Malcharist: Fact or Fiction? Big Pharma, Psychiatry’s Key Opinion Leaders and their Ghostwriters


Malcharist, Paul John Scott, Vancouver: Samizdat House, 2020.

Malcharist, by Paul John Scott, is a fictional account of one of psychiatry’s most influential key opinion leaders (KOLs), his ghostwriter, and a journalist on the trail of a big scandal in the world of Big Pharma. The story didn’t happen in reality, but Scott has done his homework in such a way that one of medicine’s darkest secrets is exposed in all of its sordid detail.

For those of us familiar with industry-sponsored clinical trials such as GlaxoSmithKline’s studies 329 and 352, it doesn’t take much imagination to draw analogies to an all-too-common theme: a psychiatrist and a ghostwriter who helped create an illusion. He takes all the credit for her labors and she disappears into the background. What is presented to the medical community, however, is a story of pharmaceutical marketing masquerading as science.

The narrative begins with a terrifying description of a patient suffering drug-induced akathisia, a side-effect of antidepressants that often ends in suicide. Chapter by chapter, Scott then introduces the central characters, journalist Griffin Wagner, ghostwriter Shivani Patel, and key opinion leader Dr. Jeremy Elton, and then weaves together the plot, in which the drug maker manipulates clinical trial data to hide the dead bodies in the statistics.

In the novel, Jeremy Elton, M.D, PhD, Director of Clinical Research, University of Dallas, Institute of Brain Studies is America’s psychiatrist—overseeing $36 million in NIMH grants, co-author of 10 textbooks, author of 600 medical journal articles, paid consultant for six Fortune 500 pharmaceutical companies, and recipient of royalties from 16 pharmaceutical patents and 13 medical devices. (101) He pushes the blockbuster drug, the antidepressant Serotonal, that is fictional drug maker Krøhn-McGill Pharmaceutical’s goose that lays the golden egg, sold to prescribers and patients to correct the elusive chemical imbalance in the brain.

Vice President for Clinical Research Seamus Cole and ghostwriter Shivani Patel lure the KOLs on board with Krøhn-McGill with lavish gifts delivered at vacation venues such as ski and tropical resorts, golf getaways, and first-class hotels in the big city. Cole’s job is to make the physicians feel a little less like prostitutes and a bit more like heroes conquering debilitating illness as they assume their role as product champions for drug sales. (31) With a disingenuous self-depreciation and flattery for his new crew, he delivers a well-rehearsed message:

“I am not an expert in psychiatry but I know that every one of you are destined for the very top of your profession, and more importantly, that we can learn a lot from you. We know your peers can learn from you, as well, especially when we arm you with cutting-edge scientific presentations to deliver at forums hosted by Krøhn-McGill Psychiatric. I think you will find Krøhn-McGill KOL status is not just an invaluable contribution of your expertise to the advancement of medical practice, but a reliable and generous second revenue stream and a feather in your cap that will elevate your profile within the community of professionals…. Some of the most welcoming resorts in the world have opened their doors to those courageous professionals willing to leverage their authority in the service of eradicating mental illness.”  (31-32)

They always buy it―hook, line and sinker.

When it comes to the issue of how the whole ghostwriting business works, Scott nails it in one purple passage, when Griffin says:

“… the pathway to market for everything you find at the pharmacy begins in medical journals, as scientists publish their findings on the experiments that broaden our understanding of human health….. So, I learned a great deal about how much these papers are the work of hired guns…. science written by marketing professionals posing as clinical researchers. It’s troubling. This process of creating evidence for the FDA seems to have become a pantomime of science…. What I mean by pantomime of science … is that we want to make sure these articles are written by scientists, not salesmen. And it turns out that they are almost entirely written by salesmen.… It’s not against the law or even the ethical codes that govern practice in the various specialties. Think of it as a loophole big enough to drive through with a bus wrapped in vinyl humping Bioferex.” (237)

Bioferex, in the story, is the name for a bone drug which treats stress fracture risk syndrome, but the journalist discovers it is really the antidepressant Serotonal, with the same fatal side-effects. (273)

In Scott’s novel, the coding of adverse events in the ghostwritten Study 463 publication, “Serotonal in the Treatment of Major Depressive Disorder,” Jeremy Elton et al., made Serotonal appear safe compared to placebo by hiding completed suicides in the study drug under the code “Suicidal Events” whereas suicidal nightmares, thoughts, and acts of self-harm were also coded as “Suicidal Events” in both the drug and the placebo groups. (126) The suicidal events that occurred in pre-randomization were also inappropriately included in the placebo group. “By inflating suicidal events in the placebo arm,” as Griffin explained the process to a confused KOL, “Makes normal life look more dangerous, and that makes the problem on the drug look more like normal life.” (274)

This general coding strategy is not fiction. Drug makers do it all the time and are caught only when there is discovery due to legal action.

