L Sellers - The Suicide Effect

The research center was on 20th Avenue and Willamette, so it was an easy bike ride from his apartment near the University of Oregon campus. It drizzled lightly on the way, but he had rain gear and didn’t mind. If the weather got worse while he was in the clinic, he’d strap his bike to the front of a city bus and get to work from there. He liked to ride, but he wasn’t a martyr about it the way some people were.

The small two-story building looked new and Robbie didn’t recall seeing it before. Gray and uninviting with minimal windows. He locked his bike to a sturdy metal rack and went inside. The interior looked like a cross between a dentist’s office and the unemployment division: Plush carpeting and soft tones in the front and counseling cubes in the rear. He approached the receptionist and told her he had an appointment.

“For the depression trial? Excellent. Do you have a referring physician?” She had a friendly smile and didn’t sound like she grew up in Eugene. Robbie couldn’t place the accent.

“No. I work at Prolabs and saw a flyer in the lunchroom.”

“Excellent. One of the company’s own.” She handed him a clipboard with a thick stack of papers. “I need you to fill out this questionnaire. Then we’ll analyze your qualifications and let you know if you’re eligible. If you are, Dr. Lucent will give you a complete physical. Also, there’s a consent form in the back. Please read through it, but it isn’t necessary to sign it yet.”

“Okay.” Robbie wondered what would make him eligible or not. Did he have to be despondent? Or too poor to afford medication?

The paperwork took forty-five minutes. After completing a health history, the next section detailed the symptoms of depression: sadness or irritability, low energy, difficulty concentrating, insomnia, low self-esteem, loss of interest in social or physical activities. For each, he had to indicate how often he experienced the symptoms and how long the feelings lasted. Then the questions became more specific: Have you ever taken medicine for depression? Yep. He listed the other drug he’d taken and noted that he was using Zoloft now.

Have you ever had thoughts of killing yourself? Didn’t everybody? He had never acted on those feelings, so he hesitated to check yes. He figured this was one of the important questions that would determine eligibility. Were they looking for people with serious depression or were they screening out the extremes? He decided to be honest and checked yes. For frequency, he indicated occasionally. He finally flipped to the consent form, which went on for pages about side effects and liability. Robbie skimmed over it. They wouldn’t give people the drug if it wasn’t safe.

He returned the clipboard to the receptionist. She smiled. “If you’d like to wait, one of our clinicians will review this now to determine your eligibility.”

“If you’re going to run a credit check, I might as well leave now.”

She gave him a hearty laugh, which cheered him up considerably.

While he waited, Robbie stepped outside and smoked a cigarette. He’d picked up the habit in high school, and even though he had come to hate it as much as his parents did, he couldn’t quit. Every time he tried, he ended up too depressed to function. So he limited himself to five or so a day most of the time. Nicotine had a direct effect on brain chemicals, and his brain needed all the stimulus it could get.

It began to rain, so he tossed the butt into the wet bark and went back inside to wait. In a few minutes, a pretty woman in a white coat came out and called his name.

“Hi. I’m Dr. Lucent. I believe you’re eligible for this trial. Would you like to proceed?” She had nearly black hair, an easy smile, and reminded him a little bit of his mother.

“Sure.”

“Great. Let’s go back to my office and go over some information.”

Robbie followed her back to a small room that looked somewhat like a doctor’s examining area. She motioned him to sit and they spend about twenty minutes going over his answers to the depression questions. Dr. Lucent kept asking him to rate his feelings on a scale of one to ten. She jotted down his responses and, at the end, performed a calculation.

After a moment, she said, “The good news is that this is not a placebo trial. The sponsor is testing its investigational therapy, Nexapra, against the currently marketed therapy, Prozac. You will be taking one of the two, but you won’t know which one. Did you read the consent form?

“Yes.”

“Do you feel you have a thorough understanding of the possible side effects?”

“I’m familiar with antidepressants.”

“Do you have any questions about the medication or the trial?”

“When do I start the new drug?”

“In a few days. First, you need to sign the consent form, then I’ll give you a complete physical, including an electrocardiogram to make sure your heart is healthy. I’ll also draw some blood. We’ll test for illegal drug use, anemia, mineral imbalances, and such.”

The doctor crossed her legs and leaned forward. Robbie got a glimpse of cleavage and his blood responded.

“You’ll take home a two-week supply of therapy today,” she continued. “But you must stop taking your other medication for two days before you start. I’ll give you a journal to jot down your experiences every day. Please note your emotional feelings as well as any changes in physical health. Any questions?”

“No.” Robbie had barely been listening. Dr. Lucent was quite attractive.

The doctor handed him the clipboard with the final page of the consent form on top. Robbie signed it and handed it back. Dr. Lucent smiled brightly.

The blood pressure and heart rate check took five minutes, and the touch of Dr. Lucent’s hands made his heart pound a bit. The electrocardiogram took longer and made him appreciate how careful the researchers were to ensure the clinical trial didn’t harm anyone.

In the end, Dr. Lucent announced he was in fine health and retrieved a pharmacy bottle from a locked cabinet. The plain white container had a bar code and a lot number and nothing else.

“Be sure to come back for a new supply before your current supply runs out. It’s important not to miss a day.” She peered over her glasses to emphasize her point. “If you experience anything unusual or concerning, please call me right away.”

“I live on campus, I experience unusual things every day.”

Dr. Lucent smiled. “Seriously. Call me if you experience any mental or physical problems.”

“All right. See you in two weeks.”

It wasn’t raining when he left so Robbie rode his bike out West 18th toward Prolabs. The ride energized him. In fact, he felt pretty damn good. For a moment, he had second thoughts about changing medications. Then he remembered how excited his father had been about this drug when Prolabs’ scientists first started to test it. That was years ago, when Robbie still lived at home and his parents were still together. He had never seen his father look so happy, so sure of something. He might as well give the drug a try.

As he was pedaling down Prolabs’ driveway, a car came up beside him and slowed. Sula, the company’s PR person, stopped and chatted with him for a moment. He’d gotten to know her a little and liked her a lot. She was too old for him as a girl friend, plus she had a kid. Still, she seemed like someone he could count on as a friend.

Cricket stood outside the entrance to the city council meeting holding a big sign that read No Exceptions! on one side and Water Quality First! on the other. He’d arrived at city hall at six in the evening, and every person entering the special session had seen his message.

The land Prolabs wanted to build a new factory on was within the city limits and was designated wetlands. He knew the state land-use codes, and the property could not be developed by any party other than the city. Even the city was required to apply to the land-use commission for a re-designation. The rules were clear, but as usual, big business was trying to go around them.