I left the Emory full-time faculty a few years before Dr. Nemeroff arrived on the scene, but remained on the clinical faculty to the present and practiced a mile away from the campus. Over the years, I heard and saw a lot of what happened as the department medicalized. But we didn’t see Dr. Nemeroff in my corner of the campus – the Psychoanalytic Institute or the Graduate Programs in the college, but he’s the kind of person that generates a buzz you feel even in his absence. I always marveled at his mile long Curriculum Vita and its outrageous number of articles. I knew he was pure biology and psychopharmacology, but on the various occasions when he spoke, I wondered about the thread of his thinking. The talks were always about coming breakthroughs, and I never figured out the theme. I saw him as something of a performer and gradually found myself avoiding his presentations. Life was good and I was busy in my new life.
After I retired [end of 2003], I began to hear about troubles – conflict of interest troubles, relieved of the editorship of Neuropsychopharmacology troubles, multiple Emory Administration troubles, and then in 2008, the Senate Investigation for corruption troubles that lead to his being removed as chairman at Emory. About that same time, I agreed to volunteer at some local clinics, and as part of that began "catching up" on pharmacology. Since I had been mainly a psychotherapist, I was way behind. What I found was horrifying, and I started blogging about it. Of course, my curiosity about Dr. Nemeroff’s part in things lead me down his road, and I got horrified all over again. I hadn’t realized that he was so much in the center of a perfect storm of troubles. I remain horrified.
So he rose from the ashes, helped to get a job at Miami as chairman by Dr. Insel of the NIMH. The short version is that Dr. Insel had been part of Nemeroff’s Department at Emory – Yerkes Primate Center and a Translational Science program. We all assumed that Dr. Nemeroff, then "boss of bosses," helped Insel become NIMH Director in 2002. Dr. Insel clearly helped Nemeroff get the Miami job by reassuring the Dean that Nemeroff was eligible for NIMH Grants [who is not telling the truth? yes…]. It felt like pay-back:
Like a bad penny, Nemeroff’s back abuzz again. He was recently awarded an NIMH research grant, having laid low for a couple of years in the aftermath of the outcry about his hiring and Insel’s involvement. Amid the expected cries of nepotism with this new award, Senator Grassley joined in with a "What the ___!?" letter to the NIMH. Ed Silverman has a great must-read post on Pharmalot summarizing the NIMH’s response. If it weren’t serious money, it would be hilarious. The NIMH was so expecting a reaction that Insel recused himself and they had a list of Talking Points [shades of Karl Rove] to meet the coming protest.
My reaction to all of this was to remember a question from a long time ago, the first time I ever saw Nemeroff’s résumé back in the late 1980s when he applied to Emory. Even then it was incredibly long. I’d never seen such a thing. And I recall wondering how has this guy gotten so many grants. I’d never heard of him making any substantive contribution to the scientific record. That question came to my my mind every time I heard him speak, every time I read of his fame. "Why is he famous?" I’d ask myself. Sure his name is on more papers than any living person. Sure he belongs to every possible organization in psychiatry. But what has he done for the science? And if the answer was as I suspected, damn little except proselytize for drugs, how did he keep getting funded? The current grant proposal hints at the answer: Here’s the main piece.
| Dr. Nemeroff’s Grant Proposal: |
| DESCRIPTION (provided by applicant): Post-traumatic Stress Disorder (PTSD) is one of the most highly prevalent psychiatric disorders and its prevalence is likely increasing in the United States and worldwide due to the rising numbers of natural disasters (earthquakes, hurricanes, tsunamis), man-made disasters (oil spills), terrorism and wars, as well as violent crime and automobile accidents. Although the majority of trauma victims experience the cardinal symptoms of re-experiencing, avoidance and hyperarousal, for the large majority of such individuals, these symptoms do not become chronic nor do they develop syndromal PTSD. It is important to identify the large minority of trauma victims with a high likelihood of developing PTSD because of the very significant medical and psychiatric morbidity and mortality associated with this disorder. |
| There is already considerable evidence that the likelihood of developing PTSD after trauma exposure is due to a combination of genetic and environmental factors. |
| This two-site, linked R-01 application seeks to utilize advances in genomics, transcriptomics and epigenetics, coupled with comprehensive clinical and psychological measures, to address this seminal unanswered question in PTSD clinical service and research. To achieve this goal, 500 trauma-exposed subjects will be recruited at the University of Miami Ryder Trauma Center and the Emory University affiliated Grady Memorial Hospital and followed at regular intervals for one year. This focused, hypothesis-driven study will scrutinize previously identified psychological and biological risk factors. Genetic risk factors include polymorphisms of the ADCYAP1R1, FKBP5, DAT, BDNF, COMT, CRFR1, 5HTTLPR, RGS2, GABA2 and 5HT3R genes, novel genetic and epigenetic risk factors and most importantly, the primary downstream effects of these genomic and epigenetic findings by the use of conventional and newer statistical modeling methods. These findings should provide the means to identify trauma survivors who will likely develop PTSD and can therefore be referred for appropriate psychotherapeutic and/or psychopharmacologic treatment. Such a strategy has the potential to help redefine psychobiological subtypes of PTSD as well as to reduce the burden of chronic PTSD on our healthcare system. |
He picks leading edge concepts and front burner technologies to weave fantastic projects based on hypotheses and speculation. He’s a breakthrough freak, a necromancer, and has a keen eye for what’s hot on the funding circuit. Nothing much comes of these productions, but it doesn’t matter because he’s already chasing the next fad. He’s amazingly facile with the latest way of talking ["… to utilize advances in genomics, transcriptomics and epigenetics"; "… novel genetic and epigenetic risk factors and most importantly, the primary downstream effects of these genomic and epigenetic findings by the use of conventional and newer statistical modeling methods"] and a master of justification ["… to address this seminal unanswered question in PTSD clinical service and research"; "… the potential to help redefine psychobiological subtypes of PTSD as well as to reduce the burden of chronic PTSD on our healthcare system"]. The paper output of this approach is impressive, but the scientific productivity – not so much.
Great commentary
Super-sized CV = PHARMA’s favorite son?
Surely you’ve seen Ross Balsessarini ‘s CV (McLean).. all 10 volumes???
Wondering why Grassley doesn’t connect the dots on this aspect of “conflict of interest”— If your claim to fame is manufactured by those who stand to profit most from your “claim to fame”…. goes beyond the ho-hum scuttle over ghostwriting. IMO
Aside from real skill with jargon, Nemeroff probably has a contact network dating back to medical school or shortly thereafter. One can never underestimate the importance of the ol’ boy network in helping empty suits get to the top.
‘empty suits‘ – a great new vocabulary
wordphrase!