Strong Medicine

by Arthur Hailey

  When Andrew arrived at St. Bede’s, Dr. Gould was in the tiny office which the hospital set aside for his use. “Come in,” he said. “And close the door.”

  Opening a desk drawer, Gould produced a bottle of scotch and two glasses. “It’s against the rules and I do this rarely. But I feel a need tonight. Will you join me?”

  Andrew said gratefully, “Yes, please.”

  Gould poured the drinks, added ice and water, and they drank in silence.

  Then Gould said, “I’ve been with Noah almost since I left you. There are several things you should know. The first is—since it will affect your practice and Noah’s patients—Noah Townsend will never practice medicine again.”

  “How is he?” Andrew asked.

  “Make that ‘where is he?’ and I’ll answer.” Gould swirled the remaining liquid in his glass. “He’s been committed to a private psychiatric hospital in Newark. In the opinion of those competent to know, he’s unlikely ever to leave.”

  As Gould described the events of the afternoon and early evening his voice was strained. At one point he commented grimly, “I hope I never go through anything like this again.”

  After leaving Andrew, when Gould and Townsend reached the main floor of St. Bede’s the chief of medicine managed to hustle Townsend, still screaming, into an unoccupied treatment room where Gould locked the door and telephoned urgently for a staff psychiatrist. When the psychiatrist arrived, between them they subdued Townsend and sedated him. Obviously, in his condition Townsend could not be taken home so the psychiatrist had done some hasty telephoning, after which Townsend was removed by ambulance to the institute in Newark. Gould and the psychiatrist accompanied him.

  By the time they arrived at the psychiatric hospital, the sedation had worn off and Townsend became violent, necessitating his being restrained in a straitjacket. “Oh, Christ, it was awful!” Gould took out a handkerchief and wiped his face.

  At that point, more or less, it became evident that Noah Townsend had become insane.

  As Ezra Gould described it, “It was as if somehow Noah had been living—for a long time and because of his drug addiction, of course—as an empty shell. God knows how he managed to keep going, but he did. Then, suddenly, what happened today caused the shell to crumple … and there was nothing functioning inside and, the way it looks now, nothing salvageable either.”

  An hour ago, Gould continued, he had been to see Noah Townsend’s wife.

  Andrew was startled. Amid all that had occurred in the past few days, he had given no thought to Hilda. He asked, “How has she taken it?”

  Gould considered before answering. “It’s hard to say. She didn’t talk a lot and she didn’t break down. I got the impression she’s been expecting something to happen, though never knowing what. I think you’d better see her yourself tomorrow.”

  “Yes,” Andrew said. “I will.”

  Gould hesitated. Then, looking at Andrew directly, he said, “There’s one more thing you and I have to discuss, and that’s the dead man, Wyrazik.”

  “I may as well tell you now,” Andrew said firmly, “I have no intention of being part of any cover-up.”

  “All right,” Gould acknowledged; his voice sharpened. “Then let me ask you this: What do you propose doing? Are you going to make a public statement, maybe to the press? After that will you volunteer as a prosecution witness in a malpractice suit? Will you help some ambulance-chasing lawyer on a fat contingency fee take away from Townsend’s wife whatever money Noah had accumulated for their old age? Will you load this hospital with damages far in excess of any insurance we carry, and which could break us financially, so we might have to reduce our services or close?”

  Andrew protested, “None of that may happen.”

  “But it could. You’ve read enough about sharp lawyers to know what they can do in court.”

  “That isn’t my problem,” Andrew insisted. “What’s important is the truth.”

  “The truth is important to us all,” Gould answered. “You don’t have a monopoly on that. But sometimes the truth can be shaded for decent reasons and in special circumstances.” His voice became persuasive. “Now listen carefully, Andrew. Hear me out.”

  The chief of medicine paused, gathering his thoughts, then said, “The dead man’s sister, Miss Wyrazik, arrived this afternoon from Kansas. Len Sweeting saw her. She’s a nice ordinary woman, he says, quite a bit older than her brother was, and of course she’s sorry about his death. But the two of them weren’t close, haven’t been for many years, so for her it’s not a shattering bereavement. There’s a father back in Kansas, but he has Parkinson’s. It’s advanced; he hasn’t long to live.”

