Silent Epidemic (Book 1 - Carol Freeman Series)

by Jill Province

  Carol continued this tirade all the way home.  By the time she got there, she was so angry she just took a pill early and went to bed. The truth was that Carol had been so angry that day she had taken two pills. She told herself that one sometimes just didn’t get it anymore, and on days like this, the extra dose seemed justified.  In general, she had been angry about one thing or another most of the time.  This would be Carol’s number one future nemesis.  The one that ultimately had the potential to take her down.

  Carol had the whole day off and reluctantly decided to take advantage of the time.  She picked up the phone and dialed the number to the doctor’s office. When the receptionist answered, Carol made an appointment for her medication checkup.  Her blood pressure and been on the rise lately, and she had attributed that to her job.  She hoped it would be better today.  Carol checked the time. She had two hours before she had to assume the insulting role of depressed patient.  She headed to the kitchen to find coffee and some mind numbing TV.

   

  Carol entered the doctor’s office on time.  Sitting in the uncomfortable wooden chair, she was keenly aware of her own nervousness.  What if he puts me through the third degree again, Carol thought.  I don’t think I can stand another round of stupid questions.  Carol got up when her name was called. The nurse frowned at her cuffed arm and said, “one-forty over ninety.”  My God, Carol thought, this is so unusual. “You might have to consider blood pressure medication if this keeps up," the nurse said.

  “I really don’t understand this,” Carol replied. “My blood pressure has always been normal.  I guess my job is really getting to me.”

  “Well, something will have to change,” the nurse warned, and added the information to her chart.  Carol sat waiting for the doctor wondering what she had the option to change.  While she thought about it, her blood pressure wasn’t the only change she had noticed.  She had these occasional bouts of nausea and diarrhea. Sometimes she felt mild flu-like symptoms when she knew she didn’t have the flu.  Strange, Carol pondered, how stress could affect you.  This would also explain those few moments of explosiveness she had experienced.  There were times at work lately when she had come un-glued.  Things that only mildly annoyed her before had suddenly become a trigger to become enraged.  Looking back on each one of those incidences, Carol couldn’t explain the rage.  It had become an even bigger source of staff alienation, not to mention her questionable job status.

  When the door to the examination room opened, Carol was relieved.  A different, friendlier face greeted her.  “Hi, Carol,” the friendly face said. “I’m Doctor Hopton.” 

  “Oh thank God," Carol said out loud.  The Doctor just looked at her with amusement.  “I was expecting the other doctor, Carol explained.  “He always gives me the third degree.” 

  “Well, you can relax” the doctor said.  “Now what can I do for you today?"  

  Carol felt all her anxiety melt away and gave the friendly face her medication history. 

  “So, if it’s okay,” she concluded, “I wondered if we could increase the dose.  It’s losing its effect.” 

  “Sure,” the friendly face responded, and quickly wrote the prescription.

  “Thanks,” Carol said in a sigh of relief. 

  “Patients usually know what’s best,” the doctor said.  She adamantly agreed.

   

  Carol returned home and found her husband in his usual spot: in front of the computer screen. “Carol, isn’t the medication you’re taking Valipene?” Josh asked without removing his eyes from the computer, or noticing her unusually early arrival. 

  “Yeah,” Carol responded while she changed into her comfortable house grubbies. “Why?” 

  “Because I see here that a company is about to launch a generic for that drug.”  Carol waited for an explanation. “This company,” Josh said, pointing to the screen, “Dominex Pharmaceuticals. And their stock is going through the roof.” 

  “That’s nice,” Carol said, picking through the mail. 

  “It’s very interesting,” Josh said.  “They still have some sort of research to complete, but this indicates that all the players here already know the outcome.”

  “Well, the sooner the better,” Carol responded.  “The cost of this stuff is ridiculous.” 

  “Says here,” Josh continued, “that anyone willing to be a part of the final research will get their medication for free.”

  “Free?” Carol echoed. 

  “Yeah, and they will pay a thousand dollars for the trial.”

  “Where do I sign up?” Carol asked.  

  Josh turned and looked at his wife.

  “The research involves people already taking the drug."

  “Okay, that’s me," Carol said, wondering about his sudden interest. 

  “The company wants those people to go off the medication for six weeks.”

  “Oh,” Carol said.

  “Yeah,” Josh sympathized.  

  Carol just walked off saying over her shoulder,

  “So what’s for dinner?” 

  “Insomnia,” Josh said in a partial joke.  The joke was lost on Carol.

   

  Sitting in front of the TV later that night, Carol pondered the possibilities. She had gone without sleep for years. Certainly she could manage it for six weeks. A thousand dollars and free meds were worth six weeks of insomnia.

  “Josh,” Carol said.

  “Huh?” he replied while distracted by the antics of a drunk driver arguing with the arresting officer.  “They show the same idiots every week,” Josh laughed. 

  “Josh,” Carol said, louder. 

  “What?” Josh said, focusing on his wife. 

  “I think I should volunteer for that research group.”

  “Okay,” Josh said, wondering if she was really serious.  “I’ll print out all the details for you.” 

