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Authors: David Matthew Klein

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Roger said, “He was suffering from Alzheimer’s. I heard he was completely lost, never should have been driving up there—or driving at all. He managed to locate the keys and just drive off. I guess he wasn’t supervised very well.”

“Look, I’ve got to take over with the kids. Brian’s going into work for a few hours and the sooner he goes, the sooner he gets back and we can go up to the lake.”

“Have you got a quick minute? Marlene’s standing right here begging to talk to you.”

Marlene got on the phone and first thing asked about Gwen’s injury. Gwen assured her she was feeling fine, getting stitches wasn’t as bad as she’d imagined. She had pictured it less precise, not as elegant—like sewing the stuffing into the turkey on Thanksgiving.

That got a laugh from Marlene.

“I’m so sorry about what happened,” Marlene said. “I feel partly responsible because I couldn’t pick up the kids and you had to drive. I didn’t know you were … you know. You didn’t say anything.”

“You needed to get in to see the doctor,” Gwen said. “What you’re going through is important.”

“Well, it turns out I’m ovulating fine. It could be something with Roger, but we might never know.”

“I hope it works out.”

“One way or another it will,” Marlene said. “I heard Roger tell you not to worry. It’s true. He’ll get you out of this.”

Off-Label

Two cars sat like boulders in a field of empty parking spaces. Brian doubted anyone was in the office; the cars had been left since last night, young researchers or admins sharing rides to the bars after work and not making it back, spending their Friday night getting laid or drunk or both. Who was going to be working on a summer weekend? He, for one. And it wouldn’t be the first time. Brian accepted weekend, night work, and travel as part of the equation: long hours plus high pressure equal financial rewards and a comfortable life for his family. The role of provider suited Brian, traditional though it was. He felt fortunate that Gwen could be a stay-at-home mom and give her attention to the kids and volunteer work, this episode with the pot yesterday just a minor accounting error on an otherwise healthy and balanced ledger. Not every family was as fortunate as his.

It’s true he no longer carried the banner of global aid and community service that had motivated him to attend medical school. His family was his community now, and he served them well. He knew the mantras: think globally, act locally, make the world better one person at a time—Gwen, Nora, Nate.

He swiped his card to unlock the door. The weekend sign-in pad sat on a table near the door, the open page blank of signatures. He had the building to himself.

His office was third from the end in a row of six offices with
window views on the parking lot side and a sea of cubicles on the other. He found his laptop where Teresa had said she left it, bottom drawer of his desk.

He turned it on, then called her cell number.

“You coming in?”

“I thought we were working at my place.”

“I had to get my laptop, so I came to the office.”

“You mean you’re going to make me get dressed?”

“That’s up to you.”

“I just got back from a run—I at least have to take a shower.”

“Don’t forget the surveys.”

That flirty banter—
You’re going to make me get dressed?
and
That’s up to you
—had been going on the entire six months they’d worked together.

Brian was ten years or so older than Teresa, and senior to her on the company’s org chart. She had been transferred up from New Jersey after the acquisition and assigned to help Brian with Zuprone market development. She didn’t report directly to him; theirs was a dotted-line relationship, which meant he supervised and mentored but did not own her. She still reported to her manager at corporate, which Brian preferred.

Their banter appeared benign enough. Teresa had a reputation for chatting this way with every guy in the office. A more important safety feature—and the reason he allowed himself to flirt in the first place—was Teresa’s weight. She had a pretty face and dazzling smile, but Brian felt no attraction and no inclination to do anything. He had comfortably classified Teresa in the “good personality” segment: no threat, no risk.

Until recently.

Over the six months Teresa had worked with Brian, she’d lost a lot of weight. A lot. It’s a good thing he remembered what she used to look like because another few pounds and she’d be pushing
knockout status and he’d have to be careful. She’d overhauled her wardrobe several times, looking better and sexier with each one, and had started wearing shorter skirts and tighter tops.

