{"id":12071,"date":"2011-08-15T21:34:07","date_gmt":"2011-08-16T01:34:07","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=12071"},"modified":"2011-08-17T20:35:00","modified_gmt":"2011-08-18T00:35:00","slug":"a-moment-of-clarity","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/08\/15\/a-moment-of-clarity\/","title":{"rendered":"a moment of clarity&#8230;"},"content":{"rendered":"<br \/>\n<blockquote>\n<div align=\"center\"><strong><a target=\"_blank\" href=\"http:\/\/neuroskeptic.blogspot.com\/2011\/08\/ghostwriter-speaks.html\"><font color=\"#200020\">A Ghostwriter Speaks<\/font><\/a><\/strong><br \/>           <strong><font color=\"#0033ff\">Neuroskeptic<\/font><\/strong><br \/>           15 August 2011<\/div>\n<p align=\"justify\">PLoS ONE offers the confessions of a former medical ghostwriter: <strong><a target=\"_blank\" href=\"http:\/\/dx.doi.org\/10.1371\/journal.pmed.1001071\">Being the Ghost in the Machine<\/a><\/strong>. The article [which is open access and short, so well worth a read] explains how Linda  Logdberg became a medical writer; what excited her about the job; what  she actually did; and what made her eventually give it up&#8230;<\/p>\n<p align=\"justify\">However, it doesn&#8217;t create bad science. A bad paper is bad because  of what it says, not because of who (ghost)wrote it. Real scientists can  write bad papers without a ghostwriter&#8217;s help. When pharmaceutical companies pay a ghostwriter, they are not doing  this to get access to special dark arts that real scientists are  innocent of. As far as I can see, it&#8217;s just more efficient to use a  specialist writer to do your scientific sins, when you&#8217;re doing it all the time&#8230;<\/p>\n<div>Logdberg says:<\/div>\n<ul>\n<div align=\"justify\"><strong><font color=\"#990000\"><sup>My career came to an end  over a job involving revising a manuscript supporting the use of a drug  for attention deficit-hyperactivity disorder (ADHD), with a duration of  action that fell between that of shorter- and longer-acting  formulations.<\/sup><\/font><\/strong><\/div>\n<p> <\/p>\n<div align=\"justify\"><strong><font color=\"#990000\"><sup>  However, I have two children with ADHD, and I failed to see the  benefit of a drug that would wear off right at suppertime, rather than a  few hours before or a few hours after. Suppertime is a time in ADHD  households when tempers and homework arguments are often at their worst. <\/sup><\/font><\/strong><\/div>\n<p> <\/p>\n<div align=\"justify\"><strong><font color=\"#990000\"><sup>  &#8230;Attempts to discuss my misgivings with the [medical] contact met  with the curt admonition to &lsquo;&lsquo;just write it.&rsquo;&rsquo; But perhaps because this  particular disorder was so close to home, I was unwilling to turn this  ugly duckling of a &lsquo;&lsquo;me-too&rsquo;&rsquo; drug into a marketable swan.<\/sup><\/font><\/strong><\/div>\n<\/ul>\n<div align=\"justify\">Many scientists will recall being in that kind of situation, albeit in a different context&#8230; Turning ugly ducklings into fundable, or publishable, swans, is part  and parcel of modern science. Of course, the ducklings are not always  as ugly as in the case Logdberg describes, but they are rarely as  beautiful as they eventually end up.<\/div>\n<\/blockquote>\n<div align=\"justify\">The article itself is short and <em>well written<\/em>. Here&#8217;s a sampler [I&#8217;ll leave her conclusions for you to read yourself]:      <\/div>\n<blockquote>\n<div align=\"center\"><a href=\"http:\/\/www.plosmedicine.org\/article\/info%3Adoi%2F10.1371%2Fjournal.pmed.1001071\" target=\"_blank\"><u><strong><font color=\"#200020\">Being the Ghost in the Machine: A Medical Ghostwriter&#8217;s Personal View<\/font><\/strong><\/u><\/a><br \/>        <strong><font color=\"#3366ff\">PLoS Medicine<\/font><\/strong> <br \/>        by Linda Logdberg<br \/>        August 9, 2011<\/div>\n<p>      <\/p>\n<div><sup><\/p>\n<div><u><strong>Introduction<\/strong><\/u><\/div>\n<p align=\"justify\">Ethical  concerns about medical ghostwriting have been directed primarily at  &ldquo;guest&rdquo; authors and the pharmaceutical companies that pay them. One  voice that is largely missing is that of the ghostwriters themselves  who, after all, create the documents that are in the ethical and legal  crosshairs. Without them, one could argue, there can be no fraud,  because it is they who create the fraudulent product. For almost 11 years, I  worked as a medical writer, creating a variety of pieces including the  occasional ghostwritten article. For the most part, I never saw the  finished paper, nor did I care to. This article describes what I did,  why I did it, why I stopped doing it, and what I think might be done  about the problem of fraud in authorship.