It was Dr. R. K. Smile himself who thought up the speakers’ bureau. Actually, one part of the idea wasn’t original. The idea of recruiting big-name doctors to recommend a particular medication to other doctors was an old one. Word of mouth was always recognized as the most effective marketing device. But if you wanted to go off-label, hmm. That was borderline. Maybe across-the-borderline, because going off-label meant getting doctors to prescribe a drug for conditions other than the ones stated on the label, for which the drug was intended. Or, of course, for no conditions at all, turning a blind eye to recreational use, or, more seriously, to addiction. Another, more colloquial term for going off-label might be becoming a drug dealer. Or even becoming a narco lord.
“I’ve spent my life crossing borders,” said Dr. R. K. Smile, at the opening of the first session of SPEIK (Smile Pharmaceuticals Expanding Information and Knowledge) in Eureka, Montana (pop. 1,037), a smallish gathering which took place in the historic Community Hall, a single-story log building in the rustic style. “I read it in a book once: if you fly above the Earth and look down, you see no frontiers. That’s my attitude. I’m a no-frontier guy in favor of flying high.” That was the secret ethos of SPI. They were all high-flying no-frontier guys.
After the Eureka meeting Dr. Smile allocated a budget of three million dollars toward the speakers’ bureau project. Over time the project became even more sophisticated in its methods. Doctors were identified and booked, fees were paid, and then, more often than not, the events unfortunately could not take place owing to unforeseeable circumstances, but the terms of the agreements with the doctors stated that the speaking fees were nonreturnable. A budget of three million dollars a year, handed out in substantial dollops of, for example, $56,000 p.a., or $45,000 p.a., or $33,000 p.a., or $43,000 p.a., or even $67,000 p.a., in return for performing speaking engagements which did not actually have to be performed! Such a budget offered opportunities that were attractive to a lot of doctors. Such a budget bought—or to use a more polite term, booked—some very senior doctors. And these were tough doctors, ready to receive these substantial sums in return for prescribing InSmile™ off-label, willing to recommend doing so to other doctors, and able to take any heat that followed.
Yes, unfortunately, some of them got investigated by their state medical boards, but they just handled it! They paid the fines and carried on. Yes, unfortunately, in the worst cases there was disciplinary action when, unfortunately, some of the tough doctors went too far! When unfortunately they allegedly handed out multiple pre-signed prescriptions to patients and some of said patients died of drug overdoses from the drugs so prescribed! When unfortunately they allegedly prescribed InSmile™ to persons with zero cancer pain! When unfortunately they allegedly defrauded Medicare of multiple millions of dollars! When unfortunately they allegedly billed insurance companies for procedures they never performed! A pain management specialist from Rhode Island who was also a SPEIK speaker was reprimanded! A neurologist who was a SPEIK speaker was arrested! These matters were shocking to Dr. Smile and all the SPI team. They moved swiftly to rectify or terminate their relationships with such medical practitioners. They were a reputable company. They were running a speakers’ bureau on the side, that was all. They were not and could not be held responsible for what their speakers might be doing on their own time. SPEIK was a reputable and highly regarded program and if its speakers believed in InSmile™, that was because of the inherent quality of the product. It was ridiculous and even slanderous to impugn the ethics of SPI staff. Yes, it was true, some of the adult children of SPEIK speakers were employed by SPI as part of the sales force, but that was on account of their high levels of beauty, not their parentage. These were grown independent men and women and it would be insulting both to their level of beauty and to SPI to allege that their employment was a ruse to give SPI leverage over their parents. SPI had no need to twist people’s arms. The profession liked buying what SPI had to sell.
One of Dr. R. K. Smile’s favorite doctors, Dr. Arthur Steiger, an experienced pain specialist from Bisbee, Arizona (pop. 5,200), was ordered to stop prescribing painkillers completely while serious allegations against him were investigated. At that time he had received more speakers’ fees from SPEIK than any other medical practitioner, even though unfortunately all the much-anticipated events at which he had been billed to speak had had to be canceled owing to unforeseeable factors. Dr. Steiger fought back when he was indicted. “There is a vendetta against doctors who prescribe opioids regularly,” he said. “But me, I’m the aggressive type. I aggressively help my patients. I’m the caring type also. I care aggressively. That’s just who I am.”
