Placebo Junkies Page 21

  This is not a smartphone-checking kind of crowd.

  This is not a magazines and bottled-water type of waiting room.

  These are not sick people in search of a cure.

  All around me, I see my future. It’s like a Benetton ad turned inside out in here—a grayscale sampling of the indigent and the addicted. Labor-dirtied men whose spring-loaded postures and darting eyes telegraph their questionable immigration status sit next to pierced and green-haired teenagers carrying their world’s worth of possessions in backpacks covered in Sharpie-drawn anarchy symbols. A woman with trembling hands sits next to a man with a trembling jaw.

  The destitute. The down-and-out. This is a no-other-options kind of crowd—each and every one of us.

  Because, let’s be honest. I’m one of them, aren’t I?

  Like its occupants, the room itself is filthy, the patchy carpet tarred over with a decade’s worth of grime, the walls covered with scuffs and smears and graffiti. An overflowing trash can sits on its side in the corner.

  Back at the hospital, there is at least the comfort of procedure and the pretense of a cure. There is protocol. Basic sanitation, at a minimum. Even when they’re torturing you—tearing your flesh, or scrambling your brain—at least they practice good hygiene while they do it. They steal your thoughts in sterile conditions. They document your screams in triplicate.

  Not here. This is a place where hopes curdle and options wither. This is the clinic at the end of the world.

  Have I been here before?

  I double over, head to my knees, trying to stop the panic that’s fluttering and expanding inside my chest like a trap-frenzied bird. I try to slow my breathing, but I can hear the animal sounds of my panting and I know I’m already too far gone.

  Have I been here before?

  “Jameson!” His name tears out of my throat in a shrieky roar. Downturned faces swivel up in concern, and even in my panic, it’s not lost on me that I am the spectacle in this roomful of castoffs. I am the down-est and the out-est.

  I am the crazy one.

  Jameson comes running and now he’s an orderly again, whisking me up and out by my arm, gripping hard enough I know it’s going to leave a bruise. By the apologies he offers over his shoulder as he steers me through the door, it’s clear he’s more embarrassed than concerned.

  “Audie, what the fuck?” he asks once we’re back in his car. “I was in the middle of a business conversation in there.” His voice is whiny, like a child who wants what he can’t have.

  “What the hell is that place?”

  He sighs. “It’s called a CRO. A contract research organization.”

  He tries to stop there, as if that answered anything at all, but he sees me glaring at him and heaves a big sigh, like I’m torturing the answer out of him.

  “It’s capitalism. That’s what it is.” He puts a hand up in the air. “I know, I know—don’t look at me like that. It’s fucking disgusting in there. They run clinical trials for whoever’s willing to pay for it. Some of the big pharmaceutical and biotech companies like to outsource the grunt work, so they pay places like this to do it for them.”

  “They do medical research in that dump? I felt like I was about to audition for a goddamn snuff film in there. Incidentally, can we get out of here? This place gives me the creeps.”

  Jameson tells me I’m being melodramatic, then puts the car in reverse. Halfway out of the parking space, he slams on the brakes. “Dammit!” he swears, and jumps out of the car. “I didn’t hit you, did I?” I hear him asking the person standing behind his car.

  I climb out, too, just in time to see the look of unhappy recognition flit across Jameson’s face. The dark-haired young man staring at the bumper that’s stopped a centimeter from his kneecaps, on the other hand, shows no sign that he’s even registered our presence. “Oh, hello there,” Jameson says. “Uh, how are things going? Well, I hope? I thought you were long gone by now.” He’s trying to use the formal, tucked-in-shirt voice he’d been using inside, but I can hear his nervous stammer jitterbugging underneath his words.

  The man hitches one bony shoulder up in response, a vague semblance of a shrug, but keeps his eyes on the car’s bumper. I have to fight the urge not to reach out and rip off the grimy hospital bracelet I see looped around his wrist; it looks like it’s been there a very long time.

