3 September 2005
The Globe and Mail
Dr. Nancy Olivieri is professor of pediatrics and medicine at the University of Toronto. She conducts (non-drug company funded) research at Toronto General Hospital, and has worked in clinics in Sri Lanka since 1996 (see www.hemoglobal.org ).
In 1998, she gained widespread attention when her research at Toronto's Hospital for Sick Children led her to believe that a new drug treatment posed dangers to some patients. Olivieri's case exploded after the drug company Apotex Inc., co-sponsor of some of the research, abruptly terminated the study.
The author John le Carré wove a fictional account of this story into his novel, The Constant Gardener.
Olivieri has never confirmed that she and le Carré ever spoke, or met, to discuss her case. But his thriller contains intriguing parallels with the issues of the Olivieri case.
Here, Olivieri comments on the movie based on the book, which opened this week. There are people who may hate The Constant Gardener: those, for example, who believe that the development and marketing of drugs to the world's most vulnerable citizens is fair, transparent and honest.
Others might be offended by the parallels drawn between the activities of Big Pharma and those of arms dealers.
Almost everyone else is going to love this movie.
In its first three minutes, The Constant Gardener begins to dramatize the exploitation of vulnerable patients in medical research conducted by certain drug companies. The movie grabs you by the throat. I cheered at several places, felt rage at others (my movie companion pointed out raising one's rage level can be good for the soul, but he might have changed his mind if I hadn't stifled, repeatedly, the impulse to stand up and scream). Most of the time, I wanted to cry.
As for this being a “thriller,” it wasn't — for me. It's the most realistic movie I've seen in years. Maybe that reflects some familiarity with overseas medicine, where patients sick enough to be rushed to intensive care here are sent home to die. Or maybe, that huge chunks of the story on the silver screen compelled me to relive years of harassment, false accusations and legal threats.
To back up a minute: When John le Carré's The Constant Gardener, on which the movie is based, was published, it did not escape notice that the story is set partly in Canada, and that the lives and adventures of two female protagonists, while different than mine, revived memories of my own unhappy experience at Sick Kids' Hospital.
In the book, activist Tessa, a strong-minded advocate for downtrodden people in an emerging country, is quickly silenced — after which her husband receives an education in the ways of Big Pharma from Lara, a doctor and researcher at a Canadian university.
Lara's troubles begin when she signs a contract with a drug company, forbidding her to publish findings from a clinical trial without the company's consent. (Years ago, I signed a similar research contract, approved by Sick Kids.) Like me, Lara studied a drug to be prescribed in poorer countries and, when she sought to disclose her subsequent concerns about the drug, was met with vigorous opposition within her hospital.
Both Tessa and Lara have personalities which could euphemistically be described as “spirited,” and both use strong language (this is, of course, where any similarity to me ends). The movie combines the book's two female characters, letting it fall to Tessa (played by Rachel Weisz) to appreciate certain practices employed in testing drugs in poor patients.
Le Carré's publishers deny that the story is based on the Sick Kids scandal. Yes, it's fiction: No drug company has attempted to bump me off or injure me, while Tessa meets her fate early, and Lara narrowly escapes being run off the road by mysterious thugs.
However, I remain the target of character assassination by those apparently opposed to my defence of patients' rights. The most recent attack strings together several anonymous accusations from “unnamed” sources — long proven false by independent inquiries — and then ludicrously blames me for the refusal of the U.S. Food and Drug Administration to license a drug.
Anonymity and secrecy also play a big role in both the book and movie versions of The Constant Gardener. The movie has a lot of cloak-and-dagger meetings and car chases with faceless drivers. The book has a chapter describing anonymous hate mail sent to the heroine, warning her to stop “poisoning decent people's lives.”
That was a tip off to Canadians, who knew that my colleagues and I had received anonymous mail warning us to “stop poisoning the air and fabric” of “decent people” at Sick Kids.
As the final movie credits roll by too rapidly for most to read, I was struck that they repeated an observation made by le Carré at the end of his book:
“As my journey through the pharmaceutical jungle progressed,” he wrote about his work and fiction, “I came to realize that. . . my story was as tame as a holiday postcard.”