“I couldn’t have said it better myself,” Dr. R. K. Smile said to Happy when he read this statement.
She nodded lovingly. “You also are a fighter like this Dr. Arizona,” she said. “Look how you have fought for your family. So so many achievements, so so much success. And when I have done my work and your name is everywhere, museums, concert halls, fish tanks, parks, then you will be too too respected by so so many people and all this noise will go. It is the Age of Anything-Can-Happen,” she explained. “This I heard on TV. And I will make Everything happen for you.” Her support warmed his heart. He loved his wife. He wondered if it would upset her if he asked her to lose a little weight.
* * *
—
THE FLICKED-UP WINGTIPS OF the G650ER reminded Dr. R. K. Smile of his wife’s hairdo. If Happy Smile’s hair were an executive jet, he thought, it would fly him nonstop to Dubai. The aircraft was his favorite toy. Sometimes on a still and sunny day he took it up from Hartsfield-Jackson just to potter about in the sky for a few hours, over Stone Mountain and Athens (pop. 115,452), Eatonton (pop. 6,555), and Milledgeville (pop. 18,933), the Chattahoochee and Talladega forests, or the route of Sherman’s march. Stonewall Jackson, Robert E. Lee, Brer Rabbit, the Tree That Owns Itself, and the War between the States were all down there and he was above them, feeling at such moments like a true son of the South, which of course he was not. He had tried to read Gone with the Wind and to learn the words of “Zip-a-Dee-Doo-Dah” and “Old Folks at Home,” but fiction and music weren’t his thing. Also, like all cultural artifacts, they reminded him of his wife; and when he went up in the sky he didn’t bring Happy along. Instead he invited a half dozen of the most attractive SPI sales reps, former colleagues of Dawn Ho’s at Jennifer’s strip club in West Palm Beach, and what happened up in the air stayed up in the air. Dr. R. K. Smile was not a perfect husband, he conceded that in his rare moments of inwardness and reflection, but in his opinion these episodes (a) did not take place on earth and so didn’t count on earth and (b) in fact made him a better husband by satisfying his secret recreational urges, his off-label desires.
Flying home from Flagstaff after his encounter with old Quichotte, he was sad, and not even the ministrations of all six salesladies simultaneously could blow away his blues. His poor relation Ismail Smile had always been an anomaly in the ranks of SPI employees, old among the young, emaciated among the luscious, a lonely figure, permanently out of step, everyone’s crazy grandpa. And yet he carried himself with a certain dignity, kept himself immaculately dressed and groomed, was well mannered, well spoken, and possessed an enviably large vocabulary, was almost always cheerful, and could unleash, at any moment, his one weapon of beauty, which was his smile. Dr. R. K. Smile feared the worst now that he had let Quichotte go. The old fellow would deteriorate into some sort of dharma bum, moving aimlessly from nowhere to nowhere, dreaming his impossible dream of love. And one of these days Dr. R. K. Smile would receive a call from a motel in the middle of nowhere and then he would have to climb into the G650ER and bring the old man’s body back with him to Atlanta and lay him to rest in Cobb County or Lovejoy. That day would probably not be far away.
In his final exchanges with Quichotte he had hinted at asking him to perform some small private services, some discreet deliveries, b
ut he hadn’t meant it. It had been a way of getting out of the room while leaving Quichotte with a scrap of self-respect and the sense of still being needed. The private services, or VIP, division of Smile Pharmaceuticals did not officially exist, and its unofficial existence was known only to a very small group, which did not include Dr. R. K. Smile’s loyal wife. The discreet servicing of the desires of the very famous was a subsection of the American economy which it was important not to ignore, but the key word there was discreet. Dr. Smile was discreet, and was willing to make house calls to the right people. Lately the demand for InSmile™ among these special, house-call-worthy customers had increased significantly, owing to a change in the OxyContin formula that decreased its appeal to recreational users, and to the special customers’ growing awareness that the sublingual spray offered instant gratification in a way that the other popular products did not. More and more gated properties from Minneapolis to Beverly Hills opened themselves to his unpretentious rental cars. He himself, small, physically unimpressive, was the forgettable type, and being forgettable was an asset in this kind of work, it assisted discretion. Like everyone in America, Dr. Smile was in thrall to celebrity, and when he entered the boudoirs and man caves of magazine-cover faces and bodies, he experienced a profoundly American joy, deepened by his secret knowledge that his net worth was probably greater than that of most of the owners of those immensely celebrated, those erotically well-known eyes, mouths, breasts, and legs, those prime manifestations of what Dr. Smile—a doctor, after all—thought of as professionally assisted perfection. He, too, was a professional. In his own way he, too, could assist.
