by Edwin Dasso
The man climbed to his haunches and put a finger to his lip then shook his head.
“No…but there’s a new guy stays over by the dumpster behind the food joint across the street. Showed up in the last couple of days…” He turned his eyes up to them and shrugged again. “Haven’t heard his name, but that’s the only new guy I’ve heard of lately. Did hear he’s not a very friendly type, though. I’ve kept my distance—couldn’t tell you what he looks like.”
“Thanks,” Jack and Smithson responded together then turned toward the exit of the alley.
“Thirsty, too!” the hobo yelled after them.
Jack stopped and turned back to him. “Then I’d suggest you get a combo meal when you grab some grub.”
Jack rushed to catch up to Smithson, who was already halfway across the street. They stopped at the entrance to the lane mentioned by the homeless guy
“Hank! Hank Greene—you in there?” Smithson hollered.
Jack and Smithson listened for several seconds then heard the sound of movement, followed by the noise of something scraping against metal.
“Hank…is that you?” Smithson called out.
“Go away! I’m not leaving. This is where I belong.”
Chapter 13
Smithson and Jack exchanged quick smiles. Jack stepped forward, but Smithson grabbed his arm, holding him back. Smithson stepped up next to Jack and looked into his eyes.
“Let me do this, Jack. I’m the reason he’s here.”
Jack remained silent, staring at Smithson for a few seconds, then shrugged. “Okay, George—I guess that makes sense.”
Smithson looked into the alley and huffed. “I just hope he hasn’t lost all faith in me.”
Jack clapped him on the shoulder. “He’ll know you have his best interests at heart.” He squinted down the alley. “I’m going to work my way around to the far end…just in case he gets any ideas about bolting that way.” Jack took off down the sidewalk at a jog.
Smithson gazed into the alley and blew out a long breath then ambled cautiously into the dank space.
“Hank, it’s George,” he called out. “We all want you to come back home.” He took a few more steps, stopping a few yards from the dumpster that had been described to them by the homeless man. “What happened with Jack and Amanda is not your fault. I know that—they know that. Jack and I think it’s gotta be a reaction to that damn study drug you were taking.” He let his head and shoulders sag. “I’m sorry I got you involved in that… I-I was only trying to help.”
“Get the fuck outta here, George—I ain’t going with you!”
Smithson popped his head up and took a few more steps toward the dumpster. “Why not?”
Hank snorted. “Are you fucking kidding me? Did you not hear what happened? I almost killed Jack…a-and Amanda!”
A muffled sob came from behind the dumpster.
“Not your fault—like I said, we all know that.”
“Not my fault?” Hank roared. His face suddenly appeared around the corner of the metal container. He clambered clumsily to his feet, his gaze locked on Smithson as he stepped into the open. “I pulled the goddam trigger! Twice!”
Smithson held his hands out in front of him. “Okay, Hank…just calm down. I’m only here to help…and if you’d like, you can give me a gut punch for getting you into this.” He gazed around the filthy surroundings, wringing his hands. “Hell, it already feels like I got one, anyway,” he mumbled.
Hank paced rapidly in small circles. “I’m still feeling a little crazy, George!” Hank’s eyes were bloodshot, dark circles beneath them. “I’d suggest you just leave—while you still can.”
Smithson stared at him, deciding to take a new tack.
“I’m not here for me, Hank.” He rested his hands on his hips. “I’m here for Amanda. She’d be here herself if she didn’t have homework. She said to tell you she misses you—doesn’t feel safe without you around.”
“Doesn’t feel safe without me around?” Hank bellowed. “Hell, she shouldn’t feel safe when I am around!”
Smithson shook his head slowly. “Not the way she sees it, Hank. Jack and I told her our theory about the study drug being the cause of your actions. She gets it. She really wants you back.” Smithson waved Hank forward. “C’mon. Let’s go.”
“It’s true,” Jack called out from behind Hank.
