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今天我们要谈 Today, we're gonna talk about
一种称为爆发性疼痛的病症 a medical condition known as breakthrough pain.
我们很想知道为什么没人说过"奥施康定" We were curious as to why nobody says OxyContin
翻 译 草草
毕竟这视频的目的就是推广奥施康定 in a video designed to promote OxyContin.
我不知道该怎么说了 I'm at a loss for words.
校 对 草草 苏葵
让我的人生变好了 It's just changed my life for the better.
奥施康定 每天70毫克
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.
时间轴 Caroline
这药才上市三年 This drug has only been on the market for three years,
就已出现服药过量和犯罪增多的情况 and there's already been a spike in overdoses and crime rates.
后 期 MythCreator
普渡制药在为我的乡亲们服务 Purdue Pharma is doing my people a great service,
总 监 苏葵
保佑他们 so God bless 'em for it.
如果服用40毫克的人 What happens if someone has breakthrough pain
发生了爆发性疼痛呢 and they're already at 40 milligrams?
又该翻倍剂量了 It is time to double the dose again
我向你们推出 as I present to you,
80毫克药片 the 80 milligram pill.
药房
脉搏 体温 Pulse rate, body temperature,
血压 呼吸率 blood pressure, respiration rate.
美国 疼痛协会 赞助
这些是四种生命体征 These are the four vital signs.
他们是身体维生功能状态的指示数据 They indicate the status of the body's life-sustaining functions
而如果这些指示数据偏离了正常水平 and serve as a basic warning to potential health problems
就是在警示可能有健康问题存在 should these indicators be off standard levels.
但我认为 But I would argue
如果我们想 that if we want to ascertain
准确评估病人健康情况 the true health of our patients,
那么这四种生命体征就不够 then these four vital signs are not enough
因为它们不能监控疼痛 because they do not monitor pain.
疼痛 From pain,
可以让我们马上得知病人是否在忍受折磨 we can instantly determine if a patient is suffering.
还有什么 And what better indicator
比疼痛量级更能 for the status of a patient's health
显示病人的健康状况 than the level of their pain?
因此 我今天在这个久负盛名之地向大家提议 Therefore, I propose to you here today in these vaunted halls
医疗界必须将疼痛 that the medical community must make pain
定为第五生命体征 the fifth vital sign.
奥施康定
成瘾剂量
第一季 第三集
看上去好些了 感觉呢 Well, it looks better. How's it feel?
感觉也好多了 It feels a lot better.
很好 我就想听你这么说 Good. That's what I wanna hear.
已经四周了 So it's been four weeks.
我想让你渐渐断药 I wanna taper you off the meds.
从周一开始 我要你 See, starting Monday, I want you to...
一天只服一片药 一直挨到下周一 take one pill a day until the next Monday,
然后我们就完全停药 and then we're gonna stop altogether.
-好 -好吗 - Oh, okay. - Okay?
好啊 Sounds good.
如果你有问题 就联系我 And if you have a problem, you call me.
就像你当初刚受伤时没做的那样 You know, like you didn't do when you first got injured?
嗯 你说了算 Yeah. You're the boss.
是的 我说了算 That's right. I'm the boss.
尤里卡斯普林斯的情况怎么样了 So what's the latest with Eureka Springs?
我们联系了一个地产商 Oh, we called a realtor.
她在给我们找房子呢 She's looking for a place for us.
跟你父母谈了吗 Talk to your folks?
我试过跟我妈谈 Well, uh, I tried to talk to my mom.
怎么样 How'd that go?
他们会觉得我肯定要下地狱 They'll think I'm going to hell,
所以我说什么也不重要了 so it doesn't really matter what I say.
你觉得你会下地狱吗 You think you're going to hell?
不 No.
我一向就不信那些 I never believed in none of that stuff,
即便小时候也不信 even when I was a kid.
那么这方面 Well, then, as far as that goes,
你是不需要担心了 you got nothing to worry about.
除非我真下了地狱 Unless I end up in hell.
嗯 Yeah.
也是 Well, yeah, there's that.
我该拿他们怎么办 What do I do about 'em?
原谅他们 Forgive 'em.
爱他们 Love 'em.
对他们耐心点 Be patient with 'em.
难说 没准有意外效果 You never know. They might surprise you.
去过你的日子吧 贝琪 Go live your life, Bets.
有时只能放手 Sometimes you gotta let it go.
明白吗 You know what I mean?
奥施康定
去他的 Fuck this shit.
我们接到报告称 We are getting reports
医生通过加倍剂量 that doctors have had a lot of success
来治疗爆发性疼痛的效果很好 treating breakthrough pain by doubling the patient's dose,
这让我们想 或者可以 so this got us thinking that perhaps there's a way
避免爆发性疼痛的发生 to prevent breakthrough pain before it even begins,
因此我们想到了... and, uh, this inspired...
个性化剂量
如果一个人需要 Why start someone at 10 milligrams
直接服用20毫克 甚至40毫克 if they really need to start at 20 milligrams,
干吗从10毫克开起 or even 40?
我们并不如病人的医生那样 We don't know the needs of a specific patient
了解他们的需求 所以我们应该 the way their doctor would, so we need to let
让医生和护士知道 physicians and nurses know
他们应该针对病人个性化剂量 they need to individualize the dose.
说得太对了 This is exactly right.
我同意 Yeah, I agree.
很好 迈克尔 很好 It's very good, Michael. Very good.
-我们开始吧 -好 - Let's move on it. - Great.
谢谢大家 Thank you, everyone.
很好 Good work.
保罗 可以留一下吗 Paul, uh, can you stay for a minute?
我想考虑在德国发售奥施康定 I wanna look into launching OC in Germany
作为非处方药发售 under a relaxed status.
-德国 -对 - Germany? - Yes.
如果我们能拿到非处方药授权 If we can obtain a relaxed status,
在那里就不会受管制了 we'd be uncontrolled there.
但德国的监管比药监局还严格 But German regulators are much stricter than the FDA,
应付他们要耗费很多时间 and it's very time-consuming dealing with them.
那是...德国啊 They're, you know, German.
谢谢你的地理课 保罗 Thank you for the geography lesson, Paul.
我知道德国不是美国 I'm aware Germany isn't the United States.
或许我们还是先专注巩固美国市场 Perhaps we should focus on shoring up the U. S.
再考虑向海外扩张 before we start making foreign moves.
我们可以慢慢研究 几个月 几年 And we'll work on it for months or years,
国家又跑不了 and it won't go anywhere.
他们不会同意的 They'll never go for this.
摩迪莫叔叔当初就是这么评论 Well, that's what Uncle Mortimer said
我制造一种针对中度慢性疼痛的 when I told him we should create a narcotic
麻醉剂的想法 for moderate long-term pain.
谢谢 Thank you.
谢谢[德语] Danke schoen.
如果你们能让这些乡村医生 If you can get these country doctors
开出个性化剂量 to individualize the dose,
会得到一个积极的副作用 you get the positive side effect
那就是拿到个性化的奖金 of individualizing your bonus.
好了 All right.
普渡制药还刚进行了 Purdue also just conducted
一项骨关节炎研究 an osteoarthritis study--
替我发一下 pass those out for me--
研究表明 如果病人每天服用60毫克或以下 and it says that if a patient is on 60 milligrams a day or less,
就可以直接停药 不会有戒断反应 they can stop cold turkey without withdrawals.
你们一定要把研究拿给医生看 Now, you make sure you show that to your doctors.
这种药太了不起了 This drug is just amazing.
好了 有趣的消息 All right, now, for a little bit of fun news,
管理层知道你们都工作得多卖力 management knows how hard you all have been working.
我们想表示一下对大家的感激 And, you know, we wanna do a little something to say thank you,
所以我很高兴地宣布 so I am pleased to announce that
普渡制药将发起一项销售比赛 Purdue is starting a sales competition
称为顶尖大赛 called the Toppers Contest.
