The Suicide Effect

by L. J. Sellers

  Can in hand, he whirled around and started back. From across the room, he watched Julie talk and chew in a delicate balance that few could pull off. Then his heart went cold. To his left, Josh Mitchell the packaging lead, was coming up the aisle between lunchroom tables. The good-looking bastard slid into his spot next to Julie and shoved Robbie’s lunch bag aside in one easy motion.

  No!

  He wanted to run, but his legs wouldn’t cooperate. They felt like lead. It seemed to take an eternity, but they carried him back. Josh was already talking to Julie, making her laugh. Robbie tried to cut in, “Hey Josh, I was sitting there.”

  Josh finished his story, then looked up with an easy confidence. “There’s a spot right there.” He pushed Robbie’s bag with the beat-up banana down the table. “You’re already up. Don’t make me move.”

  Robbie felt paralyzed. His mind whirled but his legs wouldn’t budge. Why had he gotten up? How could he have been that stupid? He had been so close to asking her out. He could not bring himself to sit down and watch Josh flirt with Julie. Robbie glanced at Julie, and she gave him a quick smile with a little shrug. Then she turned back to Josh and asked him if he played racquetball.

  Robbie’s heart was so crushed it was barely beating. Why did he try? Why did he set himself up for disappointment? He picked up his lunch bag and dragged himself to the door. His intention was to leave work and not come back. He could not bear to be humiliated again. He dropped his bag in the trash, but hesitated to ditch the Coke. He was still thirsty.

  “Hey, if you’re not going to drink that, I will.” A short, pretty redhead he hadn’t seen before sauntered up to him.

  On impulse he handed her the soda. “Go ahead.”

  “Thanks.” She took the can and smiled. “I’m Savanah. I started work here this morning.”

  “Robbie Alvarez. Six months and counting.”

  She wasn’t Julie, but she seemed nice. Robbie asked her if she’d like a tour of the factory.

  Chapter 20

  Sula spent Monday morning at the employment office, filling out paperwork and registering for a work search. Because she’d been fired, they told her she would have to wait a week or two while they investigated her claim. Sula hoped to have a job before any checks arrived. She had no desire to take taxpayers’ money.

  She had stopped at the post office and mailed several resumes on the way, but she hadn’t returned Aaron’s call. She’s played his message several times just for the charge it gave her. She almost called him back. What could it hurt to have coffee? Still, she hesitated. She had to find a job. She had to win her custody hearing. If she could, she had to stop the Nexapra clinical trials. All were high-stakes projects and she could not afford to be distracted.

  After a quick taco salad at Mucho Gustos, she headed through the downtown area, rehearsing her introduction on the way. A call that morning had netted her a fifteen-minute appointment with a clinician at the Oregon Research Center. Sula had not expected the doctor to agree to the interview and now she felt unprepared and nervous.

  The research center was in an ugly gray building on Willamette Street. Sula pulled in and parked next to a blue Honda Civic, the only car in the lot. She checked her watch: 12:52. Eight minutes early. Sula unzipped her black binder and reviewed her questions. It failed to quell her nervousness. She began to doubt her ability to be a reporter. It was a simple interview that would never make it to print. Chill, she told herself. Unable to sit any longer, she climbed out of the truck, smoothed her black skirt, and headed inside.

  Soothing tones of teal, forest green, and adobe enveloped the waiting room. Sula felt calmer already. The receptionist greeted her warmly and asked her to wait a few minutes while she located the clinician. Sula sat on the edge of an armchair, ready to pop up at a moment’s notice.

  A tall, beautiful woman with near-black hair entered the waiting area. Sula caught herself staring. The woman approached and held out her hand. “Dr. Janine Lucent.”

  “Sula Moreno. Thanks for taking time to speak with me today.” They shook hands.

  “Let’s go back to my office.”

  Sula followed her through a series of turns and they ended up in an office that was smaller than her old one at Prolabs. The tiny window had a view of a parking lot. Sula didn’t imagine the doctor spent a lot of time here, but still, it seemed like someone who had spent eight years in college deserved better.