  Andrew said, “I don’t see what all this—”

  “You will. Just listen!”

  Again Gould paused before continuing. “Wyrazik’s sister is not here to make trouble. She hasn’t asked a lot of questions. She even volunteered the statement that her brother’s health was never good. She wants his remains cremated, and afterward she’ll take the ashes back to Kansas. But she does have problems about money. When Len talked to her he discovered that.”

  “Then she’s entitled to be helped. Surely that’s the least—”

  “Exactly! We’re all agreed on that, Andrew. What’s more, financial help can be arranged.”

  “How?”

  “Len and Fergus McNair have worked it out. They’ve been busy this afternoon. Never mind all details; you and I don’t need to know them. But the fact is, our insurers—who’ve been talked to confidentially—have an interest in seeing this thing ended quietly. Wyrazik, it appears, was sending money to Kansas to help pay medical expenses for his father. Those amounts can be continued, maybe augmented. Wyrazik’s funeral expenses will be paid. And there can be a pension, not enormous but sufficient, for the sister for the remainder of her life.”

  “How will you explain that to her without admitting liability? Supposing she becomes suspicious?”

  “I imagine it’s a risk,” Gould said, “though Len and McNair don’t seem to think so, and they’re lawyers after all. They believe they can handle it discreetly. Also, I suppose, it has to do with the kind of woman Miss Wyrazik is. The most important thing: this way there won’t be any ridiculous multimillion dollar settlements.”

  “I suppose,” Andrew said, “what’s ridiculous or isn’t depends on your point of view.”

  The chief of medicine gestured impatiently. “Try to remember this: There’s no wife involved, no children with future education to be considered—just a dying old man and one middle-aged woman who’s going to be taken care of reasonably.” Gould stopped, then asked abruptly, “What were you thinking?” At the last remark Andrew had smiled.

  “A cynical thought. If Noah had to kill a patient, he couldn’t have picked one who’d be more accommodating.”

  Gould shrugged. “Life’s full of chances. This happens to be one that broke our way. Well?”

  “Well what?”

  “Well, are you going to make a public statement? Will you call the press?”

  Andrew said irritably, “Of course not. I never intended to. You knew that perfectly well.”

  “Then what else is there? You’ve already behaved correctly in bringing what you knew to the hospital’s attention. Further than that you’re not involved. You will not be a party to any settlement. You are not being asked to lie and if, for any reason, all this blew open and you were questioned officially, naturally you’d tell the truth.”

  “If that’s my position,” Andrew queried, “what about yours? Will you tell Miss Wyrazik the real cause of her brother’s death?”

  “No,” Gould answered curtly. Then he added, “That’s why some of us are in this deeper than you. And maybe why we deserve to be.”

  In the ensuing silence Andrew thought: What Ezra Gould had just said was an admission, subtle but clear, that Andrew had been right, and others wrong, four years ago when Andrew tried to bring Noah Townsend’s drug addiction out in the
open but was rebuffed. Andrew was certain now that Leonard Sweeting had told others of their conversation at that time.

  Undoubtedly the admission was the only one that ever would be made; such things were never inserted in a written record. But at least, Andrew reasoned, something had been learned—by himself, Sweeting, Gould and others. Unfortunately their learning came too late to help either Townsend or Wyrazik.

  So where, Andrew asked himself, did he go from here? The answer seemed to be: Nowhere.

  What Gould had been saying did, on the whole, make sense. It was also true that Andrew was not being asked to lie, though he was being asked to keep quiet so, in that sense, he was sharing in a cover-up. On the other hand, who else was there to tell, and what would be gained from doing so? No matter what happened, Kurt Wyrazik could not be brought back to life, and Noah Townsend—tragically but necessarily—had been removed from the scene and would menace no one else.

  “All right,” Andrew told the chief of medicine, “I’ll do nothing more.”

