Strong Medicine (82 page)

person on Wednesday. Expressed a different way: over five successive

days, the likelihood of pH measurements being identical was only one in

four. Long odds.

Yet, repeatedly, Dr. Yammer's reports on patients showed identical pH

readings day after day. Highly unlikely, even with one individual.

Impossible in the case of fifteen patients-the number reviewed by Lord

from the Yammer study.

To be absolutely sure, Lord selected fifteen other patient names and made

a similar review of blood studies. Again identical figures repeated with

unnatural frequency.

There was no need to go further. Any medical investigator would accept

the pattern already uncovered as evidence of falsificationin this

instance, criminal fraud.

With silent, seething anger, Lord cursed Dr. Yammer.

The overall report presented by Yaminer made Hexin W look extremely good.

But it was unnecessary. The drug would have looked good anyway, as was

demonstrated by every other report which Lord had read.

Lord knew what he ought to do.

He should immediately inform the FDA, laying everything before them.

After which Dr. Yammer would be officially investigated and almost

certainly prosecuted. It had happened to other doctors before, and some

had gone to prison. If Yaminer was found guilty he could go there too and

also, perhaps, lose his license to practice medicine.

But there was something else which Lord knew.

If the FDA became involved, with Yaminer's work thrown out, all of it

would have to be done again. And allowing for new arrangements that would

have to be made, it would take a year and would delay Hexin W's

introduction by the same amount of time.

Again Lord cursed Yaminer for his stupidity and the dilemma now created.

What to do?

418

If it had happened in connection with a drug about which there were doubts,

Lord told himself, he wouldn't have hesitated. He would have thrown Yammer

to the FDA wolves and offered to give evidence at Yaminer's trial.

But there wasn't any doubt about Hexin W. With or without the false report,

it was going to be a beneficial, successful medication.

So why not let the fake study go in with the other genuine ones? It was a

safe bet that no one at FDA would notice; the sheer volume of an NDA made

that unlikely. And if Yaminer's papers were looked over by an FDA examiner,

there was no reason to suppose the deception would be seen. Not everyone

was as quick to notice things as Vincent Lord.

Lord would have preferred to omit the study altogether, but knew he

couldn't. Yaminer's name was listed in other material already sent to FDA.

He also hated the idea of letting Yaminer get away with what he had done,

but there seemed no other way.

So . . . all right. Let it go. Lord initialed the Yaminer study and placed

it on a pile of others previously reviewed.

He would make sure though, Lord vowed, that the bastard never worked for

Felding-Roth again. There was a departmental file for Yaminer. Lord found

it and stuffed his own rough work sheets in, the pages he had used to

figure out the fakery. If he ever needed them, he would know exactly where

they were.

Lord's assessment of the situation proved to be correct.

The NDA was submitted and, in a satisfyingly short time, approved.

Only one thing briefly troubled Vincent Lord, making him nervous. In FDA's

National Center for Drugs and Biologies at Washington, D.C.-formerly the

Bureau of Drugs-Dr. Gideon Mace was now a deputy director. Compared with

earlier days, Mace was a changed and better person, a strict teetotaler, at

last with a good marriage, and respected at his work. His bad experience at

the Senate hearing appeared to have done him no harm. In fact, soon

afterward he had been promoted.

Word reached Lord that Mace, while not directly involved with the Hexin W

application, had taken an interest in it, as apparently he did with

anything coming into the agency from Felding-Roth. Almost certainly, Mace

still bore the company a grudge and hoped one day to get even.

419

But nothing happened as a result of Mace's interest, and when FDA

approval to market Hexin W was given, Lord's nervousness evaporated.

As with Peptide 7, it was decided that the developmental name of Hexin

W would he its product name also.

"It comes easily off the tongue and will look good on packaging," Celia

declared when it was time for the matter to be decided.

Bill Ingram agreed, adding, "Let's hope it brings us the same kind of

luck we had before."

Whether luck helped or not, Hexin W was an immediate success. Physicians,

including some in prestigious teaching hospitals, hailed it as an

important medical advance which opened up new therapies for treating

seriously ill patients. Medical journals praised both the drug and

Vincent Lord.

Many doctors in private practice began prescribing Hexin W, including

Andrew, who reported to Celia, "It looks as if you have a live one there.

It's as much a breakthrough, I think, as Lotromycin in its time."

As more and more doctors discussed the drug with each other, and patients

expressed gratitude for the relief it brought them, Hexin W's use

expanded and sales zoomed.

Other pharmaceutical companies, some of which had been wary at first,

began using Hexin W under license, incorporating it in their own products

to improve their safety. A few drugs that had been developed years before

but were never marketed because of high toxicity were brought down from

the shelf and subjected to experiments with Hexin W added.

