Strong Medicine (81 page)

Martin's name was now widely known, his person admired, respected and in

demand. Praise and accolades poured in. He had been elected a member of the

Royal Society, Britain's oldest scientific body. Other learned societies

sought him as a speaker. There was talk of a future Nobel. A knighthood was

rumored.

Amid the attention, Martin managed to retain some privacy. His home

telephone number was changed and unlisted. At the institute, Nigel Bentley

arranged for Martin to be shielded from all but the most important calls

and visitors. Even so, it was clear that Martin's earlier, inconspicuous

life would never be the same again.

Something else changed too. Yvonne decided to cease living with Martin, and

to move into a flat in Cambridge.

There was no quarrel or difficulty between them. It was simply that she

resolved, quietly and calmly, to go her separate way. Recently Martin had

been away from Harlow a good deal, leaving her alone, and at such times it

seemed pointless to make the daily twoway Harlow-Cambridge journey. When

Yvonne explained her reasoning, Martin accepted it uncritically, with

understanding. She had expected him to put up at least a token argument,

but when he failed to do so, she did not show her disappointment. They

agreed they would see each other occasionally and remain good friends.

Only Yvonne, when the moment came to leave, knew how sad, how torn she was

inside. She reminded herself how happy she was with her veterinary studies;

her third year had just begun.

Immediately following the separation, Martin was away for a week. When he

returned, it was to a darkened, empty house. It was more than five years

since it had been that way, and he didn't like it. He liked it even less as

another week passed. He found that he was lonely and missed the sight and

cheerful chatter of Yvonne. It was, he thought on going to bed one night,

as if a light in his life had abruptly gone out.

Next day, Celia telephoned from New Jersey on a business matter and, near

the end of their conversation, observed, "Martin, you

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sound depressed. Is anything wrone." It was then, in a burst of

confidence, that he told her about missing Yvonne.

"I don't understand this," Celia said. "Why did you let her go?"

"It wasn't a question of letting her. She's free, and she decided."

"Did you try to talk her out of it?"

"No.,'

"Why not?"

"It didn't seem fair," Martin said. "She has her own life to live."

Celia agreed, -Yes, she does. And she undoubtedly wants more out of it

than you were giving her. Did you consider offering her something

more-like asking her to marry you?"

"As a matter of fact, I did consider it. The day Yvonne left. But I

didn't, because it seemed . . ."

"Oh, God help us!" Celia's voice rose. "Martin Peat-Smith, if I were over

there I'd shake you. How can anyone bright enough to find Peptide 7 be

so dumb? You fool! She loves you."

Martin said doubtfully, "How do you know?"

"Because I'm a woman. Because I hadn't been five minutes in her company

before it was as plain to me as it's plain now that you are being

obtuse."

There was a silence, then Celia asked, "What are you going to do?"

"If it isn't too late . . . I will ask her to marry me."

"How will you do it?"

He hesitated. "Well, I suppose I could phone."

"Martin," Celia said, "I am your superior officer in this company, and

I am ordering you to leave that office you are in, right now, and get in

your car, and drive to find Yvonne wherever she is. What you do after

that is your affair, but I'd advise you to get down on your knees, if

necessary, and tell her you love her. The reason I'm telling you this is

that I doubt whether, in all your future life, you'll find anyone who's

better for you, or who'll love you more. And, oh yes, you might consider

stopping on the way to buy some flowers. At least you know about flowers;

I remember you sent some once to me."

Moments later, several employees in the Harlow institute were startled

to see the director, Dr. Peat-Smith, running full tilt down a corridor,

racing through the outer lobby, then jumping in his car and speeding

away.

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The wedding present from Celia and Andrew to Martin and Yvonne was an

engraved silver tray on which Celia had included lines from To a Bride

by the Essex-born seventeenth-century poet Francis Quarles:

Let all thy joys be as the month of May, And all thy days be as a

marriage day.Let sorrow, sicknen and a troubled mind Be stranger

to thee.

And then there was Hexin W. It was due to appear on the market in a

year.

18

The clinical trials of Hexin W produced a few side effects in patients who

had taken the drug in conjunction with other chosen drugs-such

combinations being the route to effective medication via the quenching of

free radicals. There were scattered reports of nausea and vomiting, and

separate occurrences of diarrhea, dizziness or elevated blood pressure.

None of this was unusual or a cause for alarm. The incidents were not

severe, nor did they appear in more than a tiny percentage of patients.

It was rare for any drug to be free from occasional side effects. Peptide

7 had been a notable exception.

