It was too bad health was so bad for business.
5.
TEMPEL PHARMACEUTICALS, INC.
ANNUAL REPORT
PRETAX AND NET INCOME
FROM CONTINUING OPERATIONS
(Figures in millions of dollars)
1983
1982
1981
(estimated*)
Net Sales
4,281.1
3,885.5
3,562.1
Pretax income
721.7
601.3
521.7
Taxes on income
327.6
299.7
245.2
Net income from continuing operations
394.1
301.6
276.5
*Best estimate based on current growth rates.
6.
Dr. William Trilling looked down at the New York City streets through the glass wall of his office, hearing the gusty wind that blew flurries of rain against the pane. The streets were jammed with cars, none of which were moving. The people below, hunched beneath their umbrellas as they walked crabwise against the wind, looked like determined little blips on a video game screen, dodging the cars and one another. “Bleep, bleep,” said Dr. Trilling, providing the sound effects himself. “Bleep. Pow!” Then another thought struck him.
My God, he thought in dawning amazement. How can people live like that?
He worked hard at maintaining his optimism, but sometimes it was hard.
He returned to his desk and glanced at the paperwork that Natalia Latoni, his head girl, had put in his In box earlier in the day. Realizing that his optimism was going to need a little help today, he carefully opened the upper drawer of his desk and glanced at the rows and rows of pills. Working for the Experimental Drugs Division of Tempel Pharmaceuticals had its perks.
Dr. Trilling had no patients, no practice, and no phone calls summoning him to hospital bedsides at inconvenient hours: that was the advantage of being in research. His job was strictly supervisory; he and his colleagues oversaw the various field-testing programs of Tempel Pharmaceuticals throughout the world.
He took two Oronidol, which would serve to lengthen his attention span and create in him a kind of rapt fascination for his paperwork; and then he took a Calispeiron, a stimulant that would serve to counteract the Parankalon that he’d taken earlier in the day in order to numb his sensations during the long commute into town.
Dr. Trilling loved the new generation of psychotropic drugs. They selected the parts of the brain they wanted and left the others alone, a process that appealed to his sense of efficiency and economy. He found them invaluable in maintaining his basic optimism.
7.
Bennie Lovett opened his umbrella briefly and snorted his speedball in its shelter. He was going to need a little artificial motivation for this one, because the rain had been turning the ground to muck for weeks. This cemetery in Hempstead was going to be an awful, sloppy job, but he was out of money and this was one of the better ways he knew to raise cash in a hurry.
Quickly, he bent to the sodden turf and cut the sod neatly into squares, which he stacked to one side. Then he removed the headstone, got out his shovel, and began to dig. The walls of his trench kept liquefying, and he had to keep shoring it up, but after he stopped for another speedball, the work went quickly.
There was an art to grave robbing, Bennie Lovett had discovered. A grave with a high mound on it was too recent, and it meant that the skull would be hard to clean, with all the dead muscle and tissue still clinging to it. A grave with a depression over it meant the coffin underneath had collapsed and possibly crushed the skeleton under its weight. The best was a level grave, which meant it was just old enough for the cadaver’s muscle and tissue to fade, turn brittle, and lose its strength.
Bennie struck the coffin, cleared the rest of the soil out, and breathed a sigh of relief that at least it was a wooden coffin. The fucking bronze ones were a bitch. He got out his axe and chopped vigorously for a few moments, then peeled back the lid to the lead inner coffin and shone his flashlight on the cadaver. An old guy, apparently, in his best suit with a gold watch and chain. Bennie pocketed the watch and chain, then hefted his ax and cut off the head with a well-placed blow.
He hefted the skull, examining it carefully in the light. It was perfect—just little bits of skin and sinew left, and a mild acid bath would soon get rid of those. He put the skull in his bag. He planned to raid two other graves before morning.
8.
The baby’s heart sounded strong and clear. Winkelstein disengaged the stethoscope from his ears and fit them carefully on the head of the mother-to-be. He watched her eyes widen in joy as she heard the heartbeat.
“Wow,” she said, and then grinned. “It’s fast,” she said.
