the executive group at the front, from where there was no applause and facial expressions showed disapproval. The board chairman seemed angry—he was speaking in low tones, heatedly, to Eli Camperdown; the Felding-Roth president nodding as he listened.

  The vice president of sales, a New Yorker named Irving Gregson who had been recently promoted, approached her. A forceful man of athletic build, Gregson was normally genial and well liked. But now he was glowering, his face flushed. “Young woman,” he declared, “you have been malicious, presumptuous and misguided; also your so-called facts are wrong. You are going to regret it. You will be dealt with later, but for now, I am ordering you to leave this sales convention and not to return.”

  “Sir,” Celia said, “won’t you at least look at the material I have—”

  “I’ll look at nothing!” Gregson’s raised voice was audible through the hall. “Get out of here!”

  “Good afternoon, Mr. Gregson,” Celia said. She turned and walked aw
ay, heading for an exit. Her step was firm, head high. She thought, later there would be time for regrets, perhaps deep dejection; for now, she had no intention of leaving this male assemblage defeated, like a weakling. Just the same, she admitted to herself, she was defeated, and of course she had known this might happen but hoped that it would not. To Celia, the faults she had described were so obvious and glaring, the reforms so plainly needed, it was hard to see how others could disagree when facts were pointed out.

  But they had. And almost certainly her employment by Felding-Roth was ended, or would be shortly. A pity. Sam Hawthorne would probably say she had done what he cautioned her not to do—overreached in trying to achieve too much. Andrew, too, had warned her—on the way back from their honeymoon when she told him about building a file of doctors’ reports. She remembered Andrew’s words: “You’re taking on something pretty big. Also some risks.” How right he had been! Yet, a principle was involved, and her own integrity, and Celia had decided long ago she would never temporize on that. What was that line from Hamlet she had learned at school? “This above all: to thine own self be true …” You paid a price for it, though. Sometimes a stiff one.

  Moving through the hall, she was aware of sympathetic glances from a few of the men still seated. That was unexpected, after all her criticisms. Not that it made any difference now.

  “One moment, please!”

  Suddenly, startling her, coming from nowhere, a voice boomed strongly over the p.a. system. “Mrs. Jordan, will you wait?”

  Celia hesitated, then stopped as the voice repeated, “Mrs. Jordan, wait!”

  Turning, she saw with surprise that the voice was Sam Hawthorne’s. Sam had left his seat, ascended the speakers’ platform, and was leaning over the microphone. Others were startled too. Irving Gregson could be heard exclaiming, “Sam … what the hell?”

  Sam passed a hand across his head, shiny under the spotlight; it was an unconscious habit when he was thinking a problem through. His craggy face was serious. “If you don’t mind, Irving, there’s something I’d like to say, and have everyone hear, before Mrs. Jordan goes.”

  Celia wondered what was coming. Surely Sam wasn’t going to endorse her expulsion by telling the world about their conversation of this morning and his warning. It would be out of character. Yet ambition did strange things to people. Was it possible that Sam believed some comment would make him look good in the eyes of the assembled brass?

  Looking up at the platform, the vice president of sales asked testily, “What is it?”

  “Well,” Sam said, close enough to the microphone so his voice could be heard again through the now-silent hall, “I guess you could say, Irving, I’m standing up here to be counted.”

  “In what way counted?” This time the question was from Eli Camperdown, now also on his feet.

  Sam Hawthorne faced the Felding-Roth president, at the same time moving closer to the mike. “Counted with Mrs. Jordan, Eli. And admitting—even though no one else seems willing to—that everything she said is true. As we all damn well know, even while pretending otherwise.”

  The silence in the hall was awesome. Only minor noises filtered in—the sound of traffic, distantly; a rattle of glassware from a kitchen; muted voices from a corridor outside. It seemed as if everyone was still, rooted, not wanting to move and thereby miss a word. Amid the quiet, Sam continued.

  “I’d also like to go on record as wishing I’d had the wit and moral courage to make the speech which Mrs. Jordan did. And there’s something else.”

  Irving Gregson interrupted. “Don’t you think you’ve said enough?”

  “Let him finish,” Eli Camperdown ordered. “It might as well all hang out.”

  The sales vice president subsided.

  “In particular,” Sam Hawthorne went on, “I agree with the opinion that if our industry fails to mend its ways, laws will be passed compelling us to do so. Moreover, those laws will be more restrictive by far than if we accept the good advice we have just heard and clean house ourselves.

  “Finally, about Mrs. Jordan. Several times already she has proved her great value to this company. In my opinion she has just done so again, and if we let her leave this room in this way, we’re all shortsighted fools.”

  Celia could scarcely believe what she heard. She had a momentary sense of shame for doubting Sam’s motives. What he had just done, she realized, was to put his own job, his ambitions, his promising future at Felding-Roth, all on the line on her behalf.

