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理查德 你严重超支 Richard, you vastly overspent,
我们感到生气 焦虑也是合理的 and it's not unreasonable that we would be upset.
会成功的 我保证 It'll work. I promise you.
翻 译 草草
药监局专门创造了一个特别标签 The FDA created a special label
声明它更不易上瘾 to say that it's less addictive.
校 对 草草 苏葵
我从未给中度疼痛的病人开过麻醉剂 I would never prescribe a narcotic for moderate pain.
那个狗屁标签是万恶之源 That fucking label caused everything.
这药才上市三年 This drug has only been on the market for three years,
时间轴 噃噃
就已出现服药过量的情况 and there's already been a spike in overdoses.
儿童遗弃上升 儿童虐待 未成年人卖淫
后 期 MythCreator
我们的社区是一场 Our community is ground zero
正在蔓延的全国灾难的原点 for a growing national catastrophe.
我们要尽己所能 We're gonna do everything we can
总 监 苏葵
找到责任人 to hold someone accountable.
但这些人 But you got all these people.
他们几乎从未直接提到奥施康定 They almost never mention OxyContin by name
而这是一则奥施康定的宣传片 in the video promoting OxyContin.
这视频是 And this video is
奥施康定的第一个重要推广 the first major introduction of OxyContin.
证明他们明知道药物的威胁性 Prove they're lying about the dangers of the drug
却还是照卖不误 and that they're selling it anyway.
我不能失业 I can't lose my job.
我得挣够钱好离开这里 I gotta make enough money to get out of here.
有种新药 药监局说它很安全 There's a new drug. The FDA said it's safe.
你是否庄严宣誓将尽己所能 Do you solemnly swear that you will correctly transcribe
准确无误地转录每一位证人 to the best of your ability all of the testimony
就大陪审团现在审议的事件 given by each and every witness testifying in the matter
所提供的所有证词 now pending before this grand jury
并对此保密 不对任何人透露 and that you will keep secret and divulge to no one
大陪审团的一切法律程序 上帝保佑 any of the proceedings of this grand jury, so help you God?
我宣誓 I do.
一款新药从构想 It takes 10 to 15 years for a new drug
到上市新药10到15年 to complete the journey from inception to the marketplace.
如果奥施康定1996年上市时失败了 If OxyContin had failed when it launched in 1996,
会造成什么后果 what would have been the consequences?
普渡制药会损失四千万美元 Purdue Pharma would have lost $40 million
而且还没有其他重要药物在研发阶段 with no significant product in the pipeline.
今天很重要 是吧 Big day, right?
第一组数据要出来了 First sets of numbers coming in?
肯定会没事的 I'm sure they'll be fine.
那对普渡制药的伤害 And how much damage would that have inflicted
会有多大 on Purdue Pharma?
很可能会让整个公司倒闭 It likely would have sunk the entire company.
还不错 They're not bad.
我们还能做得更好 We can do better.
视频证词制作的怎么样了 How's our video testimonial coming?
有点慢 A bit slow.
药物太新 The drug is so new,
目前能为它 there's not a lot of people
作证的人并不多 who can testify to it at this point.
-那就去找人来 -是 先生 - Then find some. - Yes, sir.
医生们需要知道 Physicians need to know
它可以与盘尼西林比肩 it can take its place next to penicillin
成为医药史上最浓墨重彩的一笔 as one of the most important in the history of medicine.
我们再举办更多的周末研讨会 Let's hold more weekend seminars
向医生们解释 to explain to physicians
这种药究竟多么具有革命性 how truly revolutionary this drug is.
是你最喜欢的药代表 It's your favorite pharma rep.
如果他要贿赂你放他进来 If he's gonna bribe you for access,
你该要比花更好的东西 you should get more than flowers.
下次送你美甲如何 How about a mani-pedi next time?
好啊 拜托了 Yes, please.
还有你的礼物 医生 And your present, Doc,
是带有滴定法图标的笔 is a pen with a titration chart in it.
-给 -谢谢 - There you go. - Thanks.
我还是更喜欢花 Think I'd rather have flowers.
既然你已经花钱进了我的办公室 So now that you bought your way into my office,
有什么事 what do you need?
-我们坐会儿吧 -好 - Can we sit for a minute? - Sure.
我想向你提出一个激动人心的邀请 I wanted to extend an exciting invitation your way.
普渡制药想邀请你去亚利桑那州斯科茨代尔 Purdue want to invite you to an all-expenses paid trip
一家五星级度假村 听疼痛专家 to Scottsdale, Arizona, at a five-star resort
谈论新疗法 费用全包 to hear pain experts discuss new treatments.
这样可以吗 不违法吗 Even allowed to do that? Isn't it illegal or something?
开玩笑吗 当然不违法 Oh, you kidding me? No, it absolutely is.
制药公司都这么干 这些研讨会 All the pharmas do it, and, you know, these seminars,
很有趣 也很能长见识 they're a lot of fun, and they're very informative.
我不能去 我工作很忙 I can't. I've got--I've got a full practice,
周末也一样 even on weekends.
-病人太多 -嗯 - Too many folks. - Right.
但研讨会 But the seminar
算是你在这里的工作的延伸 would be an extension of your work here.
很多疼痛专家都会去 There'll be a lot of pain experts,
你能得到一些很好的建议 and you'll walk away with some great tips.
带你妻子一起去吧 Take your wife, you know?
你们可以度过一个放松身心的水疗周末 Two of you could have a relaxing spa weekend.
我妻子因卵巢癌过世了 My wife passed away from ovarian cancer, so...
-天啊 -嗯 - Oh, my God. - Yeah.
-真抱歉 -嗯 - I'm sorry. - Yeah.
没事 没事 It's all right. It's all right.
那我回头再来问你 Well, um, I'll keep checking in with you.
想想吧 斯科茨代尔哦 And, uh... think about Scottsdale.
好 Sure.
肯定好玩的 医生 It'll be fun, Doc.
成瘾剂量
第一季 第二集
洛根 Hey, Logan.
我一想给你看看 I've been wanting to check on you.
看看你的肩膀 Wanna take a look at that shoulder.
还是那样 Doing the same.
还是只能抬到这里 Still can't lift it more-- much more than that.
肩膀疼得难受 Pains the shoulder something awful.
嗯 Yeah.
都六年多了 医生 Been more than six years, Doc.
我知道 Yeah, I know. I know.
我想让你试一种新药 Hey, there's a new medication I might want you to try.
什么样的药 What kind of medication's that?
病人刚开始服用奥施康定时 When a patient first takes OxyContin,
的确很有效 it can be very effective.
病人往往会觉得 The patient often feels like
他们的人生立刻变得不同了 their life has been instantly transformed.
很不幸 药效并不总如普渡制药宣称的那样 Unfortunately, the drug didn't always work as Purdue claimed.
怎么说 Oh, how so?
有病人和医生提出抱怨 So we've been getting some complaints from patients
药效不能坚持12小时 and doctors that the drug isn't lasting 12 hours.
人们大半夜被疼醒 People are waking up in the middle of the night in pain.
药监局的批准就是看重 Our entire FDA approval is based on the fact
药效能持续12小时 that it's a 12-hour drug.
如果不能坚持12小时 Insurance companies and hospitals won't cover it
保险公司和医院就不会承保了 if it doesn't last the full 12 hours.
怎么会这样 How did this happen?
我们一直知道药效可能 Well, we always knew it was a possibility
无法坚持12小时 that the drug wouldn't last 12 hours.
波多黎各的测试只达到了50% The Puerto Rico testing only hit at 50%--
药监局只要求达到50% The FDA only requires a 50% threshold.
谢谢 Thank you.
就这样吧 That will be all.
别担心 Don't worry.
我们会有办法的 We'll figure this out.
这是种好药 It's an excellent drug.
你妈妈担心死你了 理查 You've got your mother worried sick about you, Richie.
我们的专利过期了 Well, our patent expired.
没有替代品 就死定了 Dad would be dead without a replacement.
因为你不满足于耳屎吗 Because ear wax just isn't good enough for you.
请原谅我 Forgive me for trying to...
杀菌消毒的药物
不满足于只做必妥碘家族 make us more than the Betadine family.
