Side Effects (1984)

by Palmer, Michael

  “What if the physician wants to prescribe a medication other than the twenty-five on the card?” Kate asked.

  “Our pharmacy is fully stocked. However, because of the Monkeys, we need only one pharmacist on duty, and he or she has more time to deal with problems such as drug interaction and side effects.”

  “Amazing,” Kate said softly. “Have the Monkeys ever made an error?”

  Horner’s smile was for the first time somewhat patronizing. “Computers cannot make errors. There are programs backing up programs to guarantee that. Of course, human beings are a different story.”

  “So I’ve learned.” Kate’s cattiness was reflex. There was something about Horner’s limitless confidence in the wires, chips, discs, and other paraphernalia surrounding them that she found disquieting. “Tell me, where do the generics come from that the machines dispense?”

  “One of the drug houses. We hold a closed-bid auction each year, and the lowest bidder gets the contract.”

  “Which one has it now?” Horner’s answer had been somewhat evasive, hardly in character with the man. She watched his eyes. Was there a flicker of heightened emotion in them? She couldn’t tell.

  “Now? Redding has it. Redding Pharmaceuticals.”

  “Ah, the best and the brightest.” Kate was not being facetious. In an industry with a checkered past that included thalidomide and many other destroyers of human life, Redding stood alone in its reputation for product safety and the development of orphan drugs for conditions too rare for the drugs to be profitable. “Well, Mr. Horner, I thank you. Your Monkeys are truly incredible.”

  “My pleasure. If there’s anything else I can do, let me know.”

  Kate turned to go, but then turned back. “Do you have a list of the companies that have held the contract in years past?”

  “Since the Omnicenter opened?”

  “Yes.” For the second time, Kate sensed a change in the man’s eyes.

  “Well, it won’t be much of a list. Redding’s the only one.”

  “Eight auctions and eight Reddings, huh?”

  “No bids have even been close to theirs.”

  “Well, thanks for your help.”

  “No problem.”

  Horner’s parting handshake and smile seemed somehow more forced than had his greeting. Kate watched as he ambled off, feeling vaguely uneasy about the man, but uncertain why. She glanced at her watch. The frozen section was due in ten minutes, and the patient would be kept under anesthesia until her diagnosis was made. Aside from alerting Bill Zimmermann as to what was going on, her Omnicenter visit had accomplished essentially nothing. Still, the clinic remained the only factor common to two dead women. As she walked through the lobby to retrieve her coat, Kate ran through the possible routes by which the ovarian and blood disorders might have been acquired. Finally, with time running short, she stopped at the reception desk, and wrote a note to Zimmermann.

  Dear Bill—

  Thanks for the talk and the tour. No answers, but perhaps together we can find some. Meanwhile, I’m sending over some microbiology people to take cultures, viral and bacterial, if that’s okay with you. They will also check on techniques of instrument sterilization—perhaps a toxin has been introduced that way.

  Let me know if you come up with anything. Also, check your calendar for a night you could come north and have dinner with my husband and me. I’d enjoy the chance to know you better.

  Kate

  She sealed the note in an envelope and passed it over to the receptionist. “Could you see to it that Dr. Zimmermann gets this?” The woman smiled and nodded. Kate was halfway to the tunnel entrance when she stopped, hesitated, and then returned. She reclaimed the note, tore the envelope open, and added a PS.

  And Bill … could you please get me ten tablets of each of the medications dispensed by the Monkeys. Thanx.

  K.

  “Well, what do you say, Clyde. Can I count on you or not?”

  Norton Reese set aside the paper clip he was mangling and stared across his desk at the chief of cardiac surgery. Clyde Breslow was the fourth department head he had met with that day. The previous three had made no promises to help block Kate Bennett’s appointment, despite delicately presented guarantees that their departments would receive much-needed new equipment as soon as her nomination was defeated. In fact, two of the men, Milner in internal medicine and Hoyt, the pediatrician, had said in as many words that they were pleased with the prospect of having her on the executive committee. “Bright new blood,” Milner had called her.

