by Ray Garton
“What about... you?”
“I’m sorry?”
“You said you’ve been taking Paaxone. Are you still taking it? I mean, if it’s unavailable—”
”I ran out and couldn’t get more,” Eli said. “Just like the others, just like your ex-husband.” His mouth was dry and his tongue felt like sandpaper. Each beat of his heart pounded up through his throat, into his jaw, and thundered in his ears. He gulped, took a steadying breath, and said, “I took my last one yesterday morning. More than 24 hours ago.” His last few words broke up in a hoarse croak.
It was a windy day. Trees swayed under its force, but the smoke clung stubbornly to the sky, to the air. Dull grey smoke-filtered sunlight glowed weakly through the window over the bed, shifting and dancing with the movement of tree limbs in the wind. He’d opened the window a few inches earlier and he could hear the faint laughter of children coming from a good distance. A neighborhood dog barked persistently.
After an interminably long silence, Eli said, “Mrs. Burben?”
A click sounded over the line.
“Heh-heh-hello?” he said. But she’d hung up.
He went to the desk, dropped into the chair, and put the phone down beside the yellow legal pad. He drew a check mark beside Emily Burben’s name, then put his elbows on the desktop and his head in his hands.
Chloe had left him a note that morning. It read, “I couldn’t wake you, so I called in sick for you. I told them you had a bad cold. I hope you feel better, honey. I’m worried about you. Call me when you get up. I love you.”
He knew she was worried and confused, and he felt guilty about that. But he was afraid to tell her the truth. At the same time, he wondered if he should tell her everything so she would be prepared for... whatever happened.
He thought of her coming home from work at the end of the day and it filled him with dread. What would she come home to? What would he be like by then? Fear for her safety burned in his gut like acid.
He stood suddenly and left the room, walked aimlessly through the house. He had to get out.
Maybe I should go and not come back, he thought as he stood in the middle of the kitchen, staring blankly at the refrigerator, lost in thought. Maybe I should go someplace where I won’t hurt anyone when... this... whatever it is... happens to me. He left the kitchen and entered the living room. He stood at the window, rubbing the back of his neck as he stared out at the small front yard. But somebody needs to know, people need to be told... don’t they? Who should I tell? What should I do?
His mind felt like it was strapped to one of those carnival rides he used to line up for at the county fair when he was a kid—the Tilt-A-Whirl. He couldn’t think straight, couldn’t organize his thoughts. Everything inside his head was spinning.
He needed to talk to Roger.
Eli hurried to the bedroom to change his clothes. He considered calling Roger to let him know that he was coming over, but he didn’t feel like talking to anyone. He’d go straight over and hope he was home.
2.
“Did you talk to him?” Chloe asked Roger when she answered her cell phone. She sat at the desk in her small office. She’d been trying to work, but she couldn’t focus. She was too worried about Eli, too preoccupied with what he might be doing at home alone, especially if he were in the same state of mind he’d been in last night.
“Not yet,” Roger said. “There’s no answer.”
Chloe felt a chill fall over her like a blanket. “No answer? How many times have you called?”
“I’ve been calling since about nine. Well, since you called me and woke me from a sound and blissful sleep.”
“I’m sorry, but I’m worried. He doesn’t answer?”
“Look, you said he was up most of the night, and you couldn’t wake him this morning. Maybe he’s still asleep.”
“It’s almost eleven, Roger. I’m leaving now. I’m going home to him.”
“No, wait. People have been known to sleep until eleven. Especially when they’re up all night surfing the ‘net and pacing. Hell, I sleep until noon whenever possible.”
She sighed. Her chest felt tight and the gnawing in her gut had nothing to do with hunger.
“Look, I’ll keep calling, okay? I just wanted to let you know that we hadn’t talked yet, and I figured you were sitting there all tied up in a knot and I wanted to tell you not to worry.”
“That’s easy for you to say. I’m supposed to do the news soon.”
“I’ll be listening.”
She sighed again, but this time it was closer to a groan.
“Relax, Chloe,” Roger said. “He’s fine, I’m sure of it.”
“Would you do me a favor?”
“What’s that?”
“Drive over there and check up on him.”
“Look, if he’s asleep, we should just let him—”
”Please, Roger. Drive over there and check. You know where to find the key if the door is locked. If he’s sleeping, then let him sleep. But just in case something’s wrong, I’d feel a lot better if you’d—”
”Hold it,” Roger said. “There’s somebody at the door. I’ve gotta go.”
“Will you go over to the house?”
“Let me call you back. I want to see who’s here.”
“Okay. Call me. I’ll be on the air, but leave a message.”
As she put the phone down, her shoulders ached with tension. She felt warm so she stood and removed her pale turquoise silk jacket and hung it on the hook on the back of the door. There’d been a meeting that morning, attended by the station owner, to discuss the possibility of switching to another syndicated news network. So she’d put on a nice suit—the jacket with a matching silk wrapped skirt, a simple off-white capped-sleeve blouse, and matching turquoise high-heel pumps. But she’d gotten so little sleep the night before and had been so worried about Eli that she felt as if she’d slept in the clothes.