我知道 你有远大志向 I know, I know, you've got grand ambitions,
但我担心你会变成飞向太阳的伊卡洛斯 but I am concerned you're going to become Icarus.
如果奥施康定能达成我构想的目标 If OxyContin does what I think it can,
它会比亚瑟叔叔的一切梦想更伟大 then it's gonna be bigger than anything Uncle Arthur ever dreamed.
理查 Richie...
亚瑟死了 Arthur is dead.
罗奇雇亚瑟·赛克勒来营销安定时 When Roche hired Arthur Sackler to market Valium,
他需要想个办法把它跟利眠宁区别开 he needed to find a way to separate it from Librium.
于是亚瑟创造了一种特定的医学病症 So Arthur devised a specific medical condition
称之为精神紧张 called psychic tension.
利眠宁是缓解焦虑的 Where Librium was taken for anxiety,
但针对精神紧张需要更强效的药 you would need a much stronger medication for psychic tension.
于是 安定成了 And thus, Valium became
市面上第一号的镇定药物 the number one tranquilizer on the market
就是靠创造所谓的精神紧张症 by creating the condition known as psychic tension.
我们创造了人类文明史上 Now, we have created the greatest painkiller
最伟大的止痛药 in the history of human civilization...
我们如果想让世界都明白这一点 and all we have to do to ensure the world gets it
就需要构想一种病症 is to figure out a medical condition
让奥施康定的服用者 that would require an OxyContin patient...
需要加倍剂量 to double their dose.
今天我们要谈一种病症 Today we're gonna talk about a medical condition
爆发性疼痛
known as breakthrough pain.
它并不多见也不少见 Neither common nor rare,
爆发性疼痛是一种特定的疼痛 breakthrough pain is a specific type of pain
它会在12小时药效期间出现 that breaks through the 12-hour cycle.
我是收到了很多人的抱怨 Yeah, I've had several complaints--
或者该说质疑 or should I say questions--
说药效不能维系12小时 about the drug not lasting 12 hours.
好 你们只需要 All right, what you need to do
跟医生们说 这些病人 is tell your doctors that their patients
是遭受了爆发性疼痛 are experiencing breakthrough pain.
但我们有个很有效的解决办法 But we have an effective solution
能让病人们 that will allow their patients
靠奥施康定安眠整夜 to get a full night's sleep on OxyContin.
他们只需要把剂量翻倍 All they have to do is double the dose.
如果他们在服10毫克的 So if they are on 10 milligrams,
就改服20毫克 they double the dose to 20.
如果他们本就服20毫克 就服40毫克 If they're already on 20, they double to 40.
如果这药不像我们说的那么好用 Hey, if this drug isn't working like we say it is,
医生就不会再开了 doctors are gonna stop prescribing it.
那或许你该去改卖伟哥 Then maybe you should start selling Viagra.
谢谢帮忙了 Thanks for the help.
听着 20和40毫克的药 Look, the 20 and 40 milligrams
比10毫克的贵两倍和四倍 are two and four times more expensive than the 10.
所以如果我们能说服医生把剂量翻倍 So if we can convince doctors to double their doses,
我们的工资也能翻倍 we will be doubling our paychecks.
我知道 但... Yeah, I get that, but...
但如果它不好用呢 what if it doesn't work?
没有哪种药会对每一个病人都十分好用 No drug is going to work perfectly for every patient,
那不是我们的问题 and that's not our problem.
我们的工作就是卖药 Our job is to sell.
那我们就翻倍剂量吧 Then I guess we double the dose.
是啊 Yeah.
医生 我拿到了关于12小时药效问题的信息 Doc, I was able to get some information on the 12-hour issue,
这并不少见 and, uh, it's not uncommon.
你的病人所遭受的是爆发性疼痛 What your patient's experiencing is breakthrough pain,
可能会在第九或第十个小时里发生 and it can happen hours nine and ten,
尤其是如果疼痛非常剧烈 especially if the pain is uniquely acute.
爆发性疼痛 Breakthrough pain.
这我从未听过 I've never heard of breakthrough pain.
真的吗 You really haven't?
这个词主要是 Well, it's a--it's a term used primarily by, uh--
疼痛专家在用 by pain specialists, you know?
解决方法很简单 And the solution is--is simple.
只需要翻倍剂量 You, uh--you just double the dose.
如果病人在服10毫克 So if they're on 10 milligrams,
就翻倍到20毫克 you know, you bump them up to 20.
不不 Oh, no, no, no.
麻醉剂这么用太多了 No, that's--that's too strong for a narcotic.
我还是让她用扑热息痛 I'll just switch her to Percocet
或小剂量的吗啡吧 or low-dose morphine pills.
医生 最好别 Doc, I wouldn't do that.
那些药 它们... Tho--those drugs, you know, they're not--
它们不像奥施康定那样不成瘾 they're not non-addictive in the way that--that OC is.
而且剂量翻倍是完全安全的 And it's perfectly safe to--to double the dose.
你是说你的药 You're telling me that your drug
是这世上唯一能帮助我的病人的药吗 is the only drug in the world that can help my patients?
我是说... Well, ye--I mean, I'm saying--
这是你最佳的选择 I'm saying it's your best option, you know?
你有哪个病人 Have you had a number of patients
有爆发性疼痛的问题吗 with--with breakthrough pain issues?
就一个 Well, I guess I just got one.
我不知道 我只给四个人开了 比利 I don't know, I've only got four people on it, Billy.
嗯 但他们的情况都很好吧 Right, but they're all doing great, right?
说实话 是很有效 Yeah, it's been very effective, actually.
是吧 这不就是了 See? There you go.
还是别碰吗啡的好 医生 I--I'd stay away from morphine, Doc.
现在可不是1894年了 You know, it's not, uh, it's not 1894 anymore.
总统已经不是泰迪·罗斯福了 Teddy Roosevelt isn't president.
1894年的总统本来就不是泰迪·罗斯福 Well, Teddy Roosevelt wasn't president then either,
但我明白你的意思 but I get your point.
好吧 Uh, okay.
用吗啡给她治疗背痛 Yeah, I guess morphine would probably be too strong
可能是太过了 for her back injury anyway.
喂 Hello?
抱歉 医生 Uh, so--sorry, Doc.
你刚刚好像信号不好 I think you cut out there.
给她加到20毫克应该就行了 I think doubling her up to 20 milligrams will do the trick.
就试试吧 Just--just give it a try.
好 我不打扰你了 All right, I'll let you go.
再见 Bye.
现在有了新问题 So, um, there's a new issue.
有些医生误解 A number of doctors have the misconception
奥施康定的药效没有吗啡强 OxyContin is less powerful than morphine,
但其实 你知道 它比吗啡强 when, as you know, it's much more powerful, and, uh,
这种误解出现的越来越频繁了 the confusion has started to come up more frequently.
吗啡的一些副作用包括什么 What are some of the side effects associated with morphine?
呼吸困难 Difficulty breathing,
镇静状态 昏迷 死亡 sedation, coma, and death.
奥施康定是不是比吗啡药效更强 And is OxyContin more potent than morphine?
是的 Yes.
它的有效成分 氧可酮 Its active ingredient, oxycodone,
药效是吗啡的两倍 is twice as potent.
因此也两倍危险 And thus twice as dangerous.
这款产品才刚刚上市 I think it would be extremely dangerous
现在向医生们说明 at this early stage in the life of this product
我们的药比吗啡更强 to, um, clarify for physicians
是非常危险的 that our drug is stronger than morphine.
所以我们并不打算采取什么措施 So we do not plan to do anything about that.
我同意 And I agree with you.
你可以放心了 Well, you'll be happy to know
你不是第一个 you're not the first person
不能整夜安眠的人 who can't sleep through the night.
这并不少见 That's not uncommon.
我们有两个选择 So we've got two options.
可以给你换药 We can, uh, switch you to a different medication.
不 我不想换药 No, I-I don't wanna switch.
这药比我用过的任何药效果都好 This works better than anything I've ever used before.
好 那第二个选择就是给你翻倍药量 Okay, well, option two is I can double your dose
改服20毫克 to 20 milligrams.
如果还不行 我就给你换药 But if that doesn't work, we'll switch to something else.
如果你还晚上 And if you're still having a hard time
还是睡不着 你就联系我 sleeping through the night, you call me.
