Side Effects

by Michael Palmer

  "Well what, sugar? " The attendant rapped twice on the trunk that he was done. "Company account, Harley, " Paquette called out as he pulled away.

  "Which is it, man or woman?"

  "Which is what, darling'?"

  "God! Daddy, you're not even listening to me at all." She was seven years old with sorrel hair pulled back in two ponytails and a China doll face that was, at that moment, trying to pout. Paquette swung into a space in front of Darlington Army/Navy and stopped. Never totally calm, he was, he knew, unusually tense and distracted this morning. Still, it was Second Thursday and that gave him the right to be inattentive or cross, as he had been earlier with his wife. He turned to his daughter.

  She had mastered the expression she wanted and now sat pressed against the car door displaying it, her arms folded tightly across her chest. In that instant, Paquette knew that she was the most beautiful child on earth. He reached across and took her in his arms. The girl stiffened momentarily, then relaxed and returned the embrace. "I'm sorry, sugar,"

  Paquette said. "I wasn't listening. I'm sorry and I love you and I think God is a woman if you're a woman and a man to someone who's a man and probably a puppy dog to the puppy dogs."

  "I love you too, Daddy. And I still don't know why I should have to pray to Our Father when God might be Our Mother."

  "You know, you're right. I think that from now on we should say… Our Buddy who art in Heaven."

  "Oh, Daddy."

  Paquette checked the time. "Listen, sugar, my meeting is in half an hour. I've got to get going. You be brave, now."

  She flashed a heart-melting smile. "I don't have to be brave, Daddy.

  It's only a cleaning."

  "Well then, you be… clean. Mommy will be by in just a little while.

  You wait if she's not here by the time you're done." He watched as she ran up the stairs next to the Army/Navy and waited until she waved to him from behind the picture window painted Dr. Richard Philips, DDS.

  Then he eased the Mercedes away from the curb, and headed toward the south end of town and his eleven o'clock Second Thursday meeting with Cyrus Redding, president and chairman of the board of perhaps the largest pharmaceutical house in the world. The. meeting would start at exactly eleven and end at precisely ten minutes to noon. For seven years, as long as Paquette had been with the company, it had been like that, and like that it would remain as long as Cyrus Redding was alive and in charge. Nine o'clock, labor relations, ten o'clock, public relations, eleven, product safety, an hour and ten minutes for lunch, then research and development, sales and production, and finally from three to three-fifty, legislative liaison, department heads meeting with Cyrus Redding, one on one, the second Thursday of each month. The times and the order of Second Thursday were immutable. Vacations were to be worked around the day, illnesses to be treated and tolerated unless hospitalization was necessary. Even then, on more than one occasion, Redding had moved the meeting to a hospital room. Second Thursday, raises, new projects, criticisms, termination-all, whenever possible, on that day. The factory covered most of a thirty-acre site bordered to the south and west by pine-covered hills and to the east by Pinkham's Creek. Double fences, nine feet high with barbed wire outcroppings at the top, encircled the entire facility. The inner of the two barriers was electrified — stunning voltage during the day, lethal voltage at night and on weekends. The only approach, paralleling the new railbed from the north, was tree lined and immaculately maintained. Two hundred yards from the outer fence, a V in the roadway directed employees and shippers to the right and all others to the left. A rainbow

  sign, spanning the approach at that point announced, REDDING PHARMACEUTICALS, INCORPORATED DARLINGTON, KENTUCKY 1899

  "The Most Good for the Most People at the Least Cost" Paquette bore to the right beneath the sign and stopped by a brightly painted guardhouse, the first of a series of security measures. He found himself wondering, as he did on almost every Second Thursday, if knowing what he knew now, he would have left his university research position in Connecticut to become director of product safety. The question was a purely hypothe ical one. He had taken the job. He had agreed to play Cyrus Redding's game by Cyrus Redding's rules. Now, like it or not, he was Cyrus Redding's man. Of course an annual salary that, with benefits, exceeded four hundred thousand dollars went far toward easing pangs of conscience. Suzy was the youngest of three children, all of whom would one day be in college at the same time. He stopped at the final pass gate, handed the trunk key to the guard, and drummed nervously on the wheel while the man completed his inspection. It hardly paid to be late for a Second Thursday appointment. + Over the hundred and eighty years since Gault Darling led a band of renegades, moonshiners, and other social outcasts to a verdant spot in the foothills of the Cumberlands, and then killed two men for the right to have the new town named after himself, Darlington, Kentucky, had undergone any number of near deaths and subsequent resurgences. Disease, soldiers, Cherokees, floods, fires, and even a tornado had at one time or another brought the town to its knees. Always, though, a vestige survived, and always Darlington regrew.