每个地区销售总额最高的药代表 The sales rep with the highest grosses from each region
将得到一趟费用全包的 is gonna get an all-expense-paid trip
顶尖大赛
百慕大
百慕大之旅 to Bermuda.
好了 大家都去使劲卖 All right, so everybody get out there, you keep selling,
这房间里有个人将会被晒得很黑 and someone in this room is gonna end up with one hell of a tan.
别介意 Don't be offended when I tell you,
为了赢那趟旅行 我会不惜一刀捅了你的脖子 I would jam a knife into your carotid artery to win that trip.
好吧 这样如何 Okay. Well, how about this?
我们翻倍剂量 而且组成搭档 We double our dose and we partner up.
如果我赢了 你就是我的携伴 So if I win, you're my plus-one.
如果你赢了 你带我去 And if you win, you take me.
这样吧 如果你赢了 我跟你走 Or I'll go with you if you win.
如果我赢了 我带别人去 怎么样 And if I win, I'll go with someone else. How about that?
我不是那个意思 Yeah, I mean, that's not really what I was going for.
比利 我觉得你很棒 Oh, Billy, I think you're a riot,
但我只干很性感和很有钱的男人 but I only fuck really hot guys and really rich guys.
你既不性感也没有钱 And you are neither hot nor rich,
但你很有趣 but you are fun.
不犯浑的时候还挺可爱的 Sort of sweet when you're not being a fucking douche,
我们还是做朋友吧 so let's just be friends, okay?
因为这种单向的性张力有些让人厌倦了 'Cause this one-sided sexual tension is getting tired.
如果我赢了比赛 我们可以做在百慕大之旅中 I mean, can we be friends who fuck on the trip to Bermuda
来一炮的朋友吗 if I win the contest?
我会考虑的 Well, I'll consider it.
或许你该升级一下你那破烂了 Maybe it's time for an upgrade from that piece of shit.
我只需要把剂量个性化 I just gotta individualize the dose.
这里太美了 医生 This is beautiful, Doc.
是我最喜欢的地方之一 Yeah, it's one of my favorite spots.
德蕾雅·普莱斯一直问我 You know, Drea Price keeps asking me
你会不会去奥兰多 if you're gonna come to Orlando.
是吗 She does?
嗯 Yeah.
她是真的喜欢你 She sure liked ya.
你就去吧 带她去... Why don't you come down, take her on a--
约个会什么的 take her on a date or something?
约会 A date?
我都不记得约会时该做什么了 I wouldn't remember what you do on a date.
我都不知道该说什么 I don't know what I'd even talk about.
你可以说说... Well, you just talk about, you know--
我也不知道 well, I don't know, actually.
我并不是这方面的专家 I'm not a expert in these matters, but--
你有女朋友什么的吗 Do you have a girlfriend, or what?
-没有 -是吗 - No. No. - No?
有个很性感的药代表 Well, there's this sales rep, actually, who's hot as hell.
喜欢折磨我 Loves to torture me.
她喜欢你吗 She like you?
绝对不喜欢 Definitely not, no.
但她跟我调情 吊着我 But she flirts with me just enough to keep me going, you know?
嗯 Yeah.
这样吧 Here's an idea.
要不你去找个真心喜欢你的姑娘 Maybe you could find a girl who actually likes you.
听上去好糟 That sounds awful.
天啊 看啊 Mmm, boy. Look at this.
-医生 -嗯 - Doc. - Yeah?
我有事想跟你说 I was gonna run something by you.
你会一开始就给病人开更高的剂量吗 Would you ever start your patients on a higher dose?
如果他们的疼痛非常剧烈 If their pain was especially strong,
你会一开始就给他们开20毫克 would you start 'em at 20 milligrams
而不是10毫克吗 instead of, say, 10?
不会 Nah.
如果我给他们开了10毫克 还不够 If I had 'em on 10 and if I had to,
我就再给他们加 I'd just bump 'em up.
-对 -怎么了 - Right. - why?
没事 No, no reason.
我就想问问 I was just, uh, curious, you know?
你服奥施康定的病人都怎么样了 How are your patients doing on Oxy?
挺好 Good, good.
我正要让一个病人渐渐断药 I'm trying to, uh, you know, taper one off.
她不疼了 完全不疼了 She has no pain. Her pain's gone.
没必要渐渐断药 You don't need to taper her.
我刚读到的一项新研究显示 Actually, a new study that I just read said that
如果每日服用剂量低于60毫克 if they're taking anything less than 60 milligrams a day,
就可以立刻断药而不会有戒断反应 they can stop without withdrawals.
我回头发你 I'll send it to you.
不 Nah.
我还是让她渐渐断吧 这样安全 I'd rather have her taper, just to be safe.
格蕾丝 Hey, Grace.
我今晚应该去不了了 I don't think I'm gonna make it tonight.
你说什么呢 What the hell are you talking about?
我都到响尾蛇了 I'm already at the Rattlesnake.
我知道 我... No, I know. I know. I just--
我感觉不太好 I-I'm not feeling too great.
你真的没事吗 Are you sure there's not somethin' going on?
因为你真的好奇怪 'Cause you're acting really strange.
没事 格蕾丝 No. No, Grace.
我没事 就是... Nothing's going on. I just--
我就是不太舒服 好吗 I'm not feeling great, all right?
好吧 如果你需要什么告诉我 Okay. Well, let me know if you need anything.
不 我不需要什么 No. I don't.
-那好吧 再见 -再见 - All right, fine. Bye. - Bye.
该死 Shit! Fuck!
奥施康定 每天70毫克
我一直忍受疼痛 I'd been living with pain for so long,
但突然之间 我重拾了生活 but then almost overnight, I got my life back.
如证物1A As shown in Exhibit 1A
《我重拾生活》宣传片所示 of the "I Got My Life Back" promotional video,
普渡制药颠倒黑白 歪曲药物的基本情况 Purdue manipulated basic facts of the drug,
宣称它基本不上瘾 claiming it is essentially nonaddictive
但它显然上瘾 when it clearly was.
而这些参与者是 And these participants involved
在受骗的情况下参与其中的 were deceived into participating,
他们被告知是在拍摄缓解疼痛的公益广告 being told it was a PSA for pain relief
而不是奥施康定的广告片 instead of an advertisement for OxyContin,
他们中很多人因为用药 现在不是上瘾就是死亡 and many of them are now addicted or dead from drug use.
我们请求调阅一切内部营销材料 So we request access to all internal marketing materials,
研究资料 测试数据 research, and testing data
以判断是否还存在 to determine if there are other deceptions
像已呈给庭上的这种公然的欺骗 as flagrant as the exhibit currently for the court.
法官大人 检方所说的 Your Honor, statements made by counsel
远非事实 in no way even resemble the facts.
我的委托人清楚 My client is aware
在国内的确出现了 there have been addiction issues
成瘾问题 in this part of the world,
但将此事怪罪给普渡制药 but blaming Purdue Pharma for this
无异于将酒驾司机怪罪给百威啤酒 is like blaming Budweiser for a drunk driver.
错的是滥用药物的人 It is the fault of the drug abuser
而不是制造商 and not of the manufacturer.
传票的范围过于宽泛 The scope of the subpoena is overly broad,
他们要求查阅的信息更是机密 and the information contained in their request is privileged.
法官大人 如果没有责任... Your Honor, if there is no liability, then--
这些本地律师似乎不懂 What these local lawyers don't seem to understand
全国都在发生一场疼痛运动 is that there is a national pain movement
规模远超我的委托人和他们的药 that is far bigger than my client and its drugs.
知名疼痛组织 Renowned pain organizations
不仅为我委托人的药物背了书 have not only endorsed my client's medication,
更为广泛使用阿片类药物进行治疗背了书 but the general use of increased opioid treatment.