  “What can I do for you?” Dr. Lucent smiled warmly.

  Here we go, Sula thought. “I’m writing an article about clinical trials for mental health drugs. I understand you participate in such studies.”

  “That’s what we do here.”

  “Were you involved in a Nexapra study? It’s a drug in development by a local company.”

  “Yes. I’m familiar with the therapy. The first trial concluded several months ago. What would you like to know?”

  “Was it a success? Did most of your patients benefit from the drug?”

  Dr. Lucent let out an almost imperceptible sigh. Sula wondered if she asked something stupid. The doctor began to explain in the tone of a tired teacher. “Only half the patients in the trial received the drug, the other half received a placebo, a dummy pill. But I can’t really talk about the results of the trial, because they haven’t been published yet.”

  “The company is now recruiting for a Phase III trial, so the Phase II stage must have gone well.”

  “It did.”

  “Is there more risk involved in studies for mental health drugs? I mean compared to other types of drugs?”

  The doctor scowled. “Yes, I suppose. But we supervise the patient subjects very closely.”

  “But still,” Sula pressed her point directly, “patients who are depressed sometimes attempt suicide. Have any of your patients ever killed themselves while enrolled a clinical study?”

  “It happens.” Lucent met her eyes, unashamed.

  “Did it happen during the Nexapra study?”

  “No, but I couldn’t talk about it with you if it had.”

  Sula switched tracks. “Were there any minorities in your arm of the trial?”

  Lucent frowned again. “I’d have to look back at the records to be sure, but I don’t believe there were.” She seemed intrigued. “Why do you ask?”

  Sula was ready. “One of the things that got me interested in writing this article was something I read about minorities being under-represented in clinical trials. The article said drugs get approved without a full understanding of how they affect certain racial groups. Do you think that’s true?”

  Dr. Lucent put on her lecturer’s voice. “The full effect of a drug can’t be known until it’s been in use in a large patient population for an extended period of time.”

  Sula jotted it down because it seemed like a good quote.

  The doctor shifted uncomfortably. “Just because there weren’t any minorities in the trial here in Eugene, doesn’t mean they weren’t in the trial anywhere.”

  “There’s a substantial Latino population here. Why do you think none of them participated?”

  “I don’t know. Perhaps we’re not reaching them with our messages about the study.”

  “Where else did the Nexapra trial take place?” Sula wondered if Lucent knew about Puerto Rico.

  “I believe there was an arm of the trial in Portland.”

  “That’s it?”

  “I think so.”

  “Portland doesn’t have many minorities either. Not compared to the whole country.”

  Lucent leaned forward, a bit defensive now. “The drug still has to be tested in large patient populations. That’s what Phase III trials are for. I’m sure there will be minorities in those studies.” The doctor stood. “That’s all the time I have.”

  Sula stood too. “Will you participate in the next Nexapra trial?”

  “I currently am.”

  “It’s going on right now?” Sula was startled. She thought it would be weeks or months before the P
hase III round.

  “Yes, it just started. We’re still recruiting, but I’m very optimistic about this study and this drug.”

  “Thanks for your time.”

  Sula shook her hand and left, troubled by the idea that people were already taking Nexapra again, and so far she’d accomplished nothing, except to lose her job. There was another doctor in Portland who had tested Nexapra, and Sula planned to approach this one differently. First she needed to borrow a cell phone with a blocked caller ID.

  From the parking lot across the street, Jimmy Jorgovitch watched the girl come out of the gray building. He liked the way she moved, with long fluid strokes. He liked her looks too but couldn’t place her nationality. Maybe she was part Hawaiian. She had straight dark hair that hung well below her shoulders.

  Jimmy followed the purple truck out into traffic on Willamette Street. The bright color stood out nicely in traffic. His subject was both easy to look at and easy to follow. That meant easy money. It was about time. His private detective business had taken a huge hit when the economy went down, and he’d had to supplement his income with security work that involved way too much time on his feet. At fifty-four, he was too old for eight-hour stand-up shifts, but too broke to retire. His cop’s pension only covered the mortgage on his home and his mother’s monthly supply of medical marijuana.

