Strong Medicine

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by Arthur Hailey


  “Time and experience have demonstrated pregnancy as the single health condition which is best left to nature alone. At Felding-Roth we are living with a pregnancy-drug disaster, paying dearly for it now. For the future we will do better—morally and financially—to seek our profits elsewhere and urge others to do likewise.”

  Clinton Etheridge, a veteran director and lawyer, from whom Celia had expected antagonism, then spoke in her support.

  “Speaking of profits, I like Mrs. Jordan’s idea of turning our Montayne debacle into a commercial advantage. In case the rest of you haven’t noticed, this so-called doctrine”—the director held it up—“is damned clever. It’s a smart piece of merchandising promotion for the other drugs we sell. It will have a strong dollar value, as I think we’ll find in time.”

  Inwardly Celia winced, then reminded herself that support was worth having, even if for wrong reasons. She also wondered about Etheridge, whom she knew to be a friend and ally of Vincent Lord’s, and who sometimes brought the research director’s viewpoints to board meetings, as Sam had discovered long ago. Lord knew about the Felding-Roth Doctrine, was aware it would be considered today, and he and Etheridge would almost certainly have discussed it. So … was the support she was now receiving a remote way of Lord’s acknowledging to Celia his regrets about Montayne? She supposed she would never know.

  There was more discussion by the board members, mostly questions about how the doctrine would be put into effect. But it was the TV-radio network czar Owen Norton who had the final word.

  Looking at Celia from the opposite end of the boardroom table, Norton, who a few days earlier had celebrated his eighty-second birthday, observed dryly, “You may have noticed, Mrs. Jordan, that we are finally getting around to respecting your womanly judgment. I can only say, for myself and others like me, I am sorry we took so long.”

  “Sir,” Celia said, and meant it, “you have just made my day.”

  The vote that followed, establishing the doctrine as official company policy, was unanimous.

  The impact of the Felding-Roth Doctrine was substantial, though, with the general public, not as great as Celia had hoped.

  Doctors, with a few exceptions, liked it. One obstetrician wrote:

  Kindly send me some extra copies, one of which I shall have framed to hang on my office wall. I intend to point to it when pregnant patients suggest I am serving them less than adequately if I decline to write a prescription for some palliative which, in my opinion, they would be better off without.

  You have, by your highly ethical stand, strengthened the hands of some of us who do not believe there is a drug for every occasion. More power to you!

  The extra copies were sent—to that doctor and many others who requested them.

  Physicians who objected did so on the grounds that they, and not a pharmaceutical company, should advise patients about which drugs to take, or not, and when. But judging by the volume of mail, they were a small minority.

  The Felding-Roth Doctrine was featured widely in the company’s advertising, though this was confined to medical and scientific magazines. Celia at first favored advertising in newspapers and general publications, but was persuaded this would create antagonism from organized medicine which, along with FDA, frowned on direct approaches to consumers about prescription drugs.

  Perhaps because of this absence, newspapers gave only minor attention to the Felding-Roth Doctrine. The New York Times ran a short two-paragraph story amid its financial news, the Washington Post buried a similar report in a rear section of the paper. Elsewhere, in other newspapers, brief items appeared if there happened to be room. Television, despite public relations attempts to persuade producers otherwise, paid no attention at all.

  “If we market a drug that turns out to have harmful side effects we didn’t expect,” Bill Ingram complained to Celia, “those TV news types take our skins off. But when we do something positive like this, all we get is yawns.”

  “That’s because TV journalism is simplistic,” she responded. “Its people are trained to look for strong, quick impact, so they avoid the thoughtful, the cerebral, which take too much air time. Don’t worry, though. At times that policy can help us.”

  Ingram said doubtfully, “Be sure to tell me when it does.”

  Reaction to the Felding-Roth Doctrine from other drug firms was mixed.

