First Do No Harm Winter JenningsChapter 15 Eagle
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First, Do No Harm: Winter JenningsChapter 2: Vital Signs free porn video
Gloria Allen’s file on the Macklin operation was thick. And well organized. A Summary Sheet provided an overview. The individual sections were tab-delineated and color-coded to match the Summary. Like a legal brief that needed to pass courtroom-muster.
A separate folder contained suppositions, rumors, speculation. Facts were one thing; assumptions, projections, implied relationships another.
Everything was also on a thumb drive, but I started old-school.
I began with the facts.
Macklin Innovation Labs was founded in ... no. I would do like Daddy does — focus on the people first.
And the person at the center of it all was Hughwell Albertson Macklin. Not known as HAM. Hugh was 52 years old, a multi-billionaire. Bookending the family patriarch were Hugh’s father and Hugh’s daughter.
Father, Grant, was the founder of Macklin Innovations Lab. Daughter, Grace, was now the next in line to take over the sprawling company. If and when.
Gloria Allen’s cover letter to me stated, “The Macklins are known for three things:
One) Pushing opioids aggressively.
Two) Massive charitable donations in the family name.
Three) Little or no public awareness of the connection between peddling dope and the name ‘Macklin’.
The other significant point in her letter was “Our financing is in place. No more funding from Thatcher.”
Gloria didn’t go into money details; that told me she was as circumspect as I was trying to become. We’d talk about money face-to-face. In her league, at her lofty level, the fees she charged had to be hefty. Five hundred per billable hour? A thousand? Maybe more, depending on how many of her team were dedicated to the project.
I guess I didn’t need to know the financial details. Although, curiosity...
In any case, I’d be reimbursed from the ‘Expenses’ side of her ledger. Like a lesser attorney. Or maybe a paralegal. Or valet parker. Stop.
She had told me, “Bill my firm at $975 per diem. Itemize any expenses over $100. But don’t waste time on paperwork. And don’t shortchange yourself. If you spend a weekend doing research, bill me. But don’t chase after information that my people can dig out for you.”
Mixed feelings on my part. I’d left the cops to strike out on my own. Well, not strike out. To go independent. With the Dixie Wexler case, I’d ended up working for Matt Striker. And, indirectly, for Constance Grayson.
Now here I was reporting to Gloria Allen. Well, she’s in LA, I’m in KC and never the twain ... Stop.
When Gloria Allen first approached me to work on Macklin, I’d just slammed her then-client, Beryl Thatcher, into durance vile. Where I hoped she’d rot for a good, long time.
Thatcher had worked for the International Childcare Network and turned bad. Sold three orphaned teenagers to James and Jill Morton. Captive labor and also available bodies for the pleasure of rough sex aficionados.
What caught Gloria’s attention was one of the three ICN benefactors — Macklin Innovations Lab. Hugh Macklin in particular.
Gloria knew about Hugh Macklin — hell, anyone who paid attention was aware of the scourge of opioid addiction plaguing the country. It was no longer a hillbilly problem — the disease cut across almost every demographic line.
Macklin — Hugh and his family — tried to avoid being linked to opioid sales. But an insider like Gloria easily made the connection. And certain private and public attorneys had as well.
I liked the idea of going after the fuckers. The Macklin fuckers. They had put profits above everything else — people, society, decency. Maybe everything was legal. Probably was. But I still wanted to fuck them up.
Gloria quickly disabused me of my Quixotic ambitions.
“Big Pharma is really just a shorthand name. Not all pharmaceutical companies are guilty. And those that are ... well not everyone is equally guilty. Macklin is in a league of their own.”
“I’d still like to nail them.”
“Too late, Winter. Too late for independents like us to make a difference in the epidemic. “Know who’s going to bring Big Pharma to its knees?”
“Who?”
“The same team of piranhas who won a fifty-state, $250 billion settlement from Big Tobacco. Plaintiff attorneys, states attorneys general, the medical community. Now, was the Master Settlement Agreement perfect? Of course not. But the percentage of smokers in this country has dropped from around thirty percent in 1998 to a little over fifteen.”
“And those settlement people are turning to opioids now?”
“Yes, they’re in the process of consolidating a number of lawsuits.” Gloria grinned — a feral grin — “And they’re thinking about calling out corporate executives. By name.”
“Wow.” But what the fuck does that have to do with me?
“Certain companies are fighting back, but the tide is turning. With or without lip service from DC.”
“I read that opioid prescriptions are starting to go down.”
“In this country, yes. But Macklin and the others had already turned their sights on new markets. Mexico, Brazil, China. And they’ll apply the same tactics that worked so well here.”
