# The Case of the Quiet Participant Show: Adverse Events · Lead: Dr. Tracy Grant · Episode 1 > **This is the script.** The build is `podcast-quiet-participant.html`, generated from this file. > Write here; the build is disposable. Run-sheet and production notes live in the > build only. > > Format: `##` opens a scene · `>` is a sound cue · `**CAPS**` is a speaker · > everything else is speech · blank line between paragraphs · `*(beat)*` inline. --- ## COLD OPEN — 0:20 **TRACY (V.O.)** Sixty subjects. Twelve weeks. Somewhere out there, one of 'em had stopped talking to me. > — music sting — **ANNOUNCER** Adverse Events. From the case files of Dr. Tracy Grant, who writes the protocol, and Connie Chase, who makes it happen. **ANNOUNCER** The story you are about to hear is fiction. Any resemblance to your last study is purely coincidental and entirely predictable. **ANNOUNCER** *The Case of the Quiet Participant.* --- ## SCENE ONE — AN OFFICE > rain on glass · a radiator ticking · a page turning **TRACY (V.O.)** The DRIFT trial. Daily Routines for Improved Follow-Through. My first one as PI. We spent four days on the acronym and about eleven minutes on the aims. Sixty subjects, twelve weeks, and a budget held together with tape and optimism. One coordinator, one grad student, and a spreadsheet the size of Rhode Island. What I didn't have was any way to know when one of them went quiet on me. That bill came due in September. Participant thirty-one came in on a Tuesday in March. Signed everything. Asked good questions. The kind of subject you pray for — the kind who reads the consent form all the way to the end. All eleven pages. Including the optional saliva sample. She told me she'd never been in a study before. Asked if it would help anybody. I gave her the answer you give, the one about contributing to the evidence base, and she wrote it down. Nobody writes that down. > — music bridge, four bars, then under — ## SCENE TWO — THE SAME OFFICE > no rain now · a desk fan · a printer warming up · a last door down the hall **TRACY (V.O.)** Twelve weeks went by the way twelve weeks go when you're the one running them. Enrollment. Site calls. A monitor visit that took a year off my life. And the whole time, everything looked fine — because everything I looked at looked fine. That's the trouble with a dashboard you built yourself. It only shows you the things you thought to worry about back in month one, when you still had opinions about everything. Then, the second week of September, database lock. I pulled the export the way you do — half paying attention, already three steps into the analysis in my head. > pages feeding out of the printer · then stopping And there it was. A column of blanks going down and down like a stairwell with no bottom. > hold — nothing but room tone Thirty-one. Six weeks of nothing. Six weeks of data went out the back door and nobody in that building heard the engine. I stared at it the way a raccoon stares at a motion-sensor porch light. > a chair pushed back · paper set down slowly Six weeks. You can write it up. Put it in the report. Hand it to the IRB with a straight face and a fresh haircut. What you can't do is get it back. But you can't write up what you can't explain. So at eleven at night, with an analysis I couldn't run and nowhere in particular to be, I did the only thing left. I started working the case. > — music bridge, two bars — ## SCENE THREE — THE INVESTIGATION > the same fan, the same room · a keyboard, fast **TRACY (V.O.)** First thing you do is haul in the technology and put it under the lamp. It's almost never the technology. But it's the only suspect whose feelings you can't hurt. I pulled the send log. Forty-two prompts, every one of them out the door on schedule, every one of them delivered. > the keyboard stops Forty-two messages. Forty-two knocks on a door with nobody behind it. > a filing drawer rolls open · hanging folders pushed aside · one pulled out Second suspect: she took a powder and nobody wrote it down. It happens. People withdraw in a hallway, on a voicemail, in a sentence at the end of a phone call that everybody hears and nobody logs. So I went to the folder. No withdrawal form. No note. No adverse event. Just a file that stopped getting thicker in April and never started again — a trail gone cold in a filing drawer. > the folder closed Which left the third suspect. > a door · footsteps in the hall, unhurried **CONNIE** You're still here. **TRACY** It's my study. **CONNIE** It's my fourth study. *(beat)* They're all my study, Tracy. You people rotate. **CONNIE** Brought you a coffee. > two cups set down **TRACY** Is this the machine on four? **CONNIE** It is. **TRACY** The machine on four is a crime scene. **CONNIE** Then don't drink it. *(beat)* You're going to drink it. > a chair dragged over · someone sitting down heavily **TRACY (V.O.)