如果你不联系我 丫头 And if you don't call me, girl...
你会联系我的 Then you'll call me.
没错 That's correct.
你的搬家计划怎么样了 So how's those moving plans of yours coming along?
我不知道 或许我还是低调做人 I don't know. Maybe I just keep my head down
过个一年再考虑吧 and figure it out in a year or so.
谢丽当初跟我说 You know, when Shelly told me,
"我要搬去芬奇溪"时 "I want to move to Finch Creek,"
我想 "芬奇溪 I thought, "Finch Creek?
你疯了吗 芬奇溪 Are you nuts? Finch Creek?"
我就来自宾州西南的 I mean, I'm from this little town
一座小镇 in southwest Pennsylvania.
可是跟芬奇溪比 那里就像纽约市了 That's like New York City compared to Finch Creek.
我一来到这里就爱上了这里 I loved it the minute I got here.
那是我最好的决定 Best decision I ever made.
所以如果你想搬去尤里卡斯普林斯 So if you wanna move to Eureka Springs,
你就尽管去吧 you just go ahead and dive in the deep end and do it.
好吗 All right?
你总还能回来嘛 You can always come back.
我还能搬回来吗 Can I always move back?
谢谢 医生 Thanks, Doc.
再见 Bye.
你们能否确认你们就是制作了 Can you just confirm that you're the ad agency
《我重拾生活》宣传片的广告公司 that made the I Got My Life Back promotional video?
是 是我们 Yes, that was ours.
我们看过之后 很想知道 After reviewing it, we were curious
为什么没人说过"奥施康定" as to why nobody says "OxyContin"
毕竟这视频的目的就是推广奥施康定 in a video designed to promote OxyContin.
-是这样吗 -是啊 - They don't? - No.
40分钟时好像有人提过一次 There's maybe one mention, 40 minutes.
其他人只说 Everyone just says either, uh,
"止痛药"或是"疼痛药" "the pain medication" or "the pain medicine."
人们为了不说奥施康定简直费尽心思 You got people tying themselves up not to say OxyContin.
这是为什么 Now, why is that?
我不记得了 拍摄是多年前的事了 I don't remember, and that shoot was years ago.
而且我们的客户需要知道 And it's important our clients know
我们不会透露内部沟通的内容 we won't disclose internal communication.
你们要知道 And it's important that you know
我们可以传唤你们 that we have subpoena power.
你们要么现在回答我们的问题 So you can either answer our questions here,
要么去弗吉尼亚州罗诺克的 or you can answer 'em under oath
大陪审团面前 宣誓回答 in front of a grand jury in Roanoke, Virginia.
每年这时那里可美了 Which is beautiful this time of year.
是这样 我们现在把你们视为证人 You see, guys, right now, we view y'all as witnesses,
但也很容易变成嫌疑人 but that can quickly change to suspects.
这都是很久以前了 好吗 Look, this was all a long time ago, okay?
但我们可能接到了指示 But we might've been given instructions
他们不希望参与者 that they didn't want the participants
把药物的名字说出来 to say the name of the medication.
为什么 Why not?
如果我没记错 原本的创意 If I recall, the original concept
并不是推广奥施康定 wasn't to promote OxyContin.
他们只是要我们做一个缓解疼痛的 They just wanted us to do a public service announcement
公益宣传 for pain relief.
这或许是普渡制药不希望任何人提到 That might've been why Purdue didn't want anyone
某种特定药物的原因 to name a specific drug.
但最后的标题上 But there are titles at the end
写了奥施康定 that say OxyContin.
而且屏幕底端还注明了每位病人 And it's written at the bottom of the screen
精确的用药量 the exact milligrams each patient's on.
你们得把这事说清楚 You need to clarify this issue.
我们拍摄结束 剪辑视频时 We were given instructions to add the OxyContin graphics
才接到指示要加上奥施康定的字样 after the shoot while we were editing the video.
所以起初说是做公益广告 So it started out as a PSA,
然后在后期制作的过程中 and then somewhere in the post-production process,
才变成了奥施康定的宣传片吗 it became a promotional video for OxyContin?
是这样吗 Is that what happened?
我们只是按他们的要求来的 We just did what they wanted.
他们说"拍公益广告" 我们就拍了 They said, "Make a PSA," so that's what we shot.
后期制作时 他们又说"加上奥施康定标题" Then in post, they said "Add the OxyContin titles,"
我们就加了 so we did.
是普渡制药的哪个人 So who at Purdue Pharma
向你下达了这些具体的指示 gave you these specific instructions?
我猜猜 Oh, let me guess.
他们无法将任何普渡制药上层的高管 They had no names of any upper-level Purdue executives
-跟视频联系起来 -对 - tied to the video. - No, sir.
普渡制药费尽心思确保了不会有 Purdue went to great lengths to make sure there were
高管在此事上留下痕迹 no executives' fingerprints on anything.
我说了 这里是笔糊涂账 Like I said, that's where it gets murky,
但我们会继续查的 but we'll keep digging.
我们不会全靠这个 Won't be our entire case,
但这能有力地证明欺诈行为 but it could be great in terms of proving fraud.
至少能让法官准许我们 Or at least get a judge to grant us access
查阅所有的普渡制药资料 to all Purdue's internal files.
你们最后赶紧找到猛料 Well, you better find something big, and fast,
因为我们遇到了 because we've got a situation
可能会让整件事中止的情况 that might shut this whole thing down.
我刚接到了司法部的电话 I just got a call from Main Justice.
副总检察长要我们去华府 The Deputy Attorney General wants us to go to DC
跟他商量这件案子 to discuss this case with him.
案子还在初期 这样很不寻常 That's--that's unusual this early in the case.
是啊 I know.
如果我接到电话了 肯定是 If I'm getting calls, it must mean that someone
很有影响力的人不喜欢我们在做的事 with a lot of influence really doesn't like what we're doing.
他要什么时候见我们 When does he wanna meet with us?
两周后 In two weeks.
你们见过詹姆斯·科米本人吗 You ever met James Comey in person?
没有 他什么样 No. What's he like?
很高 He's very tall.
如果还想继续查案 I'm gonna need more on this video
视频的事还得找到更多证据 知道了吗 if we're gonna keep this case open, you got it?
给我找点好的来 Find me something good.
谢谢大家为此次行动从北卡罗莱纳州远道而来 Thanks, all, for coming out to North Carolina for this operation.
这份名单上的所有人都参与了一部名为 Everyone on this list participated in a video
《我重拾生活》的视频的拍摄 entitled I Got My Life Back.
该视频可能是证明普渡制药 This video could be a key piece of evidence
在奥施康定的宣传过程中 in proving Purdue committed fraud
有欺诈行为的关键证据 in the promotion of OxyContin.
为了更好地确定视频的细节 To better ascertain the details of the video,
我们要同时询问他们每个人 we'll interview each of them simultaneously.
这样他们就没什么机会串供 Give them less of a chance to coordinate their stories.
什么事 What do you want?
我是联邦政府的里克·曼卡索 I'm Rick Mountcastle with the federal government.
-有事吗 -是的 女士 - Can I help you? - Yes, ma'am.
我是兰迪·拉姆塞尔 My name's Randy Ramseyer.
我是政府工作人员 I work for the government.
怎么了 出什么事了 Why? What's wrong?
你拍摄的那段视频 So in the video you shot
说你服用了奥施康定的视频 where you're taking the medication OxyContin...
嗯 我是因为伤开始服用它 Yeah, I--I was taking it for a--a injury.
我注意到 你并没提到奥施康定 And I noticed you--you didn't actually call it OxyContin.
我被告知那是公益宣传 I was told it was a public service thing
想让患长期病痛的人 for chronic pain sufferers
更愿意服用止痛药 to be more comfortable taking pain medication.
但我时不时就会说漏嘴 Every now and then, I would slip up,
-说出奥施康定 -嗯 - and I would say OxyContin. - Well, yeah.
他们说 "别那么说 And they would say, "Don't say that.
就说'止痛药'" Say 'the pain medicine.'"
是制作人叫你别提到 Did the producer ask you not to say
-奥施康定吗 -对 - the--the name OxyContin? - That's right.
他要我说"阿片类药物"什么的 He--he didn't want me to say "opioid" or "opiates" either.
