Ever and Always
Chapter 1: The Beginning - 2016
Copyright© 2015 by Banadin
Ever and Always
Opening April 30, 2013
Staff Sergeant Richard King was running for his life, on a Long-Range Reconnaissance Patrol, his squad had just crossed a river when they were spotted by the Viet Cong. They were deep in Laos, so there was going to be no helicopter rescue. They were on their own. The sound of bullets cutting through the jungle canopy was followed by the chatter of AK 47s, a lot of AK 47s.
The trim young man in his tiger stripe camouflage with its hand embroidered patches ran with a long loping stride which covered the ground quickly. His thoughts were; disengage, evade. Nothing else mattered.
Rick felt a sharp burning in his arm, but he kept going without looking. His squad was in front of him, so he knew all were okay so far. The lead man disappeared; Rick at first thought he was down. However, in turn each of his squad went out of sight. They were going down a small embankment to a stream which gave them some cover.
The six-man patrol stopped at the bottom awaiting his decision. They could dig in here and hold off a similar size group or keep moving. If it was a larger group, they were in trouble. "Empty a 60mm belt to hold them and then downstream," Rick rasped as he brought his M16 to bear. Without hesitation, his orders were followed. The linked belt turned smoothly around a B3A can without any kinking. As the last man started to go out of sight, Rick followed.
"Watch out for that crazy old guy he is going to knock that lady over with his walker the way he is thrashing around."
Rick rounded a bend in the small stream and smelled meat loaf. "Meat loaf?" he thought. "Damn, I have done it again." I am in the Rest Home. "Hey Rick, calm down it's okay, you just had an episode." "I know what I had," screamed Rick in anger and frustration. You think I want this?" He pushed his walker/M16 away.
Marsha Wren was having a nice day shopping; she had found the most perfect looking dress in Macy's window when a rude man bumped into her. A passing gentleman caught her, just as she started to fall. She grabbed him for support and caught his stethoscope. "Oh no," she thought, "I am in the Rest Home. I enjoyed shopping more." The Doctor helped her down the hall. She chatted with him all the way. It was a shame no sound came out.
As they went into the room, she smelled meat loaf. "Oh good, I love meatloaf day in the school cafeteria," Marsha thought. "My homework is done, and I passed my spelling test. There is that cute new boy. I wonder whether he will notice me."
A still irate Rick King asked no one, in particular, "Why is that old bat smiling at me?"
Chapter 1 the Beginning - 2016
Worthington Manor Rest Home, Columbus, Ohio September 9, 2016
"Doctor, this is Mrs. Hansen the night nurse at Worthington Manor. I am sorry to report that Mr. Glenn passed away last night."
Pacific Care, Seattle, Washington September 10, 2016
"Dr. Jansen this is Clair over at Pacific Care. I am sorry to let you know that Mrs. Johnson died last night."
South West Rest Home, San Antonio, Texas September 12, 2016
"Dr. Jackson this is the South West Rest Home. Mrs. Rowland died last night."
Eastern Shore Rest Home, Berlin, Maryland September 12, 2016
"Dr. Purdue this is Mrs. White at Eastern Shore Rest Home. I am sorry to tell you that Mrs. Lovy Leonard passed away early this morning."
Baltimore Maryland Johns Hopkins Hospital, September 15, 2016
Research physician Dr. John Parsons took his feet off the side of the mahogany conference room table and tilted his leather chair forward, while taking a sip of his rapidly cooling coffee, before bringing up the next protocol to be discussed.
"This one is really disappointing; it looked so good on the animal tests and passed the Phase 1 safety protocol with no problems. Phase 1 is only performed on healthy people to make certain that it won't harm anyone, and to establish what side effects may occur. During Phase 1 of fifty volunteers tested, the few adverse health effects were of the mild allergic reaction level. This was to be expected from the outcomes of the previous animal tests performed."
"Now that Phase 2 with actual sufferers of advanced Alzheimer's underway, it's killing instead of curing the patients! Out of the fifty in the test, the fifteen blinds are doing well on the placebo but thirty of the thirty five being tested have died in a three-week period. All of these deaths in the first reporting period! These are the worst results I have ever seen. No way can we continue this test."
He continued, "We must find a way to be notified of an exceptional number of problems early in a study rather than to wait for the first thirty-day summary"
The pharmaceutical representative, Sharon Nielsen doodled squares on her notepad as she thought. "This drug is a loser."
"Yes, we have to stop it right away." Better to pick the drug studies to battle for, and this isn't the one.
Parsons asked his assistant Barbara to notify the National Health Institute, and the FDA that the study was being halted pending their review, but there was no doubt on the outcome of that review. He also asked her to draft a memo about the need for an early-warning system for failures like this. It had never happened before, but the lesson has been learned.
