Arthur Hailey - Strong Medicine

"And going back to the subject of research, Thalidomide was not tried experimentally on a wide range of animals before it was put to human use. After the banning of Thalidomide, for example, experiments with animals showed that some breeds of rabbits produced the same deformed foetuses as humans, demonstrating that if those full animal studies had been done, the human tragedies would never have happened.”

Celia paused, referring to her notes which she had prepared carefully for this and later occasions. Still with the same attention focused on her, she said, "Montayne, on the other hand, has had the fullest possible range of tests-including tests on various types of animals, as well as on human volunteers-in five countries, all of which have strict laws affecting drug control. Moreover, in most of those countries Montayne has been used by many thousands of women for well over a year. Let me give you just one example of how thoroughly this research and testing program has been carried out.”

Celia described the decision of Laboratoires Gironde-Chimie, the French discoverers of Montayne, to do an additional year of medical testing over and above that required by French law, to be certain of their product's quality. "Probably no drug ever introduced before," she added, "has been tested more thoroughly for safety.”

Following Celia's speech, scientific spokesmen from the company endorsed her words and answered questions from the sales force.

"How did your sales presentation go?" Andrew asked an hour or so later in the comfortable luxury of their suite at the Stanford 'Court. He had taken a few days off from his practice to accompany Celia westward and, at the same time, visit Lisa, now a freshman at Stanford and living on campus. "Well enough, I think.”

Celia kicked off her shoes, stretched tiredly, and put her feet up on a sofa.”In some ways, regional sales meetings are like a traveling road show, so we should get better with each performance.”

She regarded her husband curiously.”Do you realize that was the first time you've asked me a question about anything to do with the progress of Montayne?" "Is it?" He tried to sound surprised. "You know it is. I'd like to know why.”

"Maybe it's because you tell me everything, so I've never needed to ask.”

"That isn't true," Celia said.”The truth is, you still have reservations, haven't you?" "Look," Andrew objected, putting aside a newspaper he had been reading when she came in, "I'm not qualified to make judgments about a drug I haven't used. You've a host of scientific people, here and abroad, who know much more than I do. They say Montayne is okay. So...”

He shrugged. "But would you prescribe it for a patient?" "I don't have to. Fortunately I'm not an obstetrician or a gynaecologist.” "Fortunately?"

"A slip of the tongue.”

Andrew said impatiently, "Let's talk about something else.”

"No," Celia persisted; there was an edge to her voice.”I want to talk about this because it's important to both of us. You always used to say no woman should take any drug during pregnancy. Do you still believe that?" "Since you ask-yes, I do.”

"Isn't it possible," Celia said, "that while you were right once, that view could now be out of date? After all, it's a long time since you began practicing medicine-twenty years-and many things have changed.”

She remembered something Sam had told her.”Weren't there doctors who opposed anesthesia for pregnant women because they said... T' Andrew was becoming angry.”I told you I don't want to talk about this.”

She snapped back, "But I do!" "Dammit, Celia! I'm not involved with your Montayne and don't intend to be. I've already admitted I don't have the knowledge-" "But at St. Bede's you have influence.”

"Which I will not use-one way or the other-about Montayne.”

They were glaring at each other when the telephone rang. Celia swung her legs down and reached out to answer. A woman's voice inquired, "Mrs. Jordan?" "Yes.- "This is Felditig-Roth, Boonton. Hold, please, for Mr. Hawthorne.”

Sam came on the line.”Hi, Celia. How is everything going so far?" "Very well.”

The positive mood in which she had left the Fairmont session returned.”The presentations have gone smoothly, Everyone in the field is keen, and anxious to begin selling Montayne.”

"Great!" "Of course, the question we're all asking is: How soon will we get FDA approval?" There was a silence during which Celia sensed Sam hesitating, then he said, "For the moment, this is confidential between you and me. But I can say positively we will get FDA permission, and very soon.”

"May I ask why you're so sure?" "No.,' "Okay.”

If Sam wanted to be mysterious, Celia thought, that was his privilege, though between the two of them she could see no reason for it. She asked, "Is everything good with Juliet?" "And with my soon-to-be grandchild?" Sam chuckled.”I'm delighted to say, yes.”

