Strong Medicine

by Arthur Hailey

  “Great!”

  “Of course, the question we’re all asking is: How soon will we get FDA approval?”

  There was a silence during which Celia sensed Sam hesitating, then he said, “For the moment, this is confidential between you and me. But I can say positively we will get FDA permission, and very soon.”

  “May I ask why you’re so sure?”

  “No.”

  “Okay.” If Sam wanted to be mysterious, Celia thought, that was his privilege, though between the two of them she could see no reason for it. She asked, “Is everything good with Juliet?”

  “And with my soon-to-be grandchild?” Sam chuckled. “I’m delighted to say, yes.”

  Three months ago, Juliet and Dwight Goodsmith had happily announced Juliet’s pregnancy. The baby was due in January.

  “Give Lilian and Juliet my love,” Celia said, “and tell Juliet that with her next pregnancy she’ll be able to take Montayne.”

  “Will do. Thanks, Celia.” Sam hung up.

  While Celia was on the telephone, Andrew had gone into the bathroom to shower, then dress, prior to a thirty-five-mile drive to Palo Alto where they were due for dinner with Lisa and several newfound Stanford friends.

  During the drive and the dinner, which was relaxed and cordial, neither Celia nor Andrew referred to their argument at the hotel. At first there was a coolness between them, but it disappeared as the evening progressed. By that time, also, Celia had decided to leave well alone and not raise the subject of Montayne with her husband again. After all, everyone in the course of a lifetime had occasional mental blind spots and—though it disappointed her—this was clearly one of Andrew’s.

  9

  Sam Hawthorne, replacing the telephone after his Boonton–San Francisco conversation with Celia, found himself wishing he had not made the impulsive, positive statement he had concerning FDA approval of Montayne. It was unwise and indiscreet. Why had he done it? Probably for no other reason than the human one of seeking to impress another person—in this case Celia.

  He must watch himself, he decided. Especially after his discussion an hour ago with Vincent Lord and the decision they had reached jointly. It was a decision that could have disastrous repercussions if it were found out, though it must not be—ever. All the more reason, then, to let the FDA’s approval of Montayne, when it happened, seem natural and ordained. As it should have been, and would have been, except for that arrogant, insufferable, criminal bureaucrat at FDA!

  It was sheer bad luck that the new drug application for Montayne had drawn Dr. Gideon Mace as the reviewer.

  Sam Hawthorne had not met Mace, and didn’t want to. He had heard more than enough about the man from Vince Lord and others, and about the trouble Mace caused Felding-Roth, first with the unreasonable delay two years ago over Staidpace, and now with Montayne. Why should people like Mace possess the power they had, Sam fumed, and have to be endured by honest businessmen who sought, from the Maces of this world, no more than equal honesty and fairness?

  Fortunately, people like Mace were a minority—at FDA a small minority; Sam was certain of that. Just the same, Mace existed. He was currently sitting on the Montayne NDA, using regulations, procedural tactics, to delay it. Therefore a way to circumvent Gideon Mace had had to be found.

  Well, they had a way. At least, Felding-Roth had, in the person of Vince Lord.

  Originally, when Vince had collected—no, make that bought—evidence of criminality by Dr. Mace, purchased it with two thousand dollars of Felding-Roth cash, the voucher for that cash now buried deep in the travel expense account where auditors or the IRS would never find it … at that time Sam had been angry, critical of Vince, and shocked at the thought that the material might ever be used in the way which Vince envisaged.

  But not now. The existing situation affecting Montayne was too critical, too important, for that kind of scruples anymore. And that was another cause for anger. Anger because criminals like Mace begat criminality in others—in this case, in Sam and Vincent Lord—who had to use those same low-grade tactics for reasonable self-defense. Damn Mace!

  Still soliloquizing silently, in the quietness of his office, Sam told himself: A penalty you paid for appointment to the top job in any large company was having to make unpalatable decisions authorizing actions which, if they happened elsewhere or in a vacuum, you would consider unethical and disapprove of. But when you shouldered responsibilities involving so many people, all of them dependent on you—shareholders, directors, executive colleagues, employees, distributors, retailers, customers—it was necessary at times to swallow hard and do what was needed, however tough, unpleasant or repugnant it might seem.

