The Doctor's Former Fiancee(7)

By: Caro Carson


Always, he’d protested that money wasn’t his motive for going to Harvard Business School instead of staying with her at West Central. He’d denied that the need to excel in the corporate world was the reason he no longer wanted to open a husband-and-wife family practice in Texas. Some part of her must have believed him after all, because now, to hear him say it himself—there’s no money in treating pediatric migraines—was devastating.

Even after six years.

* * *

Braden watched the light in Lana’s eyes die, the passion in her expression fade. It was the same look he’d seen on the faces of other hopefuls whose dreams he’d had to kill. The fact that it was Lana this time didn’t make it any different.

Braden felt very tired. Too old, too wise to the ways of the world.

“This is the reality of the marketplace,” he said. “Pediatric migraineurs are only a fraction of all patients.”

“You saw these slides. They estimate over twenty-nine million Americans suffer from migraines. Even if only a few percent are pediatric, that’s still a million or more patients. That’s huge.”

“No, it’s not. Only half of your twenty-nine million even know their headaches are migraines to begin with. Only half of those will seek help from a physician, and less than half of those might be prescribed a drug like this one. Another percentage will never fill the prescription. There are barely enough adult sufferers to make a new migraine drug viable. There are not enough children.”

“To make the medicine viable? You mean profitable.”

“I mean viable. Can it begin to recoup the millions—the hundreds of millions—that were spent on bringing it to the local drugstore? I estimate that only one in five drugs that makes it to the public sells enough pills to cover the cost of inventing it in the first place.”

“I’m talking patients here. There may not be a lot of them, but there are children out there who suffer terribly from migraines. They’re in pain, Braden. They can’t play and go to school. What about them?”

At the moment, Braden hated his job with a passion. Why did he have to be the one destroying Lana’s dreams? Let someone else disillusion her.

She kept championing her cause. “The adult medicines don’t work well to relieve the pain for children. Most of the treatments aren’t even FDA approved for pediatric use—”

“As it should be. They don’t work well in pediatrics. Lana, step back and look at the big picture. When the first one or two migraine medicines ran pediatric studies, they failed. They didn’t work. Why should the other drugs in the same class throw time and money down the same drain?”

“Money. Always money. What about the patients?”

“I am thinking about patients. There is only so much money out there. What should we spend it on? Who needs it most?” He’d heard her words a dozen times before. She’d always maintained that if he cared about people, he’d be a physician, not a corporate executive.

He felt himself sucked into a time warp of sorts. Felt himself once more losing the woman he loved as she accused him of placing money before all else.

As he had a dozen times before, he tried to make her understand. “This is what I do, Lana. These are the life-and-death decisions I make now. Should I fund a pediatric migraine study that might—and I emphasize might—improve the quality of life for a fraction of a percent of all children? Or should I take those same funds—because by God, there are only so many dollars out there—should I take those same funds and invest them to develop a cardiac medicine that could prevent millions of deaths?”

He was standing, he realized, as was she. They were glaring into each other’s eyes, battling for supremacy. Again. Always.

“You make that call, Lana. Should I help three million kids who have episodes of pain, or should I help eighty million adults, the parents and grandparents of those children, who are facing death? You choose, because I don’t have enough money to do both.”

She stayed silent, but she didn’t back down, not in her body language, and not in her glare. Why had he thought this time would be different?

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