  Still the uncanny silence persisted. There was a shared awareness of a moment of high drama in which no one seemed certain what would happen next.

  It was Eli Camperdown who moved first, returning to his seat beside the chairman of the board where the two senior officers began a second urgent, low-voiced conversation. This time Camperdown was doing most of the talking—it seemed, attempting to persuade—while the elderly VanHouten listened. At first the chairman shook his head adamantly, then appeared to relent, and finally shrugged. Camperdown beckoned Irving Gregson to join them.

  Since decisions were obviously taking shape at highest level, others waited, though now a buzz of conversation filled the hall.

  It diminished as the vice president of sales left the other two and ascended the speakers’ platform. He took over the microphone from Sam Hawthorne, who returned to his seat below. Gregson surveyed the sea of curious faces, paused for effect, then permitted himself a broad grin.

  “Whatever else you may say about our sales conferences,” he declared, “we always promise you they are never dull.”

  It was the right thing to say and there was a roar of appreciative laughter in which even the dour VanHouten joined.

  “I am instructed by our chairman and president,” Gregson said, “an instruction in which I personally join, to state that a few moments ago we may all have acted hastily, even unwisely.” Again the grin, a pause, and the sales chief continued.

  “Many years ago, when I was a small boy and sometimes got into trouble—as all boys do—my mother taught me something. ‘Irving,’ she said, ‘when you’ve made an ass of yourself and an apology is called for, stand up straight, be a man, and do it handsomely.’ My dear mother, rest her soul, is dead; but somehow I can hear her voice saying, ‘Irving, my boy, that time is now.’”

  Watching and listening, Celia thought: Gregson had style. It was clearly not by accident he had been promoted to the hierarchy of sales.

  She realized he was pointing directly at her. “Mrs. Jordan, come this way, please. You too, Sam.”

  When all three of them were on the platform—Celia dazed, almost unbelieving—Gregson said, “I announced I would apologize, Mrs. Jordan, and I do. We will, after all, consider your suggestions carefully. And now I’ll relieve you of that file of yours if you don’t mind.”

  Turning to the audience Gregson said, “I believe you have just witnessed an example of why ours is a great company and will …”

  The remainder of his remarks were drowned out by applause and cheering and, moments later, executives and others were surrounding Celia, offering congratulations and shaking her hand.

  “Why did you risk it?” Sam Hawthorne asked.

  “If it comes to that,” Celia answered, “why did you?”

  It was a week later. Celia and Andrew were spending an evening at the Hawthornes’ home and during dinner—a superb meal attesting Lilian Hawthorne’s culinary skill—they had avoided the subject of the sales convention and talked of other things. A few days earlier the Russians had announced the shooting down of an American U-2 plane and the capture of its pilot, Gary Powers. Moscow charged that both were spying. The United States at first denied the charge but soon afterward President Eisenhower admitted, red-faced, that it was true. Most Americans, the Hawthornes and Jordans agreed, felt embarrassed too.

  In Britain the Queen’s sister, Princess Margaret, had set tongues wagging and raised eyebrows by marrying a professional photographer, Antony Armstrong-Jones. The wedding took
place in what the press described as a “carnival mood.” People were asking: Would the marriage diminish the prestige of the British throne? Andrew emphatically said no.

  After dinner they listened to a new recording by Elvis Presley—a pop ballad, “Fame and Fortune.” Presley had resumed his career after a year in the U.S. Army, his absence having left his popularity undimmed. The women liked “Fame and Fortune.” The men didn’t.

  Finally, over brandies in the Hawthornes’ spacious, artistically decorated living room, it was Sam who introduced the subject, closer to home, that was on all their minds.

  Answering Celia’s question, he said, “When I followed you onto that platform, maybe I just couldn’t resist being part of a dramatic scene.”

  She objected, “You know it was more than that.”

  “We all do,” Andrew put in. He was leaning back in a comfortable armchair and savoring the brandy; he had had a busy day with patients in a practice that was growing rapidly, and was tired. “You risked everything, Sam—far more than Celia.”

  “Of course, I’m grateful—” Celia began, but Sam cut her off.

  “You don’t need to be. If you want the truth, I felt I was being tested.” He addressed Andrew. “Your wife had already demonstrated she had more guts, along with greater respect for truth, than anyone else there. I didn’t want to fall below her standards.” Sam smiled at Celia. “Especially if you’re trying to follow me up the ladder at Felding-Roth.”

  “You know about that?”

  “I told him,” Lilian Hawthorne said. “I’m sorry if I broke your confidence, Celia, but Sam and I don’t keep secrets from each other.”

  “I have a secret,” Sam said; “it’s about Celia.” As the others looked at him curiously, he went on, “She isn’t going to be a detail woman anymore.”

  Andrew chuckled. “You’re firing her after all?”

  “No. Promoting her. Our company is going to have a Department of Sales Training, just as Celia suggested. She’ll help set it up—and will be assistant director.”

 

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