Damage Control by Timothy Gilbert - HTML preview

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Nick Johnson

I found a spot in the outdoor lot on the westside of Overlook Hospital in Summit, NJ.

The meeting was in the newly constructed glass tower on the west wing of the building.

It was raining, and the lot was ¾ full, forcing me to park toward the back of the lot. For a

second I thought my umbrella wasn't in the car until it turned up under a jacket lying on the back

seat floor.

“Excuse me….can you tell me how to get to Conference room 3A?” I asked the

information clerk in the lobby.

I was guessing it was on the third floor, but you never know with hospitals and the odd

room numbering.

“Follow the blue arrow around to the elevators on the other side of the tower. Take the

elevator down to LL3. Conference room 3a is the big one in the center of that floor. You can't

miss it.”

I thanked the information clerk – it was a good thing to ask.

The elevator stopped on LL3 and I saw the conference room 3a, a fishbowl in the center

of the floor just as the clerk directed. Dave Clark was busy talking with an elderly gentleman.

“Nick! Great that you could make it…you can hang your coat and bag on the rack behind

you…refreshments and light snacks are over here,” Dave stated warmly.

Wood blinds covered the windows of the room, and the aroma from coffee brewing in the

corner took on its own dimension. I was not a coffee drinker - never had been - though Susan

couldn't survive without a jolt first thing in the morning.

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Dave introduced me to the elderly gentleman, Dr. Norman Watson, who was a

Cardiologist from Boston.

“It's a pleasure to meet you, sir…”I stated.

“Nick, we appreciate you coming tonight on such short notice,” Dr. Watson declared.

Dr. Watson had an incredibly strong handshake for somebody that looked 70. He was

wearing a grey sweater vest over a white dress shirt and reading glasses dangled from his neck.

As two other gentlemen arrived, they began talking to another gentleman that I did not

know.

The drug the committee was examining was called Zyptorin. This drug had been in the

marketplace for three years, generating over $1 billion in annual sales for Distal Pharmaceutical,

Inc. Zyptorin had replaced nearly 2/3 of the sales of the former leading artery drug, Balentor,

claiming to be 40% more effective than Balentor in artery plaque reduction.

Over the past two years, complaints had surfaced about Zyptorin's claim as the superior

drug for artery plaque reduction. Distal Pharmaceutical was funding the study of 2,050 heart

patients receiving stents in the last year, with various doses being set for the study that extended to 10 cities across the U.S.

The Data Monitoring committee was due to present the statistical findings for ½ of the

patient population to the steering committee that next week. The phase three study five years ago

only tested 400 patients. Current complaints claimed that Zyptorin had not shown to be superior

to Balentor in a much wider pool of heart patients.

Dr. Watson invited me to sit next to him at the table, a mahogany table able to seat

twenty people around it. There were ten of us in the room and everybody but Dr. Watson looked

to be within 10 years of me.

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“Ok, everyone, if we can be seated at the table, I want to introduce the newest member of

our committee, Dr. Nick Johnson.”

Dave Clark came over and patted me on the back.

“Nick here is the finest Internal physician in New Jersey and we're lucky to have him

with us,” Dave said to everybody.

“Okay, guys…let's get started. I talked with Justin Witley this afternoon and he has

confirmed that they have the statistical findings for half the pool,” Dr. Watson started. “And he is ready to present these findings to us next week.”

A gentleman I didn't know leaned over the table. “And they have covered all five dose

classes across the patient sample?”

“Pete, all five dose classes have been covered, and the study for ½ of the patient pool is

complete.”

“Was Justin able to give you any hints?” Dave Clark asked.

Dr. Watson grimaced while rubbing his chin.

“Well, this first half doesn't look very promising…right now, the study is pointing us to

between 10 and 15% greater effectiveness than Balentor,” Dr. Watson continued. “And

remember, we are looking to see how many patients fall into that range.

“Wow! Less than 15% is a lousy figure....Norm, we are going to have our hands full with

Jim Newel,” a bald gentleman stated from the other side of the table.

Jim Newel was the Chief Executive Officer for Distal Pharmaceutical who had been CEO

for four years. In 2001, he was paid over $12 million dollars in salary and bonus - the 8 million

stock options didn't hurt either.

“Paul, please don't overreact here…The whole purpose of this Steering Committee is to

act as a buffer between those running this study and Distal Pharmaceutical.”

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Dr. Watson announced that a different dose pattern would be assigned to 10% of the

remaining pool to see if they could get the greater effectiveness figure into the mid 20% range.

