American Medicine God: Starting by Inheriting a Pharmaceutical Company and Selling Medicine

Pikeville, Kentucky. This is a scar in the folds of the Appalachian Mountains.

Coal trucks crawled along the winding mountain road like beetles, kicking up black dust that covered the oak leaves along the roadside.

In a prefabricated house on the edge of town, George Miller was curled up on a worn-out sofa.

He was 45 years old, but looked 60. He had worked underground for 20 years and had a back injury from being hit by a falling rock.

"George? Today is Amy's birthday."

His wife, Martha, called from the kitchen as she put candles on a cheap supermarket cake.

George didn't hear it. His world consisted of only one sound: the demon of pain screaming in his very bones.

He was trembling. Cold sweat soaked through his T-shirt, which bore the "United Coal Mine" logo.

He was looking for medicine.

The medicine bottle on the coffee table was empty. It had just been opened yesterday; it was supposed to be a week's supply.

"Damn it...damn it!"

George rummaged through the drawers like a mad dog.

No!

He crawled under the bed again, his fingers groping along the dusty floor. He remembered that a grain had fallen there before.

nor.

Panic gripped him.

Suddenly, his gaze fell on the window of his neighbor, Old Harry's house. Old Harry had broken his leg the previous week, and the doctor had prescribed him that "miracle pill."

George's eyes changed. They became the eyes of a wild beast.

......

Parkville Community Pharmacy.

Old pharmacist Arthur Duncan is checking this week's prescriptions. He's a stubborn old man who's worked in this town for forty years and knows everyone here.

He adjusted his reading glasses, his brow furrowed deeply.

"Something's not right," he muttered to himself. "This is really not right."

On the ledger in front of him, OxyContin's shipment curve looked like a rocket taking off.

Last month it was 100 bottles. This month it's 500 bottles.

If this dosage is followed, the entire town of two thousand people would be eating candy every day.

What's even more terrifying are those faces.

In the past, people who came to get their medicine would be clutching their backs or legs in pain. But recently, the way those young people and those strong miners looked when they came to get their medicine... that longing, that anxiety, and that almost climax-like sense of relief when they finally received the medicine bottle.

Arthur had seen that look before.

That's the look in the eyes of an American-style tonic addict.

"jingle."

The door was pushed open. It was George.

"Uncle Arthur," George said, sweating profusely and clutching a crumpled prescription, "Dr. Milligan... gave me a larger dose."

Arthur took the prescription.

80 mg.

"George," Arthur took off his glasses, looking seriously at the man he had watched grow up, "this is the dosage for terminal cancer patients. You just have back pain. Has Milligan gone mad?"

"Stop talking nonsense! Give me the medicine!" George suddenly roared, slamming his fist on the counter, making the glass vibrate.

Arthur was startled. He had never seen the usually mild-mannered George like this.

"No," Arthur threw the prescription back, "I can't give it to you. It'll kill you."

George froze. His facial muscles twitched, and the whites of his eyes were bloodshot.

For a fleeting moment, Arthur thought George would jump in and kill him.

But George didn't. He grabbed the prescription and rushed out like a drowning man, cursing, "I'm going to Walmart! I'm going to another pharmacy!"

Arthur watched George's departing figure, then picked up the phone.

He dialed the Kentucky Medical Board.

"I want to report this. A massacre is taking place here."

...

Washington, D.C. FDA Headquarters.

David Rossi sat in his spacious new office.

The Potomac River was bathed in springtime colors outside the window, but he had no heart to appreciate them.

As the head of the FDA’s newly established “Subject Abuse Oversight Task Force,” his desk was piled high with documents.

Victor kept his promise. In his current location, he has an office ten times larger than his previous regional office.

The phone rang. It was his ex-wife, Susie.

"David, are you coming to pick up the kids tonight?"

"Of course, darling," Rosie said gently. After a chance encounter at a bar on a snowy night, he and Susie miraculously got back together. Victor even helped him pay off his mortgage, allowing him to regain his dignity as a man in front of his ex-wife.

Rossi was in a good mood after hanging up the phone.

