Robin Cook (12 page)

Adam had joked in the past about the Four Seasons restaurant as being a symbol of the rich, though he'd never been in the place. When Percy had suggested they go there, Adam thought he was joking. When he led the way into the Grill Room, Adam almost passed out.

Putting his linen napkin on his lap, Adam tried to remember what it was like in the crowded hospital cafeteria. It seemed a million miles away. A waiter asked Adam if he wanted a drink. Not sure of himself, he looked over at Percy who calmly ordered a martini. What the hell, thought Adam, who quickly said he'd have the same.

“So what is your impression of the business now that you've gotten your feet wet?”

“It's interesting,” said Adam evasively. “Do you eat here every day?”

“No, to tell you the truth. But McGuire said to impress you.”

Adam laughed. He liked Percy's candor. “I'm impressed enough with your abilities. You're very good.”

Percy shook his head. “It's easy. Like catching fish at a trout farm. For some inexplicable reason, doctors know very little about drugs. Maybe you can tell me the reason.”

Adam thought for a moment. He'd had courses in pharmacology like everyone else, but it was true that he knew very little about the actual use of the drugs. He'd only been taught about their action on a cellular level. What little he knew about prescribing he'd picked up on the wards. Before he could answer Percy's question, their drinks arrived.

“Here's to your career with Arolen,” said Percy, holding up his glass.

“What about this pregdolen you've been pushing?” asked Adam, remembering Jennifer's recent complaints. “My wife has been having some trouble with morning sickness. Maybe I should take a couple of those starter samples.”

“I wouldn't if I were you,” said Percy, suddenly serious. “I know Arolen sells a ton of it, and a lot of people think it's the best thing since sliced bread, but I don't think the drug works and there's a possibility it's toxic.”

“What do you mean?” asked Adam.

“It's been written up in several of the more important medical journals,” said Percy, taking another sip of his drink. “Of course, I don't refer to those articles when I call on the doctors. Obviously the doctors haven't read them because they keep prescribing the stuff like crazy. It sure explodes the myth that doctors get their drug information from the medical journals. For most practitioners
that's bullshit. They get their drug information, what little they get, from the likes of me, and I only tell them what I want to tell them.”

Percy shrugged when he noticed Adam's shocked expression. “You more than anyone must know that doctors prescribe out of hunch and habit. Our job is to try to make Arolen part of that habit.”

Adam slowly turned his glass and watched the olive revolve. He was beginning to realize what he'd have to close his eyes to in this line of work.

Sensing Adam's misgivings, Percy added, “To tell you the honest truth, it will be a relief to get away from the sales end of the business.”

“Why?” asked Adam.

Percy sighed. “I don't know how much of this I should be telling you. I don't want to dampen your enthusiasm. But some weird things have been going on in my area. For instance, a number of doctors that I'd been seeing on a regular basis have been taken off my sales list. At first I thought that they'd moved away or died, but then I found out that most of them had gone on an Arolen Conference Cruise, come back, and given up their practices to go to the Julian Clinic.”

“Julian Clinic” evoked a strange response in the pit of Adam's stomach, as he remembered the name from Jennifer's story.

“Some of those doctors I'd gotten to know pretty well,” continued Percy, “so I went to see them even though the Julian Clinic isn't part of my territory. What struck me was that they had all changed somehow. A good example was a Dr. Lawrence Foley I'd been seeing since I began working for Arolen. He didn't have much use for Arolen products, but I saw him because I liked the man. In fact, we played tennis about twice a month.”

“The Lawrence Foley who just committed suicide?” asked Adam.

“That's the one,” said Percy. “And his suicide is part of the kind of change I'm talking about. I really felt I knew the man. He was a partner in one of the busiest OB-GYN practices in town. Then he went away on an Arolen cruise, came back, and gave up everything to work at the Julian Clinic. When I went to see him, he was a different man. He was so preoccupied with work, he couldn't take the time to play tennis. And he was not the suicidal type. The man had never been depressed a day in his life, and he loved his work and his wife. When I heard what happened, I couldn't believe it. After shooting his wife he put the shotgun in his mouth and . . .”

“I get the picture,” said Adam quickly. “What's the story about these Arolen Conference Cruises?”

“They are very popular medical seminars that are given on a cruise ship in the Caribbean. The lecturers are the most famous professors and researchers in their various fields. The meetings have the best reputation of any medical conventions in the country,” said Percy. “But that's all I know. Being curious, I asked Clarence McGuire about them, but he said he didn't know much more except that they were organized by MTIC.”