When, some time later, a whisper reached him, the faintest murmur from one of his top, inner-circle speakers’ bureau doctors, that a certain Indian movie actress turned American daytime TV superstar might appreciate a house call, Dr. R. K. Smile actually laughed out loud and clapped his hands. “Arré, kya baat!” he cried out in the privacy of his home office. “Whoa, what a thing!” Because now, if it all worked out as he hoped, he just might be able to make possible his poor relation’s impossible dream, at least once before the tragic inevitable occurred. He might find it in his power, and in his heart, to bring fantasy-besotted old Quichotte face-to-face with his lady love.
But we are getting ahead of ourselves. The secret approach from Miss Salma R still lay a little way ahead, in the shrinking future of the world.
Sancho Smile. That’s my name. Got that. But there’s a whole lot else I’m kind of blank about. I don’t know if I’m even really here, to tell the truth. For one thing I’m black-and-white in a full-color universe. I look at my face in a mirror and it looks like not a face but a photograph of a face. How do I feel about that? Second class. Minor league. That’s how. Also, I don’t seem to be visible right now to anyone except him. My “father.” Only he sees me. I know I’m not perceived, because when we go into the Subway in Moorcroft, Wyoming, where I was born, and he asks me if I want something, a soda, a sandwich, people look at him. That look people use on crazy people. Like he’s talking to himself, and I want to yell out, See me. I’m standing right here. But to other people I’m apparently impossible to sense. I’m what’s the word. Imperceptible.
I’m a teenager imagined by a seventy-year-old man. I guess I have to call him Dad. But here’s the thing. How am I supposed to feel properly what’s the word. Filial. When we just met. I didn’t grow up with him, we didn’t play ball in any park or whatever dads and sons do in real life. I’m just here, boom, one minute I wasn’t and the next minute I was, and what am I supposed to feel? Love at first sight? I don’t think so.
This is a problem.
I’m bounded by the limits of him. Tied to him. I’m guessing this is a thing other kids don’t feel about their dads. That when I move away from the person who made me, when I get some distance away, I feel, how to say this. Out of range. Like, the signal drops, or it threatens to drop. If I try to walk away from him, if I need my own space for a moment?, without him always breathing down my neck?, if I get too far, I start—I don’t know how to put it—breaking up. Parts of me become just static. I look like a bad TV picture. Like, wobbly. It’s scary. I have to go back to wherever he is to regain full definition. I have to move back in and stay close, or otherwise maybe I’d stop being here at all. This is something I don’t like to feel. To be chained to another human being, like a possession. For this I know what’s the word.
Slavery.
Also, not to sound sorry for myself, but I’m a motherless child. I think a lot about mother-love, how that would be, a mother, mom, stroking my hair, her bosom for my pillow.
* * *
—
I KNOW THINGS. EDUCATED THINGS. But how do I know so much, being the teenage son of a seventy-year-old, and born just the other day? I guess the answer is, I know what he knows. If I listen inside myself I hear his book learning and all his favorite TV shows also—I know them all as if I watched them myself. And if I look I can see his memories as if they were mine, memories of falling out of a tree as a little boy and needing stitches in his head, memories of kissing an Australian girl when he was nine years old and cutting his tongue on the braces on her teeth, memories of bicycle accidents and school detentions and his mother’s cooking. All his memories planted in my head.