One such was an anti-arthritic drug named Arthrigo. The patent owner was

Exeter & Stowe Laboratories of Cleveland, whose president, Alexander W.

Stowe, was well known to Celia. A former research chemist, Stowe and a

partner had formed their company a decade earlier. Since then, while the

firm remained small, it had achieved a merited reputation for

high-quality prescription products.

After a licensing deal was negotiated, Stowe came personally to

Felding-Roth headquarters. In his fifties, he was a genial figure who

wore rumpled suits, had shaggy hair, and looked absentminded, which he

wasn't. During a meeting with Celia and Vincent Lord he told them, "Our

company has FDA permission to use a combina-

420

tion of Arthrigo and Hexin W experimentally. Since both drugs have

anti-arthritic properties, we've high hopes for the outcome. Of course,

we'll keep you informed as results come in."

That was six months after Hexin W's introduction.

A few weeks later, Celia and Andrew gave a Saturday evening party at their

Morristown house in honor of Vincent Lord. Lisa and Bruce came home for the

occasion.

It was high time, Celia reasoned, that she did something personal for Lord,

if only to make clear her recognition of his outstanding contribution to

the company and to signal that any antagonism between them was now over, or

should be.

The party was a success, Lord more relaxed and happy than Celia had ever

seen him. His thin, scholarly face became flushed with pleasure as

compliments were heaped upon him. He smiled continuously and mingled easily

with the guests who included Felding-Roth executives, prominent citizens of

Morristown, others who had come specially from New York, and Martin

Peat-Smith whom Celia had asked to fly from Britain for the occasion.

The last gesture especially pleased Lord, as did Martin's toast, proposed

at Celia's request.

"The life of a research scientist," Martin declared while the other guests

fell silent, "offers challenges and excitement. But also there are wearying

years of failure, long hours of despair, and often loneliness. Only someone

who has known those black occasions can understand what Vincent endured

during his quest for Hexin W. Yet, his genius and dedication rose above

them, leading to this celebration in which I humbly join, saluting-with

you-a major scientific achievement of our time."

"Very gracious," Lisa commented later, when guests had gone and the Jordan

family was alone. "And if all tonight's company success talk gets out, it

should send Felding-Roth stock up another point or two."

Lisa, nearing her twenty-sixth birthday and four years out of Stanford, was

a financial analyst, working for a Wall Street investment banking firm. In

the fall, though, she would leave the money milieu to enter Wharton School

of Business and study for an M.B.A. degree.

"What you should do," Bruce advised his sister, "is on Monday suggest your

clients buy Felding-Roth, then on Tuesday leak to the wire services that

Dr. Peat-Smith, inventor of Peptide 7, is bullish on Hexin W."

421

She retorted, "It would be unethical. Or don't publishers worry about such

things?"

Bruce, for the past two years since graduation from Williams, had been

working for a New York textbook publisher where he was an editor in the

history department. He, too, had plans for the future, which involved a

move to Paris and studies at the Sorborme.

"We're concerned with ethics all the time," he said. "Which is why

publishers make less money than investment bankers."

"It's nice to have you both home," Celia said, "and to know that nothing's

changed."

Being president of a highly successful, wealthy company, Celia found, did

not eliminate top management problems. Compared with when the company had

been poor, there were just as many, sometimes more. However, their nature

differed. Also, nowadays there was an exhilaration, a heady excitement

lacking in the older times, on which Celia thrived.

Immediately following the social tribute to Vincent Lord, she was

exceptionally busy with financial and organizational matters, all requiring

travel. Consequently, nearly three months went by before she spoke to Lord

again concerning the Hexin W licensing contract with Exeter & Stowe. He had

come to her office about something else and she inquired, "What word is

there from Alex Stowe on their Arthrigo and Hexin WT'

He answered, "Their clinical trials seem to be working well. Everything

looks positive."

"How about adverse reports on Hexin W generally? I haven't seen any cross

my desk."

"I haven't sent you any," Lord said, "because there's been nothing of

importance. Nothing, that is, that concerns Hexin W directly."

Celia's mind, so accustomed nowadays to a diet of good news, had already

moved on quickly to something else; therefore the wriggling proviso in

Lord's last remark escaped her. Later, she would remember it with regret,

and blame herself for missing it.

For Lord, as had been his way for many years, going back to a time long

before Celia had known him, had not delivered all the truth.

422

19

The news, when it broke, came quietly. Deceptively casual, even then it

did not reveal itself entirely, and afterward it seemed to Celia as if

fate had tiptoed in, at first unheeded and wearing a prosaic scabbard from