by Stash (v5)
The waiter brought their lunch and two extra plates. Brian told the waiter to leave just the one plate in the middle and they’d share.
“Now who are you going to call?”
“What do you mean?”
“To get your supply.”
She shook her head no, she wasn’t going to be pulled into that conversation.
“All I’m asking is that you tell me if you do—and who it’s from,” Brian said.
“If I ever do, I’ll let you know.”
“So why were you so hesitant to give Gates’s name—considering the consequences to you and your family? You owe an old boyfriend such loyalty?”
“It’s called integrity, Brian. I gave him my word I wouldn’t say anything.”
“Did you get high with him when you picked up the pot?”
“No, and you already asked me that question. And he wasn’t my boyfriend.”
“So, you just smoked by yourself in the park.”
“Yes.”
He looked at her. Close to tears, but beautiful still—after almost nine years together and two kids and even or maybe especially now when she was upset. So she had a history of past relationships, what halfway normal person didn’t? She’d clipped her hair back this morning, the way he liked it, and put on more makeup than usual and even lipstick and the diamond earrings Brian had given her when Nate was born. With the stitches out, just a thin red line remained where her eyebrow was starting to grow back. She wore a chocolate skirt paired with one of his favorite blouses, pure white with simple pearl-like buttons, sheer enough that you could see the outline of her camisole when she leaned and the fabric formed to her. One extra button open at the top showing the tiny birthmark to the left of center. Earlier, he’d wanted to punish her for withholding Jude’s name for so long. Now he wanted to make love to her. He wished he could blow off his meeting and take her to a hotel for the afternoon.
He put down his fork and reached and held her free hand.
“I know this was hard for you, I don’t mean to twist it into something it’s not. You did the right thing.”
“I don’t know if he’s a drug dealer or not,” Gwen admitted. “Really, how can I know what he does? But if he isn’t and is just doing me a favor, then I don’t want to be the person that gets him harassed. And if he is some kind of drug dealer, I don’t want him knowing I snitched on him.”
“He won’t know.”
“And his daughter, Dana. What happens to her if Jude gets in trouble?”
“There’s nothing we can do about it. They have their life and we have ours.”
“She’s only eighteen.”
“What about his wife? What happened to her?”
“Ran off years ago from a rehab facility, I think it was just after I stopped working at the Patriot. Hasn’t been seen or heard from since.”
Brian looked at his watch; he had to get back for his one o’clock with Jennifer Stallworth.
“So for you it was an integrity issue?”
“Weren’t you taught not to be a tattletale?”
Brian nodded. “Sometimes you have no choice—or your choices aren’t good and you have to pick the one that does the least damage.”
“While preserving your integrity.”
“If you can. If you have your priorities straight, then integrity flows from that. You make decisions based on your priorities—on what’s important to you.” He might as well have been talking about his situation at work, trying to discover where priorities and integrity fit in. He wanted to discuss it with Gwen, but this wasn’t the right time.
“You’re saying I was wrong to buy pot from Jude—or from anyone?”
Brian shook his head. “If you want it, you have to get it somewhere, and there aren’t a lot of options in our circle. And if you don’t know anyone, how do you go about asking? Who do you approach without risking a stain on your reputation?”
“It’s definitely not college dorm days where you could follow the smell down the hall and everyone knew the resident dealer.”
The waiter returned to clear. The plate was empty except for a curl of gristle Brian had trimmed off one end of the steak. Gwen had managed to eat her share.
Did they want dessert or coffee?
Before Gwen could answer Brian said no, just the check, they had to leave.
“You need to get back?” Gwen asked.
“I’ve got a meeting in thirty minutes. But I’d rather spend the afternoon with you in bed.”
“That’s a nice offer—or it could be.”
But he had only enough time to walk Gwen to her car and make out for a few minutes.
Miracle Drug
Brian was on the phone with Dr. Marta Everson, whom he knew from industry conferences and Caladon’s physician seminars. A short, caved-in woman with tight coils of oily hair springing from her head, Dr. Everson looked like the absentminded professor, garbed in stained clothes and eyeglasses worn askew on her nose. She promoted herself aggressively, published widely, and lectured incessantly. She contributed a monthly health column for Female magazine and served as an expert source of quotes for journalists working on women’s health stories. You could find her speaking at medical conferences and trade shows on her favorite topics. Caladon paid her to travel to resorts and present “Trends in Obesity Treatment,” an educational seminar for physicians, where she subtly spread the word about Zuprone. Onstage or in front of a room, despite her physical deficiencies, she had the dynamic presence of a Hollywood starlet. Brian believed a lot of her success as a presenter had to do with her voice, which was rich and resonant as an oboe, sexual even, in complete opposition to her appearance.
“How many patients did you say were in your study?” Brian asked.
“I’m tracking twelve patients for whom I’ve prescribed Zuprone for weight loss, and three are showing significant symptoms of anorexia.”