  Those who marketed products for use by women during pregnancy were openly hostile. “A cheap shot, shoddy publicity, nothing more,” was how a spokesman for one such company described the doctrine publicly.

  From others came suggestions that Felding-Roth had attempted to be “holier than thou,” and might have harmed the industry, though in what way was not made clear. However, one or two competitors were openly admiring. “Frankly,” Celia was told by a respected industry leader, “I wish we’d thought of it first.”

  “None of which proves anything,” she confided to Andrew, “except you can’t please everyone.”

  “Be patient,” he urged. “You’ve done something good, and you’ve started ripples which are spreading. In time, you’ll be surprised how far they go.”

  Other rings of ripples were resulting from Montayne. One had its origin on Washington’s Capitol Hill.

  Aides to a congressional veteran, Senator Dennis Donahue, had spent a year, on and off, reviewing the Montayne matter and now declared it an ideal subject for their leader to focus on at a Senate investigative hearing. “Ideal,” in this case, meant with wide public interest, generous exposure and, almost certainly, television coverage. As the senator was apt to remind those closest to him politically, “Let’s never forget TV is where the masses and the votes are.”

  Accordingly, it was announced that the Senate Subcommittee on Ethical Merchandising, of which Donahue was chairman, would begin hearings in Washington, D.C., early in December. Witnesses, the senator stated during an October news conference, were already being subpoenaed. Others with firsthand knowledge of the subject were invited to communicate with the committee’s staff.

  When Celia heard the initial report, she telephoned Childers Quentin, the Washington lawyer.

  “That really is bad news,” he affirmed. “I’m afraid that your company, and probably you as its chief spokesman, Mrs. Jordan, are in for a rough time. If you’ll consider some advice, I urge you to begin preparing for the hearings now, with help from legal counsel. I know how these things work, and I assure you the senator’s staff will dig up and place on view every unsavory fact and rumor they can find.”

  11

  If the word demagogue, or dēmagōgos, had not been coined by the Ancient Greeks around the time of Cleon, it would have been invented, out of necessity, to define United States Senator Dennis Donahue. No more striking example of the breed existed.

  He was born to wealth and privilege but posed, and regularly described himself, as “a son of the common people, truly one of them, and ‘of the earth, earthy.’” No description could have been more inaccurate but, like anything repeated often enough, it became accepted and believed by many.

  Another way the senator liked to be portrayed was as “a spokesman for the poor and suffering; a foe of their oppressors.” Whether, inside his soul, he really cared about the poor and suffering, only Donahue himself knew. Either way, he made good use of them.

  Anywhere in the nation, where there happened to be a newsworthy David vs. Goliath struggle, Donahue hastened to the scene, stridently siding with the Davids, even on occasions when—to thoughtful people—Goliath was clearly in the right. “There are always more Davids, and they’re useful at election time,” an aide once explained in a moment of unguarded frankness.

  Perhaps for the same reason, in any labor dispute Donahue unfailingly supported organized labor, never favoring business even if labor excesses were involved.

  The labor and unemployment scenes were fertile fields for an ambitious politician, he had discovered early. Which was why, at times of higher than normal unemployment, the se
nator sometimes joined lines of job-seekers outside employment offices, talking with them. Ostensibly this was to “see for himself, and find out how the unemployed felt”—an admirable aim to which no reasonable person could object. Interestingly, though, the media always learned of the senator’s intentions, so that TV crews and press photographers awaited him. Thus his familiar face, wearing its most soulful expression as he discoursed with the unemployed, was on network news that night and in next day’s newspapers.

  As to other “common man” matters, the senator had discovered a recent, fruitful one in his objections to first-class, tax-deductible air travel by businessmen. If people wanted that kind of special privilege, he argued, they should pay for it themselves, and not be subsidized by other taxpayers. He introduced a Senate bill to make first-class air travel non-deductible for tax purposes, though knowing full well the bill would die somewhere in the legislative process.

