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

New York, Manhattan. The Vought Tower rooftop conference room.

Outside the window, the sky was overcast, and an autumn rain was brewing. The atmosphere inside the meeting room was even more gloomy than the weather outside.

Around a long table sat the core executives of Water Pharmaceuticals. Each of them had a copy of today's Louisville Messenger in front of them.

The front-page headline, in bold black font, read: "The Forgotten Death: The White Plague of the Appalachian Mountains."

The accompanying image is a disturbing photo: a gaunt miner lies dead in his own bathroom, with several empty medicine bottles scattered around him, the words "OxyContin" on the bottles standing out starkly.

"The stock price has dropped 8%." The CFO wiped the sweat from his brow, his voice trembling. "In less than an hour after the market opened, we've lost $20 million in market value. Wall Street is panicking."

"This is just the beginning." The public relations manager anxiously flipped through the briefing in his hands. "ABC and CBS are following up. They found the miner's widow, and the woman cried on camera, saying our drug was the devil. If we don't respond immediately, the media will engulf us."

"Respond? How can we respond?" Marcus, the VP of Sales, slammed his pen on the table. "Admit our drug is addictive? The FDA will revoke our approval tomorrow! Our sales team just conquered California, and now our backyard is on fire!"

"Perhaps we should recall this batch of products?" the chief scientific officer tentatively suggested. "Or perhaps we could revise the instructions and add stronger wording to the warning box? We could say it was an isolated incident..."

"Shut up."

A voice interrupted the entire argument.

Victor Corleone sat at the end of the long table. He wasn't looking at the newspaper or the stock prices. He was peeling an orange.

His movements were slow and meticulous, as if he wanted to remove every single white pith from the orange.

"A recall? A revised instruction manual?" Victor put a segment of orange in his mouth and chewed slowly. "That's admitting we were wrong. An apology is an admission of guilt. Once we bow our heads, those greedy lawyers will pounce and file class-action lawsuits. We'll lose every penny and go bankrupt."

“But Victor…” Marcus spread his hands, “The facts are there. That man died. Because he took our medicine.”

"No." Victor swallowed the orange, picked up the newspaper, and pointed to the photograph of the deceased. "He didn't die from taking our medicine. He died from not taking our medicine correctly."

Victor stood up and walked to the whiteboard in the conference room.

He picked up a black marker and wrote a word on the whiteboard:

ADDICTION

"This is the media's weapon against us." Victor turned to the crowd. "They say our drug is addictive. They say patients seek OxyContin like they would any other drug. That sounds terrible, doesn't it?"

The executives looked at each other, none of them daring to speak.

Victor sneered, turned around, and added a prefix to the word:

PSEUDO - (Fake)

"Pseudo-addiction." Victor tapped the whiteboard heavily with the tip of his pen.

"What is this?" The chief science officer was stunned. "This word isn't in the textbooks."

“Now we have it.” Victor stared into the scientific officer’s eyes. “Listen, Doctor. The reason patients behave like addicts—hoarding drugs, becoming agitated, even buying drugs on the black market—is not because they are addicted, but because their pain is not being adequately relieved.”

Victor spread his arms as if preaching: "This is a cry for help! They're using this extreme method to tell the doctor: 'I'm in so much pain! This dose isn't enough!' This is called 'pseudo-addiction.' It looks like addiction, but it's essentially inadequate treatment."

"So..." Saul Goodman was the first to react, his eyes lighting up, "The solution isn't to stop the medication?"

"Of course not!" Victor exclaimed. "The solution is to increase the dosage! Give them more! Until the pain subsides, the 'addictive behavior' will naturally disappear!"

Marcus gasped. "This...this is genius. Turning a bad thing into a good thing. If we promote this theory, doctors won't be afraid to prescribe the drug; they'll prescribe it even more?"

"That's called a logical closed loop," Victor said, throwing down his marker. "But that's not enough. We need a scapegoat."

He pointed to the empty medicine bottles in the newspaper photo.

"Our drug has a patented sustained-release layer, right?" Victor asked the science officer.

"Yes," the science officer nodded, "that coating is very strong, ensuring the drug is released slowly over 12 hours. Unless..."

