Empty Promises

by Edwin Dasso

  Hank startled, inadvertently pushing the button as he spun toward Smithson. His gaze shot from Smithson back to the laptop screen which read, Your Request has been Submitted. He slowly twisted around to Smithson.

  “Goddammit, George! Don’t sneak up on me like that—you spooked the shit outta me!”

  “Sorry.”

  Hank furrowed his brow. “And you made me accidentally enroll in that damn study! I was still just thinkin’ about it.”

  “Again, sorry for scaring you…but I’m not sorry you enrolled in the study. I think it’ll help you.” He turned and walked toward the door. “Besides, you can always drop out of the study at any time—it’s not like you’ll be held prisoner or anything,” he said over his shoulder.

  “Good. Been there, done that,” Hank muttered.

  Smithson stopped and slowly turned back to Hank. “Sorry about that, Hank—I didn’t intend any reference to the slave camp.”

  “I know you didn’t.”

  “Still, I’d encourage you to at least give the study a try.”

  “Maybe,” Hank said as he slapped his laptop closed then stood, storming past Smithson on his way out of the room.

  Smithson watched Hank until he disappeared around the corner at the end of the hallway. Smithson hustled after him, but by the time he rounded the corner, Hank had already disappeared out the front door.

  “Damn, you’re a stubborn man, Hank.”

  Chapter 7

  One Week Later

  Hank stopped at the intersection of hallways in the large VA facility, looking again at the directions sheet for the lab where the study Smithson had recommended was being done. He traced a finger over the diagram on the paper and looked up and down the hallway then shrugged, turned to his left, and started walking.

  “Damn places are always designed like rat mazes. It’s a wonder more people don’t die in the hallways while they’re searching for where they’re supposed to go,” he grumbled.

  He glanced quickly at the nameplates posted by every door he walked past, eventually stopping at a door at the far end of a long hall. The placard listed Greater American Pain & Spine.

  “Finally! Feels like I walked across the damn city to get here!”

  He opened the door slowly and poked his head through, gazing around the small, austere reception area, noting the musty, sterile smell so common to medical facilities. It reminded him how much he hated hospitals.

  The receptionist smiled and waved him in. “Can I help you, sir?”

  Hank approached her desk and held out the form he’d received regarding the drug study.

  “Hank Green. I’m here about the pain medication study you guys are doing.”

  The receptionist took the form from Hank, turned, and immediately fed it into a paper shredder.

  “Uh…that’s the original,” Hank said. “I don’t have another copy of that.”

  The receptionist shot him a fleeting, perfunctory smile.

  “That’s okay—we don’t need it anymore.”

  Hank shrugged. “If you say so.”

  She squinted as she focused on her computer screen then looked up at Hank.

  “Looks like we’ve got you scheduled for room seven.” She turned and pointed to a frosted-glass door. “Go through there then to the last door on the left. Someone will be in to see you soon.”

  Hank nodded and smiled at her then walked to the assigned room, flopping down on a well-worn metal chair next to an exam table. He gazed warily around the room at the various aged medical instruments hanging in racks on the walls. A vague sense of angst nibbled at the fringes of his mind, and his gaze darted repeatedly toward the door.

  “I really don’t feel like being poked and prodded. I had enough of that shit in the army.”

  He hopped up from the chair and stepped toward the door, startled when a woman in a white lab coat threw it open from the other side. She was looking at a chart and bumped into Hank.

  “Oh, my! I’m sorry, Mr.—” She glanced quickly at the forms in her hand. “Green. I didn’t mean to knock you over.” She was in her late twenties and quite attractive. “I’m Debbie; I work for Greater American Pain & Spine. I’m one of the research nurses on this study.” She held her hand out to Hank.

  Hank shook her hand but was unable to stop gawking at her face.

  She pointed at the exam table. “Why don’t you have a seat, and I’ll take your vital signs and tell you about the study.”

