Arthur Hailey - Strong Medicine

One way of using cash was to acquire other companies. On Celia's urging, the board approved purchasing the Chicago firm which was making Peptide Ts containers. That was followed by acquisition of an Arizona concern specializing in new drug delivery systems. Negotiations to buy an optical company were under way. Many more millions would be spent on a new genetic engineering research center. There would be expansions overseas. A new company headquarters was planned, since the existing Boonton building had run out of space and some departments were housed in distant, rented quarters. The new structure would be in Morristown, with a hotel as part of a Felding-Roth high-rise complex. One purchase was a jet airplane-a Gulfstream 111. Celia and Ingram used it on their North American journeyings, more frequent now because of the company's widening activities. During Celia's meeting with Seth, he also said quietly, "One thing that's good about all this money coming in is that some of it can be used to settle claims about those poor Montayne-deformed children.”

"I'm glad of that too," Celia said. She had been aware for some time that the existing reserve fund being used by Childers Quentin for Montayne settlements was almost exhausted. Seth said sadly, "I'll never feel free from my guilt about Montayne. Never.”

Sharing the sober, reflective moment, Celia thought: Amid an enormous therapeutic and financial success, it was necessary and chastening to be reminded that grim failures were also part of pharmaceutical history.

Through all of Peptide Ts bountiful triumph, Martin Peat-Smith was, as the clicW went, in seventh heaven. Not even in the most optimistic moments had he ever imagined so much would be accomplished by his research into aging. Martin's name was now widely known, his person admired, respected and in demand. Praise and accolades poured in. He had been elected a member of the Royal Society, Britain's oldest scientific body. Other learned societies sought him as a speaker. There was talk of a future Nobel. A knighthood was rumored. Amid the attention, Martin managed to retain some privacy. His home telephone number was changed and unlisted. At the institute, Nigel Bentley arranged for Martin to be shielded from all but the most important calls and visitors. Even so, it was clear that Martin's earlier, inconspicuous life would never be the same again. Something else changed too. Yvonne decided to cease living with Martin, and to move into a flat in Cambridge. There was no quarrel or difficulty between them. It was simply that she resolved, quietly and calmly, to go her separate way. Recently Martin had been away from Harlow a good deal, leaving her alone, and at such times it seemed pointless to make the daily two-way Harlow-Cambridge journey. When Yvonne explained her reasoning, Martin accepted it uncritically, with understanding. She had expected him to put up at least a token argument, but when he failed to do so, she did not show her disappointment. They agreed they would see each other occasionally and remain good friends. Only Yvonne, when the moment came to leave, knew how sad, how torn she was inside. She reminded herself how happy she was with her veterinary studies; her third year had just begun. Immediately following the separation, Martin was away for a week. When he returned, it was to a darkened, empty house. It was more than five years since it had been that way, and he didn't like it. He liked it even less as another week passed. He found that he was lonely and missed the sight and cheerful chatter of Yvonne. It was, he thought on going to bed one night, as if a light in his life had abruptly gone out. Next day, Celia telephoned from New Jersey on a business matter and, near the end of their conversation, observed, "Martin, you sound depressed. Is anything wrong.”

It was then, in a burst of confidence, that he told her about missing Yvonne. "I don't understand this," Celia said.”Why did you let her go?" "It wasn't a question of letting her. She's free, and she decided.”

"Did you try to talk her out of it?"

"No.” "Why not?" "It didn't seem fair," Martin said.”She has her own life to live.”

Celia agreed, -Yes, she does. And she undoubtedly wants more out of it than you were giving her. Did you consider offering her something more-like asking her to marry you?" "As a matter of fact, I did consider it. The day Yvonne left. But I didn't, because it seemed...”

"Oh, God help us!" Celia's voice rose.”Martin Peat-Smith, if I were over there I'd shake you. How can anyone bright enough to find Peptide 7 be so dumb? You fool! She loves you.”

Martin said doubtfully, "How do you know?" "Because I'm a woman. Because I hadn't been five minutes in her company before it was as plain to me as it's plain now that you are being obtuse.”

There was a silence, then Celia asked, "What are you going to do?" "If it isn't too late... I will ask her to marry me.”

"How will you do it?" He hesitated.”Well, I suppose I could phone.”

"Martin," Celia said, "I am your superior officer in this company, and I am ordering you to leave that office you are in, right now, and get in your car, and drive to find Yvonne wherever she is. What you do after that is your affair, but I'd advise you to get down on your knees, if necessary, and tell her you love her. The reason I'm telling you this is that I doubt whether, in all your future life, you'll find anyone whose better for you, or who'll love you more. And, oh yes, you might consider stopping on the way to buy some flowers. At least you know about flowers; I remember you sent some once to me.”