  Sam had just done that, an hour ago, in okaying a proposal by Vincent Lord to threaten Dr. Gideon Mace with exposure and therefore criminal charges if he failed to expedite the approval of Montayne.

  Blackmail. No point in mincing words or hiding behind euphemisms. It would be blackmail, which was criminal too.

  Vince had laid his plan bluntly in front of Sam. Equally bluntly Vince declared, “If we don’t make use of what we have, putting pressure on Mace, you can forget any idea of marketing Montayne in February, and maybe for another year.”

  Sam had asked, “Could it really be that long—a year?”

  “Easily, and more. Mace has only to ask for a repeat of—”

  Lord stopped as Sam waved him to silence, canceling an unnecessary question, remembering how Mace had delayed Staidpace for longer than a year.

  “There was a time,” Sam reminded the research director, “when you talked of doing what you’re proposing without involving me.”

  “I know I did,” Lord said, “but then you insisted on knowing where that two thousand dollars went, and after that I changed my mind. I’ll be taking a risk and I don’t see why I should take it alone. I’ll still handle the frontline attack, the confrontation with Mace. But I want you to know about it, and approve.”

  “You’re not suggesting we have anything in writing?”

  Lord shook his head negatively. “That’s another chance I’ll take. If it came to a showdown, you could deny this conversation ever happened.”

  It was then Sam realized that what Vince really wanted was not to be lonely, not to be the only one to know what he was going to do. Sam understood that. Loneliness was something else you experienced at the top, or near the top, and Vince was simply sharing his.

  “All right,” Sam said. “Much as I dislike myself for it, I approve. Go ahead. Do what we have to.” He added facetiously, “I assume you’re not wired for sound.”

  “If I were,” Lord answered, “I’d incriminate myself as well as you.”

  When the research director was on his way out, Sam called after him. “Vince!”

  Lord turned. “Yes?”

  “Thanks,” Sam said. “Just thanks, that’s all.”

  So all that was necessary now, Sam reasoned, was to wait. Wait, just briefly, with confidence that FDA’s approval of Montayne would come quickly, inevitably, soon.

  Since their previous encounter, Vincent Lord was aware, some changes had occurred in Dr. Gideon Mace. The FDA official looked older, which he was, but also better than before, which was surprising. His face was less red, the nose veins seemed less prominent. He had shed the shabby suit and bought a new one, also new glasses, so he no longer squinted. His manner seemed easier and, while still not friendly, was certainly less brusque and not aggressive. Perhaps one reason for the changes—a reason Vincent Lord had learned about through his contacts at the agency—was that Mace had stopped drinking and joined Alcoholics Anonymous.

  Apart from Mace personally, other things were the same or worse. The FDA Washington headquarters was the same impersonal, shabby beehive. In the cupboardlike office where Mace was seated at his desk there was more paper than ever; it was piled high everywhere, like a rising flood tide. Even crossing the floor one had to step around paper and files, put there for lack of any other space.

 
Gesturing about him, Lord asked, “Is our Montayne NDA here somewhere?”

  “Parts of it,” Mace said. “I haven’t room for it all. Montayne is what you’ve come about, I suppose.”

  “Yes,” Lord acknowledged. He was seated, facing the doctor, and even now hoping there might be no need to use the photostatic copies that were in a briefcase at his feet.

  “I’m genuinely worried about that Australian case.” Again in contrast to the past, Mace’s tone was reasonable. “You know the one I mean?”

  Lord nodded. “The woman in the Outback. Yes, the case went to court where it was thrown out, and there was also a government inquiry. Both times the accusations were checked out thoroughly, and Montayne absolved.”

  “I’ve read all that stuff,” Mace said, “but I want more details. I’ve written to Australia for them, and when they come I may have still more questions.”

  Lord protested, “But that could take months!”

  “Even if it does, I’ll be doing what I’m here for.”

  Lord made one last try. “When you held up our NDA for Staidpace, I assured you it was a good drug, free from adverse side effects and so—despite the unnecessary delay—it was. Now I’m promising you, based on my reputation as a research scientist, exactly the same is true of Montayne.”