-他叫你怎么说 -"药物" - What'd he ask you to say? - Uh, "medication."
"止痛药" "Pain--pain medication."
-止痛药 -对 - Pain medication? - Yeah.
我拍完后 他们跟我说 But they told me when I was done
我的表现很自然 that I was real natural.
我都无法相信那有多难 I can't imagine how hard that would be,
坐在镜头前 努力表现得正常点 sitting in front of a camera trying to be normal.
不 他几年前过世了 Oh, no. He died a few years ago.
我讨厌这碎石 Oh, I hate this gravel.
跟药物有关吗 And was it drug-related?
是的 他对奥施康定上瘾了 Oh, yeah, he was oxy-cuted.
当初是谁请你 Who asked you to participate
参与视频拍摄的 in the video in the first place?
我的医生 阿伦·斯潘诺斯医生 My doctor did, Dr. Alan Spanos.
阿伦·斯潘诺斯 Oh, Alan Spanos.
斯潘诺斯医生 斯潘诺斯医生 Dr. Spanos. Dr. Spanos.
是他开了奥施康定 He--he prescribed OxyContin and...
嗯 他... Yeah, he...
你没事吧 You all right?
嗯 Yeah, yeah.
最初是谁联系你的 And who reached out to you initially?
纽约的一家广告公司 It was an ad agency from New York.
找上你时 是说 And when you were approached,
要拍奥施康定的宣传片吗 was it for a video to promote OxyContin?
不是 他们是说拍公益广告 No, they said it was a public service announcement
宣传疼痛抑制和阿片类药物的使用 for pain management and general opioid use.
你是否感到意外 你叫你的病人参与的 Were you surprised that a public service announcement
公益广告的拍摄 that you asked your patients to participate in
最终被偷梁换柱 ended up being a bait and switch
变成了奥施康定的宣传片 to promote OxyContin?
我觉得宣传片还是很有益处 I thought the video was still very useful.
我们去找过了你的病人 Well, we've been interviewing your patients,
有些人显然都药物上瘾了 and some of them are clearly addicted to drugs.
你可能知道 其中一人还死于了服药过量 As you may know, one of them died of an overdose.
还有一个看上去也离死不远了 Another one appears to be well on his way.
1.5万名医生收到了一段 15,000 doctors were sent a video
你宣传奥施康定的视频 with you promoting OxyContin.
现在看来这些药 And it now appears that these pills
比视频里说的要危险得多 are a lot more dangerous than that video claims.
你不觉得困扰吗 Does that bother you?
我的工作是治疗疼痛 What I'm here to do is to cure pain,
我会用我能用的一切办法来做到这一点 and I shall use everything in my arsenal to do just that.
疼痛治疗在美国严重不足 Pain has been wildly undertreated in this country,
阿片类药物多年来一直背负不公平的中伤 and opioids have been unfairly maligned for years.
奥施康定为我饱受痛苦折磨的病人 OxyContin has worked miracles for my patients
施展了奇迹 who have suffered for years
他们如今都重拾生活了 and who are now getting their lives back.
好吧 Okay, okay.
我们掌握了一段欺诈性的视频 参与者被告知 So we got a fraudulent video of people being told
他们不能提到 not to discuss the exact drug
视频要宣传的那种药物 that they're in the video to promote.
应该足够让科米 Mm-hmm, should definitely be enough
允许我们继续了 for Comey to let us keep going.
除非他已经决定好了 Unless he's already made up his mind.
如果他不让我们查了 你会辞职吗 Would you resign if he shut us down?
不会 你呢 No. You?
不会 但我会很生气 No. I'd be pissed, though.
你还有番茄酱吗 You got another ketchup?
嗯 等一下 Yeah. Hold on quick.
喂 我是兰迪·拉姆塞尔 Hello. This is Randy Ramseyer.
我是雷金娜·卡特 Uh, hi, this is Regina Carter.
你在我公寓留了字条 You--you left a note at my apartment.
是的 是我 Yes, that was me.
我是一位助理检察官 Uh, I'm an assistant U. S. attorney,
我希望能就你大概五年前 and I was hoping that I could interview you
参与拍摄的一段视频 找你问几个问题 regarding a video that you were in about five years ago.
好 Okay.
我们什么时候可以去见你 Uh, when--when could we come see you?
我们是希望尽快见到你 Well, we were hoping as soon as possible.
我们今晚就可以去 We could come by tonight.
-今晚吗 -是的 - Tonight? - Yep.
我们吃完饭刚要走呢 We're just wrapping up a dinner.
里克 你买个单吧 Rick, could you get the check?
我们这就过去 And we will, uh-- we'll head on over there.
我们15 20分钟就能赶过去 We'll be over there in about the next 15, 20.
听着 我的遭遇就是 Listen, what happened with me
我的耐药性上来了 所以药不好使了 was the pill stopped working 'cause my tolerance grew,
医生就不断让我加倍剂量 and doctors just kept doubling my dosage.
最终我每天要服160毫克了 I was eventually taking 160 milligrams a day.
我开始上班打瞌睡 Started falling asleep at work,
丢了工作 lost my job,
我的车 my car,
然后是房子 then my house.
我不得不宣布了破产 I had to declare bankruptcy.
我很遗憾 I am so sorry to hear that.
你怎么停止服药的 How did you--how'd you stop taking the drug?
我渐渐断了药 I weaned myself off.
真是最艰难的事了 Hardest thing I ever did.
但我想着 "我要是不戒了这药 But I thought, "If I don't get off this medicine,
我会死的" I'll end up dead."
你意识到你上瘾后 And when you realized you were addicted,
你还找过斯潘诺斯医生... did you go back to Dr. Spanos to discuss--
才没有 我再没跟那男人说过话了 Hell no, I never spoke to that man ever again.
那视频利用了我们 They used us in that video.
我帮一家公司卖药挣了数十亿 I helped a company make billions selling drugs.
我们都是棋子 I mean, we were all pawns,
让人们以为那药不上瘾 making people think the drug was non-addictive.
我对此没法不心怀愧疚 And I can't help but feel guilty about that.
女士 这不是你的责任 Ma'am, you are not responsible for this.
你是受害者 他们骗了你 他们骗了你 You are a victim; they lied to you, they lied to you.
这样的公司 他们能靠钱摆平麻烦 Companies like this, they buy their way out of trouble.
黑人孩子卖个大麻就要被关进监狱几十年 Black kids selling weed go to jail for decades.
所以我们才找您 Well, that's why we're here.
抱歉打断一下 I'm sorry to interrupt.
大堂里有厕所吗 Is there a restroom in the lobby?
嗯 Yeah.
给 Here you go.
-谢谢 彼得 -不客气 - Thanks, Peter. - sure.
天啊 你居然是个缉毒署探员 God, it's so cool that you're a DEA agent.
我现在都不敢相信 I still can't believe it.
你带枪了吗 So, um, you have your gun on you?
几乎总带 Pretty much always.
你放在哪了 Where do you keep it?
我从未想到 I never thought feeling a gun
感到一把枪蹭我的腿会让我性奋 pressed against my leg would turned me on.
大部分男人觉得我的枪很别扭 Most guys are weirded out by my firearms.
他们不想跟一个有"爷们"工作的人约会 They don't wanna date someone with a "masculine" job.
我为国务院调查 I research Senegalese mineral rights
塞内加尔的矿业权 for the state department.
大家的工作都挺爷们的 Everybody's job is more masculine.
你高中时肯定是最性感的矿物学者 I bet you were the hottest mineralogist in high school.
矿物学者用得好 That's a good use of mineralogist.
你为什么约我出来 Why did you ask me out?
我觉得你可能是 I think you might be one
我见过的最美艳惊人的 of the most strikingly beautiful women
女人之一 I have ever seen.
早上好 Good morning.
我不想太唐突 I don't want to be too aggressive, but, um,
但明晚要一起吃晚饭吗 wanna grab dinner tomorrow night?
我也很想 Oh, well, yeah, I'd--I'd love to, as well,
但我要去外地几天 but I'm--I'm gonna be leaving town for a few days.
好吧 Okay.
等我回来吧 马上就聚聚 How about right when I get back?
好啊 Yeah, great.
-喝咖啡吗 -嗯 - Coffee? - Yes.