  Jameson lets out a phony laugh sound and gestures over to the guy, who shows no signs of moving. “This is the hardest-working guy I’ve ever met,” he says to me in a loud voice. He turns back to the man with an overbright smile. “You’re saving up for your wedding or something back home, isn’t that right? Or was it law school? I remember it was something important.”

  The young man turns his glassy, unfocused eyes to Jameson, but still doesn’t answer.

  Heh heh. Jameson’s nervous throat-clearing habit comes back before he can fill the awkward silence. “See, I told you this was a good gig,” he says to me. “Guys like this come over here for a month or two and make ten times what they can in a year back home. Free medical care, too. Right?” he prompts the man, who does not look like he’s been on the receiving end of proper medical care in a very long time.

  Finally, the guy seems to hear what Jameson’s saying, and a huge grin splits his face. “Ka-ching,” I think he says, though his accent makes it hard to be sure. “I got one. A side effect—one of the big, good-bad ones. I just gotta check for my check, see if it’s here yet, then I’ll go home.” This seems to amuse him, and the smile across his face goes even bigger. “Check for my check for my check,” he says again, then giggles in a high-pitched voice.

  “Ka-ching,” he sings out one more time, and then turns around to resume his shuffling, crooked path across the parking lot toward the clinic.

  “Holy fuck, Jameson” is all I can think to say as we slide back into his car.

  He shakes his head to stop me from saying anything else. “They’re not all like that. That guy … this study is … ,” he sounds rattled. “This study is more concerned with maximizing profit than most of the others I’ve worked with. The lower the overhead costs, the more money they get to keep at the end of the trial period, so some places cut corners anywhere they can. The testing you’ve been doing has all been at a university hospital. It’s just a totally different business model.”

  I try to ask him in the nicest possible way how a loony-bin orderly got so involved with whatever it is he’s talking about, but it doesn’t come out as tactfully as I’d hoped, and Jameson clamps his mouth shut and sulks in silence for almost the entire car ride back home.

  Back to the hospital, I mean.

  To the Cedar Fucking Hill Center for the Reality-Challenged.

  A few blocks out, though, he finally answers. “I help out with the recruiting. They need bodies through the door, as many as they can get. They have a tight deadline, and they get a bonus if they meet it. It’s big money, Audie. For them, for me, and for you if you’ll help me” He gives me a pointed look. “And for the volunteers, too. Most of whom, I should add, wouldn’t be getting any medical treatment at all if it weren’t for this study. So it’s not as bad as it looks, I swear.” He sounds like he’s trying to convince himself.

  Dirty rotten liar.

  “I can’t get caught recruiting anyone from Cedar Hill. I told you, O’Brien’s been breathing down my neck. But you can talk to people there. Spread the word. I’ll even go up to a sixty-forty split for anyone you recruit from there.”

  “What are they testing?” I don’t look at him when I ask. I don’t want him to know what I’m thinking.

  He perks up a little. “Long-acting antipsychotics. It’s pretty cool, actually. You take a bunch of people like the ones we saw today, it’s obvious they’re never going to comply with regular treatment, which basically consists of shoving jarfuls of pills with unpleasant side effects down their throats. We
send people like that out in the world with a handful of prescriptions they’re never going to fill, and then we wonder why so many mentally ill people are homeless or in prison.”

  He’s animated now, the sulking already forgotten. It actually makes him happy, talking about this stuff. I think about all the times I’ve seen him playing armchair doctor, reading medical journals he probably swiped out of the offices of the real doctors. This is who Jameson wants to be—a scientist, or a businessman, or some twisted hybrid of the two, instead of a lowly peon in a loony bin a half step up in rank from janitor.

  We all have our fantasy lives, don’t we? There’s a fine line between delusional and ambitious, it occurs to me. We’re all just hoping for a better reality.