At that moment, his secretary knocked on the door and came in, handing him a fax.

"Sir, an urgent tip-off has come from Kentucky. An old pharmacist claims that Water Pharmaceuticals' OxyContin is causing widespread addiction."

Rossi's smile froze.

He took the thin sheet of fax paper. The handwriting on it was messy and filled with anger and anxiety.

*"...This is legal heroin...They're murdering..."*

Rossi stared at the words as if they were barbed wire.

He opened the drawer, inside which was an "academic report" from Water Pharmaceuticals. The report was titled "Pseudo-addiction in Opioid Therapy".

The report used extremely complex medical terminology to explain a concept: the addictive behavior exhibited by patients is actually due to inadequate treatment. It is because the dosage prescribed by the doctor is insufficient, causing the patient suffering, that the so-called "drug-seeking behavior" occurs.

This is absolutely brilliant sophistry!

Rossi took a deep breath. He remembered what Victor had told him on that snowy night: "We're helping them, David. We're relieving their suffering."

He also thought of the mortgage he had just paid off and the adoring look Susie had given him again.

He picked up the pen.

On that whistleblower letter, he wrote a line of comments:

"The pharmacist is suspected of interfering with doctors' prescribing rights and obstructing patients from receiving proper treatment. It is recommended that the state commission revoke his license as a deterrent."

Rossi's fingers trembled as she finished writing that line.

But he quickly closed the folder and tossed it into the "processed" section.

For the greater good, someone always has to make a sacrifice. Isn't that right?

......

Three days later. Parkville.

Arthur Duncan was taken away.

Two state troopers shut down his pharmacy on the grounds that he "illegally refused to fulfill prescriptions, causing unnecessary suffering to patients."

On the other side of town, George Miller finally got his medicine.

Those are 80-milligram pills.

Today is Amy's tenth birthday. Colorful balloons are hanging in the house.

George swallowed a piece.

Five minutes later, that long-lost warmth enveloped him. The back pain disappeared, the anxiety vanished, and the world became soft and beautiful.

"Daddy! Let's cut the cake!" Amy, wearing a paper crown, ran over happily.

George stood up with a smile.

"Okay, baby. Daddy's here."

He picked up the cake knife.

Suddenly, a violent wave of dizziness struck.

That wasn't a warm current. That was a tsunami.

His respiratory center was completely paralyzed in that instant.

The knife in George's hand fell to the ground. Then, he fell straight forward.

"Bang!"

He slammed it on the coffee table, and cake flew everywhere.

He foamed at the mouth, and his face instantly turned bluish-purple.

"Daddy! Daddy!" Amy's scream pierced the roof.

One week later. Anglican cemetery.

The funeral was simple. A light drizzle was falling.

Martha, dressed in black mourning clothes, collapsed in the arms of her relatives, sobbing uncontrollably.

Dr. Milligan arrived. He was also wearing a black suit, with an expensive fountain pen from Walter Pharmaceuticals pinned to his breastplate.

He held Martha's hand, his face filled with sorrow.

"I'm so sorry, Martha. George already has a heart condition."

This is the official cause of death: cardiac arrest. Nobody will check the opioid levels in the blood. In this poor place, an autopsy is a luxury.

"It's not your fault, Doctor," Martha said, wiping away her tears, her voice hoarse. "At least... at least he wasn't in as much pain in the days before he passed away because of that medication. He passed away peacefully."

Standing under a tree in the distance, a young man wearing thick glasses was writing this scene down in a notebook.

He was Barry Meyer, an intern reporter for the Parkville Gazette.

He looked at the doctor who was comforting the family members, and then at the pharmacy in the distance that had just been shut down.

He wrote a sentence in his notebook:

"This is the first drop of blood. But nobody saw the wound."

The rain grew heavier, blurring the words until they were indistinct.

Meanwhile, at the headquarters of Vought Pharmaceuticals in New York, champagne was being opened. The first-quarter financial report had just been released, showing that OxyContin's sales had surpassed $100 million.

Victor Corleone stood in front of the floor-to-ceiling window, looking down at the masses below.

He couldn't hear Amy crying.

It's too high up here!