If you could picture a man used to looking at data Jeff Sabon would probably come close to who you imagined.
He had a mass of dark hair that was tied in a knot at the back. He wore round glasses with seemingly no frames and with no disrespect to the man but it looked as though he had just got out of bed and dressed in the dark. He had on a corduroy jacket and the only thing missing was the leather patches on the elbows and a row of pens in his top pocket.
He had rung Millar hours before and told him that he had seen enough of the data to have a good idea of the information. He didn’t want to meet at Millar’s gaff which was a relief to Millar. But he wanted to meet in a public place. He didn’t do pubs and he wasn’t keen on coffee. So both agreed to meet in the Tate Britain Museum on Millbank. One of Millar’s favourite museums.
Millar had agreed to meet him in the Picasso section settling on the fact that this whole business seemed surreal anyway.
Sabon was half an hour late so Millar had an opportunity to look at the works of the Spanish legend. He couldn’t claim to be an authority on art but it made him wonder who determined the brilliance and the price of these things. The Blue Period. Cubism. Sometimes you have to wonder he thought.
Millar positioned himself on a bench in front of the Weeping Woman trying to figure out why she was chewing a shard of glass when Sabon suddenly sat down next to him There was no shaking of hands or polite conversation. And there was not a lot of eye contact. But Millar could sense the man was troubled.
According to Mike, Sabon was one of those brilliant opinionated nonconformists who just could not settle down in the employ of a rigid organisation. In other words he was a maverick. He had graduated from Cambridge with distinction without doing too much work according to Mike and instead of moving on to a corporate business chose instead to tour southeast Asia studying the effects of dengue fever.
It was here apparently that he had picked up the liking for the Peruvian marching powder. A habit that kept him from holding down a proper job and a constant position of financial insolvency. Millar rather liked the sound of the man – probably because he recognised the rebel in him.
“Can I ask you who gave you this material – all this data.” That was Sabon’s opening gambit. Not hello. Nice to be here. I am a big fan of Picasso but I am more of a Magritte. Normal kind of conversation. Just straight in. What the fuck have you given me!!
Millar told him straight that it came from the sister of a lead scientist. But he didn’t tell Sabon why Sophia Frampton had given it to him. He also did not tell him that the man who had been allegedly studying that data had either committed suicide or had been murdered.
Sabon nodded slowly. His thick frizz of hair bobbed up and down as Millar spoke.
After a pause and a scan of the masterpieces on the wall Sabon started speaking slowly and softly presumably on the basis that as regards medical terminology Millar would know very little. Sabon was an astute man.
“It’s data about a SSRI which is a Selective Serotonin Uptake inhibitor. It’s used for a number of applications – depression, obsessive compulsive disorder, anxiety, post traumatic stress. It can change the mood and emotion of people. These SSRIs work by increasing levels of a group of chemicals in your brain called neurotransmitters. People are not quite sure how the process works but patients taking these SSRIs can significantly improve. In layman’s terms – they let the sunshine in.”
“And this drug is one of those.”
“Yes. It’s a very powerful drug.” Sabon tapped his head as if you give extra emphasis.
“Dangerously powerful. Is that what you are saying.” Millar did not like leading people onto the punch so to speak but he needed to bracket this drug to make sure Sabon was not talking asprin.
Sabon grimaced and turned his gaze towards one of the Picasso’s.
All drugs have side effects. Exactly the same for antidepressants. And most of them are minor. Constipation, indigestion, dizziness, insomnia, low sex drive.
That doesn’t sound that minor.
Believe me compared to depression – many people are happy to accept these irritants.
But the drug is safe?
Mr Millar every drug must have extensive trials to prove it is safe. Otherwise it is not released onto the market.
I would expect that.
Sometimes these trials take ten years. Maybe longer. In some cases fifteen years tested on animals, volunteers, patients and then vulnerable at risk individuals to make absolutely sure of its efficacy and its absence of dangerous side effects. It’s a very time consuming and complex process and it costs a lot of money. And the longer it takes – the more expensive.
Understood. Sabon was spelling it out – that was for sure. Millar nearly offered him a trowel.
Are you aware of a drug called thalidomide.