  He’s still going on about the trials. “If this stuff works, it could really make a difference. Get this—instead of pills, it’s an injectable, which gets rid of the whole compliance problem. It goes right in the spine, and lasts for months. They already know the stuff works; now they’re just focusing on administration issues, trying to figure out if placement and frequency make a difference.”

  I go cold when he says this. “Spinal injections, hmm? Let me guess: they make a little tattoo at the injection site?”

  Jameson nods, too busy accelerating through a yellow light to notice my reaction. “Yeah, they rotate the injection location, so the tats are to make sure they don’t accidentally repeat the same location.”

  I picture Charlotte’s back.

  I picture Mary’s back.

  My lips feel numb and my spine tingles in the most literal way—like someone is brushing against it with the tip of a needle. It’s funny how sometimes your body remembers things your mind doesn’t.

  Or perhaps I just have an overactive imagination.

  I know without him saying so that some sick bastard in that fly-by-night craphole of a clinic likes to get creative with their markings. Why ink up your nut-job test subjects with a boring old X-marks-the-spot when you could have fun? With little snakes eating their own tails, perhaps?

  “Jameson, did you send Charlotte there? Is that what happened—you sold her out, and something went wrong?”

  His hands go tight on the steering wheel, and he doesn’t answer.

  But his silence is an answer. “Is that why she had all that cash? Was that some kind of giant payday for both of you?”

  He pulls into the hospital parking lot too fast, car tires squealing, and then brakes hard enough that I slam forward against my seat belt. It locks into place and restrains me, just as it’s supposed to do. Just as he’s supposed to do.

  It’s for my own good.

  “ ‘She’s in a better place.’ Isn’t that what you said? And where exactly is that better place, Jameson? Did you fucking kill Charlotte?” I’m getting louder with every word. Shriller. Angrier. “Or did you just turn her into a vegetable with your little not-such-a-fucking-miracle cure?” I need to be calmer than this; I need to be more lucid than this when I ask him these questions. This is too important for crazy, I know it is, but I can’t seem to control what’s coming out anymore.

  “How much did they pay you for her? How much was Charlotte worth?” I scream. “A new pair of shoes, maybe? A set of tires for this shitty car? I hope they’re really great fucking tires, Jameson!”

  He reaches over me and flings open my door. His mouth is clamped shut—he’s done talking.

  He looks around. To make sure no one else heard me? Or maybe for help.

  My head is buzzing again, and I know that I’ve just spoiled everything. My anger sounds like a hive of bees inside my skull.

  Orderly-quick, Jameson hops out and comes around to my side, scoops me out and hustles me away from his car before I even realize what he’s doing. “This was a mistake,” he says. “You’re still fucking crazy. Go check yourself back in. Do it now, and I won’t report this to O’Brien.”

  He gets back in his car, watches me with his doors locked and windows up.

  We stay like this, staring at each other, for another minute, then he roars out of the lot, his tires nearly rolling over my foot.

  “Still crazy?” I call out after his car. The braying sound of my laughter surprises me—it’s not because anything is funny, but because my brain is spinning with the ticklish, kaleidoscope feeling of déjà vu. “Oh no, my friend. I’m just getting started!” It doesn’t even make sense, really, but I don’t care. It feels good to say it, like a satisfying line straight out of the end of some cheesy action movie.

  It sounds like something that you say just before you take back control. It sounds like a decision.

  I say it again, out loud, grinning at the way it makes a group of women walking back to their car stare at me like I’m insane. Because that’s kind of the whole fucking point, right?

  TransiGatory

  Dr. O’Brien does not like it when I challenge him. Oh no siree. He does not like it one little bit. Nor does he approve of my extracurricular activities.

  “Audie, when it comes down to it, you are a minor, and you’ve been placed under my medical guardianship. So when I discover that you haven’t been complying with treatment, then I have an obligation to take certain steps that are in your best interest. I’m just sorry we’ve come to this point again. You’d been doing so well.”

  He sounds so sure of himself when he talks like this. He thinks he’s safe, hiding behind his medical-legal jargon and his mountain range of a desk, with all those snowy paperwork peaks.

