Robin Cook (11 page)

She looked terrible. Her cheeks were streaked and her eyes were red from crying. Her hair was half in a bun, half out, hanging limply over her shoulders.

“Don't tell me,” said Adam. “Your parents are moving to Bangladesh.”

Large tears welled up in her eyes, and Adam wished he'd kept his big mouth shut. He sat down next to her and put his arm around her shoulders.

“I tried to call you earlier,” said Adam. “The phone was busy.”

Jennifer let her hands drop into her lap. “Why were you calling?”

“Just to tell you I was going to be a little late. I got you a little surprise. Interested?”

Jennifer nodded. Adam went out and got the package. She opened it slowly. Finally, after carefully refolding the paper, she opened the box.

Expecting delight, Adam was upset when Jennifer just sat holding the pretty Belle France chemise, the tears continuing to roll down her cheeks.

“Don't you like it?” he asked.

Jennifer wiped her eyes and pulled the dress out of the box, stood up and held it under her chin so she could see herself in the mirror. “It's gorgeous,” she said. “But where did you get the money?”

Adam shrugged his shoulders. “If you don't like it, I'm sure you can exchange it.”

Jennifer walked back to Adam and, with the dress still pressed against her chest, kissed him on the mouth. “I love it. It's one of the prettiest dresses I've ever seen.”

“Then why are you crying?”

“Because I had such an awful day. Did you ever meet Cheryl, Jason's secretary?”

“I don't think so,” said Adam.

“It doesn't matter,” said Jennifer. “But she was only nineteen or twenty. Today I went with her to a place called the Julian Clinic . . .”

“I know of it,” interrupted Adam. “A huge, new HMO organization, kind of like the Mayo Clinic. Some of the students that have gone there for various rotations say it's a bit weird.”

“It wasn't the place that was strange,” said Jennifer. “It was what happened. Cheryl went there to have an abortion.”

Adam cringed. “Wonderful!” he said with sarcasm. “You went with someone to have an abortion? Jennifer, are you crazy?”

“She didn't have anybody else,” explained Jennifer. “I couldn't let her go alone.”

“Of course not,” said Adam. “But if you don't mind my asking, where was her family or her boyfriend? Why did it have to be you, Jennifer?”

“I don't know,” admitted Jennifer. “But I went. And then she died!”

“Died!” repeated Adam with horror. “What did she die of? Was she sick?”

Jennifer shook her head. “She was apparently quite healthy. They were just about to do the abortion when Cheryl realized her own doctor wasn't present, and she refused to go ahead with the procedure. She expected a Dr. Foley, but the man is dead. He'd committed suicide. So another doctor was going to do the abortion.”

“In some group practices the patient can't choose which physician they see,” said Adam.

“That may be true,” said Jennifer, “but it seems to me that the patient should be informed in advance if the doctor she expected is not going to be there.”

“I can't argue with that,” said Adam. “But if she refused the abortion, how did she die?”

“They said it was diffuse intravascular coagulation. She died right in front of me. One minute she was all right, and the next minute she fell on the floor bleeding. It was awful.” Jennifer pulled her lower lip into her mouth and bit on it. Her eyes filled with tears.

Adam put both arms around her and patted her back.

Neither spoke for a few moments. Adam let Jennifer calm down while he puzzled over the story. How could Cheryl have died of DIC if the abortion had been canceled? He guessed that it had been a saline induced abortion and the solution had already been started. He was tempted to ask more
but thought it best if Jennifer weren't made to dwell on the experience.

But Jennifer was unwilling to drop the subject. “What is diffuse intravascular coagulation?” she asked. “Is it common?”

“No, no,” assured Adam. “It's very rare. I don't know too much about it. I don't think anybody does. Something starts the clotting process inside the blood vessels. I think it's associated with extensive trauma or bad burns and occasionally with abortions. But in any case, it is rare.”

“It doesn't happen to people who are just pregnant?” asked Jennifer.

“Absolutely not!” said Adam. “Now I don't want you to get medical-schoolitis and think you're going to come down with every exotic disease you hear about. Right now I want you to take a shower, try on this new dress, and then we'll eat.”

“I didn't get groceries,” said Jennifer.

