Strong Medicine by Arthur Hailey

Celia entered a room in which the air was heavy with cigar smoke. Sam was there; so were Vincent Lord, Seth Feingold, Bill Ingram, and several vice presidents, including Glen Nicholson, a company veteran who ran manufacturing, a Dr. Starbut from safety evaluation, and Julian Hammond, a youngish MBA in charge of public affairs. All were puffing at cigars, Ingram with some uncertainty; Celia had never seen him smoke before.

  “Hey, here’s Celia!” someone called out. “Sam, give her a cigar!”

  “No, no!” Sam said. “I’ve something different for the ladies.” Beaming, he went around to the far side of his desk, behind which was a small pile of chocolate boxes—Turtles. He handed one to Celia.

  “In honor of my grandson who”—Sam consulted his watch—“is now twenty minutes old.”

  For the moment, her seriousness evaporated. “Sam, that’s wonderful news! Congratulations!”

  “Thank you, Celia. I know it’s usually fathers who do the cigar-and-chocolates routine, but I decided to begin a new tradition to include grandfathers.”

  “A damn good tradition!” Nicholson, the manufacturing chief, said, and Celia added, “The Turtles were thoughtful—they’re my favorites.” She noticed that Bill Ingram, looking slightly pale, had stopped smoking his cigar.

  She asked, “Is everything okay with Juliet?”

  “Absolutely,” Sam said happily. “I had a call from Lilian at the hospital just a few minutes before you all came, which is how I got the good news—‘mother and a seven-pound baby boy, both doing well.’”

  “I’ll go to see Juliet myself,” Celia said. “Probably tomorrow.”

  “Fine! I’ll tell her to expect you. I’ll be leaving for the hospital myself right after this meeting.” It was clear that Sam was on a euphoric high.

  Dr. Starbut asked, “Why don’t we postpone?”

  “No,” Sam said, “we may as well get this over with.” Then, glancing at the others, “I assume it won’t take long.”

  Vincent Lord said, “No reason why it should.”

  Celia had a sudden sinking feeling, a conviction that all of this was going wrong, that the juxtaposition of the Montayne issue and Sam’s grandchild was the worst thing that could have happened at this time. Sam’s happy state, which others here were sharing, would eclipse their seriousness of purpose.

  Preceded by Sam, they moved to an office conference area, arranging themselves in chairs around a table. Sam was at the head. Without preliminaries, clearly wishing not to waste time, he began.

  “Celia, I sent a copy of your memo, late this morning, to everyone who’s here. A copy went also to Xav Rivkin, who was about to leave on a two-day trip to Washington, which he offered to postpone so he could be with us; however, I assured him that would not be necessary.” Sam moved his gaze around the table. “Has everyone read what Celia wrote?”

  There were affirmative nods and murmurs.

  Sam acknowledged, “Good.”

  Celia, having drafted it carefully, was glad her memorandum had been read. In it she had referred to the Australian court proceedings concerning Montayne, setting out the facts that she had discovered during her reading of the trial transcript and that had not appeared in the summary version circulated through the company earlier. She also described the recent French and Spanish incidents which had resulted in accusations against Montayne, accusations receiving publicity in France-Soir and probably elsewhere. Finally, she explained the reasoning of Gironde-Chimie and the French company’s conviction that all three allegations about Montayne were unjustified and need not cause alarm.

  What Celia did not do in her memorandum was offer any conclusions of her own, leaving those for this meeting, after hearing what others had to say.

  “Let me state right away, Celia,” Sam said, “that you were absolutely correct in bringing these matters to our attention. They are important because others will hear of them and we must be ready to tell our side of the story—the true side—when Montayne goes on sale three weeks from now.” He looked questioningly at Celia. “I’m sure that was your objective. Right?”

  The query was unexpected and she answered awkwardly, “Well, that is part of it …”

  Sam, still in a hurry, nodded and went on. “Let’s clear up something else. Vince, why wasn’t I told of those Gironde-Chimie reports Celia referred to?”

