Going Bovine meets Trainspotting in this gritty portrait of at-risk teens gaming the prescription drug trial system.
Meet Audie: Professional lab rat. Guinea pig. Serial human test subject. For Audie and her friends, “volunteering” for pharmaceutical drug trials means a quick fix and easy cash.
Sure, there’s the occasional nasty side effect, but Audie’s got things under control. If Monday’s pill causes a rash, Tuesday’s ointment usually clears it right up. Wednesday’s injection soothes the sting from Tuesday’s “cure,” and Thursday’s procedure makes her forget all about Wednesday’s headache. By the time Friday rolls around, there’s plenty of cash in hand and perhaps even a slot in a government-funded psilocybin study, because WEEKEND!
But the best fix of all is her boyfriend, Dylan, whose terminal illness just makes them even more compatible. He’s turning eighteen soon, so Audie is saving up to make it an unforgettable birthday. That means more drug trials than ever before, but Dylan is worth it.
No pain, no gain, Audie tells herself as the pills wear away at her body and mind. No pain, no gain, she repeats as her grip on reality starts to slide. . . .
Raw and irreverent, Placebo Junkies will captivate readers until the very end, when author J. C. Carleson leans in for a final twist of the knife.
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J. C. CARLESON is a former undercover CIA officer who has navigated war zones, jumped out of airplanes, and worked on the frontlines of international conflicts. She now writes when she’s not traveling the globe with her husband and two young sons. Her previous publications include The Tyrant’s Daughter, Cloaks and Veils, and Work Like a Spy: Business Tips from a Former CIA Officer.Excerpt. © Reprinted by permission. All rights reserved.:
Charlotte comes back from her six-week protocol bloated and yellow. She takes one look at me, her gaze skipping over my patchy hair and scabby skin, and her jaundiced eyes fill with tears. "You lucky bitch. You're so skinny," she says.
"Don't worry," Jameson calls out from the other room. "They're starting psychostimulant trials on Four again, probably later this week. That shit'll knock the junk off your trunk in no time."
But Charlotte refuses to cheer up. "With my luck I'll just get a placebo."
She sounds so glum I wonder if whatever gave her a case of the oompa loompas also messed with her head. It happens sometimes. It's hard to know whether it's a side effect or just a bad mood these days. For any of us. Still, after six weeks in she should be happier--most of us would kill for that kind of stint. The longest I've ever gone in was eight days. It was heavenly. Premium cable channels and doctor's orders to do nothing but lie around drinking chalky weight-loss shakes. No exertion allowed except twice-daily weigh-ins--aye aye, captain! The shakes weren't bad, either. I wonder if they ever made it to market. You'd be surprised how many of these things never do.
Jameson does his little nervous-habit throat-clearing thing as he comes in with a glass of something for Charlotte. "Drink up. It's just water with a squeeze of lime. You need to flush out your system, lower your bilirubin levels if you want to get in on anything starting before the weekend."
They don't let us volunteer if they think we still have side effects from another study. It screws up their results. But there are ways to beat the system, and if anyone knows how to do it, it's Jameson, who's kind of like a highly anxious cross between an Eagle Scout and a drug dealer, if that makes any sense. I mean, he might supplement his income with a little under-the-table pill-transfer action, but it's not like he's selling crack to schoolkids, you know? He's actually really into the medical stuff--he has all sorts of pharmaceutical reference books lying around all the time, and he reads research journals, Annals of Dermo-Oto-Neuro-blah-blah Medicine, shit like that, for fun while the rest of us play Xbox or whatever. He always wants to know what we took, how we took it, what we felt, and depending on what it is, he'll sometimes buy it off us if we have any left over. He doesn't even blush when you tell him the embarrassing parts, like rectal suppositories or period stuff. Seriously, he knows more than most of the doctors I've met--he'd probably be the world's youngest brain surgeon by now if he'd turned left instead of right back at whatever fork in the road spit him out on the low-rent side of the tracks instead.
I sometimes wonder if he shouldn't be volunteering, a guy like him. I mean, not just because he's too smart for this shit, but also because he's gotta throw off the results with all the ways he's always gaming the system. Anomalous response they call it, when you don't react the way they expect you to, and they get pissed when it happens. Well, pissed in their quiet, lab-coat-y kind of way. They're pretty cool in general, the techs. Most of them, anyway. They know we're just there to do a job, same as them.
Dougie and Scratch show up with beer and a stack of dirty magazines Dougie got from some Viagra-lite kind of trial, and Charlotte and I snort and laugh our way through the pages because they're the cleanest porno mags you'll ever see--completely raunch-free. They're really not even sexy at all, like the photographer was standing behind the camera telling the models to think about good hygiene. Just the thought of some middle-aged lab administrator leafing through a catalog of medical-grade pornography and placing a bulk smut order cracks me up, and before long we're all relaxed and it starts to feel like a party, so I reach for one of the beers even though I'm not supposed to have any alcohol during the study I'm in now. I glance over at Jameson before I take a sip and he gives me a tiny nod. He knows about the restrictions and he'd warn me if the beer was going to show up in the morning blood work. With his blessing I tilt my head back and enjoy.
Even Charlotte chills out. She's talking about this guy she knows, swears he's the reason for the tattoos. "Yeah, so he got into an appendix study. A big one, huge cash. Like, lottery kind of cash, and all you had to do was let them take out your appendix. Like anyone's ever needed an appendix, right? He doesn't even know what they're testing. Some robot laser scalpel, or something--freaking sutures that play 'Ave Maria,' whatever. Doesn't matter. So my buddy goes through with it, gets his appendix removed and collects his check. But he's kind of a dumbass, see--I mean, he's a nice enough guy, just not the sharpest tool in the shed--and he goes out and blows all the money right away on something stupid. I don't even know how he possibly spent all the money as fast as he did, but he managed. So what does he do next?"
By now we're already laughing, having a good time, and my tolerance must be way down, probably from all the weight I lost last week, because my head is feeling spinny and light. We all know exactly where this story is going, but Charlotte's such a damn good storyteller, especially now that her funk seems to have worn off, that we're all hanging on her words anyway. Charlotte's a good egg. Lights up a room when she's in a good mood, you know? She already looks a little less jaundiced, too, though it might just be the dim lights. I notice Jameson scooching the beer out of her reach while she's distracted.
"Yeah, so he shaves off his goatee, combs his hair a little different, and goes right back to the same damn office. Says he lost his intake paperwork, but he still remembers his subject number."
Scratch calls bullshit here, but Charlotte cuts him off. "No, I'm telling you. He just took a wild guess, used his old number then added ten or something. And the intake tech totally buys it. The same one, by the way, who processed him in the first time around, but he doesn't suspect a thing. It's just another lab rat checking in, right? We all look the same to them--nothing but human petri dishes shuffling through the door. So anyway, my buddy's getting prepped for surgery, and the doc sees his scar from the first time and freaks out. I mean, it's not even a real scar yet, the goddamn sutures were barely out and it's right over his appendix, of course. But I swear to God, this guy is the best liar you'll ever meet. Even better than you, Scratch." She blows him a kiss before she continues.
"Even half dosed up on the twilight sedation stuff, or whatever it was they were using for anesthesia, he manages to convince the doc his scar has nothing to do with his appendix--no, he swears it's from a car accident the week before, just a nasty gash. And the doc's busy, he just wants to move the meat off his table, you know, so he says fine, signs the paperwork, and cuts my friend open again."
"Whoops," Dougie drawls out in a baritone.
"Yeah, whoops is right. No fucking appendix, and the doc is pissed! But he'd already signed off, already cut in, so they had no choice but to pay my buddy the full amount. Again." She giggles, then wipes a tiny speck of blood from the corner of her mouth. "So thanks to him, now they do the tats."
We nod. We all have 'em. Little x's or numbers, or sometimes initials. They're not tattoo artists, the techs and the nurses, so they don't try anything fancy. They just make whatever kind of quick mark they'll remember so they don't accidentally go in twice. There's this one nurse who does a tiny smiley face, though, which I kind of appreciate. I have a couple of those.
There's a lull in the conversation, so I check my watch. "Okay, y'all, it's getting late--I'm out." I yawn a good night to everyone, then bat my eyelashes at Charlotte and Jameson. "Can you guys boost your awesome roommate creds by making sure I don't oversleep tomorrow? Pretty please? Subject processing starts at 8:30."
"Sweet electric sheep dreams," Jameson calls after me as I close my bedroom door and turn out the light. He's a little weird, I know, but who isn't? They're like my family out there, those needle-tracked guinea pig fools.
TODAY'S POST: GETTING STARTED
So, you think you want to be a professional volunteer?
First thing you should know is, not all clinical trials are created equal. General rule of thumb: the more it pays, the worse it's probably gonna hurt. More on that later. But assuming you can take it, that you're not some delicate fucking flower who can't stand the sight of blood or who gets all bent out of shape about things like radiation exposure, here are some tips for how to make a living as a human test subject:
Tip 1. Have a pulse and at least one vein that's not on the verge of collapse.
Ha ha. You think I'm kidding, but this is seriously enough to at least get you in the door. Though judging from some of the people you'll meet in the waiting room, the pulse part can be negotiable.
Tip 2. Be healthy.
Be able to fake it, anyway. Hold it in, cover it up, tell the voices in your head to pipe down for a minute, whatever it takes. Do whatever you gotta do to stay upright long enough to at least get through the screening. Once you're on the books, you can let it all hang out--you'll still get at least a partial payment even if they show you the door the minute your TB test comes back dirty.
Tip 3. Come from a healthy family.
I don't care if you come from the sickliest, dead-est family ever. When filling out the forms, no one in your family has ever died, ever, from anything except ripe old age. Healthy bastards, your forefathers, yes sirree bob! Absolutely no family history whatsoever of high blood pressure, bad cholesterol, or paranoid schizophrenia, no ma'am. Healthy as horses, every last (dead) one of 'em.
Tip 4. Be at least 18 years of age, or have parental consent.
Or, in my case, have a reasonably convincing fake ID. Don't worry, they never look too close. As long as you're a warm, willing body who meets their testing criteria, they really don't care if your driver's license has the name of the state spelled a teensy bit wrong. (For the record, yes, I DO know that Massachusetts has two t's. Lesson learned: proofread forged documents before paying.)
Ready to channel your inner pincushion and get started now? Just follow my lead and then rinse, gargle, repeat. Happy testing, fellow guinea pigs!
Damn. She's a Beagle, and it's too late to move.
I should've known. Should've seen the look on her face before I sat down, that aren't I generous set to the mouth, that martyr's twinkle in her eyes. But there's no changing seats once the needle's in, so now I'm stuck listening to her Humble Tales of Great Sacrifice and Small Thoughts About Life.
Kill me now.
There are five stations set up in the room. Deep reclining chairs covered in long strips of crinkly white paper. Bottles of juice and water within easy reach, two types of muffins. A fan going in the corner. Everything all alcohol-swabbed and vinyl-padded faint-proof. All is as it should be, if only Mother Teresa's second cousin on my left would pipe down. Yup, definitely a Beagle--a particularly annoying subtype of serial tester. Beagles are the people who act like volunteering for a drug study is some grand act of charity, like they're doing the world the biggest damn favor ever, and by God, we'd sure as heck better appreciate their sacrifice. She rummages around in her enormous quilted purse and pulls out knitting needles. Of course she does. Why do they all knit so much? Seriously, what can they possibly need with all that knotted-up yarn, these just doing my part little old ladies? Funny the way they never shut up about just how great it is, what they're doing, though, always wearing their Red Cross T-shirts and their I DONATED pins. They're gray-haired junkies in reverse, always wanting to pump shit out of their veins instead of in. And they Never. Stop. Talking.
This one's no exception. On and on and freaking on, about her favorite Crock-Pot recipes and her grandniece's birthday party, and isn't that Kelly Ripa just the sweetest thing ever, and most of all her son, her nice-boy CPA son who's almost certainly a deviant of some variety, I mean how could you not be, with a mother like this up in your grill all the time? I pick at my cuticles without saying a word, just waiting for her to mention a cat. There's always a cat. Or at the very least there's a cat-sized dog, a Shih Tzu or a Pomeranian. Something small enough for a goddamn knitted dog sweater.
Her knitting needles click-clack while she talks, making her IV line jiggle and sway, and on the opposite side of the room there's a talk show playing too loudly on the TV.
In other words, it's a typical day in the labs.
Today's an interaction study. Two drugs already on the market, already considered safe enough to use, just not necessarily together. It's not twice the money, but close. Interaction studies pay well.
This one's not complicated, but the nurse is obviously brand-new and she keeps botching things up and having to start her checklist over. It's a double-blind study, and you can just see how that totally messes with her mind. Double-blind means, basically, nobody knows who's getting what. One pill and one IV drip per subject. Is it real, or is it fake? Neither the volunteers nor the nurse knows whether we're getting sugar and saline or some toxic chemical brew--an autoclaved version of Russian roulette.
As she checks us in, the nurse keeps asking everyone in this way-too-serious voice if we're absolutely certain that we understand the risks of the study. Yeah, yeah, we all say, and even the Beagle next to me looks a bit annoyed the fifth time we have to hear the same speech.
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