“If you're really curious,” said Adam, “why not ask Bill Shelly? If what you told me is true about Arolen liking information about doctors, it seems to me they'd be fascinated by your observations. Besides, I can tell you that Bill Shelly is a surprisingly young and personable guy.”

“No kidding,” said Percy. “Maybe you're right. Maybe I'll go over there this afternoon. I've always wanted to meet Mr. Shelly and this could be my chance.”

• • •

When Adam asked Percy to drop him off at the medical center late that afternoon, he had the feeling he was not going to be the same doctor after working for Arolen. They had visited sixteen physicians' offices and had, according to Percy, dispensed over five hundred bottles of sample drugs. Most of the doctors had been like Smith: eager to get the samples, quick to accept Percy's pitch.

Adam went into the hospital through the medical school entrance and headed up to the periodical room at the library. He wanted to look up pregdolen in the recent journals. Percy's comments had made him curious, and he did not like the idea of selling a drug with really bad side effects.

He found what he wanted in a ten-month-old issue of the
New England Journal of Medicine.
It would have been hard for a practicing OB man to have missed it.

Just as Percy had suggested, pregdolen had proved inefficacious when tested against a placebo. In fact, in all but three cases the placebo had done a better job in controlling morning sickness. More importantly, the studies showed that pregdolen was often teratogenic, causing severe developmental abnormalities in fetuses.

Turning to the
Journal of Applied Pharmacology,
Adam found that despite the adverse publicity, pregdolen's sales had shown a steady increase over the years, with an especially impressive surge in the last year. Adam closed the journal, wondering if he were more awed by Arolen's marketing abilities or the average obstetrician's ignorance.

Putting the magazine back, he decided it was a tossup.

• • •

Percy Harmon felt like he was on top of the world as he drove out of the parking area of his favorite Japanese restaurant with a fabulous meal of steak sukiyaki under his belt. The restaurant was located in, of all places, Fort Lee, New Jersey, but at that hour of the night, ten-thirty, it wouldn't take more than twenty minutes to return to his apartment in Manhattan.

He did not notice the nondescript man in a blue blazer and tan slacks who'd stayed at the bar the entire time Percy had been in the restaurant. The man watched until the blue Chevy disappeared from sight, then made for the nearby phone booth. “He's left the restaurant. Should be at the garage in fifteen minutes. I'll call the airport.”

Without waiting for an answer, the man cut the connection and dropped in two more coins. He pushed the buttons slowly, almost mechanically.

Driving down the Harlem River Drive, Percy wondered why he had never thought of going to Bill Shelly before. Not only had the man welcomed Percy's observations, he'd been downright friendly. In fact, he'd taken Percy to meet the executive vice-president, and making those kinds of contacts within an organization like Arolen was invaluable. Percy felt that his future had never looked so promising.

Percy stopped in front of the garage Arolen had found for him just four blocks from his Seventy-fourth Street apartment. The only time it was inconvenient was when it was raining. It was in a huge warehouselike structure that dominated the potholed street. The entrance was barred by an imposing metal grate. Percy pressed the remote
control device that he kept in the glove compartment and the grate lifted. Above the entrance was a single sign that said simply “Parking, day, week, or month,” followed by a local telephone number.

After Percy had driven inside, the metal grille reactivated and with a terrible screeching closed with a definitive thud. There were no assigned spots, and Percy made a hopeful swing around before heading down the ramp to the next level. He preferred to park on the ground floor; the ill-lit spaces of the substreet levels always made him nervous.

Because of the late hour, Percy had to descend three levels before finding a spot. He locked the car and walked toward the stairwell, whistling to keep his spirits up. His heels echoed against the oil-stained cement floor and in the distance he could hear water dripping. Reaching the stairs, he yanked open the door and almost fainted with shock. Two men with old-fashioned crew cuts and wearing plain blue blazers faced him. They didn't move, they didn't speak. They just stood blocking his way.

Fear spread through Percy's body like a bolt of electricity. He let go of the door and stepped backward. One of the men reached out and with a bang sent the door crashing against the wall. Percy turned and fled, racing for the stairwell at the opposite end of the garage. His leather-soled shoes skidded on the concrete, making it hard for him to keep his balance.