我的委托人应该拿诺贝尔奖 My client should be given a Nobel Prize,
而不是被传唤资料 not a subpoena for materials.
我比较同意 I actually tend to agree.
不是诺贝尔奖那部分 Not on the Nobel Prize part.
请求的范围太宽泛 The scope of the request is too wide
就目前而言 as it currently stands.
你需要给我拿出更有力的证据 You need to bring me something more compelling
光是一个视频不足以支撑这么宽泛的请求 than a single video for such a broad request.
视频本该足够了 That video should have been enough.
我们再找 Hey, we'll find more.
我们早知道这不会轻松的 We knew it wasn't gonna be easy.
祝你明天的手术顺利 Hey, good luck in surgery tomorrow.
肯定会一帆风顺的 And I know it's gonna go great.
谢谢 我一周后就回来 Thanks. I'll be back in a week.
你需要休多久都行 Hey, you take as much time as you need.
我只需要一周 All I need's a week.
亲爱的 Hey, sweetie.
手术很好 You did good.
医生跟我说过程很顺利 The doctor told me it went really well.
太好了 Oh, good. Good.
你好 你感觉如何 Hey there. How you feeling?
那个...不太好 Oh, a little-- uh, not too good.
你很疼吗 Are you in a lot of pain?
嗯 我是有点疼 Yeah. Yeah. I'm feeling some pain.
你会如何描述你的疼痛 How would you describe your pain?
从1到10 Scale of one to ten?
疼痛评估表
-大概1000吧 -知道了 - Mm, about a thousand. - Got it.
我们会给你 We are gonna go ahead
开20毫克的奥施康定 and give you 20 milligrams OxyContin.
能大大减轻你的疼痛 It will significantly reduce your level of pain.
你有除了奥施康定以外的药吗 Do you have anything besides OxyContin?
为什么是20毫克 为什么不是10毫克 Why 20? Why not 10?
按病人需求个性化剂量 It's standard to individualize the dose
是标准操作 for the patient's needs.
我不要奥施康定 I don't want Oxy.
我们没有效果能与它媲美的 We don't have anything as effective.
而且非常安全 It is completely safe.
给我开泰诺就行 Just--just give me some Tylenol.
我还是 I'm gonna go ahead
给你们看看这份小册子吧 and have you guys look at this pamphlet
是关于止痛药的 on painkillers.
这些药现在很安全了 They're very safe now.
疼痛是第五项 生命体征
兰迪 手术很顺利 Hi, Randy. Surgery went well.
看上去没有问题 但得等 Your margins look clean, but I'll know for sure
病理分析出来才能确定 once the, uh, pathology comes back.
好 Right.
你感觉如何 How are you feeling?
病人不肯使用奥施康定 Patient's refusing OxyContin.
他只要泰诺 He only wants Tylenol.
那药效不够强 It won't be strong enough.
疼痛是新的第五生命体征 Pain's the new fifth vital sign.
是本医院的首要关注点 It's the top priority of this hospital.
我们会抑制疼痛 We manage it.
你们有强效的非阿片类药物吗 Do you have a strong non-opioid?
可以使用1200毫克的布洛芬 We could go with 1,200 milligrams of Motrin.
那样就不那么疼了 但药效不到12小时 It'll knock the edge off, but it doesn't last 12 hours.
奥施康定也不到 Well, neither does OxyContin.
就这样吧 布洛芬就行 That'll be fine. He'll do Motrin.
杰梅恩 Jermaine.
乡下一家药房被闯入 警官被击伤 Break-in at a rural pharmacy, officer shot.
那人只抢了四瓶奥施康定 别的没碰 Guy took only four bottles of OxyContin and nothing else.
我还在肯塔基州看到了一间疼痛诊所 I saw a pain clinic in Kentucky
简直就像瘾君子免下车快餐店 that looked like a junkie drive-through.
你为什么要去肯塔基州 What were you doing in Kentucky?
去做头发 It's where I get my hair done.
该死 布丽姬特 The fuck, Bridget?
你会为此惹大麻烦的 You could get in serious shit for this.
我只是说我看到的 Hey, I'm just making observations
并向恰当的当权机构汇报 and bringing it to the appropriate authorities.
我懂你 Look, I get it, okay? I get it.
但接下来你想干什么 But what's the next move?
你说呢 You tell me.
如果这是可卡因 你就要阻止 Well, if this were cocaine, you'd try to prevent
偷运者把他们运入国内 the smugglers from bringing the drugs into the country
并打击本地毒贩 剿灭大毒贩集团 and target local dealers to bust larger syndicates.
-是吧 -是的 - Correct? - Correct.
我不需要搞钓鱼行动去找毒品 I don't need a sting operation to find the drugs
因为我很清楚毒品在哪 because I know exactly where they are.
-在哪 -在国内的每一间药房里 - Where? - They're in every pharmacy in the country.
所以我无法联系海岸警卫队 So I can't call in the Coast Guard
包围我们的边境 to protect our borders
因为毒品已经进来了 because the drugs are already here.
那么我们该去针对谁立案呢 So who do I bring a major case against?
有后备箱的混蛋吗 Some dickhead with a truck?
肯塔基州的一间烂疼痛诊所吗 A shithole pain clinic in Kentucky?
我不知道 I don't know, okay? I don't know.
但现在有情况 But something is happening here.
一种处方药 A single prescription drug
让乡间地区的监狱人满为患 is filling up jails in rural areas.
给我找个毒品集团出来 Find me a cartel
我就可以去联系海岸警卫队 and I'll call in the Coast Guard,
但现在 这是本地犯罪问题 but right now, this is a local crime issue.
威顿先生 Uh, Mr. Wayton?
缉毒署布丽姬特·迈尔 我们通过电话 Bridget Meyer, DEA. We spoke on the phone.
对 Yeah. Hey.
怎么回事 What's going on?
我们要把柜台加高 We're gonna put in a higher counter,
这样更难跳过来 tougher to jump over.
今年第三起闯入了 Third break-in this year,
他们都是冲奥施康定来的 and all they ever take's the Oxy.
你考虑过不卖这种药吗 You ever think about not carrying the pills?
试了 但他们说我那么干就起诉我 Tried, but they told me I'd get sued if I did that.
谁说的 Who told you that?
普渡制药的那女人 That woman from Purdue.
普渡制药的药代表怎么说的 What did the Purdue rep say?
她一副在帮我的样子 She acted like she was helping me out, you know?
就好像她是我的好朋友 给我善意提醒 Like she was my good friend offering advice.
她说如果我不肯分销她的药 She said if I refused to dispense her drug,
医生和病人可以起诉我 that doctors and patients could sue me,
我会因为诉讼倒闭 and the lawsuits could put me out of business.
不管怎样 我都完蛋了 Either way, I'm screwed.
你知道她的名字吗 Do you have her name?
-该死 -不 - Fuck. - No, no, no.
你得让你的病人停用维柯丁 You've got to get your patients off Vicodin.
多个疼痛基金会的多项研究都表明 I've got one multiple studies from different pain foundations
维柯丁会严重损害肝脏 that show Vicodin is terrible for their liver.
我没有零钱 What--I don't have any change.
缉毒署布丽姬特·迈尔 请下车 Bridget Meyer, DEA. Please exit the car.
我回头再打给你 I have to call you back.
抱歉我说什么零钱 I'm so sorry about the change thing.
我开车时经常被打扰 I get hit up in my car a lot.
我想就本地药房被闯入的事 I'd like to ask you some questions
问你几个问题 about break-ins at pharmacies in the area.
不是我干的 Well, I didn't do it.
我怕刮花我的新马诺洛斯[鞋] I would never risk scratching my new Manolos.
您不是嫌疑人 女士 You're not a suspect, ma'am.