“A hundred forty beats per minute, give or take,” Winkelstein said. He gave a smile and returned to his desk. “You’ve had an exceptional pregnancy, Mrs. Lasley, for a woman your age,” he said. “Remarkably free of any difficulties. We have every reason to expect an uncomplicated birth and a healthy child.”
Isadora Lasley, her eyes dreamy as she listened to the baby’s heartbeat, nodded abstractedly. She was thirty-eight, owned a pair of expensive boutiques, and was married to a weathy contractor. This would be her first delivery. She’d opted for natural childbirth without anesthetics, a choice Winkelstein wasn’t exactly overjoyed with but one he was willing to concede as being in the realm of her choice—though he knew some anesthetists who were livid about these things. Not that it mattered in this case: Winkelstein would have an anesthetist standing by anyway.
His nurse helped Mrs. Lasley to the dressing room. He went to his office and waited for her to reappear.
She had spared no expense in regard to her child, going through about every expensive prenatal test ever devised. She had cats, so he’d tested for toxoplasmosis; she’d had amniocentesis early on to look for possible birth defects, and there had been ultrasound checks to make certain it wasn’t a tubal pregnancy. She’d tested for herpes and cytomegalic and a handful of other unlikely possibilities. She had been careful about her weight and diet, had reduced her social drinking, and given up smoking. Winkelstein and his wife saw the Lasleys socially at least a half a dozen times each year. The contrast with his Health Group patients was heartwarming.
Winkelstein picked up his pen. “I’d like to do another B-scan in a couple of weeks or so to make sure the baby’s in the right position for delivery. Every indication so far shows the baby will be making its appearance on schedule. I suppose we should think about making reservations at the hospital.”
Isadora’s eyes slowly lost their cloudy look. She frowned as she looked at Winkelstein. “I’ve been meaning to talk to you about that, Norton,” she said slowly. “I think I want to have the baby at home.”
Winkelstein returned the pen to its stand with careful precision and gazed at Isadora with unblinking brown eyes. “I don’t do home deliveries, Mrs. Lasley,” he said. “I don’t regard them as safe. Especially not in the case of a woman your age.” She looked as if she were about to say something, and he spoke quickly and firmly. “If you hemorrhage, Mrs. Lasley, you can bleed to death in minutes. There’s nothing I can do about it outside a hospital. If the baby doesn’t breathe right, I’d have to be able to have treatment available on the spot, otherwise there could be brain damage or worse.”
“You said we’d be fine!”
“I said the chances were, you and the baby would be fine. But there’s always the chance you won’t be.”
Isadora gazed stubbornly at nothing in particular for a moment. Winkelstein spoke on. “And just in case, I’d like to keep you monitored and have an anesthetist standing by. You might change your mind about anesthesia, you know. It’s been done.” Winkelstein sensed her resistance eroding, and he hastened to his final argument.
“On top of all that, Mrs. Lasley, you might be in labor for hours and
hours, and in a home birth situation, I’d have to be right there all the time—maybe for an entire twenty-four hour period, maybe longer. In a hospital they have nurses to take care of you during that time. But my being absent for all that time—it just isn’t fair to my other patients. I can’t afford to be away from them for a full day or more.”
He saw her blink slowly and thought he’d convinced her. That argument usually worked well: don’t do it for me, do it for my other patients.
Isadora spoke uncomfortably, her gaze moving rapidly about the room, never lighting on Winkelstein. “Well. You see, my husband has a niece. Whose name is Alice. Who’s just become a midwife. She could take care of me till it’s time for you to come.”
“I see.” Well, so that’s where the ideas were coming from: he hadn’t seen Isadora as the sort to pick up this kind of trendy medical chic on her own. Winkelstein frowned at her and picked his words carefully. “I don’t want to speak against you husband’s relatives, Mrs. Lasley,” he said. “Midwives were all very well and good in the eighteenth century, I suppose, but they’re not needed now, and a lot of their attitudes are … well, I suppose unprofessional is the only way to describe them.”
“I’ll have to think about it,” said Isadora. There was a stubborn firmness in her eyes.
