I was terribly sorry when I heard about your son Calvin. His death worries me on many levels. For reasons I won’t go into here, I am skeptical when I hear a student at a prestigious Manhattan school has died from a peanut allergy. Is it possible Calvin’s death was a result of something else? In my years of experience, I know that Bradley wants the majority of its students to get evaluated and that those evaluations often result in ADHD diagnoses and medication. If this was the case, it’s imperative that you get back to me as soon as possible. I will explain everything when we speak. Again, I’m sorry for your loss
.
Sincerely, Hutch Garvey, M.D
.
He looked up from the letter and Jess took it from him. She lingered over the return address. “Chesswick, Pennsylvania,” she said. “When can we go?”
S
ATURDAY MORNING, HE KISSED
T
OBY GOODBYE AND SLINKED ACROSS
the street to pick up his Zipcar. He’d told Ellie he was working on the Oscar edition. He couldn’t recall ever having worked on a Saturday. Lying to Ellie made him queasy, but it was easier than having another fight about Bradley.
Sitting behind the wheel of the gray-blue Toyota Prius, he realized he hadn’t been in a car in years, since he and Ellie used to drive up to Nantucket for the Fourth of July. He gripped the wheel firmly. It felt good. He could put his foot on the pedal and go anywhere, everywhere. A car was freedom. As he backed out he caught his reflection in the rearview mirror. His hair needed a trim and he noticed a few strands of gray at his temples. When had that happened?
He swung by D’Agostino where Jess was bouncing in place to keep warm. He pulled up, and she sprinted to the car and slid in next to him. She touched his leg. Kind of like a greeting. “Morning,” she said. He could still feel her hand after she took it away. “So.” Her gloves made a muffled sound as they clapped together. “Let’s find Hutch Garvey.”
The giddy energy of the treasure hunt pushed them forward through the tunnel and New Jersey and into Pennsylvania, but the mood turned somber when they arrived in Chesswick. They watched the post-industrial suburb of Philly slide by their windows. Each crappy, decrepit house was worse than the next.
Sean had researched Chesswick the night before: 20 percent unemployment with 25 percent of its residents living below the poverty level. He wasn’t sure what he’d expected, but not this. He’d also Googled Garvey. It turned out Garvey hadn’t just been a shrink, he was
the
kid shrink on the Upper West Side. Before he vanished a few years ago.
Soon, the neighborhood changed. Looking past the rust and rot, he realized the streets were wide and some of the houses were huge. Rich people had lived here once.
“Stop.” Jess pointed to a sagging Victorian. “That’s it.”
They stared. The paint curled away from the wood and the second floor buckled. It looked unsafe. “That’s his house?”
“That’s what it says.” She held up the envelope. “We should ring the bell.”
They plodded down the path, which was covered in six inches of snow. When they reached the front door, he searched for the bell, but there wasn’t one. No knocker either. He made a fist and pounded. When no one answered, he pounded again.
“I guess no one’s home,” Jess said.
He pounded one last time.
“Okay, okay.” Whoever was inside did not sound happy about having visitors.
Jess stepped back and they both looked up and saw a figure staring down at them from a window. A minute later, the front door opened and a wiry middle-aged man stared out at them through intense eyes. A stubbly gray film coated his cheeks. “What?”
“Dr. Garvey? Hutch Garvey?” Sean asked. The guy wore khakis and a stretched out rugby shirt.
“I’m not buying anything,” he said.
“I’m not selling anything.”
Garvey squinted at him, then gave Jess a wary once-over.
“We’d like to talk to you,” Sean said. “About Bradley.”
Garvey licked his lips. “You’re not screwing with me, are you? Because if you are, I’ll have you arrested. I swear to—
“We’re not screwing with you,” Jess said.
A muscle pulsed over Garvey’s right eye. “Who are you?”
“My son Toby is in the third grade at Bradley,” Sean said. He touched Jess’s shoulder. “This is his teacher.” Garvey perked up. “Toby almost died because the school forced me to give him Metattent Junior. He didn’t need it.”
Garvey opened the door wider. “Come in.”
Filing cabinets and accordian folders stuffed with newspaper clippings took the place of couches and chairs and coffee tables in the living room, making it look more like a storage facility than a home. Stacked at free wall space, piles of newspapers sat yellowing, waiting to be clipped. Sean caught a glimpse of an end table that had been pushed haphazardly into a corner. It was antique. Expensive looking. On it sat a framed photo of Garvey, a woman, and two kids on a big sailboat. They were smiling in the photo and Garvey looked healthy, not nervous and gray like he did now.
