Strong Medicine

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  PRAISE FOR THE WRITING OF ARTHUR HAILEY

  “The author of Airport and Hotel has the natural storyteller’s gift of keeping a reader avidly turning the pages.” —The New York Times Book Review

  Detective

  “A provocative story about justice … Imbue[d] with the same gritty realism that turned [Hailey’s] previous efforts into bestsellers.” —People

  Strong Medicine

  “From the man who made you afraid to fly (Airport), drive (Wheels), or stay in a hotel en route comes a new industry exposé.… Reeking of realism, Strong Medicine shows the good and bad sides of medicine.” —The Indianapolis News

  “This one’s a winner.… Full of drama, romance, and treachery that also informs us about issues behind the headlines.” —San Francisco Chronicle

  The Evening News

  “A tense, fast-paced page-turner … [Hailey] tells a great deal more about network news than the reader ever knew.” —The Washington Post Book World

  The Final Diagnosis

  “A fast-paced, polished novel that reads easily, entertains, and informs … Well documented and authentic.” —Chicago Sunday Tribune

  Strong Medicine

  Arthur Hailey

  PERSONAL

  The Author to His Readers

  In 1979, with publication of Overload, I announced my retirement. I was tired. My life had been full. I was, and still am, grateful to those millions of readers worldwide who have enriched my life in many ways, including making retirement possible.

  In whatever years remained I wanted to spend more time—and travel—with my dear wife Sheila, go fishing, read more books, relax with music, do other things a working writer can’t.

  What I did not know was that I was near death from six blockages in the coronary arteries—a condition diagnosed soon afterward by my friend and physician, Dr. Edward Robbins of San Francisco, who urged immediate surgery. This was done—a quadruple bypass—by Dr. Denton Cooley and his associates at the Texas Heart Institute, to where my gratitude flows strong.

  Sheila was supportive, as she has been through our long and loving marriage. It is more than coincidence in this novel that the names Celia and Sheila come similarly off the tongue.

  The aftermath of everything was my revived good health and an abundance of energy—so much of the latter that Sheila said one day, “I think you should write another book.”

  I took her advice. Strong Medicine is the result.

  April 5, 1984 A.H.

  Diseases, desperate grown,

  By desperate appliance are reliev’d,

  Or not at all.

  SHAKESPEARE, Hamlet

  We are overwhelmed as it is, with an

  infinite abundance of vaunted medicaments,

  and here they add a new one.

  THOMAS SYDENHAM, M.D. (1624–89)

  PROLOGUE

  1985

  In the 747, up forward in first class and half an hour out from London, Dr. Andrew Jordan reached for his wife’s hand and held it.

  “Stop worrying,” he urged her. “Nothing may happen.”

  “Something will happen,” she said. “Dennis Donahue will see to that.”

  Andrew grimaced at the mention of New England’s populist U.S. senator. “I was looking forward to lunch,” he objected. “Did you need to spoil it by making me nauseous?”

  “Be serious, Andrew. Remember there have been deaths. Drug-related.”

  “You were a long way removed from them.”

  “Just the same, if there are criminal proceedings, I’ll be included. I could go to prison.”

  He tried to buoy their sagging spirits. “It hasn’t happened yet, but if you do I promise to visit every day and bring cakes with hacksaw blades inside.”

  “Oh, Andrew!” She turned toward him, her smile a mixture of love and sadness.

  After twenty-eight years of marriage, he thought, how good it was to see your wife, with admiration, as beautiful, intelligent and strong. And, he told himself, he wasn’t being sentimental either. He had seen all those qualities, and more, exhibited a thousand times.

  “That’s nice,” a female voice beside them interjected.

  Andrew looked up. It was a bright, young, cheerful stewardess, observing them holding hands.

  He told her, deadpan, “Love can happen to the elderly, too.”

  “Really?” The stewardess matched his mocking tone. “That never occurred to me. More champagne?”

  “Yes, please.”

  He caught the girl inspecting him and knew, without being vain, that he still looked good, even to someone young enough to be his daughter. How had that London newspaper columnist described him last week? “The white-haired, handsome and distinguished physician husband of … et cetera, et cetera.” Though Andrew hadn’t said so, at the time he’d rather liked it.

  The champagne poured, Andrew sat back. He enjoyed the perquisites which went with first-class travel, even if today they seemed less significant than usual. It was his wife’s money which provided those embellishments, of course. While his own income as a busy internist was more than comfortable, he doubted if he would splurge on first-class fare between London and New York, and certainly could never afford the private jet in which his wife, and sometimes Andrew, traveled around North America.

  Correction, he reminded himself: had traveled until now. What changes lay immediately ahead were far from certain.

  Money, though, had never been any kind of issue in their marriage. They had never had the slightest argument about it, and right from the beginning his wife had insisted that what they had, they had together. Their bank accounts were always joint, and though Andrew’s contribution nowadays was by far the smaller, neither bothered with comparative arithmetic.

  His thoughts drifted and they continued to hold hands as the 747 thrummed westward above the Atlantic far below.

  “Andrew,” his wife said, “you’re such a comfort. Always there. And always so strong.”