“Wait at a minute…so we're reaching, so to speak, to get to 20% better than Balentor?”

Paul asked.

Dr. Watson leaned back in his chair and put his hands on the back of his head.

“Paul, you know as well as I that so much of this business is reaching, as you say…It's

not like this is your first committee. So, I am assuming the same time next week works for

everybody?” Dr Watson asked the group.

Dr. Watson checked his watch.

“You know, Norm, I've been reading some of the testimonials given by these heart

patients and I am not sure that physicians would stop prescribing Zyptorin if it is only shown to

be 10% more effective than Balentor,” Dave Clark asserted.

Paul jumped in the flow. “But you gotta admit that Jim Newel's precious Distal

Pharmaceutical stock is going to plummet if we publish a 10% result for Zyptorin.”

Dave Clark slammed his hands down on the table.

“Well that guy could use a little humility!” Dave yelled.

“Alright, that's enough…let's re-focus here,” Dr. Watson inserted. “I want everyone here

to come up with two statistics questions for next week's meeting. I don't want to appear like

we're not doing very much work for this study.”

Several at the table burst into laughter and even Dr. Watson had trouble keeping a

straight face.

“Oh, you're all about image, Norm. I think that„s great. Guys, I think he's being serious

here,” Dave said.

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“You bet I'm serious about this,” Dr Watson cried out. “Just once I'd like to run a

steering committee where we have good news to tell our pharmaceutical client.”

This was Norm Watson's third steering committee. The first two were Phase 2 drug trials

for brand new drugs which never made it out of Phase 2, so Norm was thrilled that he could work

with a drug that was actually successful in the marketplace.

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Friday, September 5th

5:30 p.m.

Every Friday night, for the past few years, Stanley ate at Luiggi's, an Italian restaurant in

town. Luiggi's had started 30 years ago as a pizzeria and was just that up to nine years ago when

Luiggi decided to add a sit down Italian restaurant next to the pizzeria. Luiggi's daughter, Vicki,

was Stanley's chauffer those Friday nights.

6:30 p.m. was dinner time for Stanley every night and that night was no different. He

went to bed around 11:30 each night, so eating at that hour wasn't too hard on the stomach. When

Stanley stopped snacking after dinner a few years ago, he dropped five pounds in two weeks.

Vicki was married to Roger up until four years ago when they divorced. They didn't have

any children and that was the key difficulty in their relationship because Vicki couldn't bear a

child and Roger didn't want to adopt. He kept saying that he didn't want somebody else's baby,

but that made no sense to Vicki. They fought about it for two years before deciding mutually to

call it quits. Last Stanley heard, Roger had moved to Fort Lauderdale, though, he never asked

Vicki about him and she no longer brought him up in conversation.

“Hey babe, you all ready?” Vicki asked Stanley, smacking her gum like a twelve year

old.

Luiggi's, two miles away from Stanley's home, looked like a restaurant right out of the

Godfather, with long and narrow white tile floors, small tables and no booths. There was an

alcove in the front east corner for the bar, but it was a small bar that seated no more than ten

people.

Vicki drove her Chevy Impala to Stanley's home every Friday to pick him up. Stanley

usually ate at the bar, while chatting with Tom the bartender and fellow patrons if they wished.

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Susan tagged along some Friday evenings and seemed surprised by her brother's chattiness -

everyone in the place knew him.

“I am, my lady. Take me to your chariot,” Stanley said flirtatiously.

Vicki giggled and took his hand.

“Uh, Stanley, you got that backwards….it's the lady who asks to be taken to the

chariot…not the guy!”

“Well, excuse me…this is the 21st century and new rules are in place.”

Vicki's Impala was a former police car for the town of Summit before Luiggi bought it at

an auction and gave it to Vicki.

It felt and smelled foggy outside - the air was eerily still. Stanley thought about

reminding Vicki to drive more carefully given the foggy conditions, but he decided to bite his

tongue instead.

“Pick up any criminals on the way over?” Stanley joked while stepping into the front

seat.

“Har har.”

The smell of fish hit him right away.

“Wow! Did you drive the Impala at the bottom of the Atlantic today? What a stink!”

“What's with the jokes tonight, mister?” Vicki yelled. “I had to make an emergency run

to the market for some shrimp this afternoon because our supplier missed an order so I had to find

a quick solution.”

