Megan's Cure (39 page)

Afterword: Reflections on Big Pharma

The first medical scandal that came to my attention was the Thalidomide disaster.

In the late 1950s and early 1960s some 10,000 babies were born with serious birth defects.
  
The most common defects were arms or legs that had never developed, leaving flipper-like appendages.
 
I still recall the photos of children with tiny, useless arms sitting in a chair while they used their remarkably agile toes to tie knots or perform other daily tasks.

Then, as someone who was news-obsessed even at a young age and would eventually become a newspaper reporter specializing in investigating scandals, I paid close attention to other medical disasters over the years. They were riveting stories.

The Tylenol murders when seven people died after taking Tylenol capsules that someone had spiked with cyanide.

The spread of AIDS through blood transfusions in the early years of the disease before tests to detect the HIV virus were perfected.
 
The father of my close high school friend died that way.

There were recalls every year of a handful of medicines and medical devices right up to the present day.
 
Vioxx.
 
Fen-phen.
 
Breast implants leaking silicon.
 
Artificial hips leaving metal shavings inside patients.
 
The problems ranged from addiction and heart attacks to liver failure and amnesia.
 
Sometimes the medicine just turned out to be ineffective or the device failed too soon.

Yet, all of this happened against the backdrop of astonishing medical success.
 
Breakthroughs in medical science seemed to hit the headlines every day.
 
Organ transplants became everyday events.
 
Diseases that once killed or maimed millions – like smallpox and polio – became nearly extinct.
 
Fatal cancers became curable.
 
Bypass surgery.
 
Artificial joints.
 
Cholesterol-reducing statins.
 
Magic Johnson survived AIDS.

That intrigued me – the duality.

On one hand, there was the world of medicine – including the pharmaceutical industry – acting like God.
 
It promised us extra years of life that would be pain-free, physically active and devoid of depression.
 

Then there was that darker side.

The one that rushed pills onto the market either neglecting – or hiding – the additional tests that would later show that the medicine promising so much good actually caused harm.
 

The sales and marketing arms of Big Pharma quietly paid doctors and scientists to tout their wares at medical conferences, bought physicians’ loyalty with presents and lavish vacations, and abruptly pulled funding when studies started to find trouble in their products.

Drug companies stopped work on promising cures because the afflicted were too few – or too poor – to bring in big profits.

In just the past few years, the problems have hit an all-time high, at least in terms of penalties levied against the industry.
 
Billion-dollar settlements have been paid by Johnson & Johnson, GlaxoSmithKline, Pfizer, Abbott and Merck.
 
Most often it’s been for overreaching with the new wave of psychotropic drugs, but painkillers and faulty artificial joints have had their place as well.

Invariably, it seems, the drug companies wait too long to pull a medicine or device once there is evidence that it’s faulty.
 
Instead, they ignore victims, stonewall regulators and hide evidence as long as possible while they wring out the last drops of profit.

I guess that’s why I chose to shine the spotlight on Big Pharma in Megan’s Cure – the Jekyll-and-Hyde nature of the business.
 
Plus there is so much at stake.
 
Often it truly is a matter of life and death.

-R. Lowe

Acknowledgments:

I am fortunate to have a number of friends and relatives who helped expand my understanding of the medical profession, hospitals, cancer research and the internal workings of laboratories.
 
Between approach shots and 20-foot putts, Dr. Scott Lee told me about his work more than two decades ago searching for genetic keys to unlock the mysteries of cancer.
 
David Egerter, whose long career writing about drugs for the industry requires expert knowledge of the underlying science, listened patiently while I lobbed questions and plot scenarios at him between lattes at the Boot and Shoe (yes…it’s a restaurant).
  
My sister Janice Lowe and her husband, Paul Wise, are both pediatricians at Stanford Hospital and helped me pretend I knew something about medicine and hospitals.
 

On the editing side, my wife Candace Turtle and friend Laura Pepper Wu nudged me back on the rails when I began to slide off.
 
My former college roommate Carl Vonderau, who also writes mystery thrillers, gave me a fantastic critique full of recommendations.
 
I implemented many of them to good effect.
 
Paul Vollmer generously helped me with a detailed line edit, catching a ton of mistakes.
 
My daughter Chenery, whose plans include medical school, both gave me excellent copy editing as well as helped paint the picture of a modern research lab.

I must also thank a large network of family and friends and who are huge supporters of my books.
 
Writing is lonely work.
 
There are moments of elation, warranted or not, but also plenty of despair.
 
You only have to look at your bookshelves to see the many examples of work that you can only dream of equaling.
 
The pats on the back are much appreciated.

I’m also grateful to the many readers who have not only plunked down a few dollars to read about Enzo Lee’s latest adventure and the ongoing events in his life, but often take the extra time to write a review or comment on Facebook.
 
I do listen to what people have to say – good and bad.
  
Collectively, those comments have taught me a lot about my own writing and greatly influenced the development of the Enzo Lee series.
  
–
R. Lowe