“We can talk about it again at your B-scan,” Winkelstein said. “But remember, I won’t do home deliveries. It’s a firm principle with me. And, as I said, it’s not fair to my other patients.”
“Alice knows a doctor who will,” said Isadora.
A wave of red fury rose in Winkelstein and stayed with him for the rest of Isadora’s visit. So the new brand of holier-than-thou, the holistic medical doctor—no doubt with a forty-dollar haircut and fresh-cut flowers on his desk—had no objection to poaching on another doctor’s preserves, did he? Or was it she? And with palpably unsafe techniques to boot. What about professional courtesy? What about medical ethics? Winkelstein had been as ambitious as any when he was young, but he’d never gone in for poaching.
He saw Isadora to the door and spent the next few minutes drumming angry fingers on his desk top. Another one gone, he thought. Next he’d have some woman who wanted to deliver her kid underwater … he’d heard that was getting to be quite a fashion these days.
Who the hell could understand them? The same woman who’d gone to the barricades in defense of abortion worried her head off about birth trauma.
Ah, well. At least he still had the Health Group. People there didn’t have the financial wherewithal to root around among treatments for the most fashionable. They took what he gave them and were glad to get it.
His eyes slid to his desk, to the framed photographs of his family. There they were, smiling in frozen perfection against a powder-blue backdrop, each surrounded by a kind of glowing artful halo. Winkelstein, his wife, Norton Junior, and Kimberlee. Taken three years ago now. Before the vice-principal found pot in Kimberlee’s locker at school, and before she’d had her first abortion.
The second had been last week. He’d tried to talk to Kimberlee since, but he’d always had to shout at her over an aural wall composed of Joe Voss and the Vidiots, and he’d given up. The girl simply hadn’t any basis for making decisions, he thought. She’d been brought up in affluence and didn’t know what she was throwing away.
Too bad she’d never worked at the Health Group, he thought savagely. Give her a dose of reality she’d never forget.
An idea descended upon Winkelstein like a warm fuzzy blue blanket. Why the hell not? he thought. He needed clerical help at the moment in order to process all the forms for Tempel and The Baum Company and the rest. He began to picture his darling little princess among the losers and diseased in the Health Group office, and began to smile.
His intercom buzzed.
“Dr. Winkelstein, one of the reps from Tempel is here. Are you available?”
Not what he needed. His next half hour was free, and he wanted some room to think without cluttering up his mind with complimentary pens and bits of pharmaceutical literature.
“Tell him I have only a few minutes,” he said grudgingly.
A long, close-cropped head thrust sideways through the door. “Hi, Dr. Winkelstein,” said Homer Bernstein. “Just thought I’d drop off some pens and some literature.” He walked into the room, fished into his pocket, and brought out a handful of Tempel Pharmaceuticals, Inc., ballpoint pens. Then he opened his case and brought out an armful of glossy, highly colored folders, advertisements for new Tempel products. “Here’s a nice little booklet on use of Interferon,” Bernstein said. “And another on using the new-generation psychotrophic drugs to help treat the elderly.” Winkelstein nodded politely. Then Bernstein reached into his case and flashed Winkelstein a devilish grin.
“You’re not gonna believe the new promotion,” he said. He brought his hand out of his case. In it was a human skull.
“Beats the hell out of pens, huh?” he said, and placed the skull carefully on Winkelstein’s desk. “For one of our best customers,” he said. “Careful. The jaw is loose.”
Winkelstein picked up the skull and looked at it in amazement. It grinned at him whitely. “Where do you get them?” he asked.
Bernstein shrugged. “Medical schools, I guess,” he said.
“Huh,” said Winkelstein. He set the skull down on his desk, then opened a drawer and put it inside. “Well, thanks,” he said. “But I think I’ll take it home with me tonight. Wouldn’t want the patients to see it.”
Bernstein gave a laugh as Winkelstein put the skull into his drawer. “Yeah,” he said. “Wouldn’t want them to think you’ve been taking souvenirs from former case studies, would you?”
9.