“Okay, okay…I'll stop with the commentary. I wasn't trying to be funny….alright, just a

little.“

Vicki ignored Stanley and started to back out of his driveway. In addition to his driveway

being too long, she usually complained about the two large rocks at the entrance to the driveway,

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rocks that many a vehicle had run over trying to navigate the exit. Most of these problems had

occurred at night. Vicki once dragged one of the rocks halfway down the street, severely

damaging the undercarriage of her Impala. Luiggi was not happy.

Stanley usually ordered the lasagna dinner with a few glasses of white wine and a

heaping portion of bread, but he thought that night could be different. He didn't know why.

“So, how's Susan doing?” Vicki inquired.

“She's okay…my mom and her are having their usual power struggle issues. I just wish

they'd cut it out…”

“What's her name…Joan, is it?”

Stanley laughed - he had no reason to at the moment – and it felt oddly good. Susan had

said that Stanley had grown more jovial in the past year, but he didn't really know what she

meant by that though it clearly made her uncomfortable. Stanley's mother, Joan, had said the

same thing to him, so maybe there was some truth to the matter. Stanley had tried to talk to Nick

about this perception of him that the ladies in the family shared, but that went nowhere fast.

“Yes, Joan is her name. I honestly don't think she wants her daughter to be happy. She's

quickly becoming a lonely old widow and it's like she wants to bring her family down with her.”

As Vicki chuckled, Stanley heard her put her gum in the wrapper and a fresh stick in her

mouth.

“Okay then! You sure have put a lot of thought into this,” she stated.

“Well I do spend a large part of my day sitting at home, just contemplating things.”

Vicki sighed heavily.

“Yeah, I wish I could do that every now and then. My life is just too damn busy.”

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They pulled into the Luiggi parking lot and Vicki came around to help Stanley out of the

car. He heard several vehicles in the lot and at least two couples talking as they walked through

the parking lot. Stanley wondered if this Friday would be busier than usual.

Luiggi's didn't take reservations, so if you were not there by 6:45pm, you'd have an hour

wait. In the summer time, a few cocktail tables were available on the back patio for people

waiting to be seated.

Terry was the bartender at Luiggi's and had been at the restaurant for five years. He spent

two years in Vietnam in the late 1960s. Terry served in the Navy, from which he had burn marks

up and down his left leg after a boat fire caused by a river attack in the jungle. This injury sent

Terry home.

Terry owned two failed restaurants in the 1980s. He then ran a lucrative catering business

before selling it for a nice sum and joining Luiggi's.

Vicki held the door open for Stanley, so he headed inside.

“There here is…Mr. Fridaaaaay night….How are you, bub?” Terry asked Stanley. When

Susan dined with him, they sat in the table section, but, otherwise, Stanley ate at the bar.

He thought there were three or four other people seated at the bar and at least one of them

was eating the fried ravioli appetizer which was quite tasty.

“I, sir, am just fine. How's business tonight?”

“It's fillin' up, it's fillin' up. Last Saturday was so packed, I thought we would have to

have folks waiting in their cars.”

Two womanly hands covered Stanley's eyes from behind, hands that smelled like

lemons.

“Hey beefcake, want to dance?”

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“Betsy, is that you, darling?” Betsy was the head waitress here and best friends with

Vicki since high school.

Betsy pecked Stanley on the cheek. “Gotta run and serve the masses…but you just let me

know when you want to eat.”

“See you later.” Stanley turned to Terry. “Hey, Terry can I just get a Miller Light to

start?”

Stanley had been on a beer thing lately, just to shake things up. The hard stuff would

always play a beautiful part of his evenings, but for a few weeks lately, Stanley really needed to

start off the evening with a domestic beer. It didn't matter what type of domestic – he kept a

hearty stock of Bud, Miller and Rolling Rock at home – as long as it was lighter than the foreign

beers. Some might have called him an alcoholic, but Stanley couldn't drive and he didn't have a

marriage that he could ruin, so, it was a pretty benign alcoholism, he'd say. Just him and his liver.

“You got it mate,” Terry answered. “What's the latest with your foot?”

Stanley liked a bartender who listened to him - Terry's good memory was a plus - though

Stanley was not sure when they last discussed his latest medical problem.

“He thinks I pulled my arch muscle. It sounds stupid, but it really hurts to walk on it. The

sad thing is there's not much he can do for it aside from resting the dang thing.”

The bartender grunted and Stanley heard the cash register open.

“He gave you some drugs for it, right?”

Terry placed the beer bottle in Stanley's left hand. He loved the feeling of an ice cold

beer touching his skin.