<\/p>\n<div><u><strong><font color=\"#200020\">What I Did<\/font><\/strong><\/u><\/div>\n<p align=\"justify\">&#8230; Ghostwriting was a  small, but real, part of my duties. I have seen published pieces that  are virtually identical to the final drafts I submitted. Regardless of  what I wrote, though, for many years I considered my role to be similar  to that of a highly paid technician and did not question its ethics. <\/p>\n<p>       <font color=\"#200020\"><u><strong>Why I Did It<\/strong><\/u> <\/font>       <\/p>\n<p align=\"justify\">&#8230;I believe that many  of the factors that kept me in medical writing apply to most medical  writers. First, I believed that I was helping people: sick people need  drugs, and physicians need to know about those drugs to prescribe them  appropriately. Second, I had young children and valued the flexibility  of working at home, which most meded companies offered at least part of  the time. Third, the work was interesting: I interacted with top  researchers and was assured of an ease of access that I never would have  had as an assistant professor. Fourth, the money was good. <em>Really<\/em>  good, especially compared with the typical assistant professor salary.  And perhaps most important in the longer run &mdash; it was fun. Traveling,  eating in high-end restaurants, wearing fashionable clothes, and rushing  to meet important deadlines&mdash;what&#8217;s not to like? <\/p>\n<div><u><strong><font color=\"#200020\">Why I Stopped Doing It<\/font><\/strong><\/u><\/div>\n<p align=\"justify\">It  turned out, there was quite a bit not to like. I&#8217;d started in smaller  companies headed by PhDs or MD\/PhDs who dealt directly with the primary  researchers and the pharmaceutical companies. There were no advertising  types in sight, and I had frequent, direct communication with the  physician-authors. I saw my role as helping a busy researcher write up  research results: he or she did the research, and I got to analyze and describe it. But as my career  developed, several of these smaller firms went out of business, and I  began to get more work from larger meded companies that were part of  large advertising agencies. The bigger the agency, the more likely it  was that my contact person was someone without a science background. In  the worst of these settings, I discussed projects only with the program  manager and had limited&mdash;or no&mdash;access to the &ldquo;author.&rdquo;<\/p>\n<p align=\"justify\">The work itself began  to lose its charm&#8230; In addition, the ethical issues began to tap me on the shoulder:  perhaps the most memorable example of this was a contraceptive product  that caused severe, unpredictable vaginal bleeding in some women. My job  was to draft a monograph that would profile the product&#8217;s benefits, one  of which, according to the client, was that although the bleeding could  be severe, it was at least something that women could <em>anticipate<\/em>. In other words&mdash;the bad news is that a meteorite will strike you, but the good news is&mdash;a meteorite will strike you!<\/p>\n<p align=\"justify\">This kind of  doublespeak became more and more troubling, and my career came to an end  over a job involving revising a manuscript supporting the use of a drug  for attention deficit-hyperactivity disorder (ADHD), with a duration of  action that fell between that of shorter- and longer-acting  formulations. However, I have two children with ADHD, and I failed to see the benefit of a drug that would wear off right at suppertime, rather than a few hours before or a few hours after. Suppertime is a time in ADHD households when tempers and homework arguments are often at their worst. So I questioned the account executive at the large agency that had hired me. In particular, I wanted to ask the physician author their view of the drug&#8217;s benefits. Attempts to discuss my misgivings with the meded contact met with the curt admonition to &ldquo;just write it.