Brian suspected she dosed on Zuprone—and why not, if it worked like that? He wasn’t going to ask. They’d never spoken about her weight or the shedding of it; he never acknowledged her appearance or made a comment about how she looked. That wasn’t their style of banter. A part of him wished she’d stop losing weight, while another part watched fascinated as if beholding a butterfly emerging from its chrysalis.

The other part of the problem was that Brian imagined Teresa might have a thing for him beyond the harmless. Yeah, she chatted up other guys, but she worked closest with him and when you see a woman every day, even the largely unused and rusty radar of a solidly married guy with kids will detect the incoming. That’s how Brian saw it: as if she’d selected him as a target to lock on to. What was the risk for her—a young, single woman from out of town? None. It wouldn’t be the worst thing for her to get something going with Brian.

But it wasn’t going to happen.

Brian got started with work. Because Gwen’s phone call had abruptly ended his presentation, he hadn’t been on hand to refocus the discussion when it got derailed, and Teresa didn’t have the authority or presence to steer the meeting back to the business case of seeking approval for Zuprone as a weight-loss drug. Now he couldn’t present again until all the marketing data had been analyzed and summarized, even though he didn’t think it had bearing on the business case.

He resigned himself to the task and got started. He opened the spreadsheets and began reviewing the prescription history of Zuprone. A whopping 70 percent of prescriptions written over the past two years for Zuprone were off-label—for weight loss, not
anxiety. That in itself wasn’t the problem; some drugs on the market had an 80 percent off-label rate. The problem was whether that 70 percent could be primarily attributed to Caladon’s marketing practices or simply physicians using their independent medical judgment and following customary prescribing patterns. Idealists and the FDA insisted there was a difference; an industry veteran like Wilcox would scoff.

He noticed movement outside the window and saw Teresa park her Saab next to his car. She got out, reached back in, and shut the door with her foot. She carried a leather briefcase slung over her shoulder and a coffee in each hand. He watched her walk toward the door, holding the cups out in front of her, wearing faded jeans ripped in one knee and a fitted, plunging pink cardigan that gave too much away.

A moment later she stood at his office door.

“I took the liberty of getting you a coffee.”

Her hair hung flat and damp from her shower, and he could smell her floral shampoo or soap. He’d thrown on jeans and T-shirt this morning without showering or washing his face. At least he had brushed his teeth. Had he combed his hair? Too late to look now and what did it matter anyway.

She set the coffees on his desk and pulled up an extra chair beside him, then retrieved a stack of paper surveys from her briefcase. “How’s everything at home? I mean with Gwen?”

“She’s okay—six stitches in her eyebrow. But the situation is a little complicated.”

Teresa waited, but Brian didn’t go on. He shouldn’t have added that part about it being complicated.

“Let’s get started and set objectives,” Brian said. “It’s hard to know what we’ve got in front of us at this point.”

He said there were two issues on the table: whether Caladon should seek FDA approval of Zuprone as a weight-loss drug and
whether the marketing practices to date for Zuprone could be construed as illegal.

“As for seeking FDA approval, I think the business case proves out,” Brian said. “My recommendation is that we move forward with the application, in expectation that the FDA focus will follow the clinical trials and not past marketing practices. It’s too bad I didn’t get to that conclusion in the meeting, or the favorable cost projections. And now they’re clamoring for the marketing data.”

“What’s your feeling—do you think we’ve crossed the line?”

“Wilcox has been aggressive in setting direction, but legal has seen all of our programs.”

“Do you think we could end up with a four-hundred-million-dollar fine like Warner-Lambert?”

“That’s what we’re here to avoid. Probably not that much, since Zuprone doesn’t have the sales of Neurontin, but the damage to the brand name would be huge—and we would lose our jobs, of course.”

“There are lots of jobs in the drug industry.”

That may be true, but Brian didn’t want to relocate and take one of them unless he was down to his last option.

Teresa pointed out that Caladon would never make as much money on the drug if they kept to the off-label strategy as they would if they got FDA approval.

Brian said, “We’ll project the numbers and the consequences of either applying for approval or not, add some kind of summary of marketing efforts, then hand it over to Stephen and Jennifer and let the lawyers decide.”

