Cry of the Needle

by Radford, Roger

  ‘We are in deep, deep trouble,’ he recently told an American TV reporter. ‘I’m talking about hundreds of thousands of patients who will be paralysed. This stuff can have an immediate effect, or conversely, can take between eighteen months and four years before it exerts its paralytic and painful effects in our patients. We are sitting on a time bomb. What’s going to happen is the biggest medical story of our time.’

  He said the constituents of Triamerol were, in effect, a mixture of alcohol and detergent. He said it was like old-fashioned antifreeze.

  ‘Now, would you let someone open up one of your nerves and pour that stuff on it? It’s going to paralyse you. You can’t put that anywhere near a nerve.’

  Dr Wellington’s studies show that even if the needle is correctly placed in the epidural space, the drug can seep through the dura into the spinal fluid.

  ‘If any of it leaks, 100% of these patients will get arachnoiditis.’ He said the results could be catastrophic. ‘If you’re numb from the rib margins down and lose your bladder function, and you lose control of your legs and leak faeces the rest of your life, then that is serious.’

  In many cases, the pain and emotional damage is more obvious than the outward signs of injury. This makes it easy for doctors to pass off the problem as psychological and to suggest that the patient is malingering. Once the damage has been done, many doctors drop the patients like a hot potato.

  After more than twenty years of campaigning, Dr Wellington and his colleagues forced Parados into issuing instructions to doctors not to use Triamerol in epidurals. But in the UK, Australia and New Zealand, no such instructions have been issued.

  The warning on the drug packets outside the United States, says Dr Wellington, ‘is much more passive. In effect, it says, “don’t put it where you’re not supposed to.”’

  He added: ‘That’s just like a truck’s about to hit you and I whisper get out of the way. It’s laughable.’

  Why do American patients get the benefit of a strong warning, while UK patients have to take their chances? It seems Parados’ decidedly soft position here has clearly left doctors with the impression that the company is prepared to turn a blind eye to what they are doing and to let them get on with it.

  ‘I think that Parados has approached the problem of Triamerol with a great deal of self-interest,’ says Dr Wellington. ‘It should have been banned (for epidural use) years ago.’

  Oil-based dyes and Triamerol. Different drugs. Same story. The greatest medical tragedy of the late twentieth century is continuing unchecked into the new millennium. This outrage must cease. Now.’

  The article also dealt at length with what it termed the ‘culpability, cover-up and denial’ by successive British governments. At the end was a box outlining the newspaper’s aim to campaign for an inquiry into invasive spinal procedures.

  Kelly slowly lowered the newspaper onto the desk. He stared at the console in front of him. ‘Bastards,’ he muttered. The old anger welled inside him, anger that in the past had had only one outlet.

  ‘What’s up, Kieran?’ It was Parsons. ‘You look like you’ve seen a ghost.’ The bespectacled security man leaned over and just managed to catch a glimpse of the headline and opening paragraph before Kelly rolled up the newspaper and thrust it under his arm.

  ‘Mind the shop, will you, Bill, I’m going home half an hour early. Tell them I didn’t feel well.’ With this, Kelly hurried away towards the exit. The first light of dawn was infusing life into the City of London, but scant relief into the person of Kieran Patrick Kelly.

  As he drove home, the Irishman reflected on the article in The Times. While on the one hand it meant that the guilt for Teresa’s condition had several addresses, there was comfort, scant though it was, in the fact that her disease now had a name, and that she might be able to share her pain with other sufferers, those who knew exactly how she felt.

  Within fifteen minutes and a couple of jumped red lights, Kelly had drawn up outside his home. He could barely contain his eagerness as he unlocked the front door. It was five thirty in the morning. All was still. Should Teresa be asleep, he would not disturb her. He’d allow himself to give her a peck on her forehead, that’s all.

  Even the creaking stairs seemed to be heralding the important news that he held in his hand. He glimpsed into the children’s bedroom. Sian was snoring gently. How sweet was that sound, he thought, before creeping into his own bedroom. Thankfully, baby Patrick was also sleeping soundly in his crib.

