Academic Stalking

One of the consequences of taking a stand on an academic issue that has commercial implications seems to be ongoing academic harassment or stalking. The person most affected by harassment of this sort has been Nancy Olivieri on whom a whole book has appeared that seems aimed at discrediting her (see review - post 1).

In my case, after the issue of the University of Toronto breaching my contract became public in 2001, the media contacted both the university and me. The university directed reporters to J. Coyne, a psychologist at the University of Pennsylvania. The reports that I have from journalists who contacted Dr. Coyne indicate they found his responses off-putting and did not use them. Coyne wrote instead to the Globe and Mail, the British Medical Journal and elsewhere, voicing his concerns that Healy’s research was flawed and the only surprise about the Healy case was that anyone had seen fit to hire him in the first instance.

As it transpired, unbeknownst to me, Coyne had been contributing to a psychology listserv for some time before this (post 2). The tone of these communications across a range of issues and people is abusive. The authoritative note when it comes to issues to do with me is surprising given that Coyne has never contacted me for clarification of anything. The bombardment has continued over 6 years, suggesting a certain obsessive preoccupation - or academic stalking. Until recently, I regarded this stalking as a minor irritation.

In 2004, however, the stakes became higher. In February 2004, the United States Food and Drug Administration (FDA) convened a panel to consider the question of suicidality on antidepressants in trials conducted in children. In a first official recognition of this problem, the panel concluded there were grounds for concern. A further hearing was scheduled in September 2004. Prior to the September hearing, Pfizer made a submission to the FDA web site. This was a 50-page “billet doux” full of sweeping accusations about Healy that bore considerable resemblances to the points made by Coyne (post 3).

FDA refused to post a response from me. This response was later posted on the Alliance for Human Research Protection (AHRP) web site and appeared as an article in Ethical Human Sciences (post 4).

In January 2005, Britain brought in a Freedom of Information Act. I applied to Lilly, Pfizer and GSK to get material they held on me and got 116 pieces of information from Lilly. These suggest that the company put people in audiences when I am presenting, consider legal action against me on the basis of reports that appear in the media, prefer not to fund events in which I am a participant, and have worked out standard responses to Healy issues including dismissing what I do as motivated by involvement as an expert witness in legal actions. Ten of the briefer of these documents are posted here (post 5).

In April 2005, the American Journal of Bioethics posted an article by Coyne on the Martyrdom of David Healy. From Coyne’s listserv posts, it is clear that this had been in the pipeline for several years. It was posted online rather than in print (post 6).

Some months later I heard that the Collegicum Internationale NeuroPsychopharmacologicum (CINP), one of the psychopharmacological organisations of which I was a member, were investigating the allegations made by Coyne. As I heard it, one of the senior figures in CINP whose blood pressure seems to rise visibly when my name is mentioned had instigated this. Apparently one can be investigated by academic bodies these days without ever being told there is an investigation going on. I am now aware of several investigations and panels who have met and discussed Healy – without seeking any input from me. CINP appear to have dropped the matter.

The Martyrdom article led to an overture from Allan Horwitz of Rutgers University to see whether I would participate in a debate with Coyne. I agreed. This was scheduled for Columbia in October 2005. After the debate had been set up, Coyne pulled out. I gave a lecture anyway and both lecture and slides were posted on the AHRP web site in the first instance and now here (post 7 & post 8).

A week later Coyne gave a lecture at Rutgers. Many of the points he apparently made surfaced in an email a few weeks later. I have taken these points as the basis for a series of questions to Coyne. These questions were posted on the AHRP web site and remain unanswered. They are posted here (post 9).

In March 2006, I received a letter from the General Medical Council (GMC), the body with whom all British physicians have to register in order to practice. This is a body that has the powers to strike a physician off. It was a letter of complaint (post 10). The letter from the GMC to me contained a letter to the GMC by David Nutt, a professor of psychiatry and psychopharmacology in Bristol, in which Nutt refers to details in the Coyne article as the grounds for a possible complaint (post 11).