好几家药房被告知他们必须出售 Several of the pharmacists complained they were told
奥施康定 即便他们不想 they had to carry OxyContin when they didn't want to.
-谁说的 -他们说是你说的 - Who told them that? - They said you did.
他们说你拿诉讼来威胁他们 They said you threatened them with lawsuits.
什么 Oh, what?
你开玩笑吧 Oh, you're fucking kidding me.
不 我是想帮他们 Um, no. No. I tried to help them.
我跟他们说医生和病人可以起诉他们 I told them doctors and patients could sue them.
我可没提我的公司 I never said anything about my company.
他们觉得是你在威胁他们 Well, they took it as a threat from you.
他们觉得自己被迫 They felt they were being bullied
出售一种他们不想出售的药 into carrying a drug they didn't wanna carry.
我不意外他们会有误解 Well, I'm not surprised they were confused.
这里的人挺蠢的 They're pretty stupid down here.
近亲繁殖的坏处 That's what happens when you fuck your sister.
是你的雇主指示你 Were you instructed to threaten these pharmacies
威胁这些药房吗 by your employers?
不是 No.
我得走了 And I have to go.
我还有几个问题 I just have a few more questions.
-法律要求我必须回答吗 -不 - Do I have to answer them by law? - No, you do not.
那祝你愉快了 女士 Then you have a great day, ma'am.
见到你很高兴 谢谢请我们来 Good to see you. Thank you for having us.
-不客气 -见到你很高兴 - Oh, of course. - Nice to see you.
你能来太好了 Glad you could come.
看看理查德啊 Check out Richard.
我不知道他还会笑呢 I didn't know he knew how to smile.
那是没搞垮公司的释然之笑 It's a smile of relief he didn't sink the company.
我不知道我是庆幸我们可能创造了热卖药 I don't know if I'm happier we have a potential blockbuster
还是气他真做到了 or annoyed he actually pulled it off.
我听说办公室的人都讨厌他 I heard everyone at the office hates him.
受不了他 Can't stand him.
我跟他说氧可酮是什么之前 You know, he didn't even know what oxycodone was
他都不知道 until I told him,
现在他对每个人都进行微操 and now he micromanages everyone
就好像自己是上帝对医药的馈赠 like he's God's gift to medicine.
他要发表祝酒词了 He's gonna make a toast.
特蕾莎和我想敬一杯酒 Theresa and I would like to toast
庆祝康奈尔赛克勒机构的开幕 the opening of the Sackler Institute at Cornell
我们家族 as we make our family
也成为了美国第一大慈善家族 the most philanthropic in America.
谢谢 摩迪莫 Thank you, Mortimer.
我还想向宴会的主人 我儿子理查德祝一杯酒 I'd also like to toast our host, my son, Richard,
他为我们最新的产品奥施康定尽心竭力 for his tireless work on our latest product, OxyContin.
该药才上市几个月 It's only been out a few months,
已经在疼痛抑制方面 and it's already a major breakthrough
取得了重大突破 in pain management.
敬理查德 So to Richard.
敬理查德 To Richard.
你好吗 Hi. How are you?
你的数据不错 Your numbers are good,
但还可以更好些 but they can be even better.
继续想办法说服医生推行个性化剂量 Just keep pushing your doctors to individualize the dose,
我还会再跟进的 and I will keep checking in.
谢谢 Thank you.
乖安琦 Good Unch.
乖狗狗 Good boy. Good boy.
爸爸讨厌你把它带来办公室 Dad hates it when you bring him into the office.
那就别告诉他 Then, uh, don't tell him.
安琦是什么的简称吗 Is Unch short for something?
怎么了 What's going on?
那个... Uh, so...
-德国是行不通了 -为什么 - Uh, Germany isn't gonna work. - Why not?
我们得证明奥施康定有小的滥用可能 We have to prove OC has minimal abuse liability,
我们不能这么说 and we-we can't make that claim.
这只是消极思维 That's-that's just negative thinking.
我们不能再进行一次长期试验以获取更多数据吗 Can't we run another long-term trial to get more data?
还做过长期试验吗 I wasn't aware there were any long-term trials.
理查德博士 Dr. Richard,
即便我们能让奥施康定作为非处方药 even if we could get OxyContin designated uncontrolled,
它在德国是极有可能作为非处方药 it's highly likely it will be abused in Germany
被被滥用 under that classification
到时就会被重归为处方药 and then be reclassified as controlled.
该死 我受够了这些"不行"了 God damn it, I'm sick of all these fucking noes!
我要个"行" I want a yes.
德国跟美国不一样 Germany isn't like the U. S.
我们别想钻他们法律的空子 We can't maneuver around their laws.
你在浪费时间做一件 You're wasting a lot of time on something
只会被驳回的事 that will get revoked.
这还是文化问题 It's also cultural.
德国人就不相信阿片类药物 The Germans don't believe in opioids.
他们相信痛苦是治疗的一部分 They believe suffering is part of healing.
保罗 可以让我们单独谈谈吗 Um, hey, Paul, will give us a minute?
理查 Richie.
进展很好 It's going great.
真的 It really is.
药的销售有所好转 The drug has turned a corner.
我们处于上升趋势中 We're on an upswing.
你和贝丝该去旅旅游 You and Beth should take a trip.
放松一下 Relax.
你好多年没休息过了 You haven't had a break in years.
我陪陪大卫和女儿们吧 Go spend some time with David and girls.
没时间休息 There's no time for a break.
没有休息可言 There is no break.
也永远不会有 There will never be a break.
我知道我对人很苛刻 Look, I-I know I can be hard on people,
但还有什么比治愈疼痛 but can you think of any greater venture
更伟大的 to help humanity
帮助人类的尝试吗 than curing pain?
我们得把药卖到德国 We need to get this drug into Germany.
拜托 约翰 Please, John, just...
别急着放弃 don't give up so fast.
好吧 Okay.
好 我们继续努力 Okay. We'll-we'll keep trying.
谢谢 Thank you.
这天气算我们走运了 伙计 We got lucky with the weather, buddy.
是啊 No doubt.
很高兴能出来 远离烦恼 It's just nice to get out and get away from things.
是啊 我真想就坐在这里 Oh, amen. I could just sit here
盯着河水看 真的 and stare at the river, to be honest.
现如今的世界真疯狂 Pretty crazy world, these days there.
天啊 真是混乱 Oh, Lord. Lord. Oh, it's a mess.
你读到过或听到过 You know, you read about or heard about
有些项目 any of these programs
当他们觉得谁是同性恋 if you think someone's a homosexual,
就靠祈祷让那人摆脱这种取向 they--they're gonna pray away the gay?
你听说过吗 You ever hear of them?
嗯 我听说过 Oh, yeah. I've heard of that.
-嗯 -怎么了 - Yeah. - Why?
我在格林斯博罗有个朋友 I got a friend up in Greensboro.
他打算把自己的孩子送去那种地方 He's thinking of sending his kid to one.
怎么 你是说那个不好使吗 What, you saying they don't work or something?
那就是卖神油 It's snake oil business.
祈祷是好 I mean, prayer is good,
但它对这事没什么作用 but it's not gonna do any more or less for that
就像对其他事也一样 than it would for anything else.
倒不是我吹嘘《圣经》 医生 Well, not to be a Bible thumper, Doc,
但如果你有那样的孩子 but if you had a kid like that
你又相信《圣经》 and you believed in the good word,
你会想做点什么帮助他们吧 you'd wanna do something to try to help 'em, wouldn't you?
对 但几乎所有研究都表明 Yeah, except most all the research says
那只是人天生的样子 that's just, you know, how people are born.
是他们的本质 It's who they are.
-研究 -嗯 - Research, huh. - Yeah. Yeah.
我不知道 或许吧 I don't know. Maybe.
我有个亲戚的孩子 My cousin's got a kid who's, uh,
可能是那样的 maybe that way.