  The Irishman stepped gently towards his own bed. Teresa had left the curtains open, and the dawn light played on the carapace of her gentle face. She was indeed asleep, but she must have had a hard night for, despite its serenity, the face was pallid. Her striking red hair was damp with sweat. For a few moments he stared at the delicate contours. Then a seed of concern began to sprout in the pit of his stomach. He felt his heartbeat begin to race, the tingling flush of fear tightening every muscle.

  Half fearing the worst, it was another few seconds before he knelt beside the bed and kissed her forehead.

  In an instant, Kieran Kelly found his body flinging itself backwards against the bedroom wall in a paroxysm that vented itself only in a dry scream.

  CHAPTER 2

  The Everglades

  Professor Jonathan Tring first sank to his knees and then launched his not insubstantial frame to lie prone on the prow of the airboat. With the huge fan switched off, there was a deathly silence, save for the rustling of the saw grass and reeds, as he thrust aside a couple of large clumps. The lamp from his hard-hat pierced the darkness and played on an area about a yard ahead.

  ‘Can you see one, Jonathan?’ whispered the familiar Southern drawl of his companion. ‘Take care now, ol’ boy, or they’ll have your pecker if you ain’t careful.’

  Considering why they were there, the joke might have seemed to some to be in poor taste. Dr Eugene Smith, however, possessed a winning way, and Tring was more than grateful for a little light entertainment. Events of the last six months had driven him almost to distraction. The Proctors, especially, had contrived to lead him a merry dance. He was beginning to wish he’d never met them. ‘Don’t worry, Eugene,’ said Tring soothingly, ‘I can see it now. It’s a three-footer.’

  Tring was a pukka thirty-something Briton with an accent that was pure Received English. His grey-green eyes and thick, blond wavy hair combined with ruggedly handsome looks to leave the native girls drooling. This helped make his not infrequent trips to the States so invigorating. If only the world knew what scientists did when they let their hair down, he thought.

  The Englishman had arrived in Florida a week earlier, his research sponsored by Parados Pharmaceuticals, his employer and a medium-sized player in the drug market worldwide. Tring was the company’s new medical director, and there were already some who saw the brilliant professor as a future chairman of the company. He was more circumspect, preferring the excitement of the leading edge of research to the internecine warfare of the boardroom.

  Tring dipped his hands into the black murky waters either side of the prow. This was his third trip to the Everglades and he never ceased to be amazed by the place. From the air, it seemed a vast, mysterious world of land and water at the edge of which civilization seemed to stop. From the highway, it appeared as an endless prairie above which birds flew in winter, while in summer towering storms deluged the land, giving sustenance to the swarms of mosquitoes. Here, life teemed, water flowed and creatures struggled for survival in miraculous cycles that had been repeated over and over since prehistoric times.

  Only today there was a difference. Now the cycles were dependent on Humankind, on those who had tamed the waters and channelled the streams, and as a result, held the survival of this beautiful, fragile region in their hands.

  Tring knew that man, as usual, was screwing things up. All the water feeding into the region was being controlled by artificial means. The complex food chain of the Everglades that had always been dependent on n
atural cycles of rain and drought was now at the mercy of those who manned the pipes and dykes to meet the demands of Florida’s ever-growing human population. Two major highways, remarkable feats of wetland engineering, now cut across the once-pristine, free-flowing river of grass. Fertilizers and insecticides, so important to farmers yet deadly to many creatures of the wild, were threatening to upset the fragile balance of nature.

  This was why Tring was here. Parados was sponsoring research into what these pollutants could do, and he was part of a scientific team called in to investigate the declining number of alligators.

  ‘I’ve got it!’ the Englishman hissed. With his right hand clasped tightly around the baby alligator’s neck and the left holding the tail, he hauled the reptile aboard the boat. The scientist whipped it over onto its back.