  But I know his secrets.

  The snakes are talking to me again, telling me things I can use against him. Even now they’re twisting and shining atop his fancy silver pen, only he’s too fucking blind to see it. Is it one snake with two heads? Or is it two snakes conjoined? It doesn’t matter. One is clearly stronger than the other. I smile as it begins to eat its twin—I do so admire a strong survival instinct.

  You get hungry enough, eventually you’re willing to do whatever it takes to save yourself.

  I turn my snake-charmer smile on the doctor.

  “And do you also have an obligation to take money for force-feeding me all those pills? Are you also obligated to keep the bonus you get for hooking me up to your machines?”

  His hand freezes in his beard, midstroke.

  He doesn’t take many notes anymore. Hasn’t for days and days. Instead, he just taps his pen on my stagnant file.

  tap tap tap tap

  The silver caduceus atop the pen catches the light. It’s such an appropriate symbol for doctors, don’t you think? It’s from Greek mythology—from the staff carried by Hermes. Hermes, the god of thieves and commerce.

  Oh yes, I’ve done my homework. This is one test I’m determined to pass.

  tap tap tap tap

  “I’ve been perfectly clear all along that you’re part of an experimental protocol, Audie. Yes, my study is being funded, in part, by grants from the pharmaceutical industry, but in no way does that influence my clinical judgment.”

  He flinches when I hiss at him.

  I’ve grown much stronger lately. I’m getting stronger every day.

  “Your tan is fading,” I tell him. “Remind me—where was this year’s conference? Hawaii? How nice that they paid your way. And a little bird told me you were even the keynote speaker. How much do they pay keynote speakers at medical conferences in luxury hotels in Hawaii these days?”

  I wink at the dominant snake atop Dr. O’Brien’s pen. You could almost forget the weaker twin was ever there in the first place.

  O’Brien sighs and closes my file, sets the pen on top of it. He’s conceding his defeat: he has nothing left to write. “Audie,” he says after a long silence. “Your mind is tricking you right now, offering you false solutions. Is there any part of you that can understand that?”

  “I promise you that my solution is a hell of a lot better than what
you’re peddling, doc.” I say it gently, since I’ve obviously already won the battle. No sense being a poor sport.

  He just nods slowly and sort of wilts into his chair. Even his beard looks limp and defeated.

  It’s survival of the fittest. I am the dominant snake in the room now. I am consuming him, consuming his research, consuming his career.

  I control the cycle.

  He is so cowed that he doesn’t even notice when I slide his pen into my pocket as I stand up and walk out of the office. Outside, in the hallway, I celebrate my victory with my hand wrapped around my prize, glorying in the heavy silver sharpness now in my palm. It’s beautiful and dangerous and I very much want to keep it.

  I toss it into a trash bin as I leave the building, just to prove to myself that I can.

  Chapter 45

  I’m catching up on some reading when Jameson comes in a few hours later full of bullshit excuses. “I forgot my lucky sweatshirt,” I hear him say to the nurses in the little office where they congregate, isolating themselves from the “residents” (ha) in their care. [Avoidant Personality Disorder, diagnostic code 301.82]. “It’s a game night, so I have to have it. You know how it is.”

  They accept his ridiculous explanation [ritualized behavior indicative of Obsessive Compulsive Personality Disorder, diagnostic code 301.4] without comment. He’s just an orderly (excuse me, a psychiatric technician) again here—almost as invisible to them as I am.

  I’m sitting in the common area, a sad little lounge where crazy people can blend into ugly upholstery as they ignore one another. It’s the same place where I remember a party happening. The guinea pig blowout where I last saw Charlotte.

  The strong stench of urine bridges both versions of the room.

  The befores and afters are clicking into place, though sometimes they hop around and switch positions on me midthought. Often the facts and the faces are exactly the same. The only thing that changes is my interpretation.

  Before: Party!