Summary:
Dr.
R. K. Smile, MD, founder of Smile Pharmaceuticals, Inc. (SPI), enjoys a sudden lurch into fortune
and celebrity. Dubbed the ‘Little King’ by his Atlanta-based Indian community,
Dr. Smile is a towering medical authority, philanderer and philanthropist, known
to be both generous and avaricious. His pinnacle pharmaceutical coup, the
patent that has earned him billionaire status, is InSmile™, a sublingual
fentanyl spray designed for terminally ill cancer patients. Dr. Smile’s entrepreneurial
vim, however, hardly stems from benevolent medical research, but rather an
‘excellent business model’ that he observed on a visit to India during which a Bombay
‘urchin’ handed him a business card that read, ‘Are
you alcoholic? We can help. Call this number for liquor home delivery.’ The
blunt practicality of building a market around sating addiction strikes the
doctor as entirely sensible. Often wistful about India’s ‘old days,’ Dr. Smile
fondly recounts the insouciance of neighborhood dispensary hawkers, their
willingness to ‘hand out drugs without a doctor’s chit.’ Though admitting that
‘it was bad for [their] customers’ health but good for the health of the
business,’ Dr. Smile yearns to replicate a similar culture of delinquent
pharmacology, an unregulated market capable of profiting from supply-and-demand forces
but indifferent to the wellbeing of its patrons.
In
the meantime, Dr. Smile’s wife, Mrs. Happy Smile, a simpering and daft
socialite, envisions grand branding prospects that will globalize the Smile
name through ostentatious publicity—inscribed name placards at the ‘Opera, art
gallery, university, hospital […] your name will be so, so big.’ She refers to
the worldwide reputation of the OxyContin family, the proliferation of the
family’s name and esteemed place among prestigious cultural institutions: ‘So,
so many wings they have,’ she says, ‘Metropolitan Museum wing named after them,
Louvre wing also, London Royal Academy wing also. A bird with so, so many wings
can fly so, so high.’
InSmile™ sales drive Dr. Smile’s burgeoning drug trade, as his prescription becomes preferred
to conventional OxyContin highs due to its ‘instant gratification’ in the form
of an oral spray. While SPI fulfills special house-calls for American
celebrities and customers in ‘gated communities from Minneapolis to Beverly
Hills,’ it also ships millions of opioid products to places such as Kermit and
Mount Gay, West Virginia—communities, outside fictional contexts, that bear real-world
vestiges of the opioid epidemic (West Virginia has the highest rate of
drug overdose in the United States). Through a lecture series scheme, Dr. Smile
bribes respected doctors to publicize and prescribe the medication, further
entrenching the dangerous drug in medical circles.
As
the SPI empire collapses following a SWAT-led arrest of his wife, Dr. Smile muses
indignantly on his reputation and the ingratitude of his clients. Tugged again
by nostalgia for the old country, he justifies his drug trafficking by likening
it to quotidian misdemeanors, instances when one could circumvent the
inconveniences of India’s law by knowing how to pull the venal strings of corrupt
systems—like cutting a long ticket queue at the rail station, he says, by paying
a little extra at a backyard office; or bribing government officers to stamp
customs papers required to ship restricted antiques abroad—‘We know what is the
oil that greases the wheels.’ With this deleterious mindset, combining nostalgia
and entrepreneurial greed, Dr. Smile’s future is uncertain, but he is resolved
to return—after all, he says, ‘I have lawyers.’
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