  Hank glanced fleetingly behind him at the table then backed slowly toward it, his eyes still glued on Debbie, stumbling when his heel hit a leg on the table. Hank’s cheeks grew warm with embarrassment.

  “Oh! Don’t hurt yourself,” Debbie quipped then smiled at Hank.

  “Yeah,” he mumbled. “I don’t need any more injuries.”

  He sat on the exam table, and Debbie grabbed his wrist and looked at her watch as she checked his heart rate.

  “This study is what’s called a randomized, double-blind study, Mr. Greene, so I need to tell you that you may not actually get the study drug. You may just get a placebo. Do you know what a placebo is?”

  Hank nodded. “The fake stuff.”

  “Well, yes, that’s one way to put it. The ‘double-blind’ means that even I won’t know whether you get the study drug or the placebo.”

  Hank grunted. “I bet I’ll be able to tell you very quickly which it is.”

  Debbie gave him a confused look. “Yes…well, maybe you will.”

  She recorded his vital signs, told him more details regarding the study, then handed him a tablet holding several release forms.

  “Can you sign these, please?”

  Hank glanced at the clipboard then at Debbie before hesitantly taking it from her. He licked drops of sweat from his upper lip as he read the documents, finally resting the sheaf on his lap and looking up at her.

  “Um…I’ve had a little…problem with addiction in the past. What’re the odds this drug would get me hooked again?”

  Debbie smiled but was silent for several seconds. “Well, that’s one of the things we want to study…”

  Hank shot a nervous glance at the forms then looked back at her. “So, you…can’t tell me what that risk is?”

  Her jaw worked, but she said nothing, as if she was searching for words.

  “Well?”

  “Um…I’m, uh, not supposed to tell you this, but…w-we think the risk is almost nonexistent.”

  “Almost?” Hank raised the tablet and held it out toward her.

  She unbuttoned her lab coat, and it fell open, the lowcut shirt under it displaying her ample cleavage. “I don’t think you should worry about it.” She placed a hand on his knee. “At all.”

  “Really?” He tried in vain to keep his gaze away from her breasts. “You promise it won’t happen?”

  She smiled uneasily, nodding slowly. “Sure. I…promise.”

  Hank remained silent, regarding her skeptically.

  “Do you still want to continue?” She put her hands in the pockets of her lab coat, pulling it further open, exposing even more of her bosom.

  Hank glanced fleetingly at her chest, shaking his head slowly. “I…suppose.”

  “Okay. I’ll go get the syringe while you sign the releases.” She opened the door and stopped. “This may take a few minutes,” she said then left.

  Hank hopped off the exam table and paced around the room. “I’m not so sure about this—I have a bad feeling,” he muttered, repeatedly shooting fleeting glances at the door. A sudden burst of pain in his thigh made him catch his breath. “Sonofabitch, that hurts!” He huffed then sat back on the exam table. “Maybe if I just get this one dose, it’ll help me get ahead of this pain.” He began leafing through the forms, signing on the indicated lines.

  Debbie returned after several minutes, carrying a syringe. She took the signed papers from Hank, quickly leafed through them, then pointed at his arm.

  “Will you roll up your sleeve, please?” She wiped his ski
n with an alcohol swab then paused, the needle poised just above his skin. “Wow! I hope these hard muscles of yours don’t bend my needle,” she joked. “Ready?”

  Hank shook his head slowly. “No…but let’s give it a try and see what happens...”

  Hank winced as she slid the needle under the skin on his shoulder and quickly injected its contents. Within a matter of seconds, Hank felt the old, familiar sensations from when he’d used narcotics on the street. His angst about becoming addicted melted away as he was seduced by the chemical siren song of euphoria.

  “Oh, yeah! If that ain’t the stuff you’re testing,” he muttered dreamily, his eyelids drooping, “it oughta be.”

  His head sagged as a feeling of warmth enveloped his body like a mother’s embrace, bliss caressing his mind and shooing away any worries as he floated on feel-good clouds. He forgot why he’d even come to the VA and gazed blankly at Debbie.