“Like what?”
“I have to admit that Macklin played the game brilliantly.”
“Example?” Like Daddy, I liked specifics.
“Okay.” Sigh. “Macklin founded the National Pain Management Organization.”
“Sounds official.”
“Yeah that’s what it sounds like. And that non-profit body convinced a large part of the medical universe to make pain the fifth vital sign. Along with body temps, pulse rates, respiratory rates, blood pressure.”
I thought about that. “So now doctors are asking patients if they’re in any pain.”
“And guess what? A lot of us are.”
I nodded.
She smiled, “Back a generation or so ago, the Supreme Court rejected the idea of physician-assisted suicide. So in 2000, Congress — echoes of the War on Drugs — declared a Decade of Pain Control and Research.”
“And that’s where Macklin slipped in the vital-sign provision.”
“Yes.”
“So, opioids.”
“Yes. And, legitimate prescribers who keep the dosages within acceptable ranges have helped millions of patients. Although a different kind of pain relief is often overlooked.”
“What’s that?”
“Not to lecture, but I’ve had to drill down pretty deeply.” Gloria shrugged, “Goes with the territory.”
“I understand.”
“Let’s start with the good that pharmaceuticals do. Specifically, in our case, with chronic pain. It’s real, it’s pervasive, it’s debilitating. Between ten and thirty percent of Americans suffer from it. The societal cost is over six hundred billion dollars — more than cancer and heart disease combined.”
“Wow.”
“The medical community is finally starting to realize that pain is the disease, not the symptom.”
I nodded.
“Okay, pain. It can be psychological in nature. Doesn’t mean it isn’t real. But a good pain psychologist can do a world of good with back pain, neck pain, fibromyalgia symptoms.”
“Okay.”
“Of course certain pharmaceutical companies downplay anything that isn’t product related. And doctors simply are not well enough trained in pain medicine. So alternative solutions have been ignored.”
“Like what?”
“Cognitive behavioral therapy, mindfulness-based stress reduction, avoidance of catastrophizing your pain.” She smiled, “That means focusing on the worst that can happen because of the pain — losing your job, your wife leaving, passing the condition down to your children.”
“Got it.”
“Neuroimaging studies prove that catastrophizing really does amplify the pain you feel. And patients tend to do that when they bounce from specialist to specialist. It’s a basic fear — fear of the unknown; not being sure what’s wrong, not knowing what will happen in the future.”
I said, “So, it’s all part of the cycle, which eventually morphs into an epidemic.”
“Yes, but it’s not all bleak out there. There are alternative therapies that will emerge. Are emerging. Somatic tracking — it’s an offshoot of mindfulness meditation. Patients assess their own feelings and sensations — a sort of pain reprocessing.”
“Sounds a little science fictiony.”
“That it does. But look at cognitive behavioral therapy as a benign option to two unpleasant alternatives — addictive drugs and risky, expensive surgery.”
“Makes sense.”
Gloria looked at me. Evaluating. Decided to press on.
“Last year, when I first started looking into Macklin, I flew to England. Oxford. For the sole purpose of being hurt.”
“What!”
“The University has a 7-Tesla MRI; only a few hundred in the world. It generates a magnetic field four times as powerful as a regular MRI.”
“Okay.”
She smiled, almost fondly, “Then the neuroscientist applied capsaicin to my shin.”
“Huh?”
“It provides the burn from chili peppers. Then she stuck needles into me, put a hot water bottle on the capsaicin. Other fun stuff. The Tesla measured my ... pain, my level of neural activity. The scan showed it in colors — three-dimensional pixels. Cool to hot, yellow to red.”
“Gosh.”
“We’re only scratching the surface. Only beginning to understand pain. A wise woman, Elaine Scarry, wrote, ‘To have great pain is to have certainty. To hear that another person has pain is to have doubt.”
I said, “Subjectivity. I’ve come across that with insurance cases. Disability claims.”
“Yes. Pain is freakishly important in law. Hundreds of thousands of cases each and every year. Personal injury, Social Security and private-insurance disability. Some think — many disagree — that MRI and PET scans will someday be admissible as evidence of pain.”
I said, “Do you think so?”
Shrug. “Maybe. The technology needs to get a lot better. But it’s already more reliable than, say, eyewitness testimony.”
“Yeah, four people see a car wreck, we get four different versions.”
Gloria said, “Back to Big Pharma. As we learn more about pain, begin to measure it more accurately, drug development could come back into the spotlight. Pain medications are sort of a pharmaceutical graveyard these days.”
“Because of the opioids epidemic?”
