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Healthy Males Needed For Research Study," beckons the tiny announcement in the Miami Herald classifieds. "Ages 18-45; 5 days confinement; 18 clinic visits." Then, in slightly larger type: "We Pay You $1100."
A call to the listed phone number yields a curt female receptionist and an address on NW 22nd Avenue in Miami's Allapattah neighborhood, where interested parties are instructed to stop by for a checkup. There, in the bleak waiting room of an ordinary-looking medical clinic, candidates are handed an eleven-page form describing the research study, which involves an "investigational new drug" for the treatment of high blood pressure.
The confinement consists of a 36-hour inpatient stayover at the clinic, followed by nine brief daily checkups, whereupon the process is repeated. The form warns that clinicians will extract blood from each participant 50 times and that in a past experiment involving the same drug, some people experienced side effects including headaches, diarrhea, and abnormalities in liver enzymes. A similar class of drugs has caused, among other side effects, nausea, low white blood cell counts, excessively low blood pressure, and kidney damage.
Tucked away on the form's third page is another warning: "The investigator shall inform you of all known risks, however, you must consent to take part in this study with full knowledge that there may be adverse physical, mental or genetic results which the investigator has no way of anticipating."
For some, such a disclaimer might provoke deep reflection about the nature of human mortality. For Jim Farrell, self-described "professional lab rat," it's barely a distraction. "I guess you never know what might happen -- side effects and all," shrugs Farrell, who by his own count has participated in about eight clinical drug trials during the past three years. "I figure considering the shit I put in my system from the 1960s to the present, the shit they're putting in me won't make a difference."
At a little before noon on this midwinter morning, the 54-year-old Farrell is hunched over the counter at Wolfie's on South Beach, clutching a Heineken A his lunch. Two weeks earlier, he completed a seven-week inpatient-outpatient study at a northeast Dade facility testing the interaction of four prostate and blood-pressure drugs. He practically bounded out of the clinic that morning carrying a small suitcase, his manual typewriter, and his salary of $2400, full of plans to rent a cheap room for a few days, then head north to work at a friend's business in Palm Beach County. "I think I'm going to have a bloody mary, call up the ex, and see if I can get my life back together again," he declared at the time.
Indeed, Farrell needed such a plan. A native of Massachusetts and a former bank robber who has spent a considerable block of time behind bars, Farrell has had a disastrous two years. The hurricane blew his wife and him out of their home and into a FEMA trailer park. On three different occasions, he was admitted to the psychiatric ward of the Veterans Administration Medical Center, and once entered a substance abuse center to treat alcoholism. He divorced and spent long periods of time living on the street, sleeping in parks, at the Salvation Army, or, as he says, "anyplace I could find that was halfway safe and dry."
It was during this period of desperation that Farrell became involved in clinical drug studies. "I wouldn't say I got hooked on them, but I will say they sure come in useful," he observes.
Each year thousands of people in Miami participate in drug trials. Many suffer from the illnesses the drugs are supposed to combat. But in the competitive world of drug research and development, there's also a need for a pool of healthy volunteers to serve as blank slates on which the markings of a new drug can be observed. This need has given rise to a population of professional subjects who regularly rent out their bodies, not for the betterment of mankind, but for the money.
The lab rats are a mercurial band of unskilled laborers far removed from the frontiers of modern medicine they're helping to chart. Many live on the margins of society, indigent and in need of cash, homeless or nearly homeless. They're alcoholics who have drained their last penny or gamblers who've bet theirs away, low-rent travelers looking to move on or layabouts who can't motivate themselves. A few are elderly citizens who could use the financial boost. Most don't look to clinical studies as their sole source of income; many say they're only a study or two away from their last A if only they can build up enough savings this time to buy a car and find more gainful employment somewhere else. But a substantial number return to sign another consent form, ingest another set of mysterious pills, and submit to more prodding and probing.
Despite his intentions to put his life on an even keel, Farrell didn't leave Dade when he got out of the seven-week study. A day after taking a room in a cheap Miami Beach hotel, he hailed a taxi and instructed the cabbie to turn off the meter. The two of them, in Farrell's words, "hit every titty bar from here to North Miami." By the next morning he was broke. "Bad judgment," he concludes, draining his beer.