  Meanwhile, the amount of news coverage was remarkable. Keeping the idea afloat, Senator Donahue made a point of traveling tourist class himself, by air, informing the press before each journey. However, no first-class passenger ever had as much attention lavished on him as Donahue, back in his tourist seat. One thing he failed to mention publicly was that the bulk of his air travel was in the luxury of private aircraft—either chartered through a family trust fund or made available by friends.

  In appearance, Donahue was stocky, and had a cherubic face which made him look younger than the forty-nine he was. He was overweight without being fat, and referred to himself as “comfortably upholstered.” Most of the time, especially when on public view, he exuded friendliness, expressed through an easy grin. His dress and hairstyle had a studied untidiness, conforming with the “common man” image.

  While objective observers saw Donahue for the opportunist he was, he was genuinely liked by many people, not only members of his own party, but political opponents. One reason was that he had a sense of humor and could take a joke at his own expense. Another was that he was good company, always interesting to be with.

  The last made him attractive to some women, a situation Donahue had a reputation for taking advantage of, even though he had a secure marriage and was seen frequently in the company of his wife and teenage children.

  This was the Senator Donahue who, shortly after 10 A.M. on the first Tuesday of December, gaveled to order the Senate Subcommittee on Ethical Merchandising, and announced that proceedings would begin with a short statement of his own.

  The committee was meeting in Room SR-253 of the Old Senate Office Building, an impressive setting. The chairman and fellow senators sat behind an elevated U-shaped desk, facing witnesses and the public. Three large windows overlooked the Senate park and fountain. There was a marble fireplace. Beige curtains had printed on them the Great Seal of the United States.

  “All of us here,” Dennis Donahue began, reading from a prepared paper, “are aware of the ghastly, worldwide tragedy involving children whose brainpower and other normal functions have allegedly been destroyed by a drug which, until recently, was prescribed and sold in this country. The name of that drug is Montayne.”

  The senator was a strong, commanding speaker, and the hundred or so people in the room were attentively silent. TV cameras were focused on him. Besides Donahue, eight other senators were present—five from Donahue’s own majority party, and three from the minority. To the chairman’s left was Stanley Urbach, the committee’s chief counsel, a former district attorney from Boston. Behind the senators were fifteen members of the committee staff, some seated, others standing.

  “What these hearings will investigate,” Donahue continued, “is the responsibility for this series of events, and whether …”

  Celia, who was scheduled to be the first witness, listened as the opening statement continued along predictable lines. She was seated at a green-baize-covered table and beside her was her counsel, Childers Quentin. She had persuaded the courtly Quentin to accept this extra responsibility because, as she told him, “There’s no other lawyer who knows more than you do, now, about Montayne, and I have confidence in your advice.”

  That advice, relating to today, had been specific and forthright. “Describe the full facts as honestly, clearly and briefly as possible,” Quentin insisted, “and do not attempt to be smart, or to score off Dennis Donahue.”

  The last admonition had been in response to Celia’s wish to bring out in evidence the fact that, more than two years earlier when Montayne’s U.S. introduction was being delayed at FDA—some thought unreasonably—Donahue had been among those protesting the delay, describing it then as “clearly ridiculous in the circumstances.”

  “Absolutely not!” Quentin had ruled. “For one thing, Donahue will have remembered that remark; if not, his staff will remind him, so he’ll be ready to deal with it. He’d probably say he was one more victim of drug company propaganda, or something of the kind. And, for another, you’d arouse his antagonism, which is extremely unwise.”

  The lawyer then outlined for Celia some Washington facts of life.

  “A United States senator has enormous power and influence, in some ways even more than a President because the exercise of power is less visible. There isn’t a government department a senator can’t reach into and have something done, providing it isn’t outrageous or illegal. Important people inside and outside government will fall over themselves to do a senator a favor, even if that favor is harmful to someone else. It’s a system of trades and, within that system, a senator’s power—which can be used benevolently or to destroy—is the biggest trading chip of all. Which is why it’s a foolish person indeed who chooses to make an enemy of a U.S. senator.”

