Page 17 of Strong Medicine


  “Noah was an addict, but he was still a doctor,” Celia pointed out. “And you know perfectly well, Andrew, doctors can get all the drugs they want, one way or another. If Noah hadn’t got his from detail people he’d simply have written prescriptions, which maybe he did as well as getting samples.” She added with some heat, “Besides, when the medical profession does nothing about doctors who become addicts, why should pharmaceutical companies be expected to be different?”

  “A fair question,” Andrew conceded, “for which I don’t have an answer.”

  Then, in August of 1967, Celia’s reassignment happened.

  Preceding it, one significant event occurred near the end of 1966. Sam Hawthorne was promoted to executive vice president, making it clear that unless something accidental intervened, Sam would someday soon be at the head of Felding-Roth. Thus, Celia’s judgment ten years earlier when choosing a mentor in the company seemed close to being proved correct.

  It was Sam who eventually sent for her and told her with a smile, “Okay, your O-T-C servitude is over.”

  Sam was now in a palatial office with a comfortable conference area, and instead of one secretary outside his door, his new job rated two. At a previous meeting he confided to Celia, “Damned if I know how I keep them busy. I think they dictate letters to each other.”

  Now Sam announced, “I’m offering you the post of Latin-American Director for Pharmaceutical Products. If you accept you’ll operate from here, though you’ll be away a bit, with quite a lot of travel.” He regarded her interrogatively. “How would Andrew feel about that? And you about the children?”

  Without hesitation Celia answered, “We’ll work it out.”

  Sam nodded approvingly. “I expected that was what you’d say.”

  The news delighted and excited her. Celia was well aware that international business in pharmaceuticals was becoming increasingly important. The opportunity was excellent, even better than she had hoped for.

  As if reading her mind, Sam said, “International is where the future is for sales. So far we’ve barely probed beneath the surface, in Latin America especially.” He waved a hand in dismissal. “Go home now. Share the news with Andrew. Tomorrow we’ll get down to details.”

  Thus began five years which proved a Rubicon in Celia’s career. It also, far from making the Jordans’ family life more difficult, immeasurably enriched it. As Celia was to write later in a letter to her sister Janet, “All of us benefited in ways we never expected. Andrew and I because we had more real togetherness when Andrew traveled with me than we ever did at home, where both of us were busy with our separate working lives. And the children gained because when they traveled too, it enlarged their education and made their thinking international.”

  From the beginning, when Celia brought home the news about her new appointment, Andrew was happy for her and supportive. He was relieved that her time with O-T-C was over, and if he had doubts about family separations which her new work would entail, he kept them to himself. His attitude, like Celia’s, was: We’ll make it work.

  Then, thinking about it more, Andrew decided he would use the opportunity to take some time away from the pressures of medicine and travel with Celia when he could. Andrew, now just a year away from being forty, was determined to profit from the lesson of Noah Townsend whose breakdown, he believed, began with overwork and too much stress. Andrew had watched other doctors, too, become obsessed with their profession to the exclusion of all else, to the detriment of themselves and their families.

  In the medical practice he had joined as a newly qualified internist eleven years earlier—the year before he and Celia met and were married—Andrew was now senior partner. The second doctor, Oscar Aarons, a stocky, brisk and bustling Canadian with a lively sense of humor, had proved to be an asset in whom Andrew had great confidence, and he enjoyed their burgeoning friendship. A third internist, Benton Fox, a twenty-eight-year-old with excellent credentials, had been with them for just a month and was already working well.

  When Andrew told Celia of his intention to travel with her sometimes she was overjoyed; as it worked out, he went along on South American journeyings several times a year. Occasionally, depending on school arrangements, one or both of the children traveled too.

  All of it was made easier by some fortunate arrangements at home. Winnie August, their young English housekeeper-cum-cook, having long ago abandoned her plan to move on to Australia, and being virtually a member of the Jordan family after seven years, was married in the spring of ’67. Incredibly, her husband’s last name was March. As Winnie put it, “If it ’ad to be another month, I should be glad it ain’t December.”

