American Medicine God: Starting by Inheriting a Pharmaceutical Company and Selling Medicine

Washington, D.C., Capitol Hill.

The October morning was slightly chilly, but Room 216 of the Senate Hart Office Building was as hot as a sauna. This was the venue for a hearing of the Committee on Health and Human Services, and the air was thick with a distinctive smell—a mixture of worn carpet, freshly ground coffee, printer toner, and tense sweat.

This has the smell of power.

The spotlight flashed wildly, and the lenses of dozens of cameras, like black holes, greedily devoured every detail of the scene, finally focusing on the man sitting in the witness stand—FDA Commissioner David Rossi.

David Rossi wore a tailored dark blue suit and a sophisticated burgundy tie today. His hair was neatly combed, and his face displayed just the right amount of weariness and determination, like a public servant working day and night for the public good.

"Chief of Staff," a senior Democratic senator from California, seated on the dais, adjusted his reading glasses, waving a clipping from The Washington Post, his tone aggressive, "critics have pointed out that since the implementation of PDUFA (Prescription Drug User Fee Act), nearly half of the FDA's budget has come from 'payments' from pharmaceutical companies. Does this mean that regulators have become service providers? In pursuit of approval speed, have you sacrificed the most basic drug safety?"

The senator paused, his gaze sweeping across the room, before uttering his carefully prepared line: "Are you serving the American people, or serving the stock prices of Pfizer and Vought?"

This was a sharp question, like a scalpel trying to cut open the abscess of Washington's "revolving door." Reporters at the scene raised their recorders, anticipating a loss of composure from the bureau chief.

But David Rossi did not panic.

He slowly picked up the water glass in front of him, took a sip, and moistened his throat. This action gave him three seconds to think, and also made him look more composed.

"Senator," David put down his water glass, looked directly into the other man's eyes, his gaze filled with sincerity and heartache, "this is a serious misunderstanding, and even an insult to the character of the thousands of hardworking scientists present here."

His voice, transmitted through the microphone, resonated in every corner of the hearing hall, loud and steady, carrying an undeniable sense of "professionalism".

"We must clarify one concept: efficiency is life."

David took out a document from his Hermès briefcase—the expedited approval letter for the "Walter Nirvana Phase III Clinical Trial," which had just been signed and taken effect that morning.

"Just yesterday, we opened the fast track for a revolutionary brain repair drug. For an early-stage Alzheimer's patient who is losing their memory, or a young person who is unable to work due to anxiety, an earlier approval means an earlier chance to rediscover themselves, rather than sinking into confusion."

He held up the document as if displaying a banner of justice.

"Senator, you mentioned 'payment.' Yes, the pharmaceutical companies paid. But where did that money go? It didn't go into anyone's pocket. It became the salaries of the 300 neuroscientists, data analysts, and clinicians we hired! It became the upgrades to our computer systems! It became the fuel that accelerated our approval process!"

David became more and more agitated as he spoke. He stood up, placed his hands on the table, leaned forward, and adopted a posture of fighting for the public good.

"In the past five years, thanks to the resources provided by PDUFA, we have made the United States the country with the fastest access to new drugs in the world. Previously, our patients had to wait for Europeans to get their life-saving drugs first, and then wait for two years; now, the whole world is waiting for the United States! Is this the result of our 'sacrifice'? No, this is the medal of our struggle! This is not 'being captured,' this is 'the awakening of administrative efficiency'! We are protecting the American people—protecting them from the killing of 'waiting.'"

These words resonated deeply, reconstructing "charging" as "resource optimization" and equating "speed" with "humanitarianism."

"Well said!"

Just then, in the first row of the hearing panel, a relative of an elderly woman with gray hair and a dazed expression shouted excitedly. Her voice trembled with tears in her eyes, "If the FDA hadn't accelerated the approval of the clinical trial, my husband might not even recognize me! Commissioner Rossie is saving lives! Those politicians who just sit in their offices pointing fingers have no idea what we're going through!"

The camera immediately captured this deeply moving scene. The California senator opened his mouth, his face flushed red. Faced with such powerful "public opinion" and "moral high ground," any rebuttal would seem cold-blooded and ruthless.

