Friday, December 28, 2012

What in the Name of Medicine?: Preface

’Twas a few days before Christmas / in a land shaken and wary, /
A superstorm’d wreaked havoc / and other things were scary: /
A shooting of youngsters, / a fiscal cliff looming; /
Were pink slips ahead / in the early winter gloomy? /

Sir Teddy stirred gently / and eyed Kody asleep; /
Frank the ad guy was / away earning his keep. /
“Dare I post the first entries / of a hairy biz story?” /
Sir Teddy’s perplexed but / he feels not too worried. /

“Kids look forward to Christmas / as the innocent do; /
While adults check their smart phones / for alerts and ‘What’s news?’ /
The worries about taxes and / big business ’noia /
Mean the adults smile at kids / and still check messages in the foyer.”


Here comes a set of entries that in a sense have been in the works for over two years. They address a bizarre congealed set of mishaps, dense work, extreme pressure, and what I would call “corporate hysteria,” in the midst of my finishing up working for what I will call “[Agency X]” in this set of entries. I use the pseudonym to decrease the potential for any possible Googlebombing or other such mischief (or even more normal linking by the company’s real name—psst, it’s similar to “C*mm*nHe*lth”—with the consequence of rising high in search results). In working toward producing these entries, I have had mixed feelings, occasional self-questioning, exhaustion, and other such correlates of dealing with an extremely complex ethical situation for many months.


Qualified to do the analysis; slow because of the moral shock

I feel I am well equipped by experience and general understanding of the relevant industry to do these entries, but have been slow to produce them in part because I’ve felt as if I didn’t think it would be me that would have to produce these. Indeed, I think [Agency X] has—over the long term and regarding a wealth of workers—set itself up for this kind of analysis and criticism (including my entries that name the firm since spring 2012), and I have been aware of its ethical problems (and odd style of doing business) for some years, though in not so organized a form as you see on this blog.

But just as anyone would hate to have to do a post mortem of his own career breakdown, I have had anger, embarrassment, and such being faced with the task of doing this. I also am glad to reach some kind of end with the set of entries that start with this preface.


[Agency X’s] efforts to mitigate have been nonexistent or pitiful

Of course, the reason I have done this on my own is, in part, that it has made things cleaner and more efficient if I have pursued this case my own way. It is to be noted that, as aware as [Agency X] has surely been about my representations of what it did with me in August 2010, it has made no serious effort to come to fair and respectful terms on this. The one letter it sent me in late March/early April 2011 was laughable: I read it through the envelope before returning it as “refused.” The letter claimed, among other things, that there had been no “meeting” concerning me in August 2010, and no complaint made about me.

The writer, a human resources manager, said she had checked into this “matter” herself when she’d heard about some claims made about it. This was almost too absurd, and on the intelligence-insulting side. Why send such a letter a full seven months after I had left the company? (Well, in part, it followed shortly after I’d written a former coworker about the August 2010 matter…a long, very interesting story in itself from February-March 2011, not to be told here.) And I had never made a big point in previous public remarks about the August 2010 stuff about a “meeting,” so it was interesting (and amusing) that the HR person saw fit to deny this. It was almost like confirming a meeting had happened.


The public’s interest is at stake

Even if these claims were correct, it was all too little, too late. I had made a number of explicit claims about the company on my personal Web site (which I discontinued in August 2011), and in fact, as I didn’t reveal until this year (on my blog), I had already written to the FDA, with the first response from it in December 2010. Indeed, if it wasn’t for a problem that arose in August 2010 that I saw fit to write the FDA about, to which the FDA responded no fewer than two times (the second in October 2011), there wouldn’t be as much justification as there is in posting this series of blog entries (with the risks and difficulties involved for me) on the cluster of mishaps in August 2010.

I will have conclusions to draw about what this means for the public at large in due time, but keep one thing in mind—apart from the issue of how a claim of “harassment of a fellow employee” or the like should be acceptably handled in a corporate setting. This is that, when it comes to the promotions and advertisements of products made by Big Pharma, an account for which I was heavily working on when the cluster of mishaps occurred, laypeople might remember that when medicine is served by Big Money driving Big Promotions for Big-Expense Drug, in order to get Big Number of Sales (to serve Big Number of Shareholders, etc.), it shouldn’t be any surprise that, sometimes, the stress of delivering the Big Promotions can breed monsters that not only disserves a lowly, occasionally-erring worker like myself (who tries hard in his quality-serving work), as well as other workers in the inevitable team, but also may put the public at risk due to possible errors arising from management-driven, intentional mishandling of documents that are enclosed with a product and meant to support the public’s being served well by the medication.

If an advertising/promotions company can’t handle proofreading of FDA-required documents in the normally so-simple way it can and should be done, why should we put unblinking faith in all the other aspects of the Big Numbers style of business that Big Pharma conducts?


A note on two types of methods

Let me explain a couple different phases of what I have to report of (1) the August 2010 mess and (2) sequelae, and the different methods tied to each. This will help you understand the narrative that I post under the heading “What in the Name of Medicine?” In part this will show how strangely this set of issues has proceeded for over two years—e.g., including how CommonHealth has dealt with it.

The weeks up through August 27, of course, I can report on as having witnessed what I was aware of. In a court of law, or in some other legal proceeding, this would be considered what an “affiant” does (in written affidavits) or a witness (as in a courtroom)—that is, someone who can swear to be a witness to some facts. What I will post on this blog largely is witnessed stuff (or unambiguous documents).