“I wasn’t expecting company,” Garvey mumbled, with a wave of his hand. “Come upstairs to my office.”
They followed Garvey up the uneven steps of the old house. Crammed in among more filing cabinets in his office was a wide antique desk that he guessed had resided in a much larger room at some point in the past. “Sit, sit, please,” Garvey said.
“That’s quite a collection,” Jess said, eyeing a shelf of Pez dispensers. Batman, Daffy, Spiderman, Fred Flintstone—he had them all. Dozens of them. Not only was it an impressive display, it was fun, colorful. The guy must have a sense of humor. One that wasn’t in attendance today.
“It took me twenty-five years to find all those,” he said. “The kids love it.
Loved
it.” He clapped his hands. “So,” Garvey said. “How did you find out about me?”
“The Drakes,” Sean said. “Their cleaning lady found your note in their trash.”
He sighed. “I’m afraid that’s where the majority of my correspondence ends up. No one wants to listen to what I have to say.”
“We do,” Jess said. “What did you mean in your letter, about peanut allergies?”
Garvey blew air out his mouth, disgusted. “It’s code, obviously. Think about it. When I was a kid, no one had peanut allergies. Okay, some kids did, obviously. Of course. But the numbers reported today? Come on.”
“Code for what?”
He turned to Sean. “You came here because your child got sick from medicine he was taking. Unnecessary medicine. I agree. But it’s much bigger than one or two children. It’s happening all the time at these schools. I’ve been trying to expose this thing for years.”
Sean swallowed, reminding himself to breathe.
“But every time a kid goes down, it’s a peanut allergy, a bee sting, something, anything other than a reaction to the amphetamines or methylphenidates they’ve been given to make them zombies at school. And for some reason parents aren’t coming forward.” He scooted his chair closer, fixing Sean with a grateful expression. “Until now.”
“Why not?”
“Stigma? Embarrassment? Fear?” Garvey shrugged. “Who knows?” He paused, gathering himself. “So Mr …”
“Call me Sean.”
“Sean, tell me what happened to your son. And don’t leave anything out.”
Garvey scribbled in his notebook as Sean told him what had happened to Toby and what he suspected had happened to Calvin. He included what Noah had said, how the school had pressured him to get Toby evaluated and also about Dr. Altherra. He told Garvey how Melanie Drake had reacted when he asked about the medication.
“Okay,” he said, finishing his notes. “Okay. I’m going to get you up to speed on the big picture.”
“There’s a big picture?” Jess asked.
“You have to know the background before you can understand any of what’s going on now. I read everything,” he said, making a sweeping gesture to all the cabinets and newspapers and clippings surrounding them,
“everything
written about it.”
“Why haven’t you called the police if you know Bradley’s doing this?”
“Been there, done that,” he said. “It’s not that easy. These schools, Bradley especially, have an uncanny way of making you look like an escapee from the loony bin if you say anything negative about them. Look at me. My family wants nothing to do with me. My practice, my reputation—all ruined. I’m banished to fucking Chesswick, PA.” He shook his head. “Hard evidence. That’s what I’m working on. You can help me with this.”
“But,” Sean said, suddenly worried about what he was getting into. “What do you mean?”
“First, you have to listen. I’m going to give you the background, the history, the numbers. Numbers never lie.”
“I don’t need to know the history. I know my son didn’t have ADHD. If you’re telling me this has happened before, that’s enough for me.”
“Sean, please. Pay attention.” Garvey raised his eyebrows in warning. “Attention Deficit and hyperactivity are serious problems from which fewer than two percent of the population suffers.” He snorted. “The ADHD being diagnosed today is a disorder fabricated by big pharmaceutical companies to make big, and I mean
huge
money on drug sales.”
“It’s not
fabricated,”
Jess said. “I’ve taught kids who’ve literally jumped off walls and bitten other students.”
