David Manning looked across his desk at the unwanted and uninvited visitor. He had refused another nature walk.
"You're out of time," Rico stated. "My employer will give you twenty-four hours to agree to ditch the added research.”
"Your employer can go screw himself,” David spat and shot to the door. With one trembling hand on the door, he pointed the other at Rico. "Tell Dominex to go screw themselves," and opened the door so hard, it hit the wall with an amazing force.
Rico got to his feet and walked to the open doorway.
"Take twenty-four hours to think about it."
"I don't need twenty-four hours," Manning yelled, unconcerned about the open door. "I gave you my answer. Do I have to draw you a diagram?”
Rico refrained from commenting about the interesting visual the FDA man had just offered, and looked at the red-faced, trembling man. He actually thought he saw steam coming out of his ears.
"Okay, Manning," Rico said walking through the door. Turning back, he said, "Oh and Manning, expect a visitor, and I don't think it will be the ghost of Christmas past." Very clever, Rico thought to himself as he entered the elevator. But I don't have a real warm feeling about this.
Ann usually woke up at 2:00 PM, so when the phone rang at twelve thirty, she was not pleased. She let the answer machine pick up the call and was just rolling over to go back to sleep, when she heard Rico's voice. Ann grabbed up the phone and greeted Rico in a groggy voice.
"You're on," was all Rico said.
"When?"
"As soon as you can get there."
"So, how far do I go with this?" Ann asked.
"Give him a chance to change his mind. Once you tell his wife, it's over - so be convincing. But if it does go that far, take it all the way.”
“Should I profess our undying love for each other?”
“Good idea. That little sting will remind him that we don’t play. Maybe next time he won’t push his luck.”
“I never make house calls," Ann interjected. "Believe me, I'll have his attention."
Ann glanced at the clock and groaned. She had only gotten to bed just five hours ago. "Strong coffee," she mumbled and went to the kitchen.
David Manning sat in his living room with the TV on, but he had no idea what he was watching. He was preoccupied. When the doorbell rang, the frazzled FDA man jumped to his feet. “I’ll get it," he said. There was no reply from the kitchen, where his wife was putting dinner together. When David opened the door, he was finally face to face with his worst nightmare.
“Hi, David," Ann greeted. “We need to talk."
“You’re wasting your time,” he responded. “She already knows."
“Who is it?" came the voice of his wife, as she approached the opened doorway.
Sam was getting tired of dialing the number to his outside handy man and listening to the phone ring. He was getting ready to hang up when the receiver was quickly snatched up.
“It didn’t work," Rico told his employer. Sam said nothing. “I really didn’t think he had it in him," Rico continued, “but his wife already knew everything."
“Damn.” Sam sunk into his chair.
“We still have to pay her," Rico reminded him reluctantly.
“Yeah, I know. Talk to you later," he said, and hung up.
The failed blackmail was unprecedented. They had never had to resort to such pathetic tactics in the first place. The cash was always enough. Now, they were out of ammunition. Sam had no choice. He began to formulate a new plan. As he bent and un-bent the paper clip in his hand, he pondered his options. Conceding to the research was going to create a long and unacceptable delay in marketing Suprame. Finding a shortcut didn’t seem to be an available solution. Sam shook his head in disgust. He had been trying to force the hand of someone who would not budge. Manning’s annoying propensity for procedure had been a major stumbling block since his promotion. How could he win against someone like that? Doing things by the book was not Dominex’s style, but that was what Manning required. As Sam searched his creative mind for the answer, a smile slowly came to his face. He pressed the intercom buzzer and said, “Margie."
“Yes?" the phone speaker chimed.
“I want to meet with all of the research team this afternoon, and tell Jeff Edwards that I want him to attend as well."
“Yes sir," the phone speaker replied. Sam sat and continued to formulate a plan. This would take more time than blackmail, but it was fool proof. Sam was quietly congratulating himself on his ingenuity when his phone buzzed again. “Sam, Mr. Edwards was not in his office in the marketing department." Sam put one hand on his balding head and cursed under his breath. “A Sheila Montgomery said she would be glad to attend. But where’s Jeff?" Sam sat shaking his head at his own stupid forgetfulness.
“Sorry, Margie," he replied. “Jeff was transferred to R and D."
“Research and Development? When did this happen?”
“Never mind," Sam said annoyed at the outcome. “Just please find him."
Sam did not need an outsider at this meeting and as far as he was concerned, Sheila was an outsider. He didn’t know her and was sure as hell not ready to trust her, no matter how good the CEO thought she was. His estimate of Charles Roman’s ability to evaluate things objectively when it came to his hormones was minimal at best. “Oh, well," Sam sighed. “If the CEO can’t keep his dick out of the equation, I can’t keep being his safety net.”