Well, there you go. That’s weight loss, isn’t it?
He shouldn’t have had the extra glass of wine at lunch with Gwen.
“How long have they been taking Zuprone?”
“Between six and eighteen months.” That husky voice, making six sound like sex. Although no one would be taking Zuprone for sex, since one of its documented side effects was reduced sex drive in those treated for anxiety. Which seemed to Brian a case of piling on the anxiety, not mitigating it.
“What dosage are you prescribing?”
“120 milligrams daily.”
“That’s twice the recommended dosage,” Brian pointed out.
“For anxiety, yes. There are no recommended doses for weight loss—it’s not FDA approved for that indication.”
As if she were telling him news.
“The fact is, Brian, you have a serious issue with Zuprone and you must do something about it.”
“It could be a dosing issue.”
“Are you a licensed physician?” Everson asked, knowing the answer. “It’s common knowledge among the medical community that 120 milligrams is the weight-loss dosage. It’s what I’ve been mentioning in the seminars.”
“That’s right, the seminars,” Brian said. “Caladon is paying you to present at seminars twice a month.”
“Not anymore they’re not. I can’t continue in the face of this evidence.”
It wouldn’t be the worst thing if Marta bowed out of the seminars, or if the series were canceled altogether. During an earlier meeting with Jennifer and Stephen, they agreed the seminars were the riskiest of the marketing practices and needed to be toned down or turned off. Brian also had issued his final recommendation that they should begin the application process with the FDA to seek approval for Zuprone. He’d hate to reverse himself on that, even though no paperwork had been filed yet.
“Did you contact Stephen?”
“Of course I called Stephen. I left him a voice mail and he never called back. I guess your medical director doesn’t seem to think there’s an issue. Have you had other physicians reporting problems?”
/>
“We haven’t, no problems,” Brian told her. “As a matter of fact, we have several internally published studies that show no serious side effects from using Zuprone for weight loss. And these trials are scientifically based, not just anecdotal evidence.”
“Are you doubting what I’m personally witnessing in my patients?”
“No, no I’m not doubting it,” Brian said. “I’m just letting you know we have other studies. As you’re well aware, I cannot offer them to you unless you make a request.”
“I don’t want your studies; I know exactly what they’re for. What I want is for you to issue warnings about the dangers of prescribing Zuprone for weight loss,” Everson said. “I’m treating some very sick women here.” Even in her aggressive, demanding words, the throaty undertones flourished.
“I understand you’re upset, Marta, but I think you need to put this in a broader perspective. You’re talking about a universe of twelve patients …”
“Three of whom have developed anorexic symptoms. That’s twenty-five percent.”
“… and no control group to compare them against. And you’re dosing at 120 milligrams while our studies used 100.”
“I’m giving Caladon the benefit of the doubt here. I’m giving the company a chance to correct a major problem. It’s not like I’m bringing this up for selfish reasons—I won’t have the income from the seminars any longer. And I called you because I thought Brian Raine of all people would appreciate the gravity of this situation.”
“I do appreciate it. I’m just as concerned as you are.”
“Drug companies must be more accountable for putting people at such great risk.”
“Marta, I’m sorry, we’re not the ones prescribing the medication for off-label uses. That’s at the discretion of physicians.”
Marta snorted. “Physicians have become dependent more on drug companies than their peers for information. You know that as well as I do. What do you think those seminars are about? Physicians believe what they hear in them.”
“That sounds more like an indictment of your profession than mine.”
“I regret signing a speaking contract with Caladon. It makes me feel like I’m hawking potions in traveling carnivals.”
You’re the one who’s hungry for the stage, Brian thought.
As if on cue to Brian’s thoughts, Marta added, “I could get a lot of media attention on this, you know.”
“I would caution you against that at this point.”
“Caution me? What’s that supposed to mean?”
He had to deflect her. “You’re a highly respected physician, Marta, and you have an excellent reputation among your colleagues and in the media—and with Caladon, who pays you generously for the seminars. Bringing up a study that is not really a study at all but just the isolated experience of a few patients … Well, that could harm everyone, including you and your reputation.”
Marta paused for a few seconds, then found her voice again. “Would it harm the untold number of people out there taking Zuprone for weight loss? What about them? Are you cautioning them as well? Would it harm Caladon? How much has Caladon profited from this off-label use of Zuprone?”
How much have you? Brian wanted to shoot back. He was getting nowhere. He’d stuck to the company line as best he could, but one of the attorneys or Stephen should be handling this. He wished he hadn’t picked up his phone without looking at caller ID. He thought it would be Gwen calling, thanking him for lunch earlier that day, whispering something in his ear, a promise for later.
“Marta, I’ll have Stephen call you back as soon as possible. He should be the one to address this with you.”
“You want to abdicate, is that what you’re saying?”