  “Maybe I don’t have to start right away.”  Carol had just increased her dosage from one to two milligram tablets and wanted to get a few last night’s sleep in before she had to go back to the long nights of insomnia.

  A commercial came on and the couple watched the confusion develop due to a garbled cellular phone conversation.  Josh shook his head while he got up to go to his computer.  When he returned, a high-speed police chase was under way.  “Here,” Josh said, and handed the printed material to Carol. Carol read the contents and pointed to the page. 

  “Here’s the contact person. I’ll call her tomorrow.”

   

   

  Chapter 6

      

  Sheila Montgomery sat in her new office. She was so happy to be off the street, so to speak, and in the real line of fire. She had volunteered to help compile the study group for the last phase of the company’s research on Suprame.  Her incentive strategy had been readily approved and was working well to attract a large group of volunteers.  Her own personal incentive had been to remain at the pulse of Dominex’s activities.  She had been the only one to volunteer for this initial endeavor, and despite Sam’s obvious reluctance to put her in the middle of their precious study he had had no choice.  She was currently in the driver’s seat.

  Although the FDA required a random group, it was Sheila’s primary responsibility to carefully screen each candidate.  The precedence that the company’s medical staff had outlined was very specific, and those who did not meet the criteria were immediately rejected.  Valipene had been prescribed primarily for seizures when it first hit the medical community twenty years before.  From there, it had also been used for a wide range of anxiety disorders.  The candidates with a history of seizures were immediately rejected for obvious reasons of liability.  There had not been too many contacts from individuals suffering from anxiety; however, a few brave souls had made contact with the company and were also rejected.  The outcome of those individuals would have had a profound effect on the r
esearch results. In fact, any candidate with a history of any kind of psychiatric problem was immediately shown the door.

  Sheila was closing in on her quota of five hundred test subjects and was looking over the list of volunteers when her secretary buzzed in. “I have a Carol Freeman on the line," her phone announced. 

  “Have you finished screening her?” Sheila inquired. 

  “Yes, ma’am, and she qualifies,” Sheila took the call.

  “Okay," she concluded. “You will be required to stop taking the drug for six weeks, and that will begin in one month.  On that day, we want you to arrive here at our office at nine AM to check in and have a physical examination."  Sheila opened the schedule book, and gave Carol her appointment and start date.  Satisfied that she had been understood, she hung up the phone and added Carol’s name to the list.

  Preparing for this study had required a lot of leg work in the beginning, but now she was finding that the project had taken on a life of its own. With things moving so well, she decided to call it a day.  Sheila was definitely enjoying coming and going as she pleased without so much as a disapproving glace from anyone.  No one in their right mind would mess with her.  She was a good “friend” of the CEO.  A relationship that was not yet completely platonic, but her ability to dodge the man had resulted in minimal contact these days.

  Sheila had a mission and her focus remained on one target and one target only.  Charles Roman was simply a means to that end.  Satisfied that there was no unfinished business, she left the office and headed home.

  * * * * * * * * * * * * *

  “I’m sorry, Mr. Edwards.  Ms. Montgomery has left for the day," the receptionist stated timidly. 

  “That’s okay," Jeff replied.  “I just need to check some of the study information.  I’ll be in and out of there."  With that, Jeff Edwards entered the empty office, leaving a skeptical receptionist as he closed the office door.  Jeff could not believe the twisty turns of his job with Dominex.  He had spent years working a traditional eight-hour day, and now he was sneaking around his old office.  Lucky for him, he did not have to try to blend into the woodwork.  He belonged here. He would not have been very good at the spy business, because he stuck out like a sore thumb.  Jeff had long thin wispy blond hair that he combed straight back and wore in a ponytail.  His appearance was somewhat awkward due to his excessive height.  He was six-foot five, and only weighed about one-ninety soaking wet. He also never had to shave.  His face and body parts remained forever hairless.   

  Jeff continued to rummage through Sheila’s drawers, looking for anything significant about the research study.  The sour expression on his face conveyed his opinion of the woman now occupying his old office.  He was not at all pleased with the shift in job responsibilities. Especially when his old position was now filled by someone he felt was so completely unqualified.  Not only was this woman out of the office more often than in, but when she was here, she seemed more interested in what every other department was doing rather than in her own.

  This made Jeff’s assignment that much easier, but the fact that marketing in general had been taking somewhat of a dive was disheartening.  After all, Jeff had built that department himself.  He felt he had a personal stake in its success.  He had to admit that a lot of the problems in the marketing department now had to do with the type of products they were selling, and that the delay in Suprame had not just effected marketing.  The entire company had taken a hit.  But there was some consolation in the fact that Sheila’s name was connected to the dive rather than his own.

  Jeff found the clipboard with the impressive list of volunteers for the research group that Sheila had compiled and noted the total. The information included the names of the volunteers, their ages and diagnosis.  There was also a space provided for the length of time the individual had been on the medication.  “Good,” Jeff said to himself, and removed the pages from the clipboard.  On his way past the secretary’s desk, he smiled and said, “I’ll have this back later.”  Jeff headed for the nearest copy machine.