“So here’s the situation," Sam concluded to the attending staff. “We can’t release this new medication without drug termination research.”
“How long will this take?” one member chimed in.
“Depends," was the answer from within the group. “The difference in the chemical compound between Valipene and Suprame is almost undetectable. If we find an existing group on the original drug now who are willing to undergo a period of abstinence, that might be acceptable."
“Right,” another added. “Then at least we don’t have to wait for a new test group to begin taking the drug."
“How long of an abstinence period do we have to monitor?" came the next inquiry.
“Six weeks," Sam stated, avoiding eye contact with the CEO.
“And how long will the test subjects have to have been on the medication?” This question came from Sheila.
“Varying stages," Sam answered with surprise at such an intelligent question.
“It will take us some time to accumulate an appropriate test group,” someone interjected.
“Right,” Sam agreed. “Anyone want to volunteer for the recruitment stage of the study?” He looked over the group and saw only one raised hand. Sheila was smiling at him with her hand held high enough for everyone to see. Shit, he thought to himself. How would it look if he rejected the only volunteer for a job that nobody else wanted? He stalled, hoping someone, anyone else might rise to the occasion, but no one did. He didn’t blame them. It was a long tedious process. “Okay, Sheila," he conceded, and silently prayed he would not regret the outcome. “Then if there are no further question,” and after a brief silence, it appeared no one had any, “let’s get on it immediately," Sam said concluding the meeting.
Everyone stood to leave. “Oh, Jeff,” Sam interjected. “Could you wait just moment?” When the room cleared, there were three men remaining. Sam, Jeff, and an annoyed CEO.
“Are we sure there is no way around this?” A question Sam had expected and knew he was not going to avoid.
“Yes, Charles," Sam responded. “We forced our hand one too many times and the FDA isn’t budging this time.”
“But what if these test results aren’t good?” Charles demanded. Sam looked at Jeff, and said,
“Charles, they will be." Charles looked at both men and knew he could count on them. Besides, this was now getting into an area he wanted to know nothing about.
“Fine," he said. “I’ll give you six months, and I mean six months.” And with that, the CEO was out the door. Sam knew he meant it. Now turning his attention to Jeff Edwards, he said,
“Okay, business man, here’s the plan.”
Carol was sitting in a small room with ten other patients. The chairs were arranged in a circle. She was trying hard to stay focused on the rambling of one group member.
“So, if you were drunk when you had a wreck, your body would be so relaxed that you probably wouldn’t get hurt.”
“Wait a minute,” Carol interjected. “Are you trying to tell the group that they should stay drunk all the time in case they have a wreck?”
“Well, no," the patient responded, while the rest of the group began snickering. Carol held back a smile herself. She couldn‘t believe what these people came up with.
“Listen," she stated firmly. “If you think back on all the ‘wrecks’ in your life, it was the drug or the drink that caused the wreck in the first place.” The group could see that their counselor was on a role, and knew her well enough not to say a word. The laughter faded. “We all need to get something here," she continued. “The world owes us nothing. No one cares if we make something of our lives or if we trash it." Carol looked at the sheepish group and realized she was hitting them pretty hard. Looking up at the clock, she said, “Come on guys, you all deserve better. See you next week.” As the group noisily stood to go, Carol added, “And make sure you go to at least three meetings this week. I’ll be checking your meeting sheets." Carol hadn’t checked a meeting sheet in a long time, and wondered if any of them were even attending their mandatory twelve step meetings.
What had started out as a “liberal” approach had turned into “addicts run amuck.” She had believed that if you treated people with dignity and respect, they would rise to the occasion. This had not turned out to be the case. Addicts were fast learners, and most of them already knew what they could and could not get away with. Carol had resigned herself to the situation by saying that the patients were adults. If they wanted to recover, they were given the tools. She was not responsible for their bad decisions. But the truth was that she could not be a hard liner. Carol was as soft hearted as they came when it applied to troubled human beings. If coddling facilitated recovery, Carol would have rehabilitated the entire world by now. But addicts did not need coddling. They needed someone to shine a harsh light on their reality, and the consequences that had resulted from their chosen path. Carol did not have it in her to force people’s faces into the obvious mud. Her compassion was her greatest gift, as well as her biggest obstacle.
She had just made her way back to her office and a ringing phone. “God, the receptionist must have radar," she thought. “This is Carol,” she answered.
“Line three,” was the reply. Carol punched the button and stated her name once again.