  Breslow, Napoleonic in size and temper, watched Reese’s discomfort with some amusement. “Now jes’ what is it about that little lady that bothers you so, Norton?” he asked in a thick drawl that often disappeared when he was screaming at the nurses and throwing instruments about the operating room or screaming at the medical students and throwing instruments about the dog lab. “She refuse to spread those cute little buns of hers for ya or what?”

  “The bitch made me look bad in front of the board of trustees, Clyde. You should remember that. It was your fucking operating microscope that caused all the trouble. I’ll be damned if I’m going to have her on my executive committee.”

  “Whoa, there, Norton. Your executive committee? Now ain’t you gettin’ just the slightest bit possessive about a group you don’t even have a vote in?”

  “Look, Clyde, I’ve had a bad day. Do you back me on this and talk to the surgical boys or don’t you?”

  “Now that jes’ depends, don’t it?”

  “The extra resident’s slot? Clyde, I can’t do it. I told you that.”

  “Then maybe you jes’ better get used to seeing that pretty little face of Katey B.’s at the meetin’s every other Tuesday.”

  Reese snapped a pencil in half. “All right. I’ll try,” he said, silently cursing Kate Bennett for putting him in a position to be manipulated by a man like Breslow.

  “You do that. Know what I think, Norton? I think you’re scared of that woman. That’s what I think. A looker with smarts is more than you kin handle.”

  Without warning, Reese exploded. “Look, Clyde,” he said, slamming his desk chair against the wall as he stood, “you have enough fucking trouble remembering that the heart is above the belly button without taking up playing amateur shrink. Now get the hell out of here and get me some support in this thing. I’ll do what I can about your goddamn resident.”

  With a plastic smile, Clyde Breslow backed out of the office. Reese sank into his chair. Frightened of Kate Bennett? The hell he was. He just couldn’t stand a snotty, do-gooder kid going around trying to act grown up. She ought to be home keeping house and screwing that lawyer husband of hers.

  “Mr. Reese, there’s a call for you on two.” The secretary’s voice startled him, and lunging for the intercom, he spilled the dregs of a cup of coffee on his desk.

  “Dammit, Betty, I told you no calls.”

  “I know you did, sir. I’m sorry. It’s Mr. Horner from the Omnicenter. He says it’s very important.”

  Reese sighed. “All right. Tell him to call me on three seven four four.” He blotted up the coffee and waited for his private line to ring. It was unusual for Carl Horner to call at all. Omnicenter business was usually handled by Arlen Paquette, Redding’s director of product safety. In the few moments before 3744 rang, he speculated on the nature of a problem that might be of such concern that Horner would call. None of his speculations prepared him for the reality.

  “Mr. Reese,” Horner said, “I’m calling on behalf of a mutual friend of ours.” Cyrus Redding’s name was one Horner would never say over the phone, but Reese had no doubt whom he meant.

  “How is our friend?”

  “A bit upset, Mr. Reese. One of your staff physicians has been nosing about the Omnicenter, asking questions about our pharmacy and requesting Dr. Zimmermann to send her samples of the medications we dispense.”

  The word “her” brought Reese a bone-deep chill. “Who is it?” he asked,
already knowing the answer.

  “It’s the pathologist, Dr. Bennett. She’s investigating the deaths of two women who were patients of ours.”

  “Damn her,” Reese said too softly to be heard. “Horner, are you … I mean, is the Omnicenter responsible for the deaths?”

  “That appears to be negative.”

  “What do you mean appears to be? Do you know what’s at stake? Paquette promised me nothing like this would happen.” Reese began feeling a tightness in his chest and dropped a nitroglycerine tablet under his tongue, vowing that if this discomfort was the start of the big one, his last act on earth would be to shoot Kate Bennett between the eyes.

  “Our friend says for you to remain cool and not to worry. However, he would like you to find some effective way of … diverting Dr. Bennett’s interest away from the Omnicenter until we can fix up a few things and do a little more investigating into the two deaths in question.”

