When The Regnant, her four sons, Dr. Lauren Lewis, and Agent Chennai arrived at the JFM they were greeted at the door by Dr. Lewis's staff.
"Your Majesty, Please allow me to introduce my staff." Dr. Lewis started off from left to right of those lined up to greet The Regnant.
'This Dr. Abigail Danna, Deputy Chief of the JFM. This is Dr. Hollis Gardholt, Chief Operating Officer. This our Head Nurse and soon to be Doctor of General Medicine in her own right, Jobina. This is Dr. Louis Padameshi, who works in General Medicine. This Dr. Leena Alderic, Head of our Laboratory Facilities. This is Dr. Wildford Gallo, Head of our Research Department. And this is Dr. Russo Monteiro, Head of our Programs and Clinical Trials Department."
"Nice to meet you all here today. My daughter, Emilia is also and Scientist and a Physician."
'Yes, Your Majesty, we are keen admirers of her work." Dr. Danna replied.
"She loves her work. There are times she can be locked up in her labs for days." The Regnant replied.
"Sounds dedicated, Your Majesty" Dr. Gallo said.
"You have no idea." The Regnant replied.
"Your Majesty, Drs. Danna and Gardholt will accompany us on tour. We shall see the rest of the staff again when we tour their departments."
"Very good." The Regnant replied. Drs. Gardhold and Danna fell in step with Dr. Lewis and the Regnant and her sons while the remaining staff dispersed.
"Your Majesty, if you will excuse me?" Agent Chennai asked.
"Yes, Nadu, of course." The Regnant replied. Agent Chennai then departed from the group.
"Your Majesty, as you can see this facility is out in the suburbs where there is ample land and ample privacy for our work." Dr. Lewis said.
"This facility is quite large. How many buildings?" Julian asked.
"About 25 total to support our general, medical, clinical, and laboratory relationships. We are steadily building our teaching department."
"Any Shared-Use Lab Facilities?" The Regnant asked. Dr. Lewis looked at The Regnant with surprise that she knew of such things.
"Because of the nature of our staff, no. But we do have claimed humans who are trained researchers that work here." Dr. Lewis replied
"Claimed Humans." The Regnant said as she shook her head. "Yes, Agent Chennai informed me the Fae on this plane of existence have such practices."
"Is that not the case within the Presidium?" Dr. Lewis asked.
"No. It is slavery. Pure and simple. But I understand why the practice evolved here. An inversion of circumstances, I guess." The Regnant replied.
"While I applaud your stance it may be harder to enforce." Dr. Lewis said.
"You mean that the Fae on this plane will run amok snatching humans at will with utter disregard of the laws I impose?" The Regnant queried.
"Yes, Your Majesty." Dr. Lewis replied.
"Then those will be dead Fae." The Regnant said.
"Yes, Your Majesty. Well, shall we continue?" Dr. Lewis replied.
"Dr. Lewis, do not think me willful. You have yet to know and understand the Presidium. Your do not know our history and what it took to achieve our current way of life. We have fought hard for it. Lost billions of Fae lives because there were those who had cruel and greedy motivations. I will fight to ensure that we do not return to such circumstances, and I will destroy anything and anyone who dares to circumvent my will or our way of life. I do not like my house disturbed." The Regnant explained.
"You know, I simply cannot argue with that, Your Majesty." Dr. Lewis replied.
"I most certainly hope not doctor. Particularly, from someone who may one day sit next to Bo as her companion in rule." The Regnant said as she smiled. Dr. Lewis met The Regnant's smile with a smile and a blush.
"We can continue now. So how many departments do you have?" The Regnant said as they continued their tour.
"We have 35 departments for our daily hospital work that include Medical, Support, Administrative Patient Services. This is separate from the 25 departments we have within our Laboratories and Teaching Programs." Dr. Gardholt replied.
"Your Majesty, I must say I am impressed by your grasp of the medical structure." Dr. Danna said.
"Aside from listening to my daughter, I have to be highly versant in the medical arena when crafting package agreements between the delegations. We do a great deal of aid work within the Presidium that is managed and guided between the Offices of City Outreach and the Parliamentary Council, and the Presidium Medical staffs." The Regnant replied.
"The Presidium does aid work, Your Majesty?" Dr. Lewis asked.
"Enough to have a standing program. The Presidium may be more technologically advanced than this plane, but we still have our problems. All of my children as Patrons of their respective cities play active roles in maintaining the health and prosperity of their respective patronages. Sounds as if you appreciate aid work, Dr. Lewis?" The Regnant commented.
"It is one of my personal passions never to forget that all medicine is fundamental. I find field work to be a great challenge, and extremely rewarding." Dr. Lewis replied.
