After the Fall

by Patricia Gussin

  “Thank you, Dr. Nelson. And let me tell you how sorry I am about your injury. I know you are at Keystone Pharma now. That must be quite a change from the operating room and research labs. The pharmaceutical industry is a far cry from academia. Right?”

  “I have lots to learn, that’s for sure, but I have a great staff. I must admit, though, filling Dr. Minn’s shoes is not going to be easy. He was beloved by his Keystone colleagues.”

  “A great loss, indeed,” agreed Harter. “He seemed to be the pivotal force in R&D at Keystone. I assume Dr. Win White will be taking over Immunone. I haven’t had much experience with Dr. White, as Dr. Minn usually attended the FDA meetings in person.”

  Laura cringed at the thought of Win White, with his volatile temper, interacting with the FDA. A surefire formula for disaster, despite the man’s clinical and strategic brilliance. “No, Mr. Harter, I will be handling Immunone. And that’s why I’m calling, to respond to the fax you sent. About your problems locating the source documents related to the deaths in the clinical trials.”

  Laura heard a sharp intake of breath. “But you just started.”

  “True, but I know the data. I’ve personally reviewed each case. I have seen the reports that contain the specific information you list as missing.”

  “Look here, Dr. Nelson. I have been in this project management job for twenty-five years. You have been in your job for what—a few days? When I say we do not have the data to adequately assess the safety of a new drug, I think I know what I’m talking about.”

  Definitely off on the wrong foot, Laura wished she’d waited longer for the missing records to be documented so she’d have them in front of her now as she laid down this challenge. Now she’d jumped the gun, assuming this would be an easy call to clarify a misunderstanding.

  “Mr. Harter, I was not implying anything controversial, just that the information you need does indeed exist. It’s all been submitted to you, but in case you are having difficulty locating it, Keystone is pulling it together. And once we have it, we’ll send it by express directly to your attention at the Parklawn Building in Rockville. Right?”

  “If Keystone plans to send me any documents, Dr. Nelson, I suggest you go through Dr. Louis Sigmund. He’s the head of regulatory affairs at your company. He’s the proper person in your organization to call me. Don’t bother with a carrier. It’ll only get lost. Louis knows that. He knows the proper way to deliver documents to us.”

  Laura had not expected this dressing down. She was the head of research at the third largest pharmaceutical company in the world. And an FDA project manager had just told her to fuck off. Yes, there was a lot about working with the FDA that she didn’t understand. You should have followed protocol, Laura.

  “I see,” she said, not wanting to capitulate, not wanting to burn any bridges, just wanting to get that data into the FDA and put this whole mess to bed.

  “I expect it will take some time—if you have the data—to pull it together and get it back to us. Then, of course, we’ll have to review it, verify it. That all takes time, Dr. Nelson.”

  When Laura had presented at the FDA Advisory Committee, Mr. Harter had seemed pleasant enough as he flitted about distributing reports, seeing to the needs of the FDA medical staff, the committee members, and the presenters from Keystone Pharma, herself included. So why was he now coming off as such a self-righteous, negativist jerk? At the conclusion of the meeting, the FDA reviewers, the committee members, and the various spectators—including the media—had been upbeat and optimistic. Laura especially remembered the exotic young woman from Replica, the scientist who had discovered Immunone’s drug category and who had called her yesterday trying to get information on the drug’s approval. Hadn’t she seen her deep in conversation with Jake Harter in an alcove off the meeting room?

  “Thanks for your time, Mr. Harter,” Laura said. “Just so you know, I personally went over the data you’re looking for with your department’s medical reviewer, Dr. Hayes.”

  “He’s the junior reviewer here,” Harter said. “I hope he didn’t misplace it if he did have it in his possession.”

  “Tell him not to worry, Mr. Harter. I have replicate copies of everything in my office in Tampa should Keystone have any difficulty locating the data, which I’m sure they won’t.”

  Silence met this statement, and Laura said a simple good-bye. She could have heard a mumbled “shit” on the other end, but it could as well have been her own expletive as she slammed down the phone.