The word, “malcharist,” the publisher’s flyer informs us, is a neologism for “bad power,” “bad sacrament,” or “bad spirit.” Like many real-life ghostwriters who went public with their story, Shivani Patel suffers a guilty conscience from her participation in malcharist activities—namely, knowingly misrepresenting the science and misleading doctors and patients. (289) She seeks salvation by teaming up with Griffin to expose Krøhn-McGill’s fraud. Gaining access to “bad data” stored in off-shore locations out of reach of the U. S. legal system, Patel finds the motherlode—but it comes at a price. (288-289)

This book is published by Samizdat House, the fiction imprint of Samizdat Health Writer’s Co-operative. The brainchild of David Healy, Samizdat (Russianсамиздат, self-publishing) is the name for the underground publishing industry that arose from forbidden literature of the former Soviet Union. Healy’s Samizdat House does for medicine what Samizdat did for the Eastern Bloc countries in the twentieth century. By recognizing the need for freedom of thought and freedom of the press, this enterprise dares to take on the pharmaceutical industry and avoids the censor of corporate lawyers working on behalf of the mainstream publishing industry.

Scott’s book, published in this co-operative venture, is the first fiction title. It is a well-written, well-researched, cleverly-crafted novel―a must-read for medical professionals, and especially aspiring key opinion leaders.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Healys Book: Children of the Cure on study 329 (Paxil) is a lived experience and research master work. Anyone who really wants to know how suicide/violence/homicide is linked to all around corruption should buy this book. Page 59 reads like a scene out of Godfather. Page 243 sets out the case for drug induced insanity of James Holmes cinema batman film horror show – the usual suspect is ramped up sertraline UK licensed for PTSD. For those of you who have suffered horrific akathisia it will be shocking to read that the women involved in key stages in ghost writing and publication didn’t show contrition. Today Paxil is also licensed for PTSD in the UK and we see psych pushing to get people assessed for Covid19 PTSD. The anti- lock down activists such as Piers Corbyn and Kate Shemirani are – so far – no where on grasping the significance of this. They are of the view that 5G and chemtrails cause suicide. Mean while psych will be laughing nodoubt looking to get them detained – ‘seen as a danger to other people’ – if their efforts gain more traction and don’t implode.

    For those of you who are new to this and are suffering stress, depression, anxiety over Covid19 and are thinking of going to your GP, first go to David Healys blog and read up on all this. It will seem alien and difficult to you at first but keep with it. Also go to Peter Breggin’s site and on Youtube.

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  2. Thank you for this excellent overview of MALCHARIST; a truly breathtaking and compelling novel.
    Any endeavour which increases public and prescriber awareness of AKATHISIA surely must be of profound public health importance? Malcharist achieves this, whilst leaving the reader absolutely gripped.

    I cannot recommend reading Malcharist highly enough, and would anticipate that literary award nominations must surely follow?

    Wouldn’t this gifted novel make a fantastic film?

    Thank you Paul John Scott and SAMIZDAT HOUSE: A Magnificent Achievement.

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    • Let’s hope for that, TRM. Big Pharma and psychiatry’s crimes against humanity need to be exposed to all of humanity. Thank you, Leemon, for the book review. “bad power,” “bad sacrament,” or “bad spirit,” indeed those describe the reality of big Pharma and the Holy Spirit blaspheming psychologists and psychiatrists (according to my medical records).

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        • They have no excuse since Robert Whitaker wrote the book. Unless of course they can’t read either. Or hear.
          An intelligent physician would be well aware that it would be impossible to pump out safe “medications” with the speed pharma does. I’ve only ever seen one doc, many years ago, a neurologist who said That “the MRI was obsolete 25 years ago. And I believe it was probably 25 years ago that I saw him. I remember how very cool that was to hear.

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          • We are undergoing a transitional phase in my State. Leaving people permanently unemployable is way too much of a burden on taxpayers, so we have begun unintentionally negatively outcoming any inconvenient truths in the Emergency Dept. What the hell, we know no one will make any complaints anyway, because they will simply be put on the ‘list’, and like Jamal Kashoggi, when they do turn up in one of our ‘centres’, they will be ‘treated’ with the care and respect they deserve for pointing out the misconduct of our overlords.

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  3. “medicine’s darkest secrets is exposed in all of its sordid detail.”

    It is not difficult to expose them, they rely on the public’s lack of intelligence and interest.
    Above all, it should never be referred to as “medicine”. That is a gross misrepresentation
    of what we are dealing with. Speaking of misrepresentations, psychiatrists are not doctors at all.
    They are psychiatrists which only ever gives them entry to a club and the dark occult.