  The research director’s face muscles twitched. “Because, Sam, if I sent you every query that comes in concerning all of our products, in the first place I wouldn’t be doing my job of assessing what’s important scientifically and what isn’t, and in the second you’d have a stack of paper on your desk so high you’d get no other work done.”

  The explanation appeared to satisfy Sam because he instructed, “Give us your opinion of those reports.”

  “They’re both self-canceling,” Lord declared. “They show, with a thoroughness that satisfies me entirely, that Gironde-Chimie’s conclusion about the non-involvement of Montayne in either incident is correct scientifically.”

  “And the case in Australia? Do those extra points Celia raised have any bearing on the earlier conclusion?”

  Celia thought: We’re sitting here, all of us, speaking casually of “incidents” and “cases” and “conclusions” when what it’s really about—even if Montayne is not involved—is babies who’ll be “vegetables” throughout their lives, unable to walk or even move their limbs or use their brains in any normal way. Are we really so indifferent, or is it fear that stops us from using the real, unpalatable words? Perhaps, too, we’re relieved those babies are in distant places, and we shall never see them … unlike Sam’s grandson, close at hand, whose birth we’re celebrating with chocolates and cigars.

  Lord was answering Sam’s question, his displeasure with Celia only thinly veiled. “Those ‘extra points,’ as you choose to dignify them, change nothing whatsoever. In fact, I fail to see the slightest reason for bringing them up.”

  There was an audible murmur of relief around the table.

  “While we’re here, though, and for the record,” Lord continued, “I’ve prepared a commentary, from a scientific viewpoint, of the three incidents—Australian, French and Spanish.” He hesitated. “I know we’re in a hurry …”

  Sam asked, “How long will it take?”

  “I promise to be no more than ten minutes.”

  Sam glanced at his watch. “Okay, but limit it to that.”

  This is all wrong! Celia’s mind was pleading, silently and frantically. This entire issue is too vital, too important to be hurried in this way. But she checked her racing thoughts, concentrating instead on Vincent Lord’s words.

  The research director was at once authoritative, convincing, reassuring. Examining the backgrounds of the three defective babies and their parents, one by one, he pointed out how any one of many causes may disrupt a normal pregnancy, causing damage to a fetus. In particular, “an unregulated mix of chemicals in the human body, especially drugs and alcohol together,” could have disastrous effects, of which examples were tragic and frequent.

  In all the cases under review, Lord argued, there were so many adverse possibilities, some of them compelling, that it became unreasonable and non-scientific to blame Montayne, especially when the worldwide record of Montayne was so immaculate and other probabilities so strong. He used the words “hysteria” and “probable fraud” in describing attempts to pin responsibility on the drug, plus the accompanying publicity.

  The other men listened gravely and seemed to be impressed. As perhaps they are right to be, Celia thought. She wished she could be as unequivocal and confident as Vince. She truly wanted to be, and recognized that Lord’s qualifications to make the judgments he had were far greater than her own. Yet she, who until only yesterday had been one of Montayne’s strongest supporters, simply wasn’t sure.

  Lord concluded eloquently. “With any new drug that is introduced, there are always claims that it is doing harm, that adverse side effects exist, outweighing benefits. Such claims may be responsi
ble and based on genuine concern by qualified professionals, or they may be irresponsible, made by unqualified people, based on nothing.

  “Yet each submission, both in the public interest, and to protect companies like ours which cannot afford to produce a dangerous drug, must be examined carefully, unemotionally, scientifically. For—make no mistake!—no complaint, no criticism concerning any pharmaceutical product can be totally ignored.

  “What must be determined, of course, is whether an adverse reaction in someone who has taken a particular drug is from that drug or from some other source, remembering there are many sources where adverse happenings can originate.

  “Well, I am satisfied that the most careful examinations have been done in the instances we are discussing. The charges have been examined and the bad effects described did not, it has been found, originate with Montayne.