“You sure you don’t want me to do this? I know you were planning on time off, your family must be waiting for you.”

“And you have nothing else to do this weekend?”

“Not really,” Teresa admitted. “I might drive down to New Jersey tomorrow to see my brother.”

Brian shrugged. “Let’s get started, then I’ll take off. We want to discover, where possible, any correlation between physicians we’ve called on or who have attended our seminars, and the frequency and reason around their prescriptions for Zuprone.”

He sorted the spreadsheet data by the number of prescriptions written by each physician, then by which physicians attended one of Caladon’s educational seminars on obesity. Although they had hired independent physicians to conduct the events, the seminars could be called into question, given that Caladon paid doctors to attend and hosted them in Marco Island, Las Vegas, Steamboat Springs, and other resorts.

When Brian mentioned a physician’s name from the seminar list, Teresa flipped through the paper copies of follow-up surveys they’d gotten back from seminar attendees. It was the only way to correlate physician to prescription indication—whether it was written for weight loss or anxiety—and at what rate physicians who attended the seminars wrote Zuprone prescriptions for weight loss. Only about a third of the attendees had completed surveys, enough to provide general direction perhaps but not to be statistically relevant.

When finished with the surveys, they would look at data from the sales reps about which physicians requested copies of Caladon’s internal studies on Zuprone and which HMOs and health plans included Zuprone on their drug plan formularies.

Teresa sat close to him, sharing the space beneath the desk where one pair of legs belonged. Too close. Their knees touched a few times. Then elbows. Each time Brian edged back. Then Teresa leaned forward to point at something on his screen, and Brian felt her breast touch his arm. He wasn’t sure. He couldn’t look. But he knew what breasts felt like pressed against him. He considered moving around to the side of his desk to avoid a second occurrence.
As he debated this prudish—or prudent—move, his phone rang, Gwen calling.

“How’s it going?”

“Fine, I said I’d call when I was finished.” What a radar on that woman.

“I’m just asking—don’t be angry.”

“Sorry, I’m just trying to get it done.”

“You can take your time, I’ve decided we’re not going.”

“Why? I thought your appointment wasn’t until Tuesday night.”

“Appointment?” Gwen said. “Is someone in your office?”

“No, it’s just …” Why was he lying? Gwen knew he worked with Teresa, and she had met her once at the holiday party when Teresa first moved up to New York. Gwen had liked her well enough and seemed to classify her as nonthreatening, for the same reasons Brian had.

But Gwen hadn’t seen Teresa since then.

“Why did you change your mind about the lake?” Brian asked.

“I’m going to the funeral.”

“What funeral?”

“James Anderson,” Gwen said. “It’s Monday morning. We’d have to come back tomorrow night and that would give us only a day at the lake.”

“I don’t know if that’s a good idea. Let’s talk about this later when we’re together.”

“I think I should go.”

“What about the kids—I thought you said they’d be disappointed.”

“I think we’re all disappointed, but it’s not worth driving up there for one day. You can take an extra day next weekend and we can go then.”

“I guess it’s better anyway, since I have a pile of work to get through.”

He finished with the call and waited for Teresa to say something. Sure enough: “Did someone die? I heard you mention a funeral.”

Brian could have deflected the question—an uncle or a neighbor passed away. Or told Teresa a bleached version of events. But what came out was the whole story: Gwen getting high, the accident that wasn’t her fault, arrest, death of the old man driving the other car. It was a gross violation of Brian’s own personal privacy rules, and could damage his reputation if word got out around the office, yet he couldn’t stop even as he heard himself speaking.

“Oh my God—you guys get high?” Surprised and pleased, as if she’d been let in on a juicy secret.

“Not
you guys
, just Gwen.”

“Well, okay, that I can understand.”

“What does that mean?”

“When I met your wife she struck me as pretty relaxed and easygoing. You seem more the buttoned-up type.”

He probably did seem that way to her. If he was such a dud, then why did she keep flirting with him? The challenge, probably—see if she could spark up the wet one.

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