Thursday, July 18, 2013

The Study                                                                                                                                    

“It just isn’t fair.  This can’t be happening.  What are we going to do?  Rebecca’s Leukemia was responding so well to the Triton-proclax.  Why the hell were they taking it off the market?  There is nothing else that works.  She hasn’t had seizures, she hasn’t fainted. She can’t drive a car while on it, big deal.  It’s keeping her alive. Doc, what the hell are we supposed to do? What if it was your wife, Doc?”

“John… Rebecca, please.  You knew this was a trial program when you signed up.”

“But it’s working, Doc. It’s working.”

“The first few months of the study went well. Last week reports of seizures started to come in. There have been 7 deaths reported in the past two days.  The trial is a failure.  Triton-proclax 50/20 is shutdown.”

“It’s still on the market in Argentina, isn’t it, Doc?  It’s still available in Argentina.”

“It’s not the same drug, John.  I’m sorry. Rebecca, I want you to stay at home for the next week. Rest, and eat whatever you feel like eating. Please write down everything you eat, and make a note of anything unusual that you may feel. Please come back to the office this Tuesday, and Thursday. I want to take some blood tests. It’s important that we monitor your withdrawal from Triton-proclax 50/20 closely. There is a very limited sample of people who came off the trial early, and there were … complications. So it’s important to stay on top of things.”

John and Rebecca shuffled out of Dr. Mallory’s office. Their thirty something faces suddenly looking forty something under the strain of their despair. Rebecca’s complexion had turned from rosy to ashen, not from her illness, but from her loss of hope.

Rebecca stayed in bed all weekend. She didn’t have much of an appetite. She felt like a condemned woman, her bedroom had become her death row cell. She sat at her dressing table and started to write notes of farewell to everyone in her life. She had no idea how rapidly her condition would worsen now that she had been removed from her wonder drug. John, on the other hand, set out to find Triton-proclax on the black market.

On Tuesday Rebecca struggled to get herself dressed, then John drove Rebecca to the doctor’s office for her blood test. After their office visit they drove home, not speaking until John finally broke the silence.

“Honey.  I got a name today. A pharmacist over in Braperton county.  I can get a thirty-day supply for ten thousand dollars.”

“What are you talking about, John? You heard the Doctor.”

“No. Honey. Really, this guy said that the pharmaceutical company was ordered to collect and destroy all the Triton-proclax distributed for the study. He says a guy on the inside at the incinerator plant replaced the real Triton-proclax with Argentine knock-offs.  We can have as much as we can pay cash for, but we have to hurry. There aren’t that many pills to be had.”

“John, I don’t know.”

“Oh Rebecca, please, I love you. I can’t go on without you. Please, let’s do this.”

“John, I can’t right now. Please, let’s sleep on it tonight.  We’ll talk about it in the morning.”

“What the hell is there to talk about?”

“John, please.”

They drove on in silence.  John occasionally took his eyes off the road to look at Rebecca. He saw the tears in her eyes. He didn’t push the conversation. He didn’t have to. John knew exactly what he had to do the next morning.

***

John was disappointed to find that it would be seven to ten business days before his company 401-K plan administrator could put a cashiers check for a hundred thousand dollars in his hand.  He tried to wait, but he could not.  With each passing hour he knew the supply of pills was in danger of being bought up by other people.  People just like him, with loved ones just as sick.  But John didn’t care.  This was his wife.  She was the only person he cared about.  John decided to take ten grand out of his savings account.  It would buy a thirty-day supply.  That was enough to cover the wait for his big check, and hopefully he could promise the pharmacist a big sale, and he would keep a supply around for him.  That was a naive thought on John’s part, but he couldn’t see it.

He took the hour-long drive to Braperton county, and as instructed by his source he pulled up to the rear entrance of the pharmacy.  He parked next to a dumpster, walked to the beat up metal rear door and rang the bell.  A man in a white coat opened the metal door and John simply said, “TP 50/20,” and he flashed the thick wad of hundred dollar bills. The man in the white coat simply said, “Wait here,” and the metal door closed.