-嗯 -嗯 - Yeah. - Yeah.
急诊室中的服药过量患者激增 罪魁祸首是止痛药
哈兰郡疼痛诊所
初诊500美元 Initial consultation's 500.
然后你每28天来续一次药 125美元 Then you come in every 28 days for your refill for 125.
我续药时需要见医生吗 Do I meet with a doctor for my refill appointment?
你想见的话 Only if you want to,
你也可以直接拿药走人 or you can just pick up your prescription.
医生的预约排到下周四了 The doctor is booked till next Thursday,
你可以回家填表 so you can fill those at home if you like.
我今天可以见到医生吗 Is there any way that I can meet with a doctor today?
我的肩膀真的疼得厉害 I have really bad shoulder pain.
大家都是 So does everyone else.
祝你愉快 Have a good day.
你个混蛋 You piece of shit!
过来 Come on!
别动 Don't you fucking move.
起来 Come on.
你听说过可卡因泛滥吗 Have you ever heard of the crack epidemic?
1980年代那在穷人社区非常严重 It was big in poor neighborhoods in the 1980s.
大量黑人可卡因上瘾 Huge portions of the Black population were hooked on crack.
那时候我还是个住在华府的孩子 I grew up in D. C. during this time,
我奶奶家公寓的街对面有间 and there was this convenience store across the street
便利店 from my grandma's apartment.
它的停车场简直是战区 And the parking lot was a warzone.
人们在那里贩毒 相互残杀 People selling drugs, killing each other.
我奶奶被抢劫了三次 My grandma got mugged three times.
我就在这样的环境里长大 卢卡斯 This was how I grew up, Lucas.
眼看我的朋友因毒品而死 Watching my friends die from drugs.
如果你再这么下去 If you continue on this path,
你也会跟他们一样 you're going to end up just like them.
你奶奶现在没事了吧 Is your grandma okay now?
她没事 She's fine.
多谢关心 Thanks for asking.
我不是想抢她的钱 我... I didn't want her money. I was...
我是想偷她的处方 I was trying to steal her prescription.
你怎么知道她有处方 How do you know she had one?
她从疼痛诊所出来的 She came out of the pain clinic.
人人都去那里拿奥施康定的处方 That's where everyone gets their Oxy prescriptions.
你打算拿处方干什么 And what would you do with it?
我班上有个姑娘 八年级的 There's a girl in my class, eighth grade.
她有个哥哥会做假身份证 And she's got this older brother that makes fake IDs,
我们就拿那个去续药 so we use it to get the prescription filled.
拿走一半 卖一半 Take half and sell the other half.
你们学校有多少孩子在嗑奥施康定 How many kids in your school are on OxyContin?
我不知道 I don't know.
一半吧 Maybe half.
这里呢 疼吗 Now how about here? Any pain?
不疼 Nope.
我抬高点呢 疼吗 If I lift higher, does that hurt?
什么感觉都没有 Don't feel a thing.
你觉得你能完全活动开吗 And you--and you feel like you have full range of motion?
对 跟从前一样了 Yeah. Just like before.
你觉得那药的效果能维持12小时吗 You think the drug lasted 12 hours?
-我没计时 -睡眠呢 - Well, I didn't time it. - How about sleep?
能睡整夜吗 Any problems sleeping through the night?
能 效果好的不得了 No, it worked like a charm.
我上周还去打保龄球了 I actually went bowling last week.
我本以为我再也打不了保龄球了 I didn't think I'd ever get to go bowling again.
多谢你 医生 I appreciate it, Doc,
你确定吗 医生 Sure about this, Doc?
你想去州内任何一家牛排店我都能带你去 I'll take you to any steakhouse in the state.
我非常确定 I'm sure as can be.
看看那派 Mmm, look at that pie.
南茜家的鸡肉可是天下无敌 You can't beat the chicken here at Nancy's.
-要什么 医生 -博 - What can I get you, Doc? - Hey, Bo.
你知道我喜欢什么 You know what I like.
-你呢 -一样的 - For you? - Uh, I'll have the same.
你和你爸关系好吗 You and your dad close?
并不太好 Um, not really.
他是个作家 教授 He's a writer and a professor.
我兄弟写短篇故事 他们挺亲的 Brother writes short stories, so they're close.
-妈妈是个诗人 -真的 - Mom's a poet. - Really?
嗯 Yeah.
克林顿总统的继弟
我算是家族里的罗杰·克林顿 I'm sort of the, uh, Roger Clinton of the family.
嗯 Well...
我相信他们也为你骄傲的 I'm sure they're very proud of you.
嗯 Yeah.
你考虑过再次约会吗 So, um, you ever think about dating again, or...
没有 没兴趣 Nah. No interest.
你该去参加我们斯科茨代尔的周末研讨会 Well, you should come to our weekend seminar in Scottsdale.
非常好玩 而且不用你出钱 They're a ton of fun, and it's all expenses paid,
那里有很多不错的女人 and a ton of interesting women there.
医生 护士 疼痛专家 Doctors, nurses, pain specialists.
罗素·博诺伊也要讲话 Russell Portenoy is gonna speak.
-是吗 -嗯 他是主讲人 - He is? - Yeah, he's the main speaker.
谢丽住院时 You know, when Shelly was in the hospital,
我读过他的一些文章 I read some of his articles, and, uh,
帮助很大 they really helped.
真的 Gotta say.
如果你能记住 帮我个忙 Do me a favor if you think of it.
替我跟他说 我很感激 Uh, mention to him that, uh, I'm really grateful.
谢谢了 So thank you.
去参加斯科茨代尔的研讨会 Come to the seminar in Scottsdale
自己跟他说吧 and tell him yourself.
妈妈 Hey, Mom?
怎么了 亲爱的 Yes, dear?
我觉得我们该谈谈 I think there's something we should talk about.
好 Okay.
你可能不愿意听这种话 但是... This may be hard for you to hear, but...
我喜欢女孩 I like girls.
我一直都是这样 I always have.
不是作为朋友 Not just as friends.
我知道爸爸会很难过 And I know--I know Dad is gonna be real upset,
但或许你可以跟他谈谈 but maybe you could talk to him
告诉他 什么都不会改变 and tell him that nothing's gonna be different.
我还是那个人 I'm--I'm still the same person.
真的 I promise I am.
我... I just...
我不能再这么活着了 I can't live like this anymore.
我只想做自己 I just wanna be myself.
对不起 亲爱的 I'm sorry, dear.
你对我说话了吗 Did you say something to me?
没有 No.
那花了多少钱 How much those run you?
我准备好了 I'm ready.
准备好做什么 For what?
我想去 I want to do it.
我想去尤里卡斯普林斯 I want to move to Eureka Springs.
你开玩笑吗 Are you kidding me?
我这一周以来感觉好多了 I've been feeling a lot better this past week.
我意识到你是对的 And I realized you were right.
煤炭只是份工作 Coal's a job.
不是人生 It's--it's not a life.
我想跟你共度人生 I want my life with you.
你真美 贝琪 Your face is so pretty, Bets.
它就不该被煤灰蒙住 It should never be covered in soot.
布丽姬特 我们听说你喜欢来这里 Hey, Bridget. We heard this was your spot.
搞什么 Oh, what the fuck?
布丽姬特 很高兴再见到你 Hey, Bridget. Great to see you again.
你的离婚怎么样了 How's your divorce coming?
判了 要喝一杯吗 It's finalized. Want a drink?
我们都不喝 Uh, neither of us drink.
并不意外 Not surprised.
你不需要这样 You don't have to be like this.
我们是同一阵营的 We're on the same side.
我是在帮你们 I'm helping you.
我想在帮你们避免浪费时间 I'm saving you from wasting your time.
药监局 司法部 医生 他们都想要那药 The FDA, Justice, the doctors, they all want their drugs.
大制药公司则不惜血本 And big pharma will spend everything they can
确保他们拿到药 to make sure that they get them.
这种情况只会一直这么下去 And this is just gonna keep going and going
直到我们变成一个嗑药的僵尸之国 till we're all just one big pill-popping zombie nation.
你看过普渡制药的《我重拾人生》宣传片吗 Have you seen Purdue's I Got My Life Back video?
-当然 -那是谎言 - Sure. - It's a fraud.