  In 1858, the Lexington-Knoxville Railway passed close enough to Darlington to send off a spur, the primary purpose of which was the transport of coal from the rich Juniper mines. By the end of the century, however, output from the Junipers had fallen to a trickle, and the railbed was left to rot. Darlington was once again in danger of becoming a ghost town. Shops closed. The schoolhouse and Baptist church burned down and were not rebuilt. Town government dwindled and then disappeared. In the end, where once there had been well over a thousand, only a handful remained. Fortunately for the town, one of those was Elton Darling, self-proclaimed descendant of Gault. In 1897, Darling engineered a massive hoax utilizing three pouches of low-grade gold ore, two confederates, and a remarkable ability to seem totally inebriated when stone sober. Rumors of the "Darlington Lode" spread quicky through cities from Chicago to Atlanta, and Darlington acquired an instant citizenry, many of whom stayed on, either out of love for the beauty of the area or out of lack of resources to move elsewhere. Having single-handedly repopulated his town, Elton Darling set about giving it an industry, making use of the area's only readily available resource, the sulfur-rich water of Pinkham's Creek, a tributary of the Cumberland River. In less than a year, with some food coloring smoky-glassed bottles, an attractive label, and an aggressive sales force, the vile water of Pinkham's Creek, uninhabitable by even the hardiest fish, had become Darling's Astounding Rejuvenator and Purgator, an elixir alleged effective against conditions ranging from dropsy to baldness. Over the years before his death in 1939, Elton Darling made such changes in his product as the market and times demanded. He also made a modest fortune.

  By the time his son, Tyrone, took control of the family enterprises, the rejuvenator had been replaced by a variety of vitamin and mineral supplements, and Darlington Pharmaceuticals was being traded, though lightly, on the American Stock Exchange. Far from being the visionary and businessman his father was, lyrone Darling spent much of his time, and most of his money, on a string of unsuccessful thoroughbreds and a succession of city women, each of whom was more adept at consuming money than he was at making it. Darling's solution to his diminishing cash reserves was simple, issue more stock and sell off some of his own. In the fall of 1947, at the annual Darlington stockholders meeting, the ax fell. Intermediaries for a man spoken of only as Mr. Redding produced proof of ownership of more than fifty-three percent of Darlington Pharmaceuticals and in a matter of less than a day, took over the company on behalf of Mr. Cyrus Redding of New York, New York. Stripped of influence, as well as of a source of income, Darling tried to negotiate. To the best of anyone's knowledge, he had not succeeded even in meeting with the man who had replaced him when, on the following New Year's Eve, he and a woman named Densmore were shot to death by the woman's husband. Thus it was that the fortunes of Darlington, Kentucky became tied to a reclusive genius named Cyrus Redding and to the pharmaceutica
l house that now bore his name. In the years to follow, there were a number of minor successes, Terranyd, a concentrated tetracycline, Rebac, an over-the-counter antacid, and several cold preparations.

  Redding Pharmaceuticals doubled in size, and the population of Darlington grew proportionally. Then, in the early 1960s, Redding obtained exclusive U. S. patents to several successful European products, including the tranquilizer that was, following a blitzkrieg promotional campaign, to become one of the most prescribed pharmaceuticals in the world. A year after release of the drug, Darlington was selected an All american City, and shortly after that, the Darlington Dukes minor league baseball franchise was established.