The Hexin W trials, which occupied two and a half years, were overseen

personally by Dr. Vincent Lord. In doing so he handed over other

responsibilities to subordinates, leaving himself free for what had

become a task of total dedication. At this vital, near-final stage he

wanted nothing to go wrong with the launching of his brainchild. Nothing

which, through someone else's neglect or inefficiency, might diminish his

scientific glory.

Lord had watched with mixed feelings the enormous, continuing success of

Peptide 7. On the one hand he experienced some jealousy of Martin

Peat-Smith. But on the other, Felding-Roth was now a

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stronger company because of Peptide 7, and thus better equipped to handle

another product that looked as if it could be equally, or even more,

successful.

Results from the Hexin W trials had delighted Lord. No major adverse side

effect appeared. Those minor ones which did were either controllable, or

unimportant in relation to the drug's positive, excellent uses.

In what was known as Phase III testing, where the medication was given

to patients who were ill, under conditions similar to those foreseen for

later use, the outcome had been uniformly good. The drug had been taken,

over substantial periods of time, by more than six thousand persons, many

in hospitals under controlled conditions-an ideal setup for test

purposes.

Six thousand was a larger number than in most Phase 111's, but was

decided on because of the need to study Hexin W's effects when taken with

various other drugs, hitherto unsafe.

Arthritis patients, as had been hoped, responded particularly well. They

were able to take Hexin W not only alone, but with other strong

anti-inflammatory drugs that formerly had been denied them.

Coordinating the testing, in several widely separated locations, had been

a mammoth task for which extra help had been recruited, both inside the

company and out. But now it was done. Enormous amounts of data were

assembled at Felding-Roth headquarters and, before submitting it to the

FDA in the form of a new drug application, Lord was reviewing as much of

the material as he could.

Because of his personal interest, he found the process mostly a pleasure.

Yet, suddenly, it ceased to be when he encountered one set of case

reports.

What Vince Lord read, then reread more carefully, at first caused him

concern, after that perplexity, and eventually blazing anger.

The reports in question were from a Dr. Yaminer who practiced medicine

in Phoenix, Arizona. Lord did not know Yaminer personally, though he was

familiar with the name and knew a little about the doctor's background.

Yaminer was an internist. He had a substantial private practice and held

staff appointments at two hospitals. Like many other aoctots involved in

the Hexin W testing program, he had been employed by Felding-Roth to

study the effect of the drug on a group of patients-in his case one

hundred. Before such studies began, the

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patients' permission had to be obtained, but this was seldom difficult.

The arrangement was a normal one, used routinely by pharmaceutical

companies wishing to field-test new drugs. Yaminer had done work for

Felding-Roth before, and for other drug firms too.

Doctors who contracted to do such work liked the arrangement for one of two

reasons, sometimes both. Some were genuinely interested in research. All

enjoyed the substantial money it brought in.

For a little extra labor, spread over several months, a doctor would

receive between five hundred and a thousand dollars per patient, the amount

varying with the drug company involved and the importance of the

medication. For his Hexin W case studies, Yaminer had received eighty-five

thousand dollars. A doctor's own costs for such work were small, therefore

most of the money was profit.

But the system had a weakness.

Because the work was so lucrative, a few doctors were tempted to take on

more of it than they could property handle. This led to comer cutting

and-with surprising frequency-falsification of data.

In a word: fraud.

Dr. Yaminer, Lord was certain, had perpetrated fraud in sending in reports

about the effects of Hexin W.

There were two possibilities as to what had happened. Either Yaminer had

failed to do the studies he was supposed to on the patients he had named,

or some, perhaps most, of the hundred listed patients did not exist, except

in the doctor's imagination. He had made them up, invented them, as well as

their test "results."

Making a guess based on experience, Lord believed the second to be true.

Either way, how did he know?

One reason-Yaminer had done his fake reporting in a hurry and been

careless. What had caught Lord's eye to begin was a close similarity

between the handwriting on patient report forms on different dates. Usually

such entries varied, and not only the handwriting, but the writing

instrument. Even if a doctor used the same ball-point pen every day, it

seldom performed with exact consistency.

That in itself was not conclusive. Yaminer could have made earlier notes,

then transformed them patiently into neater, finished

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reports. But for a busy doctor it was unlikely. Which prompted Lord to

look for more.

He found it.

Among tests performed on patients receiving experimental drugs was one

to measure urine pH-acidity or alkalinity. For an average person the

result would be expressed in the range 5 to 8. But each measurement, on

separate days, was an "independent event" and usually varied, meaning

that a reading of 4 on Tuesday did not make likely another 4 in the same