Shortly after I landed in Agartala towards the end of 1988, some seemingly philosophical questions confronted me. All for the wrong reasons, you know. Not because I was a Bengali who loved squandering time on theoretical balderdash. This was, after all, my first job and I intended to retain it. Come hell or high water. The issue of a philosophical dilemma was posed by this very thing. I was a simpleton, and hadn’t still lost my innocence. There was reason for me to be upset over the question of what was right, and what wasn’t.
It was still early in one’s life to throw away ideals to the winds. So I started off as ethically as I could. Within weeks it dawned on me that I was living in a fool’s paradise. I was in Tripura as a medical representative, to sell drugs for a leading pharmaceutical company. Here you couldn’t meet your sales targets if you behaved like a gentleman. For, everyone else around wasn’t. A gentleman, I mean. From the doctors to the retailers, from the stockists to the company warlords. It didn’t matter how you sold your medicines, as long as you did.
After the first month (when I failed to meet my target), I decided to hard-sell. From the doctors to the retailers. I tried every trick in the trade. I tried more with my ingenuity, aggressively at that. I would never dress as a sales executive is supposed to; I would be in a jeans and t-shirt. Often in slippers. I would carry samples in my pockets, and would be as unshaven as I usually am. I didn’t give a damn, and neither did the doctors. My targets were the young doctors there, of my age; they took to me well. I started doing relatively well for myself. My company’s products did well too. For me it was a job, it was a question of livelihood. Till one fine day.
That fine day was an early morning when the 1988-89 winter days were in their last throes. Morning OPD hours would always be chaotic, and so they were. Yet the banter in the OPD room was infectious. If I was there, the young doctors knew it was fun hour. Life was fun.
Till I threw a poser at the boss of the lot, “Are you sure my products figure in your prescriptions?” This particular boss and all his understudies were in my pocket. I had befriended them, then bought off their allegiance with my unending samples and overflowing gifts. But today, even though my smile was friendly, my eyes were not.
The patient he was examining was a young and pregnant tribal girl. Young, very young to be a mother. Still in her teens, I am sure. The doctor scribbled the prescription and showed it off shamelessly. To yours truly. It took me a moment to realise what he was asking this girl to ingest over the next few days. It was Norfloxacin, two tablets TID, for five days.
If you are not in the business of drugs, then you wouldn’t know what it meant. So, let me explain to you as briefly as I can.
That was the time when antibiotics were becoming drugs of the past, antibacterials were in. The first to hit the market big time was this antibacterial called Norfloxacin. It was potent, and it was expensive. During those days my company sold it at Rs 8 per tablet. Of course, over time prices dropped drastically as the demand skyrocketed. But then, coming back to the drug itself. This was reckoned to be a powerful drug for many reasons, one of them being the fact that its half-life was on the higher side.
In other words, it would remain in the bloodstream longer. For this very reason you did not require too much of it, and not certainly so frequently as you had to swallow the earlier-day antibiotics. If the girl to whom this was prescribed followed the regimen, at the end of the course she would have little other than Norfloxacin flowing in her blood. No, she wouldn’t have died. But this was something that, to me, was simply not done.
I looked at the girl again. This time carefully. She seemed resigned to fate. It was probably a pregnancy she hadn’t wanted. Probably she was too ill. She stood there without uttering a word. All the monosyllabic speaking was done by the gnarled old man who stood behind her, his hands on her shoulders. Her father he was, obviously; one who too seemed resigned to fate. They were tribals. Tripuris, if you want me to be precise. The girl’s pachra and risha (skirt and blouse, to us) were wearing out. A look at the two and you would know they did not live off more than Rs 10 a day. I looked at the girl, into her eyes. She was staring at the prescription, a semblance of hope in her eyes. Her gaze sapped something inside me.
No, this is just not done. The prescription is an overkill for a urinary tract infection (UTI), dangerous in fact. I was furious with the physician. The banter went to hell, and I made the man rewrite the prescription, making him drop my product and opt instead for a much mild antibiotic. The doctor didn’t like it a wee bit; this after all I had made him do in front of his juniors. The bonhomie between me and the doctors ended then and there. On my part, I made up my mind that whatever happens or doesn’t, I am not going to make a career out of selling medicines. Then on, I hated the pharmaceutical industry. It was ruthless, it was powerful. Without scruples. And it did the dirty job through callous medical representatives.
I did work as an medical representative for a short while again because I needed a job. But I couldn’t do as well as I had earlier. You can’t sell medicines if you play it straight. The pharmaceutical industry was rich and influential. The MBBS folks did not know so much about drugs as the Bachelors of Pharmacy did. There was nothing called a level-playing field. And MRs would do anything to meet targets.
You coaxed or arm-twisted pharmacists. You cajoled or bought off doctors. The pink papers would continue writing about how much the pharmaceutical industry was on a roll. If there were losers in this cold-blooded game, it were the patients. The people. The people have no idea how much of guinea pigs they are being reduced to. Pharma companies actually control our lives more than you would believe after reading those Robin Cook thrillers. Reality is scarier.
I am so glad that today, more than 20 years later, the Medical Council of India (MCI) wants to punish doctors for accepting gifts and free hospitality. And it has also written to the health ministry saying this, “Doctors are under our jurisdiction and we have now regulated them. But the other half – pharma companies – too need regulation on equal terms.” The MCI has sought equal and stringent regulation for these companies. Will the government do its bit?
I do what I need to, I write what I need to. And if I, even for a moment, waver, I only need to remember the face of that young tribal girl.
Subir Ghosh is a New Delhi-based independent journalist and writer. He has worked with the Press Trust of India (PTI) and The Telegraph, and handled publications/communications for the Centre for Science and Environment (CSE), the Federation of Hotels and Restaurant Associations of India (FHRAI), and the Wildlife Trust of India (WTI). He specialises in Northeast affairs and is an advisory council member with the Centre for Northeast Studies (C-NES). He is the author of ‘Frontier Travails: Northeast – The Politics of a Mess’ published by Macmillan India, and has won two national awards in children’s fiction. His subjects of interest include conflict, ethnicities, wildlife, human rights, poverty, media, and cinema. He blogs at www.write2kill.in where the above story was first published.