他们拍摄时被告知只是公益广告 They were told it was a PSA when they shot it.
而且好几位参与者都上瘾了 And several of those participants became addicted.
还有几个死了 或是要死了 Few of them are dead or close to it.
你们知道谁会对那个感兴趣吗 You know who'd be interested in that?
莎拉·米勒和朱蒂·科恩 Sarah Miller and Judy Cohen.
莎拉·米勒 朱蒂·科恩 Sarah Miller, Judy Cohen.
司法部消费者诉讼办公室的 At the DOJ's office of consumer litigation.
我以为他们都是即将到来的 Well, I thought they were all conspirators
僵尸天启阴谋的成员呢 in the upcoming zombie apocalypse.
也不都是 Not everybody.
我今天只能提供这么多消息了 Now, that was my tip for the day, boys,
麻烦你们二位滚粗 so if you can both kindly fuck off,
那对我会再好不过 I'd certainly be better off for it.
谢谢 布丽姬特 Thank you, Bridget.
很遗憾你离婚了 I'm sorry about your divorce.
我不知道该怎么说了 I'm at a loss for words.
我简直想哭 It--it--it--it almost makes me want to tear up a little bit,
它让我的人生变好了 but I--it--it's just changed my life for the better.
我回到家时还精力饱满 I'm coming home with energy to spare.
晚上还能有精力干点什么 简直前所未有 Just to have the evening to do things with was unheard of.
我们从一开始就跟普渡制药有麻烦 We've been having problems with Purdue from the get-go.
-那个标签吗 -那个标签 - Like the label? - Like the label.
柯蒂斯·莱特批准 So when Curtis Wright approved
最初那个药监局标签时 内部有反对吗 the original FDA label, was there internal pushback?
当然 Oh, yeah.
黛安·斯奈泽勒给他发电邮说 Diane Schnitzler emailed him that
普渡制药宣称的"不易上瘾"听上去像鬼扯 Purdue's "less addictive" claims sounded like bullshit.
莱特先生怎么说的 What was Mr. Wright's response?
他说 "其他 戴安 这真是真的" He said, "Actually, Diane, this is literally true."
柯蒂斯·莱特是药监局的医疗审核官 So Curtis Wright is the FDA medical review officer
为普渡制药批准了前所未有的标签 who approves an unprecedented label for Purdue.
然后他又去了普渡制药工作 And then he goes and he works for Purdue.
你觉得他跟普渡制药达成交易了吗 So do you think there's quid pro quo with Purdue
所以才用了这么慷慨的措辞吗 to grant such generous wording?
我知道 Yeah, well, I get that
看上去像是腐败 it has the appearance of corruption,
但也可能没有这种事 but it's possible there wasn't.
柯蒂斯·莱特的作法 是行业规则 What Curtis Wright did is the way the industry works.
是旋转门 It's a revolving door
政府人员一离任 where as soon as people leave the government,
就去为他们之前监管的人工作 they go and work for the exact people they were regulating
还能拿五倍的薪酬 这是合法的 for five times the money, and it's all legal.
看上去像是腐败 What appears to be corruption
但系统本就如此 is simply how the system works.
这个广告说 病人每天只需要服两片药 Here's an ad, says patient only needs two pills a day,
但药效往往不能坚持12小时 but the drug often didn't last 12 hours.
所以这样的广告 So how does an ad like this
怎么能获得药监局的审批 get through the FDA approval process?
那你得去问罗纳德·里根了 You'll have to ask Ronald Reagan.
他现在也为普渡制药工作了吗 Does he work for Purdue now too?
不是 但他削弱了药监局力量后 No, but when he gutted the FDA,
药监局就从监管大制药公司 they went from policing big pharma
变成了看他们眼色 to being at their mercy.
39名雇员要负责审阅35000件宣传材料 39 employees are responsible for 35,000 promotional items.
他们怎么可能好好监管 How do they grant proper oversight?
给我五分钟 Just give me five minutes.
这是个信誉体系 It works as an honor system.
制药公司要诚实 Drug companies are supposed to be honest.
是啊 I know.
所以 如果有公司在宣传营销上 So if a company was being criminally dishonest
有违法的欺骗行为 in its promotional marketing,
而诈骗的标准又太高 what would you charge them with
你们会怎么起诉 if--if fraud was too high a bar?
莎拉 Sarah?
你们可以先出去一下吗 Can you all give us a moment?
如果是我 就起诉他们违法贴假标签 If it were me, I'd charge them with criminal misbranding.
没听说过这种罪名 Never heard of that before.
大部分人是没听过 Most people haven't.
非常适合这件事 因为你不需要证明 It's perfect for this because you don't have to prove
假标签导致了服药过量 the misbranding caused the overdoses
或是指向某个具体的人 or pin it on an individual,
只需要证明公司给药物贴了错误标签 just that the company misbranded the drug.
谢谢 Thank you.
不客气 You're welcome.
我想要更多热水 I want more hot water.
还要吗 你都要煮熟了 More hot water? You're already boiling.
这够了吧 亲爱的 I think that's enough. All right, sweetheart?
你冲我吐舌头吗 You stick your tongue out at me?
给我吧 拿到了 Let me take that. Oh, I got it.
我拿到你的舌头了 好吃 I got your tongue. It's pretty good.
好 嘘 Okay. Shh, shh, shh.
查到什么了 What do you got?
不妙 Nothing good.
司法部不喜欢制药公司的案子 Main Justice doesn't like the pharma case.
但等等 But wait--wait-wait a minute, wait a minute.
你知道为什么吗 Do you know why?
现在就让我停手太早了吧 Seems pretty early to pull the plug on me.
我不知道详细情况 I don't have details.
只知道科米不喜欢这件案子 Just that Comey doesn't like the case.
好吧 知道了 谢谢 All right, got it. Thanks.
怎么了 What's wrong?
上面想停止我的制药公司案 DAG wants to shut my pharma case down.
这也太急了吧 Isn't that a little fast?
我一直知道我们可能 I always knew there was a chance
会被司法部叫停 we might get shut down by Main Justice.
要我说 这烂透了 It's pretty crappy if you ask me.
等我们去找科米时 可别说"烂透了" I wouldn't say "crappy" when we go to Comey.
他不喜欢那样的语言 He doesn't like that kind of language.
不 那是阿什克罗夫特 No, that's Ashcroft.
我听说有次科米说了"粪" 就被他骂了 I heard he dressed Comey down one time for saying "turd."
如果科米叫我们停止查案 我就说 Comey tells us the case is off, I'm gonna say,
"这真是个大粪堡 先生" "Well, that's one big turd burger, sir."
听着 我们回来后第二天 So, uh, listen, day after we get back,
我得去做手术 I gotta have surgery.
然后请假一周 I'm gonna be out for a week.
你没事吧 You okay?
我得了前列腺癌 I have prostate cancer.
他们花了点时间才找到 但没事的 It took 'em a minute to find it, but it's fine.
他们认为没有扩散 They don't think it spread.
就需要一周时间 Just, uh--just need a week.
我很遗憾 兰迪 I'm so sorry, Randy.
休两周 三周 你需要多久都行 Just take two weeks off, or three, as long as you need.
不 一周就行 No, I just need a week.
我可以为你祈祷吗 Is it okay if I pray for you?
-现在吗 -那也行 - Right now? - I could.
不 不用了 Oh, no. No, it's all right.
我不信那个 It's not really my thing.
还是谢谢了 Thank you, though.
我去找找餐巾 I just want to see if I can find some napkins.
好 让我来应付 Okay, so just let me handle this.
哪怕科米说我们没戏了 也不代表我们没戏了 Even if Comey says we're dead, it doesn't mean we're dead.
那代表什么 Then what does it mean?
代表我们没戏了 It means we're dead.
我接到了关于你们调查的投诉 Getting some complaints about your investigation.
说你们失控了 That it's out of control.
这绝不属实 先生 Well, that's just not true, sir.
我们每一步都是照章办事 We--we've been doing this whole thing by the book.
他们也非常专业 These guys are behaving like pros.
而且此事非常严重 And this is a very serious issue that warrants
我们投入的关注度很有必要 all the attention we've been giving it.
严重 Serious?
鸡能严重到什么程度 Well, how serious does chicken get?