  “That’s funny,” he replied. “Strong is what I was thinking about you.”

  “There are different kinds of strength. And I need yours.”

  The usual airline bustle was beginning, preparatory to service of their meal. Stowaway tables were being released, white linen and silverware appearing on them.

  After a while his wife said, “Whatever happens, I’m going to fight.”

  “Haven’t you always?”

  She was thinking carefully, as usual. “Within the next few days I’ll choose a lawyer. It must be someone solid but not flamboyant. Too much showmanship would be a mistake.”

  He squeezed her hand. “That’s my girl.”

  She smiled back at him. “Will you sit beside me in court?”

  “Every day. Patients can fend for themselves until it’s done.”

  “You’d never let that happen, but I would like you with me.”

  “There are other doctors. Arrangements will be made.”

  “Maybe,” his wife said, “maybe, with the right lawyer, we can pull off a miracle.”

  Andrew dipped a knife into a helping of caviar that had just been placed before him. However acute their troubles, there was no point in passing up that.

  “It could happen,” he said, spreading the caviar on toast. “We started with a miracle, you and I. And there’ve been others since, which you’ve made happen. Why not one more? This time just for you.”

  “It would be a miracle.”

  “Will be,” he corrected gently.

  Andrew closed his eyes. The champagne and the altitude had made him sleepy. But in his sleepiness he
remembered the first miracle.

  Long ago.

  ONE

  1957–1963

  1

  Dr. Jordan said quietly, “Your wife is dying, John. She has a few hours more, that’s all.” He added, conscious of the pale, anguished face of the slight young man before him, still dressed in his factory work clothes, “I wish I could tell you something else. But I thought you’d want the truth.”

  They were in St. Bede’s Hospital in Morristown, New Jersey. Early evening noises from outside—small-town noises—filtered in, barely disturbing the silence between them.

  In the dimmed light of the hospital room, Andrew watched the Adam’s apple of the patient’s husband bob twice convulsively before he managed to get out, “I just can’t believe it. We’re just beginning. Getting started. You know we have a baby.”

  “Yes, I know.”

  “It’s so …”

  “Unfair?”

  The young man nodded. A good, decent man, hardworking from the look of him. John Rowe. He was twenty-five, only four years younger than Dr. Jordan himself, and he was taking this badly—not surprisingly. Andrew wished he could comfort the other man more. Though Andrew encountered death often enough and was trained to know the signs of death’s approach, he still was uncertain about communicating with a dying person’s friends or family. Should a doctor be blunt, direct, or was there some subtler way? It was something they didn’t teach in medical school, or afterward either.

  “Viruses are unfair,” he said, “though mostly they don’t act the way this has with Mary. Usually they’ll respond to treatment.”

  “Isn’t there anything? Some drug which could …?”

  Andrew shook his head. No point in going into details by answering: Not yet. So far, no drug for the acute coma of advanced infectious hepatitis. Nor would anything be gained by saying that, earlier today, he had consulted his senior partner in practice, Dr. Noah Townsend, who also happened to be the hospital’s chief of medicine.

  An hour earlier Townsend had told Andrew, “You’ve done all you can. There’s nothing I’d have done differently.” It was then that Andrew sent a message to the factory, in the nearby town of Boonton where John Rowe was working on the swing shift.

  Goddam! Andrew’s eyes glanced at the elevated metal bed with the still figure. It was the only bed in the room because of the prominent “ISOLATION” notice in the corridor outside. The I.V. bottle on its stand stood behind the bed, dripping its contents—dextrose, normal saline, B-complex vitamins—into Mary Rowe through a needle in a forearm vein. It was already dark outside; occasionally there were rumblings from a storm and it was raining heavily. A lousy night. And the last night of living for this young wife and mother who had been healthy and active only a week ago. Goddam! It was unfair.

  Today was Friday. Last Monday Mary Rowe, petite and pretty, though clearly unwell, had appeared in Andrew’s office. She complained of feeling sick, weak, and she couldn’t eat. Her temperature was 100.5.

  Four days earlier, Mrs. Rowe told him, she had had the same symptoms plus some vomiting, then the next day felt better and believed the trouble, whatever it was, was going away. But now it had returned. She was feeling terrible, even worse than before.

  Andrew checked the whites of Mary Rowe’s eyes; they showed a tinge of yellow. Already areas of her skin were showing jaundice too. He palpated the liver, which was tender and enlarged. Questioning elicited that she had been to Mexico with her husband for a brief vacation the previous month. Yes, they had stayed in a small, offbeat hotel because it was cheap. Yes, she had eaten local food and drunk the water.

  “I’m admitting you to the hospital immediately,” Andrew told her. “We need a blood test to confirm, but I’m as certain as I can be that you have infectious hepatitis.”

  Then, because Mary Rowe had seemed frightened, he explained that most likely she had consumed contaminated food or water in Mexico, the contamination probably from an infected food handler. It happened frequently in countries where sanitation was poor.

  As to treatment, it would be mostly supportive, with adequate fluid intake into the body given intravenously. Complete recovery for ninety-five percent of people, Andrew added, took three to four months, though Mary should be able to go home from the hospital in a matter of days.

