Carol went up to the front office to check her mailbox. She had been anxiously waiting for the lab to drop off her latest batch of drug screen results. The large green and white envelope was folded into her designated slot and she grabbed it. Not willing to wait a minute longer, she tore the envelope open and sorted through the pages until she found the alias she was looking for.
There it was in green and white. Lorenzo White, alias Brian Carter, was positive for benzodiazepines.
“Oh, shit," Carol exclaimed.
Several of the secretaries and counselors looked over in her direction.
“Fallen angel," Carol explained sheepishly and quickly walked back to her office.
She closed the door and sat down on the patient’s sofa. What am I going to tell Brian? Then the full reality suddenly hit her. If Brian was being given a compound with the same agent as Valipene, then everyone going to this doctor was being deceived in the same way. Carol had no idea how many people were going to see Dr. Donovan, but this whole situation had just escalated from unfortunate victim to intended harm. Carol got the paper she had used to compile names and phone numbers, and dialed the number for Jerry Owens. Carol waited, but she only got his voice mail. She left a generic message. She did not want to leave any details on an answer machine.
Her next contact was Brian Carter. Carol knew he would be home and dreaded having to break this kind of news to him. He had been so happy, thinking he was free from his addiction. He was more of a prisoner now than he had been before. Brian answered on the third ring. “Hey, Brian," Carol said, trying to sound cheerful.
“Hey, counselor. How’s it going?"
“Listen, buddy, I got your lab result."
“And what did it say? Do I have some fatal disease?"
Carol began stalling for time and said, “As near as I can tell, you are going to outlive us all."
“So everything is okay?" he concluded.
Carol did not respond.
“Uh oh," Brian said, when he got no response.
“You want this over the phone or do you want to meet me somewhere?" she asked, finally.
“That bad?"
“You know where the Denny’s is on Memorial and 285?" Carol asked.
“Yeah," Brian answered. “It’s not far from where I live.”
“I’ll meet you there in thirty minutes."
Carol cleaned off her desk and brought the patient files back up to the file room. Files were always locked away each night for patient confidentiality. There had never been a break in at Newberg Mental Health, as far as anyone knew. Carol couldn’t imagine what anyone would do with patient information. There were much better things to go after in the middle of the night, but it was regulation nonetheless, and they were all required to comply. Carol signed out early, telling the receptionist that her symptoms had gotten worse. The girl nodded sympathetically. Everyone knew that Carol was sick and had been unusually nice to her. Carol left the building and drove to the Denny’s to meet her “fallen angel.”
Brian was already seated at a booth when she arrived. Carol scooted into the seat opposite him and said, “”You look good for someone terminal." Brian did not laugh.
“Okay, tell me what is going on," he demanded, visibly shaken. Carol could not put him off any longer. She told him about his drug screen result and explained that the result could only be from one substance. It had to have been in the vitamins, and that was what had made him feel better. “So, you’re telling me that I am back on that drug?" Brian said in alarm.
“You are," she confirmed. Brian grabbed his water glass with one shaky hand, barely able to navigate it to his mouth. “Brian, I am so sorry," Carol said not knowing what else to do.
Brian sat quietly for what seemed like an eternity to Carol. She allowed him the time he needed. She was used to uncomfortable silences. “This is a nightmare," he said finally. “The harder I fight it, the deeper I fall."
“Brian, this was not your fault," she said soothingly. “You had no way of knowing what they were giving you.”
“Yeah, well, you didn’t fall for it," Brian laughed ironically. “You had enough sense to stay away from doctors altogether."
“Wait,” Carol interjected. “Don’t turn my obsessive paranoia into a virtue. I am just as confused as you are. I just happened to pick the right phobia. I got lucky." Brian grabbed the water glass again, having the same shaky result.
“What am I going to do?" he wailed, as tears welled up in his eyes. He didn’t want to cry in front of anyone, but he had not been able to contain himself. Carol handed him a napkin and waited.
After a moment Carol said, “Brian, there are only two choices." She didn’t have to provide much more of an explanation than that. He knew exactly what she meant.
“There are always only two choices," she continued. “It doesn’t matter what brought us to this point. All that matters now is that we are addicts. I kept trying to tell myself that my situation was different and that I wasn’t like those hard-core addicts I work with. But you know what?" she said, in deep reflection. “There is no difference.”