  When Andrew learned that Hank March, a likable, energetic man who worked at various outdoor jobs, was looking for steady employment, he offered him a post as chauffeur-gardener and general handyman. Since live-in accommodation would be included, the offer was accepted with appreciation from both Winnie and Hank. For his part, Andrew continued to be grateful for Celia’s foresight in insisting, shortly after their marriage, that they buy a large house.

  Within a short time Hank seemed as indispensable as his wife, now Winnie March.

  Thus Andrew and Celia could leave home, with or without the children, confident their interests would be taken care of in their absence.

  One note of family sadness intruded at this time. Celia’s mother, Mildred, died of respiratory failure after a severe asthma attack. She was sixty-one.

  Her mother’s death affected Celia greatly. Despite the strength and support of Andrew and the children, she experienced a sense of “aloneness” which persisted long afterward, though the feeling, Andrew assured her, was entirely normal.

  “I’ve seen it happen in patients,” he said. “The death of a second parent is like severing an umbilical cord to our past. No matter how much we grow up, while at least one parent is alive there’s always a sense of having someone to fall back on. When both are gone, we know we are truly on our own.”

  Celia’s younger sister, Janet, flew to Philadelphia for the funeral, though leaving her busy oilman husband and their two small children in the Middle East. Afterward, Janet and Celia had a few days together in Morristown, each promising they would try to make mutual visits more frequently in future.

  6

  The sights and sounds of faraway places fascinated Andrew. While Celia transacted her Latin-American business with regional functionaries at outposts of Felding-Roth, he explored the offbeat intricacies of foreign cities or savored scenes of rural life outside. The Parque Colón of Buenos Aires became familiar, as did great herds of grazing cattle on the Argentine pampas. So did Colombia’s Bogotá, surrounded by mountain grandeur, where downward-sloping streets, the calles, carried streams of icy water from the Andes, and ancient mule carts jousted with modern autos for a share of space. In Costa Rica, Andrew came to know the Meseta Central, the country’s heartland and, beyond it, dense broadleaf forests where mahogany and cedar grew. From Montevideo’s narrow, congested Old City streets there were journeys into Uruguay’s valleys, the air fragrant with the scent of verbena and aromatic shrubs. There was Brazil’s dynamic São Paulo city, on the edge of the Great Escarpment and, behind it, wide grassy plains with rich red-purple earth, the terra roxa.

  When the children were traveling, Andrew took them along on his explorations. At other times he reconnoitered, then Celia joined him when her work permitted.

  One of Andrew’s pleasures was bargaining in native shops and making purchases. The drugstores—droguerias—often with their wares crowded into tiny spaces, fascinated him. He talked with pharmacists and occasionally managed to hold conversations with local doctors. He already had a smattering of Spanish and Portuguese and his use of both languages improved with practice. Celia was learning the languages too; at times they helped each other.

  Despite it all, not every trip was a success. Celia worked hard. Sometimes, trying to solve local problems against an unfamiliar background was a strain. The
result was tiredness and normal human frictions which led, on one occasion, to the fiercest, most bitter fight of Andrew and Celia’s marriage, a collision of wills and viewpoints they were unlikely to forget.

  It happened in Ecuador and, like most husband-and-wife quarrels, this one started off low-key.

  They were staying, with Lisa and Bruce, in the capital, Quito, a high mountain city in a cupped palm of the Andes, and a place of vicious contrasts—mostly between religion and reality. On the one hand was a profusion of ornate churches and monasteries with golden altars, carved choir stalls, crucifixes of silver and ivory, and monstrances vulgar with encrusted jewels. On the other was dirty, barefoot poverty and a peasantry undoubtedly the poorest on the continent with wages—for those lucky enough to find work—of some ten cents a day.

  Also in contrast to the poverty was the Hotel Quito, an excellent hostelry in which the Jordan family had a suite. It was to the suite that Celia returned in the early evening, after a generally frustrating day spent with the Felding-Roth gerente local, Señor Antonio José Moreno.