&rdquo; But perhaps because this particular disorder was so close to home, I was unwilling to turn this ugly duckling of a &ldquo;me-too&rdquo; drug into a marketable swan.<\/p>\n<p align=\"justify\">I decided it was time to burn my medical writing bridges and contacted <em>The New York Times<\/em>,  which coincidentally had planned an investigative article on  pharmaceutical marketing to physicians. I was interviewed for this <a href=\"http:\/\/www.nytimes.com\/2002\/11\/22\/busine%E2%80%8Bss\/madison-ave-has-growing-role-in-the-b%E2%80%8Business-of-drug-research.html?src=pm\" target=\"_blank\"><u><strong><font color=\"#200020\"> article<\/font><\/strong><\/u><\/a>, written by Melody Petersen, by Ms. Petersen and Walt Bogdanich.  Shortly after its publication, I received a  polite letter from an executive of the meded company asking for all the  materials back and reminding me of my confidentiality agreement. I also  received a direct threat of legal retaliation in a phone call from my  former contact at that agency.<\/p>\n<p><u><strong><font color=\"#200020\">What I Think Now<\/font><\/strong><\/u><\/p>\n<div>&#8230;<\/div>\n<p><\/sup><\/div>\n<\/blockquote>\n<div align=\"justify\">The thing I liked about this article is that I believed what she said. She was not defensive, attacking, self-justifying, or self-flagellating. She had a moment in the course of things when what she was doing became clear to her, a point of empathy with the parents and children who were impacted by her work, and she realized the side of things that wasn&#8217;t so apparent to her before. The &quot;straw&quot; had arrived and the &quot;camel&quot; was burdened enough to feel it. She was not a technical support writer or an editorial assistant, she was a ghost-writer and knew it &#8211; doing ad work for a pharmaceutical company. <\/div>\n<p align=\"justify\">I would hold that scientists who are proud of their work wouldn&#8217;t use a ghost-writer in the first place. Writing the article is part of the process. <strong><font color=\"#0033ff\">Neuroskeptic<\/font><\/strong><font color=\"#0066ff\"> <\/font>points out that the real author can be as big a sinner as any ghost-writer. That may be true, but at least it&#8217;s on their hands. That seems dreadfully important to me. And she wasn&#8217;t even in contact with the &quot;authors.&quot; She was working with a <em>meded<\/em> handler in an advertising firm.<\/p>\n<div align=\"justify\">Dr. Logdberg proposes a legitimate role for the medical writer in scientific writing. I didn&#8217;t include that part because I&#8217;m not sure I agree with her. If, as she suggests, the writer were a part of a scientific team and not working for a pharmaceutical company or some other agency that was not involved in the research itself, that might be possible. But that&#8217;s something to think about in a future where such a situation was assured. Right now, the abuse has been too great to contemplate that possibility. Medical writing is a part of a corrupt system and can&#8217;t be tolerated at any level. At least that&#8217;s what I think. If someone&#8217;s really part of the team, they need to be openly listed in the author list and held responsible for what the article says. <em>By the way, Dr. Logdberg really is a good writer&#8230;<\/em>   <\/div>\n","protected":false},"excerpt":{"rendered":"<p>A Ghostwriter Speaks Neuroskeptic 15 August 2011 PLoS ONE offers the confessions of a former medical ghostwriter: Being the Ghost in the Machine. The article [which is open access and short, so well worth a read] explains how Linda Logdberg became a medical writer; what excited her about the job; what she actually did; and [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-12071","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/12071","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=12071"}],"version-history":[{"count":11,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/12071\/revisions"}],"predecessor-version":[{"id":12135,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/12071\/revisions\/12135"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=12071"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=12071"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=12071"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}