“How can you say that?" Brian asked incredulously.
“Look at what we are dealing with right now,” Carol explained. “Our bodies need that drug. Without it, we can’t function. From a medical stand point there is no difference between our addiction and an alcoholic’s.”
“Okay, medically speaking, maybe not," Brian conceded. “But we didn’t run around popping pills all day and all night. We were only following a doctor’s advice.” The man was visibly shaken by the implication.
“Brian, did you ever take more on a given day than you were supposed to?" Carol interjected.
“What do you mean?" he asked defensively.
“Say you had a really bad day," Carol continued. “Did you ever justify an extra dose because you had had a really bad day?" Brian thought about it for a moment, and shrugged his shoulders.
“A few times, maybe."
“Don’t feel bad,” she said. “I did too." Carol was coming to grips with her own reality, and like it or not, Brian was going to go along for the ride. “I got blindsided because I had this hard and fast definition of addiction in my head," Carol continued. “If you were not compulsive and out of control, you were okay. We didn’t have to jump from doctor to doctor because the dose wasn’t cutting it anymore…" Suddenly, Carol stopped in mid thought.
“What?” Brian inquired.
“Increase in tolerance," Carol whispered to herself.
“What does that mean?" he asked.
“Increase in tolerance," she said again, looking straight at Brian. “The other sign of addiction is an increase in tolerance. That means the original dose becomes ineffective and you need more to achieve the same result. I was on one-milligram tablets. Within a really short space of time, that dose wasn’t getting it anymore. I started having strange symptoms." All of a sudden it was as if a light had been turned on in Carol’s head. “Those strange little symptoms were tolerance withdrawal."
“Okay, now you’ve really lost me," Brian interjected.
“Once the body’s tolerance to the drug increases, the dose is no longer enough to keep the person from going into withdrawal.”
“I guess that was when I started increasing my dosage," Brian said contritely.
“Precisely," Carol agreed. “And let’s be honest. Did we tell anyone about our extra pill popping behavior?"
“Well, no one would have understood," Brian said, again on the defense.
“Or was it that we didn’t understand it ourselves?" Carol added. Brian didn’t answer but simply nodded. The truth was blinding and impossible to deny.
“And here’s the clincher,” Carol announced. “The ultimate definition of addiction is the preference for a mood and mind altered state. We have to ask ourselves, why did we need sedatives in the first place?" Brian shrugged his shoulders. He clearly had never thought about that question and had no ready answer. Carol sat shaking her head. The truth had been staring her in the face for months, but she had been so busy taking care of everyone else and blaming doctors and pharmaceutical companies for her tragedy, that she had missed noticing the train wreck that had become her life. The wreck that she herself had caused.
“The reason I couldn’t sleep at night was because of my obsessive need to fix everyone and everything. I would become outraged at all the injustice in the world and it kept me in knots all the time," Carol reflected.
“So, how is it that you can suddenly see all this now?" Brian asked.
Carol thought about it for a minute and then said, “I got too sick to keep up the pace. You have to keep moving to stay ahead of the obvious. I can’t move fast enough anymore.”
“I think I know what you mean," Brian admitted reluctantly. “Ever since I became chair-bound, I have had to focus on everything that I had been able to ignore before.” Carol looked at Brian and nodded. Both sat and silently pondered their new awareness.
Finally, Carol let out a long breath and said, “So, regardless of the unconventional way we got here, we’re addicts. The road we are on now is identical to everyone else’s and no amount of denial or rage is going to change that fact.”
“So, what is the first step?" Brian asked bravely. Carol began to laugh.
“This isn’t funny," Brian said, trying not to smile.
“I’m laughing, because there actually is a first step; twelve to be exact."
“Okay,” Brian said, “what is it?"
“Powerlessness," Carol stated. “Admitting that we are powerless over this drug, and that our lives as a result have become unmanageable.”
“Boy, is that a fact," he agreed.
Carol fished a small book out of her purse.
“Here," she said, handing it to Brian. “Here are all twelve steps, along with a list of meetings. I get my meetings at work, and whether I had realized it or not, they were actually helping me get through this."
“But I thought those meetings were for addicts who can’t stop."
“On the surface, it is," Carol explained. “But underneath the obvious cause and effect, those meetings help us come to grips with what brought us to our addiction in the first place. Recovery isn’t just abstinence," she explained. “It is also about admitting the truth about ourselves and learning to live a better way."