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  4. What is interesting is when they coined the word “science fiction” in the book and movie industry, they could just as easily made documentaries.
    When people recommend someone see a neurologist, they do not realize that first off, a neurologist does not “know” the brain. He cannot see anything that has not been documented, or found. He cannot see all the possible “damage” that might be there. And even IF he sees something that is different, he does not know what those differences mean or what their function really mean in the grand scheme of things. So IF that is causing “symptoms”, his recommendation would be to see a shrink.
    Shrinks are the go to for all undiscovered and all invented things. Shrinks serve the lack of science, not science itself.

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    • They see “potentials” Sam.

      Like the Community Nurse who had police drag me out into the street in front of my Father and Mother in law, placed against a police van and searched, and then thrown into that van wrote as his justification for this ‘treatment’, that I had “potential for damage to reputation and meaningful relationships”. This is the equivalent of rapists seeing their victims begging for it, and their ‘followup’ to conceal their misconduct about as pleasant.

      So what happens when “patients” = dollars, and every person who walks through your door is a potential “patient”? Might explain the amount of people getting very sick because of potential poisonings lol

      “Think of it as a loophole big enough to drive through with a bus wrapped in vinyl humping Bioferex.””

      That’s how I see our Mental Health Act (one giant human rights abusing loophole), when the Chief Psychiatrist who is charged with “protecting consumers, carers and the community” and who “provides expert legal advice to the Minister” doesn’t recognise the protection of a burden of proof (“suspect on reasonable grounds” becomes ‘suspect’ for the lawyers among y’all) for incarceration and forced drugging. Citizens being snatched from their beds by police (who will provide a referral to enable ‘remotes’ of potential “patients”) and receiving dribble therapy within the hour for no other reason than a Community Nurse ‘suspects’ that they might have an illness they made up via the corrupt practice of ‘verballing’. Arbitrary detentions and torture now perfectly “reasonable” and combined with the ability to deny access to legal representation, the sky really is the limit.

      It does of course mean that when the Chief Psychiatrist left his previous position (at the Royal College of Psychiatrists) to take up the role of protector of the community, and said he could advance the cause of his profession much better from the role as Chief Psychiatrist, he was right. By ignoring the legal protections afforded the community (in fact, denying the existence of these legal protections in writing) he has provided carte blanche and zero accountability to his colleagues. I guess they all laugh at the fancy dress parties paid for by Big Pharma when he turns up dressed as a pirate with a patch over one eye. Because that eye isn’t the only thing being covered up to maintain the illusion of medicine to the public.

      Consider, in my instance the effects of being ‘spiked’ with their drugs was used to create the illusion of an illness (conceal the proof of the ‘spiking’ and claim it is a delusion if the victim complains about being drugged without their knowledge [and allow the use of a known torture method]) to justify the use of the drugs (disguised as a ‘chemical restraint’) against my will that would have made me very ill before I even had the chance to be ‘assessed’ by a psychiatrist. It’s the equivalent of being incarcerated for life by police for evidence they ‘planted’ and not even having the opportunity to have that evidence tested in a court of law because your in prison and can’t get access. And these same people are pointing fingers at China? lol talk about anasognosic. Still, what can one do when the State is allowing ‘unintended negative outcomes’ in the E.D. of people who have the misfortune of obtaining the proof they were tortured and kidnapped? It’s not like the police are going to be in a hurry to find their copy of the Criminal Code when they are the ones doing the torturing. And these ‘accidental’ overdoses in the E.D. not being looked at too hard (in fact police have done everything they possibly can to NOT look. The documents they don’t want from me may as well be a big steamin pile I put on the counter at the Station. And I can be arrested for having the proof I was ‘spiked’ from my own medical records. Imagine, having proof of crimes becomes a crime? How positively Kafkaesque.)

      Good to know there is an independent publisher who, should I ever manage to obtain asylum, be prepared to publish a truth that is almost stranger than fiction. Amazing how these people are getting away with this right under the shadow of our noses.

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      • How does one defend themselves in court, and why should one if no law was broken? The courts should not be involved in incarcerating innocent people.
        Judge: “why is this woman here”
        How does this not all become very confusing? Basically judges are listening to others over the victims. The victim knows this going in. It is not really the judge making a decision, it is the shrink that has the power over the courts. The judges are just puppets.
        Of course it’s so ludicrous and the courts, the judges, the lawyers are all just waiting for someone, anyone to fix the mess psychiatrists made. The convicting shrinks are very knowledgeable about their own agendas, and I bet each time they wind up in court, are simply trying to sound believable.
        They know that eventually they will be caught for the criminals they are.

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