  The animal, seemingly impervious to the indignity to which it was being subjected, made little effort to break free. The lamp from Eugene Smith’s hard-hat played on the creature’s dank white underbelly. The American inserted his little finger into a hole and hooked out the alligator’s stunted phallus. ‘Jesus!’ Smith gasped in exasperation at the seventh deformity of the night. ‘This one also ain’t never gonna be no daddy.’

  Tring shared his colleague’s desperation. What was happening in the Everglades was mirrored in his own country, albeit not to the same extent. Nevertheless, there was no doubting that the human population in the UK was being affected by water pollution. Sperm counts were down and getting lower by the year. The chemical companies and all those pouring effluent into the rivers had much to answer for.

  The indignant ringing of his mobile phone interrupted the Englishman’s thoughts. It was the hotel switchboard.

  ‘Sorry to trouble you, sir,’ came an apologetic female voice. ‘We have an urgent fax from your head office in the UK. Shall I read it?’

  ‘Yes, go ahead,’ replied Tring, wondering what on earth could be so important that it could not wait until later.

  ‘It reads: “Return UK immediately. I will be incommunicado until you arrive. JP.”’

  ‘Is that all?’

  ‘Yes, sir.’

  Tring thanked the girl and tugged on Eugene Smith’s sleeve. The American was still bent over the belly-up alligator. ‘Eugene, old boy, throw this one back and let’s vamoose. They want me back in the UK pronto.’

  ‘They damn well might have chosen better timing,’ Smith grunted, still holding the alligator’s miniature phallus between thumb and forefinger.

  ‘Did they say why?’ There was a tinge of disappointment in the American’s voice. He would miss the tall Limey.

  ‘No,’ the professor replied, scratching his head. ‘And it seems they don’t want me to know... yet.’

  A day later and the scientist was back across the pond. His boss had apparently been singing his praises, although it was said that when Jack Proctor lauded you, your letter of resignation was already written.

  ‘Smart people with smart ideas make for smart business, and that’s why I brought Professor Jonathan Tring into this organisation.’

  The compliment was made by a man who commanded attention, not least because of his vocal and physical attributes. John Albert Proctor was a Yorkshire terrier who looked and growled like a bulldog. He was stocky and muscle-bound, with gimlets for eyes, a couple of unsightly warts either side of his pug nose, and jowls that hung like heavily laden coat hangers. Snatch away his pinstripe suit and he could have been a market trader dealing in bone china seconds. That he ruled Parados Pharmaceuticals with an iron fist would have surprised nobody acquainted with the history of other leaders of men who were, in the parlance of the politically correct, vertically challenged. Being a middle-aged multi-millionaire, it was also little wonder that he had availed himself of a wife half his age, and that she was stunningly beautiful. Tring smiled diffidently at Proctor’s compliment. The scientist was more at ease with molecules than with mankind, his taut six-foot-two-inch frame and craggy good looks suggesting a man with a physical rather than a cerebral occupation.

  ‘We have been called the fastest-growing pharmaceutical company in this country,’ Proctor continued, the pug face beaming with bonhomie.

  ‘And in order to keep it up, we have to be at the leading edge of research and development. We’re now in the twenty-first century, and the pace of technology demands constant application. You have a hard act to follow, Jonathan.’

  The faces around the boardroom table nodded in acquiescence. They had all benefited from the expertise of the late medical director, Dr Martin Locke, who had developed several drugs that became market leaders. His suicide had shocked the industry and curtailed a talent that was about to enjoy its finest triumph. Worse still, it had caused Parados shares to drop a few points. The one thing Jack Proctor abhorred was a drop in the index. Although he was the majority and controlling shareholder, he liked to keep the others happy, and, in general, they had been kept very happy indeed.

  ‘Nevertheless,’ Proctor went on, ‘I have the fullest confidence that Professor Tring will add a new dimension to our efforts. We must not remain complacent. While we’ve bucked the trend by coming up with new products to replace the high-profit drugs going off patent, it does mean that others see us a target for acquisition. Companies big and small are tangoing with each other, but let me say quite categorically that they’ll dance to my tune, and that the only acquiring around here is going to be done by me.’