  Marilyn Wyman sipped at a cup of tea and risked a minute glance at her gold Rolex. Ten minutes to go and another Second Thursday would be over for Redding's director of public relations. From across his enormous desk, Cyrus Redding appraised her through his Coke-bottle spectacles.

  "There are exactly eight minutes and thirty seconds to go, Marilyn," he said. "Does that help?"

  "I'm sorry, sir." Wyman, in her midfifties, had been with the company longer than had any other department head. Still, no one had ever heard her refer to her employer as anything other than Mr. Redding or, to his face, sir. She had close-cut gray-brown hair and a sophisticated sensuality that she used with consummate skill in dealing with media representatives of both sexes. "We have one final piece of business. No small piece, either. It's Arthgard."

  "I thought it had been taken off the market."

  "In England it has, but not yet here. It has been only eight weeks since we released it and already it is in the top forty in volume and the top twenty-five in actual dollar return."

  "That's a shame. The feedback I've gotten from pharmacists and patients has been excellent, too. Still, the British have proven it responsible for how many deaths so far, sixty?"

  "Eighty-five, actually."

  "Eighty-five." Reflexively, Wyman shuddered. Arthgard had been released to the American market almost immediately after the patent had been acquired by Reddinz. Though she had no way of knowing how it had been accomplished, the FDA-required testing periods, both laboratory and clinical, seemed to have been circumvented. It was not her place to ask about such things. Testing was the provinoe of Arlen Paquette, and the exchange of information between department heads was not only frowned upon by Redding but, in most cases, forbidden. "Well, we still have Lapsol and Carmalon, " she said. "The figures I looked at yesterday showed them both in the top ten of antiarthritic preparations. I'll write a press release announcing the suspension of our Arthgard production and then see what I can do to remind the public about both of those other products."

  "You will do no such thing, Marilyn."

  "Pardon?"

  Redding pulled a computer printout from a file on his desk. "Do you have any idea how many millions it cost us to buy the Arthgard patent, test the product, go into production, advertise, get samples out to physicians, and finally distribute the product to pharmacies and hospitals? Correction, Miss Wyman. Not how many millions-how many tens of millions? " Marilyn Wyman shook her head. Redding continued. "The projections I have here say that, at our present rate of increase in sales, the product would have to stay on the market for another ten weeks just for us to break even. That is where you will be concentrating your efforts."

  "But…" Redding's icy look made it clear that there was to be no dialogue on the matter. She stared down at the toes of her two-hundred-dollar Ferragamo pumps. "Yes, sir."

  "I've got some preliminary data from that survey firm you contracted with showing that less than forty percent of physicians and less than ten percent of consumers are even aware of what's going on in England. I want those numbers to stay in that ball park for the next ten weeks."

  "But…"

  "Dammit, I am not looking for buts. I am looking for ten weeks of sales so that we can get our ass out of this product without having it burned off. Our legislative liaison will do his job with the FDA. Now if you want to give me buts, I'll find a PR person who does her job.

  And need I remind you that her first job will be to do something creative with that M. Wyman file I have locked away?"

  Wyman bit at her lower lip and nodded. It had been several years since Redding had mentioned the collection of photographs, telephone conversations, and recordings from the company hotel suite she had vacationed in at Acapulco. Beneath her expertly applied makeup, she was ashen. Redding, seeing the capitulation in her eyes, softened. "Marilyn, listen. You do your part. I promise that if there's any trouble on this side of the Atlantic with Arthgard, we'll pull it immediately. Okay?

  Good. Now tell me, how's that little buggy of yours riding?"

  "The Alpha? Fine, thank you. Needs a tune-up. That's all."

  "Well, don't bother. Just bring it over to Buddy Michaels at Darlington Sport. He's got a spanking new Lotus just arrived and itching for you to show it the beauty of the Kentucky countryside." He checked the slim digital timepiece built into his desk. "Eight minutes of eleven. It's been a good meeting, Marilyn. As usual, you're doing an excellent job.

  Why don't you stop by next week and give me a progress report. I also want to hear how that new Lotus of yours handles the downgrade on the back side of Black Mountain." With a smile, a nod, and the smallest gesture of one hand, Marilyn Wyman was dismissed. Arlen Paquette was drinking coffee in the sumptuous sitting room outside of Redding's office when Wyman emerged. Though they had worked for the same company for years, they seldom met in situations other than Second Thursday.