  “Finally, there is one more fact it is essential to remember: If a drug should be falsely blamed for an adverse effect it has not caused, and because of that false accusation be withheld from general use, then countless people would be deprived of its therapeutic benefits. In my opinion they should not be so deprived of the benefits of Montayne.”

  It was an impressive conclusion, as Celia admitted to herself.

  Sam clearly expressed the feeling of others when he said, “Thank you, Vince. I think you’ve made us all feel better.” He eased his chair back from the table. “I don’t believe we need any formal resolution. I am satisfied that it is perfectly safe to continue full speed ahead with Montayne, and I presume everyone else agrees.”

  There were nods of assent from the other men.

  “Well,” Sam said, “I guess that’s everything. Now, if you’ll all excuse me …”

  “I’m sorry,” Celia said, “but I’m afraid that isn’t everything.”

  Heads turned toward her.

  Sam said impatiently, “What is it?”

  “I’d like to ask Vince a question.”

  “Well … if you must.”

  Celia looked down at notes she had made. “Vince, you stated that Montayne was not the cause of the three babies in Australia, France and Spain being born as ‘vegetables’—babies, we ought to remember, who cannot move their limbs and lack normally functioning brains.” If others were afraid of putting unpleasant truths into words, she decided, she would not be.

  Lord said, “I’m glad you were listening.”

  She ignored the unpleasant tone and asked, “Since Montayne was not the cause of those deformities, what was?”

  “I thought I made clear it could be one of several, or even many, causes.”

  She persisted, “But which one?”

  Lord said exasperatedly, “How do I know which one? It could have been a different cause in each case. All I know is, based on scientific judgment by experts on the spot, the cause was not Montayne.”

  “So the truth is, no one knows with certainty what did damage those fetuses and cause the deformed births.”

  The research director threw up his hands. “For God’s sake, I’ve already said so! In different words, maybe, but—”

  “Celia,” Sam interjected, “just what are you getting at?”

  “What I’m getting at,” she answered, “is that despite everything Vince has said, I’m uncomfortable. No one knows. I’m still not satisfied. I’m having doubts.”

  Someone asked, “What kind of doubts?”

  “About Montayne.” It was Celia’s turn to survey the faces around her. “I have a feeling—if you like, call it instinct—that something is wrong, something we don’t yet know about. Also that there are questions to which we ought to know the answers, but we don’t.”

  Lord sneered, “A woman’s instinct, I suppose.”

  She snapped, “What’s wrong with that?”

  Sam ordered sharply, “Everybody cool it!” He told Celia, “If you have a suggestion, let’s hear it.”

  “My suggestion,” she said, “is that we should delay the launching of Montayne.”

  She was conscious of everyone in the room regarding her with incredulity.

  Sam’s lips had tightened. “Delay for how long, and precisely why?”

  Celia said deliberately and carefully, “I suggest a postponement of six months. In that time there may be no more instances of defective births. Or there could be. I hope it doesn’t happen, but if it does there could be information we do not have now, and which would give us, perhaps, greater confidence to proceed with Montayne.”

  There was a shocked silence which Sam broke. “You can’t be serious.”

  “I am very serious.” She met his eyes directly. When she came here she had been uncertain of her own feelings. She had been uneasy—but with ambivalence. Now she was ambivalent no longer because, far from reassuring her, Vincent Lord’s emphatic certainty—too much certainty!—had reinforced her doubts.

  And yes, she admitted to herself, in taking the stand she had just declared, she was relying on her instincts, and little more. But her instincts had been right before.

  Celia knew there was a difficult task ahead of her to convince the others, with Sam the most important. But they had to be convinced. They must be persuaded that it was now in everyone’s best interest to delay Montayne’s American debut—in the interest of pregnant women who might take the drug and have their babies endangered; of the company, Felding-Roth; and of all of them here who were responsible for what the company did.

  “Do you have any idea,” Sam was asking, still shocked, “what a delay in launching Montayne would involve?”

  “Of course I do!” Celia let her own voice take on an edge. “Who would know better than me? Has anyone been more involved with Montayne than I have?”

