The Middleman

 The Middleman is the fourth novel by Mike Papantonio that I’ve reviewed in this blog, and I’ve given the author high praise for his earlier works, all of which had lawyer Nick “Deke” Deketomis as his protagonist. This novel is another great story with Deke, his Florida law firm, and a successful sociopath, Connor Devlin. Out of the blue, Deke was requested that he look into the family business by one of his law school classmates, Matt Redmond, who was concerned about the business being taken over by a character, Devlin, who he no longer trusted. The family business was a pharmaceutical company. Having been started by Matt’s grandfather as a successful chain of pharmacies, the company had evolved into a pharmacy benefit manager, PBM. Essentially, they were a middleman, the go-between that connected drug manufacturers, medical insurance companies, retail pharmacies, and consumers. Essentially, the PBM had a role in controlling the price of drugs, and in this case, it was insulin that was at issue. Devlin was driving up the cost of insulin and was using illegal means to do so. He was a charismatic man who successfully charmed everyone until they were in too deep to extricate themselves from his scheme. From a consumer point of view, the cost of insulin was being pushed beyond the means of many. Deaths were occurring within the companies that offered any resistance to Devlin’s plans.

 As he explained the reality of PBMs, the author presented a great cast of characters. The reader should know that PBMs are a reality which controls what medications insurance companies will authorize for reimbursement. There were family dynamics that were believably presented. Devlin was both a narcissist and a sociopath. As a psychoanalyst, I found myself reviewing the many people with character pathology that I interviewed and treated over the course of my career. I’ve known narcissists who were not sociopaths, but I’ve not known a sociopath who was not a narcissist.

 

The author brings this story about the trauma caused by this narcissistic sociopath to a satisfactory conclusion. The plot was well presented, so once again, Mr. Papantonio has created a story that gets my strongest recommendation.