The door was closed for only a minute or two, but it seemed like an eternity. John nervously looked around expecting the police or federal agents to swoop down on him.  Then the metal door opened and the exchange was made. The man in the white coat didn’t count the money.  John asked, “Aren’t you going to count it?” The man stopped, looked John square in the eyes and said, “I’m the only supplier there is. You aren’t going to cheat me out of a couple of hundred, and screw yourself too.”  The door closed. The transaction was over.  Now John had to face Rebecca with the news of what he had done.

***

John thought but could not find the words he needed to have his taboo conversation with Rebecca.  That evening as they finished dinner without much conversation, John took the bottle of pills out of his pocket and placed them on the table in front of Rebecca.  Her head sunk to her chest, and tears streamed from her eyes as she reached out and grasped the bottle of pills.  As she clutched the bottle to her chest, her crying escalated into a mournful wailing; mixed with a bittersweet feeling joy, and then once again, the immediate realization that the joy was temporary at best.

***

John’s hundred thousand was enough to buy the last of the Triton-proclax 50/20 available on the black market.  They had a one-year supply of pills, a year of hoping for a miracle.

The bi-weekly visits to Dr. Mallory’s office for monitoring continued for the next few months. One evening after the blood was drawn Dr Mallory asked Rebecca to join him in his office.

“Rebecca.”
“Yes, Dr. Mallory?”
“Rebecca, you must be doing something different from my other Triton-proclax 50/20 patients.  Are you sure you are writing down everything you are eating and drinking?”
“YES, yes, of course, Dr. Mallory, of course I am, everything.”
“Rebecca…Look me in the eye. You have done something you shouldn’t have, haven’t you?”

She couldn’t look him in the eye. Her own eyes were filling with tears.
“Rebecca, that’s very risky.”
“Do you want me to stop, Dr. Mallory?”
There was a long silence. “No Rebecca. I don’t want you to stop.  But I do need you to be honest with me. It’s the only way we can get through this.”
“You don’t want me to stop?”
“Rebecca. We are going to be honest with each other, agreed?”
“Agreed.”
“Rebecca… You are the last surviving member of the Triton-proclax 50/20 trial.
“What?”
“When the other patients came off the drug, their white count exploded. I want to try and wean you off the drug slowly.  Monitoring you every step of the way. Will you work with me Rebecca?”
“Yes, I have no other choice, do I?”

“Rebecca I believe this will be a long, but hopefully a successful process.  I’m going to insert what’s called a central access catheter in your arm, so we don’t have to keep sticking you with needles, OK?”
“Let’s go for it, Dr. Mallory.”
“I’ll also need you to bring in your pills, Rebecca.” There was another long pause in the conversation. “Rebecca, we have to trust one another.”
“Okay Dr. Mallory, I’ll bring them in.”

Rebecca brought her supply of Triton-proclax 50/20 into Dr. Mallory.  Most of it that is; she kept a months supply hidden at home, just in case.

The revelation of Rebecca’s supply presented Dr. Mallory with a new problem. Rebecca’s ill-gotten stash of Triton-proclax 50/20 was in fact the Argentine knock-off, not the real drug. It seemed that hope was the medicine that was keeping Rebecca alive. Dr. Mallory’s new challenge was to keep Rebecca’s hope alive while concocting a successful ruse to wean her off the counterfeit drug.

With the help of his close friends and colleagues in the fields of medicine and psychology, Dr Mallory was successful in treating Rebecca.  Today Rebecca is still in remission, and her marriage to John is stronger than ever. Dr, Mallory, is a new believer in the power of faith and the human spirit in treating disease.

1 comment:

  1. Well told...reminds me of reading those drug inserts that fold out into a giant "map" of information and somewhere in there is the list of side effects and effectiveness of drug and effectiveness of placebo...and sometimes they are pretty doggone close.

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