“Carol," the caller began. “Carl is worse. He won’t come out of his room and he has nailed his bedroom door shut. He thinks everyone is in on this big plan to use his thoughts."
“Has Carl been in to see the doctor?" Carol asked.
“He wouldn’t go," Mrs. Banner continued. “He said that the mental health center was the primary headquarters for ‘Them.’”
Jesus, Carol thought to herself.
“And I think he got his hands on a gun," the mother added.
“What?" Carol asked, instantly at attention. “How long has he had a gun?”
“A few days, the mother answered.
“I’m going to have to call the police,” Carol stated.
“Oh no,” the woman wailed. “He’s not a criminal. Please don’t involve the police.”
“It’s just for safe transport,” Carol said reassuringly. “We have to get him to the hospital.” Carol let the woman absorb the information.
“Okay,” she conceded. “Please hurry.”
“I have to get a doctor to sign a form for involuntary commitment,” Carol added. “Since he is considered an adult, you can’t do that for him. As soon as I get that, I’ll make the call.”
“Thank you,” the mother said, conveying her panic and desperation.
Carol dialed the number for Tri-County’s “doc on call” and asked for the doctor to be paged.
“That will be Doctor Morganstern,” the operator answered. Carol thanked her.
“Dr. Morganstern,” she groaned. The doctor was a new addition to Tri-County and did not work and play well with others. Morganstern did not readily admit patients, and Carol had already complained about her once before to Spears, when the doctor had refused to admit a cocaine addict who had begged to be admitted into detox.
“Cocaine addicts do not go through withdrawal,” the doctor had stated adamantly. Carol had attempted to argue that even though severe depression and sleep deprivation were not life threatening, they were still symptoms of withdrawal. She had attempted to persuade the doctor by adding that most of them can’t stop using without some kind of controlled intervention. In the end, the patient had been left to his own devises. Carol was certain that those devises had resulted in the patient’s demise.
She busied herself with the pile of papers on her desk. The paper trail of a bureaucratic system was a losing proposition. She was writing furiously when her phone rang. “Line two," she was told. Carol pressed line two and identified herself.
“This is Doctor Morganstern. What have you got?” Carol had to deliver Carl’s history from memory amidst the stack of unrelated files that had overtaken her workspace. When she finished, the doctor asked if he was a danger to himself or anyone else. Carol couldn’t believe the question.
“Well, I’m guessing that if he has a gun, he might decide to use it." She was having a hard time keeping the sarcasm out of her voice.
“Do we know for a fact that he has a gun?" the doctor asked.
“No," Carol answered. “His mother said she thought he did."
“And when you assessed him, did he present with any safety issues?" the doctor asked. Carol paused remembering a psychotic Carl wearing the tin foil helmet. The same patient who was now fortified in his room with the doors nailed shut.
“Safety issues, Dr. Morganstern?" Carol asked in disbelief. “He thinks that an alien force is after him. Up until now, he has chosen to hide from them. I guess the safety issue goes to what he’ll do in self-defense."
“We can’t admit him based on what he might do. Tell the family to make an appointment.”
“What?" Carol said, feeling her temper rise.
“Didn’t you say he did not keep his last appointment?" the doctor asked.
“Yes," Carol replied. “I also said that he would not come in because he thought we were in on the plan."
“Well, we can’t be responsible if the patient won’t come in for help,” Morganstern replied with finality. “Just make the appointment,” and with that, the doctor was gone.
Carol was furious. She hated this system. A patient with no money had to be holding a gun to their own head or pointing it at someone else before they could get any attention. The only benefit to the stupid admitting policy was that state workers didn’t have to work, and insurance companies saved a bundle. Carol felt one of her rages coming on. She knew she was momentarily out of control, and should have taken a walk around the block. Instead, she made the fatal choice. She punched in the number for the Medical Director.
“This is Carol Freeman, and I need to speak to Dr. Abernathy now," Carol spat into the phone. When the Medical Director answered the call, Carol sprang into action. “Dr. Abernathy, we are having a big problem with Dr. Morganstern,” she explained. “I have lodged prior complaints, but nothing has changed.”
“Why don’t you tell me what the problem is this time?" the doctor interjected.
Carol went through the entire scenario, adding her commentary along the way. When she was done, there was a momentary silence. Finally the doctor responded. “Well, Miss… what is it? Freeman? We managed to hold this center together before you came here, and I believe we will manage after you are gone.” Carol’s rage was replaced by fear. She was about to soften her approach, when she heard the doctor loudly hang up.
“Oh shit,” Carol said out loud. She tried to get the doctor back on the line before he followed through with his implied threat.