  Mace said stolidly, “It’s your opinion, not mine, that the Staidpace delay was unnecessary. In any case, that has nothing to do with Montayne.”

  “In a way it has,” Lord said, knowing he now had no alternative, glancing behind him to be sure the outer door was closed. “It has, because I think what you are doing to us at Felding-Roth relates not to our latest NDA, but to your own state of mind. You have a lot of personal problems which are getting the better of you, creating unfair prejudices, clouding your judgment. Some of those personal problems have come to my company’s attention.”

  Mace bridled and his voice sharpened. “What the hell are you talking about?”

  “This,” Lord said. He had the briefcase open and extracted papers. “These are brokerage transaction slips, canceled checks, bank statements, and other items which show you made over sixteen thousand dollars illegal profit, utilizing confidential FDA information concerning two generic drug companies, Binvus Products and Minto Labs.”

  Lord added the dozen sheets or so to the paper clutter already on Mace’s desk. “I think you should look these over carefully. I’m aware you’ve seen them all before, but it may be news to you that someone else has copies. And by the way, these are copies of copies. Keeping or destroying them will do no good.”

  It was obvious that Mace recognized instantly the top item—one of the brokerage transaction slips. His hands were shaking as he picked it up, then followed with the other papers, inspecting them one by one and clearly with equal recognition. As he progressed, his face went ashen and his mouth worked spasmodically. Lord wondered if Mace would have a stroke or heart attack on the spot. But instead, putting the papers down, Mace asked in a whisper, “Where did you get these?”

  “That isn’t important,” Lord answered briskly. “What matters is: we have them and are considering making them available to the Attorney General and probably the press. In that event, of course, there will be an inquiry, and if you’ve been involved in more incidents of the same kind, those will come out too.”

  From Mace’s increasingly frightened expression, Lord knew his last random shot had hit home. There were more incidents. Now each of them knew it.

  Lord remembered something he had once said to Sam Hawthorne in foreseeing what was happening now. “When the time comes, let me do the dirty work.” Then he had added silently, I might even enjoy it. Well, now that it was happening, Lord realized, he was enjoying it. It gave him pleasure to wield power over Mace, to behold an adversary so expert in dishing out humiliation now experiencing the same, and suffering and squirming.

  “You’ll go to jail, of course,” Lord pointed out, “and I imagine there’ll be a big fine which should clean you out financially.”

  Mace said desperately, “This is blackmail. You could be …” His voice was nervous, thin and reedy. Lord roughly cut him off.

  “Forget that! There are plenty of ways of handling this so our company’s involvement isn’t known, and there are no witnesses here, just you and me.” Lord reached over, gathered up the papers he had shown to Mace, and returned them to his briefcase. He had remembered, just in time, that his own fingerprints were on them; no sense in taking a chance on leaving evidence behind.

  Mace was a broken man. Lord saw with disgust there was spittle on the other man’s lips which bubbled as he asked feebly, “What do you want?”

  “I think you know,” Lord said. “I guess you could sum up what we would like as ‘an attitude of reasonableness.’”

  A despairing whisper. “You want that drug approved. Montayne.”

  Lord remained silent.

  “Listen,” Mace pleaded, half sobbing now, “I meant it when I said there is a problem … that Australian case, the doubts about Montayne … I truly believe there may be something there … you ought to …”

  Lord said contemptuously, “We’ve already talked about it. Better people than you have assured us the Australian case was meaningless.”

  Again a silence.

  “If it happens … the approval?”

  “In certain circumstances,” Lord said carefully, “the papers from which the copies I have shown you were made would not be given to the Attorney General or the press. Instead they would be handed over to you with a guarantee that, to the best of our knowledge, no other copies exist.”

  “How could I be sure?”

  “On that, you would have to take my word.”

  Mace was attempting to recover; there was savage hatred in his eyes. “What’s your word worth, you bastard?”

  “Forgive my mentioning it,” Vincent Lord said calmly, “but you’re in no position to call anybody names.”

  It took two weeks. Even with Gideon Mace impelling them, the wheels of bureaucracy needed time to turn. But at the end of that time, approval of Montayne was a fait accompli. The drug could be prescribed and sold, with FDA approval, throughout the United States.

