After writing comes the hard work

The author has finished the book…

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Publisher: Great. Now you have to go on the road.

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Writer: Why?

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Publisher: It’s part of the process. You write, we publish, you promote. There’s bookstore signings and some meetings… a women’s group in Stockholm organizing a panel on women who eat men for breakfast or some such…  Thursday, flight tomorrow, here’s your ticket. You’ll be met.

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Writer: What’s my line?

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Publisher: Talk about your next big thing, an old chap with three sons, that three arrows analogy… How’s it coming?

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Writer: Getting there. He’s becoming more obsessive about finding his identity, he’s never come to terms with his inner female, his shrink tells him to confront his sons. Drawing on American psychobabble.

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Publisher: Sounds marketable. Oh, a couple more things. We need blurbs and photos.

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Writer: Blurbs?

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Publisher: Get your writing friends to recommend the book. Big names. Celebrities.

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Writer: I’m not keen on having my photo on the book. Let the words speak for themselves.

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Publisher: Readers want to see you. They can see who is speaking to them. Someone they can relate to.

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Writer: But some readers want to imagine what the writer looks like. They want to create their own image.

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Publisher: Forget them. They’re a minority. We’re in the visual age. A good PR photo helps sales. We’ll see to it.

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Voice-over

Starting out writers may be not be aware just how much other stuff will interrupt their writing. Even if a book generates sales, royalties and residuals, it’s still just the script. Once it’s written, find a producer (publisher), generate publicity (do the PR), hire actors (the author and booksellers), rent a theater (signing venues and conferences), follow up (manage social media). A book is just part of a production.

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Two doctors, Woodruff and Borst, we might describe them as followers of Hippocrates rather than drug company salespeople, are discussing the implications of published vs unpublished studies.

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Woodruff: In 2006 the number of prescriptions written for antidepressant drugs was greater than for any other class of medication in the U.S. I should have gone into psychiatry.

Borst: And become a Prozac salesman?

Woodruff: It would help keep the wolf from the door.

Borst: Come on, Harry, you're an honest doc, you know the figures: 94% of published studies on antidepressant drugs report positive effects to taking the drug under investigation, but 96% of unpublished studies find questionable or no benefits to taking antidepressants.

Woodruff: I know, Bill. I’ve had patients come to me with depression and they say the medication doesn’t work. And I know that’s often the case. But sometimes I think part of the problem is with the patient. They give up taking the meds before they’ve had a chance to work. Get impatient to see results or don’t like the side effects.

Borst: The amount of negative data on drug use is remarkable, though. We know that drug companies like to see studies that show positive results and “lose” studies that show no results. They are biased.

Woodruff: Yeah, and there’s another worrying aspect to getting good data. Medical journals prefer to publish articles that demonstrate a treatment benefit. Could the drug companies be in collusion with the medical journals? Is there a huge reef of hidden data telling different stories about drug treatments that drug companies don't want the public to see?

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Voiceover

The two docs agree on the dark side of drug marketing. Woodruff mildly regrets some lost income. He is slightly sympathetic to prescribing medication, shall we say 55-45? Yet seeing his more skeptical colleague Borst is aggressively anti-medication (shall we estimate Borst at 70-30?) Woodruff concedes and goes into agreement mode. There is a suspicion that Woodruff could be persuaded to be either pro- or anti-medication.

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