Diagnosing Illness Just by Looking at Faces? (3)
Here we were in the internal medicine ward at Stanford Hospital. Dean Clayton Rich of Stanford Medical School sat in the corner of the nurses' station, furtively munching on something pitiful. He was dodging the nurses' eyes. He looked like he'd pulled an all-nighter the day before.
I greeted the professor, and Dean Rich startled, fiddling with his bow tie.
"Good morning, Professor."
"You're in. How's internal medicine residency treating you?"
I nodded. It was way better than residency back in Korea. America was relatively advanced in education and work culture, at least. Not that there were no overnight shifts or other issues...
"Seems good."
The nurses bustled around the station. Hospitals in the 1970s had several times more staff than modern Korean ones.
The dean eyed me. "Why'd you choose internal medicine residency?"
"It's the specialty with the most opportunities."
I answered shamelessly. The dean was an internist himself. He looked at me and chuckled in disbelief.
"Yeah, that's you all right."
Internal medicine was the best path to hospital leadership, sure, but that wasn't the real reason. What did titles matter to a doctor? Simple.
"I like seeing patients and coming up with new drugs or treatments. Internal medicine lets me do both."
The dean pondered for a moment.
"Heard you wrote a paper on a rare disease case this time. Professor Harris was involved, but rumor has it you came up with the diagnosis and treatment."
"Oh, that. Yeah."
That paper had made it into The Lancet. Kawasaki Disease wasn't well-known in America yet, and its treatment wasn't established.
"How'd you pull that off?"
The process was straightforward.
"Kawasaki Disease is a relatively new syndrome, so despite its deadly complications, it's often misdiagnosed as something else. I pointed that out, and..."
Dean Rich squinted.
"That's why they fast-tracked it."
That's why The Lancet had rushed my paper. It needed to get out now for Kawasaki patients.
"Practical paper."
One feature of medical research: studies that actually save lives and can be used in clinics get written and published fast. Especially in the 1970s.
"Getting into The Lancet isn't easy."
The dean trailed off. The Lancet was one of the world's most prestigious journals. Hard to publish in, but it had a dedicated section for case reports. This case qualified—a new disease, plus an effective treatment. In original history, effective Kawasaki treatment came a decade later.
Like that. Dean Rich finished the chart, grabbed the patient list, and stood.
"Let's round on the ward patients."
I nodded. The dean's specialty was endocrinology—think hormones. I walked the endocrinology ward hallway with him, checking room numbers on the list.
"Since we're on the topic, what's the most important disease in endocrinology?"
"Diabetes."
"And the most important drug for diabetes?"
Tough question. Insulin was the most dramatic, but few diabetics used it—only severe cases.
"Insulin."
"That stuff extracted from animal pancreases?"
"Ah."
I stopped short. Something clicked. Stanford's recent gene recombination research, bacterial restriction enzymes. The 1970s hadn't produced human recombinant insulin yet. Maybe I could accelerate that discovery! Oh, another letter to a journal. My mind raced. Professor Berg or McDevitt could help. Recombinant insulin production.
I looked back at the professor.
"Soon we'll make insulin in test tubes. That's what Professor Berg's gene editing work is about."
"Another research project? I don't know much molecular biology, so I can't help much."
The dean had long left frontline research for clinical work and admin. He sighed again.
"Feels like you just enrolled yesterday. Now you're a doctor, churning out achievements that'd take others a decade."
"Thank you."
"I picked well... You'll be an outstanding doctor. The best student I've ever seen, teacher."
I nodded solemnly.
Here we were in Stanford Hospital's Lab 8. The day with the Weiseman Foundation had arrived fast. Remember, the chance to pitch my invention to pharma companies.
I sat in the lab with the EpiPen blueprints spread out—the one I'd used at the party. The EpiPen was basically done. I'd prepped the designs years ago. Simple as a pen, right? For the drug inside, off-the-shelf epinephrine subcutaneous syringes. Patent already filed—easier than expected. Stanford's name probably helped. Famous for tech.
Now, the key: convincing the pharma reps I'd meet soon...
What approach would work best?
How to get a pharma company to say yes to making and distributing the EpiPen? We'd love to save lives, but that's doctor/patient talk. Pharma's different. What words would convince their staff this was worth investing in—a valuable drug and invention?
I toyed with my pen. The pitch: EpiPen wasn't just a new delivery method; it could shift the company's profits and position. A production issue, too. ROI potential. Even as charity, PR and image boost. Pharma usually ignores that, though? What claim would make them believe and mass-produce?
The next day... Rigelotte Weiseman and one attendant waited at the campus gate. She'd said she'd come herself. She wore plainer clothes than expected: brown outfit, white shirt, bread-hat to avoid eyes, yellow sunglasses. The attendant kinda ruined the disguise, though. Retro style? Nah, normal for this era.
I waved; she lowered her sunglasses with one hand and looked at me.
"Off to meet pharma?"
"Yes."
"First, suit shopping. If timings work, I'd like to hit Syntex's conference room too..."
Rigelotte covered her mouth, laughing.
"Thank you."
"Weiseman gift. Can't walk into a meeting in anything."
I walked beside Rigelotte for a bit. California's weather was perfect—spring or fall year-round.
"Got your pitch ready? Pharma folks are as stubborn as they come."
I nodded. Drugs aren't sold just because you want to or succeed in making them. Hurdles galore: academic approval, research, FDA. Even then, mostly doctor-prescribed, not direct to patients. Risky structure.
"It's for carrying before sickness hits—expands market from sick to healthy. Proactive placement in public spots, first-aid kits..."
"Not bad?"
Rigelotte tilted her head.
"Lobby government to mandate emergency drugs like EpiPens in restaurants, public places—like defibrillators or Band-Aids."
Blind money strategy. American pharma could swing it.
"Thinking like a pharma exec."
"Well... Expecting people to carry EpiPens daily is unrealistic. Better in public spots."
Severe allergy folks do carry them daily, though.
Rigelotte turned.
"Suit today, no custom. Armani. And I'll pick the outfit...!"
She smiled at me.