“I noticed,” said Adam. “No matter. I have a wallet full of money and I'm dying to tell you how I got it. You take a shower and we'll go out to a fancy restaurant and celebrate, OK?”

Jennifer got a tissue and blew her nose. “OK,” she managed. “I hope I'll be good company. I'm so upset.”

While Jennifer showered, Adam stepped into the living room and looked up DIC. As he expected, the condition was not related to pregnancy. Putting the medical text back on the shelf, he noticed the
PDR.
His curiosity piqued, he slipped the volume out of the bookcase and turned to the section for Arolen Pharmaceuticals. Except for an extensive list of generic antibiotics, Arolen did not have many exclusive products in the patented prescription drug category. There were several tranquilizers
that Adam did not recognize as well as some anti-nausea preparations, including one for pregnant women, called pregdolen.

Adam wondered how Arolen managed to do so well with such a small list of new products. They had to sell a lot of drugs to pay for the impressive headquarters. He put the book back, deciding Arolen's financial base was none of his business. At least not as long as they continued to pay his generous salary.

Two days later, Adam was waiting on the street in front of his apartment house for the Arolen rep to pick him up. McGuire had called the preceding evening and said that a Percy Harmon would meet Adam at eight-thirty and take him on a round of sales calls.

Adam had been standing outside for nearly twenty minutes, but despite the cold drizzle he was glad to be out of the apartment. Although he and Jennifer had patched up their quarrel, she was still upset that he had dropped out of medical school and taken a job at a drug company. He knew part of the reason her reaction bothered him so much was his own ambivalence about working for Arolen. Still, it wasn't forever and it did solve their financial problems. Maybe his in-laws would even tell her he'd done the right thing when she went out to visit today, but he doubted it.

A blue Chevy was slowing in front of him. The driver stopped and rolled down the window. “Can you tell me where 514 is?”

“Percy Harmon?” called Adam.

“You betcha,” answered the driver as he leaned over and opened the passenger-side door.

Closing his jacket against the rain, Adam ran down the steps and ducked into the car.

Percy apologized for being late, explaining that traffic on the FDR Drive had been murderous due to an accident at the Forty-ninth Street exit.

Adam liked Percy immediately, appreciating his friendliness. He was a little older than Adam and was dressed in a dark blue suit with a red polka-dot tie and matching handkerchief. He looked businesslike and successful.

They turned north on Park Avenue and headed uptown.

“Clarence McGuire was pretty enthusiastic about you on the telephone,” said Percy. “What's your secret?”

“I don't know for sure,” said Adam, “but I suppose it's because I was a third-year medical student at the medical center.”

“Good God, of course that's it!” said Percy. “No wonder they loved you. With your background, you'll be way ahead of us laymen.”

Adam was far from convinced. He'd learned a lot of facts about bones and enzymes, and the function of T-lymphocytes. But how useful was that information to Arolen? Besides, such facts had a disturbing way of dropping out of Adam's mind after a particular test was over. He glanced around the inside of Percy's car. There were pamphlets in boxes on the back seat. Next to the boxes were looseleaf notebooks, computer printouts, and a pile of order forms. Printed memoranda were stuck into the recesses on the dash. The car had the look of a busy office. Adam was not convinced that his medical-school background would be of
any use in his new job. He glanced over at Percy, who was busy navigating the New York City traffic. The man looked relaxed and confident and Adam felt envious.

“How'd you get involved with Arolen?” asked Adam.

“I was recruited straight out of business school,” said Percy. “I'd taken some health economics courses in college and was interested in the health field. Somehow Arolen found out and contacted me for an interview. I researched the company and was impressed. Being a sales rep has been fun, but I'm looking forward to the next step. And thanks to you, I'm heading off for the managerial training in Puerto Rico.”

“What do you mean ‘thanks to me'?”

“Clarence told me that you were going to be my replacement. I've been trying to go to Puerto Rico for a year.”

“They offered me the same opportunity,” said Adam.