  “Thank you,” Gould acknowledged. He looked at his watch. “It’s been a long day. I’m going home.”

  Andrew went to see Hilda Townsend the following afternoon.

  Townsend was age sixty-three, Hilda four years younger. For a woman of her age, she was attractive. She had kept her figure in good shape. Her face was firm. Her hair, while entirely gray, was cut stylishly short. Today she was dressed smartly in white linen slacks and a blue silk blouse. Around her neck she wore a thin gold chain.

  Andrew had expected her to show signs of strain, perhaps of weeping. There were none.

  The Townsends lived in a small but pleasant two-storied house on Hill Street, Morristown, not far from the medical office at Elm and Franklin to which, on fine-weather days, Noah Townsend had often walked. There were no servants in the house and Hilda let Andrew in herself, preceding him to a sitting room. It was a room, furnished in soft browns and beiges, which overlooked a garden.

  When they were seated, Hilda said matter-of-factly, “Would you like something, Andrew? A drink? Tea, perhaps?”

  He shook his head. “No, thanks.” Then he said, “Hilda, I don’t know what else to say except—I’m terribly sorry.”

  She nodded, as if the words were expected, then asked, “Were you dreading this? Coming here to see me?”

  “A little,” he admitted.

  “I thought so. But there’s no need. And don’t be surprised or shocked because I’m not weeping, or wringing my hands, or doing any of those other emotional, womanly things.”

  Uncertain how to respond, he simply said, “All right.”

  As if she had not heard, Hilda Townsend went on, “The fact is, I’ve done them all, done them so often, and for so long, that now they’re far behind me. For years I shed so many tears that my supply ran dry. I used to think that little pieces of my heart were breaking off while I watched Noah destroy himself. And when I couldn’t make him understand or even listen, I came to think that all of my heart was gone and only an inner piece of stone was left. Does any of that make sense?”

  “I think so,” Andrew said, and thought: How little each of us knows of the sufferings of other people! For years Hilda Townsend must have lived behind a wall of loyal concealment, a wall which Andrew had neither known of nor suspected. He remembered, too, Ezra Gould’s words of the night before. “She didn’t talk a lot … I got the impression she’s been expecting something to happen, though never knowing what.”

  “You knew about Noah and the drugs,” Hilda said. “Didn’t you?”

  “Yes.”

  Her voice became accusing. “You’re a doctor. Why did you do nothing?”

  “I tried. At the hospital. Four years ago.”

  “And no one there would listen?”

  “Something like that.”

  “Could you have tried harder?”

  “Yes,” he said. “Looking back now, I think I could have.”

  She sighed. “You probably wouldn’t have succeeded.” Abruptly she switched subjects. “I went to see Noah this morning, or rather tried to see him. He was raving. He didn’t know me. He doesn’t know anyone.”

  “Hilda,” Andrew said gently, “is there anything I can do, anything, to help you?”

  She ignored the question. “Does Celia feel any guilt about what’s happened?”

  The question startled him. “I haven’t told her yet. I will this evening. But as to guilt—”

  “She should!” The words were spoken savagely. In the same tone, Hilda went on, “Celia is a part of that greedy, ruthless, money-coining, high-pressure drug business. They do anything to sell their drugs, to get doctors to prescribe them and people to use them, even if the drugs aren’t needed. Anything!”

  Andrew said quietly, “No pharmaceutical company forced Noah to take the drugs he did.”

  “Maybe not directly.” Hilda’s voice rose. “But Noah took drugs, and so do others, because the companies surround doctors with them! They deluge them! With sleazy, oh-so-clever, limitless advertising, page after page in medical magazines which doctors have to read, and with an avalanche of mail, and with free trips and hospitality and booze—all of it designed to make doctors think drugs, always drugs, still more drugs! The companies, every one of them, swamp doctors with free samples, telling them they can have any drug they want, in whatever quantity, and just by asking! No restrictions, never any questions! You know it, Andrew.” She stopped. “I want to ask you something.”

  He told her, “If I can answer, I will.”

  “Lots of salesmen—detail men—came into the office. Noah saw them all the time. Don’t you think that some of them, maybe all of them, knew how much he was taking drugs, were aware he was an addict?”