“That’s right,” Garvey said. “Two percent of the population will benefit from being medicated. No doubt about it. Don’t believe me. Go read the
Journal of Attention Disorders
from June. Penn State psychologists tested 1,473 children and concluded children are no more or less inattentive and impulsive today than in 1983. And yet ADD is spreading across the country like a virus with diagnoses increasing 5.5 percent every single year. There’s no more actual ADD now than there was thirty years ago, but doctors wrote 51.5 million prescriptions for attention drugs in 2010, up 83 percent from 2006.” He sat back, as if exhausted, and let his hands fall into his lap. “Boys are not docile, easily controllable, or easily teachable like some girls. It takes more energy, more creativity, more patience to teach boys.”
“True,” Jess said. “It’s harder.”
“And when teachers aren’t interested in teaching, that shows up on the report cards and in conferences. Parents get scared their kids are going to fail out of school. Cue the school psychologist, psycho-pharmacologist, pharmacist, and the problem is solved. Easy, right?” The guy was amped up, but he seemed to know his facts. “It’s why 13.2 percent of all boys have been diagnosed at some point with ADHD as opposed to 5.6 percent of girls.”
The numbers were staggering. He didn’t know what to ask first. “So that’s what Bradley does?” Sean asked. “That’s what happened to Toby?”
“That would be my theory,” he said. “Even with what you’ve just told me, I don’t know all the particulars of what happened to Toby, but I do know the history.”
He cleared his throat and sat back in his chair professorially. “Ritalin has been around for half a century. In 1957, the Ciba Pharmaceutical Company started marketing it to people with chronic fatigue and psychosis associated with depression and narcolepsy. Sure, why not? It’s speed! It’ll pep up anyone, right?” He let out a bitter laugh. “They’ve marketed it over the years for a host of other problems. Starting in the sixties, they used it on kids with hyperkinetic syndrome, which later became ADD. Now there’s ADHD, Attention Deficit Hyperactivity Disorder. Pretty much the same thing, just add some hyperness to the mix. You get the idea. In the seventies and eighties, drug companies developed a handful of other stimulants to treat it. But medicating children back then was still unusual, except in extreme cases where children were a danger to themselves and others.” Garvey’s eyes widened in anticipation of his next point. “But then, suddenly—and no one knows why—between 1991 and 1999, sales of Ritalin and other ADD medications increased five hundred percent in the U.S. alone.” He paused for emphasis. “Five
hundred
percent. The United States, land of the free, consumes 85 percent of the world’s production of Ritalin. The numbers are insane. In 2010, attention drugs were a 7.42 billion-dollar industry.” Garvey opened a medical journal to a flagged page and read aloud: “Shire Pharmaceuticals sold 759 million dollar’s worth of Adderall XR, that’s extended release, in 2004 alone.” He snapped the journal closed. “And that’s not even mentioning Concerta, Strattera, Provigil, or the original Metattent—which, by the way never did much business until the Junior version came out.”
“That’s what Toby was taking,” Sean confirmed.
“Ah yes.” Garvey shook his head to convey something between awe and disgust. “The kiddie pill. Right. Other than some food coloring to make them look more like Flintstones vitamins, the active ingredients are virtually the same as in Ritalin.”
“But …” What was the right question? “Then why did … Didn’t the FDA have to …”
“Puh-leese,” Garvey spat out. “The FDA. I’m talking about the medication wars, Sean. Have you heard anything I’ve said? Do you think a little obstacle like the Federal Drug Administration is going to get in the way of big pharma?”
“Isn’t that the point?” Jess said.
Garvey sighed. “Listen carefully. I’m only going to do this once.” He settled into the leather chair and continued the lecture. “When the original Metattent hit the market in 1980, sales never even came close to Ritalin’s. The public had no reason to choose it over Ritalin, since it was—for all intents and purposes—the same drug. Plus, don’t forget, Ritalin had the name recognition and the decades of quote-unquote
evidence
of its safety. Klovis, the company that made Metattent, they knew they had to get a gimmick, and fast. They got the gimmick, all right. But it wasn’t fast. It took twenty years to get Metattent Junior approved. And by 2004, when it hit the market, there were more children taking ADD medication than ever. Parents were now on the Internet reading all sorts of horror stories about Ritalin, talking to each other online about it. And voilà. Suddenly, their doctors present them with a new drug specifically designed to put all those fears to rest. Supply and demand. It’s basic economics. And with roughly two million children a
month
taking drugs for ADD in this country, there was plenty of demand. The first year Metattent Junior was on the market, it outsold Ritalin for the pre-teen set two to one. The second year, it made $980 million, three times what it cost to develop the drug.”