Side Effects (1984)

by Palmer, Michael

  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 By the time his son, Tyrone, took control of the family enterprises, the rejuvenator had been replaced by a variety of vitamin and mineral supplements, and Darlington Pharmaceuticals was being traded, though lightly, on the American Stock Exchange.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, Tyrone 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 pharmaceutical 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 Redding. 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 wit
h 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 trouble 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.”

  “In other words,” Redding said, “first the patient has to be sensitive to the drug and then he has to get enough of it.”

  “Exactly. And statistically, that combination doesn’t come up too often. Arthgard has been so effective, though, and so well marketed, that literally millions of prescriptions have been written in the six years since it was first released in the United Kingdom. A death here, a death there. Weeks or months and miles in between. No way to connect them to the drug. Finally, a number of problems show up at just about the same time in just about the same place, and one doc in one hospital in one town in the corner of Sussex puts it all together. A little publicity, and suddenly reports begin pouring in from all over the British world.”

  “Do you have any idea how many hundreds of thousands of arthritis patients have had their suffering relieved by Arthgard?”

  “I can guess. And I understand what you’re saying. Risk-benefit ratio. That’s all people in our industry, or any health provider for that matter, have to go by.”

  “I’ve decided to keep Arthgard on the American market for ten more weeks.” Redding dropped the bomb quietly and simply; then he sat back and watched Paquette’s reaction. Noticeably, at least, there was none.

  “Fine,” Paquette said. “Would you like me to continue the Denver testing? We have about an eighteen-month head start on the overall marketplace.”

  “By all means, Arlen.”

  Paquette nodded, scratched a note on the Arthgard file, and slid it back in his briefcase, struggling to maintain his composure. There was little to be gained by revealing his true feelings about what Redding was doing, and much—oh, so much—to lose. His involvement in the testing centers alone—involvement of which Redding possessed detailed documentation—was enough to send him to prison. In fact, he suspected that Redding could claim no knowledge of either facility and make that claim stick. Even if no confrontation occurred, the chances were that he would be fired or demoted … or worse. Several years before, a department head had been openly critical of Redding and his methods, to the point of discussing his feelings with the editor of the Darlington Clarion Journal. Not a week later, the man, a superb horseman, had his neck broken in a riding accident and died within hours of reaching Darlington Regional Hospital.

  “Have you the product test reports for this month?”

  “Yes, sir. I took them off the computer yesterday evening.”

  Paquette was rummaging through his briefcase for the progress reports on the fourteen medications currently being investigated when he heard the soft hum of Redding’s wheelchair.

  “Just leave the reports on my desk, Arlen,” Redding said, gliding to the center of the room. “I’ll review them later. Could you bring my coffee over to the table, please? I want to apprise you of a potential problem at the Omnicenter, and I could use a break from talking across this desk.”

  Paquette did as he was asked, keeping his eyes averted from Redding as much as possible, lest the man, a warlock when it came to reading the thoughts of others, realized how distasteful the Arthgard decision was to him. On the day of their first interview, over eight years ago, he had sensed that uncanny ability in the aging invalid. It was as if all the power that would have gone into locomotion had simply been transferred to another function.

  “Arlen, the Omnicenter was already operational when you joined us, yes?”

  “Sort of, sir.” Paquette settled into the Chesterfield and took a long draught of the coffee he had surreptitiously augmented with cognac while Redding was motoring across the room. “The computers were in, our people were in place, and the finances had been worked out, but no formal testing programs had been started.”

  “Yes, of course. I remember
now. You should go easy on that cognac so early in the day, my friend. It’s terrible on the digestion. In the course of your dealings in Boston, did you by chance run into a woman pathologist named Bennett, first name Kathryn, or Kate?”

  Paquette shook his head. He had set his coffee aside, no longer finding reassurance in the warm, velvety swallows. “Reese keeps me away from as many people as possible.” He smiled and whispered, “I think he’s ashamed of me.”

  Redding enjoyed the humor. “Such a reaction would be typical of the man, wouldn’t it. He lacks the highly advanced abilities to appreciate and respect. With him, a person is to be either controlled or feared—none of the subtleties in between.”

  “Exactly.” Paquette was impressed, but not surprised, by the insight. As far as he knew, Redding had had but one direct contact with the Metropolitan Hospital administrator, but for the Warlock, one was usually enough. “What about this Dr. Bennett?”

  “She has begun investigating the Omnicenter in connection with two unusual deaths she has autopsied. The women in question had similar blood and reproductive organ disease, and both were Omnicenter patients.”

  “So are a fair percentage of all the women in Boston,” Paquette said. “Have you talked to our people?”

  “Carl called me. Both women have participated at various times in our work, but never with the same product. The Omnicenter connection appears to be a red herring.”

  “Unfortunately, we have other herrings in that building which are not so red.”

  “That is precisely my concern,” Redding said, “and now yours. I have sent instructions to Reese that he is to find a way to divert young Dr. Bennett’s interest away from our facility. He seems to think he can do so. However, I have had my sources do some checking on this woman, and I tell you, Norton Reese is no match for her, intellectually or in strength of character.”