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Authors: Mark Jeffrey
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you know that pharmaceutical salespeople have the highest percentage of former prom kings and queens of any profession? It’s true. All those kids who were the hottest in high school, they go to college and then, bam! They’re done. The real world hits them.
“So what do they do? I’ll tell you what. They go into sales — usually pharma, because it’s so lucrative. And just like that, they’re back again, just like high school and college, hanging with the hot crowd, and hotting around with doctors and nurses. It’s sexy.
“Only — they don’t really know what they’re selling. And they don’t much care. All they’re worried about is hitting their quota — and where the next kegger is come Saturday night.
“Anyway, this one smooth talking guy comes along and introduces me to Quaofloxin. It’s a new injectable for a variety of illnesses. The studies on it are out of John Hopkins, Harvard, you name it. They’ve got graphs that all go up, up, up to Mars. Liquid sunshine, just pop it in a vein twice a week.
“But the real attraction is the gifts and kickbacks that come with it. The more you prescribe, the more kickbacks you get. Oh it’s not supposed to work like that, but that’s exactly how it does work. They structure it in ways that make it so it doesn’t appear to be a kickback, it’s a ‘gift’ or a ‘reward’. But the result is the same: your bank account starts filling up.
“Well, Quaofloxin made my practice possible. In the first few years, when my business probably would have folded, those extra reward dollars worked wonders on my account. Even so, right around the second year, I started to have my doubts about Quaofloxin: too many of my patients were showing side effects. Some suffered convulsions; others developed severe neck and back pain. One lost the ability to walk. One even died, after losing the ability to breathe. Now, mind you, I wasn’t absolutely sure that it was the Quaofloxin was directly responsible — and all the studies indicated the opposite, that the drug was completely safe.
“Even still, I might have gotten off the Quaofloxin crack pipe, if it hadn’t been for our baby.”
Elspeth paused for a moment, a spasm of pain wracking her face. “Oscar had just lost his job when I got pregnant. By the time I went on maternity leave, we were basically living off of what I’d managed to sock away from the Quaofloxin ‘rewards’. And that’s when we got our second shock: our baby daughter was born with a faulty heart valve. She wasn’t expected to live.
“So the operations began. There were four of them total. Four! Can you imagine that? On a body that tiny? And of course we had health insurance, but no insurance covers something like this, not really. The medical bills started piling up. I had to go back to work, far sooner than I wanted to, but there was no choice.
“We were desperate. We badly needed money for our baby to live. It was that simple. It was an equation. If you had the money, you could pay for life. If not … well, then not. I mean, holy shit , right? When your child is at stake, you’ll do anything. So I loaded up on the Quaofloxin. I doubled down. I prescribed it like candy.
“And I didn’t think I was doing anything wrong, mind you. The rational part of my brain, the scientific part, it reasoned that the best science backed this stuff up. So what if I made money from it? And not just money — money I desperately needed? That was capitalism. That was the free market. But I ignored the little voice in my brain, the gut instinct you get as a doctor, the intuition that something was off. I pushed it down, chalked it up to irrational guilt. Guilt over what? Success? That I was a Doctor? You’re goddamn right I was Doctor! I’d worked my ass off in school
“So what do they do? I’ll tell you what. They go into sales — usually pharma, because it’s so lucrative. And just like that, they’re back again, just like high school and college, hanging with the hot crowd, and hotting around with doctors and nurses. It’s sexy.
“Only — they don’t really know what they’re selling. And they don’t much care. All they’re worried about is hitting their quota — and where the next kegger is come Saturday night.
“Anyway, this one smooth talking guy comes along and introduces me to Quaofloxin. It’s a new injectable for a variety of illnesses. The studies on it are out of John Hopkins, Harvard, you name it. They’ve got graphs that all go up, up, up to Mars. Liquid sunshine, just pop it in a vein twice a week.
“But the real attraction is the gifts and kickbacks that come with it. The more you prescribe, the more kickbacks you get. Oh it’s not supposed to work like that, but that’s exactly how it does work. They structure it in ways that make it so it doesn’t appear to be a kickback, it’s a ‘gift’ or a ‘reward’. But the result is the same: your bank account starts filling up.
“Well, Quaofloxin made my practice possible. In the first few years, when my business probably would have folded, those extra reward dollars worked wonders on my account. Even so, right around the second year, I started to have my doubts about Quaofloxin: too many of my patients were showing side effects. Some suffered convulsions; others developed severe neck and back pain. One lost the ability to walk. One even died, after losing the ability to breathe. Now, mind you, I wasn’t absolutely sure that it was the Quaofloxin was directly responsible — and all the studies indicated the opposite, that the drug was completely safe.
“Even still, I might have gotten off the Quaofloxin crack pipe, if it hadn’t been for our baby.”
Elspeth paused for a moment, a spasm of pain wracking her face. “Oscar had just lost his job when I got pregnant. By the time I went on maternity leave, we were basically living off of what I’d managed to sock away from the Quaofloxin ‘rewards’. And that’s when we got our second shock: our baby daughter was born with a faulty heart valve. She wasn’t expected to live.
“So the operations began. There were four of them total. Four! Can you imagine that? On a body that tiny? And of course we had health insurance, but no insurance covers something like this, not really. The medical bills started piling up. I had to go back to work, far sooner than I wanted to, but there was no choice.
“We were desperate. We badly needed money for our baby to live. It was that simple. It was an equation. If you had the money, you could pay for life. If not … well, then not. I mean, holy shit , right? When your child is at stake, you’ll do anything. So I loaded up on the Quaofloxin. I doubled down. I prescribed it like candy.
“And I didn’t think I was doing anything wrong, mind you. The rational part of my brain, the scientific part, it reasoned that the best science backed this stuff up. So what if I made money from it? And not just money — money I desperately needed? That was capitalism. That was the free market. But I ignored the little voice in my brain, the gut instinct you get as a doctor, the intuition that something was off. I pushed it down, chalked it up to irrational guilt. Guilt over what? Success? That I was a Doctor? You’re goddamn right I was Doctor! I’d worked my ass off in school
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