这完全有违他所信仰的一切 Just, uh, goes against about everything he believes in.
你应该跟你亲戚说 Why don't you tell your cousin
想想看 just to-- just think for a minute
那孩子会有多难受 about how hard it is on that kid.
我不知道他心里能不能过得去 医生 I don't know if he can let it go, Doc.
他当然能 Sure he can.
他可以提醒自己 他对孩子的爱 He can just remind himself that his love for his kid
要比这世上的任何东西都更重要 is bigger than anything else in the world.
他的确爱那孩子 He sure does love that kid.
是啊 Sure does.
你感觉还好吗 You feeling all right?
嗯 我挺好的 Yeah, I'm fine.
就是累了 Just tired.
你没发烧啊 Well, you don't have a fever.
杰瑞 吃饭了 Jer, dinner's up.
主 感谢你的 Bless us, oh Lord, for these are gifts,
无限恩赐 阿门 which are boundless, oh Lord. Amen.
你钓到什么了吗 So did you catch anything?
几条鳟鱼 没必要留着 Well, a couple of trout. Not worth, uh, keeping, though.
-芬尼克斯呢 -没钓到 - And Finnix? - Oh, no.
他并不是真想钓鱼 He wasn't really interested in fishing.
他似乎更想 He seemed, uh, more interested
谈论他朋友的同性恋孩子 in talking about his friend's gay kid.
他为什么要说那个 And why would he do that?
我不知道 那得问他了 I don't know. Have to ask him, I guess.
还把这事看得很重 Sure made a big deal about it, though.
说研究表明 人们天生就是那样 Said how research shows people are born that way,
什么的 so on, so forth.
他心里还是个城里人 That's the, uh, city boy still in him.
他都在这里待了40年了 He's been here for 40 years.
看来他并不是真正的信徒 是吧 Well, I guess he ain't a true believer, then, is he?
父母能听到的最糟的消息 The worst thing that, uh, a parent could hear is that...
就是我们的孩子 Our kid is, um,
是酷儿 男同或蕾丝 queer or gay or lesbian
不管他们现在都怎么叫 or whatever they say now.
如果你是会要了我的命 贝琪 It'd kill me if you were, Bets.
真会要我命的 It'd absolutely kill me.
嗯 Well...
那你是死了 I guess you're dead, then.
你是有话对我说吗 You got something to say to me,
还是想让老芬尼克斯医生替你说 or you want old Doc Finnix to say it for you?
我刚说了 I just said it.
你没听到吗 Didn't you hear me?
你呢 And what about you?
你这次听到了吗 You hear me this time?!
你别在我家里 You don't raise your voice
对你妈这么大呼小叫 听到了吗 to your mom in my house, you hear me?
你不用担心那个了 You don't have to worry about that,
我会走的 爸爸 'cause I'll leave, Dad.
你再不用看你的酷儿孩子了 You won't ever have to look at your queer kid ever again.
好啊 Well...
那样最好了 I think that's best.
-不 -好啊 - No! - Fine.
我这周末就走 I'll leave this weekend.
-你去吧 -不 杰瑞 - You do that. - No, Jer. No.
你哪都不用去 You don't have to go anywhere.
不 我得走 No, I do.
这里不欢迎我 I'm not wanted here.
不 她不用走 No. She doesn't have to leave!
我不在乎 I don't care.
我不在乎 真的 I don't care. I really don't.
杰瑞 我不在乎 Jerry, I don't care.
该死 Oh, shit. Oh, shit.
你检查甲烷监控器了吗 Did you check the methane monitor?
贝琪 你检查甲烷监控器了吗 Besty. Did you check the methane monitor?
嗯 Yeah.
嗯 没问题 没问题 Yeah, it's all clear. It's all clear.
救命 Help!
你看过甲烷监控器吗 Did you read the methane monitor?
当然看了 Of course I did.
埃迪怎么样了 How's Eddie?
说吧 Go ahead.
他们认为他右臂得截肢了 They, uh, think he's gonna lose his right arm.
读数是多少 What was the number?
爆炸前的读数是多少 On the readout, before the explosion?
-是四以上吗 -不是 - Was it above a four? - No.
如果有那么高 机器会直接停摆 When the levels are that high, the machine just shuts down.
但我们都知道有时它不好用 And we both know it sometimes gets disabled,
所以才要你做检查 which is why you're there to check it.
是粉尘让你看不清吗 Was dust obscuring the readout?
说实话吧 Just--just tell the truth.
可能是吧 There might have been.
你知不知道那人可能会因你而死 Do you realize that men might be dead 'cause of you?
而矿井也可能因此被关闭 That it's possible this mine will close?
你知道你造成了多大损害吗 Do you know how much damage you have done?
我不懂 I don't understand.
什么 你不懂什么 What? What don't you understand?
我... I don't--
我不知道我是怎么了 I don't understand what's happening to me.
-谢谢 -我想来点那个 - Gracias. - Hey, I want some of that.
是吗 Yeah?
真不错 Oh, it's really good.
你想去试试吗 You wanna jump in?
-这我会 -等等 - Yeah, I can do that. - Hold on. Hold on.
抱歉 Sorry.
这太好吃了 This is fucking great.
-是工作的事 可以吗 -去吧 - Um, it's work. Is that okay? - Yeah, go ahead.
-没事 -好 - No problem. - Okay.
喂 Hello?
迈尔探员 Hi. Agent Meyer?
我是威顿药房的迈克·威顿 This is Mike Wayton from Wayton's Pharmacy.
我不知道你是不是还在调查 I don't know if you're still investigating
闯入这里的那人 但他被抓到了 the guy that broke in here, but they got him.
在哪抓到的 Where did they catch him?
他的浴缸里 In his bathtub.
他因为服药过量死了 He was dead from an overdose.
他女儿就在隔壁 His little girl in the next room.
我也不想卖那玩意 但那些人... I tried not to sell that stuff, but those people--
布丽姬特 Bridget!
真抱歉 我得挂了 I'm--I'm so sorry. Uh, I-I gotta go.
谢谢你 Thank you, um...
相信我 这不是你的错 and I promise you, it is not your fault.
多谢你这么说 I appreciate that.
-你还想要吗 -不用了 - You want some more? - No, I'm okay.
想在这里站会儿 看看吗 You, uh, want to stop here, take a look?
就这里吧 Yeah, right here.
你们学校有多少孩子在嗑奥施康定 How many kids in your school are on OxyContin?
一半吧 Maybe half.
布丽姬特 Bridget.
这里呢 Down here.
-你没事吧 -我没事 - Are you okay? - Yeah, I'm fine.
我知道我们才约会了九个月 Uh, I know we've only been dating for nine months,
但我对其他任何人的尊重 but I have never been with someone
崇敬 that I respected
在意和爱 and admired and cared for
都不及我对你 and loved as much as I love you.
你是我的英雄 You're my hero,
如果你愿意做我的妻子 and I would be so honored
我会无比荣幸 if you would be my--my wife.
天啊 Oh, my God.
-好吗 -好 - Yes? - Yes!
好 对不起 Yes! I'm sorry. I'm so sorry.
-不用道歉 来 等等 -天啊 - Don't apologize. Here. Wait. - Oh, my God!
-好了吗 -嗯 戴上了 天啊 - You think you got it? - Wait, I got it. Oh, my God!
天啊 Oh, my gosh!
好 Okay.
您找我 长官 You asked to speak to me, sir?
别插手管控部 Stay out of Diversion's domain.
你想说的都说了 我们也听了 You made a presentation, and we listened.
但这绝对不代表你有权 But in no way did this give you the right
开展独立调查 to start an independent investigation.
我明白 长官 I understand, sir.
我立刻就把自己发现的一切 And I immediately gave everything I uncovered
都给了管控部 但我认为我们必须查下去 to Diversion, but I believe we must pursue.