Brian absorbed Carol’s words and said, “Well, I guess I just went to my first meeting."
“This was the power addition," Carol said, smiling. “No charge."
Carol left Brian to go home and begin his recovery all over again. She ran over all they had talked about and all that she had come to realize. She knew that from this moment, she could no longer run her life in the same obsessive way. She would never be able to justify her old behavior. The change would be hard, but without it she would never fully recover.
Sam shook hands with Gary Price and thanked him for seeing him on such short notice. “Not a problem," Price responded. “How can I help you?”
“I need to make arrangements for a loan,” Sam began. “You’re familiar with our company and all of its assets?" The bank manager nodded. “Well, we have had an unfortunate delay in the market date of our new drug."
“I see," Price responded.
“And although our spending was justified in preparation of the new product, we were not prepared for this long delay.”
“How much of a delay are we talking?"
“No more than two months," Sam said. “So, we just need a short term loan of, let’s say, two million to be paid off in six months.”
Price looked over the list of assets Sam had brought with him. “We can probably do that,” Price said finally. “But with all your other outstanding debt, we will have to have this paid off on time."
“Great,” Sam said, and stood up to shake the bank manager’s hand.
“So, you realize that we are providing this loan against your company’s assets?" Price confirmed before accepting the handshake.
Sam nodded and said, “Once this drug goes on the market, we won’t have any problem paying this off."
“Okay," Price agreed. “I’ll draw up the papers and you can come by tomorrow to sign them."
“Thanks again," Sam said, and went out the door.
When Carol arrived at home she noticed the answering machine blinking, indicating one message. She hit the play button and listened. It was Jerry Owens letting her know that she could contact him at the number provided any time after 5:00 PM. His home phone number, she thought. Carol decided that she could probably trust this guy. She checked the time. She couldn’t contact him for at least another hour and she had really wanted to check on Clair Warner before speaking with anyone from Dominex.
Carol pulled out her number sheet and dialed the number she had gotten off Clair’s intake form. A very groggy sounding person answered the phone and Carol did not recognize the voice. “Is this Clair?" she inquired.
“Yes," the voice answered weakly.
“Clair, this is Carol Freeman from the mental health center. I wanted to check in and see how you are doing."
“Oh, that’s very sweet of you," Clair said, a little more coherently. “I went to that doctor they told me to go to and I can’t believe how great I feel.” Carol closed her eyes and sat in the nearest chair waiting to hear the rest.
“These vitamins are great,” Clair continued. “I know you are only supposed to take one a day but I was in really bad shape.”
Oh no, Carol thought.
“How many did you take?" she asked hesitantly.
“Just two today."
“Today," Carol repeated. “How many did you take on other days?”
“Well, yesterday I took three and I’ve certainly been catching up on all my lost sleep."
“I bet you have," Carol said, sadly. “Go splash some cold water on your face, and come back to the phone. I need to fill you in on a few things.” Carol could hear the phone being put down and waited for her to return.
When she returned, Carol filled her in on everything she knew about the vitamins the doctor was handing out. Clair listened to the explanation. “I guess I should have known that a vitamin couldn’t make me feel this much better, or this sleepy," Clair interjected.
“You’re lucky you haven’t had to be rushed to the emergency room from an overdose," Carol instructed adamantly.
“Carol, I don’t think I can go off this medication. I have thought about it and the withdrawal was too much for me to handle."
“I definitely understand," Carol assured her, “but you have to promise to stop taking more than one per day.” Clair promised and thanked Carol for being so concerned about her. Before Carol could question her any further Clair was gone.
In Carol’s line of work she had received promises from the pros and had come to know a line of bull pretty well when she heard it. She really had no idea about Clair’s medication history other than what Clair had reported. But she was pretty sure that the sweet woman who had come into her office the other day had just crossed over the line into a whole new world of drug use. Carol felt absolutely helpless. There was nothing more she could do. Clair was an adult and as such, she was allowed to make her own choices, bad or good. At least she had been warned about the possibility of an overdose. Carol looked up at the ceiling and said, “Please take care of her."
She was about to change out of her work clothes when the phone rang.
“Carol, this is Jerry Owens," the caller announced. “I thought I’d try you once more before leaving the office.” Carol wasn’t sure how to approach the issue or if she could trust Jerry’s motives, but she had to do something.