The sequelae of the weeks that ended August 27, especially as they ranged over many months, are very interesting in their own right, but they concern things perceived, inferred, etc., by me indirectly. (None of this specially organized material will be posted yet, though in some ways it is very interesting to those who might value the witnessed stuff.) For the most part, this sequelae account concerns things represented, and ascertainable, online.

Note that this would never have been possible at businesses before about 2000. In the old days, if there was weird office politics going on, it was stuff you witnessed in the office. Of course, in this instance, if you ever had a legal case, a lot of your evidence—in witnesses, etc.—was subject to witnesses’ not being available; or if documents were of issue, could they be accessed?, etc. When dealing with online material, you can print out items or store things electronically. But then the problem becomes interpreting what you find online. Here, I would need to employ a certain measure of probability a lot of the time.

What I tracked online—largely via LinkedIn, bless its heart—was highly suggestive regarding the understanding among those at CommonHealth who seemed concerned to keep an eye on me and what I said about the company online. Things I ascertained ranged from the relatively indifferent to the amusing to the bizarre. In some cases, the meaning was pretty clear (such as someone, in mid-October 2010, reviewing my LinkedIn profile shortly after I had first gotten it going—and this someone would turn out to be one of the more important “watchwomen” of what I was doing). In other cases, you had to infer, with only a certain amount of likelihood, what was going on.

The fact that you had to make an educated guess, and conclude only with probability, wasn’t so bad. Actually, if you could conclude that X seemed to be going on with, say, 60 percent probability, then if you saw something else happen, that took X as a hypothetical basis, and this latter thing had a pretty strong (much-better-than-even) probability, then that tended to make X now look like more than 60 percent likely. A good example of this would be in my sequelae account, not to be posted here.


A thumbnail sketch of the worst problems the analysis/narrative heads toward

The following series of entries is about basically witnessed stuff.

In the week of August 23-27, the product information (P.I.) documents for the opioid-addiction treatment Suboxone film—P.I.s are distributed with consumer-level packagings of the product, can be found on the company’s Web site, and provide the basis for information in the PDR (Physicians’ Desk Reference)—were being handled for layout-related proofreading by the Ferguson division of [Agency X] and not, as editorial director Tweedle Dee himself made clear, an outside vendor that any Big Pharma company would typically use and which also provided certification that the vendor had produced the P.I. appropriately. For the Suboxone film P.I.s, the client apparently allowed and promoted this unusual handling by us.

Strangely, the outside vendor was laying out the documents, but we were proofreading them, even though the vendor typically had its own proofreaders, and even in aspects of this layout process the vendor’s own one or more editor(s) was/were proofreading the P.I.s also, at least to some special purpose. Then, as errors during the layout process happened, and new versions were produced, we at Ferguson proofread the new versions.

For the new (to-receive-approval) film version of Suboxone, there were two (six-point-type and nine-point type) P.I.s, with identical wording, the duo of which were laid out three times over Wednesday and Thursday—and I was the only proofreader being led to read them. There were specific instructions to have each read word-for-word (against backup) twice, i.e., by two proofreaders, and Tweedle Dee was even specifically asked by a staffer on Tuesday whether the P.I.s would be read twice (i.e., in line with the idea they should be). Whatever he answered, they were not read by another person.

In fact, once I even pointed out to him—while getting exhausted by the repeated readings of the same tedious copy—that a second person should be reading them, and he muttered something as if in agreement—and this was not done. In essence, I read the P.I.s, in terms of the same wordage being read, six times.

Common sense should tell you that this sort of thing would be exhausting (you can download a copy of the P.I. from the medication Web site and see how tedious the copy is), and thus could run into errors in terms of not catching every possible error due to fatigue or boredom. This situation created anxiety and anger for me. It also contradicted [Agency X’s] own policy for any such important documents, and it defied the specific instructions for these items. The reading just by me wasn’t something I demanded. And of course we could not provide the certification that the supposed outside vendor usually furnished with such work.


In this way and in other, even more disturbing ways (including a bad-faith move I postulate) that I’ll recount in the narrative, the P.I.s were handled unprofessionally. They were handled apparently in large part or exclusively out of billing considerations (which I’ll explain), not so much in terms of what were editorially effective and best-practices methods.

Any claim that Tweedle Dee (or anyone else) made that two editors indeed proofread the P.I.s in their multiple versions, as was specifically requested during the production process I was in, is absolutely false, and insultingly so to me. (This mishandling of the P.I.s would be a key part of my complaint that I sent to the FDA in fall 2010.) Subtleties and qualifications of all this will be seen in the subsequent parts of this series.

This, of course, showed no consideration for my work effectiveness (as to work on other items in the future).

Further, amid all the stress of that last week I was there, for me to be defamed with an alert as Tweedle Dum did and yet for her to have me in on Friday to do more bill-beefing-up P.I. work—as if I could be so stupid not to notice the results of an alert that had gone out to so many people—obviously not only shows a managerial temper for doing legally questionable things (related to case law on harassment matters I’ll come to later on), but shows there was no real expectation that I’d be called back, so ultimately my career prospects were hurt.

And, again, on Friday, if I was to be the only proofreader for this, there was the issue of public interest being served, if the P.I. was to be mishandled, though here the problem was less likely or crucial, because the tablet form of Suboxone had been in circulation for years, and its P.I. should have been pretty settled.

The defamatory-alert issue is something that is very extensively addressed by the sequelae account I mentioned above, which has to wait.

For now, I hold Tweedle Dum, the trafficking manager, and Tweedle Dee, the “director of editorial services,” primarily responsible for the P.I.-related issues.