Looking over his shoulder, he was relieved to see that neither of the two men was in pursuit. He reached the door of the far exit and tried to pull it open. The handle didn't budge. His heart sank. The door was locked!

All he could hear was the rasping sound of his own breath and the constant drip of water. The only other way out was the ramp and he started toward it. He was almost there when he saw one of the men standing immobile at the base of the sloping driveway, his arms at his side. Percy ducked behind a parked car and tried to think what to do. Obviously the men had split up; one was watching the stairwell, the other the ramp. It was then that Percy remembered the old automobile elevator in the center.

Keeping low, he moved toward it stealthily. When he reached it, he raised the wooden gate, ducked under, then lowered it after himself. The other three walls of the elevator were enclosed with a heavy wire mesh. The only light came from a bare overhead bulb. Percy's shaking finger pushed the button marked “1.”

The elevator activated with a snapping noise, followed by the high-pitched whine of an electric motor. To Percy's relief, the platform jolted, then slowly started to rise.

The elevator moved at an agonizingly slow rate, and Percy was no more than six feet from street level when the two men materialized beneath him.

Without haste, one of them walked over to the elevator control and, to Percy's horror, reversed its direction. Panic-stricken, Percy repeatedly pushed the button, but the elevator relentlessly continued its descent. Gradually, he realized that they had planned for him to use the elevator. That was why they had not chased him. They wanted to trap him.

“What do you want?” he shouted. “You can have my money.” Desperately, he pulled out his wallet and tossed it through the wooden lattice to the
garage floor. One of the men bent and picked it up. Without looking through it, he pocketed it. The other man had pulled out what Percy first thought was a gun. But as he drew closer he realized it was a syringe.

Percy backed to the rear of the elevator, feeling like a trapped animal. As the machinery ground to a stop, one of the men reached out and raised the wooden gate. Percy screamed in terror and slid to the floor.

Just over an hour later, a blue van pulled onto the tarmac at Teterboro Airport and rolled to a stop in front of a Gulf Stream jet. Two men got out, walked to the rear of the van, and hefted out a sizable wooden crate. Silently, the cargo door on the plane slid open.

There must have been more than a hundred people in the conference room. All had come to watch their friends and relatives graduate the Arolen sales course. Arnold Wiseman, the man who'd been in charge of the course, sat in the front of the podium next to Bill Shelly. To their right was a large limp American flag.

Adam was somewhat embarrassed by the ceremony, aware that Arolen was making more of a production than the four weeks of classes deserved. Yet it was fitting, since Adam had learned that nine-tenths of what the drug rep sold was pure show.

When he thought about it, Adam was amazed at how quickly those four weeks had gone. From the first day, he had realized that his two and a half years of medical school put him ahead of everyone else. Half of the other twenty students had degrees in pharmacology, five had master's degrees in business administration, and the rest were from various departments of Arolen Pharmaceuticals.

Adam searched the crowd for Jennifer, thinking
she might have changed her mind at the last minute and come, but even as he searched he realized it was a vain hope. She'd been against his working for Arolen from the beginning, and even if she had overcome her distaste for his new job, her morning sickness had become so severe that she could rarely leave the apartment before noon. Still, he couldn't keep himself from staring at all the dark-haired women in the audience in case by some miracle she had arrived.

Suddenly his roving gaze stopped short at a small man with dark curly hair dressed in a black raincoat. He was standing by the entrance with his hands thrust into his pockets. Plain, wire-rimmed eyeglasses rested on his aquiline nose.

Adam turned away, thinking his eyes were playing a trick on him. Then he slowly turned to look at the man again. There was no doubt. It was his father.

Adam spent the rest of the ceremony in a state of shock. When the formalities were concluded and the reception had begun, he pushed his way toward the door where the man was standing. It was his father all right.

“Dad?” said Adam.

Dr. Schonberg turned around. He was holding a shrimp on the end of a toothpick. There was no smile on his lips or in his eyes.

“What a surprise,” said Adam, unsure how to act. He was flattered that his father had come, but nervous too.

“So it is true,” said Dr. Schonberg sternly. “You're working for Arolen Pharmaceuticals!”

Adam nodded.

“What happened to medical school?” asked Dr. Schonberg angrily. “What am I going to say to
your mother? And after I went to such lengths to be sure you would be admitted!”

“I think my A average had something to do with that,” said Adam. “Besides, I'll go back. I've just taken a leave of absence.”