Hank spun toward Jack then back to Smithson, his expression flashing between anger and yearning. “I-I know what you fuckers are up to! You think you’re going to distract me and then one of you will jump me.” He shook his head vehemently. “Ain’t gonna happen!” He looked past Smithson toward the opening of the alley, crouching down like a sprinter about to start a race.
Jack halted his advance. “We’re not trying to trick you, Hank! We’ll leave without you if that’s what you really want…”
“But don’t be surprised if we show up again—with Amanda,” Smithson quickly called out. “You know how obstinate she can be when she wants something. You really want to disappoint her?”
Hank clambered to his feet, nodding slowly at Smithson then snickered. “Yeah, she can be a little pain in the ass.”
“And if she gets this close to you, she’ll never leave without you, Hank. You know that…so you might as well come with Jack and me now.” He chuckled. “It’ll be easier on you if you do.”
“I ain’t going into no damn rehab!” he yelled, jabbing a finger toward Smithson.
Smithson held his hands in front of him. “No, no. We get it. That won’t happen. Jack and I will arrange for you to get care on an outpatient basis—you can probably stay at the house during treatment.”
Hank again paced rapidly then stopped suddenly and glared at Smithson. “No lock-ups—right?”
“Exactly!” Jack said resolutely. “I’ve been there, too, Hank. It’s not pleasant. I understand you’re not wanting to go there.”
Hank spun toward Jack then back to Smithson, his lip trembling. “A-and you r-really think Amanda will be okay with me coming back?”
“Okay? Hell, she’ll be miserable until you’re back!” Smithson waved Hank toward him. “C’mon. Come home with us, and she’ll tell you that herself.”
Hank hung his head and swiped at tears on his cheeks. “I-I do miss her…” He slowly raised his eyes to Smithson. “I miss all of you guys—you’re the only family I’ve got.”
“Let’s go home then.”
Hank nodded slowly and shuffled closer, coming to a stop next to Smithson. The general smiled, put his arm around Hank’s shoulder, and pulled him close.
“We’re all family.” Smithson glanced over his shoulder at Jack, who was smiling broadly as he jogged toward Smithson.
Chapter 14
A handful of the Pharmadosh senior research & development team working under Martin Lankin shuffled into the executive conference room. Some took seats at the far end of the table from where Carvin Schanlon sat; others just leaned against the wall behind those who were sitting. They all remained silent, none even looking in Schanlon’s direction. Lankin took a seat just to the right of Schanlon.
Lankin turned to look at his colleagues, frowned, and then turned back to Schanlon. “Thank you for taking the time to meet with us, Mr. Schanlon. I know you’re very busy.”
Schanlon shot him a quick glare and motioned with his hand for Martin to hurry.
“First of all, my team and I want to thank you for reconsidering my termination—”
“Cut to the chase, Lankin, before I change my mind about that!” Schanlon interjected tersely. He turned his glare on the other people scattered about the room. “What do you clowns want to talk to me about?”
Martin shot a quick glance at his colleagues then turned back to Schanlon.
“I don’t know if you know everybody here, but these are the senior members of the supracentyl R&D team.”
“I know who they are—just get to the point.” Schanlon sneered at Martin. “If you have one.”
&nbs
p; Several of the people in the room started fidgeting with pens or squirming in their seats, several casting longing glances at the door. Martin waved a hand at one of the men sitting at the table.
“Tom, why don’t you go ahead and start? Please be candid.”
Tom’s eyebrows shot up as he stared at Martin then locked his gaze on the tabletop.
“Well…we, um, have some concerns,” he muttered. “W-we’ve reviewed the results of that primate study you had done, Mr. Schanlon.” His gaze darted to Schanlon then back to the tabletop. “Those results align with the findings of our assays.” He cleared his throat. “I’m in charge of doing our FDA filings, and I think there may be…challenges to getting a credible FDA NDA filed for supracentyl.”
“Bullshit!” Schanlon roared. “That’s what I’m paying pussies like you for—we not only need something credible, we need it expedited!”
Tom sat silently, his mouth hanging open, a look of shock covering his face.