“The Doctor is on another line," the receptionist told her. “Do you want to hold?” Carol had a pretty good idea who the doctor was on the line with, and quietly returned the receiver to its cradle. What had she done? She knew full well that management at Tri-County did not take kindly at all to having their authority questioned. This had not been the way to get Carl, or anyone else for that matter any help.
Carol waited for the inevitable. The one constant at Newberg Mental Health was the rapid and efficient information highway. People doing their jobs at the speed of drying paint was one thing, but consequences and revenge were always top priority. She didn’t have to wait long. Spears was in her doorway looking at her angrily.
“Carol, get in my office." Carol walked down the hall and planted herself in the appointed chair. She was not given the opportunity to speak. “Are you out of your mind?" Spears spat.
“No, the patient is," Carol interjected.
“Shut up," Spears yelled. “What do you think you are doing, complaining about one of our doctors to the medical director? You are supposed to come to me.”
“I did,” Carol pleaded.
“Bullshit,” Spears yelled. Carol was flabbergasted. She had never heard the Center Director talk this way. She knew she shouldn’t have handled the problem this way, but the doctor was wrong. Couldn’t anyone see that?
“Carol, I don’t want you to make any more decisions on your own. If you have to go to the bathroom, ask me, and I’ll tell you if you really have to go.”
Spears was livid, and Carol kept quiet.
“I don’t trust you anymore,” he continued. “If you tell me something, I will assume that it is a lie.”
That hit Carol hard. She had made some bad decisions and was clearly not a good politician, but she was not a liar.
“Do you have anything to say?” Spears challenged.
Carol felt beat to her knees. She had just lost the one thing she valued most: her credibility.
“In light of this conversation,” Carol said, “I don’t really care anymore.”
“Then get out of my office,” Spears ordered.
Carol shot out the door and did not stop until she got to the receptionist’s desk. “I’m sick,” Carol said. “I’m going home.” She charged furiously out the door, leaving a bewildered group in her wake.
Driving down the small town road to the interstate, she was strangely resolved. She didn’t feel like crying, she felt angry. This bastard had just called her a liar. No one had that right. He had just stepped over a very important line as far as she was concerned. She had devoted herself to this job. She had jumped in and done anything he had asked her to do, and she had done it with the spirit of a champion. Now she was supposed to ask him if she could go to the bathroom. “He can kiss my ass,” she announced to the empty car. She began the process of letting go.
Carol called in sick the following morning. She was not ready to face the mess that had become her rapidly deteriorating career. Padding around the empty house, she marveled at how well she felt, despite the tragedy of the day before. She had personally begun to feel so much better since she had started sleeping. She had been taking one pill each night as prescribed for the past few months and couldn’t believe that such a small little pill could have such a profound effect on her insomnia. It was beginning to lose a little of its initial effect, but all in all, she was sleeping and that was all that mattered.
Now at least when the people around her fell short, she didn’t mind so much taking up the slack. What Carol failed to realize was that her unfortunate need to hold the world together had been a big part of what was causing her insomnia. This was an issue that would eventually be the second biggest nemesis in her life. But for now, she was satisfied. Her only immediate dilemma was having to see the strange little doctor again. She was keenly aware that she had only five pills left, and with no refills, Carol had no choice but to return for another visit.
The last visit had made her blood boil for days. The strange little man had asked her if she had thought about hurting herself or anyone else. Carol had gotten irate. “I ask those questions myself to others every day," she had responded coldly. “I don’t need a ‘psych eval,’ I need to sleep every night.” Nevertheless, the strange little doctor told her she was depressed and had notated the diagnosis in her medical chart before he would write her another prescription. “Fine, I’m depressed,” Carol said sarcastically, and left the office with the only thing that mattered, her pills.
Driving home from the doctor’s office that day, Carol had debated loudly to herself. “I know depressed when I see depressed,” she announced out loud to no one. “And I’m not depressed. Maybe a little homicidal.” The guy actually had to slap a label on her before she could walk out the door with a prescription. Insomnia wasn’t enough?
Carol continued this tirade all the way home. By the time she got there, she was so angry she just took a pill early and went to bed. The truth was that Carol had been so angry that day she had taken two pills. She told herself that one sometimes just didn’t get it anymore, and on days like this, the extra dose seemed justified. In general, she had been angry about one thing or another most of the time. This would be Carol’s number one future nemesis. The one that ultimately had the potential to take her down.
Carol had the whole day off and reluctantly decided to take advantage of the time. She picked up the phone and dialed the number to the doctor’s office. When the receptionist answered, Carol made an appointment for her medication checkup. Her blood pressure and been on the rise lately, and she had attributed that to her job. She hoped it would be better today. Carol checked the time. She had two hours before she had to assume the insulting role of depressed patient. She headed to the kitchen to find coffee and some mind numbing TV.
