CHAPTER 4
Standing at the base of the Wilhelm Genetics skyscraper, I tingled at the thought of riding up in the glass elevator. I was sure the view of the Boston skyline from the fortieth floor would be spectacular, but there were lots of spectacular views I could no longer stomach. I had only five minutes before my appointment with Vivian Sutcliffe, director of patient access for Wilhelm Genetics, to get my nerves on.
Train delays. Damn trains.
I did everything possible to get here early enough to take the stairs. Man plans. God laughs. Still, arranging this meeting was no simple task, and I wasn’t about to let a little thing like paralyzing acrophobia keep me from making the appointment on time.
My conversation with Leonard Tate, now two days in the past, deteriorated faster than a reality star’s career. Tate must have said, “I’m sorry, but that’s our policy,” at least a dozen times before I demanded to speak to a senior customer service representative from Atrium. Then, like tag team wrestlers, it was Carlotta Duncan’s turn to say, “I’m sorry, but that’s Atrium’s policy.”
I hung up the phone, leaving the Atrium reps with the highly ineffective parting salvo, “Thanks for nothing.” I couldn’t think of anything more clever to say. I was too floored, too angry, too dumbfounded to speak.
Rather than stay stuck in Atrium’s maddening constraints, I turned my attention to the Web, where I found a glimmer of hope in the form of Wilhelm Genetics Access Solutions program—a service for patients and their health-care providers to assist with coverage and reimbursement support. Hopefully, this trip on the insurance merry-go-round would yield me the brass ring.
Wilhelm Genetics newly constructed headquarters in Boston’s downtown financial district stood in stark contrast to the surrounding historic buildings that gave the city its unique architectural character. The towering skyscraper was a rectangular structure, ultramodern in design, which reflected Boston’s scenic harbor in its mirrored glass windows. I entered the foyer, shaking off a seasonally cool early April day in New England. If there was one bit of hope to be extracted from the building’s sleek interior, it was a feeling that this company could afford to be charitable. The burnished marble floors and walls appeared flecked with gold, while the majestic light fixtures descending from a thirty-foot-high ceiling would fit in just fine at the Museum of Fine Arts.
My footsteps echoed across the cavernous space on my way to the security desk, manned by two sentries well dressed in white oxford shirts, black ties, and official-looking badges. I signed the guest registry, noted the time on my iPhone—two minutes until my meeting with Sutcliffe—and then followed their directions to the elevator bank. Already I was shaking, and I hadn’t yet set foot inside what my brain considered a glass tomb.
My mind kept saying, Don’t be late, but my body spoke otherwise.
I wish I had listened to my body.
Acrophobia comes from the Greek ákron, meaning “peak, summit, edge,” and phobos, meaning “fear.” Fear of heights is not an irrational emotion, especially if there is no protection to safeguard one from a fall. But I’m a mountain climber, dammit. I once lived my life on the edge. Now, years after what I did to Brooks Hall, I can’t even get near an edge without getting the shakes. My shrink wasn’t too surprised by the sudden onset of the condition. Acrophobia has historically been attributed to a traumatic experience involving heights. Newer theories have evolved, casting some doubt on that supposition, but I’d be willing to bet none of those theorists ever cut a safety rope, knowing he’d kill the guy bound to the other end.
The elevator chimed, doors whooshed open, and four other people, close to my back and waiting for a ride up, basically pushed me inside. Buttons were pressed. Floor numbers illuminated. I was going to the highest floor. Figured. The doors closed with a Star Trek–like swoosh, and the elevator blasted skyward like a rocket ship. From behind me, I heard an ooooh and aaah from one of the passengers gazing in wonderment at the rapidly diminishing view of downtown Boston. Meanwhile, my throat closed and every pore in my body began to secrete something: salt, water, and fear.
I felt my face flush, heartbeat fluttering like a bird newly freed from its cage. I held my breath but could feel my knees start to go slack. The roomy elevator seemed to get smaller, as if the four people riding up with me were multiplying, engulfing every conceivable square inch of space.
Don’t pass out. . . . Don’t pass out. . . .
I closed my eyes tight, balled my fists. Then I saw him.
Brooks wasn’t wearing his sunglasses, though. His eyes were nothing but two dark voids, wide and round like a doll’s, while his face had gone entirely black from frostbite. My hands involuntarily jerked upward, as though I’d been holding on to a taut rope that had been sliced in two. My mouth formed an O shape, allowing my silent scream to escape. I kept my eyes closed tight and felt fuel injected with panic.
I used to stand on the top of the world.
Just when the air inside the elevator seemed as thin as it did at twenty thousand feet, the voyage came to an abrupt stop. I opened my eyes and saw we were only on the twentieth floor. I jumped out of the elevator, pushing aside a woman who had planned to get off on that floor. She wasn’t bothered by my abruptness, it seemed. I suspected she’d seen my skin go pale as snow, eyes ringed with sweat, wide and alert. My chest kept heaving, as if I were breathing through half a straw.
“Are you all right?” the woman asked. She looked ready to call 911.
“I’m fine . . . fine . . . ,” I managed to wheeze out. “Think I’m going to take the stairs from here. Quick twenty-floor hike will do the heart some good.”
Her smile expressed great relief in not being called upon to perform CPR and equal degrees of gratitude to be free of my company.