  With a wan smile, Mary had asked: What about the other five percent?

  Andrew laughed and told her, “Forget it! That’s a statistic you won’t be part of.”

  Which was where he had been wrong.

  Instead of improving, Mary Rowe’s condition worsened. The bilirubin in her blood went up and up, indicating increased jaundice, which was obvious from the alarming yellow of her skin. Even more critical, by Wednesday tests revealed a dangerous level of ammonia in the blood. It was ammonia, originating in the intestines, which the deteriorating liver could no longer handle.

  Then yesterday her mental state had deteriorated. She was confused, disoriented, didn’t know where she was or why, and failed to recognize either Andrew or her husband. That was when Andrew warned John Rowe that his wife was gravely ill.

  The frustration at being able to do nothing to help gnawed at Andrew all day Thursday and, in between seeing patients in his office, he kept thinking about the problem, but to no effect. An obstacle to recovery, he realized, was that accumulation of ammonia. How to clear it? He knew that, given the present state of medicine, there was no effective way.

  Finally, and unfairly he supposed now, he had taken out his frustration by blowing his stack at the damned drug company saleswoman who had come into his office late in the afternoon. She was a “detail man.” Or should it be “detail woman?” Not that he cared. He didn’t even remember her name or her appearance, except that she wore glasses and was young, just a kid, and probably inexperienced.

  The saleswoman was from Felding-Roth Pharmaceuticals. Afterward Andrew wondered why he had agreed to see her when the receptionist announced that she was waiting, but he had, thinking perhaps he might learn something, though when she started talking about the latest antibiotic her company had just put on the market, his thoughts began wandering until she said, “You’re not even listening to me, Doctor,” and that had made him mad.

  “Maybe it’s because I’ve something better to think about and you’re wasting my time.”

  It was rude, and usually he wouldn’t have been that way. But his intense worry about Mary Rowe was coupled with a long dislike of drug companies and their high-pressure selling. Sure, there were some good drugs which the big firms produced, but their huckstering, including sucking up to doctors, was something Andrew found offensive. He had encountered it first in medical school where students—future prescribers, as the drug companies well knew—were sought after, flattered and pandered to by drug firm representatives. Among other things, the drug reps gave away stethoscopes and medical bags which some students accepted gladly. Andrew wasn’t one of them. Though he had little money, he preferred to keep his independence and buy his own.

  “Maybe you’ll tell me, Doctor,” the Felding-Roth saleswoman had said yesterday, “what it is that’s so all-fired important.”

  It was then he had let her have it, telling her about Mary Rowe who was critical with ammonia intoxication, and adding caustically that he wished companies like Felding-Roth, instead of coming up with some “me-too” antibiotic which was probably no better or worse than half a dozen others already available, would work on a drug to stop excess ammonia production …

  He had stopped then, already ashamed of the outburst, and would probably have apologized except that the saleswoman, having gathered up her papers and samples, was on the way out, saying simply as she left, “Good afternoon, Doctor.”

  So much for yesterday, and Andrew was no closer to being able to help his patient, Mary Rowe.

  This morning he had taken a phone call from the head floor nurse, Mrs. Ludlow.

  “Dr. Jordan, I’m worried about your patient, Rowe. She’s becoming comatose, n
ot responding at all.”

  Andrew hurried to the hospital. A resident was with Mary Rowe who, by now, was in a deep coma. Although hurrying over was the thing to do, Andrew had known before arriving that no heroic measures were possible. All they could do was keep the intravenous fluids flowing. That, and hope.

  Now, near the end of the day, it was clear that hope had been in vain. Mary Rowe’s condition seemed irreversible.

  Fighting back tears, John Rowe asked, “Will she be conscious again, Doctor? Will Mary know I’m here?”

  “I’m sorry,” Andrew said. “It isn’t likely.”

  “I’ll stay with her, just the same.”

  “Of course. The nurses will be close by, and I’ll instruct the resident.”

  “Thank you, Doctor.”

  Leaving, Andrew wondered: Thanks for what? He felt the need for coffee and headed for where he knew some would be brewing.

  The doctors’ lounge was a boxlike place, sparsely furnished with a few chairs, a mail rack, a TV, a small desk, and lockers for attending physicians. But it had the advantages of privacy and constant coffee. No one else was there when Andrew arrived.

  He poured himself coffee and slipped into an old, well-worn armchair. No need to stay at the hospital any longer, but he instinctively put off departure for his bachelor apartment—Noah Townsend’s wife, Hilda, had found it for him—which was comfortable though sometimes lonely.

  The coffee was hot. While letting it cool, Andrew glanced at a Newark Star-Ledger. Prominent on the newspaper’s front page was a report about something called “Sputnik”—an earth satellite, whatever that might be, which the Russians had recently shot into outer space amid fanfare heralding “the dawn of a new space age.” While President Eisenhower, according to the news story, was expected to order speedup of a U.S. space program, American scientists were “shocked and humiliated” by the Russians’ technological lead. Andrew hoped some of the shock would spill over into medical science. Though good progress had been made during the twelve years since World War II, there were still so many depressing gaps, unanswered questions.