Dr. Trilling, signing his authorizations, was humming in his office high above the world. Dr. Winkelstein gets his initial ten grand for the Tynadette study. Dr. Amardas Singh of Chamba gets his initial three grand for his birth control study. Wherever Chamba is, Trilling thought, they probably need birth control. Dr. José Martín Rodriguez y Saavedra in Buenos Aires gets four grand on completion of his new serum study. Good boy, José. Third World doctors, Trilling thought, seem to come cheaper, but there were always certain risks. All the studies in Salvador had been canceled.
His intercom lit up and buzzed imperiously. He regretted leaving his signing of the vouchers—ever since he’d taken the Oronidol, he found it fascinating to think of all the strange places he was sending Tempel’s money to—but he recognized the sound of duty when he heard it. “Buzz buzz buzz,” he said absently, and then picked up the phone. He cleared his throat to make his voice seem deep and grave.
“Trilling here,” he said.
“Dr. Trilling, this is Jeanie.” Trilling spent a long moment trying to remember who Jeanie might be. Ah, yes, his new secretary, just sent from the temporary agency. Tempel used a lot of temporaries, since that meant they didn’t have to pay the unemployment, insurance, or benefits. Which, of course, meant more money floating around the world for the important things.
This one was about thirty. Kind of bony and flat-chested, to his way of thinking, big cornflower-blue eyes under thick glasses. She spoke with a western accent that Trilling, without any evidence, assumed was Texan. Her brown hair was in a style that had become popular with a lot of white girls these days, long strands down the nape of her neck but short and brushy everywhere else. When she’d been introduced to him, she’d worn three sets of leg warmers under her skirt. She’d been wearing cowboy boots when she came into the office, before switching to the heels she wore at her desk. Trilling was glad that thin, tall heels had come back into style. Her legs were good.
“What is it, Jeanie?” His telephone voice was good, he thought. It was a voice that belonged to a kindly and responsible doctor.
“The mail’s just come in. There’s a letter here I’m not sure I know what to do with. It’s from the FDA.”
Trilling felt a very active centipede crawl madly up and down his spine. “Why don’t you
ask Natalia about it?” he said.
“She’s on her lunch break.”
“Oh,” he said. “Is it lunchtime already?” Good old Oronidol.
But the FDA—oh, damn. He wasn’t in shape to deal with the FDA today. “Better bring it in,” he said.
Jeanie was wearing her leg warmers pulled over her bare feet and was carrying a cup of coffee in her free hand. She put the letter on his desk. “It’s about some kind of heart medication called TriPhiloden,” she said. “They say it’s been mass-marketed by Tempel since 1977, and we still haven’t submitted our twenty-five follow-up case reports to qualify for full approval. The FDA is wondering where the reports are.”
TriPhiloden? Trilling’s memory trundled vaguely over his internal index. “Oh,” he said. “I remember that stuff now. Isn’t there a file?”
Jeanie was patient. “I don’t know where the file is. I’ll ask Natalia when she comes back.”
“I don’t think we have the case studies up here,” Trilling said. “I think all the follow-up reports are in another department, or two other departments, or somewhere. Word processing and the TriPhiloden consultants should have them. I suppose the failures have held up the processing.”
“Failures?” Jeanie asked.
“Yes. Patient failures. We have a lot of delays when they keep dying like that.”
In the sudden thunderous silence, Trilling had the suspicion that perhaps he’d said something wrong. Panic thrashed in him like a floundering eel. He looked up into Jeanie’s wide blue eyes. “It happens all the time,” he said. “Heart patients, you know. They’re not well people.”
“I guess not.” Then: “Failure?”
“The FDA,” Trilling mused. “Look. If they call, I’m not in. I have to think about this.”
Jeanie nodded briskly. Dr. Trilling realized he was overreacting to the whole situation and cursed the Oronidol he’d taken. It was good for plodding through a lot of detail work, but it was hopeless in dealing with a crisis. Dicryptomine, he thought. It would stimulate production of acetylcholine and other neurotransmitters and help him think. But it tended to put a nasty edge to reality, so he’d take some Shacocacine to help smooth things out and let him suppress his panic reaction.
The Year’s Best Science Fiction: Third Annual Collection Page 44