There was initial silence in the audience, but then Victor Corleone, in the VIP seats at the back of the hearing, led the applause.

His applause was powerful, steady, and rhythmic, like a clear signal.

Immediately afterwards, representatives from pharmaceutical associations, patient rights organizations, and some swing voters joined in the applause. Soon, the applause was deafening, drowning out the dissenting voices, and some even stood up to salute.

Barry, sitting next to Victor, leaned closer and whispered, "A brilliant speech. David's level is high enough to run for governor. Who brought that 'family representative' over there? His acting was very convincing."

"She is a genuine family member." Victor looked at the triumphant director on the stage, a cool scrutiny flashing in his eyes. "Genuine anxiety and fear are the best props. We simply gave her a microphone and let her say what we needed at the right time."

Following the hearing, the committee will vote on the fifth renewal of the PDUFA Act.

Barry glanced at the vote count sheet in his hand, a satisfied smile playing on his lips. "Aside from a few hardliners like Sanders, most of the key members have been won over. The new bill's provisions will be much more favorable to us. This isn't just a renewal; it's an upgrade."

"Be more specific." Victor straightened his cuffs, his gaze still fixed on David Rossi, who was being interviewed by a reporter.

"For example, the broad application of 'Mental Health Biomarkers'," Barry explained. "That's at the heart of our lobbying effort. Previously, approving a psychiatric drug required lengthy psychological evaluations and behavioral observations, which were too subjective and too slow."

"Time is money. In this industry, time is more valuable than gold," Victor said calmly, taking a sip of his mineral water.

"Now, under the new terms, we no longer need to wait years for behavioral improvement. We can get approved for marketing simply by demonstrating that the drug can regulate the levels of neurotransmitters in the brain or improve a specific active area on a brain scan."

He held up two fingers and waved them in front of Victor: "This can reduce the average clinical trial time from eight years to four years, and lower research and development costs by 40%. More importantly, it means we can legalize 'preventive treatment.' Even if you don't have symptoms yet, as long as your 'biomarkers' show you are at risk, you are our customer."

Victor nodded in satisfaction: "Very good. This is what I mean by 'rules dividend.' Instead of fighting tooth and nail with your opponents in the market, change the rules of the game at the source. When we define 'what is healthy,' we've already won."

Just then, David Rossi finished speaking. Amid applause and flashing lights, he stepped down from the podium and walked straight towards the exit, passing by the area where Victor was.

Surrounded by assistants, bodyguards, and reporters, David looked like a rock star.

As he passed Victor, he didn't stop, shake hands, or even give a clear nod. The two brushed past each other like strangers.

But in that instant, their eyes met briefly in the air for 0.1 seconds.

David's eyes said, "Mission accomplished, I have fulfilled my mission."

Victor's eyes seemed to say, "Payment settled, pleasant cooperation."

This is a new kind of interaction. It doesn't happen in dark alleys, doesn't involve suitcases stuffed with cash, and doesn't require sneaky recording pens. It happens in brightly lit congressional halls, in the circulation of official documents bearing the national emblem, and in every seemingly rigorous legal clause.

It is legal. It is institutionalized. It is perfect.

Victor stood up, buttoned his suit jacket, and felt the powerful aura surrounding him.

"Let's go, Barry."

"Where to?"

"Go see our 'ally.' The people from the National Association for Mental Health and Psychiatry (NMHPA) should already be here."

Victor strode forward, his leather shoes clicking crisply on the marble floor, each step feeling like a tap on the nerves of the nation.

"Capitol Hill is just the first step. What we need to change is not just the speed of FDA approvals, but also the 'medical standards' of the entire healthcare system."

"Medical examination standards?" Barry followed behind, somewhat puzzled.

“Yes.” Victor stopped and glanced at the Stars and Stripes fluttering outside the window. “If you can’t quantify anxiety, you can’t price it. We need to set a standard for mental fatigue, a standard that no one can refuse. When anxiety becomes a number, it becomes a commodity.”

Sunlight streamed onto the white dome, reflecting a dazzling light. But to Victor, it shimmered more like the luster of gold coins.