  At Felding-Roth there was joy that the company’s February marketing target would now be met.

  Taking no chances on the mail or another messenger, Vincent Lord traveled to Washington and delivered the incriminating papers personally to Dr. Mace.

  Lord had kept his word. All additional copies were destroyed.

  In the privacy of Mace’s office, with both men standing, a minimum of words passed between them.

  “This is what was promised.” Lord proffered a brown manila envelope.

  Mace accepted the envelope, inspected its contents, then turned his eyes toward Lord. In a voice dripping hatred, he said, “You and your company now have an enemy at FDA. I give you my warning: someday you’ll regret this.”

  Lord shrugged, made no reply, and left.

  10

  In November, on a Friday afternoon, Celia visited Dr. Maud Stavely at the New York headquarters of Citizens for Safer Medicine.

  The visit was an impulse decision. Celia was in Manhattan anyway, with two hours free between appointments, when she decided to satisfy her curiosity about an adversary she had never met. She did not telephone in advance, knowing that if she did, Stavely would almost certainly refuse to see her. That kind of turndown had been experienced by others in the pharmaceutical business.

  Celia remembered something which Lorne Eagledon, president of the Pharmaceutical Manufacturers Association in Washington, had told her not long before. Eagledon, genial and easygoing, had been a government lawyer before his present trade association job.

  “As head of PMA, representing all the major drug companies,” he said, “I like to keep contact with consumer groups. Sure, we oppose each other, but sometimes they have useful things to say, and our industry should listen. That’s why I invite Ralph Nader to lunch twice a ye
ar. True, Ralph and I don’t have much common ground, but we talk, and listen to each other’s viewpoints, which is a civilized thing to do. But when I invited Maud Stavely to have lunch for the same reason—oh, boy!”

  With prompting from Celia, the PMA chief had continued, “Well, Dr. Stavely informed me she had plenty to do in her full-time fight against a thoroughly bad, immoral industry—ours—without wasting her valuable time on a big-business lackey with unacceptable opinions—me. Furthermore, she said never mind lunch—she would choke on a chocolate bar paid for with drug firms’ tainted money.” Eagledon had laughed. “So we never met, which I regret.”

  A dreary rain was falling as Celia’s taxi stopped at a dingy six-story building on Thirty-seventh Street near Seventh Avenue. The building’s main floor was occupied by a plumbing supplies store whose front window had been broken, then patched with tape. From a dowdy hallway with peeling paint, a tiny, arthritic elevator grumbled its way to the top floor and CSM.

  As Celia left the elevator she faced an open door and, in a small room beyond, an elderly white-haired woman seated at a battered metal desk. A card facing outward read: Volunteer: Mrs. O. Thom. The woman had been pecking at an Underwood typewriter circa 1950. Looking up as Celia entered, she announced, “I keep telling them I won’t do any more work here unless this wretched machine is fixed. It’s the capital ‘I’ that never works. How can you write to people without an ‘I’?”

  Celia said helpfully, “You could try using ‘we’ every time instead.”

  Mrs. O. Thom snapped, “What about this letter, then? It’s supposed to go to Idaho. Should I rename the state Wedaho?”

  “I do see your problem,” Celia said. “I wish I could help. Is Dr. Stavely in?”

  “Yes, she’s in. Who are you?”

  “Oh, just someone interested in your organization. I’d like to talk to her.”

  Mrs. Thom looked as if she would ask more questions, then changed her mind. Getting up, she walked through another doorway and out of sight. While she was away, Celia caught glimpses of several other people working in adjoining rooms. There was a sense of busy activity, including the sounds of another typewriter clattering and brisk phone conversations. Closer to hand, brochures and leaflets, some prepared for mailing, were piled high. A stack of incoming mail awaited opening. Judging by appearances, though, CSM was not burdened with excess cash. The office furnishings, Celia thought, were either someone else’s discards or had been bought at a junk dealer’s. Long ago, the floors were carpeted, but now the carpeting was worn so thin it had almost disappeared, and in places bare boards were visible through holes. As in the downstairs lobby, what was left of the paint was peeling.