  * * * * * * * * * * * * * * * * * * *

   

  The FDA had always been a complex overlay of multiple agendas.  But lately, the daily traffic was getting to be more than David Manning could manage.  He had not been in charge of final approvals until recently, but he was certainly paying the price for his predecessor’s leniency.   There had been numerous complaints coming in daily about Valipene.  These problems were not just being reported about that one medication.  The problems seemed to extend to any medication with the same underlying compound.  These drugs had been on the market for forty years.  The problem now was that people no longer took pills for an entire lifetime without question.  With the more advanced communication system of the Internet, people had access to more information and felt more autonomous in their own treatment.

  Prior requirements by the FDA had only met prior prescribing habits.  Drugs were tested based on the use and the side effects of the drugs while they were being taken.  The issue of drug termination had never really been an issue before, but it certainly had become one now.  No one at the FDA wanted to be accused of burying information, even though it had been common practice with Bob Whitford at the helm.  As long as he had remained in his position, he had covered his own tracks.  Now David found himself falling into them daily.  No wonder the guy had been able to retire so soon.   He had raked in a lot more than a government job salary. 

  The other problem David was facing was that the drug companies had grown in size and power.  There were now a staggering number of interested parties attached to its successes and failures, and many of them were not even connected directly with the companies themselves.  As more and more people in public office began to benefit from the financial success of pharmaceuticals, pressure had become hard bearing on the FDA to approve various medications, whether or not they had met all requirements.  The casualties that had been left in the wake of “FDA and political sellout” had been manageable up to this point.  David wondered how long the walls of grace could contain these potential disasters before there was a massive flood.

  David himself had recently avoided a disaster of a more personal nature.  He wished he could have taken the credit, but in the final run, it had been his wife’s amazing backbone, not his.  David would remember that day for the rest of his life.  He had not been able to bring himself to tell his wife anything.  How could he expect her to understand what he had no way of understanding himself?

  When the stripper had shown up on his doorstep, he thought he was going to have a heart attack.  It was his wife that had saved the day.  She had invited the stripper to come inside, and then quietly listened to her story.  When the girl was done, his wife had calmly sent her away, stating that she had already known about her husband’s brief indiscretion.

  “Did you really know?" David had asked, closing the door and still in fear for his marriage. 

  “David," his wife answered. “Do you really think I could be married to you all this time, and not know when there is a problem?” 

  “Why didn’t you say something?" David said, in a rush of relief. 

  “I didn’t say I was happy about it," his wife answered, and walked off.  She did not inflict any further verbal punishment on him.  As far as she could tell, he had already suffered the required amount.

  Now, David was free.  He had spent months feeling trapped inside the clenched fist of Dominex Pharmaceuticals and now they would pay the price.  “Those people have no idea who they are screwing with," he said out loud with a new sense of power.  David looked at the preliminary research proposal submitted by Dominex.  He couldn’t see any holes in it initially, but he would find them eventually.  “That drug will never see the light of day if I have to die keeping it off the market." 

  * * * * * * * * * * * * * * * * * * * * * *

   


  March twentieth was a date that Carol would remember forever.  It was the day she was demoted from her management position at Newberg Mental Health. Driving home in the freezing car, she ran over the events in her head.  She had been summoned to Spears’s office.  She had not felt nervous or worried.  She had felt numb.  Spears had not said a word, and had simply handed her a form to read.

   

  This is to inform you that you have been terminated from your position with Tri-County Health Systems as Addiction Program Manager, effective this date.  You are being offered the position of addiction counselor with Newberg Mental Health.  If you have any further questions regarding your transfer, you may contact the Department of Human Resources.

   

  There had been a whole page of legal mumbo jumbo, but Carol did not take the time to read it.  She had gotten the message.   Starting Monday, she would be working in the same department, but would no longer be the manager.  “Sign it," was all Spears had said to her.  Carol had just gazed back at the tiny man.  She knew she had made some mistakes, but her heart had always been in the right place.

  Carol had started out with so much respect for Spears.  In the final run, Buck Spears had turned out to be the perfect model of a state worker.  The unspoken code of ethics at Tri-County was “Never make waves.”  The order of the day in a wave-free work place required tight controls.  No one who had the potential to create those waves was allowed to survive, regardless of how valid the issue.  Carol had not been Spears’s first casualty, and knew she would not be his last. 

  As she pulled up to a stoplight, Carol began to feel the temperature of the car, and adjusted the heat.  As her state of numbness subsided, Carol felt a sense of sadness and relief.  She drove the remaining miles home.

   

  Josh Freeman was a man driven by his desire to be free.  He believed in the great American dream.  He just didn’t agree with the traditional method of obtaining it.  He compared the forty-plus hour workweek lifestyle to running a marathon on a treadmill.  In the end, you may have run a thousand miles, but you are in the same place as where you began.  The system was designed to feed itself.  Its manpower was simply a means of continuation, with no end in sight for the worker bee.  His vision of happiness was the open road and a whole world waiting to be explored.