"Also make the Repository up in Towson aware that they are to return the drugs to Benton Pharmaceuticals for disposal. Have them send us all the originals of the test results for our files, put test samples in long-term storage and immediately notify the various doctors who have patients in the study that it has been discontinued. Though at this rate, there will be no patients left alive. On second thought call all the Doctor's offices directly." He shook his head slowly; this really looked like a promising path for halting if not curing Alzheimer's.
The Repository in Towson administering this particular study took the notice in stride. They handled dozens of studies of this nature every year. Most end in failure; that was the nature of pharmaceutical drug development. They would be provided the drug in the correct dosage format by the Ethical drug house. The Ethical house as opposed to the Generic house also would provide a list of the Doctors, who had patients in the study. They would ship the test medications to the Doctors, who had enrolled the patients in the study.
Each Doctor had been notified of the profile of patients that were desired to be in the study. In this case people of both sexes between the ages of seventy to ninety five in physically good health exhibiting signs of advanced dementia, which had been diagnosed as Alzheimer's were the target.
The Doctors had been recruited by trade journal advertisement, Internet postings, or by trade representatives from the Pharmaceutical firm during office visits. The interested Doctors submitted the health history of patients who they thought qualified. Once accepted the medication would be sent to the Doctor for dispensing.
In turn the Doctor would send to the Repository whatever information was needed for the study. In this case, it was the results of a monthly physical, along with the results of cognitive and neuropsychological tests. Brain scans had been run prior to the start of the medication to establish a baseline, and it was intended to perform them again at six months.
This information was all passed on to the supervising physician to interpret, in this case Dr. John Parsons acting as a paid agent of Benton Pharmaceutical, who was acknowledged as an expert in the field. That was all out the window now.
Benton representative Nielsen spoke up, "On a more positive note, there were several variations of this drug. They have all passed animal testing. We intend to apply for permission to start new Phase 1 tests for safety. We will be very cautious about moving them to Phase 2, but this pathway is not closed."
"Let's hope Sharon. It feels like you guys are going in the correct direction."
Baltimore WBAL nightly news September 16, 2016
Newscaster Abi Jackson's attractive face took on a solemn look that also included anger as she continued, "A further update on the alleged patient sexual abuse incident at the West-Side Nursing home. There are five patients with full-blown AIDS along with complications, and another seventeen have tested positive for HIV. These are all advanced Alzheimer's cases. The male nurse Carl Howard being charged is in custody, but his lawyer is not allowing any comments. District Attorney Dave Mathews reports while there can be no testimony from the victims, the DNA evidence is very clear, and he will be pressing charges." "In other news..."
West Side Nursing home Baltimore September 17, 2016
The small conference room's warm feeling from its cherry wood furniture was at total odds with the cold business discussion.
"I really don't care what your Profit & Loss sheet will suffer," Attorney Bill Watson retorted, "The publicity on the sexual abuse is so bad you have to get these people out of here. Can you get those with AID's into a different facility?"
He went on, "The Oaks Hospice Group has a facility for those who really do not have a home, but don't want to die in a hospital. They have to charge a lot, but it would look good for us, and get them off site. With their complications, none will live very long, and all have the paperwork which indicates they do not want extra-ordinary measures taken to keep them alive."
The General Health Insurance company representative frowned as he thought this through, and then supported this position by pointing out that this would actually be a least-cost path for them in the long run.
"Even though we do in house Hospice care, and even if it does cost more by having them out of here, it will quiet matters down, and the patient loss will stop. People just don't want their loved ones in danger, especially those who feel guilty for dumping them here in the first place."
The Nursing Home Director, thinking of her Board of Directors reaction to the cost was about to object to this line of reasoning, but stopped as she realized she could not win this discussion.
"I will contact the Oaks Hospice Group; it has an excellent reputation and looks good, so if it is shown on TV, it won't look like we are just getting rid of them. We should be able to get all five with full-blown aids out of here this week. They need extra attention, so they would be hard to hide."
The Nursing Director went on, "The others will look like any other patient, but we can move them into the back wing, and redirect the traffic flow so people won't know they are still on site. Two of those being shipped out could have been an additional problem since they were also involved in an Alzheimer study but their Doctor just notified us the study has been discontinued. Sometimes things work out for the best."
Baltimore WBAL Nightly News - September 16, 2018
Abi Jackson wearing a lady's blue pinstriped business suit and light make up, continued in that non-accent of professional reporters, "The jury has found sex abuser Carl Howard guilty of multiple counts of rape and murder for the West-Side Nursing home deaths in 2016. Stay tuned for tonight's editorial for our thoughts on providing for safety of patients, and how that lack contributed to the bankruptcy of the West-Side Nursing home. Now let's turn to Bill for tomorrow's weather."
Oaks Hospice Group, September 27, 2018