What people are saying about The Goose That Laid the Golden Egg: Accutane – the truth that had to be told.
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Palm trees lined the road leading from the Orlando airport. A few puffs of white clouds sat unmoving in the brilliant blue Florida sky. My seven-year-old son, Lucca, played a hand-held computer game in the back seat of the cab. My wife, Viola, and twelve-year-old daughter, Lucia, looked out the window. I rode up front, thinking about how much I would be paid for the lectures I would be giving over the next year or so. The year was 2001.
We checked into the Disney World Hotel and went up to our rooms. Lucca grabbed the room key and ran ahead. He opened the door, ran in and jumped on the bed.
“Is this our room?” he asked, excitedly.
“Get your bags, Lucca,” I said.
When the family was settled, I headed for the courtesy room of the private company that organized medical education events on behalf of GlaxoSmithKline (GSK), the makers of the antidepressant drug, Paxil. They had invited me to give the kick-off lecture for their initiative to push Paxil into the market for people with anxiety disorders. They called it Psychnet. The plan was for me to give a lecture to a bunch of psychiatrists from across the country, educating them about the benefits of Paxil in the treatment of anxiety disorders, and they would in turn, for pay, fan out across the country giving lectures to other psychiatrists on the same topic. Not only would I get paid for doing this, but I would be tagged as a preferred speaker for their nationwide lecture series for psychiatrists. Over the next year or two, I would give about 15 talks across the country, with the usual price being $2,000 plus travel expenses. However, I learned that many of the speakers canceled at the last moment, so I could squeeze out as much as $5,000 for giving a talk at the last minute’s notice.
I stood for a moment before the door and checked my suit to see if it had any spots on it. Then I knocked.
“Come on in, Dr. Bremner,” an attractive and smiling Asian woman said as she opened the door. “We’re going over your slides now.”
The room was filled with a bunch of good-looking young people hunched over laptops who seemed bright and energetic. A floor-to-ceiling plain glass window looked out over palm trees evenly spaced over a closely cut green lawn with the blue of the Florida sea just beyond.
“How does this look?” The woman waved me over to one of the laptops.
I scrolled through the slides.
“You’ve got some great graphic art support,” I responded. That brought on a spontaneous smile.
“Thanks, Doctor. Any corrections?”
“No, these look great. When do I go out?”
“Your talk is in 30 minutes.”
There was a knock at the door. She walked over and opened it.
Scott Sproul entered the room. We had hung out together at a bar the year before and gossiped about the ups and downs of the pharmaceutical industry. Scott was one of the most up-beat people I ever met. He was now head of the Paxil marketing team.
“Thanks for coming down, Doug.” He slapped me on the back. “How’s the family?”
“They’re doing great.” The attention made me feel uncomfortable.
“Have they ever been to Disney World before?”
“No, this is the first time. Thanks for the invite.”
“Well, it’s great to have you here, Doug. I think you’re gonna really help us get our message out about Paxil.”
“Glad to help.” And I meant it.
“Here’re some tickets for Disney World for you and your family, for the weekend.”
“Wow, that’s really nice of you. I really appreciate it.”
“No problem. Ready for your lecture?”
We walked toward the lecture hall. He opened the door and slapped me on the back.
“Go on out there and sell some Paxil, Doug!”
* * *
A few weeks later I was coming back through the Hartsfield-Jackson International Airport in Atlanta after giving an out-of-town lecture, when I ran into Charlie Nemeroff, M.D., Chairman of the Department of Psychiatry at Emory University School of Medicine, in Atlanta, where I had just been recruited. He was an energetic and gregarious man who was in constant motion. Nemeroff was known as one of the leaders in the field of academic psychiatry, what we called a “shining light.” A recent magazine article about him was called “Boss of Bosses,” and prominently featured him on the cover, in a white jacket with his arms folded across his chest.
“How’s it going, Doug?” he asked.
“Great. Thanks for the recommendation to be a speaker for the Psychnet program.”
“We take care of our faculty at Emory. Hey, Doug. About that Accutane study you’re doing?”
“Make sure you meet with the dean about it. He’s a dermatologist. We don’t want any political hot potatoes. And get the dermatologists involved. They can refer acne patients to you.”
He looked tired. He’d probably been on the road for a while.
“OK, no problem.”
“Well, I’ve got to run. Catching a plane to Fort Lauderdale to give a talk about norepinephrine and depression. Are you interested in norepinephrine, Doug?”
“Yeah, sure.” Nemeroff had done some research on the effects of Paxil on the norepinephrine system. GSK was using that angle to market Paxil as being better than the other SSRI antidepressants. They were eager to get people like Nemeroff out there talking about the science behind it all.
“Ok, catch you later.” He turned and walked off, pulling his rolling suitcase behind him.
I stood there and watched him walk away. While waiting for an appointment with him just after moving to Atlanta, I had seen his curriculum vitae sitting out on a table. It listed work as a consultant for the maker of Accutane, but it didn’t look active, and he was consulting for a gazillion other drug companies, so I figured it was no big deal. Nevertheless, I felt a little uneasy. Whenever there was money involved, you had to be careful.
Don’t worry about it, I thought. Just meet with the people like he asked you to do, don’t make any waves, do what you’re told, and everything will work out fine.
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