** Connie Chase had been running trials in that building since before I had the letters after my name. Three PIs had come through ahead of me. She had never once said which one she liked. **TRACY** Alvarez. Thirty-one. Anything? **CONNIE** March intake, Tuesday cohort. She was good. **CONNIE** *(beat)* I pulled her file an hour ago. **TRACY** You already knew. **CONNIE** I already knew. I've been sitting here since eight trying to work out how I missed it. **TRACY (V.O.)** So much for the third degree. My last suspect had turned herself in two hours before I got there. **TRACY** You read the weekly compliance report. **CONNIE** Every Monday. Between this and two other protocols, it's the only hour I get, and I spend it on that report. **CONNIE** Ninety-one percent compliance. Ninety-three. Eighty-nine. Week after week. I thought we were doing *well*, Tracy. I was pleased. **TRACY** Then how does somebody go six weeks — **CONNIE** Because she wasn't *in* it. > a chair creaks · a cup set down on wood **CONNIE** The report lists who reported. She didn't report, so she's not on the page. Ninety-one percent of fifty-nine. **CONNIE** I never counted the rows. Who counts the rows? You look at the number at the top and the number's good. **TRACY (V.O.)** Fifty-nine lines where there should have been sixty. For six weeks. In a report I designed. And the report had an alibi. Every number in it was true. That's what made it such a good one. > hold — just the fan, neither of them saying anything **TRACY (V.O.)** And that was the case. No villain. No mistake. My coordinator did her job every Monday for twelve weeks, reading a report built to show her everything except the thing that mattered. Absence doesn't print. And a percentage will hold perfectly steady while the thing it's a percentage *of* quietly walks out the door. > — music bridge, two bars — ## SCENE FOUR — THE CALL > a handset lifted · a number dialled, slowly · ring · ring · ring · pickup **TRACY** Hi — is this Ms. Alvarez? This is Dr. Grant, from the DRIFT study at the university. > a voice on the line — warm, indistinct, never words **TRACY** No. No, you're not in any trouble. I'm calling because we haven't heard from you in a while, and I wanted to make sure you were all right. > the voice again, longer **TRACY (V.O.)** Her mother had gone into the hospital the second week of April. Ninety minutes each way, every day, for six weeks. She'd thought about the study exactly twice, and both times she'd been standing in a parking garage with no signal. > the voice — short this time **TRACY** You've got nothing to apologize for. Nothing at all. > the voice — shorter still **TRACY** She did? *(beat)* No, that's — I'm glad. I'm really glad. > the handset set back in the cradle · the fan · nothing else ## SCENE FIVE — THE CLOSE > the fan switched off · and then, for the first time this episode, rain **TRACY (V.O.)** Her mother came home in June. She wanted me to know that. Six weeks of my data gone, and the thing she wanted to tell me was that her mother came home. She wasn't a dropout. She wasn't non-compliant. She was a person having the worst spring of her life, and my study never noticed. The data was gone. That part was mine to own, and I did, in a limitations section nobody will ever read. Connie was right. Every report we had told us who showed up. Not one of them ever told us who didn't. So I built the other report. Not a percentage — a list. Blank on a good week. And when it isn't blank, those are the calls I make that morning. Then I did the part that mattered. I wrote a name next to it. I've run four studies since DRIFT. Every one of them, somebody's job has been to notice when it goes quiet. > a desk lamp clicks off Not a system. Somebody. > — music — **ANNOUNCER** This has been *The Case of the Quiet Participant.* --- ## SIGN-OFF — 0:30 > — music up — **ANNOUNCER** Dr. —— appeared as the Voice of the Grants Office. **ANNOUNCER** Adverse Events is brought to you by Software for Research. For those who love discovery more than data entry. **ANNOUNCER** And even though the IRB classifies this as greater than minimal risk whenever they hear us: this is Adverse Events. > — music out —