Schanlon spun toward Martin. “Anything else you dumbasses need clarified?”
“But…our assays align with the study results,” one of the other staff stated. “We all think this implies a significant risk that this drug would have an unacceptably high risk for addiction. We’re not even sure we can develop an effective antidote—”
Schanlon jumped from his chair and leaned his fists on the table then glared at everyone sitting around the table.
“I don’t really give a rat’s ass about an ‘effective’ antidote!” He jabbed a finger at them. “You’re assuming we’d even want to reverse all the effects. We won’t! I only want a reversal agent so we can assure the FDA we have one available—it doesn’t have to work well.”
Tom sat back in his chair and crossed his arms over his chest then locked his gaze on Schanlon. “Look, Mr. Schanlon, it’s one thing when you’re testing on primates but,” he glanced around quickly at his colleagues, “we won’t have anything to do with tests being conducted on humans—we think there’s just too much risk.”
“Well, that’s where you fucked up!” Schanlon yelled. “Thinking. I’m not paying you to think. I’m paying you to do what I tell you to do and to keep your whining to yourselves.” He shook his head. “I figured you dipshits would wimp out on me. That’s why I started human trials without you…using veterans who get referred to Greater American Pain & Spine by staff I embedded in VA clinics.”
A murmur ran around the room, and Martin spun in his chair toward Schanlon.
“B-but you can’t do that! It’s against the law to do human studies without FDA approval!”
“Fuck the FDA—I own them!”
“B-but these veterans—it would be unethical on our part to subject them to such risk.”
“Fuck the veterans, too!” Schanlon grinned fiendishly and shrugged. “Look, people, these vets who frequent VA hospitals aren’t good for anything but experimenting on anyway.” He cackled. “Hell, they’re only a little better than the monkeys that were in the primate study I arranged.” He growled and slapped the table. “But those ASPCA activists are a pain in the ass to deal with. Fortunately, there’s no similar organizations for vets.” He jabbed Martin in the shoulder. “That makes vets a perfect study group for us.”
“But…what would the American Society for Testing and Materials do to us if they ever discovered that we did an unapproved human trial?” He waved an arm at his colleagues. “We could all end up in jail!”
Schanlon spun toward Lankin and slapped him across the shoulder. “You let me worry about them! Meanwhile, you just keep doing what I tell you to do. I’ve already got production arrangements made with some foreigners…and they’re wondering what the delay is.”
Martin’s mouth hung open as his gaze darted between his shoulder and Schanlon. He slowly stood from his chair, shaking his head as he glared at Schanlon. “I don’t think so…”
All of the staff who had been sitting also stood. They bustled toward the door, casting looks of disbelief at Schanlon as they filed silently from the room. Martin stopped at the door and turned back to Schanlon.
“With all due respect, you can’t do this without us, sir—and you can’t force us to violate the law.” He turned and stepped through the door.
“The hell I can’t, you worthless pieces of crap!” Schanlon screamed, spittle flying onto the tabletop. “Just watch me!” He laughed loudly. “Oh, wait, you won’t be able to watch me because you won’t be employees anymore! You’re all fired!”
He threw his glass against the door, shards of the smashed glass flying onto the floor and table.
Chapter 15
The Day After Hank was Found in The Alley
Hank and Jack rose from their seats in the office of Harley Grant, MD, a well-known addictionologist that Brent Love had referred them to.
“Thanks, Dr. Grant,” Hank said as he shook the man’s hand. “I’m all-in on this, so just tell me what I need to do, and I’ll do it.”
Grant smiled and nodded. “I won’t lie—it’s a tough road ahead, but we’ll get you through it, Hank.”
“Yeah…I remember from the last time…” Hank mumbled then opened the door to leave, holding it for Jack.
“Can you give me a couple of minutes with Dr. Grant?” Jack asked Hank. “I want to do that doctor mumbo-jumbo talk thing with him.”
“Sure. I don’t mind at all not having to listen to that crap,” Hank quipped, wiping his palms on his pants as he shifted his weight rapidly from foot to foot.