为什么 Why?
斯佩尔曼探员跟我说 Agent Spellman told me
我们之所以不能追查奥施康定的事 that the reason we can't pursue an OxyContin case
是因为我们没毒品集团可查 is that there is no cartel to go after.
这种药在美国是合法的 The drug is here legally
而且医学界现在也广泛 and opioids are now widely accepted
接受了阿片类药物 in the medical community.
但我认为我找到了毒品集团 But I believe I found the cartel.
-是吗 -是的 长官 - Oh, you have? - Yes, sir.
我连他们的地址都有 I even have their address.
康涅狄格州斯坦福德特莱瑟大道201号 201 Tresser Boulevard, Stamford, Connecticut.
那是普渡制药的大总部地址 That's the main headquarters of Purdue Pharma.
他们是奥施康定的制造者 They are the makers of OxyContin,
他们就是毒品集团 长官 and they are the cartel, sir.
他们在向医生和病人 They are lying to doctors and patients
隐瞒药物的危险性 还拿起诉做威胁 about the dangers of the drug, and they are forcing pharmacies
逼迫药房出售该药 to carry it with threats of lawsuits if they don't.
药监局也成了不知情的同谋 And the FDA is an unwitting coconspirator
因为他们向普渡制药签发了一种警示标签 because they issued Purdue a warning label
让他们可以宣传该药不像其他阿片类药物 that gives them cover to say that the drug is less addictive
那么容易上瘾 但显然并不是如此 than other opioids when it's clearly not.
药监局会跟普渡制药合谋吗 Could the FDA be colluding with Purdue?
有可能 It's possible.
批准了这个警示标签中非同寻常措辞的人 The individual who approved this highly unusual wording
如今在普渡制药工作 on the warning label now works for Purdue.
-真的吗 -对 长官 - Really? - Yes, sir.
柯蒂斯·莱特 我们得马上行动了 Curtis Wright. We need to act now.
我们得马上开始追查普渡制药 长官 We have to go after Purdue Pharma now, sir.
马上开始 Right now.
你对你的配枪多有感情 How attached are you to your service pistol?
为什么这么问 Why do you ask?
管控部探员不能拿枪 Diversion agents aren't allowed to carry firearms.
你要调我走吗 Are you transferring me?
不是 No.
不 我要给你升职 No, I'm promoting you.
我要你去管控部 I'd like you to be deputy director
做副主任 of the diversion division.
那边需要个有种的人 They need someone with balls over there.
我接受 I accept.
恭喜 布丽姬特 Congratulations, Bridget.
你现在是缉毒署官阶最高的女性了 I believe you're now the highest ranking woman in the DEA.
谢谢 Thank you.
医生 Oh, hey, Doc.
这是里克·曼卡索检察官 This is Rick Mountcastle, U. S. Attorney's office.
我们想就我们在查的一件案子 See, uh, we wanna ask you a few questions
问你几个问题 about a case that we're working on.
好啊 Sure.
据兰迪说 他的护士曾 So Randy described a scenario in which his nurse
非常咄咄逼人地要他用奥施康定 was quite forceful about him taking OxyContin.
这是常规操作吗 Is that standard?
什么意思 What do you mean?
这是医院的政策吗 I mean, is there some sort of hospital policy
推销奥施康定 to push OxyContin?
如果病人认为我们没能好好抑制他们的疼痛 The hospital can now get sued if the patient felt
医院就可能遭到起诉 that we didn't manage their pain properly.
也可以在网上给我们打差评 Or they can write us a bad review online,
那样的话 工作人员就会被管理层批评 which would cause the staff to be rebuked by management.
有护士因为网上评论被解雇 Nurses have been fired over online reviews.
是光这家医院吗 Is that just this hospital?
不 全国都这样 No. All across the country.
网络改变了很多事 Internet has really changed things.
网络评论让国内的 Online reviews have caused a shift
阿片类药物处方发生了改变吗 in national opioid prescribing?
你感觉怎么样 How are you feeling?
好点了 I'm a little better.
多谢 医生 谢谢 I appreciate it, Doc. Thank you.
那好 我们回头再来看你 All right. Well, I'll check back in.
老护士都很不喜欢 The older nurses hate it.
所有阿片类药物 All the opioids.
我想给你看这个 I wanted to show you this.
疼痛学会渗透了医院 Pain societies have infiltrated the hospital rooms,
他们很喜欢小册子 and they love their pamphlets.
疼痛是第五生命体征
我今天之前就没听过这个说法 I never heard that phrase before today,
现在我满眼都是了 and now it's everywhere I look.
阿帕拉契亚疼痛基金会
谢谢你们来 Thank you all for coming.
我是阿帕拉契亚疼痛基金会的罗杰·瑟比 I'm Roger Thurby from the Appalachian Pain Foundation.
我们今晚要谈论社区内的阿片类药物使用 We're here tonight to discuss opioids in our community.
我们知道此事最近颇受关注 We know they've been getting a lot of attention lately
很多人都因上瘾饱受折磨 and there's been some folks struggling with addiction,
所以我们叫来了相关专家 so we decided to gather experts on the situation
公开进行讨论 and discuss it publicly.
首先 我要把麦克风交给 First, I'd like to turn the microphone over
芭芭拉·穆林斯女士 她是《疼痛周刊》的 to Ms. Barbara Mullins, who's on the editorial board
编委会成员 of the "Journal of Pain."
谢谢今晚请我来 Thank y'all for having me here tonight.
阿片类药物滥用的确在成为趋势 Opioid abuse is certainly growing,
但一定要区分药物滥用者 but it's important to distinguish between abusers
和真正需要治疗疼痛药物的病人 and legitimate pain patients who need these medicines.
这是一致意见吗 So is this a consensus?
问题不在于药 而是滥用者本身 Pills aren't the issue, it's the addicts abusing them?
当然 但我也认为 Absolutely, but I also think it's important
制药行业要更加努力 the pharmaceutical industry does a better job
跟执法部门合作 working with law enforcement
避免这些产品流入滥用者手中 to keep these products out of the hands of abusers.
他们也要承担一定责任 They have some responsibility here too.
我的坐骨神经痛很严重 Uh, my sciatica was so bad
我早上都无法起床 I couldn't even get up in the morning.
我终于要恢复正常了 And right when I finally get back to normal,
我好怕我的药会因为这些瘾君子 I'm terrified my drugs are gonna be pulled
而被撤掉 'cause of these junkies.
不会的 女士 Absolutely not, ma'am.
我们在尽全力确保 We are doing everything in our power
您能用上药 to make sure you get your medication.
是 后面的先生 Yes, sir, in the back.
我听一些人说 I've been hearing from some folks
真正的问题在于奥施康定 the real problem is, OxyContin is
其实比制药商说的更易上瘾 much more addictive than its maker claims.
-这是真的吗 -不 那是误解 - Is there any truth to that? - No, it's a misconception.
维柯丁滥用/销售比 Vicodin is actually being abused
其实要高得多 at a much higher rate of its total sales.
是啊 高得多 That's right. Much higher.
其实 维柯丁可能会损害你的肝脏 And actually, Vicodin is potentially bad for your liver.
我是不会用它的 I personally wouldn't use it.
我也是 I wouldn't either.
它有成瘾性 It has addictive qualities,
而只有不到1%的人会对奥施康定上瘾 whereas less than 1% of people become addicted to OxyContin.
-你感觉怎么样 -我挺好 - Hey. How you feeling? - I'm good. I'm good.
-你们好吗 -挺好 我们想你了 - How y'all doing? - Good. We missed ya.
他们在会议室呢 Hey, the guys are in the conference room.
去跟那些疯子谈了 Get in here and talk to these maniacs.
