Paul Grondahl
Robert Whitaker
doesn't mince words in arguing that the American medical establishment has failed in its
treatment of people with schizophrenia in his new book, "Mad in America" (Perseus; 304 pages; $27).
The book's subtitle lays out his scorching indictment: "Bad Science, Bad Medicine and
the Enduring Mistreatment of the Mentally Ill."
"Why should living in a country with rich resources, and with advanced medical
treatments for disorders of every kind, be so toxic to those who are severely mentally
ill?" Whitaker writes in the book's preface.
The answers he finds are harrowing. Whitaker describes early methods of controlling the
insane by removing teeth, ovaries and intestines; dunking them in freezing water; spinning
them on mechanical devices until they grew weak and nearly passed out; electroshock
therapy; forced lobotomies; and the assault of so-called miracle drugs such as thorazine
with dangerous side effects and poor results. Whitaker, 49, a former Times Union medical
writer who now lives in Cambridge, Mass., expanded a 1998 series of articles he co-wrote
for The Boston Globe that received a prestigious Polk award for medical writing and was
named a finalist for the Pulitzer Prize.
"This book is the result of a long educational process, in which I've learned that
money plays a big role in influencing medical treatment and the public doesn't get the
whole story," Whitaker says by phone from Cambridge.
Drug market
Bolstered by a historical overview of horrific methods used to restrain the insane across
the United States in the 19th and early 20th centuries, Whitaker builds to a crescendo of
outrage against large pharmaceutical companies and their tactics in the 1980s and 1990s to
capture a lucrative market for new antipsychotic drugs.
Whitaker shows how "big pharma," as it's known, skewed clinical trials, obscured
dangerous side effects, hired sham scientists to report results and encouraged patients to
take powerful drugs that increased their delusions as fodder for research.
While Whitaker's book has come under attack by some psychiatrists and those who work for
the drug multinationals he criticizes, advocates for the mentally ill have praised the
work.
David Oaks, director of Support Coalition International, an advocacy group for people with
mental illnesses, called Whitaker's investigation "a dose of truth therapy"
about the "secret underside of the psychiatric establishment."
Whitaker, who was assigned the medical beat after joining the Times Union in 1989, didn't
start out looking for trouble.
"At first, I wrote a lot of gee-whiz, pro-science pieces," Whitaker says.
"But then I started seeing how the bottom line really drives medicine and that a lot
of fabrications were being woven around clinical trials to protect profits."
Whitaker wrote an award-winning series at the [Albany, NY] Times Union in 1992 about
bungled operations by inadequately trained surgeons. That led to a Knight Science
Journalism Fellowship at the Massachusetts Institute of Technology in 1993.
Clinical trials
He returned to the Times Union briefly in 1994, but left later that year to become
director of publications at Harvard Medical School. He departed Harvard to start up Center
Watch, a journal that covered the business of clinical trials in the development of new
drugs.
"That's when the influence of corporate money on the process and science of testing
drugs became painfully clear," Whitaker says.
Using investigative journalistic techniques, Whitaker exposed a drug research corporation
that was employing Enron-esque subterfuge to hide losses and inflate earnings. Whitaker's
reporting helped eventually to send the president of that failed company to jail.
Whitaker honed his research skills and developed a thick skin at the helm of Center Watch.
"I had a lot of angry CEOs screaming at me and threatening lawsuits because negative
publicity caused their stock price to drop," Whitaker says. "Our badge of honor
among analysts was that we weren't just an industry mouthpiece."
An article for Fortune magazine about Zonagen Inc., a biopharmaceutical company that
produced a drug for male sexual dysfunction, received the National Association of Science
Writers' award for best magazine article in 1998.
"We laid out how the public was being misled about the drug trials to pump up the
stock price," says Whitaker, who co-wrote the story with Fortune staff writer David
Stipp.
First book
That same year, Whitaker sold his stake in Center Watch to devote himself to researching
and writing "Mad in
America," his first book.
During his Center Watch days, Whitaker stumbled upon psychiatric research in which
American scientists gave the mentally ill chemical agents intended to heighten their
psychoses. More digging revealed that outcomes for people with schizophrenia in the United
States have actually gotten worse in the past 25 years. Schizophrenia outcomes in
developing countries such as India and Nigeria are better than in the United States.
Whitaker's main goal in writing "Mad in America" was to take a fresh look
at the suffering of more than 2 million Americans diagnosed with schizophrenia and to spur
a national debate about how best to bring them relief.
The Times Union (Albany, NY)
March 3, 2002 Sunday