In past columns, I have commented on the challenges we in the health care industry face in regards to public trust, both in medical education as well as in biomedical research. These issues have been well chronicled both in professional and lay publications. I recently read a book by one of my favorite spy and mystery novel authors, John Le Carre. Much to my amazement, instead of Mr. Le Carre writing about international, intergovernmental espionage, his newest novel, The Constant Gardener, concerns the exact issues of public trust in clinical research that I have addressed previously in these pages. True, with the demise of the cold war, Mr. Le Carre's novels have been evolving from the classic The Spy Who Came In From The Cold; Tinker, Tailor, Soldier, Spy; The Honorable School Boy; and Smiley's People to more current events in books such as the Little Drummer Girl, The Russia House, and Single and Single.
The Constant Gardener, based mostly in Kenya, concerns the brutal murders of the wife (Tessa) of a British diplomat (Justin Quayle) and a local Kenyan physician. After wading through background information concerning Tessa's relationships with the various Kenyan communities and seemingly unconnected events including the illness, death, and disappearance of a local native woman who shared a hospital ward with our heroine, it becomes apparent that the epicenter of the plot concerns a large international pharmaceutical conglomerate, AIDS, and the clinical trials of a newly manufactured drug. The protagonist, Justin Quayle, undertakes a journey across Africa, Canada, and Europe, and finally determines his wife's death was related to the pharmaceutical companies' efforts to cover up the fact that their AIDS wonder drug had previously unidentified side effects. They were marketing this drug in third world countries and using falsified data to then be able to use this drug in the western world. Their arrogance, fed by their profit appetite, was the motivation to disregard public need and trust while corrupting scientists and clinicians in the health care community.
Isn't it interesting that a world-renowned master spy novelist has turned his focus to the pharmaceutical companies and their relationships with the academic and health care communities to spin his yarn of intrigue? In a sense, his interest in this area is a proxy for the measurement of the seriousness of this issue. It is yet another piece of evidence of our need as academicians to rid ourselves of conflicts of interest and strive to regain this public trust.
I heartily recommend The Constant Gardener to you on the merits of its literary value in addition to the significant message it holds for those of us dedicated to health care in an academic environment.
William W. Pinsky, MD, Executive Vice President and Chief Academic Officer, Alton Ochsner Medical Foundation
- Ochsner Clinic and Alton Ochsner Medical Foundation