  Jimmy had been barely able to contain his excitement when the big guy in the suit hired him for a round-the-clock surveillance job. The man had called and arranged to meet him in a bar, then declined to give his name. He’s put a stack of fifties on the table between them and Jimmy had agreed to take the job.

  Afterward, he’d watched the guy get into the black Commander and had jotted down the license. He’d given the plate number to one of his buddies on the force to check out. Jimmy knew exactly who he was working for. He figured the girl was Rudker’s mistress, and Rudker suspected her of cheating on him. Much of Jimmy’s work was about other people’s distrust.

  Tailing this chick was a plum assignment. Jimmy had watched her through his high-powered binoculars last night as she changed into pajamas. He liked her long legs, small perky breasts, and allover tan. Jimmy understood that flesh spying wasn’t cool or legal, but since the girl didn’t know and wasn’t hurt by it, he couldn’t resist. Watching her up close on occasion kept him from going stir crazy, sitting in the car on the side of the street.

  Today she was on the move, heading back into the center of town. Her stops at the post office, employment office, Mucho Gusto, and Oregon Research Center had been noted in his journal: time of arrival and time of departure for all. He was under strict instruction not to let her detect his surveillance, so he hadn’t followed her into any of the buildings.

  Her trip to the post office was the biggest worry. The girl had carried a couple of manila envelops into the main branch and had come out empty handed. Rudker would be upset about that. Jimmy’s assignment also included checking her curbside mailbox—and confiscating anything addressed to the FDA. Stealing mail was a felony and Jimmy had told Rudker he wouldn’t do it. Rudker had then offered a ten thousand dollar bonus for any such envelope Jimmy brought to him.

  As much as he could use the money, Jimmy hoped he wouldn’t be faced with the decision. If the shit hit the fan later, Rudker was the kind of guy who would make sure the fan was pointed at someone else. The girl’s mailbox had been empty when he checked this morning, but she’d taken big envelopes into the post office. Rudker would be upset, but what could he have done? Knocked her down in a federal parking lot?

  The purple truck made a right on 13th Avenue. Jimmy pulled his ’95 Olds into the next lane and followed her. A bright ball of sun burst through the thin layer of clouds. He fumbled through the clutter on his dashboard for his sunglasses. They weren’t there. He glanced down at the console and spotted them next to an empty drink cup from Taco Bell. By the time he got the shades on, his eyes were already watering.

  He looked up and didn’t see the truck. He stayed in the center lane on 13th and glanced down Oak to see if she had turned. He spotted the white canopy crossing 11th. The next street, Pearl, was one-way, going the wrong way. Jimmy passed it, then turned left on High. Now he was two streets away and two blocks behind. Predicting what she would do next was a crapshoot. She may have already parked on Broadway for some shoe shopping. Or she could have turned right on 7th Avenue to head across the Ferry Street Bridge. Or maybe she would stay on Oak and take it all the way to the Fifth Street Market.

  Jimmy didn’t have to guess. He saw the truck turn right in front of him onto High from 7th. Now he was only a block behind her. The light changed to yellow and he sped through it. The woman in the minivan next to him honked. Jimmy stayed focused on the purple truck. It passed the Fifth Street Public Market, then parked on the opposite side of the street in front of an old building. Jimmy passed by as the girl got out. In his rearview mirror, he saw her enter the one-story structure. He sped up to Skinner’s Butte Park and turned around. He stopped a block away from the truck and parked on the opposite side of the street. He had no idea what business was located in the building but he would find out.

  In five minutes, the girl came out, got in her truck, and made a cell phone call.

  Sula parked in front of the plain, no-signage building where her friend Hannah was a drafter for a group of engineers. Hannah would likely be in her office and have her cell phone with her. Her friend paid for the caller ID block because she was hiding from an abusive ex husband and was paranoid about letting her phone number get out.

  Sula put a quarter into the meter and trotted into the building. Bright and spacious, the interior smelled of apples because of the daycare downstairs. Sula waved and smiled at the receptionist and kept going. She’d been here a few times.