She had to go on the air in a few minutes. All she wanted to do was be with Eli, to make sure he was okay, to keep him safe. It made no sense, but she couldn’t shake the feeling that whatever was wrong, it was somehow endangering him.
3.
Teresa Price looked up at the clock on the wall and watched the lunch hour slipping away as her stomach rumbled with hunger. Dr. Reasoner was behind schedule—again—and his waiting room was full, with only one empty chair. Teresa was sure it wouldn’t remain empty for long. A soft rock FM station played quietly over the speakers and Stevie Nicks sang “Rhiannon.”
The office was understaffed that day. Normally, Teresa never manned the desk—she was a medical assistant. But Roberta Drummond had called in sick and Tina Burgeson had to leave to rush her mother to the hospital because she was having breathing problems. That left Teresa and Karen Marx, who had gone down the street to pick up a takeout order at a Mexican restaurant.
“Do you know how much longer it’s going to be, Teresa?”
She smiled apologetically at the heavyset middle-aged woman who’d approached the reception desk. “At least another half hour before he can see you, Mrs. Pardo. I’m really sorry, but you know how he is.”
Mrs. Pardo nodded and waved a hand dismissively. “He’s thorough and he listens, so he gets behind in his schedule. That’s why I see him. I just wondered. I can wait. I brought a book.” She returned to her seat beside Darlene Fugelman, a petite, smiling blond who was seven months pregnant.
Everett’s patients were fiercely loyal. Most of them knew what a valuable rarity he was among doctors these days. He got to know his patients personally and he took time to listen to them and ask questions about how they felt, how they were taking care of themselves. He’d once told Teresa, “Each patient is the world’s foremost expert on how he or she feels. If I can’t listen to what they have to say about themselves, I might as well hang up my stethoscope and go home.”
Teresa had worked for plenty of other doctors, and she knew how they operated. They crammed too many patients into each day, then
allotted only a few minutes to each one, which wasn’t enough to get familiar with their needs or really listen to them discuss their symptoms. As a result, they did not view their patients as individuals but as part of a statistical pool of conditions and ailments and measurements like age, weight, blood pressure, and cholesterol levels. When patients fell outside that statistical pool in any way—well, that was just too bad. They were given the same quick, generic treatment as everyone else.
Most of the doctors Teresa had worked for in the past gave more quality time and attention to the drug company representatives, or “detailers,” who came to their offices than to their patients. They were all the same, the detailers—young, beautiful, and terribly ingratiating. If the doctor was male, it was usually gorgeous female reps who showed up at his office; female doctors were typically visited by handsome, hunky male detailers.
Drug companies employed a ratio of one rep to every half-dozen doctors, and they visited doctor’s offices so often—several times a week—that they were almost as much a part of a doctor’s daily life as patients. They were adept at creating relationships with doctors as well as their staffs. With each visit they brought gifts, provided expensive lunches and dinners for doctors and their staffs, and they always came with a bag full of free samples of expensive drugs for doctors to hand out to their patients, thus making each doctor as much a representative of the drug company as the detailers themselves.
Along with expensive meals, drug companies provided doctors with all-expenses-paid trips to exotic locales for “educational” purposes. The “education” was covered with a few hours of meetings and seminars in the morning, leaving the afternoons and evenings open for golf and skiing and other high-end entertainment, all of which was paid for by the drug companies. Sometimes these companies invited doctors to attend these functions as paid “consultants” and “advisors,” so not only were they receiving free trips, meals, hotel rooms and entertainment, they were being paid to partake. This allowed these companies to shower doctors with gifts, travel, entertainment and money without technically violating antikickback laws.
They were great perqs and doctors took advantage of them. In any other profession, it would be seen as bribery, but doctors bristled and became defensive whenever it was suggested that they might be swayed by such lavishments. Most of them seemed to think they were entitled to such gratuities, that it was their right as noble healers to be treated with such generosity. That always made Teresa laugh.
If patients knew how deeply involved drug companies were in their healthcare, they would be up in arms. Several years ago, Teresa had worked at a clinic in Sacramento where drug reps were allowed to roam the halls and enter procedure and examining rooms with almost as much freedom as the doctors themselves. It wasn’t uncommon for the reps to accompany doctors to patients’ bedsides or sit in while a doctor examined patients. If the patient asked who the man or woman was, the doctor simply explained that the person was observing his work and allowed the patient to conclude, quite naturally, that the rep was another doctor. These drug reps shadowed the doctors through their day to advise them on the use of their products. The worst part was that most doctors took this advice as if it were coming from a colleague with as much medical training and knowledge as the doctors themselves rather than from a young, attractive and extremely friendly and flattering drug company representative.
Drug companies sponsored medical conferences and provided accredited postgraduate “education” for doctors—all of which ended up touting the products of those companies as the best treatments for various ailments whether they were or not. The cost of all of this—the billions of dollars of free samples given to doctors every year, the meals and trips and gifts, the massive marketing efforts disguised as “education,” as well as the gargantuan costs of the undisguised marketing these companies did in the form of television commercials and other advertisements—fell directly in the lap of the consumer in the form of grossly inflated drug costs. And everyone pretended that no influence was being peddled, that no biases were being created, that there was no corruption involved. Guidelines were issued by various governing bodies, but they were voluntary and, like the laws that applied to such things, full of loopholes.