  Still, the greeting between them was warm, both sensing that in another place and at another time, they might well have become friends. At precisely eleven o'clock, Marilyn Wyman exited through the door to the reception area and Paquette crossed to Redding's door, knocked once, and entered. Hour three of Second Thursday had begun. Redding greeted Paquette with a handshake across his desk. On occasion, usually when their agenda was small, the man would guide his motorized wheelchair to a spot by the coffee table at one end of his huge office and motion Paquette to the maroon Chesterfield sofa opposite him. This day, however, there was no such gesture. "I've sent for lunch, Arlen. We may run over."

  Paquette tensed. In seven years, his eleven o'clock visit had never run over. "I'm all yours, " he said, realizing, as he was sure the old man across from him did, that the words were more than a polite figure of speech. "Have you any problem areas you wish to discuss with me before we start?"

  Paquette shook his head. He knew Cyrus Redding abhorred what he called "surprises." If Paquette encountered major problems in the course of his work, a call and immediate discussion with Redding were in order. "Fine,

  " Redding said, adjusting his tie and then combing his gray crew cut back with his fingers. "I have two situations that we must ponder together. The first concerns Arthgard. Do you have your file handy?"

  "I have my files on everything that is current, " Paquette said, rummaging through his large, well-worn briefcase. "Is our testing on Arthgard current? " Redding's tone suggested that he would consider an affirmative response a "surprise."

  "Yes and no, sir. The formal testing was completed several months ago.

  You have my report"

  "Yes, I remember."

  "However, " Paquette continued, "I began reading about the problems in the UK, and decided to continue dispensing the drug to some of the test subjects at the Women's Health Center in Denver."

  "Excellent thinking, Arlen. Excellent. Have there been any side effects so far?"

  "Minor ones only. Breast engorgement and pain, stomach upsets, diarrhea, hair loss in half a dozen, loss of libido, rashes, and palpitations.

  Nothing serious or life threatening."

  Serious or life threatening. Even after seven years, Paquette's inner feelings were belied by the callousness of his words. Still, he was Redding's man, and Redding was concerned only with those side effects that would be severe enough, consistently enough to cause tr
ouble for the company. Only those were deemed reason to delay or cancel the quick release of a new product into the marketplace. In a business where a week often translated into millions of dollars, and a jump on the competition into tens of millions, Redding had set his priorities. "How many subjects were involved in the Arthgard testing?"

  "Counting those at the Denver facility and at the Omnicenter, in Boston, there were almost a thousand." He checked his notes. "Nine hundred and seventy."

  "And no one from the Omnicenter is receiving Arthgard right now?"

  "The testing there was stopped months ago. There were too many other products that we had to work into the system."

  Paquette knew that the Arthgard recall in Great Britain was going to prove a fiasco, if not a disaster, for Redding Pharmaceuticals, a company that had not suffered a product recall or even an FDA probe since the man in the wheelchair had taken over. Testing of pharmaceuticals in Europe seldom met FDA standards. Still, the UK had a decent safety record, and the Boston and Denver testing facilities served as a double check on all foreign-developed products, as well as on drugs invented in Redding Labs. Problems inherent in various products-at least by Cyrus Redding's definition of problems-had always been identified before any major commitment by the company was undertaken… always, until now. "Tell me, Arlen, " Redding said, drawing a cup of coffee from a spigot built into his desk and lacing it with a splash from a small decanter, "what do you think happened? How did this get past us?

  " Paquette searched for any tension, any note of condemnation in the man's words. There was none that he could tell. "Well, " he said,

  "basically, it boils down to a matter of numbers." He paused, deciding how scientific to make his explanation. He knew nothing of Cyrus Redding's background, but he was certain from past discussions that there was science in it somewhere. Straightforward and not condescending-that was how he would play it. "The Arthgard side effect-the cardiac toxicity that is being blamed for the deaths in England-seems to be part allergy and part dose related."