Malcharist: “One of Medicine’s Darkest Secrets Is Exposed in All of Its Sordid Detail”

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From RxISK: Leemon B. McHenry, co-author of The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Wakefield Press, 2020), reviews the first novel published by David Healy’s international writers’ co-operative, Samizdat Health.

“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.

. . . 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.

. . . Scott’s book, published in this co-operative venture [Samizdat Health], 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.”

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  1. I read this book a few months ago and basically enjoyed it ( I’ll get to the basically shortly). The novel describes the ways pharmaceutical companies have (among other things) lied, distorted clinical trial results, hidden side effects of their drugs, and attempted to sell medications for all sorts of conditions whether these medicines can help or not. As a former medical writer, I was engrossed by how accurately Scott describes some of the really evil things that are going on. Scott describes the trials and tribulations of a journalist who gets burned when he publicizes some of the wrong doings of a pharmaceutical company. He also follows that company’s guilt-ridden ghost writer as she has increasing doubts about her role in the company’s deceptions. The depiction of those two main characters is decent. But Scott goes overboard in what pharmaceutical companies can do as for example when he lets the chief villain erase all proof of the existence of a main character. No way. My other objection is the jazzy writing style Scott uses. It may not bother everyone, but I didn’t like it. For example, “Yeah, conno-f….ing-rations. Lobster bake-on the beach is going to get us some sunsetty fantasy shots.” Or “Mad honeys, the full Abercrombie.” But for me the pleasure of reading a nicely plotted novel that so satisfyingly exposed the wrongdoings of the pharmaceutical industry outweighed the book’s faults.

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