"My daughter Emilia has the same passion for field work in all of her concentrations. Her favorite is sustainable, clean environments. You two would get along perfectly." The Regnant said.
"I look forward to working with her. It is my understanding from Bo all of your children have an impressive set of multiple responsibilities." Dr. Lewis said. Dr. Lewis replied.
"I am fortunate not to have louts for children." The Regnant said proudly as she glanced at her four sons behind her. "Every last one of them makes Helen and me proud. But I owe it all to Helen. While they are our children they are more her than me."
"I am sure you do yourself a disservice in your own influence." Dr. Lewis said. The Regnant smiled.
"I give all credit to Helen, and her sense of family. I may be at the forefront, but she sets the tone. She is the heart of our family, and I am a better wife and mother because of it. As you and Bo grow your family together you will realize there will come a time you will just have to trust certain aspects of your family life to the other. I trusted the upbringing of our children to Helen because I knew if they were raised fundamentally with her nature and perspective they would turn out well, and I would be a blessed woman for it. Helen is the center of our world. We would be lost without her." The Regnant replied. Dr. Lewis looked at The Regnant and smiled.
"Yes, Doctor?"
"That is the most loving statement I have ever heard in my life." Dr. Lewis said.
"Me as well." Dr. Danna chimed in.
"Me three." Dr. Gardholt said. The Regnant smiled.
"Now as you may be aware, Your Majesty we are in the process of staging our next round of Clinical Trials. Drs. Danna and Gardholt will oversee their progression once I depart for the Presidium. It is my hope Your Majesty that I will still be able to be part of some of the scientific efforts here once I depart for the Presidium."
"As I said you are free to run your new responsibilities as you wish so long as the needs of the Presidium are met."
"Thank you, Your Majesty. Now as you may know we have already put to market a drug that has cured Dementia."
"It is my understanding that was the ailment Bo's mother was stricken with?" Dakari queried.
"Correct Your Serene Highness. Although Mary was part of my initial testing prior to official testing it was her case that allowed me to make specific adjustments to the drug itself in order to put it through its approval phases. I still monitor her for any aberrant changes."
"How is she doing?" Jock asked.
"Exceptionally well Your Serene Highness." Dr. Lewis replied.
"So what's your next trial?" The Regnant asked.
"Well, our drugs for High Cholesterol and High Blood pressure are being prepared for Phase 2 trials, but our drugs for diabetes and heart disease will be the next two big ones entering Phase One trials." Dr. Lewis replied.
"Heart disease is that large of a problem?" The Regnant asked surprised.
"The Presidium doesn't have Heart Disease?" The Regnant only smiled in response which caused Dr. Lewis to let out an exasperated "Really?" The Regnant smiled more broadly.
"Moving on." Dr. Lewis said. "The first step in the drug discovery and development process is preclinical testing, which is done through test tube and animal models. This work provides for the earliest evidence of the potential success and safety of a drug. Once the preclinical results pass the institutional review boards, actual clinical trials can proceed."
"Understood."
"Phase I trials are generally small trials that are designed to test the safety of a new drug or combination. Phase II trials are trials that focus on identifying the utility of a particular drug at a particular dose and schedule in a fairly uniform patient population. These trials aim to clarify the activity of an agent. Phase III clinical trials are large trials that directly compare a new approach to the current standard of care. At this stage, patients are randomized to one approach or another, and success is measured by factors such as overall survival, quality of life issues, etc." Dr. Lewis explained.
"Understood."
"Once a drug passes Phase III and passes final reviews there is a period of post-market surveillance in case new safety issues emerge." Dr. Lewis finished.
"How long does the entire approval process take?" The Regnant asked.
"Anywhere from five to eight years from the start of clinical testing to drug approval." Dr. Lewis replied.
"What is the performance percentage?" This came from Antony.
"Market average is from 5% to 30%, Your Serene Highness. Here at the JFM we have been very careful to put to market pharmaceuticals that can and do work safely so right now we are clocking at 100%." Dr. Gardholt replied proudly.
"Dr. Lewis, this is all quite impressive for an operation that has only established itself in the last ten years." The Regnant noted.
"Well, we have learned from our mistakes. Rather than operate independently, we have since learned to pool and cultivate our resources. You have Bo and Kenzi to thank for that. The model they established at the DRM…the Dal, with pooling resources and support for their programs that has spurred the acceptance and support of the JFM model." Dr. Lewis replied.
"Clearly." The Regnant said.
"Your Majesty, I would like for us to continue with a tour of the Laboratory Facilities. You can observe our Teaching Program as we go along." Dr. Lewis directed.
"Lead the way, Dr. Lewis."