Carol entered the doctor’s office on time. Sitting in the uncomfortable wooden chair, she was keenly aware of her own nervousness. What if he puts me through the third degree again, Carol thought. I don’t think I can stand another round of stupid questions. Carol got up when her name was called. The nurse frowned at her cuffed arm and said, “one-forty over ninety.” My God, Carol thought, this is so unusual. “You might have to consider blood pressure medication if this keeps up," the nurse said.
“I really don’t understand this,” Carol replied. “My blood pressure has always been normal. I guess my job is really getting to me.”
“Well, something will have to change,” the nurse warned, and added the information to her chart. Carol sat waiting for the doctor wondering what she had the option to change. While she thought about it, her blood pressure wasn’t the only change she had noticed. She had these occasional bouts of nausea and diarrhea. Sometimes she felt mild flu-like symptoms when she knew she didn’t have the flu. Strange, Carol pondered, how stress could affect you. This would also explain those few moments of explosiveness she had experienced. There were times at work lately when she had come un-glued. Things that only mildly annoyed her before had suddenly become a trigger to become enraged. Looking back on each one of those incidences, Carol couldn’t explain the rage. It had become an even bigger source of staff alienation, not to mention her questionable job status.
When the door to the examination room opened, Carol was relieved. A different, friendlier face greeted her. “Hi, Carol,” the friendly face said. “I’m Doctor Hopton.”
“Oh thank God," Carol said out loud. The Doctor just looked at her with amusement. “I was expecting the other doctor, Carol explained. “He always gives me the third degree.”
“Well, you can relax” the doctor said. “Now what can I do for you today?"
Carol felt all her anxiety melt away and gave the friendly face her medication history.
“So, if it’s okay,” she concluded, “I wondered if we could increase the dose. It’s losing its effect.”
“Sure,” the friendly face responded, and quickly wrote the prescription.
“Thanks,” Carol said in a sigh of relief.
“Patients usually know what’s best,” the doctor said. She adamantly agreed.
Carol returned home and found her husband in his usual spot: in front of the computer screen. “Carol, isn’t the medication you’re taking Valipene?” Josh asked without removing his eyes from the computer, or noticing her unusually early arrival.
“Yeah,” Carol responded while she changed into her comfortable house grubbies. “Why?”
“Because I see here that a company is about to launch a generic for that drug.” Carol waited for an explanation. “This company,” Josh said, pointing to the screen, “Dominex Pharmaceuticals. And their stock is going through the roof.”
“That’s nice,” Carol said, picking through the mail.
“It’s very interesting,” Josh said. “They still have some sort of research to complete, but this indicates that all the players here already know the outcome.”
“Well, the sooner the better,” Carol responded. “The cost of this stuff is ridiculous.”
“Says here,” Josh continued, “that anyone willing to be a part of the final research will get their medication for free.”
“Free?” Carol echoed.
“Yeah, and they will pay a thousand dollars for the trial.”
“Where do I sign up?” Carol asked.
Josh turned and looked at his wife.
“The research involves people already taking the drug."
“Okay, that’s me," Carol said, wondering about his sudden interest.
“The company wants those people to go off the medication for six weeks.”
“Oh,” Carol said.
“Yeah,” Josh sympathized.
Carol just walked off saying over her shoulder,
“So what’s for dinner?”
“Insomnia,” Josh said in a partial joke. The joke was lost on Carol.
Sitting in front of the TV later that night, Carol pondered the possibilities. She had gone without sleep for years. Certainly she could manage it for six weeks. A thousand dollars and free meds were worth six weeks of insomnia.
“Josh,” Carol said.
“Huh?” he replied while distracted by the antics of a drunk driver arguing with the arresting officer. “They show the same idiots every week,” Josh laughed.
“Josh,” Carol said, louder.
“What?” Josh said, focusing on his wife.
“I think I should volunteer for that research group.”
“Okay,” Josh said, wondering if she was really serious. “I’ll print out all the details for you.”
“Maybe I don’t have to start right away.” Carol had just increased her dosage from one to two milligram tablets and wanted to get a few last night’s sleep in before she had to go back to the long nights of insomnia.
A commercial came on and the couple watched the confusion develop due to a garbled cellular phone conversation. Josh shook his head while he got up to go to his computer. When he returned, a high-speed police chase was under way. “Here,” Josh said, and handed the printed material to Carol. Carol read the contents and pointed to the page.
“Here’s the contact person. I’ll call her tomorrow.”