  “No,” Sam said. “That’s why what you’re saying is so unbelievable.”

  “It’s also why you can be sure I’m not making the suggestion lightly.”

  Sam turned toward Seth Feingold. “What do you estimate it would cost us to delay Montayne?”

  The elderly comptroller looked uncomfortable. He was Celia’s friend. Also he was out of his depth where scientific matters were concerned and plainly wished he were not involved. Bill Ingram, too, appeared discomfited; Celia sensed that Bill was torn by inner conflicts—loyalty to her and probably his own ideas about Montayne. Well, we all have our problems, she thought, and I, at this moment, certainly have mine.

  One thing had been resolved, though. There was no longer any sense of haste. Clearly, Sam and others had accepted that the issue raised by Celia must be resolved, however long it took.

  Feingold had his head down and was making calculations with a pencil. Looking up, he advised, “In round figures we’ve committed thirty-two million dollars to Montayne. Not all of it has been spent, so perhaps a quarter would be retrievable. But there are substantial general costs I’ve not included. As to the real cost of a delay, it’s impossible to guess. It would depend on the length of delay and the eventual effect on projected sales.”

  “I’ll tell you one effect there would be,” Hammond, of public affairs, declared. “If we delay Montayne now, the press will have a field day. They’ll discredit the drug and it might never recover.”

  Sam acknowledged, “I’ve thought of that too. Delay at this point would, in some ways, be as bad as canceling.”

  He swung back to Celia, his tone accusing. “If we did as you suggest—and for the vaguest of reasons—have you given any thought to the questions and angry reaction there would be from the board of directors and stockholders? And have you considered our employees who would have to be laid off, who might lose their jobs permanently?”

  “Yes,” she said, trying to stay calm, concealing the agony this was causing her, “I have thought of all that. I thought about it last night and through most of today.”

  Sam grunted skeptically, then returned to Feingold. “So one way or another we’d be taking a chance of losing twenty-eight millions, more or less, to say nothing of a much greater loss of anticipated pro
fits.”

  The comptroller glanced regretfully at Celia as he answered, “That’s the potential loss, it’s true.”

  Sam said grimly, “And we can’t afford it, can we?”

  Feingold shook his head sadly. “No.”

  “However,” Celia pointed out, “the loss could be greater still if we ran into trouble with Montayne.”

  Glen Nicholson said uneasily, “There is that to think about.” It was the first support, even if tentative, which Celia had received and she shot the manufacturing chief a grateful glance.

  Vincent Lord chimed in, “But we don’t expect to have trouble. That is, unless the rest of you”—he surveyed the others—“are willing to accept the lady as our ranking scientific expert.”

  There was some halfhearted laughter, quickly snuffed out at an impatient gesture from Sam.

  “Celia,” Sam said, “please listen to me carefully.” His voice was serious, but more controlled than a few moments ago, and again their eyes met directly. “I’d like you to reconsider. It could be that you’ve spoken hastily and made a judgment without weighing all the implications. Each of us here does similar things at times. I certainly have, and have had to swallow my pride and backtrack, admitting I’ve been wrong. If you were to do that now, none of us would think an iota the worse of you, and what happened here will end here. I promise that, just as I urge you to change your mind. What do you say?”

  She was silent, not wanting to rush into a commitment either way without considering it first. Sam had just offered her—easily, graciously, as was his way—a dignified route out. All she had to do was utter a word, a phrase, and the impasse would be over, a crisis averted as swiftly as it came. The offer was extraordinarily tempting.

  Before she could answer, Sam added, “You have a lot at stake personally.”

  She knew exactly what he meant. Her appointment as corporate vice president of sales and merchandising had not yet been confirmed. And if what was happening here proceeded to its logical conclusion, it might never be.

  Sam was right. There was a lot at stake.

  She took a moment more to consider, then told him quietly and decisively, “Sam, I’m sorry. I have weighed everything. I do know what’s at stake. But I must still recommend that we delay the introduction of Montayne.”

 
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