  She had to tell Louis Sigmund about her unorthodox call, and as soon as she arrived at Keystone, she headed straight to his office. His secretary informed her that he was in a meeting with his staff, going over budgets. “I need to see him now,” she said. “My office.”

  The elderly woman peered up over her half glasses. “Now,” she repeated. “You want me to interrupt his meeting?”

  “Now,” Laura confirmed, heading back to her office. She guessed that the gentlemanly Dr. Minn did not make such demands. And normally, neither did she, but she’d just dug herself into a hole with the FDA. Wait until Paul Parnell found out his new hire had doomed the gazillion-dollar Immunone approval.

  Louis arrived momentarily, toting a monogrammed leather binder. “Laura. Is something wrong?”

  She figured anxiety must be written all over her face. One thing she was not: a good poker player.

  “Yes, Louis. Let me tell you what just happened. Please, sit down.”

  They sat across from each other at her conference table. He opened the binder to a lined yellow note pad, but didn’t pull out a pen.

  “Immunone?” he guessed. “I’ve been waiting all day for information from Science Information. Impossible that we never submitted the data. Nothing like this has ever happened. I can’t—”

  “Yes, Louis, I need to talk about Immunone. I haven’t heard whether Medical and Information Management have what we need or not. We can head to Mel Greenberg’s office after this.”

  “Good idea,” Louis jumped up, hesitating when Laura remained seated.

  “I called the FDA,” Laura said.

  Louis reseated himself with a thud, as incredulity crossed his face. “You did?”

  “I spoke to Jake Harter. The project manager.”

  Louis nodded. “Not a bad guy,” he said, “as project managers in the agency go.”

  “He was quite hostile,” Laura knew she had to be honest. Sugarcoating wouldn’t help.

  “I’m not understanding,” Louis said.

  “I called to tell him that I’d personally reviewed the death cases. That I reviewed them all with Dr. Hayes.” Louis’ expression was skeptical. “Karl Hayes, one of Immunone’s medical reviewers.”

  “Yes. Of course I know him,” Louis said. “He’s the junior reviewer under Susan Ridley. They had to have reviewed the death cases.”

  “He was most unreceptive. Defensive, I guess. Told me all communications needed to come from you. Pretty much put me in my place. Then I told him that I have replicate reports in my Tampa office—former Tampa office.”

  “Laura, I know you meant well, but the FDA has certain expectations. Communications have to go through channels. Regulatory affairs manages document transmission and advises on all FDA matters. Otherwise, things get out of control, and these one-on-one interactions cause misunderstandings. That’s what happened here. I’ll give him a call. Smooth things over. Depending on when we have a data package ready, I can hand deliver it. I work with these project managers all the time. It’ll be fine.”

  “I’m not sure, Louis. He seemed belligerent. Maybe he just doesn’t like me. He said he assumed Win White would be taking over Immunone.”

  “Trust me, Laura, Jake Harter detests our medical director. They’re like oil and water. He did, however, seem to respect Fred Minn. Maybe it’s just you taking his place—”

  “Perhaps, but I’m not backing down for the time being. Keep me posted. Today’s Tuesday. If Mel has any trouble finding what we
need, I’ll fly to Tampa.”

  “Let’s go check Mel’s progress in locating that missing data. Better that it come officially from Keystone than from your Tampa office.”

  But Laura would go to Tampa. Tonight. She had to arrange for Johnny Greenwood’s lung transplant.

  CHAPTER THIRTY-SIX

  TUESDAY, MARCH 3

  Addie called the department secretary at Replica, told her she’d left early, she was ill. And she was ill. After Dru left she’d vomited the contents of her stomach, then dry retched over and over. Now she sat with a cup of tea, and her stomach so far had not revolted.

  How to deal with Dru’s message? She’d known the day may come, but so abruptly? Give up forever the independence she’d come to take for granted?

  What were her options? Did she have any? Or did she have to submit—as Muslim women had done over the centuries?