  “What am I supposed to do?”

  “That, Mr. Reese, I do not know. Our friend suggests firing the woman.”

  “I can’t do that. I don’t hire and fire doctors, for Christ’s sake.”

  “Our friend would like something done as soon as possible. He has asked me to remind you that certain contracts are up for renewal in less than a month.”

  “Fuck him.”

  “Pardon?”

  “I said, all right. I’ll think of something.” Suddenly, he brightened. “In fact,” he said, reaching into his desk drawer, “I think I already have.”

  “Fine,” Carl Horner said. “All of us involved appreciate your efforts. I’m sure our friend will be extremely beholden when you succeed.”

  Reese noted the use of ‘when’ instead of ‘if,’ but it no longer mattered. “I’ll be in touch,” he said. Replacing the receiver, he extracted a folder marked “Schultz/Geary.” Inside were a number of newspaper articles; the official autopsy report, signed by Stanley Willoughby and Kathryn Bennett, MDs; and an explanatory note from Sheila Pierce. Also in the folder were a number of laboratory tests on a man named John Schultz—a patient who, as far as he or Sheila could tell, never existed in Metropolitan Hospital. While the chances of some kind of coverup weren’t a hundred percent, they certainly seemed close to that.

  Sheila, he thought as he readied a piece of paper in his typewriter, if this works out, I’m going to see to it that you get at least an extra night or two each month. “To Charles C. Estep, Editor, The Boston Globe.” Reese whispered the words as he typed them. He paused and checked the hour. By the time he was done with a rough draft, the pathology unit would be empty. A sheet of Kate Bennett’s stationery and a sample of her signature would then be all he needed to solve any number of problems. The woman would be out of his hair, perhaps permanently, and Cryus Redding would be—how had Horner put it?—extremely beholden.

  “Dear Mr. Estep …”

  As Norton Reese typed, he began humming “There Is Nothing Like a Dame.”

  5

  Thursday 13 December

  “Do you think God is a man or a woman, Daddy?”

  Suzy Paquette sat cross-legged on the passenger seat of her father’s new Mercedes 450 SL, parked by the pump at Bowen’s Texaco.

  Behind the wheel, Arlen Paquette watched the mid-morning traffic glide by along Main Street, his thoughts neither on the traffic nor on the question he had just been asked.

  “Well, Daddy?”

  “Well what, sugar?” The attendant rapped twice on the trunk that he was done. “Company account, Harley,” Paquette called out as he pulled away.

  “Which is it, man or woman?”

  “Which is what, darlin’?”

  “God! Daddy, you’re not even listening to me at all.” She was seven years old with sorrel hair pulled back in two ponytails and a China doll face that was, at that moment, trying to pout.

  Paquette swung into a space in front of Darlington Army/Navy and stopped. Never totally calm, he was, he knew, unusually tense and distracted this morning. Still, it was Second Thursday and that gave him the right to be inattentive or cross, as he had been earlier with his wife. He turned to his daughter. She had mastered the expression she wanted and now sat pressed against the car door displaying it, her arms folded tightly across her chest. In that instant, Paquette knew that she was the most beautiful child on earth. He reached across and took her in his arms. The girl stiffened momentarily, then relaxed and returned the embrace.

  “I’m sorry, sugar,” Paquette said. “I wasn’t listening. I’m sorry and I love you and I think God is a woman if you’re a woman and a man to someone who’s a man and probably a puppy dog to the puppy dogs.”

  “I love you too, Daddy. And I still don’t know why I should have to pray to Our Father when God might be Our Mother.”

  “You know, you’re right. I think that from now on we should say … ‘Our Buddy who art in Heaven.’ ”

  “Oh, Daddy.”

  Paquette checked the time. “Listen, sugar, my meeting is in half an hour. I’ve got to get going. You be brave, now.”

  She flashed a heart-melting smile. “I don’t have to be brave, Daddy. It’s only a cleaning.”

