The Last Trial: Scott Turow
With the pandemic at its highest in some states and in others hopefully slowing down, this novel comes at a time when we reflect on the choices made by pharmaceutical companies hoping to create a drug that will cure an illness, prevent it from coming back or a vaccine that the public will have to take yearly just like the one for the flu.
This story centers around a drug or medication called g.Livia hopefully one that will cure different types of type 2 cancers. Tumors after taking this drug are thought to shrink and in many cases the patients do very well but what happens when the FDA approves a drug before enough clinical trials are done? What happens when the side effects are not equally spelled out and at first patients soar and do very well and then an allergic reaction to the medication takes over and the patient dies a horrific death.
Dr. Kiril Pafko a former Nobel Prize Winner is the one facing charges of insider trading, murder, and fraud. All that he stands for is up and placed in the limelight. These charges are strong and to win and be acquitted he enlists the help of 85-year-old Alejandro “Sandy,” Stern as his legal defense including his daughter Marta and unique and colorful granddaughter Pinky.
Stern is a cancer researcher and has taken this drug successfully. Pafko has a shady past and his failing are laid out by the prosecution in detail one at a time. Is he innocent of the charges laid against him? Will Stern risk it all to win this case. His health is failing, his heart is not up to par and the prologue lets us know that one member of the league community has a heart attack but just who was not revealed.
The trial is intense, and the Judge plays no favorites although she has allegiances in some ways to both Stern and Moses the prosecuting attorney. Respect for the law is paramount and the Judge will not take sides and reprimands are dealt as she sees fit when rules are not adhered to and questions are asked that she specifically outlined as not to be included when asking witnesses questions. Kiril is said to have committed many crimes and the victims died after taking g-Livia but the question that remains in the minds of many is without this drug would they die anyway? Did the drug help them in any way? Did they ever get any better and when asking an epidemiologist his expert opinion about allergic reactions and the percentage of cancer patients that recover from treatment, it took him a while to use his phone to scroll down for the answers making it seem that he was unsure of his responses and yet he stated he is not an allergic reaction.
The trial is quite descriptive and the evidence and the cross examinations on both sides are long, explanations of procedures explained so that readers understand why Kiril is on trial and why this drug might not be safe for cancer patients yet there are many hidden truths that come out.
This drug was first given Breakthrough Therapy designation. Patko is charged with securities fraud for insider trading that she told PT stock right are he received the call from the Wall Street Journal reporter. The author then explains about the witnesses that would be called when Stern resumes his opening statement that these witnesses are there to say what the government wants them to say. They will not be prosecuted for their role in the events they are testifying about. He is also being charged with murder for the deaths of patients that were given the drug and they claim they dies of an allergic reaction but in most cases they were doing better at first and no one knows what caused this reaction. A complex trial and clinical trials of two separate patient groups: One that receives the real drug in question and the other a placebo. The data is carefully organized and the findings are hidden so that no one knows which patients are in which group and the final results are not revealed as yet because the data is huge, the understanding of and ramifications of what they show could prove that Karil might be guilty and knew that the drug was not really for FDA approval. The author also has the many people who own stocks in the company talk about how much they sold claiming that Kiril kept all his. Things get interesting when Dr. Robb, a prosecution witness takes the stand and her explanations are quite telling and you begin to wonder who is guilty and what Kiril might be hiding. The question is would you if you had to take a chance on a new drug that is tested but the true statistics are not quite forthcoming if you knew that it might prolong or safe your life? Stern is taking this drug but what ingredients in this drug would cause sudden death and an allergic reaction? None of the doctors involved or the FDA or anyone the lab where the statistics and tests were being conducted considered that question.
There were 12 episodes that investigators keyed that were similar: high fevers, rigors, and elevated blood pressure. Each described as sudden onset and death happened within 36 hours of hospitalization or sooner. Are these adverse events the FDA should have been told about? The person on the stand is from the FDA and would have suspended the approval process for g-livia immediately to investigate further. But these deaths were omitted by Global A . What about the data from Pafko Computer A? Dr. Robb is speaking for the FDA and is she saying that the only reason she would not support approval of g-lives is because those 12 deaths shown on Pafko Computer A raise question her mind about the safety and effectiveness of the medicine. The author through Dr. Robb elaborates further .
Each chapter heading is titled with the name of the person in the stand, so you hear various viewpoints about this drug and their involvement. Olga Fernandez was the Director of Marketing and public relations for Pafko Therapeutics. Her relationship with Kirin was both professional and personal.
A trial filled with surprises and the unexpected and some hidden truths and lies that the defendant does not want brought to light. Things about Lep his son and his part in handling the trials and data for this drug are partially revealed but some documents Kiril does not want made public. The author eludes that he might be covering up for something his son might have done or protect Donatella his wife from anything that might hurt or embarrass her considering his past.
Lies, untold truths, deceptions and a shockwave hit the courtroom when the verdict is delivered. Did he manipulate the data? Did he use g-livia for profit and gain? Insider trading was he guilty of that and fraud?
With the memories of both Clara and Helen weighing on his mind, Stern fights the past, deals with the present and must make an ethical choice at the end. Two mistresses, Innis, and Olga and one man who cannot resist temptation as his wife, Donatella will have to handle the final blow.
Two women and one he cannot get out of his mind, Kiril feels that his life was defined by his Nobel Prize and he feels his contribution to g-livia. Olga, Innis, and Lep what part did they play in the deceptions about this drug? Who really changed the data set? A son and a father at different ends of the spectrum and one that would do anything to discredit the other. How far with a parent go to protect a child? In the end who will pay the price for g-livia and will it go back on the market and who will run the company? The ending will create much pause for thought as author Scott Turow leaves us wondering if Stern will take it one step further, will he defend the one person that could go to prison for the fraud and deceptions? Who won THE LAST TRIAL? Anyone?
Anyone studying to become a trial lawyer will benefit greatly from reading this novel as the author goes into detail about how to prepare opening and closing arguments and how to present motions and information in court.
A well thought out novel and very timely as we wonder about the medications and drugs being used for COVID19.
Fran Lewis: just reviews