  Addie didn’t waste time on that question. The answer: submission.

  All that was left to her now were the logistics.

  Would it still be possible—one way or another—to get the $7.5 million? Stash it somewhere? Keep it in America? Open one of those offshore accounts? She knew that certain Iraqis had huge sums of money in foreign accounts all over the world. Saddam and his sons and sons-in-law were experts at exploiting the global financial system.

  Dru was a banker, but when he’d mentioned the money to her father, he’d dismissed it as inconsequential. And Dru, who seemed so anxious for her to collect the Immunone money, now seemed disinterested. Dru was so scared that he’d put his wife and sons in hiding. Addie admitted that her years in the West had made her a capitalist. Under capitalism, if you worked hard, you were rewarded. Well, she’d worked hard, was ready for her reward. Could she simply walk away?

  There has to be a way, Addie kept telling herself as she rose to make herself another cup of tea. What am I going to do? Then she thought of Jake. His proposal of marriage. Could that be her way out? What if they were secretly married before her flight on Friday? Could a husband collect for her? In Iraq, husbands controlled their wife’s finances.

  She knew that in America they’d need a state license, so she called the State of Maryland to ask about marriage licenses. She was transferred to a woman who grudgingly provided the requirements: picture IDs for both; for Jake, a death certificate for his wife—had to be certified; she’d need her green card; no blood tests; waiting period—two days, or to be exact, 48 hours; cash money up to $85. You had to go to the circuit court. She copied down the addresses of the ones she thought far enough away from Rockville but within an hour or so drive. If they got the license today—there was still enough time—they could be married on Thursday.

  Next, she needed to call Jake at work, something she never did. She remembered the trouble she’d caused by calling him at his home the night his wife was killed right there in his house. Could he get in trouble with this call too?

  As she picked up the phone, Addie’s hands started to tremble. She set it back down. Did she have everything figured out? Her job: she needed to be employed by Replica when the approval milestone for Immunone was finalized. That she couldn’t control. Maybe Jake could, but he had not been forthcoming. The thought had never occurred to her before, but could she take a leave of absence from Replica? Tomorrow, she’d go to Human Resources, tell them her father was critically ill—the truth, if Dru could be believed—request a medical condolence leave, or whatever they called it—maybe for a month. By then Immunone would certainly be approved, and Jake, as her husband, could get the money and invest it for her. He might have to resign at the FDA because of their conflict of interest paranoia, but with that kind of money, so what?

  Again, she reached for the phone. One more consideration shook her resolve. Jake—could Jake be trusted? Did he love her enough to protect her money even if she never returned to America? She started to dial. She thought he did. Hadn’t he said he’d convert to the Islamic religion? She had to put her faith in him. He was her only hope for a future beyond complete subservience as a Muslim woman.

  Jake answered on the third ring. For that, Addie thanked Allah. She didn’t want the department secretary announcing this forbidden call for all ears to hear. “Drug Evaluation. Immunology. Jake Harter.”

  “Jake, this is Addie,” she whispered.

  “Not a good time,” Jake said, automatic, perturbed. Then in a more concerned tone, “Is something wrong? Are you okay? I mean, calling me here?”

  “I need you to come here, Jake. Right away.” Still a whisper. She checked her watch. One fifteen. He could make it here in fifteen minutes. Another hour to get to the courthouse she’d chosen.

  “Why are you whispering? I can’t hear you. Is somebody there? Addie, are the police with you?”

  Addie glanced at the note she’d made about marriage license requirements. Jake would have to stop home on his way to her place. He’d need his wife’s death certificate. What about a birth certificate? No, the form said a driver’s license is okay. He’ll have that in his wallet. “No,” she spoke in her phone voice, a bit louder than her normal face-to-face voice. “But go home and get your wife’s death certificate.” She glanced again at the specifications. “A certified copy,” she said. “That’s very important.”

  Should she tell him what she wanted now, on the phone? Or wait and do it in person?