The hypocrisy of all of this had always infuriated Teresa and she had to tell herself to ignore it, because there was nothing she could do about it. Then she went to work for Everett and he restored some of her faith in doctors and the field of medicine in America.
A few years ago, Everett had had a come-to-Jesus moment about prescription drugs. He’d pulled a lot of the meds he’d been prescribing to patients, and cut others in half. Then he severely limited the access drug reps had to him, and he stopped taking any of the perqs they offered. After that, he’d started sacrificing sleep to spend time fully researching the drugs he prescribed. Most doctors simply did not have the time to do that and instead relied on summaries of the information. But most of those summaries were compiled and provided by the drug companies themselves or sources that were friendly toward those companies. Teresa’s curiosity had gotten the better of her and she’d asked Everett once about the sudden change.
“I’m just tired of being told which drugs to prescribe to my patients by the people who are getting rich off of them,” Everett had said, “people who have no medical training and are interested only in profit. The results of drug trials are too often manipulated and used deceptively to make the drug look more effective than it is. When they say the side effects of their drugs are rare, they apply a very odd definition to the word ‘rare,’ and some of the side effects they never mention and even try to conceal. Not only do they heavily market the drugs themselves, they heavily market the conditions they’re supposed to treat in an effort to convince patients they need those drugs, when the fact is they often don’t. The pharmaceutical industry has infiltrated and virtually seized control of the medical establishment. The whole game has become so rigged that I just don’t want to play anymore. So I’m pulling out as much as I can. I can be had when I’m not paying attention, but I can’t be bought at the expense of my patients. It’s my name on the door, not a drug company’s.”
It was a hot topic with Everett, but he only discussed it among trusted friends. When he expressed his feelings to other doctors, they became prickly as they defended the system and claimed that they were in no way influenced by the gratuities and benefits they received from drug companies. That usually annoyed Everett so much that he could not keep quiet, and the conversation invariably turned into an argument. So he kept his thoughts on the subject to himself unless he was with people he knew well and trusted.
Teresa suspected the big change in attitude and behavior had something to do with the fact that Everett had renewed contact with an old friend from medical school, Dr. Tara Varadaraj. Everett spoke of her often and with admiration. Dr. Varadaraj, a psychiatrist, had given up his practice to devote her time to research, and her focus was on psychiatric drugs. He’d written a few books about the potential dangers and proven ineffectiveness of psychiatric and mood-altering drugs, and what she saw as the deadly ease with which doctors prescribed them, too often to patients who didn’t need them. Teresa had read Dr. Varadaraj’s books and they made her want to stand up and cheer the fact that someone was finally saying what needed to be said. Her message seemed to have had a strong affect on Everett and she admired him for the changes he’d made in his approach to prescription drugs, especially considering that those changes were not very popular among his peers.
It was hard not to have a little crush on Everett. He paid a price for his devotion to his work. He was single and had no time for a social life. He was often pale and tired, and Teresa suspected he didn’t eat right. The girls in the office paid attention and tried to remedy that when they could by bringing him home-cooked food. There weren’t too many like him around anymore, and they knew that.
When Stevie Nicks finished her song, Billy Joel began to sing “Just the Way You Are.”
The office door opened and someone stumbled into the waiting room with a gasp. Teresa lifted her head with a startled jerk to see Barbara Mannetti enter the office.
Oh, no, Teresa thought. What now?
Barb did not have an appointment. That meant she was probably hoping to be squeezed in. Teresa sighed. Everett had far more patience than she with Barb, but Everett insisted she be treated with just as much respect and dignity as everyone else, so Teresa did her best.
Barb wore large round sunglasses and her lips were plastered with bright red lipstick. Her hair, dyed its usual black, was in a bouffant that had been mussed by the wind outside. Gawdy red clip-on earrings dangled from her lobes and she wore a loud red, green, and yellow flower-print blouse with black Capri pants that were not flattering. She was in her late fifties and shaped like a pear but she behaved and dressed as if she were in her twenties and shaped like a model. She had a host of ailments, but most of them stemmed from emotional problems. After years of heavy drinking, Everett had managed to get her off the booze and into therapy with Dr. Erica Myerson, and that had brought about some improvements. But she was still a high-maintenance patient.
“Hello, Barb,” Teresa said.
As she approached the desk, Barb took off her sunglasses and put them in the big straw bag that hung from her left shoulder. Her eyes were thick with mauve eyeshadow and heavy mascara. She patted her hair in an effort to repair the wind’s damage.
“It’s blowing out there,” she said, a little winded, her voice trembling, “but it’s still so hot and smoky. Look, Teresa, honey, I know I don’t have an appointment, but I really need to see Dr. Reasoner.” Her pudgy-fingered, liver-spotted hands did not hold still as she placed them on the desk. The blood-red polish on her long nails was chipped and peeling. Her arms jittered and her whole body stayed in constant movement as she stood at the desk, mouth opening and closing, sucking her lips between her teeth now and then.