  Moreno, fat and complacent, had made clear that any visit by a head office functionary was not only an unwelcome intrusion on his territory, but an affront to his personal competence. Moreover, whenever Celia suggested changes in procedures, he had given her what she now knew to be a standard Latin-American response, “En este país, así se hace, Señora.” When Celia suggested that an attitude of “In this country that is how it is done” could sanctify inefficiency and sometimes be unethical, she was met by the same bland rejoinder and a shrug.

  One of Celia’s concerns was the inadequate information being given to Ecuadorian physicians about Felding-Roth drugs, in particular their possible side effects. When she pointed this out, Moreno argued, “The other companies do it like this. So do we. To say too much about things which perhaps are not going to happen would be perjudicial to us.”

  While Celia had authority to issue orders, she knew that Moreno, as the man on the spot and a successful sales entrepreneur, would interpret them later—aided by differences of language—as he chose.

  Now, in the hotel suite living room, her frustrations still seething, she asked Andrew, “Where are the children?”

  “In bed and asleep,” he answered. “They decided to go early. We had a grueling day.”

  The fact of not seeing Lisa and Bruce, to which she had been looking forward, as well as what seemed a coolness in Andrew’s tone, irritated Celia and she snapped, “You’re not the only one who had a lousy day.”

  “I didn’t say it was lousy, just grueling,” he observed. “Though for me there were unpleasant portions.”

  Though neither realized it, the high altitude of Quito—more than nine thousand feet above sea level—was having an effect on them both. In Celia it produced a physical weariness, worsening her already downbeat mood. And Andrew had a sharpened acuity, an aggressive edginess, in contrast to his normal easygoing ways at home.

  Celia said, “‘Unpleasant portions!’ I don’t know what you’re talking about.”

  “I’m talking about that!” Andrew jabbed a finger, pointing to a collection of pharmaceutical bottles and packages on a side table.

  With an expression of distaste, she told him, “I’ve had enough of that stuff for one day, so I suggest you get those out of here.”

  “You mean you’re not interested?” His tone was sarcastic.

  “Dammit! No!”

  “Frankly, I didn’t expect you to be. Because what I have here is about drug companies and it’s unpleasant.” Andrew picked up a small plastic container. “Today, as well as taking the children out, I did some shopping and asked questions.”

  Flipping open the container top, he poured tablets into his hand and held them out. “Do you know what these are?”

  “Of course I don’t!” Dropping into a chair, Celia peeled off her shoes and left them where they fell. “What’s more, I don’t care.”

  “You should care! Those are Thalidomide and I bought them today in a local drogueria—without a prescription.”

  The reply jolted Celia and the sharp exchange might have ended there, except that Andrew went on, “The fact that I could buy them, five years after they should have been withdrawn, and buy other dangerous drugs marketed here without proper warnings because there are no government agencies to insist on adequate labeling, is typical of the don’t-give-a-damn attitude of American drug firms, including your own precious Felding-Roth!”

  The injustice, as Celia saw it, when she had spent a large part of her day attempting to change what Andrew had just criticized, inflamed her to hot anger. It also robbed her of all reason. Instead of telling Andrew, as she had intended to do later that evening, of her frustration with Antonio José Moreno, she threw back at him her version of Moreno’s answer. “What the hell do you know about local problems and regulations? What right have you to come here and tell Ecuador how to run this country?”

  Andrew’s face went white. “The right I have is that I’m a doctor! And I know that pregnant women who take these tablets will have babies with flippers instead of arms. Do you know what the pharmacist told me today? He said, yes he had heard about Thalidomide, but he didn’t know these tablets were the same thing because they’re called Ondasil. And in case you don’t know, Celia, or don’t want to know, Thalidomide has been sold by drug companies under fifty-three different names.”

  Without waiting for a response, he stormed on, “Why always so many different names for drugs? Certainly not to help patients or their doctors. The only reason anyone can think of is to sow confusion and aid the drug firms when there’s trouble. Speaking of trouble, look at this!”