Three months ago, Juliet and Dwight Goodsmith had happily announced Juliet's pregnancy. The baby was due in January. "Give Lilian and Juliet my love," Celia said, "and tell Juliet that with her next pregnancy she'll be able to take Montayne.”

"Will do. Thanks, Celia.”

Sam hung up. While Celia was on the telephone, Andrew had gone into the bathroom to shower, then dress, prior to a thirty-five-mile drive to Palo Alto where they were due for dinner with Lisa and several newfound Stanford friends. During the drive and the dinner, which was relaxed and cordial, neither Celia nor Andrew referred to their argument at the hotel. At first there was a coolness between them, but it disappeared as the evening progressed. By that time, also, Celia had decided to leave well alone and not raise the subject of Montayne with her husband again. After all, everyone in the course of a lifetime had occasional mental blind spots and-though it disappointed herthis was clearly one of Andrew's.

Sam Hawthorne, replacing the telephone after his Boonton-San Francisco conversation with Celia, found himself wishing he had not made the impulsive, positive statement he had concerning FDA approval of Montayne. It was unwise and indiscreet. Why had he done it? Probably for no other reason than the human one of seeking to impress another person-in this case Celia. He must watch himself, he decided. Especially after his discussion an hour ago with Vincent Lord and the decision they had reached jointly. It was a decision that could have disastrous repercussions if it were found out, though it must not be--ever. All the more reason, then, to let the FDA's approval of Montayne, when it happened, seem natural and ordained. As it should have been, and would have been, except for that arrogant, insufferable, criminal bureaucrat at FDA I It was sheer bad luck that the new drug application for Montayne had drawn Dr. Gideon Mace as the reviewer. Sam Hawthorne had not met Mace, and didn't want to. He had heard more than enough about the man from Vince Lord and others, and about the trouble Mace caused Felding-Roth, first with the unreasonable delay two years ago over Staidpace, and now with Montayne. Why should people like Mace possess the power they had, Sam fumed, and have to be endured by honest businessmen who sought, from the Maces of this world, no more than equal honesty and fairness? Fortunately, people like Mace were a minority-at FDA a small minority; Sam was certain of that. Just the same, Mace existed. He was currently sitting on the Montayne NDA, using regulations, procedural tactics, to delay it. Therefore a way to circumvent Gideon Mace had had to be found. Well, they had a way. At least, Felding-Roth had, in the person of Vince Lord. Originally, when Vince had collected-no, make that bought evidence of criminality by Dr. Mace, purchased it with two thousand dollars of Felding-Roth cash, the voucher for that cash now buried deep in the travel expense account where auditors or the IRS would never find it... at that time Sam had been angry, critical of Vince, and shocked at the thought that the material might ever be used in the way which Vince envisaged. But not now. The existing situation affecting Montayne was too critical, too important, for that kind of scruples anymore. And that was another cause for anger. Anger because criminals Re Mace begat criminality in others-in this case, in Sam and Vincent Lord -who had to use those same low-grade tactics for reasonable self-defense. Damn Macel Still soliloquizing silently, in the quietness of his office, Sam told himself. A penalty you paid for appointment to the top job in any large company was having to make unpalatable decisions authorizing actions which, if they happened elsewhere or in a vacuum, you would consider unethical and disapprove of, But when you shouldered responsibilities involving so many people, all of them dependent on you-shareholders, directors, executive colleagues, employees, distributors, retailers, customers-it was necessary at times to swallow hard and do what was needed, however tough, unpleasant or repugnant it might seem. Sam had just done that, an hour ago, in okaying a proposal by Vincent Lord to threaten Dr. Gideon Mace with exposure and therefore criminal charges if he failed to expedite the approval of Montayne. Blackmail. No point in mincing words or hiding behind euphemisms. It would be blackmail, which was criminal too. Vince had laid his plan bluntly in front of Sam. Equally bluntly Vince declared, "If we don't make use of what we have, putting pressure on Mace, you can forget any idea of marketing Montayne in February, and maybe for another year.”