  The chairman’s determined missive did not go unappreciated by his audience. They knew that any takeover of Parados would probably cost them their jobs. Many companies had reacted to new and tougher times by slashing their workforce. One out of six jobs had been lost since those who paid the drug bills had been in open revolt over the high cost of medicine. Although the directors of finance, distribution and sales and marketing may not have liked Proctor, they knew where their bread was buttered. Merger mania had gripped the industry. Giants like Glaxo and Wellcome, Pharmacia and Upjohn had amalgamated. In the past few years alone, drug companies had put together more than a hundred billion dollars worth of major mergers or acquisitions. Some companies, such as America’s Merck and Britain’s SmithKline Beecham, had decided that if you couldn’t beat them, you could buy them. They bought up prescription-management companies that sold drugs at lower prices. Then, to cap it all, Glaxo Wellcome had merged with SmithKline to become the world’s market leader. The once gentlemanly industry, in which hostile deals were almost unknown, had turned vicious. And should there ever be a Pill, Inc., then the men around the boardroom table would prefer Jack Proctor to be at its head. The old hands present could sense their boss was getting up a head of steam.

  ‘While we’ve made good profits from producing generic brands, we must continue to make sure we keep being innovative.’ Proctor shook his stubby fist to emphasise the point. ‘The weakness of big companies is that size is no guarantee of success in developing new products. Huge firms lose flexibility and creativity. We are middle of the road and that’s just about the best place to be right now.’ The chairman took a beat to allow affirmation from his audience, then, ‘but our great company is only as good as the people in it. And that means you, each and every one of you. Leaders must steer those under them to perform at their best by making them feel comfortable and rewarded, not just by salary, but also by recognition and positive reinforcement. You should each increase your levels of competence in information technology so that it is a productivity tool and not simply an intellectual toy. To keep abreast of what’s happening in world markets, you need a perspective that extends beyond the borders of the company. Change is also vital. No company can afford to stand still. Some of you probably know the story about the flea circus.’

  Tring noted that the faces around the table remained blank. He had a distinct feeling that they had heard all this before.

  ‘You put a bunch of fleas into a box,’ the chairman went on, ‘and they start to hop up and down. When you remove the lid, they all continue to
hop up to the same level. They don’t want to hit their heads on the ceiling that still exists in their own minds. And that’s exactly how it is in an organisation. If the ceiling is gone, managers must make this clear to their colleagues. People in organisations are programmed just like the fleas. They know how high they can hop without getting hurt. But this says nowt about their abilities. They, and you, can hop higher!’

  Jack Proctor pounded the table as he finished his rally and then stared disconcertingly at Tring. The breast-beating was over. Everyone knew the real reason for the meeting except, it seemed, the professor. The Yorkshireman took out a copy of The Times from his briefcase and looked sternly at his new ward. ‘And now, lad, let me tell you why I had you recalled.’

  Tring listened attentively while Proctor read out the newspaper story in full. It was soon clear to him that his boss wanted a damage limitation exercise.

  ‘Jonathan,’ he said conspiratorially, ‘I want you to be our front man on this. You will liaise with the media and the Government. Basically, you will be the voice of Parados.’

  ‘But you know I’m busy with the new product,’ the professor protested. The last thing he wanted was to get involved in a slanging match over something he had neither introduced nor worked on. He was a scientist. Triamerol was an old product and, anyway, it had been a previous incumbent’s baby. The machinations revealed by the newspaper article were something for which he felt no responsibility.

  ‘You’re the best man for the job, Jonathan,’ said Proctor bullishly. He was the boss and would not be put off by his ward’s protestations. ‘I want you to work on a strategy to handle this. The last thing we need is a scandal that will hit our share price and leave us open to predators. I have my own ideas, but I want to hear yours first.’

  With this, the chairman arose, zipped up his briefcase with an exaggerated flourish and waddled out of the boardroom.

  Tring looked forlornly at the rest of the board members. He sensed that no help would be forthcoming there. ‘Rather you than me,’ he thought he heard one mutter.