  Selecting another bottle, Andrew held it out. Celia could read the label: Chloromycetin.

  “If you bought this in the U.S.,” he declared, “there’d be a published warning about possible side effects, especially fatal blood dyscrasias. Not here, though! Not a word!”

  From the collection on the table he chose one more. “I got this today, too. Take a look at Felding-Roth’s Lotromycin, which you and I both know about. We also know it shouldn’t be used by anyone with impaired kidney function, or by pregnant women, or women breastfeeding infants. But is there a printed warning saying so? Not on your life! Who cares if a few people suffer or die here because they haven’t been cautioned? After all, it’s only Ecuador, a long way from New Jersey. Why should Felding-Roth care? Or Celia Jordan?”

  She screamed back at him, “How dare you say that to me!”

  Now Andrew lost control.

  “I dare,” he answered fiercely, “because I’ve seen you change. Change little by little over eleven years. From having decent feelings and ideals and caring, to not caring quite so much, then relaxing while you helped push useless over-the-counter junk, and now moving on to this—using phony head-in-the-sand excuses to justify something which you know is evil, but won’t concede, even to yourself.” His voice rose. “What happened to that idealistic girl who first brought me Lotromycin and wanted to raise the ethics of the drug business, the same one who stood up, straight and strong, at a New York sales meeting and criticized dishonest detailing? You want to know what happened to her? I think she sold out.”

  Andrew stopped, then inquired scathingly, “Were ambition and promotion worth it?”

  “You bastard!” Acting instinctively, without rational thought, Celia reached down and, seizing one of the shoes she had dropped moments earlier, threw it hard at Andrew. Her aim was unerring. The shoe’s stiletto heel struck him on the left side of his face, opening a gash from which blood spurted. But Celia failed to see. Blind to all else, she hurled venomous words.

  “What gives you the right to be so goddam holy about morals and ideals? What happened to yours? Where were your precious ideals when you did nothing about Noah Townsend, and let him go on practicing medicine for nearly five years, when all that time he was high on drugs, and a danger to himself and others? And don’t blame the hospital! Their ina
ction doesn’t excuse you! You know it!

  “And what about that patient,” Celia stormed on, “the young one, Wyrazik? Was it really Noah who killed him, or was it you? You, because when you could have done something about Noah, you did nothing, and left doing anything until too late. Do you ever lie awake nights wondering about that, and feeling guilty? Because you should! And do you ever wonder if there weren’t some other patients Noah killed during those five years, others you don’t know about, and who died because of your neglect? Do you hear me, you self-righteous hypocrite? Answer!”

  Abruptly Celia stopped. Stopped, not only because she had run out of words, but because she had never seen such anguish as on Andrew’s face. Her hand went to her mouth.

  She said softly, to herself, in horror, “Oh, my God! What have I done!”

  Then it was not just anguish in Andrew’s expression which she saw, but sudden shock at something happening behind her. Following his gaze, Celia wheeled. Two small pajama-clad figures had come into the room. In their uncontrolled fury, both parents had forgotten Lisa and Bruce in the bedroom next door.

  “Mommy! Daddy!” It was Lisa’s voice, choked with tears.

  Bruce was sobbing uncontrollably.

  Celia rushed toward both, arms outstretched, in tears herself. But Lisa was faster. Dodging her mother, she went to Andrew.

  “Daddy, you’re hurt!” She saw the shoe, which had blood on the heel, and cried out, “Mommy, how could you!”

  Andrew touched his face, which was still bleeding. Blood seemed everywhere—on his hands, his shirt, the floor.

  Now Bruce joined Lisa, clinging to his father while Celia watched helplessly, guiltily, standing back.

  It was Andrew who resolutely broke the impasse.

  “No!” he told the children. “Don’t do this! You must not take sides! Your mother and I have been foolish. Both of us were wrong, and we’re ashamed, and all of us will talk about it later. But this is still one family. We belong together.”