"Unless what?"

"Unless the patient grinds it up, destroying the coating, and then inhales it through the nose, or injects it, then a 12-hour dose would be released in seconds, producing a tremendous high, but also extremely likely to cause respiratory depression and death."

"Bingo." Victor snapped his fingers. "So, why did that miner die? Because he was a drug addict. He was a jerk. He didn't follow medical advice. He ground up our high-tech pills and smoked them. It's like someone buys a Ferrari and then crashes into a tree at 200 miles per hour. Would you blame the Ferrari? No, you'd say he was crazy."

Victor walked back to his seat and looked down at everyone.

"This is our public relations strategy: Blame the Victim."

"First, promote the concept of 'pseudo-addiction.' Tell doctors that any behavior that resembles addiction is due to insufficient medication. This is an academic counterattack."

"Second, they stigmatize the victims. They tell the media that those who died were 'trash' who abused drugs. Our drugs are for legitimate patients, not for addicts to have fun. This is a moral severance."

"Did you understand?"

There was a few seconds of silence in the conference room, then applause erupted. First Thor, then Marcus, and finally even the conflicted science officer joined in.

……

Three days later. CNN studio. Prime-time evening interview program.

Victor did not appear in person. Seated in the spotlight was Dr. Portnoy, a white-haired, highly respected pain medicine expert. He was the president of the American Pain Association, funded by Water Pharmaceuticals.

Sitting opposite me is a host known for his sharp and incisive remarks.

"Dr. Portnoy," the host pressed, "data shows that drug overdose deaths in the Appalachian region have increased by 300% in the past three months. Shouldn't Waterpunk's OxyContin be held responsible for this?"

The doctor adjusted his glasses, his face filled with anguish. "This is a tragedy. But we must distinguish cause from effect. OxyContin is a legally approved drug by the FDA. It uses state-of-the-art sustained-release technology, and as long as it is swallowed whole, it is absolutely safe."

"But people are dying!"

"Those who died were the ones who disrupted the drug's structure." The doctor produced a chart, which Victor had the public relations department create overnight. "The investigation shows that 95% of the deaths involved 'misuse' or 'abuse.' These people had a history of drug abuse. They were marginalized members of society. We cannot deprive millions of innocent people who are truly suffering from pain of their right to treatment because of the misbehavior of a few. That's inhumane."

"But Doctor, some doctors have reported that this drug is more addictive than advertised..."

"That's a misunderstanding!" the doctor interrupted the host excitedly. "That's called 'pseudo-addiction'! This is the latest discovery in the medical field. It's pain crying out for help! If we stop prescribing medication out of fear, that would be a violation of the Hippocratic Oath! What we need to do is not prohibit drugs, but educate. Educate patients not to crush pills, and educate doctors not to be stingy with dosages!"

in front of the TV.

Victor sat on the leather sofa in his office, swirling a glass of red wine in his hand.

On screen, the host's momentum clearly weakened, while Dr. Portnoy grew stronger and more assertive, seizing the moral high ground.

"Well done," Thor exclaimed. "This turnaround was perfect. I checked the latest polls, and people are starting to think the miner who died deserved it. The stock price has already recovered in after-hours trading."

Victor didn't laugh. His eyes were as cold as an icebox.

"Saul, do you know what the most ironic thing is?"

"What?"

Victor looked at the screen where the person was eloquently discussing the theory of "pseudo-addiction," a mocking smile playing on his lips.

"That miner... was actually an honest man. He never did drugs. He was just in so much pain and couldn't afford that many pills, so he listened to the street thugs and ground up the pills to save time and make them work faster."

Victor took a sip of red wine.

"He wasn't a drug addict. He was just a desperate poor man."

Thor paused, a chill running down his spine. "Then why are you still..."

"Because we're only safe if we define him as 'trash.'" Victor stood up, walked to the floor-to-ceiling window, and looked down at the brightly lit New York City. "In this world, there are only two kinds of people: those who define the rules, and those who are defined. As long as we have the power to define, black can become white, and poison can become candy."

"Remember, Saul. Nobody cares whether trash lives or dies. As long as we turn our victims into trash, we're forever innocent."