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“We’ll see about that,” he mumbled. “I’m giving you one last chance to tell me what happened,” he demanded as if he expected me to be threatened by him. “I have nothing that I want to say to you. Besides, I don’t have to talk to you if I don’t want to. I know my rights". “Yeah, you’re just a know-it-all, aren’t you?” he said as he closed the file. The look he gave me was chilling. I might have pushed his buttons or something, I don’t know, but he wasn’t happy. “Well,” he said as he got up from his chair, “I can’t make you talk. You’ve given me no reason to keep you here. On the other hand, you give me no reason to let you go either.” “So what are you going to do, throw me in jail?” I asked. He pulled out his chair and moved it to the front of the room. Then he walked towards the door and locked it. “I’m not going to put you in jail,” he replied as he took off his jacket and hung it on the back of the chair. He rolled up both his sleeves, shaking his head as he was doing so. Now, I’m. ”“Doesn’t that mean continuing with the histrelin?” Sierra asked.“It’s a different mechanism. Ideally we’d like to use an androgen synthesis inhibitor. These stop the production of testosterone, but those drugs are either breathtakingly expensive or still in development. The one that’s approved is fifty thousand a year.”“That’s worse than the histrelin,” Glenn replied.“Exactly. Instead we start with an androgen antagonist. These block the action of the testosterone she produces, and are quite reasonably priced. Our first line is spironolactone. It’s a daily pill, available as a generic and costs only about twenty dollars a month.”“That’s quite a bit more reasonable,” Glenn remarked. “If it’s generic, there’s no co-pay. The insurance will cover it all.”“It’s well tolerated, however the drug’s primary use is to treat congestive heart failure or fluid buildup. Its anti-androgen properties are actually side-effects we exploit.”“So, the drug’s primary purposes become side-effects,” Glenn.
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