  “Well then, you be … clean. Mommy will be by in just a little while. You wait if she’s not here by the time you’re done.” He watched as she ran up the stairs next to the Army/Navy and waited until she waved to him from behind the picture window painted Dr. Richard Philips, DDS. Then he eased the Mercedes away from the curb, and headed toward the south end of town and his eleven o’clock Second Thursday meeting with Cyrus Redding, president and chairman of the board of perhaps the largest pharmaceutical house in the world. The meeting would start at exactly eleven and end at precisely ten minutes to noon. For seven years, as long as Paquette had been with the company, it had been like that, and like that it would remain as long as Cyrus Redding was alive and in charge. Nine o’clock, labor relations; ten o’clock, public relations; eleven, product safety; an hour and ten minutes for lunch, then research and development, sales and production, and finally from three to three-fifty, legislative liaison: department heads meeting with Cyrus Redding, one on one, the second Thursday of each month. The times and the order of Second Thursday were immutable. Vacations were to be worked around the day, illnesses to be treated and tolerated unless hospitalization was necessary. Even then, on more than one occasion, Redding had moved the meeting to a hospital room. Second Thursday: raises, new projects, criticisms, termination—all, whenever possible, on that day.

  The factory covered most of a thirty-acre site bordered to the south and west by pine-covered hills and to the east by Pinkham’s Creek. Double fences, nine feet high with barbed wire outcroppings at the top, encircled the entire facility. The inner of the two barriers was electrified—stunning voltage during the day, lethal voltage at night and on weekends. The only approach, paralleling the new railbed from the north, was tree lined and immaculately maintained. Two hundred yards from the outer fence, a V in the roadway directed employees and shippers to the right and all others to the left. A rainbow sign, spanning the approach at that point announced:

  REDDING PHARMACEUTICALS, INCORPORATED

  DARLINGTON, KENTUCKY

  1899

  “The Most Good for the Most People at the Least Cost”

  Paquette bore to the right beneath the sign and stopped by a brightly painted guardhouse, the first of a series of security measures. He found himself wondering, as he did on almost every Second Thursday, if knowing what he knew now, he would have left his university research position in Connecticut to become director of product safety. The question was a purely hypothetical one. He had taken the job. He had agreed to play Cyrus Redding’s game by Cyrus Redding’s rules. Now, like it or not, he was Cyrus Redding’s man. Of course an annual salary that, with benefits, exceeded four hundred thousand dollars went far toward easing pangs of conscience. Suzy was the youngest of three children, all of whom would one day be in college at the same time. He stopped at the fina
l pass gate, handed the trunk key to the guard, and drummed nervously on the wheel while the man completed his inspection. It hardly paid to be late for a Second Thursday appointment.

  Over the hundred and eighty years since Gault Darling led a band of renegades, moonshiners, and other social outcasts to a verdant spot in the foothills of the Cumberlands, and then killed two men for the right to have the new town named after himself, Darlington, Kentucky, had undergone any number of near deaths and subsequent resurgences. Disease, soldiers, Cherokees, floods, fires, and even a tornado had at one time or another brought the town to its knees. Always, though, a vestige survived, and always Darlington regrew.

  In 1858, the Lexington-Knoxville Railway passed close enough to Darlington to send off a spur, the primary purpose of which was the transport of coal from the rich Juniper mines. By the end of the century, however, output from the Junipers had fallen to a trickle, and the railbed was left to rot. Darlington was once again in danger of becoming a ghost town. Shops closed. The school-house and Baptist church burned down and were not rebuilt. Town government dwindled and then disappeared. In the end, where once there had been well over a thousand, only a handful remained. Fortunately for the town, one of those was Elton Darling, self-proclaimed descendant of Gault.

  In 1897, Darling engineered a massive hoax utilizing three pouches of low-grade gold ore, two confederates, and a remarkable ability to seem totally inebriated when stone sober. Rumors of the “Darlington Lode” spread quickly through cities from Chicago to Atlanta, and Darlington acquired an instant citizenry, many of whom stayed on, either out of love for the beauty of the area or out of lack of resources to move elsewhere.