“Stephen’s our medical director. I’m not abdicating, I’m escalating.” He had to control his voice better, but Everson was getting to him now. “Can you at least give him the opportunity to speak with you before you do anything else? Don’t you think that’s the right thing to do, especially considering your own association with Caladon and in particular Zuprone?”
Reluctantly, Dr. Everson agreed.
“I’ll get in touch with him right away,” Brian said. “I’m sure you’ll hear back from him within a day.”
After getting Marta Everson off the phone, Brian called Stephen Jeffries’s office. He had moved to the New Jersey headquarters after the acquisition of Pherogenix; he also kept an office upstate and traveled often. He got Stephen’s voice mail and was routed to his assistant. When Gina answered, Brian told her he had to speak with Stephen as soon as possible.
“He’s in San Jose at Pacik Labs,” Gina said. “Do you have his new mobile number?”
“Could you give it to me?”
He wrote down the number.
“It’s noon on the West Coast, this might be a good time to catch him,” Gina said. “He’s probably on his lunch run.”
Stephen ran every day at noon, wearing a headset to take and make calls.
He answered his phone panting.
“I’m running through downtown San Jose, the fucking sky is brown from smog. Imagine what I’m embedding in my lungs now.”
“The benefits of running outweigh it,” Brian said.
“Let’s hope so. What’s on your mind?”
Brian explained his call with Marta Everson. Her alleged study of patients on Zuprone—all twelve of them. The symptoms of anorexia. Her demand that Caladon do something about it.
“Jesus, Hurricane Marta,” Stephen said. “She left me a voice mail, I didn’t pay much attention.”
“Sounds like it could be a problem.”
“It isn’t a problem—she’s a fucking problem. I’ve never met anyone so desperate for publicity. We never should have hired her for the seminars. Whose decision was that, yours?”
Brian didn’t answer, and Stephen continued. “What do you think we should do?” He cleared his throat, and Brian heard a series of short gasps.
“Have you heard of anyone else reporting these side effects?” Brian asked.
“A handful of incidents, yes, but there are many causes of anorexia and someone with a weight problem is already predisposed to weight-related illnesses, including anorexia and bulimia. I don’t think it’s an issue, Brian. And I don’t think it’s related to Zuprone. Do you know how many prescriptions were written for Zuprone for weight loss last year?”
“One-point-two million,” Brian stated.
“That’s right. And next year it will be, what—double that? Didn’t you just present some figures on that to Wilcox and Garcia?”
“Of the one-point-two million prescriptions, the majority were written in the past six months,” Brian said. “It may be too early for the problems Everson reported to start showing up in any significance.”
“Oh, shit, I think I was supposed to turn there. You think I should try to run across the freeway?”
“Everson said she might publish her findings.”
Stephen laughed. “Twelve patients? No, I can run up this ramp and avoid it. I’d never get past all those cars. Did you tell her about our own studies? You and Teresa compiled a whole library, didn’t you? That was good work, really helpful for the reps.”
“She’s seen the reps carrying them around at the seminars. She knows what they are and doesn’t want them.”
“We can get her back on our side,” Stephen said. “I know everybody is supercautious and our industry has a target on its backside for anyone with ammunition these days, but we can handle this correctly and it will blow over.”
“I told Marta you’d get in touch with her as soon as possible, within a day. I had to tell her something.”
“That’s okay, I’ll take care of it. Consider it off your plate. Shit, Brian, it’s hard to breathe out here.”
Later, getting coffee in the cafeteria, Brian saw Teresa at the vending machine. She hadn’t noticed him come in and he watched her put coins into the slot and bend to retrieve her diet soda. Here was a woman
whose ass had steadily diminished over the past six months, requiring several wardrobe overhauls. Lots of new clothes on that body, each change more tailored, more fitted, than the last. Brian noticed. Everyone had. There had been an increasing volume of banter and cracks among the guys about Teresa behind her back. That was one of them: “I’d like to get her from behind her back.”
While her body underwent rapid transformation, her demeanor held steady. Teresa had always been outgoing and chatty, friendly to everyone at the office—both women and men, no enemies. A personality that might have been a defense mechanism for an overweight woman became offense for a slimmer one. Now men interpreted her sweetness as flirting, her chitchatting as interest. Yet Brian doubted she was seeing anyone right now, and on those weekends when she went back to New Jersey she talked about visiting her parents and brother, nothing about a boyfriend.
“Hey you,” Teresa said, turning around with her can of soda. “You look a little dazed.”
“A lot going on.”
“Tell me about it. Are we still meeting later to put together the Zuprone training for the new reps?”
“I have to postpone,” Brian said.
He debated whether to tell her about his conversations with Marta Everson and Stephen Jeffries. He didn’t want to be the information source regarding serious accusations and problems about Zuprone. The upheaval in the company would be felt like an earthquake; Caladon would find itself in crisis management mode because of something Brian brought to attention.