THE ADJUSTMENT CLINIC

Dr. Paul DeCarlo stared at the medical director of the central nervous system drug development department and then turned his gaze to the large window overlooking the main lobby to the Wilson Medical Products United States headquarters. A brisk wind made audible snapping sounds of the American flag and the dark blue white-bordered flag with the giant WMP central letters. The flags were always waving energetically throughout the year and especially on clear early summer days like today’s bright June cloudless presentation.

“Don’t we usually just send one of our data management staff out with the truck to the FDA? Why me?”

The medical director leaned forward at his desk to the standing DeCarlo. “Word came down from the VP of Medical Affairs. They insist the MD in charge of the Legg infiltration see this thing through. You’re going with the truck to the FDA and that’s final.”

DeCarlo was in his mid-thirties and had worked his way up the Wilson ladder by claiming credit for the work of others and was, in general, a tattletale on any of his co-workers who voiced discontent and malcontent toward upper management. No one liked DeCarlo except his medical director and the medical director’s female associate who, in turn, had taken the credit for the results of DeCarlo’s stolen accomplishments.

DeCarlo looked at the large semi-trailer truck as the many boxes containing the NDA for Wilson’s new miracle pain drug was being loaded. He tried to think positive. “Well, I always wanted to ride in one of these big rigs. They always seem in control of the main highways, especially at night.”

“Dr. DeCarlo. Dr. DeCarlo.” The female clerk rushed up to him before he boarded the truck. “You forgot to sign for the cargo.” She thrust the cover letter of the three-page document on a clipboard for him and gave him a pen.

“I have to sign this?” DeCarlo read the cover letter stating his position with Wilson’s and responsibility for the NDA.

“Yes. Please hurry so we can release the truck.”

DeCarlo signed and waved to Corey Frimple, the truck driver. DeCarlo had met Frimple two-nights ago at the company’s big party celebrating the completion and send-off of the NDA. DeCarlo had told his wife about the trip to the FDA.

“Is that two-faced boss of yours guaranteeing a raise or a boost to the bonus?” Missy DeCarlo never wanted her husband to enter corporate medicine. She wanted the bigger money and status of being a successful physician’s wife. DeCarlo, however, lacked not only a good patient bedside manner but couldn’t get along with his colleagues. He couldn’t find a partner to share night or weekend call for hospital coverage and in general, his patients left him after only two or three visits. DeCarlo’s demeanor was easily assimilated into the political milieu of a corporate structure.

“Yes. I specifically asked about this. Riding shotgun on this truck is extra duty.”

“How come no one else on the MD staff ever had to ride the truck to the FDA?” Missy probed.

“Good Question. I checked on that and I found out one of the new consultants in charge of morale and motivation convinced upper management it was the kind of action, which stimulates company loyalty. Anyway, some of the other jerk associate directors turned green with envy, so I’m earning points by going.”

“What about Legg Pharmaceuticals? What happens if they find out you worked for them only to spy on their progress for their pain killer?”

“Everything was legal. On the books at Wilson, I never worked for them during my interim at Legg. According to the current paper trail, I was just re-hired at Wilson’s.”

“I heard you could go to jail if you get caught about spying on Legg’s.”

“Forget it. It’s old news. Help me pick out my truck travel clothes.”

DeCarlo wore a gray corduroy sport coat, casual shirt and khaki chinos with tan sneakers. He pulled himself up to the passenger seat. DeCarlo adjusted his corduroy sport coat as he fastened his seat belt. “Wow, Corey, this truck is really high off the road.” DeCarlo looked out the window and around his side of the truck.

“Yeah. These rigs are great for intimidating cars and smaller trucks. We kind of rule the highway, especially running at night.”

“Can I work the CB radio and talk to other trucks?” DeCarlo lifted the microphone from its rest.

“No. We’re on radio silence until we deliver the goods. These NDA trips are top secret.”

“You know Corey, we’re becoming computerized at Wilson. These trips with sealed crates of paper data may be a thing of the past in a few years.”

“Maybe, but let’s get going.”

“Okay, Corey.” DeCarlo rubbed his hands together. “Let’s get this thing on the road.”

Frimple wore a brown leather bomber jacket and jeans with brown ostrich quill western boots. Frimple started the diesel engine causing black smoke to billow up from the double stack mufflers with dark acrid swirls blowing forward until the truck moved ahead.

DeCarlo felt good about this trip. In the future he could tell his colleagues about being a passenger on one of the ancient road treks transporting an NDA to the FDA. He looked through the small window behind him but could only see the trailer’s aluminum sides and rear wheels.

The FDA required paper filing of all documents pertinent to the NDA for registration of a new drug. Eventually, it was held that electronic filings would occur once the FDA became totally computer literate. In 1989, word processing and computer clinical trial reports with the complete NDA package for the efficacy and safety of a drug was still 100% paper. The entire NDA was packed in boxes behind him in the trailer and labeled for each division of the FDA to scoop up the appropriate section for the review process. DeCarlo had watched as the efficacy and safety data filled up more than half the semi-trailer truck. The rest of the truck contained the boxes of data and data summaries for pharmacokinetics of the drug and for secondary indications other than pain, like sedation and relaxation. Wilson Medical’s new pain drug had a broad label to work for pain management in surgical specialties as well as for medical conditions. DeCarlo had watched as Corey Frimple pulled down the metal door to the trailer with only two-inches of clearance to the stacked boxes. The door was then locked and sealed. The FDA receiving officer was the only one who could now unseal the data load. If the seal was broken on arrival the truck and its load would be turned back.