I found the stairs and climbed the twenty floors at a brisk pace. I made it to the top, carrying with me a stark reminder that my condition hadn’t lessened with the years. If anything, it had only gotten worse.
I arrived at Sutcliffe’s office breathless, my face flushed, T-shirt soaked with sweat, and heart still hammering. I took a seat in the waiting room after giving my name to the receptionist. The demure woman seated behind a glass enclosure offered me a drink of water, along with a weary assessment of my condition. I drank in slow sips while waiting ten long minutes for Sutcliffe to show. I guess only one of us cared about being punctual.
Vivian Sutcliffe, a stocky woman dressed in a plaid skirt and black turtleneck sweater, with dark hair to match, emerged through a double set of glass doors. She gave me a congenial smile that somehow conveyed sympathy. It was certainly a practiced reaction on her part, assuming most visitors came to her under the cloud of troubled circumstance.
“Mr. Bodine,” Sutcliffe said, extending her hand. “I’m so sorry I’m late. Busy morning. I hope you had an easy time getting up here. Security can be pretty arduous these days.”
“It wasn’t a problem,” I said.
“Did you love the view coming up? I never tire of it.”
“I’m sure it was beautiful,” I said.
Sutcliffe paused, showed some confusion in her large brown eyes, but didn’t press for an explanation. I kept pace as she led me down a carpeted corridor with low ceilings, illuminated by the artificial unpleasantness of fluorescent lights. She opened the door to a conference room, motioning me to join her inside. The room itself was small, one round table and four chairs. Thankfully, no windows.
A glossy blue folder awaited me on the conference table. It was chock-full of papers and titled Wilhelm Genetics Access Solutions. A photograph of a well-dressed man, maybe in his early sixties, adorned the front cover. His silver hair, neatly trimmed, accentuated deep creases on his face, giving him the distinctive look of power. I thought it peculiar that Wilhelm Genetics’ marketing material didn’t advertise a beaming, happy family, saved by the generosity of the Access Solutions program.
It all became clear when I read the accompanying copy. The man whose face adorned the front flap of the Access Solutions folder was Manfred von Wilhelm, CEO of Wilhelm Genetics. His message to prospective consumers was simple: “Because everyone should get the medicine they need.”
Sutcliffe saw me studying Wilhelm’s face.
“Mr. von Wilhelm has personally donated several million dollars to our Access Solutions fund.”
“Seems like a charitable guy,” I said.
“Well, our job is to help families like yours get the medication you need. We know these are tough times. Millions are uninsured, and millions more are underinsured. My office is tasked with helping families get through the financial aid process as quickly and painlessly as possible.”
“To be honest, I was surprised you agreed to meet with me in person,” I said. “From what I read about these programs, a lot of it is done online.”
Sutcliffe seemed to take personal satisfaction from my observation. “Our office is unique in that regard. We believe, with Mr. von Wilhelm’s full support, that a personal touch during what is obviously a difficult time not only builds goodwill with our customers, but sets an example for the rest of the industry to follow.”
“Well, I think this industry is pretty messed up,” I said. “I’m paying a lot of premiums without getting much for my money.”
“Do you mind if I ask who you’re insured with?”
“Atrium,” I said.
Sutcliffe groaned. “Goodness, they’re difficult to deal with.”
I nodded my head vigorously and recounted my experience with Leonard Tate.
“So they wouldn’t make a generic shortage exception?” Sutcliffe said in a voice wavering with disgust.
“What’s that?” I asked.
“Some insurance companies will cover the full cost of a brand-name drug if the generic isn’t available. I guess Atrium isn’t one of them.”
“Well, how much do you think Ruby and I will be able to get toward the cost?”
Sutcliffe already had my application. I’d sent it to her the day after I hung up on Tate. She knew how much money we made. She smiled, and I felt lighter already.
“It looks like you’ll be able to get the maximum coverage.”
I smiled back. My body tingled like it was full of helium.
“That’s great news,” I said, letting go a deep sigh. “That’s incredibly generous.”
“Twelve thousand dollars is the largest per patient donation of any major pharmaceutical company.”
I swallowed air.
“Twelve thousand?” I said. “Ruby’s course of treatment is well over three hundred thousand dollars.”
Sutcliffe appeared genuinely surprised. “I’m sorry,” she said. “But you don’t qualify for our full access program.”
“What? Why not?”
“Because you have some form of insurance. The full access program is only for the uninsured. It’s also given out by lottery. We couldn’t afford to give our medications out for free. I guess I should have been more clear on the phone.”
I was speechless. For a while, I just stared blankly at the floor. Thinking.
This wasn’t a question of going into debt. This was about not being able to get the drug at all. Twelve thousand dollars represented two weeks of treatment at most.
I buried my indignation. At least we had something—a start.
“My wife and I are truly grateful for your generosity,” I said.
Vivian Sutcliffe smiled, evidently pleased. “We’re glad we can help.”
“One thing,” I asked, my mind already racing. “If Atrium is so bad and inflexible, what are some insurance companies that would have covered us for the full course of treatment?”
“Oh, that’s an easy one,” Sutcliffe said. “UniSol Health is the biggest and the best. They’d cover the full cost, even if the generic were available. I should know, because that’s who insures Wilhelm Genetics employees.”
“Thanks,” I said. I meant it, too. Because now I knew how I was going to fix our problem.