  Celia had taken the advice to heart and cautioned herself to remember it in any exchange with Dennis Donahue, whom she already detested.

  Also accompanying Celia was Vincent Lord, now seated on the other side of Quentin. While Celia would make a statement on behalf of Felding-Roth and then be cross-examined, the research director’s role was solely to answer questions if required.

  Senator Donahue concluded his remarks, paused briefly, then announced, “Our first witness is Mrs. Celia Jordan, president of Felding-Roth Pharmaceuticals of New Jersey. Mrs. Jordan, do you wish to introduce your associates?”

  “Yes, Senator.” In a few words, Celia introduced Quentin and Lord.

  Donahue nodded. “Mr. Quentin we know well. Dr. Lord, we are glad to have you with us. Mrs. Jordan, you have a statement, I believe. Please proceed.”

  Celia remained seated at the witness table as she began, speaking into a microphone in front of her.

  “Mr. Chairman and members of the subcommittee: First and foremost my company wishes to express its great sorrow and sympathy for those families which have been part of what Senator Donahue, a few moments ago, described correctly as a worldwide tragedy. While the full scientific evidence is not yet in, and may take years to assemble, it now appears certain that the drug Montayne was responsible for damage to fetuses in wombs of pregnant women—in a very small section of the total population, and in circumstances impossible to foresee during the extensive testing of that drug, originally in France, later in other countries, and before its official approval by FDA for use in the United States.”

  Celia’s voice was clear, but low-keyed and deliberately not forceful. Her statement had been carefully drafted and worked on by several people, though principally by herself and Childers Quentin. She stayed with the text as she read, merely adding an occasional phrase where appropriate.

  “Something else my company wishes to point out is that it has, in all matters concerning Montayne—at every stage of testing, distribution, and reporting—complied with the law. Indeed, when serious doubts were raised about the drug, my company went beyond requirements of the law, and withdrew Montayne voluntarily, without waiting for a decision by the FDA.”

  Celia continued, “I now wish to go back and review the origins of Montayne in France, where it was developed by
Laboratoires Gironde-Chimie, a company of excellent reputation and with a long history of successful …”

  As well as being precise, the report being delivered was impersonal. That, too, had been decided after discussions at Felding-Roth headquarters and at Childers Quentin’s offices in Washington.

  Quentin had asked Celia, “How do you wish to handle the matter of your resignation over Montayne?”

  “Not at all,” she had replied. “My resignation was personal, a matter of instinct and conscience. Now that I’m back, I’m representing the company, reporting what the company did.”

  “And where is your conscience in all that?”

  “Still intact, still in place,” she responded sharply. “If I’m asked about my resignation I’ll answer honestly. It’s simply that I don’t propose to bring it up, simply to make myself look good.”

  Celia had reminded Quentin, too, of the lack of any scientific grounds for her resignation—a weakness she had been aware of at the time, and her reason for not going public.

  She now informed the Senate subcommittee, “No doubts whatever about the safety of Montayne arose until a report from Australia in June 1976. Even then, there seemed no reason for concern because an Australian government investigation …”

  Step by step she traced the Montayne story. The recital took forty minutes, at which point Celia concluded, “My company has complied with committee subpoenas by supplying documents confirming all that I have said. We remain ready to cooperate in any other way, and to respond to questions.”

  The questions began at once, the first from the committee counsel, Stanley Urbach, long-faced and thin-lipped, who gave the impression of smiling only on rare occasions.

  “Mrs. Jordan, you referred to the first Australian report that raised possible doubts about Montayne. That would be seven to eight months before your company placed the drug on sale in the United States. Is that correct?”

  She calculated mentally. “Yes.”

  “Mentioned in your statement were two other adverse reports, one from France, another from Spain, both also occurring before your company’s U.S. marketing of Montayne. Again correct?”

 

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