Story code: ST-000803
Part 2: The Captive Market
“Excuse me,” the woman said. The scent of her expensive perfume-something floral and sharp, like crushed lilies-cut through the heavy, rich aroma of garlic and butter. She offered a tight, polite smile that didn’t reach her eyes, the kind of smile reserved for panhandlers on the subway. “You’re standing a little close.”
David didn’t move. He kept his body squared to the reception window, forcing her to stay trapped in his shadow. He stared at the gold double-helix on the clipboard she had slid onto the counter. “Four hundred percent,” he said. His voice was quieter than he expected. It sounded like it was coming from someone else, someone detached and floating above the sterile clinic. “You pushed the margin by four hundred percent.”
The woman’s polite smile froze. She took a half-step back, her designer heel catching slightly on the linoleum. Her eyes darted to the receptionist behind the glass, then back to David. She was sizing him up: the frayed, oil-stained collar of his work jacket, the dark circles under his eyes, the hollow set of his jaw. He knew exactly what she saw. A liability.
“I’m sorry, I was on a private call,” she said, her tone dipping into a cold, professional warning. “Brenda, is Dr. Evans available?”
“Hey,” David said. He shifted his weight, blocking her line of sight to the glass window. “Look at me.”
“Sir.” She clutched her heavy leather tote bag higher on her shoulder, pulling it tight against her camel coat. “I don’t know what your problem is, but I’m here on business.”
“My daughter is seven.” David’s hands were trembling. He shoved them deep into his jacket pockets so she wouldn’t see. His fingers brushed against his dead phone, the useless GoFundMe campaign trapped inside it. “She takes ten units of Novacor-R every single day. Six months ago, a vial was eighty dollars. Today it’s three hundred and forty. You just bought steak for this entire office with the money I couldn’t pay my electric bill with.”
The waiting room had gone completely silent. The low hum of the fluorescent lights suddenly sounded like a roar. An older man reading a magazine two chairs down slowly lowered the glossy pages to his lap, watching them with wide eyes.
“David,” the receptionist said through the glass, her voice losing its previous warmth. She stood up, her hand hovering near the beige telephone on her desk. “You need to step back. You’re making Ms. Sterling uncomfortable.”
“Ms. Sterling,” David repeated. He kept his eyes locked on the woman. The polished veneer was cracking. She looked annoyed, inconvenienced. Not guilty. Not ashamed. Just irritated that a bug had landed on her windshield.
“Listen,” Sterling said, exhaling sharply as if she were explaining a math problem to a slow child. “I understand that out-of-pocket costs can be frustrating in the current landscape. But Novacor reinvests millions into R&D to ensure patients get the highest quality care. There are patient assistance programs you can apply for online-”
“I applied,” David interrupted, his voice cracking. “They denied us because I make fifty dollars too much a month working night shifts at the warehouse. Fifty dollars. That’s a rounding error to you. To Maya, it’s her life.”
“I really can’t discuss corporate pricing policy with a patient,” Sterling said, her eyes darting toward the clinic’s heavy wooden double doors that led to the exam rooms. “And quite frankly, your aggressive behavior is uncalled for. I’m going to ask you to step aside.”
She tried to push past him. As she moved, her heavy leather tote bag swung forward, bumping against David’s hip. The top zipper was open. Inside, packed neatly in custom foam cutouts, were rows of small, pristine white boxes stamped with the blue double-helix logo. Samples. She was bringing free samples to the doctor to grease the wheels for the new pricing structure. There was enough insulin in that bag to keep Maya alive for six months, just sitting there next to a compact mirror and a pack of spearmint gum.
David’s breath hitched in his throat. He couldn’t look away from the white boxes. The air in the room felt impossibly thin, rushing past his ears in a high-pitched whine.
The heavy wooden double doors swung open. Dr. Evans stepped into the waiting room. He was a tall, exhausted-looking man with thinning hair and a stethoscope slung carelessly around his neck. His eyes lit up at the smell of the catered lunch, then darkened instantly as he took in the frozen tableau at the reception desk. “Brenda, what’s going on here?”
“Dr. Evans,” Sterling said, relief flooding her voice. She quickly stepped around David, using the doctor’s arrival to put distance between them. “I brought the Q3 luncheon, but this man is harassing me.”
“David,” Dr. Evans said, his voice dropping into a stern, authoritative register. “What are you doing? Your appointment for Maya isn’t until next Tuesday.”
“I need a refill script, Doc,” David said, his eyes still glued to Sterling’s tote bag. “And I need samples. You know we’re out. You know I can’t afford the pharmacy right now.”
“We’ve talked about this,” Dr. Evans said, lowering his voice, clearly embarrassed in front of the regional director. “I can’t just hand out samples indefinitely. The clinic has strict auditing rules now. Novacor tracks the lot numbers.”
“Because she tells you to!” David pointed a shaking finger at Sterling. “She just bragged on the phone about a captive market! She’s got a dozen vials in that bag right now! Just give me one. One vial, Doc.”
“That’s enough,” Sterling snapped, recovering her corporate armor. “These are promotional items for licensed facilities. They are property of Novacor. Dr. Evans, if your clinic can’t secure its waiting area, my company will have to reconsider our distribution partnership here.”
The threat hung in the air, heavy and absolute. Dr. Evans paled. He looked at David, his expression hardening from sympathy to cold self-preservation.
“David, I’m going to have to ask you to leave,” the doctor said quietly. “Now. Or I’ll have Brenda call security, and I’ll have to discharge Maya as a patient of this practice.”
David felt the floor drop out from under him. Discharge Maya. If he lost this pediatrician, he’d have to start over at the county hospital, waiting months for an intake appointment. Maya didn’t have months. She had three days.
Sterling smirked, a tiny, victorious upward pull at the corner of her glossy lips. She adjusted her camel coat and reached into her bag, pulling the heavy brass zipper shut to hide the white boxes from view. The metallic zip sounded like a vault locking.
David looked at the doctor, who was already turning away to inspect the catered boxes of steak. He looked at the receptionist, whose fingers were now resting firmly on the telephone receiver. He looked at the gold zipper on the leather bag. He thought about Maya bracing for the needle, trusting him to make the pain mean something.
David lunged forward and grabbed the straps of the Novacor tote bag.