“Partly. But companies abandon development of new drugs when patients don’t show any improvement. The thing is ... that can be because of a variety of other reasons — anxiety, depression, pain expectation. Big Pharma is giving up on drugs that could have had high efficacy.”
I said, “Why? Their bottom line?”
“That, and there hasn’t been an accurate way to measure pain. Nor relief. The community has been relying solely, or mostly, on subjective ratings from patients.”
I said, “And that Tesla MRI might change the dynamics.”
“That, or something else. It’s early days, Winter. For example, in Oxford, I learned there is one area of the brain that is active all the time. At a consistently high level. It’s called the dorsal posterior region of the insula.”
She was talking without notes. Fuck.
“With better understanding of the brain, with the new imaging technology, they now have a biological benchmark of agony.”
I said, “Progress,” just to be saying something.
Gloria thought for a moment, “You know, there is actually a well-regarded program in Kansas City that helps break the pain cycle.”
“Oh?”
“Yeah, too many patients are caught in a ... a pain loop. Different doctors, different, and sometimes conflicting, meds. Just one specialist who is looking at the overall picture can perform miracles. Pain miracles.”
“I could see that.”
Gloria smiled, “There’s a famous quote. Jeremy Bentham. ‘Nature has placed mankind under the governance of two sovereign masters, pain and pleasure.’”
What I took away from that conversation wasn’t a better understanding of pain, of treatment. It was that Gloria Allen was not only sharp, she worked hard. Drilled down, as she said.
I pegged her as one stalwart woman, perhaps even formidable.
Myself? Put me in the pleasure column. Fuck a bunch of pain.
Walker turned shy, “Can I tell Pilar about ... you know.”
I knew.
“Tell Pilar everything. Just like with Vanessa and me.”
“I should tell Vanessa? Instead of you?”
“In addition to me.”
“Oh.”
I didn’t bother to ask about these frequent flyer miles. I’d keep ‘em.
Over the next few weeks, I would get to know Gloria’s principal assistant pretty well. Killer-bee smart, a willowy 30-year old black woman named Sistine Sanders. Same last name as my ex ... but so what?
Sistine, my new bestie, had flown me to Los Angeles, first class, on United. Reserved a Hertz car and a room in the Beverly Wilshire. Beverly Hills Cop. Told me to grab my room, have a night on the town and report for duty in the morning. Monday morning.
Sitting in my black two-seater Mercedes, I figured out how to lower the convertible top. The rear window went up, the trunk lid raised itself, the top accordioned its own disappearance. Pretty slick, but I put the top back into play. Only my second time in the City of Angels and I felt a little ... Midwestern.
I tapped in the hotel address and Ms. Mechanical surprised me by not directing me to a freeway. I ended up taking La Cienega into West Hollywood and turning left on Wilshire. There it was, just like in the movies. I went around the block and turned east, back again on Wilshire.
I knew from the Google Maps research that Walker had done that Gloria’s office was about thirty blocks east of the hotel. Same street, but I drove past it that Sunday afternoon, just in case. Just to be sure.
The Saturday before I left for LA, Vanessa took my hand, “The kids want to talk about the flag. Walker especially.”
“Of course.”
They waited until after dinner. Until Vanessa and I shared a blunt. I suppressed a smile. Typical Walker. To worry so much about me, about my feelings. Figured the discussion would be easier if I were more ... relaxed.
Matt’s triangular flag was resting in a presentation box, looking just as it had when it had been handed to me. Blue field and stars facing up. The four of us looked at it sitting on our kitchen table.
Walker said, “The protocol is...”
I mock-punched him in the nose. “Since when do you care about protocol? You break every rule in the book. You and Pilar.” I glared at Hobo, “That dog too.”
Walker cleared his throat, “We aren’t supposed to unfold it.”
Vanessa said, gently, “That’s one school of thought, honey.”
Pilar said, with a little heat, “Well, it’s our school.”
I said, Ms. Mature, Ms. Keep the Peace, said, “Well, let’s not unfold it. What next?”
Walker said, “There are folded-flag cases. You know, for display.”
Pilar said, “Or we could have one made.”
I looked at Vanessa; this was important to the kids. She said, “I like the custom idea, Pilar. What do you guys suggest?”
“Plexiglass. Clear plexiglass.”
Walker stood and walked to the west wall. Hobo tracked him closely; never know when an empanada might materialize. The Proper Villain was engaged in his usual rigorous power nap.
Walker placed his palm on the wall, touched a spot next to our rack of copper pots. “We could put it here. Matt liked our kitchen.” He glanced at me, suddenly concerned he may have said something...
