I guess a blogger who writes an obscure blog doesn’t have to apologize for getting stuck on a topic. I read the response from Dr. Nemeroff to the accusations of ghost-writing, and I felt the urge to write. He has that effect on me.
In a statement to The Herald, Nemeroff wrote: "… Schatzberg and I conceptualized this project and developed an outline… long before there was any involvement from a pharmaceutical company. Diane Coniglio… provided editorial assistance and expanded on the outline, and she was acknowledged in the preface."
The key here is "expanded on the outline." In a letter on February 4, 1997, Sally Laden of STI writes:
I am pleased to provide an update on the status of this project – We have begun development of the text, and Diane Coniglio, PharmD is the primary technical writer and project manager. I will be working closely with Diane at all times and will serve as technical editor. You and Alan are in good hands with Diane; she has many years of experience and is a creative and accomplished technical writer.
By February 25, 1997, STI had a preliminary draft ready for the "authors" to look at. My perusal and that of others find that it closely matches the final book.
"Such editorial assistants can provide help with such tasks as tracking down references and the like, but certainly do not have the clinical expertise or experience to put such a volume together." Nemeroff called accusations of ghostwriting "blatantly false and inaccurate."
Considering the fact that the draft and the final book are plenty close to each other, one might say that this diminishing comment about "editorial assistants" is just a plain old lie. Ms. Coniglio is clearly no dumb blond secretary, but is, as Sally Laden says, a "creative and accomplished technical writer." Whether Nemeroff or Schatzberg wrote an outline or not, Coniglio sure filled in the words.
"In the two years that elapsed between the 1997 letter from Ms. Laden and the finalization of the book and the contract with the publisher, I do not recall Dr. Schatzberg nor I having any contact with any SmithKline Beecham personnel concerning its content," Nemeroff stated.
What does that have to do with who wrote the words? The POGO letter makes no accusation that there was any such contact. They dealt with STI, as outlined in the Februray 4, 1997 letter.
"With each successive draft, we scrutinized every page and rewrote and edited as we deemed necessary. The final product reflects this process. An unrestricted educational grant assumes that we had control of the final product and that was indeed the case."
Good for you guys, editing the ghostwritten text Ms. Coniglio provided. I guess the reason so much was unchanged between the first draft and the final product was that she captured your thoughts the very first time around.
"In view of the reference to sponsor comments in the letter, I would guess that they would have had to review the content to comply with [Food and Drug Administration] regulations on a pharmaceutical company distributing a publication, but this is hardly my area of expertise."
I’ll say [hardly his area of expertise]. I don’t even know what he’s talking about. And what’s with, "a pharmaceutical company distributing a publication?" Was GSK "distributing a publication?" We know they bought most of them to give away to family docs. Was that in the works from the start? the reason for writing the book? That doesn’t sound like an unrestricted educational grant to me. In this paragraph, Nemeroff seem to be admitting that this book was something the companies [GSK and Oragon] got him to do so they would have a give-away for their reps to pass along to primary care physicians. No wonder it was ghost-writen.
"Finally, it is important to note that the book was peer reviewed by multiple outside experts No questions of bias were raised"…
Which, like every other point in this rebuttal, has absolutely nothing to do with whether it was ghost-written or not.
I propose the following scenario. Schatzberg and Nemeroff first published their megatome Textbook of Psychopharmacology in 1995 which became quickly "the" book to own on the topic. Someone at GSK had the idea shortly thereafter, how about a mini-version for Primary Care Physicians who would never see the other book. It could be published as a how-to version and then given away by the reps to Primary Care Physicians. The book would play it straight. The people at STI could write it. Nemeroff and Schatzberg could edit it. And it would in no way either appear or actually be an advertisement for GSK products. GSK’s gain would be that Primary Care Physicians would be more comfortable prescribing psychoactive drugs, and they’d lean GSK’s way because GSK gave them the book. The same would be true for Organon [Remeron]. GSK and Organon bought 20,000 of the 26,000 copies sold and handed them out as freebies. All Nemeroff and Schatzberg had to do was read over the drafts. STI woulds take care of the rest, using the big Textbook of Psychopharmacology as a reference.
Early in medical school [the first week] we were given a doctor’s bag with a tuning fork, a reflex hammer, and a stethoscope by Eli Lilly. It was a very effective advertisement – though at the time, I just thought it was nice. And we all learned anatomy through the illustrations of F. Netter in the CIBA Atlases that were given out at every juncture. It was a way of developing respect for the Brand, not to advertise a specific product. I expect that was the same idea behind Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care. The complaint lodged by POGO wasn’t that the book "advertized," the complaint was that the authors didn’t write the book. Nemeroff’s defense doesn’t address that allegation. In fact, it confirms it in a way ["With each successive draft, we scrutinized every page and rewrote and edited as we deemed necessary"]. Scrutinizing drafts is not the same as writing a book. The cover doesn’t say "by Sally Laden and Diane Coniglio, Scrutinized by Charles Nemeroff and Alan Schatzberg." It says:
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