As soon as the door closed, Jack spun toward Grant.
“How the hell did he get addicted so quickly, Harley? He only had a single dose, for chrissake!” Jack grumbled.
Grant shrugged. “Depending on the individual, that may be all it takes. As you know, some people are more susceptible to becoming addicted.”
“But…Hank’s been clean for several years and was hell-bent on never getting hooked again…and he’s been as disciplined recently as he was back in the Green Berets. I just don’t get it.”
“It’s not just a psychological thing, though, Jack. Even if he’s disciplined, his neuroanatomy may predispose him to addiction.”
“I’m no expert on addiction…what does that mean? Are you saying we won’t be able to help him?”
“No, sorry, I didn’t mean that at all.” Grant took a deep breath. “Opioid dependence and some of the most distressing opioid withdrawal symptoms stem from changes in an area at the base of the brain—the locus ceruleus. Do you remember that from med school?”
Jack shook his head and chuckled. “No. That was a long time ago.”
“Well, anyway, neurons in that area produce the noradrenaline that stimulates wakefulness, breathing, blood pressure, and general alertness, among other functions. When narcotic molecules link to mu receptors on neurons in the locus ceruleus, they suppress the release of that noradrenaline, resulting in drowsiness, slowed respiration, low blood pressure—I’m sure you are familiar with those effects of opioid intoxication?”
“I still work in the ER, so, yes, I’m very aware of those,” Jack responded.
“Addiction happens, in part, when the brain creates a memory imprint that associates the drug-induced euphoria associated with that functional depression and the environment in which that feeling occurred. These memories, called ‘conditioned associations,’ often lead to the craving for a drug when the abuser re-encounters those persons, places, or things that were present when they previously were exposed to narcotics. The associations can be strong enough to drive abusers to seek out more drugs…in spite of any obstacles.”
“That’s the part that confuses me about this episode, though,” Jack responded. “Hank went to a hospital, not some damn back-alley dive, and he only had a single dose! I don’t see how he could have any ‘conditioned associations’ that would turn him back into an addict.”
“That part is a little…unusual.” Grant held his arms up at his sides. “But…these imprints are permanent—maybe Hank’s are str
onger than most. Maybe they’re still in place from his prior addiction. I just don’t know at this point.”
“And all his clean living and discipline since his debauchery days wouldn’t make any difference?” Jack asked, somewhat surprised.
“Not necessarily. Again, everybody’s different…”
“Will that make getting him through detox this time tougher?” Jack grimaced. “I’d hate to see him go through the torture he did last time. Jeez, I thought that was going to kill him!”
“Well, with repeated exposure to opioids, the locus ceruleus neurons go into overdrive. When opioids are not present in the brain, as will be the case during detox, these brain cells in overdrive still release excessive amounts of noradrenaline. That’s what triggers the jitters, anxiety, muscle cramps, and diarrhea during withdrawal.” He frowned and sighed. “To an observer, it can look like someone is dying…actually, they can die if the reaction is bad enough.”
“Yeah, I know. I’ve seen enough patients in withdrawal who come to the ER.”
Harley nodded. “The chemical imbalance—”
Jack held a hand up to stop Harley. “Harley, no offense, but I don’t care about all the details. I know you’re really into this stuff, but I don’t want a damn Grand Rounds lecture—I just want to know what it’s gonna take to get Hank through this.”
Harley had an offended look on his face as he fidgeted with his graying ponytail. “A lot of misery and sweat,” he replied bluntly. “And doing it on an outpatient basis is going to make it even tougher.”
“Good or bad, that part isn’t open for debate. I promised Hank he wouldn’t be locked up during his detox.”
“I’ll do the best I can.” Grant shrugged. “The rest is up to him.”
Jack clapped him on the shoulder. “I know you will. Brent Love gushed about how good you are.” Jack touched a finger to his lip as he mused. “And while you’re getting Hank through this, I’m going over to the VA. See if I can get some answers about this study drug they gave him.”