  “Wh-why am I here again?” he slurred, barely able to put together a coherent sentence.

  Debbie giggled. “For the study, Mr. Green.” She suddenly looked concerned as she focused on Hank’s face. “Are you okay?”

  “Oh…yeah…”

  Some personal notion of the Spartan god Phobos awakened in the back of his mind, telling Hank to fight the alluring ecstasy. The voice warned him that he was being enticed to the same craggy shoreline that had previously left him sleeping in cardboard boxes in alleyways. The place where he knew he would meet his end this time if he again traversed it. He shook his head hard, trying to shake free of the rapture, knowing it offered nothing but empty promises in the end. But the sensations were overwhelming—stronger than anything he’d ever experienced from any previous narcotic, and the voice of logic dwindled to silence. He slipped into the inviting mental waters and started paddling toward the ill-defined but treacherous shoreline of addiction. He smiled lazily, no longer feeling the pain in his leg, uncertain he’d even care if he could feel it.

  “I think it’s working…”

  “Are you going to be able to get home alright, Mr. Green?” Debbie asked fretfully.

  “Sure, baby,” he murmured lethargically, his head wobbling as he gazed absently at her. “I can tell you already that ain’t no damned placebo, though.” He pointed at the empty syringe she held.

  He stood and staggered toward the door, Debbie holding on to his arm to stabilize him.

  “Maybe I better call someone to come get you. You seem to be having an untoward reaction.”

  He jerked his arm away and turned his face toward her, giving her a muddled smile.

  “No, thanks. I’ll be fine.”

  He fumbled with the door knob for several seconds then stumbled out the door, bouncing off the doorframe as he made his way through the opening.

  Chapter 8

  Boardroom of Pharmadosh, Inc., a Large, U.S. Pharmaceutical Company

  Schanlon strutted silently around the large table, taking note of the board members’ enthusiastic looks as their gazes followed his movement. He liked to build anticipation in his audiences. Keep them guessing what was coming. He smirked. Manipulating them. It was a feeling of control. Of power—and it intoxicated him. He stopped abruptly at the head of the huge slab of live-edge, black walnut and spun to face his listeners. He leaned on the cool smoothness of the table, his eyes enticingly turning respectively to each of them. This group was no different than others he’d played, and it was time for the maestro to raise his baton!

  “I want to ask you all a question.”

  Several of the seated people exchanged quick glances, shrugged, then looked expectantly at Schanlon.

  “Go for it,” one of them eventually responded.

  He stood straight, fleetingly locking eyes with each person in turn.

  “If you could describe the traits of a perfect product for a drug company, what would they be?” he asked, like a college professor quizzing a class.

  “Big profit potential,” someone immediately stated resolutely.

  Schanlon nodded. “Absolutely.”

  “Public demand. A strong market,” another called out.

  “A must!” Schanlon responded.

  “Something the government won’t find a reason to interfere with,” a third hollered.

  “Damn straight!” someone else responded.

  Schanlon laughed. “No argument there.”

  He looked around the table once more, rolling his eyes as he noticed the woman with her hand raised.

  “Yes, Beverly?” he asked, barely able to conceal his impatience. He knew she was a nurse and had heard she would often advocate for consumers.

  “It works as advertised—I mean, that it actually helps people in the way it’s supposed to.”

  Schanlon again rolled his eyes and snickered. “Well, duh. That’s why we’re here, right?”

  He and several others around the table snickered derisively, like a high school clique of girls laughing at the class nerd. Schanlon held his hands up to halt the clamor then flicked on a dazzling PowerPoint slide on the wall-mounted screen behind him, causing several in the audience to shield their eyes from the brilliance.

  “You’re all right! But let me tell you about my idea of a perfect pharmaceutical product—a product feature that would be the route to achieving all of the success factors you’ve just mentioned.” He flipped to the next slide of his presentation, waving a hand in the general direction of the screen. “In a word—addiction.”