“To go straight to Puerto Rico?” exclaimed Percy. “My God, man, take them up on it. I don't know if you know it but Arolen is owned by an extremely fast-growing financial group. About ten years ago some clever guys started an organization called MTIC to invest in the health industry. Arolen was one of their first acquisitions. When they got control of the company, it was an inconsequential drug house. Now it is challenging the biggies like Lilly and Merck. Joining now, you'll still be getting in on the ground floor. Who did you meet out at Arolen besides Clarence McGuire?”

“Bill Shelly and Dr. Nachman.”

Percy whistled and took his eyes off the traffic long enough to give Adam an appraising glance.
“You got to meet two of the original MTIC founders. Both are rumored to be on the board of directors of MTIC as well as having executive positions with Arolen. And how did you meet Nachman? He is the head of research down in Puerto Rico.”

“He was here for some meeting,” explained Adam curtly. Percy's response made him wonder anew if Arolen was interested in him or, despite their assurances, his father.

“The other thing about Puerto Rico,” Percy was saying, “is that the center there is as luxurious as a resort. I've only been there once, but it is out of this world. I'm looking forward to training there. It's going to seem like a paid vacation.”

Watching the rain beat on the windshield, Adam wondered what kind of maternity facilities they had in Puerto Rico. The idea of bright sun as well as the chance to get Jennifer away from her parents had certain appeal. He sighed. It was nice to daydream, but the fact of the matter was that he wanted to stay as near to the medical center as possible. Puerto Rico was out of the question.

“Here we are,” said Percy, guiding the car over to the curb in front of a typical midtown New York City apartment building. He parked in a “No Standing” tow zone, opened the glove compartment and took out a small sign that read: “Visiting Physician.” “This represents a slight distortion of the usual meaning of this phrase, but it's nonetheless true,” he said, smiling at Adam. “Now let's plan the attack. The idea here is for you to get some idea of what it's like to call on a typical physician. This fellow's name is Dr. Jerry Smith. He happens to be a very successful Park Avenue obstetrician. He's also a horse's ass. He thinks of himself as some intellectual giant, so it will be
extremely easy to butter him up. He also likes free samples, a predilection which we will be happy to indulge. Any questions before we go to battle?”

Adam said no, but Dr. Markowitz's comment about defecting to the enemy haunted him as he got out of the car. Percy opened the trunk and gave Adam a large umbrella to hold while he got out a bunch of drug samples.

“Smith's favorites are tranquilizers,” said Percy. “Whatever he does with them all, I have no idea.” Percy loaded a small cardboard box with a variety of drugs, then closed the trunk.

Dr. Smith's office was packed with women. The air was close and smelled of damp wool.

Adam hurried after Percy, who went straight to the receptionist. Reluctantly, Adam glanced around and saw many pairs of eyes regarding him over the tops of magazines.

“Hello, Carol,” Percy was saying. “What a stunning outfit. And your hair! There's something different. Don't tell me. Let me guess. You got a perm. God, it looks terrific. And how's that little boy of yours? Good, huh. Well, let me introduce you to Adam Schonberg. He's going to be taking over my customers. Now, would you mind if he looked at that dynamite photo you have of your boy? The one on the bear rug.”

Adam found himself holding a cube of plexiglass with different photos on each side. Percy adjusted it in his hand so that he was looking at a chubby baby lying on a bath towel.

“And Carol, what about your father?” asked Percy, taking the picture cube out of Adam's hands and putting it back down on the desk. “Is he out of the hospital yet?”

Two minutes later Percy and Adam were
standing in the doctor's consultation room, waiting for Smith to appear. “That was an amazing performance,” whispered Adam.

“Piece of cake,” said Percy with a wave of his hand. “But I'll tell you something. The receptionist or nurse is the person you have to impress in the doctor's office. She controls access to the physician and if you don't handle her properly, you'll die of old age waiting to get in.”

“But you acted like you were good friends with that woman,” said Adam. “How did you know all those things about her personal life?”

“Arolen provides you with that kind of information,” said Percy simply. “Arolen keeps a complete record on every member of each physician's staff as well as the doctor himself. You feed it into the computer. Then when you have questions, you can get the answers. Nothing mysterious about it. It's just attention to detail.”