I jumped in, “Yes, he did like our kitchen. Particularly the dinners you guys fixed. That’ll be a perfect place.”
Overlooking the three Greta Gunther bullet holes in our hardwood floor.
Gloria Allen’s Wilshire office was on the 14th floor. I checked the building directory — yep, the true 14th. There was a 13th floor, unlike in many buildings constructed by cautious developers for wary clients.
A slender black woman, my height, smiled warmly. “Welcome to Gloria AllenLand. I’m Sistine Sanders.”
“Winter Jennings. And thank you for all the arrangements. Very nice.”
Gloria Allen fought for victim’s rights, for women’s rights, for the underdog, for the downtrodden. But someone, or some corporations, had paid her a lot of money over the years. Decades.
She and her partners had the entire floor. It was casually elegant. Comfortable, stylish furniture. An eclectic collection of modern art and sculpture everywhere.
I glanced at three black and white Daumier caricatures behind the receptionist’s desk. I knew, without knowing, they’d be originals.
Soft, barely perceptible, background music — 70s pop. “American Pie” at the moment. Gloria would have been in her 30s when that came out.
I followed Sistine, noting that she walked with a ... rhythmic slither. I studied her from behind; made a mental note to practice that graceful stride. She led me through quiet, carpeted hallways to the northeast corner. She smiled, “Four corner offices — three of them are conference rooms.”
Wouldn’t take a professional detective, licensed, to figure out who occupied number four. The music segued to “Heart of Glass.”
Gloria Allen breezed in, smiling, hand extended. Her erect posture, and her confidence, made her seem taller than she was. “Welcome.”
“Thank you.”
The three of us sat at the eastern corner of a table that accommodated 38 chairs. I counted.
Gloria said, “Ready to get to work?”
“I am.”
A woman around 40, smartly dressed, wheeled in a coffee service. Asked for my order. Upscale Oxbridge accent. A real one. I was amused to see a Waterford bowl of bite-sized Snickers bars. Which Gloria consumed, one after the other, in dainty nibbles. The candy, not the bowl.
Gloria said, “Sistine and I are attorneys. Lawyers chase shadows. You’re a detective. You chase the men who cast the shadows.”
I thought, but didn’t say, ‘women’. Gender aside, it was a pretty nifty job description.
Gloria poured a second cup of coffee for herself. “Let’s start with the money. Sistine.”
Sistine smiled at me, lot of smiling this morning. “There’s a nationwide coalition of concerned parties. It’s a public-private entity designed to take down Macklin and the other opioid pushers.”
Gloria said, “Gathers and Gates.”
“Who are they?”
Another smile, “There is no Gathers. Nor Gates. Sistine.”
“It’s really just whimsical wordplay. A faction of private attorneys, city and state prosecutors, media mavens, a few high-level government executives. Private sector health officials. Many of them were on the team that won the Big Tobacco settlement.”
“I see.”
“The corporate name states the intention — Gather evidence. And put the bastards behind locked Gates.”
My turn to smile, “I like it. Gathers and Gates.”
“With an ampersand. They don’t quite have representatives from all fifty states yet. I think the last seven will be signing on soon.”
Gloria said, “Six. Arizona came in last night.”
“Six. Okay we work for, but don’t report to, Gathers and Gates. They’re funding us to take Macklin on. On a different front. Parallel to, but not directly related to opioids.”
Gloria said, “They paid us a six-month retainer. Which will fully fund us through the end of the year. Then both sides will review our progress and decide on the next course of action. If any.”
Six months. More job security than I’ve had since ... ever.
Sistine said, “Your compensation is included in the budget.”
Gloria said, “Plus a performance bonus. If one is warranted.”
I refrained from blurting, “How much?” Just nodded. Business as usual.
Sistine handed me an embossed card, “My contact info. Home and here. You can reach me 24/7.” She passed me a second card, “But my assistant will be your primary contact.”
I read it. Carmen Ortega.
Gloria stood up. “Carmen will get you started. We’ll meet here every morning at seven.”
She and Sistine left. I reached for a Snickers bar.
This week’s New Yorker drawing: A giant space ship, shaped like a vacuum cleaner is hovering over a couple walking down a sidewalk.
Winning caption: “I have a feeling they are going to treat us like dirt.”
The Grand Duchess Anastasia Nikolaevna had a suitor, a gentleman caller. We were all a bit surprised that she deigned to receive a mere commoner. Noblesse oblige. I guess.
Mortimer Lurch was a professional driver. Yellow Cab before the gig economy screwed that particular pooch. He repainted his cab and affiliated himself with the zTrip folks. Then he finally gave in and is now one of the legions of Uber drivers.
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