疼痛学会已经推广很多年了 Pain Society has been pushing them for years,
一旦疼痛被认可为第五种生命体征 and once pain became accepted as the fifth vital sign, yeah,
强生就从反阿片类药物转变成了支持 J-Co went from anti-opioid to pro-opioid.
格雷格 Hey, Gregg!
听上去是在说很有趣的事呢 Conversation sounded like a barrel of laughs.
我可以拿瓶汽水也来听听吗 Mind if I grab a sarsaparilla and join y'all?
兄弟 你说休一周 Brother, when you said one week,
就休一周啊 you really meant it.
兰迪 你感觉如何 Randy, how are you feeling?
我可能没事了 I think I just might be in the clear.
所有检测都是阴性 Everything's negative.
太好了 That's wonderful news.
这些疼痛基金会都什么情况 So what have we got on these pain foundations?
完全合法 是吗 Totally legit, right?
都是群有一说一的人 Just a bunch of straight shooters.
是啊 年度人道主义大师 Yeah. Humanitarians of the year.
首先是阿帕拉契亚疼痛基金会 Uh, started with the Appalachian Pain Foundation.
我调出了他们的纳税申报单 你说对了 里克 Pulled their tax returns, and you were spot-on, Rick.
2000年 他们收到了来自普渡制药的两万美元拨款 In 2000, they got a $20,000 grant from Purdue Pharma
用于成立该组织 to literally start their organization.
你怎么发现的 What tipped you off?
他们在猛推奥施康定 而贬低维柯丁 When they were pushing OxyContin and trashing Vicodin.
真含蓄 Subtle.
你查到普渡制药和其他疼痛组织的联系了吗 Did you find Purdue connections with other pain societies?
先生们 坐稳了吧 Gentlemen, it is time to buckle up.
美国疼痛学会宣称 The American Pain Society claims
他们是独立医学团体 to be an independent medical group
代表了疼痛医疗专家 representing physician pain specialists,
但它的资金有相当一部分 but it receives a sizable portion of its funding
来自制药行业 from the drug industry,
包括来自普渡制药的大额拨款 including significant grants from Purdue Pharma,
在他们的大力资助下 who are one of the biggest beneficiaries
该学会成功将疼痛 of the society's successful effort
定义为了第五生命体征 to make pain the fifth vital sign.
疼痛是第五生命体征
普渡制药还大笔花钱 Purdue also spent heavily
资助美国疼痛药物学院 to subsidize the American Academy of Pain Medicine
1997年 and, in 1997,
花了50万美元资助由这两个团体 spent $500,000 to underwrite the work of a joint committee
组成的委员会推出一份报告 formed by these two groups, which issued a report
敦促更广泛地使用强效麻醉剂 urging the broader use of powerful narcotics.
普渡制药还慷慨地资助了 Now, Purdue also contributed generously
病人宣传团体 to patient advocacy groups,
比如国家疼痛治疗基金会 like the National Foundation for the Treatment of Pain
美国慢性 疼痛协会
美国慢性疼痛协会 and the American Chronic Pain Association,
但实际上 他们资助了 but in effect, they helped fund
一整个疼痛团体网络 an entire network of pain groups
他们打出独立机构的名号 that represented themselves as independent,
却都在大力推广阿片类药物的使用 but all heavily promoted the use of opioids.
请求上前 法官大人 Uh, permission to approach the bench, Your Honor?
您可能见过这份疼痛表 Now, you might recognize this pain chart,
因为全国各地的医院病房里 as, uh, it's in hospital rooms and doctor's offices
医生办公室里都有 all across the country.
它由对抗疼痛伙伴组织提供 It's from the organization Partners Against Pain,
该组织表面上是教育联盟 which is ostensibly an educational alliance
致力于疼痛治疗 dedicated to the treatment of pain,
但实际上 but, in fact,
它完全由普渡制药资助经营 it is fully funded and run by Purdue Pharma.
完全属于普渡制药 It is 100% Purdue-owned.
它事实上就是普渡制药的影子公司 In effect, it's Purdue's shadow company,
他们渗透了 which has infiltrated
医院病房 医生办公室 hospital rooms and doctor's offices
神不知鬼不觉地带动医生 as a stealth tool to prompt pain discussions
护士和病人探讨疼痛 between doctors, nurses, and patients
目标就是开出更多阿片类药物 with the goal of prescribing more opioids--
反对 推测 Objection. Conjecture.
普渡制药从未隐瞒与 Purdue has never hidden its relationship
对抗疼痛伙伴组织的关系 with Partners Against Pain.
那为什么不在这些疼痛表上标注普渡制药 Then why not put Purdue Pharma on these pain charts
而是要用另一家公司的名号 instead of a different company name?
法官大人 Your honor, th--
继续 Proceed.
对抗疼痛伙伴组织还有个网站 Partners Against Pain also has a website
假装成了病人宣传团体 masquerading as a patient advocacy group
对抗疼痛伙伴组织
就为了引导忍受疼痛的人去看专家 to guide pain sufferers to specialists,
获得你需要的缓解
疼痛治疗发生改变
脑扫描显示纤维肌痛让痛觉更敏感
但它让你去看的专家 but every specialist that it sends you to
都是开奥施康定的频率很高的医生 is a doctor with a very high rate of prescribing OxyContin.
所以疼痛团体都是部分或完全 So pain societies partially or fully funded
由普渡制药和其他制药公司资助的 by Purdue Pharma and other pharmaceutical companies
他们实际上就是大制药公司的宣传机器 are de facto propaganda divisions for big pharma.
这种欺骗如此有效 普渡制药的一些药代表 The deception is so effective that some sales reps at Purdue
爆发性疼痛
还以为自己用的是独立数据 thought they were using independent data
并引用来自美国疼痛学会的研究 when they were quoting studies from the American Pain Society
还喊出"疼痛是第五生命体征"这样的口号 with slogans like, "Pain is the fifth vital sign."
当然了 疼痛的解决方案 And, of course, the solution for pain
永远都是加大阿片类药物的使用 is always, always an increased use of opioids.
这五年里的使用增长如此迅猛 And it's an increase so high in the last five years
只能与 it's at levels not seen
《哈里森麻醉剂税法》实施前的情况相比 since the run-up to the Harrison Narcotics Tax Act...
那是1914年了 of 1914.
谢谢 法官大人 Thank you, Your Honor.
准许调阅与营销 研究 Permission granted to release requested documents
和分销相关的文件的请求 relating to marketing, research, and distribution.
好啊 All right.
抓住他们吧 老大 Go get 'em, Boss.
我知道你们都很想知道 I know you all are dying to know the results
顶尖大赛的结果 of the Toppers Contest.
好了 但我宣布赢家之前 All right, but before I name the winner,
我得说 I just have to say
你们这季的表现太棒了 what an incredible quarter you had.
"个性化剂量"让很多医生 "Individualize the Dose" got a huge number of doctors
直接从20毫克开始 有人甚至从40毫克开始 to start at 20 milligrams, and some at even 40!
你们太棒了 You guys fucking rock!
但赢家只能有一个 All right, but there can only be one winner.
本季的赢家就是 And this quarter, it is...
托德·布朗沃德 Todd Brunward.
太好了 好啊 Fuck yeah! Come on!
好了 All right. All right.
托德 Todd, Todd sold
卖出了76.7万美元的奥施康定 $767,000 worth of OxyContin,
是国内最高的之一 one of the highest in the nation.
托德 上来吧 Todd, come up here.
跟大家说说你怎么做到的 Tell everybody how you did it.
就是靠卖力 Well, you know, it was all hustle
和决心 and determination.
我走访了我信息管理系统名单上的每位医生 Yeah, I went to every doctor on my IMS sheet
跟他们讲了我们的药 and, uh, told them what we got here.
大骗子 他才没卖力呢 He's such a liar. He didn't hustle shit.