Adam glanced around Smith's office. It was elegantly furnished, composed of dark lacquered cabinets and floor-to-ceiling bookshelves. Facing into the room was a large mahogany desk, piled high with journals. Adam glanced at the date on the top issue of the
American Journal of Obstetrics and Gynecology.
It was more than a year old. A paper mailing binder was still around the magazine. It had never been opened.

The door opened. Dr. Smith stopped on the threshold and called down the hall. “Put the next patients into rooms six and seven.”

A voice answered, but it was too far away to hear.

“I know I'm behind schedule,” shouted Dr. Smith. “So what else is new? Tell them I've got an important conference.” He came into the office and kicked
the door shut behind him. “Nurses, shit!” He was a big man with an impressive paunch. His heavy jowls made him look like an old bulldog.

“Dr. Smith, how are you?” beamed Percy. Smith allowed the rep to shake his hand and then quickly retreated behind his desk, where he brought out a pack of filter-tipped Camels. He lit one and blew the smoke out through his nostrils.

“I'd like you to meet Adam Schonberg,” continued Percy, gesturing toward Adam. “He's started training for Arolen and I'm taking him around to meet a few of my more prestigious clients.”

The doctor smiled and said, “Well, what do you boys have for me this morning?”

“All sorts of samples,” said Percy, putting the cardboard box on the edge of the desk and opening it. Dr. Smith eagerly moved forward on his chair.

“I know how much you like Marlium, Arolen's top-selling tranquilizer, so I brought you a good supply. You'll notice that the packaging has been improved. Patients love these new bright yellow bottles. I also have a reprint for you. Studies just completed at the Julian Clinic here in New York indicate that Marlium has the fewest side effects of any tranquilizer on the market today. But I don't have to tell you that. You've been telling us the same thing for as long as I can remember.”

“Damn right,” said Dr. Smith.

Percy lined up the other drug samples in neat rows on Dr. Smith's desk, all the time maintaining a running commentary on the proven excellence of the various products. At every possible juncture he complimented Dr. Smith's perspicacity in prescribing Arolen drugs for his patients.

“And last but not least,” said Percy, “I've brought you fifty starter samples of pregdolen. I know I
don't have to convince you of the virtues of this drug for morning sickness. You were one of the first to recognize its value. However, I do have a reprint of a recent article that I'd like you to read when you get a chance. It compares pregdolen with other similar drugs on the market and shows that pregdolen is cleared by the liver faster than anything put out by the competition.”

Percy put a glossy reprint on top of one of the piles on Dr. Smith's desk.

“By the way, how is that boy of yours, David? Isn't he a junior now up at Boston University? Adam, you should meet this kid. Looks like Tom Selleck, only better.”

“He's doing very well, thanks,” beamed Dr. Smith. He took one last drag on his cigarette before crushing it in a beanbag ashtray. “The kid is premed, you know.”

“I know,” said Percy. “He's not going to have any trouble getting into medical school.”

Fifteen minutes later Adam found himself climbing back into the passenger side of the Chevy Celebrity. Percy slid the umbrella in on the floor of the back seat and then got behind the wheel. There was a parking ticket under the windshield wiper.

“Oh, well,” said Percy. “That sign of mine doesn't always work.” He turned on the wipers and the ticket disappeared. “Ta-da!” he said, raising his hands as if he'd just done a magic trick. “The car is registered to Arolen and the legal department takes care of that sort of thing. Now, let's see who's next.” He picked up the clipboard and turned to the next computer printout.

The morning passed quickly as Adam watched Percy expertly handle receptionists and push Arolen products onto busy practitioners. Adam was amazed
at how effective Percy was with the physicians. Having talked with Percy all morning, he was aware of how little scientific information Percy had to draw on. Yet it didn't seem to matter. Percy knew just enough to make it sound as if he knew a great deal, and armed with a lot of current drug information, he was able to snow the physician. Adam began to appreciate the low regard that Arolen had for the intelligence of the average doctor.

Around eleven-thirty, after leaving the office of an internist on Sutton Place South, Percy got into the car and rested his head on the steering wheel. “I think I'm having a hypoglycemic crisis. I gotta get something to eat. Is it too early for you?”

“It's never too early for me,” said Adam.

“Great!” said Percy. “Since Arolen is paying, we're going to do it right.”