  Andrew considered. He thought of the untidy profusion of drugs, all in manufacturers’ containers and packages, in Noah’s office. “Yes,” he answered. “Yes, I think it’s likely that they knew.”

  “Yet it didn’t stop them, did it? Bastards! They just went on delivering. Giving Noah anything he wanted. Helping him destroy himself. That’s the rotten, filthy business your wife is in, Andrew, and I loathe it!”

  “There’s something in what you’ve said, Hilda,” he acknowledged. “Maybe a lot. And while it isn’t the whole picture, I’d like you to know I understand your feelings.”

  “Do you?” Hilda Townsend’s voice mixed contempt and bitterness. “Then explain them to Celia sometime. Maybe she’ll consider changing to another line of work.”

  Then, as if a pent-up force had at last broken free, she put her head in her hands and began to cry.

  5

  The mid-to-late-1960s was a time when women’s lib became a phrase on many lips and a fixture in the news. In 1963 Betty Friedan had published The Feminine Mystique, a declaration of war on “the second-class citizenship of women.” Her book became the vade mecum of the women’s movement and the Friedan voice was now heard frequently. Germaine Greer and Kate Millett joined the movement, adding literary and artistic style. Gloria Steinem effectively combined women’s advocacy with journalism and feminist politics.

  Women’s lib had its mockers. Abbie Hoffman, a counterculture celebrity of the period, declared, “The only alliance I would make with the women’s lib movement is in bed.” And historians, reminding the world that few things are ever new, pointed out that in 1792 in England, one Mary Wollstonecraft courageously published A Vindication of the Rights of Woman, arguing, “Tyrants and sensualists … endeavor to keep women in the dark, because the former only want slaves, and the latter a plaything.”

  But many in the 1960s took the movement seriously, and thoughtful men explored their consciences.

  Celia’s attitude to women’s lib was approving and sympathetic. She bought copies of The Feminine Mystique and gave them to several male executives at Felding-Roth. One was Vincent Lord, who returned the book with a scribbled note, “I have no use for this rubbish.” Sam Hawthorne, influenced by his wife Lilian, an ardent libber herself,
was more sympathetic. He told Celia, “You’re proof that this company has no sex discrimination.”

  She shook her head in disagreement. “I had to claw my way to where I am, Sam—with your help, but also fighting male prejudice, and you know it.”

  “But you don’t have to do that anymore.”

  “That’s because I’ve proved myself as a producer, and I’m useful. Which makes me a freak, an exception. Also, you know how little support there is whenever I argue for more women on the detail force.”

  He laughed. “Okay, I concede, but attitudes are changing. Apart from that, you’re still the best example a man could have for treating women as equals.”

  Despite her private advocacy, Celia took no active part in women’s lib. She decided—selfishly, as she admitted to herself—that, first, she didn’t need it personally; second, she didn’t have the time.

  Celia’s working time continued to be occupied with O-T-C products at Bray & Commonwealth. Despite Sam’s promise of a change to other duties, no new assignment seemed in sight for Celia, and his urging to “be patient for a few months” proved an underestimate.

  Meanwhile, at home, Celia shared with Andrew the anguish following Noah Townsend’s breakdown and committal to a mental institution. As time went on, the prediction of Dr. Gould that Noah would never be discharged seemed increasingly and sadly to be true.

  Andrew had told Celia of Hilda Townsend’s tirade about drug companies and excessive free samples, and was surprised to find her sympathetic. “Hilda’s right,” Celia said. “The amount of free drugs handed out is crazy and I guess we all know it. But competition made the scene the way it is. Now, no one company could cut back without being at a disadvantage.”

  “Surely,” Andrew remonstrated, “drug companies could get together and make some agreement to cut back.”

  “No,” Celia said. “Even if they wanted to, that would be collusion and against the law.”

  “Then how about a case like Noah’s? Where drug company detail people must have known, or at least had a good idea, that Noah was heavily on drugs. Should they have kept feeding his habit the way they did?”