All posts by Brian Martin

Brian Martin is professor of social sciences at the University of Wollongong, Australia, and vice president of Whistleblowers Australia. He is the author of a dozen books and hundreds of articles on dissent, nonviolence, scientific controversies, democracy, information issues, education and other topics.

Marking essays: making it easier and more fun

It’s worthwhile discovering methods to make marking more enjoyable. The same methods can be used to tackle other dreaded tasks.

libraryPapers3

Sitting on your desk is a pile of essays that need to be marked. There might be just 10 or 20, or maybe 50, 100 or more. For most teachers, this is not an eagerly awaited task. Is there some way to make marking easier and more enjoyable?

I’ve been marking undergraduate essays for over 25 years and have tried out various methods to make the task less onerous. Gradually I’ve discovered ways that work well for me. You may or may not want to adapt these for your own circumstances. In any case, I encourage you to undertake your own search for better methods. If you’re looking ahead at 25 years of marking, surely it’s worthwhile to explore better ways to go about it.

Pacing

Because marking is generally seen as unpleasant, it is very common to postpone starting. Doing other things, such as reading a book, checking emails, searching the web or even doing housework, suddenly seems more appealing. After all, it really won’t matter much if you start tomorrow. Days and sometimes weeks go by until it becomes urgent to do the marking. Then it becomes a matter of long exhausting hours of mental labour. It seems like a marathon, and only goes to prove that it really was something to be avoided.

The habits of procrastination and bingeing are deep-seated. Most teachers learned them when they were students, cramming for exams or doing all-nighters to write essays.

desk-and-papers

The solution to the syndrome of procrastination and binge marking is simple: tackle just a few essays each day. If I have 80 essays and need to finish marking them in two weeks, I set myself a target of six every day. Six essays seem much less daunting than 80.

The hard part is getting started. It’s best to begin marking the very first day or, if some essays come in early, before the due date.

Robert Boice researched the habits of highly productive new academics, and found the secret of success was working in moderation. Academics who did a little every day — research, writing, class preparation — were vastly more productive than those who waited for big blocks of time to complete tasks in lengthy sessions. Furthermore, the ones who worked in moderation were less stressed.

I can’t tell you how to change habits of procrastination and bingeing; you can learn a lot from various self-help books. All I can say is that it’s one of the most important things you can do to make marking easier.

keep-calm-carry-on-marking-essays-2

Staying fresh

My goal is to approach each essay feeling fresh and positive. Doing only a moderate number of essays per day helps. So does taking breaks. After marking one or two essays, I’ll take a break: a stretch, a snack, some research work, some reading, perhaps the dishes.

If I’m doing only an hour’s worth of marking per day, a break may not be needed. For anything longer, breaks are vital.

Marking requires mental effort, and the mind behaves like a muscle. Do too much and it gets tired and cries out in pain. Do the right amount and it gets stronger day by day. This is another reason for pacing: marking gradually becomes easier. So often it’s better to start with a few essays on the first day and increase the daily target later.

stressed teacher

Going faster

How long does it take to mark an essay? A few teachers I’ve met may spend an hour or more, reading and rereading the essay, writing lengthy comments and agonising over the mark. My goal, though, is to go faster while maintaining quality.

Many people read at 200 to 300 words per minute. Yet it is possible to read several times this fast while maintaining comprehension. To do this requires practice, going a little bit faster until it seems natural, and then pushing to go faster still.

Going faster is similar to progressive training of the body, with greater speed or strength developing over time. It’s also similar to typists who train so they can achieve amazing speeds with great accuracy.

My aim is to be fresh and to maintain concentration so I need to read an essay only once and retain a short-term memory of it, perhaps jotting down a few notes along the way. I then type all my comments. If I feel a need to read the essay again, it usually means I haven’t maintained concentration. Time for a break.

Marking less

Even the most efficient marker can be daunted by the prospect of hundreds of essays. If you have some control over assessments, then there are ways to cut back on the marking load.

One option is to simply reduce the number of assignments. Students are often overloaded with work, and could do a better job on fewer assignments, putting more effort into each one.

Another option is to mark some student performance during class. I used to have students do short oral presentations. With a simple template, I would scribble feedback on a sheet of paper and give this to the students at the end of the class. One advantage for students was getting feedback promptly, which seldom happens with essays.

Yet another option is to have frequent small assignments, but only mark some of them. For example, in one class students had to write eight mini-essays, one per week. However, only two these were marked, in weeks chosen randomly after weeks four and eight. Some students complained that they wanted all their submissions marked; I responded by saying that marking just two of them was equivalent to having an exam in which only two of eight possible questions were asked.

Another source of essay marking overload is writing too many comments. I discovered that some students were discouraged by too much red ink. Others never bothered to read my comments at all. In one case a student – one of the weakest in the class – glanced at the mark and immediately deposited the essay in the rubbish bin. All the effort I had put into commenting on strengths and weaknesses was for naught.

red-ink

For final assignments, some of my colleagues have a policy of asking students to say in advance whether they want comments. Students who don’t ask just receive a mark.

Years ago, I used to correct spelling and grammar as well as give comments on content. But I don’t teach English composition, so why become a proofreader? So I stopped giving detailed feedback on expression, and concentrate on content.

grading+essays

My current system is to write brief comments on each assessment criterion, mentioning strengths and ways to improve, and to supplement this with “general comments” that are generic for the whole class. The general comments explain my expectations and elaborate on how essays could be better. I say in my feedback that if my specific comments don’t say anything about a particular aspect of the assignment, then the student should look to the general comments. This approach avoids the need to write the same comments on essay after essay.