This led to a response to the GMC from me outlining the development of these issues and questioning whether this constituted a case of academic harassment (post 12).

Dr Nutt’s letter to the GMC had also raised the matter of the conflicts of interest that academics may have, and it referred to an editorial by Guy Goodwin, the professor of psychiatry in Oxford, in the Journal of Psychopharmacology which Dr. Nutt edits. I had responded to the Goodwin editorial in the Journal of Psychopharmacology, but this was not included in Dr Nutt’s letter to the GMC. It was included with my letter to the GMC as were a series of notes taken in a conversation between Dr. Goodwin and Pfizer about Healy and the suicide risk of antidepressants (post 13A & 13B).

As my response to the Goodwin editorial makes clear, sometime before this I had also made an overture to Guy Goodwin about holding a debate on the issues surrounding the SSRI and suicide controversy. It was difficult for journals like the BMJ and Lancet to get to grips with the issues in a controversy like this and inviting the major journals to a debate might enable them to feel more confident as to the significance of the issues. The editors who were invited all agreed to come, but Guy Goodwin was not interested to host the event (post 14).

At the same time, I applied to Bristol and Oxford Universities under Freedom of Information provisions. What emerged from Oxford and Bristol was a series of 3 earlier draft letters to the GMC (post 15) and a further letter tackling the Healy issues (post 16), as well as emails between Oxford and Bristol about Healy (post 17), along with further correspondence between Dr. Nutt and the GMC (post 18).

The Oxford Bristol correspondence included Dr. Phil Cowen, a professor of psychiatry at Oxford, who had reviewed for the BMJ the first BBC programme about Seroxat/Paxil (post 19), and later reviewed my book, The Creation of Psychopharmacology (post 20). This latter review had been used by two pharmaceutical companies as evidence to indicate that Healy’s views were not mainstream.

The GMC had by now responded to my first letter (post 21). Their reply and these materials provided the basis for a further letter from me to the GMC outlining the systematic aspect to these complaints (post 22).

Two weeks later, Glaxo SmithKline issued a letter to all doctors indicating that a new analysis of Paroxetine clinical trials pointed to a 6-fold increase in suicidal behaviour on paroxetine in placebo controlled trials (post 23). This took place against a background of increasing evidence that Glaxo SmithKline had handled the data on suicidal acts in their clinical trials in a manner that minimised apparent problems caused by paroxetine (Paxil/Seroxat) (post 24).

This laid the basis for a final letter to the GMC (post 25).

The GMC responded, dropping the case but suggesting that the Coyne-Healy issues were all but par for the course for academia (post 26).

After the case was closed, the Journal of Psychopharmacology, of which Dr Nutt is the editor, contained an editorial by Pierre Blier, the deputy editor, that again deplored the use of the media to raise concerns about the hazards of treatment (post 27). I have responded (post 28).

There is always more than one side to a story. For this reason, this site is therefore open to Dave Nutt or others mentioned above to reorganize the pieces of the jigsaw or to add to them in a way that might move matters forward.

Has Dr Nutt’s response been provoked by finding friends of his in the British regulatory body, the MHRA, under attack by the media? He might well have felt the portrayal of his friends was unfair and required a response. The notion that a psychiatrist should not take issues to the media coming from Dr Nutt is however disingenuous, as he regularly features in the media, making a wide variety of claims, some of which other clinicians might regard as injudicious (see post 28).

Was the complaint prompted by links to pharmaceutical companies? There are clear links between Drs. Nutt and Goodwin and pharmaceutical companies in this area but then there are links between me and these companies also. Perhaps the only solid lesson to draw is companies probably take notes on most conversations they have with academics and these notes could come back to haunt any of us.

Does this story illustrate the problems between the Irish and the English? The Irish are up front and misread English conversations where much is hidden between the lines. The English fail to take what the Irish say at face value, suspecting hidden agendas. My accounts of the Prozac controversies praise Dave Nutt. But where I see a consistent and unambiguous message – thanking him for what he has done - he may have read the opposite. In English circles, with respect, with all due respect, and with the greatest possible respect mean the precise opposite to what they mean in Ireland.