There’s something else. It’s the strangest thing. Sometimes, when I’m in here, rummaging around in my own head, using the words he gave me and the knowledge he passed down, uncovering my memories which are his memories, his life story which I could claim as my own if I wasn’t smart enough to know better…just sometimes, not every time…I get the weirdest sense that there’s someone else in here. Crazy, right? I’m as crazy as he is, the old guy. But who or what is this third person? I’m just going to say this the way it comes to me to say it, even though it makes no sense and makes me sound…unreliable. It feels to me, at those moments when I have this sense of a stranger, as if there’s somebody under slash behind slash above the old man. Somebody—yes—making him the way he made me. Somebody putting his life, his thoughts, his feelings, his memories into the old man the way the old man put that stuff inside me. In which case whose life am I remembering here? The old man’s or the phantom’s?
This is driving me nuts. Who is that under there slash over there slash in there? Who are you? If you’re his Creator, are you mine as well?
There’s a name for this. For the person behind the story. The old guy, Dad, he has a lot of material on this. He doesn’t seem to believe in such an entity, doesn’t seem to sense his presence the way I’m doing, but his head is full of thoughts about the entity all the same. His head and therefore my head too. I have to think about this now. I’ll just come right out and say it: God. Maybe he and I, God and I, could understand each other, maybe we could have a good discussion, because, you know, both imaginary.
If you get imagined into being, does that mean that after that you can just be? If I knew how to reach him, God, I’d ask him that. And also, does he really feel seen? I understand that plenty of people say they talk to him every day, they walk with him, etc., but does he really truly do that? I mean step out beside them on the sidewalk, looking out for oncoming pedestrian traffic. I doubt it. I’m the one out here trying not to let people bump into me, because I’m imperceptible. See above.
Even God had a mother. That’s a difference between us. I’ll put that in the plural. Even gods had moms. Holy Mary mother of etc. Also Aditi mother of Indra. Also Rhea mother of Zeus. If I knew how to reach them, I’d ask them about the benefits of mother-love. Were they close? Was it wonderful? Did they talk? Was maternal guidance given and gratefully received? Did they use those bosoms for their pillows?
Also, a question regarding beginnings: Did the mothers have mothers? I’m confused. Is there nothing before the mother, no space or time for there to be anything in, until the Birth and after that, everything? I ask because I have only him, Dad, but before
him presumably another father and another, begat begat begat. But me, he made me all by himself using what’s the word. Parthenogenesis. Water fleas, scorpions, parasitic wasps, and me. Gods could do this also. Dionysus born from the thigh of Zeus. But he, Dad, he’s not godlike. I say this not to be rude but because it’s obvious. This is no Olympian being.
* * *
—
TIME TO BE STRICT with myself. Get real, Sancho. There’s probably nothing slash nobody behind the story. It’s just some kind of illusion. Double vision. Echo chamber. Déjà vu. I don’t know what to call it. It’s just him, Dad, becoming an echo of himself. That’s it. I’m going with that. Beyond that, there’s only madness, a.k.a. getting religion. I have no intention of going crazy or getting religion. One nutty old coot is more than enough in this car.
However: I’m reserving the right to think about this some more.
* * *
—
SOMETHING MUST HAVE HAPPENED to him sometime. Something went wrong with him somewhere along the line. It’s buried deep but I’m looking. I’m looking under Roseanne and Ellen and Whoopi and Carpool Karaoke and all the rest. He’s got so much book learning in his head under the TV stuff, it even comes out of my mouth, and I never looked at a book that didn’t have a gorgeous lady on the cover, preferably deficient in the wardrobe department. Maxim, Sports Illustrated swimwear edition, these are my idea of books. This is what I check to keep in touch with what’s going on. Even those I haven’t checked so many of, my period on the planet being so far of brief duration. But he has the whole big-word library in his head—and what does he do with it? Watches reruns of old sci-fi movies about close encounters and the end of the world. And Special Victims Unit, he would be in love with Mariska Hargitay a.k.a. Olivia Benson if he wasn’t already crazy smitten with Miss Salma R, America’s Oprah 2.0, specially tooled for the younger demographic.
Quichotte Page 9