“Mr. Owens,” Carol began carefully, “there are some very bizarre things going on with the volunteers in your study."
“Well, it’s not exactly my study,” Jerry qualified, “but go on."
Carol proceeded to fill Jerry in on what had happened to both Brian and Clair as a result of their office visits with Dr. Donovan. Jerry did not respond immediately, as he came to realize how public this knowledge had become. What should he do now? At no time in any of his conversations with Sheila had they discussed the possibility that the volunteers would figure out what was going on.
“Well, as I said,” Jerry improvised, “I’m not directly involved with the study."
“I’m confused, then," Carol stated. “When you contacted me the first time, you said you were following up on our progress."
“That’s true," Jerry stuttered, working hard to keep from sounding like an idiot. “They give the Marketing Department assignments from other areas during down time." Jerry was shaking his head at the stupidity of his statement.
“But you do work for Dominex Pharmaceuticals," Carol said, stating the obvious. “And last time we spoke, you said you would get my information to the right person." Jerry knew where this was going and didn’t have a clue what he was going to say next. “So, who would that be in this particular case?" Carol inquired adamantly.
“I’m not really sure," Jerry said, wanting to unplug the phone from the wall, “but I will try to find out."
“Don’t bother," Carol stated. “They probably already know, don’t you think?" Carol was on the war path at that moment, which always resulted in enough dripping sarcasm to repaint a small house.
“I’m sorry I couldn’t be more helpful," Jerry offered weakly, trying to gracefully end a conversation that was rapidly going down the tubes.
“So am I," Carol said angrily, and hung up.
“I’m going to kill Sheila," Jerry said, out loud to no one. “She leaves me here to contain a tidal wave, while she goes off to the happy bakery in Newark, New Jersey." Jerry continued his tirade for several minutes before sitting down at his desk. He checked the time, knowing that Sheila would most likely still be in the office. He hated relying on email. It required that the recipient be available on the other end to receive it.
Jerry visualized his 401K being flushed down the toilet. What could Sheila tell him that he didn’t already know? This new turn in the Dominex saga had the potential to take the whole company down. If that happened, Jerry, Sheila, and a whole lot of other hard working people with families were going down right along with it. The “mission,” as he understood it, was to target the sedative issue and make it public. At no time had Sheila ever alluded to taking out the whole company. Dominex represented a whole generation of good products and good employees. This was one of those ethical issues that could be debated forever. People were going to get hurt in this situation, no matter which side of the argument they took.
The volunteer’s new awareness was a time bomb with a very short fuse. Time was of the essence. If they didn’t clean up this mess, and quickly, Sheila’s “mission” would never see daylight, and the company would most likely be shut down. He didn’t have time to wait for an email from her. They have to know, Jerry concluded. He was young and single and despite his attachment to his 401K, he would survive the fall. But there were a lot of people who wouldn’t. Jerry had known and worked beside these people for a long time, and genuinely cared about their survival. Then there was the bigger issue. The whole sedative problem had to be exposed. And that required the delicate fabric of time. I have to tell Sam, Jerry decided reluctantly, and went out the door to find him.
Carol was livid. He knew! This person’s character was yet to be decided, but he was a terrible liar. There were so many layers of deceit going on at that company, she couldn’t begin to understand it all. But she knew that it had to stop.
Carol stood by the phone, wondering what she could do, when the familiar rush of panic came in on her. “It’s happening again," she cried out, and rushed into the bedroom. Carol quickly lied down on the bed and started the slow breathing exercise that had worked before. This panic attack was far worse this time. Carol worked to control the wave that was attempting to overtake her. After a good thirty minutes of controlled breathing, Carol felt safe to sit up.
She went to the bathroom, and wiped the ocean of water off her face and neck. Looking into the mirror, Carol was reminded of the blatant truth about her own nature, and her recovery. She no longer had the luxury of being a crusader. This illness was life sensitive. Every intense emotion that resulted from her past knee jerk reactions was causing the withdrawal symptoms to take her into a chokehold. Weak and dizzy, Carol went back to lie down. Who would save the day? For the first time she was faced with an answer she had never thought of before. It was possible that the day might not be saved by anyone. This was now a test of faith. Letting go and letting a higher authority deal with all the chaos was a process with which she was completely unfamiliar.