Or is this an example of sibling rivalry that has little to do with academic harassment? Drs. Nutt, Goodwin, Cowen and I go back to the early 1980s. Our research interests have overlapped, and our relations in the past have been collegial.

For the sake of this collegiality it might be better to quietly drop this issue. The reason for not doing so is to put the phenomenon of academic stalking or harassment on the map. This story has developed to a point of closure. It seems worth posting in order to convey something of what others such as Nancy Olivieri have had to go through.

When the issue of academic stalking comes up, everyone knows it happens but no-one can point good examples of just what can happen. Shoulders shrug in a this-is-the-way-of-the-world fashion. Why make matters worse when nothing can really be done to make a difference. This fatalism ensures that nothing will happen. But if a phenomenon gets named and markers get put down, there is a chance something might happen.

There is a good chance that the latest twist to this story involving friends has not stemmed from the same motives that led to the Martyrdom article and Pfizer’s billet doux, but, whatever sources it stemmed from, this could have been the straw that broke the camel’s back. Disciplinary investigations of this sort can take a horrifying toll on those investigated. Academics should be able to find a better way to solve their problems than this.

David Healy
September 2006

Responses

As indicated above, in the interests of fair play, this site is open to responses from those mentioned in the posted documents. Phil Cowen has responded and his response is posted here:

I am a great fan of David Healy’s writing and was honoured to find two of my reviews on his website, albeit under the section entitled “academic stalking”. I can assure David (what is probably sadly obvious) that these two articles are my own unaided work and, in particular, free of any conspiratorial influence from my detested siblings, Goodwin and Nutt. The review in the British Medical Journal was sub-edited but, as is the way, only to remove the best jokes. As far as I was concerned on publication both pieces of work fell into well-merited obscurity.

I was therefore surprised, about a year after the review in “Psychological Medicine” appeared, to receive this e-mail from David (post). Of course, at the time I did not have the benefit of David’s psychological analysis of our cultural differences, which he explores interestingly on this website. To put it simply, it just didn’t occur to me that his e-mailed message was an open expression of Irish friendship and respect. To perceive it, as I did, as a message that might have been produced in collaboration with Tony Soprano was clearly a mistake because I now understand that David is vehemently opposed to any form of academic harassment.

In fact in scientific terms I don’t think there is a great difference of opinion between David and myself about the risks of SSRIs. Almost fifteen years ago, Aidan Power and I wrote an article in which we concluded, “However, as with other antidepressants, patients taking fluoxetine may experience rare adverse reactions than can be associated with the development of suicidal thinking and behaviour.” (British Journal of Psychiatry, 161, 735-741, 1992). This is still my view; however, I believe that when SSRIs are used carefully their risk-benefit ratio remains favourable. The important question of how SSRI prescription impacts on suicide rates in the population will probably be answered definitively over the next few years.

The two reviews posted on this web-site deal with another aspect of the SSRI controversy; how in post-modern media, scientific arguments are transformed into competing melodramas in which protagonists acquire archetypal roles, for example, hero, villain, martyr, conspirator. This transformation can certainly produce riveting media products, but inevitably human and scientific complexity is lost; Mark Twain remarked that it was no surprise that truth was stranger than fiction because fiction has to make sense. While I regard the efficacy and safety of SSRIs as very important issues for public health, the two reviews probably do not take David himself quite as seriously as he would like to be taken. However, I certainly did not intend either piece to be mean-spirited and it was my aim in the “Psychological Medicine” article to pay tribute to David’s skills as a writer and explorer of the motivations that lay behind some of the most important medical discoveries of the last century. I hope I was successful in this.

What I can say is that both these articles, with their limitations and imperfections, were written as open and independent expressions of my opinion. I count myself immensely fortunate to be part of a tradition, all too limited in human discourse, which not only allows but encourages freedom of thought and speech. Sadly this freedom is often under threat and I am in complete agreement with David that must do our very best to defend it no matter from what source the attacks might come.

Phil Cowen
November 2006