“Yeah, pain killers, but I'm not supposed to mix with alcohol – now how the hell am I

going to do that?”

Terry laughed softly.

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“What'd you decide for your Mom's birthday?” Terry asked from the other side of the

bar. “I thought I saw Susan downtown the other day, but I was zipping by in the car and I

couldn't be sure.”

Stanley heard Terry begin a champagne discussion with some folks at the end of the bar

closest to the door. He waited for this party to finish its order.

“Susan is going to buy some jewelry, which should make the old bat happy, I guess.”

Stanley trusted that Terry was listening.

“Yeah, gifts get so much harder and complicated as we get older, don't they?” Terry

responded.

Stanley thought he would start with the garlic cheese bread that Luiggi served with an

artichoke dip that was out of this world.

“Stanley, it's so good to see you….it's the Whitney's,” Meg Whitney's voice rang out

behind him.

The Whitney's were old family friends. Stanley's parents and the Whitney's used to play

bridge once a month with two other couples. This went on for twenty years.

“Will and Beverly, how are you tonight?”

While Stanley was usually terrible with names, these two he knew rather well. Stanley

always thought the name William Whitney was a little odd, but it worked for him. He started a

vending machine business forty years ago and now ran a family business that served nearly 2/3 of

the vending machines in the tri-state area. The Whitney's had two sons that handled most of the

business affairs the past few years.

“We are splendid, indeed, Stanley! We have been traveling in Ireland and Scotland the

past few weeks but it's great to be home,” Beverly exclaimed.

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Beverly had gone a little heavy on the perfume tonight, and Stanley couldn't tell if they

were coming or going.

“Are you two just arriving?”

“No, no…we just finished a wonderful dinner. Hey, what's this I hear about Nick serving

on a drug study committee? That's fantastic!”

Beverly and Joan talked all of the time, but Stanley was surprised that Susan would tell

their mother about Nick's business. So much of what his sister told Stanley stopped with him.

Stanley understood what the big fuss was with Nick being asked to be on the committee, since it

seemed like an honor to him. While his sister was having trouble seeing it that way, Stanley felt

like that real estate misunderstanding years ago with Nick's friend was something she should

have let go a long time ago.

“Well, it's actually for a drug that's already out there…but I don't have a lot of the

details…but it sounds like a pretty high profile study.”

Will laughed. “Yeah, there's big dollars at stake with these damn studies.”

“Hey how is your bridge game these days?” Stanley asked.

A hand was placed on Stanley's shoulder, and he thought it was Beverly's. She was a

huggy kind of person.

“We all miss Dave so much…your mother is very lucky to have such loving children

living nearby. We still play bridge a few times a year but it's not like it used to be.”

Beverly planted a kiss on Stanley's cheek.

“Well, we will let you get back to your evening out. It's great to see you Stanley,” Will

stated.

“Likewise, guys. You have a good weekend now.”

Stanley turned back to the bar.

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“It sounds like your brother-in-law is moving up the doctor ranks, huh, Stanley,” Terry

inquired.

“I think his first meeting is tonight.”

Susan kept apologizing all week to Stanley about canceling their Friday night plans even

though her excuse was a good one in Stanley's mind.

“Well, that's cool…hey, you want to start ordering your food for the night?”

“Terry, I think I'm going with the garlic cheese bread with that awesome artichoke dip.”

Terry groaned a bit. “Those guys in the kitchen can't make that dip fast enough during

the weekend…oh, those guys over to your left offered you this glass of their champagne.”

He slid the glass over to Stanley.

“Really…cool…what are we celebrating?” He said loud enough so they could hear him.

Stanley turned to his left while saying this.

“A very successful business transaction,” the Eastern European voice stated.

Stanley heard glasses clinking together and words that weren't in English were said

among the group; still he didn't have a clue how many folks were in their party.

“Well, hear, hear, guys…thanks for the bubbly,” Stanley said.

He didn't really know his champagnes, but this sure tasted like one of Luiggi's finest.

Stanley heard one of the gentlemen getting off his stool and a glass set down beside him.

“Stanley, right?”

He grabbed Stanley's right hand and shook it.

“You got it…and you are?

“Oleg.”

“Nice to meet you Oleg.”

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Stanley wasn't far off with his thinking that his voice was Eastern European, maybe a

little more east than that. Oleg sounded Russian.

“Stanley, we couldn't help but overhear you talking about your brother-in-law, the doctor

– what's his name?”