“It was marketed in the late 1950’s. It was prescribed as a cure for anxiety and insomnia and morning sickness. It was deemed so safe they gave it to pregnant women. As a result two thousand children died and ten thousand were born with horrible deformities. Those poor children are still suffering today.”
For the first time Sabon stopped looking at the floor and looked at Millar in the eyes.
“And do you know what is even more sick is that the company that made that drug has never apologised to its victims and today is trading with a billion pound turnover. Compensation for those victims has been negligible. That is what you are dealing with. Pharmaceutical companies that are prepared to rush through untested drugs purely for profit. And I am talking billions.”
Sabon looked round the room nervously. They were the only ones there apart from a half dozing security guard and two pensioner ladies studying a canvas.
What are you getting at. Are you telling me that this drug has not been tested properly.
I can’t be sure at this stage but it looks as though some of the trial data was tampered with.
In what respect.
As I said Mr Millar I am not 100% positive but it looks as though some of the dates have been changed and it could be that they did not test the drugs over a long enough period. They might have been tested only for a two or three year period instead of over ten years.
“Just two or three years!”. Millar tried to lower my voice
Sabon continued. “It depends on the type of drug. But normally drugs are subjected to three separate clinical trials. But as I said it is not unknown for a drug to be tested for fifteen years before being granted a licence.
Sabon looked around increasing in nervousness. He leant towards Millar and lowered his voice. His hands stuffed deep into his pockets.
“When you come up with a new drug. It is not hard to prove its effectiveness with clinical trials. But what you need to do is to make sure that there are no side effects. If people take these drugs over a long period – what will it do to their brain?”
And you think this drug has been rushed through.
I can’t prove it totally – but there seems to be a lot of data missing and gaps in the clinical trials.
So what could be the possible outcome if this drug is dangerous.
You are dealing with the brain. People can react in many different ways.
What go mad. Commit suicide. Become murderers. Millar needed some extreme examples.
Sabon was looking nervous. As if he was aware of some ominous consequences by continuing the conversation. But he went on
“There have been antidepressants in the past that have been taken off the market because of cases of liver failure and death. The companies involved have known about the side effects but have continued to market these drugs. They make billions from these drugs so why worry about a few organ failures. That is what you are dealing with here. And that’s the tip of the iceberg. Over the last thirty years with all the technology at our disposal there have been drugs released in the market that have caused heart attacks, renal toxicity, madness and multi organ failures.”
Why would doctors prescribe such a risky drug.
“The truth is either they don’t know the implications of what they are prescribing or they are being incentivised to prescribe this drug.”
Lets take the majority of doctors – GP’s. There are many different types of anti- depressants. By and large they all work the same. But if a new one comes on the market and it comes with a ringing endorsement from various professors and other doctors supported by good case histories – then your normnal GP is not going to question the science. That is out of their league.
And you think there are others being paid?
Most phramaceutical companies employ key opinion leaders – doctors, psychiatrists whoever respected in their profession to give lectures, go to conferences and write papers supporting thier particular drug. If the top psychiatrist of a mental health unit gives the thumbs up – someone who is an expert in their field – that’s hard to push back right.
And these key opinion leaders as you call them are being paid.
Are you kidding me. Holidays, schools fees, deposits into off shore accounts. For the pharma companies its a drop in the ocean. And for a psychiatrist or doctor who might be looking to retire shortly and top up their pension and swan off to the blue yonder – these things are too tempting for them. Their work is done.
So what are wqe looking at here?
Well if the trial data has been tampered with and the drug has not been properly tested – then anything could happen. Sometimes drug are highly effective over a short period but taken over a longer period there is a build up of the chemicals and then….”
He snapped his fingers together sharply. The click echoing around the gallery.
But if you suspect a drug has not been tested properly..you can report it.
“You can. But you have to have evidence. Not anecdotal. Real proof. And it’s hard to prove anyway. A depressed person might act strangely taking drugs or not. Who is to say that their action is down to the drug or their state of mind.”
Not for the first time did Sabon look fidgety. “Listen I have got to go.”
OK – now what.
I need to hang onto that data a little longer – just to be sure
How long are you going to take..
Sabon got up and walked briskly away calling behind him.
“I will call you again in the next day or two.”
It might have been Millar’s imagination but Picasso’s Weeping Woman seemed to shed an extra tear.