“Why?” demanded Dr. Schonberg.

“Because we need the money,” said Adam. “We are going to have a child.”

For a moment Adam thought he saw a softening in his father's expression. Then Dr. Schonberg was looking about the room with distaste. “So you have allied yourself with this . . .” He gestured at the sumptuously appointed hall. “Don't tell me you are unaware that business interests are trying to take over the medical profession.”

“Arolen provides a public service,” said Adam defensively.

“Spare me,” said Dr. Schonberg. “I'm not interested in their propaganda. The drug houses and the holding companies that control them are out to make money like any other industry, yet they waste millions of PR dollars trying to convince the public otherwise. Well, it is a lie. And to think that my own son has become a part of it and because of that girl he married . . .”

“Her name is Jennifer,” snapped Adam, feeling the blood rise to his face.

“Dr. David Schonberg.” Bill Shelly had come up behind Adam, champagne glass in hand. “Welcome to Arolen. I'm sure you are as proud of your son as we are. My name is Bill Shelly.”

Dr. Schonberg ignored the hand. “I know who you are,” he said. “And to be perfectly honest, I am appalled rather than proud to see my son here. The only reason I responded to your invitation was to make certain that Arolen is not expecting
any special considerations because Adam here has joined your organization.”

“Dad,” sputtered Adam.

“I've always appreciated honesty,” said Bill, withdrawing his hand, “and I can assure you that we did not hire Adam because his father is with the FDA.”

“I hope that is true,” said Dr. Schonberg. “I wouldn't want you to think that Arolen will have an easier time getting new drugs approved.”

Without waiting for a reply, Dr. Schonberg tossed his shrimp into a wastebasket and pushed through the crowd toward the door.

Adam shook his head in disbelief. “I'm terribly sorry,” he said to Bill Shelly.

“There is no need to apologize,” interrupted Bill. “You're not responsible for your father's beliefs. He's had lots of experience with the less honest companies in our field. I'm only sorry that he's not had enough contact with Arolen to appreciate the difference.”

“That may be true,” said Adam, “but it still does not excuse his behavior.”

“Maybe someday we could convince your father to take one of the Arolen Conference Cruises. Have you heard of them?”

Adam nodded, remembering Percy Harmon. He had not thought about the man for over a month, but now Adam wondered why the genial rep had not kept in touch as he'd promised.

“We've invited your father many times,” continued Bill. “Not only on the cruise, but also to visit our research facilities in Puerto Rico. Perhaps you might be able to talk him into accepting our invitation. I'm certain that if he did, his opinion about Arolen would change.”

Adam forced a laugh. “At this point in my life I couldn't talk my father into accepting a free Rembrandt painting. We're barely on speaking terms. Frankly, I was shocked to see him here today.”

“That's a shame,” said Bill. “We'd love your father to be one of our featured lecturers. You know that the seminars have the best reputation in the country. And, of course, all your father's expenses would be paid if he agreed to speak.”

“Sounds like you should try to appeal to my mother,” laughed Adam.

“Spouses are not invited,” said Bill as he guided Adam toward the champagne table.

“Why not?” asked Adam, taking a drink.

“The cruises are strictly academic,” said Bill.

“Yeah, sure,” said Adam.

“I mean it,” said Bill. “The cruises are sponsored by Arolen, but they are run by MTIC. The only reason the company chose a ship was to keep the doctors from their usual interruptions: no telephone, no patients, and no stockbrokers. Each cruise concentrates on a particular clinical or research topic, and we invite the top men in each field to lecture. The quality of the seminars is really superb.”

“So the ship just goes out to sea and anchors?” asked Adam.

“Oh, no,” said Bill. “The ship leaves from Miami, travels to the Virgin Islands, then to Puerto Rico, then back to Miami. Some of the guests, usually the lecturers, disembark in Puerto Rico to visit our research institute.”

“So it's all work and no play. Not even any gambling?”

“Well, just a little gambling,” admitted Bill with a smile. “Anyway, your father would enjoy the
experience, so if you have any influence as far as that might be concerned, you might try to use it.”

Adam nodded, but he was still thinking about Percy Harmon. He'd seemed so sincere that Adam was surprised that he'd not called. He was about to ask Shelly when the rep had left Manhattan, but Bill was saying, “Have you given any more thought to our managerial training offer?”

“To tell the truth,” said Adam, “I've been completely absorbed by the sales course. But I promise to think about it.”