  Hannah was hunched over her computer, drawing air ducts with a CAD program. She was heavy set with spiky blond hair and fifteen years older than Sula. They had played softball together the summer before and had bonded over their shared survivor mentality.

  Hannah jumped up and gave her a tight squeeze. “What’s wrong?”

  “That obvious?”

  “Oh yeah. You look stressed.”

  Sula remembered seeing herself in the mirror and thinking she had aged. Now she knew it wasn’t her imagination. “I lost my job.”

  “Oh shit. What happened?” Hannah sunk back down.

  “It’s a long story, and I don’t want to take up your work time. I’ll tell you over lunch, real soon, I promise. Right now I need to borrow your cell phone.”

  “Sure.” Hannah pulled it from her pocket and handed it over. Her curiosity was evident, but she didn’t ask.

  “I need to make an anonymous phone call.”

  “Ahh.” Her friend nodded in understanding. “You will give me every juicy detail next time I see you.”

  “Of course.” Sula grinned. “Can I borrow your yellow pages?”

  Sula quickly found what she needed and moved toward the exit. “I’ll bring it back in a few minutes.”

  “No rush.”

  She took the phone out to her truck and checked the name and number she had jotted down at Paul’s house. She focused for a moment on what she would say, checked her watch—2:17—then dialed the Portland number. She hoped Hannah had free long distance.

  “Riverside Medical Clinic.” The young woman who answered the phone was cheerful but in a hurry.

  “This is Dr. Susan Giacomo. I need to speak with Dr. Gwartney about a patient.” Sula had picked Guiacomo from the psychiatric physicians’ section of the phone book.

  “I’ll see if he’s available.”

  After a two minute and thirty-five second wait, a pleasant male voice came on the line. “This is Dr. Gwartney.”

  Sula took a deep breath. “Hello. This is Susan Giacomo. I have a small psychiatric practice in Eugene. I hope you’ll be able to give me some information.”

  “I will if I can.”

  “I have a patient, a young man
in his early twenties. He’s been taking Paxil, and it keeps his mood stable but causes him insomnia. I’m considering the Nexapra trial as a next step. It’s a head-to-head study against Prozac, so I expect him to be fine either way. But I wanted to talk to someone who’s had experience with Nexapra.”

  “I’m very excited about its potential,” Gwartney said. “Seventy percent of the patients in our arm of the trial responded favorably, and the side-effect profile seems quite mild. Some loss of appetite. Some orgasm delay, but much less than other SSRIs. What else do you want to know?”

  “What about insomnia?” Sula didn’t want to hit the suicide question too soon.

  “About the same as placebo.”

  “Excellent.” A city bus roared by just as she spoke. She hoped Dr. Gwartney wouldn’t hear it and wonder where she was calling from. “What about the thirty percent who didn’t respond well?” she plunged ahead. “Any serious consequences?”

  “Unfortunately, there was one suicide. A woman in her late twenties.”

  Sula’s heart rate picked up, but she forced herself to sound casual. “What do you know about her? Any history of suicide attempts?”

  “None that she reported or she wouldn’t have gotten into the trial.”

  “Of course.” He sounded a little defensive and she had to be careful with her last question. “Were there any minorities in the trial? My patient is Hispanic and I worry that he doesn’t metabolize medicine well.”

  “We don’t ask participants to identify their race, but I can tell you that we had one forty-year-old black man and,” Dr. Gwartney hesitated, “the woman who committed suicide looked Hispanic. Her last name was James, but she was married.”

  Goosebumps surfaced on her arms. A suicide who looked Hispanic. A third genetic victim? Sula had to stay with the charade for another moment. “What do you think? Should I get my patient into this trial?”

  “If he’s been through several therapy changes and you’re trying to get him stable, I would wait until Nexapra is on the market. As you know, there will be a delay between the end of the trial and FDA’s approval. During that time, the drug will not be available, so you’ll have to find something else for him in the mean time.” The doctor chuckled softly. “But as a clinical investigator I have to say, we need all the participants we can recruit to get this drug on the market quickly. It’s your call.”