  “What? Addie, I’m in the middle of a major issue here. Can we discuss this later? I can’t believe—”

  “Jake, you have to do this for me. For us. If you love me.”

  “There’s no question I do, but I can’t leave.” He hesitated. In a low voice he said, “It’s about Immunone. Tell you about it when I see you. I’ll try to get out early.”

  All week she’d been begging him for information and now he offers to share. If they didn’t get the license today, for her, there would be no Immunone.

  “I no longer care. Jake, if you don’t come to my house with what I asked you for, I will not be here tonight. I’ll be out of your life forever.” There it was: the ultimatum. If he wouldn’t do this for her, he certainly could not be trusted to protect her money. She held her breath. She’d either be leaving the United States single, or she’d be married with access to a fortune when she finished whatever task Saddam Hussein’s sons wanted her to do.

  Voices in the background, Jake calling, “I’ll be right there.”

  Addie breathed, then gulped as she realized he’d not been addressing her, but whomever was on his side of the line.

  “Addie, I don’t know what’s going on, but you have to promise me no police are involved.”

  “No police,” she said. “Hurry, please.”

  CHAPTER THIRTY-SEVEN

  TUESDAY, MARCH 3

  What did Addie’s threat mean, she’d never see him again? Addie was a grounded woman, not a drama queen. She’d never pressured him before. He hoped he could trust her and that this wasn’t some kind of trap to link him to Karolee’s death. He was still a person of interest and he would be for some time. The spouse was always in the cops’ crosshairs, even a disinherited spouse.

  How could Karolee cut him out? Was it even legal? Could he risk a legal challenge without incriminating himself? He was facing enough complications. And suddenly, this Addie emergency. What could this possibly be about? He had to go to her. She was his life. All these problems traced back to his need to be with her. The old doctor’s death. Karolee’s fate. All so that he and Addie could have a life together. And they would.

  He cursed the streak of shitty luck that know-it-all woman doctor was bringing down. What had she meant by “she had the data in Tampa?” Did it mean she simply had to hop on one of Keystone Pharma’s jets, drop into her former office, pick up the files, fly back, dump them on Sid Casey’s desk, completely discrediting Jake? No way she could accomplish this in time for the meeting Casey had called for tomorrow morning. And he’d put the fear of God into the woman about proper FDA protocol. All bluster, but she wouldn’t know tha
t.

  Jake had been thinking about ways to deal with Dr. Nelson when Addie called, all frantic.

  He pulled the Jeep into his driveway and started to get out, preoccupied with why Addie would want to see Karolee’s death certificate when the details of his wife’s murder had been in all the papers—

  “Hey, Jake!” His neighbor bolted out of his door, pulling a knit cap on his balding head. “Cops were here again, man. Dogs this time. First time they brought the dogs, far as I can tell. Didn’t go inside. Just had them sniff all around. Came on my property too. Didn’t ask permission, but hell, I don’t care. Anything to find the guy who killed Karolee. Right, Jake?”

  Dogs? Two weeks after the attack? Shit, could they track all the way back to Mack’s garage where I left the Jeep that night? No way, not with the snow. But why come with the dogs?

  “Thanks for letting me know. I have no idea what they’re looking for, but yes, whatever it takes to find the bastard that killed my wife.”

  “You gonna keep living here?” his neighbor asked. “In the house? Alone?”

  “Yeah,” Jake said. Not at all sure where he’d be living. “Hey, I’ve got to get moving. Just stopped to pick something up. Gotta go.” Without waiting for a reply, Jake let himself into the house, headed toward his study where he kept the important papers. There it was: Karolee’s death certificate, a certified copy. Why would Addie insist he bring it with him? Without further thought, he jumped back into the Jeep and headed to her place.

  Addie had given him a key to her apartment so he let himself inside. She wasn’t in the living room, but as soon as he called her name, she came flying into his arms. He hardly recognized her. Her eyes were ablaze, puffy red circles surrounded them. Even the thought of her crying wrenched his heart. What could have happened?