The Rx Carousel is a metaphor for the drug research pipeline in pharmaceutical companies. The horses on the outer ring of the carousel represent a company’s lead products. They are beautifully presented to Wall Street and the company’s goal is to grab the brass ring of FDA approval hoping that will lead to achieving the status of “blockbuster” drug through successful commercialization. Occasionally the horses on the outside get damaged and may have to be moved to an inner circle until they possibly re-emerge with a new paint job. This book is the product of my imagination and is written purely for the reader’s entertainment. The pharmaceutical industry is constantly subject to scrutiny and criticism by the media, politicians, and the public. Yet these same critics cheerfully hail the discovery of a new drug whether it be for sexual enhancement or the treatment of a cancer. The discontinuity exists because human health is perceived by many as a “right,” and, as a consequence, they believe that innovation in this sector should not come at a cost. This story describes the frenetic life of Jonathan Grayhall, CEO of a small drug company situated in Silicon Valley, Calif. The main storyline is one of a typical business and includes politics, backstabbing, setbacks, survival, and success. Within the business framework is an imbedded story of romance, sexual wrongdoing, intrigue, and revenge. A highly toxic jellyfish is the source of a new chemical entity for drug research, but we learn it can also bring extreme pain and suffering. Like the industry, the book moves at a fast pace and the ending has a surprise twist. Where the book differs from most offerings in this genre, is the occasional peek behind the “Rx curtain” that a 30-year executive brings to the narrative. The public is generally unfamiliar with the trials and tribulations faced by the average pharmaceutical company, how strictly they are regulated, and the investments and efforts being made to correct unacceptable practices. For those from the industry, I hope there will be head nodding as they read through the pages and recognize familiar scenarios. For those who know little about the driving forces in the industry, I hope you find the dialogue illuminating.