“Do that,” said Bill, his eyes gleaming over the rim of his champagne glass.

• • •

Later that afternoon Adam was in McGuire's office, going over his sales territory. “You'll be taking over Percy Harmon's area,” said McGuire. “Normally we'd assign a more experienced rep, but as you know we have great confidence in you. Here, let me show you.”

Clarence opened up a map of Manhattan with a large portion of the east side outlined in yellow marking pencil. It started at Thirty-fourth Street and ran north, bounded on the west by Fifth Avenue and on the east by the river. Adam was disappointed that it did not include his medical center, but New York Hospital, Mount Sinai, and the Julian Clinic were within the border.

As if reading Adam's mind, Clarence said, “Of course you understand that you are not responsible for hospitals or large health maintenance organizations like the Julian Clinic.”

“Why not?” questioned Adam.

“You are eager!” Clarence laughed. “But I can
assure you that you will be busy enough with the private MDs in your area. All hospitals are handled by the main office.”

“The Julian Clinic is more than a hospital,” said Adam.

“That's true,” said Clarence. “In fact, there is a special relationship between Arolen and the Julian, since both are controlled by MTIC. Consequently, the Julian provides Arolen with direct access to clinical information, and Arolen provides the Julian with special educational opportunities.”

Leaning forward, Clarence picked up a computer printout and put it on Adam's lap. “If you have any concern about not being busy enough, just take a quick glance at this list of your clients.”

The weight of the material in Adam's lap was considerable. The front page said: “Upper East Side Manhattan MD Listing.” Under that was written: “Property of Arolen Pharmaceuticals, Montclair, New Jersey”; and in the lower right-hand corner was the single word “Confidential.”

Adam flipped through the sheets and saw an alphabetical list of physicians followed by their addresses and phone numbers. The first name on the last page was Clark Vandermer, 67 East 36th Street.

As Adam considered what it would be like calling on Jennifer's obstetrician, McGuire launched into a long description of the kinds of doctors Adam would be seeing.

“Any questions?” he said at last.

“Yes,” said Adam, remembering the one he'd forgotten to ask Shelly that morning. “Do you know what happened to Percy Harmon?”

Clarence shook his head. “I'd heard that he was to take the managerial course in Puerto Rico, but I
don't know if he actually did. I have no idea. Why do you ask?”

“No particular reason,” said Adam.

“Well, if you don't have any other questions, you can be on your way. We're always available if you need us, and don't let me forget, here are the keys to your Arolen car. It's a Buick Century.”

Adam took the keys.

“And here is the address of a parking garage. It's as near to your apartment as my staff could arrange. We pick up the rent.”

Adam took the paper, again awed by his company's generosity. A parking place in the city was worth as much as a car.

“And last but not least, here's your computer access code, as was explained to you during the sales course. Your personal computer is in the trunk of the car. Good luck to you.”

Adam took the final envelope and shook hands once again with the district sales manager. He was now officially an Arolen detail man.

• • •

After tuning the radio to an FM rock station, Adam rolled down the window and jauntily stuck out an elbow. Traveling at fifty miles an hour, he felt unaccountably light-headed. Then he recalled his father's sneering disbelief and his smile faded.

“We need the money!” he said out loud. “If you'd helped us, I'd still be in medical school.”

His mood did not improve when he reached the apartment only to find it empty, a short note taped to the refrigerator: “Gone home.” Adam tore it off and threw it across the room.

He pulled open the refrigerator door and looked
inside. There was a little leftover roast chicken. He took it out along with a jar of mayonnaise and two pieces of rye. After making a sandwich, he went into the living room and set up his personal computer. Turning it on, he keyed in his access code. What doctor should he look up? Hesitating a moment, he keyed in Vandermer's name. Then he took the telephone off the cradle and hooked it up to the modem. When everything was ready, he pushed the execute button, leaned back, and took a hefty bite from his sandwich. Small red lights appeared on the modem, indicating that he was attached to the Arolen mainframe.

The screen in front of Adam shimmered, then some text appeared. Adam stopped chewing for a moment and leaned forward to read.

CLARK VANDERMER, M.D., F.A.C.O.G.

___Biographical data

___Personal data

___Economic data

___Professional data

___Pharmaceutical usage data
(press space bar to select)

His interest aroused, Adam pressed the space bar until the cursor was next to “Personal data.” Then he pressed the execute key. Again he got an index: