Authors: J.C. Carleson
Placebo Junkies (23 page)
“Really? Audie, are you serious? Are you completely serious?”
The look on Dylan's face is pricelessâthis is all turning out even better than I'd imagined.
He's so handsome, but the last few weeks have been hard on him. Really hard. You almost wouldn't recognize him, the way his cheekbones stand out now and the way his eyes almost look like they've changed color. They're darker now, a stormy shade that's hard to pin down. It's because of the pain, I think. It can change a person, it really can.
Trust me, I'd know.
It makes me so happy to do this for him, after all he's been through. After all he's done for me.
I tell him all about the trip. “I'm taking care of every detail,” I say. “No luxury spared.” I tell him all about Castillo Finisterre, since his memory isn't what it used to be and he doesn't quite remember seeing it that night on TVâthe spa, the guided kayak tours through meandering glaciers, the unbelievable views. “I mean, it's the end of the freaking world. How amazing is that?”
Nothing compares to the look on his face. The way he's looking at me right now, almost overwhelmed with happiness and surprise. Nothing beats feeling
loved
like this. Good and fully and finally fucking loved.
I wouldn't trade it for anything.
Moments like this make me feel sorry for those poor fools who get so caught up in the day-to-day bullshit that they never take the time to unplug and just
escape
now and then.
The sad thing is, most people don't know how. They don't realize that the paralysis they feel is in their minds.
And so is the cure.
All our lives we're told what to do, what to strive for. Two plus two equals four, they tell us. If you can just get to four, then you'll be
complete/correct/balanced/approved.
Aim for four, then pat yourself on the back for a job well done once you get there.
Fuck that. I want more. I reject the restraints and the crutches. I reject anything that numbs or sedates or embalms.
I choose five. I choose the castle at the end of the world.
Have I shown you the pictures?
It's kind of hard to see it, the way it's carved into the cliffs the way it is. But take another look. Give yourself a minute to get into the right frame of mind. Now look again, there, between the ice floes.
No?
The thing is, you have to make a choice. You can look at the picture and choose to see icebergs crashing, melting, and careening into cruel, dark waves below. The only thing you'll see, then, is the end. Or you can look again, and this time you can choose to see the castle carved into the ice, so high and precarious it almost seems like it's floating. So pure and dreamlike you could almost mistake it for a cloud.
Choose to look at it like this, and instead of the end of the world, you'll see the ultimate
what next.
Sometimes you have to retrain your brain to see what's possible instead of what's obvious.
The trip isn't completely finalized, not quite yet. But do you see the way Dylan has his arms around me? Do you see the way he kisses me? The way his lips dance over every inch of my flesh, the way they
know
me in the best possible way? Watch how he's careful of the tender spots along my spine, the old ones and the new; see how his fingertips draw gentle little circles, tracing the lines of the tattoos hidden beneath my clothes.
It's hard to break away from something as perfect as this, sometimes.
Once I'm back on my feet, I'll finally have enough to pay for the whole trip. It may hurt a bit, but that's okay. Because this is a love story.
The IV piercing my arm is Cupid's arrow.
The hum and the beep of the life support are the priest reciting the vows.
Watch how my heartbeat responds when you give it a little poke:
I do. I do. I do.
It doesn't matter that I'm in pretty rough shape, or that I'm alone. I'm doing this for him, so he is in the room with me, even if he's not. My eyes don't need to be open to know he's by my side.
I choose five. I choose the castle at the end of the world. I choose love. I've found what I was looking for, and I've written my own perfect, happy ending.
Because this is a love story. If you can't see that, maybe you're just not trying hard enough.
In late June 2013, I crawled out of bed at 3:30 a.m. and wrote what is now the prologue and first chapter of
Placebo Junkies.
This fact is remarkable for several reasons. First, because I was traveling with an infant at the time and was so jet-lagged and sleep-deprived that it's amazing that
anything
could compel me to get up at such an early hour. And second, because never before in my writing career have words come so fast and furiousâas if several entire chapters had been gifted to me by some character in a dream I could no longer remember.
It may have felt like it at 3:30 in the morning, but the concept definitely did not materialize out of thin air. Instead, it was inspired by two very brief and totally unrelated experiences from the day before; it just took a short night's restless sleep for the ideas to loop and coil and, ultimately, converge in my travel-fatigued mind.
I spent the day before my 3:30 a.m. writing session in a section of Seattle with a large homeless-youth population. I'd worked in this neighborhood for several summers back when I was in college, and at first glance, not much seemed to have changed over the years. But unlike when I was nineteen and passing through the occasional cluster of homeless teens as I made my way home on public transportation, this time I reacted as an adult and as a mother. These were
kids,
I now saw. That day, with my own children in tow, the thought of the circumstances that must have led to these young people living on the streets struck me as particularly heartbreaking.
A few hours later, I woke up from the nap I was taking in the car en route to my in-laws' house, where we were staying. I opened my eyes as we pulled up to a red light and stared groggily at a small, handwritten sign staked into the ground. “I made hundreds of dollars losing weight and so can you!” the sloppy writing said. “Get paid to try an amazing new weight-loss drug.” Two digits of the phone number provided had been scribbled out and corrected with a different-colored marker.
Does anyone, ever, actually believe signs like that are legit? Who would possibly think it a good idea to swallow pills provided by a random stranger who stuck a homemade sign at an intersection?
I wondered about the sign until our light turned green, and then promptly forgot all about it.
That night, the two elements came together while I slept: the characters, as viewed on the streets of Seattle; and the premise, inspired by a dubious claim on a roadside sign.
When I sent the initial chapters to my literary agent, semi-apologetically since they were “kind of crazy,” I thought that the concept was perhaps a little too outlandish. I mean, come onâpeople actually trying to make a living by participating in paid drug studies? No way.
But once I started to research, I was amazed to learn that my concept wasn't outlandish at all, and that the practice of making a living via paid medical trials has a long and well-documented history.
In the course of conducting research for this book, I spoke to numerous people on each side of the testing equation. I even interviewed several people who had personal experience as both a subject and as a researcher. One, a physician who now runs clinical trials, regularly “volunteered” for drug studies while he was in medical school in order to earn extra money. Another source, who is employed by a contract research organization (CRO), had enrolled in a clinical trial of birth control pills along with several other coworkers, because, heyâfree birth control!
The people I spoke to had had wildly varying experiences. One source on the research side told me horror stories of some of the studies she had facilitated; she had personally witnessed the recruitment of obviously mentally ill “volunteers” from a New Orleans bus station. Another source employed by a research organization in Mexico, on the other hand, described scrupulously designed and controlled studies with both ethics and safety considerations paramount.
Many of the paid test subjects thought it was a great way to earn easy money. Others swore they'd never make that same mistake again.
My book is not intended to condemn clinical trials. Personally, I like having the latest and greatest medicine available when I'm sick, and human-subject testing is a critical part of getting drugs onto pharmacy shelves. Furthermore, the overwhelming majority of the men and women who are a part of the discovery process are dedicated to ethical and safe practices. There are, of course, exceptionsâon both sides. But in this book, I specifically wanted to avoid the traditional medical-thriller pattern of having “Big Bad Pharma” at the root of the evil. Instead, I wanted to turn things upside down a little. I wanted to create a spin on a medical thriller, in which Big Pharma did not play the typical villain's role. This gave me a joyride of an opportunity to explore a number of themes that I find fascinating: control, ideological versus physical threats, perspective, causation, and intent.
One of the biggest challenges I faced while writing
Placebo Junkies
was achieving the right balance between certain scenes that are (I hope) quite funny and certain topics that are not at all funny. I have a sense of humor that veers sharply toward dark and a solid appreciation for the poetically grotesque, but I absolutely did not want to make light of any of the very serious subjects touched upon in the book: mental illness, drug addiction, medical ethics, or human-subject testing, among others. My goal, then, was to craft a story that simultaneously thrills and challenges readers.
Placebo Junkies
is intended to spin assumptions and prompt questions and discussions, and it is my sincere hope that it does.
Writing
Placebo Junkies
involved some of the most extensive and most outlandish research that I have ever conducted for a book; I remain surprised that my Internet search history alone didn't trigger some sort of legal intervention. Due to the subject matter, I can't name or properly thank most of those who provided me with data, insight, and personal stories. From the CRO employees who provided inside information both damning and exculpatory, to the physicians who answered my bizarre questions with only a mild eyebrow raise, to the individuals who told me about their own volunteer experiences, to the heavily inked and pierced cashier at the grocery store who cheerfully answered my questions about body modification every time I shoppedâplease know that you are appreciated! I'll break my policy of source discretion only to thank my retired-radiologist fatherâmostly for not calling the authorities on any of the many occasions when I asked questions about how one might go about tampering with an MRI machine or the mechanics of spinal injections gone wrongâ¦.
I can, however, name some of the good people who helped this book come into existence on the publishing side. Many thanks to my agent, Jessica Regel, and my editor, Katherine Harrison, for taking a chance and championing the strange little nugget of an idea and a voice that only later grew into a proper book. Thank you to Ray Shappell for noticing that my title had just the right number of letters to fit on a couple of pillboxes and designing an amazing cover around that concept. Much appreciation to Iris Broudy, Artie Bennett, and Alison Kolani for saving me many times over with their copyediting magic. (Was it terribly immature of me to snicker a little whenever I read your utterly professional corrections of things like my improper habit of writing
douche bag
as one word?) Thanks also to Heather Kelly for tackling some complex interior design issues, and to managing editor Dawn Ryan for her support!
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