Moments later, several employees in the Harlow institute were startled to see the director, Dr. Peat-Smith, running full tilt down a corridor, racing through the outer lobby, then jumping in his car and speeding away. The wedding present from Celia and Andrew to Martin and Yvonne was an engraved silver tray on which Celia had included lines from To a Bride by the Essex-born seventeenth-century poet Francis Quarles:

Let all thy joys be as the month of May, And all thy days be as a marriage day. Let sorrow, sickness and a troubled mind Be stranger to thee.

And then there was Hexin W. It was due to appear on the market in a year.

The clinical trials of Hexin W produced a few side effects in patients who had taken the drug in conjunction with other chosen drugs-such combinations being the route to effective medication via the quenching of free radicals. There were scattered reports of nausea and vomiting, and separate occurrences of diarrhea, dizziness or elevated blood pressure. None of this was unusual or a cause for alarm. The incidents were not severe, nor did they appear in more than a tiny percentage of patients. It was rare for any drug to be free from occasional side effects. Peptide 7 had been a notable exception. The Hexin W trials, which occupied two and a half years, were overseen personally by Dr. Vincent Lord. In doing so he handed over other responsibilities to subordinates, leaving himself free for what had become a task of total dedication. At this vital, near-final stage he wanted nothing to go wrong with the launching of his brainchild. Nothing which, through someone else's neglect or inefficiency, might diminish his scientific glory. Lord had watched with mixed feelings the enormous, continuing success of Peptide 7. On the one hand he experienced some jealousy of Martin Peat-Smith. But on the other, Felding-Roth was now a stronger company because of Peptide 7, and thus better equipped to handle another product that looked as if it could be equally, or even more, successful. Results from the Hexin W trials had delighted Lord. No major adverse side effect appeared. Those minor ones which did were either controllable, or unimportant in relation to the drug's positive, excellent uses. In what was known as Phase III testing, where the medication was given to patients who were ill, under conditions similar to those foreseen for later use, the outcome had been uniformly good. The drug had been taken, over substantial periods of time, by more than six thousand persons, many in hospitals under controlled conditions-an ideal setup for test purposes. Six thousand was a larger number than in most Phase 111's, but was decided on because of the need to study Hexin W's effects when taken with various other drugs, hitherto unsafe. Arthritis patients, as had been hoped, responded particularly well. They were able to take Hexin W not only alone, but with other strong anti-inflammatory drugs that formerly had been denied them. Coordinating the testing, in several widely separated locations, had been a mammoth task for which extra help had been recruited, both inside the company and out. But now it was done. Enormous amounts of data were assembled at Felding-Roth headquarters and, before submitting it to the FDA in the form of a new drug application, Lord was reviewing as much of the material as he could. Because of his personal interest, he found the process mostly a pleasure. Yet, suddenly, it ceased to be when he encountered one set of case reports. What Vince Lord read, then reread more carefully, at first caused him concern, after that perplexity, and eventually blazing anger. The reports in question were from a Dr. Yaminer who practiced medicine in Phoenix, Arizona. Lord did not know Yaminer personally, though he was familiar with the name and knew a little about the doctor's background. Yaminer was an internist. He had a substantial private practice and held staff appointments at two hospitals. Like many other doctors involved in the Hexin W testing program, he had been employed by Felding-Roth to study the effect of the drug on a group of patients-in his case one hundred. Before such studies began, the patients' permission had to be obtained, but this was seldom difficult. The arrangement was a normal one, used routinely by pharmaceutical companies wishing to field-test new drugs. Yaminer had done work for Felding-Roth before, and for other drug firms too. Doctors who contracted to do such work liked the arrangement for one of two reasons, sometimes both. Some were genuinely interested in research. All enjoyed the substantial money it brought in. For a little extra labor, spread over several months, a doctor would receive between five hundred and a thousand dollars per patient, the amount varying with the drug company involved and the importance of the medication. For his Hexin W case studies, Yaminer had received eighty-five thousand dollars. A doctor's own costs for such work were small, therefore most of the money was profit. But the system had a weakness. Because the work was so lucrative, a few doctors were tempted to take on more of it than they could property handle. This led to comer cutting and-with surprising frequency-falsification of data. In a word: fraud. Dr. Yaminer, Lord was certain, had perpetrated fraud in sending in reports about the effects of Hexin W. There were two possibilities as to what had happened. Either Yaminer had failed to do the studies he was supposed to on the patients he had named, or some, perhaps most, of the hundred listed patients did not exist, except in the doctor's imagination. He had made them up, invented them, as well as their test "results.”