-什么意思 -他找到了靠山 - What do you mean? - He has a whale.
有个医生在开药房呢 One doctor running a pill mill.
什么意思 What's a pill mill?
就是疯狂过度开药的医生 It's a doctor who overprescribes like crazy.
如果你能找到这样的人就赚翻了 It's a total gold mine if you can land one.
托德每个月就干几小时 Todd works a few hours a month,
然后整天打电游 抽大麻 then plays video games and smokes pot all day.
他靠药房医生赢真不公平 It is so unfair that he wins with a pill mill.
嗯 Yeah.
他难道不该举报这样的医生吗 Shouldn't he report a doctor for something like that?
如果他敢举报可能会被解雇 He'd probably get fired if he reported him.
普渡制药想要这样的人吗 So Purdue want whales?
当然了 Oh, sure.
你可不想断这种人的财路 You don't wanna shut a whale down.
而是要拉拢他 You wanna reel it in.
塞缪 Sam.
你不知道见到你我多开心 Oh, I can't tell you how happy I am to see you.
-太久没见了 -是啊 - It's been way too long. - Way too long.
你看上去很棒 Yeah, you look wonderful.
-得了 -你干什么了 - Oh, come on. - What'd you do?
有时我会想到你一个人守在家里 I sometimes think about you all holed up in that house
让我心疼 and it just breaks my heart.
谢丽也不会希望这样的 It's not what Shelly would want.
那都怪她 Well, it's her fault.
是她把我拉去了山里 She's the one that dragged me down to the mountains.
但她知道你也会跟她去 Yeah, but she knew you'd follow her.
是啊 Yeah, she did.
-你后悔过吗 -后悔什么 - Do you ever regret it? - Regret what?
在阿帕拉契亚待那么多年 Spending all those years in Appalachia?
作为班级第一从杜克毕业 Top of your class at Duke,
拿到约翰霍普金斯的奖学金 a fellowship at Johns Hopkins.
挺厉害的 It's pretty heady stuff.
-是啊 是不错 -嗯 - Yeah. That's pretty good. - Yeah.
不 No.
我喜欢那里 I like it down there.
并不是我计划好的那种人生 Yeah, I mean, it's not exactly the life I had planned,
但挺不错的 but it's been good.
挺好的 It's good.
直到你妹妹走了 Until your sister left.
我也想她 I miss her too.
但你还有很长的人生呢 But you got a lot of years still.
是啊 Uh, yeah.
这其实... That's kinda...
就是我想过来 kinda why I wanted to come up here
看看你的原因 芭芭拉 and visit with you, Barbara.
就是 You know, this whole idea
再次约会的事 of, uh, dating again,
光是说起来就觉得奇怪 I mean, it's really, you know, odd just saying dating.
但是... But...
我不知道 I don't know.
首先 让我觉得 First of all, it makes me feel...
愧疚 guilty.
就好像我在对不起谢丽 Like I'm doing wrong by Shelly, you know?
你是遇到什么人了吗 What, did you meet someone?
我不知道 I don't know.
可能吧 Maybe.
塞缪 如果你余生 Sam, if you spend the rest of your life
都锁在那栋房子里 locked away in that house,
那才是对不起 you will be doing a great disservice
你娶的那个烈性子的女人 to that spitfire you married.
但这真的可以吗 But is it really okay?
你在拿痛苦当作不去生活的借口 You're using your pain as an excuse not to live.
但你该重新开始生活了 But it's time to start living again.
喂 Hello?
哎呦喂 Well, be still my heart.
是我的白马王子吗 Is this my knight in shining armor?
大概是吧 Oh, well, yeah, I guess.
拜托告诉我几周后我们会在奥兰多见面 Please tell me I'm gonna see you in Orlando in a few weeks.
嗯 Yeah, well, uh,
我其实就是为这事打来 actually, that's why I'm calling.
我想问问你是不是还希望我去 I, you know, wanted to know if, uh, you still wanted me to.
-当然了 -那好 - Well, of course, I do. - Well, good. Good.
是啊 你还要再发表讲话 Yes, and you're gonna make another speech,
而这次你还有钱拿 and you're gonna get paid for it this time.
带泳裤来 Bring your swim trunks.
好啊 Oh, all right.
我恐怕没有 Well, I don't know if-- not sure I got any,
但我会去买一条的 but I'll, uh--I'll swing by and pick some up.
那个...我再打给你 Hey, can you-- I'm gonna call you--
我回头打给你 call you a little later.
我得接下电话 I gotta take this call here.
-嗯 好 周三见 -好 好的 - Yes. All right. See you Wednesday. - All right. All right.
好 很期待 All right. Looking forward to it.
喂 Hello?
芬尼克斯医生 你在哪 Dr. Finnix, where are you?
我在华府 我来看谢丽的姐姐了 I'm in D.C. I'm visiting Shelly's sister.
快回来 Well, you gotta come back.
矿井发生了爆炸 There was an explosion at the mine.
多严重 How--how bad?
没死人 Everyone's alive,
但很多人入院了 but a bunch are at the hospital.
贝琪·马勒穆伤得挺重 Betsy Mallum is in bad shape.
好的 我就回去 Okay. All right. I'm on my way.
-早 -早 - Morning. - Morning.
几个箱子要这么大的车装吗 Big truck for just a couple boxes.
他们要拿文件淹死我们 They're drowning us in paperwork.
这还不到一半呢 This isn't half of it.
天啊 Oh, Lord.
光是分类就得花一年时间 It's gonna take us over a year just to catalog all this.
他们在此期间还将继续卖药 And they'll keep selling pills the entire time.
我们找过了德国监管部门 So we've been talking to the German regulators,
但还是不断碰壁 and we just keep hitting a brick wall.
你为什么要挑 Why did you have to pick
世界最不好申请非处方药的国家 the hardest country in the world
申请非处方药 to get a drug uncontrolled?
跟我来 Follow me.
抱歉打扰 但可以让我跟我弟 I'm, uh, sorry to bother you, but would you mind giving me
单独待会儿吗 a few minutes alone with my brother?
我之所以要拿下德国的非处方药审批 The reason why I want to get relaxed status in Germany
正是因为 is precisely because
他们的确拥有欧洲最严格的规章 they do have the strictest regulations in Europe.
如果能在德国通过 If we get Germany uncontrolled,
即便最终被取消 even if the status is eventually revoked,
它也会为我们打开整个欧洲的大门 it will serve as a gateway to the rest of Europe,
这样我们就能打开大部分全球市场了 which will then open us up to the majority of global markets.
这家族史上没有谁 No one in the history of this family
能与我们将实现的成就相提并论 will ever come close to accomplishing what we're gonna do.
我们要治好整个世界的疼痛 We're going to cure the world of its pain.
很遗憾 X光片显示 So unfortunately, the x-rays show
你断了四根肋骨 you've got four broken ribs.
嗯 我看到了 Yeah. I saw it there.
谢谢 医生 Thank you very much, Doc.
芬尼克斯医生 别急 Uh, Dr. Finnix, please don't rush.
-这伤很重 -我知道 - This is a real injury. - I know.
我知道 I know, yeah.
但我有点着急 I'm just in a little bit of a hurry here.
按1到10的级别 你认为你的疼痛是几级 On a scale of one to ten, how would you rate your pain?
那是什么 What is that?
我没戴读书镜 I don't have my, uh-- my readers.
这是疼痛评估表 It's a pain assessment chart.
我没见过这个呢 Oh, I've never seen one of those.
我不知道 I don't know.
五 六吧 就算是五吧 5, 6, call it a 5, I don't know.
好 All right.
我给你开20毫克的奥施康定 I'm gonna start you at 20 milligrams of OxyContin.
20毫克 20?
我一般都给我的病人开10毫克 I usually start my patients at, uh, 10.
我喜欢个性化剂量 Well, I like to individualize the dose.