The Zyprexa Papers

The Zyprexa Papers
by Jim Gottstein, Anchorage Alaska
ISBN-10: 0578627264, 232 pages

A review by Dr. David Healy

The Zyprexa Papers has two interlocking parts. One centers on a set of documents relating to Eli Lilly’s Zyprexa (olanzapine), a company cash cow, which had been made available under a secrecy order to lawyers acting for hundreds of people injured by Zyprexa.

The other centres on Bill Bigley, a man enmeshed in the Alaskan mental health system since the early 1980s with over 70 admissions. Patients, like Bill, drowning in rather than being saved by the mental health system, face compulsory detention and forced drugging orders.  The implementation of these orders involves legal processes that are honoured in the breach rather than the observance. At these hearings, people are non-personned. Their views about the lives they might want to lead, the conditions they supposedly have, and the “treatments” about to be forced on them are not just ignored but used as evidence they have these “conditions” and need to be treated.

Jim Gottstein set up PsychRights, the Law Project for Psychiatric Rights, in 2002, aimed at representing people like Bill Bigley. Honour the legal process and who knows what might happen.

On November 28, 2006, Gottstein got a phone call from David Egilman, an expert witness for plaintiffs injured by Zyprexa. As an expert, Egilman had access to Lilly documents detailing how they would sell Zyprexa for everything under the sun and hide the evidence of the dangers their cash cow posed.  Unbeknownst to Gottstein, the cases were about to settle and Egilman was hoping someone would subpoena the documents to get them out from under seal. Gottstein, who represented people at risk of being forced to take this and related drugs was a good person to choose. He had a legitimate interest in acquiring documents he could show the court and argue “look they are proposing to give Mr. Bigley a drug that may drastically shorten his life with little evidence it will do him much good”. 

Gottstein made clear to Egilman what he needed to do in respect of the confidentiality order he’d signed to shore up both their positions. Despite intimations that Egilman would not do this, Gottstein subpoenaed the documents believing that he had kept to the letter of the law.  When the documents arrived, he arranged for a number of interested parties to get copies. Lilly took legal action against him and Egilman and won a Pyrrhic victory.

This much is well-known. The papers have been widely distributed and have opened some peoples’ eyes.  Gottstein doesn’t detail the content of these papers — what every non-person knew about the capacity of these drugs to cause diabetes, metabolic syndrome, suicidality and other problems. The fascination lies in how little of this appears to be known by the psychiatrists who might lock you and me up and inflict treatment on us and how pharma takes psychiatrists for idiots.

It’s rather like how little Germans during World War II knew about what was happening in their country. And just like German functionaries drew up specifications for drainage in vehicles to transport people to concentration camps, much as they would have done for transporting animals, so also Judge Weinstein dealing with Gottstein’s actions stuck rigidly to the legal specifications without questioning what in fact was going on. And if that sounds grimly American, everything we know about what pharma gets up to comes from legal actions in the US and a handful of lawyers like Gottstein. The rest of the world has made no contribution to what we now know.

Many people coming to this book might figure that the Bigley saga plays second fiddle to what is after all called The Zyprexa Papers. A switch from the dizzying heights of New York courtroom drama to an Alaskan backwater. But Bill Bigley’s case is the beating heart of this book. The Zyprexa papers are the bait for Gottstein’s masterly portrayal of how the system treated Bill and will treat you and anyone you know who comes into contact with it.

There are no wins in this book. You won’t come away uplifted. You won’t even have the gratification of seeing people you’d like to hate being vilified – Gottstein blames no-one but himself (for not being smarter). There is one group conspicuous by their absence in these pages – the people Lilly and other companies find so easy to fool.  And the sense has to be that they are so easy to fool because people like Bill simply don’t register on their radar. If there was any passion for others left in these zombies, any interest in taking on a challenge, things might be different.

If you start reading, be warned, all of your defences will be stripped away. If you think what happens to Bill Bigley could only happen in some out of way place, like Anchorage, think again – this is the reality of being a non-person in New York, Washington, Berlin, London and likely Beijing too. 

Bill Bigley died in November 2012. Gottstein waited 7 years to finish this book. It takes a certain amount of time and distance to write a book as good as this.

It also takes a certain amount of nerve. It is likely that no conventional publisher would take a risk on publishing this.  All the more reason to buy The Zyprexa Papers.

Why write at all? Because this book had to be written. Because the system will keep doing to you and those you know what it did to Bill Bigley unless you pick up the torch that Jim Gottstein is passing on.  You can start by sending a copy of this book to a shrink near you today.

Available on Amazon.com: The Zyprexa Papers