booklog 2015 – 2) Gemma Halliday – Spying in High Heels

Chicklit mystery set in Los Angeles. Maddie Springer is a young fashion designer who tries to track down her lawyer boyfriend when he goes missing, and finds herself in the middle of embezzlement and murder. I nearly stopped reading on the first page, wherein Maddie describes her behaviour on the freeway when she’s late for a meeting with her boyfriend. Almost causing an accident by cutting into lanes and doing her make-up in the mirror at high speed was presumably supposed to make her look adorably ditzy, but I simply found it loathsome. I did keep reading, but it coloured my view of the character for the rest of the book.

It’s an odd one for me. The mystery plot was enjoyable if predictable, and there were things I liked a lot, with some good supporting characters; but it was hard work getting to the end and if it had been a paper edition I would have probably been high-speed skim-reading. No more than a two star for me and I’m not inclined to try anything else by this author, even if I can see why other people were bowled over by it.

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book log 2015 – 1) Ben Goldacre – Bad Pharma

I was a bit pathetic at book logging last year, wasn’t I? Doubtless I shall be again this year, but I’m going to try to do slightly better and at least get to the end of January before it all goes horribly wrong…

Ben Goldacre is a very angry man, with good reason. In this book he lays out how the pharmaceutical industry has distorted drug research in pursuit of profit, sometimes intentionally, sometimes entirely without malice but with equally devastating effects for patient welfare. This matters because patients are prescribed less effective drugs, or drugs which are outright harmful, at huge financial expense to those paying for the drugs. This isn’t a conspiracy theory book; Goldacre is quite clear that many valuable drugs have come out of the industry, and that most of the people who work in it want to make better drugs. He sets out in detail how and why bias is introduced into both research and prescribing practices, putting it in layman’s terms but linking to the research papers and court documents that back up what he’s saying. He also addresses the failings of the current regulatory system, and proposes ways to improve things — pointing out that unless real controls with serious financial penalties are put in place, even those companies which genuinely want to reform will be under commercial pressure to continue with bad practice in a race to the bottom.

It’s a dense and at times exhausting read. But Goldacre has done a decent job of making the issue accessible to a wide audience with a direct interest, from patients to practising doctors and academics. You can skim a lot of the book to get the general gist, or you can read it in details without following the links, or you can dig into research material he drew on and has laid out in meticulous footnotes and citations. He concludes the original edition with practical suggestions about what individual people can do to improve things, often simply by asking questions.

I read the second edition, which has a “what happened next” chapter about the reaction to the first edition. As he had predicted, there was a backlash in an attempt to discredit him — but there was also a lot of covert feedback from industry personnel acknowledging the problems and considering how to improve things. While there’s always a “the lurkers support me in email” issue with uncredited sources, he does also offer some examples of companies which have publicly moved to improve transparency.

Bad Pharma is an angry but rational examination of a real problem that affects millions of people, including almost anyone reading this review. It’s a worthwhile read, even if it makes for uncomfortable reading for patients, doctors and companies alike.

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