  Murmurs rumbled around the table, even some gasps and moans. He raised his arms, motioning for the group to calm.

  “I know, I know—to some of you, that’s a four-letter word…but step back a minute,” he said loudly. He turned to face the slide, which showed a short list of bullet points. “What does it really mean?”

  “Why don’t you tell us, Carvin?” someone called out skeptically.

  “Forget all the technical aspects listed on this slide.” He spun back to his audience. “When you look at addiction objectively, it is nothing more than a body expressing its need for something. Like a craving for a nutrient that has been lacking in your diet. Who hasn’t had that at some point?”

  He brought up the next slide, ignoring Beverly as she held up her hand and waved it as she shook her head.

  “In the pharmaceutical arena, addiction technically occurs when a person cannot control the impulse to use a drug…even if there are negative consequences. That’s the defining characteristic. Brain-imaging studies from people addicted to drugs even show physical changes in areas of the brain that are critical for judgment, decision-making, learning, memory, and behavior. Those are all hard, undeniable facts.”

  “I don’t think I like where this is going,” Beverly called out.

  Schanlon flashed his teeth at her in what some might have generously described as a smile. Others may have called it a snarl.

  “Just go with me, Bev,” he said tersely.

  Beverly slowly lowered her hand, slumping back in her chair, narrowing her eyes as she regarded Schanlon.

  He thrust an index finger above his head. “But…what if these people are addicted to something that is helping them? Would that be so bad? After all, we’re all addicts at some level, aren’t we? And not all of the things we’re addicted to are bad for us.” He took a deep, exaggerated breath. “We all need oxygen.” He waved at the buffet table against the wall. “We all need food.” He nodded toward one of the board members who was quite obese. “Some of us are obviously addicted to that.”

  The man slowly set down his partially eaten pastry and averted his gaze, his face flushing.

  “Linkage of addictive chemicals with the…correct receptors actually perform a simple task—they trigger a biochemical response in the brain. Nearly all addictive drugs directly or indirectly target the brain’s reward system. Technically, they flood that circuit with dopamine, giving a person a feeling of pleasure. Eating and sex are good examples of things that elicit this response. In other words, a person is rewarded for d
oing—or consuming—something that is perceived as good for them.”

  He turned his back to his audience, staring silently at the projected slide.

  “Yeah, so?” someone finally challenged after a short period of silence.

  Schanlon smirked then put on a poker face and whirled back to the table.

  “So…our research team has created some chemical modifications that not only increases this pleasure response in the reward system, but even better, the alteration makes it almost impossible to break the bond between dopamine and the pleasure receptors!” He jabbed an index finger at each person seated around the conference table. “Do you understand what that means?”

  They all gawked at him, several people shrugging.

  “It means, ladies and gentlemen, that we can now create the perfect drug company product! The public will get one taste and crave, no—demand—our products! They will be addicted!”

  Beverly shot out of her chair. “Now I really don’t like where this is going. Exactly what ‘product’ are you talking about?”

  Schanlon frowned. “That’s hardly relevant, Beverly,” he replied haughtily.

  She jabbed a finger at him. “Like hell, it isn’t! Answer the damn question!”

  He glared at her a few seconds. “No. I won’t. It’s a stupid question.”

  Her mouth dropped open, her jaw working as her face reddened. Her gaze snapped to her colleagues around the table, but no one was looking at her, their attention focused on Schanlon.

  Schanlon again pointed at each of them seated around the conference table. “Look. You all told me you wanted me to increase the profitability of this company. I’m telling you how I intend to do that. We can now create a drug that people will have to have…even after a single dose. They’ll be rewarded for taking the drug—it’ll make them feel good.” He glared at Beverly. “The drug will merely give them what their body is demanding.”

  He stood straight and turned to the screen.

  “We’ll make the chemical alterations to an existing generic drug so we can produce it cheaply—but we’ll have guaranteed demand for our brand. This will allow us to set the price wherever we want. Cheap production costs, huge demand.”