-鸡 -什么鸡 先生 - Chicken? - Chicken, sir?
对 鸡 Yes, chicken.
什么意思 鸡 What do you--what do you mean by chicken?
你是说 Do you mean, like,
吃的鸡 还是害怕 chicken the food or chicken you're scared?
胆小如鸡 Like you--you're a chicken?
吃的鸡 Chicken, the food.
你们为什么要调查养鸡的 Why are you investigating the chicken guy?
山德士上校吗 Colonel Sanders?
不 是弗兰克·普渡 No, Frank Perdue.
不 先生 不不不 Oh, no, sir. No, no, no, no.
我们不是在调查普渡农场 Uh, we are not investigating Perdue Farms.
我们是在调查普渡制药 We are investigating Purdue Pharma.
拼写不一样吧 It's--it's spelled differently, I think.
是啊 是U 不是E Yeah, it's spelled with a "U" instead of an "E."
对 普渡制药 Yeah, Purdue Pharma.
是制造奥施康定的那家公司 No, it's the company that manufactures OxyContin.
不是 养鸡的农民 It's not the--the, um-- it's not the chicken people.
肯定是我的手下搞错了 Well, my staff must have been misinformed.
或许对我们提出投诉的人 Well, perhaps whoever's complaining about us
就是想把您搞糊涂 先生 is trying to get you off our track, sir.
而且不是没理由的 现在还早 And for good reason. It's early days.
但我们已经掌握了重要线索 We already have substantial leads.
蛊惑性广告 对成瘾性撒谎 Manipulative advertising, false claims about addiction,
因为普渡在药物安全性的问题上 overdoses are skyrocketing while Purdue continues to lie
欺骗医生 病人 药监局 about the drug's safety to doctors,
导致服药过量持续激增 to patients, and the FDA.
这是件大案 We have a major case here.
那去把案子立住吧 Well, then go make your case.
您要不要来顶 Hey, can I offer you
普渡制药赠送的渔夫帽 a complementary OxyContin bucket hat?
-不了 -我们的光碟呢 - Uh, no. - Maybe one of our compact discs?
-不了 谢谢 -好 - No, thanks. - All right.
-祝您愉快 -谢谢 - Hey, well, enjoy your day. - Okay, thanks.
芬尼克斯医生 很高兴你来了 Dr. Finnix, so glad you could make it.
-谢谢 -挺丰盛 是吧 - Thanks. - Hell of a spread, right?
是啊 Oh, you bet.
我可没说谎吧 I wasn't lying to you.
是啊 No, you weren't.
我想为您介绍罗素·博诺伊医生 Um, I wanted to introduce you to Dr. Russell Portenoy.
-认识你很荣幸 -不 - Pleasure to meet you. - Oh, no.
相信我 是我感到荣幸 The honor's all mine. Believe me.
你客气了 You're very kind.
老实说 我觉得有点傻 I feel a little silly, to be honest with you,
但我带来了你的书 but I actually brought your book down
不知你周末期间 and I wonder if you'd sign it for me
如果有时间 能不能给我签名 over the weekend if you have a chance.
开玩笑吗 我很荣幸 Are you kidding? It'd be my honor.
-好啊 -好 - All right, great. - Great.
别让我们耽误你吃东西 Well, look, don't let us get between you and the food.
-千万别错过龙虾 -好 比利 - Don't miss out on that lobster. - All right, Billy.
我们回头见 And, uh, we'll see you shortly.
-我们就在这边 -好 - We're just over here. - All right.
好 医生 All right, Doc.
我们很荣幸 大家百忙之中 We're honored that you'd take a break
能抽出时间 跟我们共度周末 from your busy schedules to spend the weekend with us,
还有 and--as well as--
国内首屈一指的疼痛组织 the country's leading independent pain organizations.
我们请来了美国疼痛基金会的代表 We have representatives from the American Pain Foundation,
国家疼痛治疗基金会的代表 the National Foundation for the Treatment of Pain,
美国慢性疼痛协会的代表 American Chronic Pain Association,
美国疼痛学会的代表 the American Pain Society,
和美国疼痛药物学院的代表 and the American Academy of Pain Medicine.
但首先 我们想有请 But to start us off, we wanna begin
国内最顶尖的疼痛专家 with the foremost pain specialist in the country.
他是斯隆-凯特林疼痛和缓和治疗服务机构的 He is co-chief of the Pain and Palliative care Service
联合主任 有请罗素·博诺伊医生 at Sloan-Kettering, Dr. Russell Portenoy.
罗素·博诺伊医生
这真的是疼痛治疗史上 This is truly a special moment
一个特别的时刻 in the history of pain care.
医院 医生 智库 甚至药监局 Hospitals, doctors, think tanks, and even the FDA
都在重新思考疼痛治疗的本质 are rethinking the very nature of pain treatment.
我们发现有些阿片类药物 And what we've learned is that opioids, certain kinds,
远不像原本人们认为的那么容易上瘾 are not nearly as addictive as they have been perceived.
麻醉剂是可能会滥用 Narcotics can be abused
也的确不适合所有场合 and are not appropriate in all instances.
但如果医生可以恰当地开药 But when properly prescribed by doctors,
就几乎从不会导致上瘾 they almost never lead to addiction.
大部分立刻起效的阿片类药物 In most immediate-release opioids,
血浆水平在兴奋和痛苦间激烈震荡 blood plasma levels spike between euphoria and pain.
但奥施康定的缓释系统 But OxyContin's time-release system
让血浆水平 causes blood plasma levels
更加平缓 没那么多波峰波谷 to have fewer peaks and valleys,
这制造了平台效应 creating a plateau effect,
这样就没那么容易让人兴奋 which results in less euphoria
也就没那么容易引发滥用 and less potential for abuse.
医生参加了这些周末研讨会吗 And did--did doctors attend these weekend seminars?
是的 很多人都去了 Yes, many of them did.
这是塞缪尔·芬尼克斯医生 This is Dr. Samuel Finnix.
在阿帕拉契亚经营一家诊所 Runs a patient care practice in Appalachia.
德蕾雅是我们从强生公司挖来的 And, Drea here, we stole from Johnson and Johnson
她负责南方 and she, uh, she runs the South.
为我们负责多个南方区域 Covers multiple Southern territories for us.
见到你很荣幸 It's an honor to meet you.
认识你很高兴 Nice to meet you.
我来自阿拉巴马州的一个小镇 I'm from a small town in Alabama,
所以我知道本地医生多重要 so I know how important the local doctor is.
嗯 Yeah.
你给矿工们开奥施康定了吗 Have you been prescribing OxyContin to your miners?
给几个人开了 To a few, yeah.
是很有效 Yeah, it's been-- it's been effective.
这些活动上都发生了什么 And what occurred at these events?
医生往往都被普渡制药拉拢了 Doctors were often co-opted by Purdue Pharma.
你该让芬尼克斯医生谈谈 You should do a talk with Dr. Finnix.
人们肯定会想听到关于他的病人的事 I bet people would love to hear about his patients.
好主意 你觉得怎么样 Great idea. Yeah, well, what do you think?
不 我做不到上去 No, I-I can't really get up
当着大家的面讲话 and speak in front of people.
得了 你才厉害呢 Oh, please. You're far more impressive.
你可是前线工作者 You're on the front lines.
想想看那多了不起 Just think how incredible it would be
如果一个煤炭小镇的故事 if the story of a coal town
能改变全国各地的人的生活 could help change lives all over the country.
是啊 而且很简单 Absolutely. And I mean, it'd be easy.
我来问你问题 You know, I'd be asking you the questions
你不需要添油加醋什么的 so you don't have to embellish anything.
就把你的所见所闻告诉大家 Just, uh, tell people what you're seeing.
让这些城里小子 It'd be wonderful for these city boys
看看我们乡下人怎么做事也好 to see how us country folks get things done.
嗯 行啊 Yeah. Well, uh, sure.
好吧 Okay, I guess.
你来问我问题吗 You're gonna ask me the questions?
是的 我就在你身边 Absolutely. I'll be right with you.
好吧 那看看吧 All right, well. See how that goes.
塞缪尔·芬尼克斯医生 跟我们说说 So, uh, Dr. Samuel Finnix, tell us, what kind of ailments
你的病人通常患什么疾病 do your patients typically have?
