Side Effects (16 page)

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 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."

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"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
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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 y ou 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."

"He would be the last to admit that."

"I agree." Redding opened a manila folder he had apparently placed on the coffee table prior to Paquette's arrival. "Here are copies for you of all the information we have obtained thus far on the woman. I want you to go to Boston and keep tabs on things. Do not show yourself in any way without checking with me first. Meet with our Omnicenter people only if absolutely necessary."

"Yes, sir."

"There is a small item in that report which may be of some help to us. Bennett's father-in-law heads the law firm that handles the Metropolitan Hospital account, as well as some of the Northeast business of the Tiny Tummies line of breakfast cereals. Although the connection is not generally known, Tiny Foods is a subsidiary of ours. The man's name is Winfield Samuels. From all I can tell, he's a businessman."
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Paquette nodded. Coming from Cyrus Redding, the appellation "businessman" was the highest praise. It meant the man was, like Redding himself, a pragmatist who would not allow emotions to cloud his handling of an issue. "Do you have any idea of what Reese has in mind to deal with the doctor?" "No, except that Carl Horner says he seems quite sure of himself." "If that's the case," Paquette said, "I should be back in just a few days." Redding smiled benignly. "I told you how I perceive the Bennett-Reese matchup, Arlen," he said. "I've had reservations made for you at the Ritz. Open-ended reservations." METRO DOC LABELS BOBBY JUNKIE.

The layout editor of the Herald had, it seemed, dusted off type that had not been used since D-Day. The paper lay on the living room floor, along with the Globe and Roscoe, who was keeping an equal distance between himself and both his masters. It was still afternoon, but the mood and the dense overcast outside made the hour feel much later.

The calls had begun at two that morning and had continued until Jared unplugged their phones at four thirty. Letters, typed on Kathryn Bennett's stationery and signed by her, had been dropped off at both Boston dailies and all three major television stations sometime during the previous night. The gist of the letters was that, driven by conscience and a sense of duty to the people of Boston, Kate had decided to tell the truth about Bobby Geary.

Stan Willoughby, who was mentioned in the letter, and Norton Reese, as Metro administrator, were called immediately by reporters. The pathology chief, not as sharp as he might have been had he not been woken from a sound sleep, confirmed the story, adding that Kate was an honest and highly competent pathologist whom, he was sure, had good reason for doing what she had done. It was not until an hour after speaking with the first newsman that he thought to call her. By then, Kate's line was so busy that it took him almost another hour to get through. Meanwhile, Norton Reese, aided by Marco Sebastian and an emergency session with the hospital computers, had confirmed that there was, in fact, no patient named John Schultz ever treated or tested at Metropolitan Hospital. Reese was careful to add that he knew absolutely nothing of the allegations lodged by Dr. Bennett, whom he described as a brilliant woman with a tendency at times to rebel against traditional modes of conduct. Questioned for details, he refused further comment.