“All right.” DeCarlo waved to some of the pain-team members at the loading dock. It was amazing to see any of his colleagues at five in the morning. Maybe that morale officer was right. He could see the faces and sensed they were feeling good about the fruits of their labors going off to the FDA. In the near future, a significant bonus would be in their paychecks after FDA approval.

The route they had to take from Wilson headquarters in northern New Jersey to the FDA building just outside of Washington DC in Maryland would bring them to Pennsylvania in forty-five minutes and then cut laterally east to New Jersey and the New Jersey Turnpike. From the turnpike they would go through Delaware and cut west to reach the perimeter of DC and upper Maryland. Right now they were entering a tiny zone in Pennsylvania that protruded into their itinerary.

“This part of the trip is slow. They’re always doing construction on this segment of the road. See up ahead, the road is narrowing to one lane. We’ll be crawling along for awhile.” Frimple down-shifted causing the giant truck to hiss, roar and belch black smoke from its dual stacks.

The road expanded again to three lanes for about fifteen-minutes. There was little traffic at this time of the morning. DeCarlo looked at his watch. It was five-thirty-five.

“Oh oh, looks like a detour ahead.” Frimple geared the truck down with more hissing of the hydraulics and a groaning protest from the diesel engine.

A state police car with its rotating dome lights was beside a tank truck which appeared jack-knifed across the highway. The state trooper waved Frimple to a stop and Frimple rolled down his window.

“What’s happening officer?”

“We have about a two-hour delay to get this tanker rig moved. Take this right detour. It loops around. You’ll be back on the highway in fifteen-minutes.”

“Okay.” Frimple took the exit onto the tree-lined two-lane road. “I hate this, but it happens more often than not.”

“This road is bumpy.” DeCarlo missed the comfort of his big Buick.

“So what. Our cargo isn’t fragile.”

The truck disappeared around the wooded landscape out of sight of the highway. The driver of a car parked on the side of the road in the opposite direction picked up his car phone.

“They just passed me.” The man watched the black smoke from the truck’s stacks diffuse into the atmosphere.

The state trooper answered the man. “Good. Take care of things at your end.” The trooper got into the police car and shut off the rotating blue and red lights. The tank car

started its engine, straightened out and moved down the Pennsylvania highway.

╦

The parked car moved onto the road behind the trailer truck. After five-minutes the man spoke into the phone again. “They’re three miles away. I’m right behind them.”

“This road should begin its turn back according to the state cop’s direction.” Frimple looked at the road which showed no indication of looping back toward the highway. Another state police car with its lights flashing was horizontal across the road blocking both lanes.

“What the Christ?” Frimple looked at DeCarlo. “Now what?” Frimple brought the truck to a hissing stop and rolled down the window.

Two state troopers moved toward the truck. “You’ll have to get out of your vehicle.” The trooper barked at Frimple and then noticed DeCarlo. “Both of you.”

The second trooper went around to the passenger side of the truck.

“What? Why do we have to get out? What’s going on?” Frimple protested.

“Just get out. We’re looking for a hijacked truck. Get down and show me your cargo manifest papers.”

“Hijacked truck. This is ridiculous.” Frimple opened the truck door and stepped onto the road.

The trooper took the papers and walked with Frimple and DeCarlo to the back of the truck. He looked at the papers. “Open it up.”

“This cargo is sealed. It has to remain intact until an official at the FDA

acknowledges that no tampering has taken place.”

“Open it, now.” The trooper drew his pistol.

“Now wait a minute. I’m an executive of Wilson Medical Products. You can’t do this.” DeCarlo reached into his jacket pocket to get his identification.

“Raise your hands.” The second trooper pointed his gun at DeCarlo.

DeCarlo began to sweat. “What is this?”

“Break the seal, driver.” The trooper motioned to the tagged lock with the gun.

Frimple complied when the gun barrel was pressed against his chest. He broke the seal, opened the rear folding door and raised it.

The trooper looked at the manifest papers and checked the exposed boxes.

“This is the right truck. Okay you two, move to the side of the road and stay facing the woods.”

The car that had tailed them pulled behind the truck which was now at the side of the road. A small tank truck labeled “Septic Tank Pump Service” pulled to the left of the rear of the trailer truck. A man got out and pulled out a long hose. He began pumping what smelled like kerosene onto the NDA boxes.

Frimple smelled the fuel and turned to look.

“Don’t turn around.” The trooper prodded him in the back with the gun muzzle.

The man from the car went up to DeCarlo. “Your name is Paul DeCarlo? Dr. Paul DeCarlo?”

“Yes. How did you know?”

“I’m just making sure.” He pulled out his automatic and fired two bullets into DeCarlo’s face.

“Oh my God.” Frimple looked at DeCarlo’s twitching form thrown back to the edge of the road. He now smelled the black smoke from the burning trailer as the boxes of NDA documents were set ablaze.

“You want to look at your truck. Go ahead and look.” The second trooper pushed him forward.

“What’s going to happen to me? I’m just a truck driver.” Frimple was tremulous.

“You were just a truck driver.” The car driver in civilian clothes fired his 9mm automatic twice into Frimple’s chest. He turned to the state policemen. “Okay. We’ll take

it from here. This rig has to burn completely. You two get out of here with that car. We’ll see you at the debriefing.”