我的病人大多是矿工 Many of my patients are miners,
所以我见到的多是背伤 肩拉伤 so I see back injuries, shoulder lacerations,
手骨折 等等 broken hands, things like that.
按您的经验 是不是可以说 And you would say, in your experience,
疼痛是矿区日常生活的一部分 pain is part of everyday life in the mines?
是的 Yes, it is. Yes.
我也有亲身的疼痛经历 I-I have, um, uh, firsthand experience of pain.
我父亲确诊了一种罕见癌症 My father was diagnosed with a rare form of cancer.
我很遗憾 Oh, I'm sorry.
谢谢 他幸存下来了 Thank you. Which he survived,
但眼看他遭受折磨 but watching him suffer through that
是我经历的最艰难的事之一 was one of the--the hardest things that I've been through.
你也亲眼见识过 You also have firsthand experience
那样的病痛吧 with that kind of pain, right?
是啊 I do, yeah.
我妻子患有癌症 My wife had cancer, um,
她过世了 她没活下来 and, uh, well, she passed away; she didn't make it.
我很遗憾 I'm so sorry.
普渡制药 美施康定 Purdue's drug, MS Contin,
在她的弥留之际大大地帮了她 是吧 was very helpful to her in her final days, wasn't it?
是的 是帮了大忙 It was. It was--it was helpful.
所以我愿意让我的病人 That's why I wanted to try OxyContin
试试奥施康定 因为我不希望他们受苦 on my patients because, uh, I don't want them to suffer.
如果真有药 If there's a drug out there
能帮他们 我想试试 that can help them, well, then I-I want to try.
病人们也愿意试 是吧 And the patients are wanting to try it, too, right?
是的 Heck yeah, they are.
我知道大部分人 I know most people don't, you know,
不会去考虑我们山里的人 they don't think about us up there in the mountains.
但这些人 But these people,
要知道 you know,
二战时期 当国家一夜之间 when this country needed to build airplanes,
需要建造飞机时 uh, during World War II overnight,
你们以为那些钢材是怎么来的 where--where do you think that steel came from?
我们驾车经过的桥梁 你们居住的高楼大厦 The bridges we drive across, the high rises you live in,
我们看橄榄球的体育场 stadiums where we all watch football,
那都是钢材 that's all--that's steel.
钢材来自煤炭 And steel comes from coal.
我可能说太多了 Um, I'm probably talking too much.
我说太多了吗 Am I talking too much?
没有 请讲吧 No, please, please.
你以为是谁去把煤 And who do you think digs that coal out of the--
从山坳里挖出来的 out of the mountains in the hollows?
是我的病人们 My patients do.
那工作很危险 It's dangerous work, and...
他们每天都要拿命冒险 they risk their lives every day
就为了让这样的地方能亮灯 to keeps the lights on in places like this.
为了让大城市灯火通明 To keep the lights on in the big cities.
为了让你们美丽的家里有灯光 Keep the lights on in your fine homes.
他们用自己的后背 And, uh, they carry the burden
扛起了建造国家的重担 of building this nation on their backs,
他们理应不需要再忍受疼痛 and they deserve to do it without pain.
所以如果这种药能帮助这些好人 So if this drug can help these good folks
过上更好的生活 养活家人 have a better life and feed their families,
那普渡制药在为这些人 well, then Purdue Pharma is doing these people,
我的乡亲们 服务 my people, a great service, so...
保佑他们 God bless them for it.
-你紧张吗 -嗯 - Were you nervous? - Yeah.
你看上去并不紧张 Oh, well, you didn't look nervous.
-你太棒了 -失陪一下 - You were incredible. - Would you excuse me?
你太棒了 You were absolutely incredible.
我来过上百次这种场合 真的 I've been to hundreds of these, and seriously,
我从未这么感动过 I've never been so moved.
-谢谢 -多谢了 - Oh, thank you. - Really appreciate it.
丹尼尔 介意我 Hey, Daniel. Do you mind if I steal
拉走周末之星一会儿吗 the star of the weekend for just a few minutes?
当然不介意 谢谢 很高兴跟你谈话 Of course not--thank you. Nice talking to you.
我也是 Nice talking to you.
我得跟你说 你为那些 I have to tell you, you spoke for the people
往往在国内没什么话语权的人说了话 that don't often get a voice in this country.
那个 谢谢你说服我上去 Well, look, thanks for getting me up there.
你说得太美了 Oh, it was beautiful.
普渡制药有一个发言人部门 You know, Purdue has a speaker's bureau.
如果你能去是他们有幸 这里可以吗 They'd be lucky to have you. Is this okay?
嗯 那是什么 Yeah. What's that?
我们雇用发言人 Oh, we pay speakers
去全国各地参加这样的活动 to go to events like this around the country.
他们每次讲话能拿五百到三千美元呢 They get $500 to $3,000 for a speech.
那些发言人有钱拿吗 Those speakers get paid?
是的 这不是秘密 Oh, yeah. It's not a secret.
你该考虑一下 You should think about it.
你刚刚在上面表现很好 You were great up there.
那人太棒了 That guy's amazing.
嗯 他是很特别 Yeah. He's, uh--he's really special.
你爸爸的事我很遗憾 And I'm sorry about your dad.
他现在没事了吧 Is he okay now?
嗯 我... Yeah, I, uh...
那是我编的 I made that up.
我爸没得过癌症 My, uh--my dad never had cancer.
这是我第一次 This is the first time
想干你 that I've ever wanted to fuck you.
你想采取下行动吗 You, uh--you want to do something about that?
威廉 还是算了吧 William, I don't think so.
但这虽然是第一次 But just because this is the first time
但未必是最后一次 doesn't mean that it's the last.
每月一次 你可以度过一个愉快的周末 Once a month, you could have a fun weekend for yourself
如果你不嫌烦 and you'd get to see my big smile
还能看到我的迷人微笑 if it wouldn't bother you too much.
我想你的微笑不会让任何人觉得烦 Oh, I don't think seeing your smile would bother anyone.
你不是说药好用吗 I thought you said it was working.
之前是好用 It was.
我就回来 I'll be right back.
在很多案例中 高剂量 There are many cases where a higher dose
很快再次失效 loses its effectiveness fairly quickly
因为病人开始产生耐药性 because the patient develops a tolerance.
这导致服药者很快地再次增加剂量 This makes the user increase their dose again at a fast rate.
这危险吗 And is that dangerous?
当然 Absolutely.
这是奥施康定的服药过量率 It's one of the reasons why overdose rates
要高得多的原因之一 are so much higher on OxyContin.
这是新的数据 These are the new numbers,
可以看到跟最初的 and you'll see a significant difference
发布数据明显不同 from the initial rollout figures.
好多了 Better.
真棒 理查 Really great job, Richie.
太棒了 That's really great.
是啊 销售数据的确是 Yes, yes, there's been a definite improvement
有所提升 in the sales figures.
我们还发现参加了周末研讨会的医生 We also found doctors who attended the weekend seminars
开出的处方是不参加的医生的两倍 have been writing twice as many prescriptions as doctors who don't.
那我们就再多办些周末研讨会 Then we should throw more weekend seminars.
但是更重要的是 剂量翻倍 But, um, more significantly, doubling the dose
不仅解决了爆发性疼痛的问题 not only solved the breakthrough pain issue,
还提高了我们的底线 it increased our bottom line,
因为制造20毫克和40毫克的成本 since manufacturing a 20 milligram or 40 milligram
跟10毫克几乎无异 is almost the same cost as a 10 milligram.
这样收入速度 This is bringing in revenue
要远快于预期 at a much faster rate than projected.
我一直担心一种情况 There's a scenario I've been concerned about.
是什么呢 我亲爱的堂姐 And what is that, my dear cousin?
如果服用40毫克的人 Well, what happens if someone has breakthrough pain
发生了爆发性疼痛呢 and they're already at 40 milligrams?
上一季的销售报告很棒 The sales reports from last quarter were terrific,
以至于 我很高兴地宣布 so much so that I am pleased to announce
我们将推出新产品 that we will be launching a brand-new product.
女士们先生们 又该翻倍剂量了 Ladies and gentlemen, it is time to double the dose again
我向你们推出80毫克药片 as I present to you the 80-milligram pill.