Varied assignments

Monotony is a great source of pain in marking. If there are 50 essays each answering the question “What are the factors behind the rise of social media?” the task quickly becomes tedious. If you are marking essays for someone else’s class and have no control over essay questions, you have my sympathies. Luckily, I’ve usually been able to set my own assignment topics. One of my goals has been to make it interesting for me to mark essays — even the ones that aren’t so good.

Thinking up assignments that are stimulating for students to carry out and for me to mark is not easy, but it has been worthwhile. Two ways of doing this are to give students quite a bit of choice in their topics and to invite or require them to use unconventional formats.

In an environmental politics class, we covered a series of topics such as sustainable development and the precautionary principle. Each week I asked the students to write a comment on that week’s environmental topic using a randomly chosen political, economic or other theory or framework, such as liberalism, militarism, feminism or Buddhism. Then for the final assignment, students had to write a dialogue between two characters, as in a script for a play, with footnotes as appropriate. Each character had to represent or embody some theory, for example Mao Tsetung for Marxism and Gandhi for pacifism. The characters had to discuss some environmental topic. So one possible dialogue would be between Mao and Gandhi discussing sustainable development.

For marking purposes, this assignment was delightful. Every submission was different, and many students were creative in their choices. One student crafted a discussion between Thomas the Tank Engine and Percy the Small Engine. Percy was a Rastafarian and used rasta slang; footnotes explained unusual terms.

When designing such unorthodox assignments, it can be challenging to explain to students exactly what is expected. I’ve found a fairly good method: with students’ permission, I post top assignments from previous years on my website. These show the format expected, for example a dialogue, and by demonstrating really good work can provide an inspiration to do well.

Designing an assignment that is interesting to mark has a spin-off effect. It can change the mode of covering the content. In many cases, I’ve found it effective to let students investigate topics themselves rather than me delivering lectures. For the environmental politics class, we had an excellent textbook for the environmental topics, and I let the students (many of whom were doing an environmental science degree) look up topics like liberalism and Buddhism on their own.

To some, this might seem to be abdicating a teacher’s responsibility to provide authoritative perspectives on content. For me, it is part of encouraging students to learn on their own, including finding relevant readings, understanding concepts and applying them to case studies.

In making marking more enjoyable, I also hope to make learning more enjoyable for students. By getting students to do more work on their own and tackle unorthodox assignments, I hope to encourage student creativity and initiative. I remind myself that for the teacher to work hard often is not all that relevant to student learning. Students learn more when they work hard, and they are more likely to work hard on an interesting assignment. When the assignment is interesting to both students and the teacher, it is a win-win solution.

posting-on-fb

Other applications

If marking can be made reasonably enjoyable, what about other dreaded tasks? What is dreaded depends on the person, and might be paperwork filing, housework, gardening, tax returns or practising the violin. Often it’s whatever you’re avoiding. Whatever the challenge, the same sorts of principles can be applied.

1. Work in moderation, a little bit each day, rather than procrastinating and bingeing.

2. Remain fresh and alert by taking breaks when needed.

3. Practise going a bit faster while maintaining quality.

4. Aim to do what’s good enough, not at perfection.

5. Redesign the task to make it more interesting.

Brian Martin
bmartin@uow.edu.au

Further reading

Robert Boice, Advice for New Faculty Members: Nihil Nimus (Boston: Allyn & Bacon, 2000): on moderation as a philosophy for academic work.

Charles Duhigg, The Power of Habit: Why We Do What We Do in Life and Business (New York: Random House, 2012): a fascinating account including advice on changing habits. (See Brian’s commentary.)

http://www.bmartin.cc/classes/: subject outlines and outstanding student work illustrating unusual types of assignments.

Acknowledgements Thanks to Paula Arvela, Don Eldridge, Kathy Flynn and Anne Melano for helpful comments.

A prostate story

Who benefits from testing to see if you have prostate cancer?

Being told “You’ve got cancer” can strike fear into a person’s heart. For middle-aged men, prostate cancer is the most common reason to hear this diagnosis.

Ive-got-cancer

Here’s how it usually happens. You have a simple blood test and receive a figure for your PSA, the prostate specific antigen. Anything above 4.0 is supposed to be a cause for worry, and possibly more tests. The number gives the PSA blood level in nanograms per millilitre.

I remember having the test done quite some years ago. A nurse rang to give me the results. She said “It’s 4.1”. I thought, this seems a bit high given my lifestyle. Then she said, “Oh, sorry, it’s actually 0.1”. That was okay, then. Little did I know.

An elevated PSA level is considered a cause for worry. The doctor might recommend a biopsy just to be sure, or the patient might want to know. This can lead to trouble. If the biopsy is positive for cancer, what next?

holy-psa-cropped

In the US, most urologists recommend removal of the prostate, an operation called a prostatectomy. This is supposed to get rid of the cancer. It sounds straightforward, but the operation is extremely delicate. The prostate straddles the urethra, the channel for urine and semen, and is surrounded by many sensitive nerves.

Sometimes the operation doesn’t get rid of the cancer. And quite often the operation has serious side effects: most men are left impotent and many become incontinent.

Instead of removing the prostate, another option is called “active surveillance” or “watchful waiting”, though it might better be called “worried waiting”. What this means is checking at regular intervals to see whether the PSA score is increasing.

Although most men in their 50s and 60s have cancer in their prostates, relatively few of them die of it. The cancer is usually slow-growing, so slow-growing that something else kills them first. They die with prostate cancer, not from prostate cancer.

Because the advantages of taking a PSA test are so limited, and the possible side-effects of unnecessary treatment are so severe, some researchers and policy-makers have argued that healthy men should not be screened using the test. On the other side are those – including urologists and advocacy groups, among others – who argue that PSA testing saves lives, and accuse the no-screening advocates of playing with men’s lives.

This debate has played out differently in different countries. In Britain, watchful waiting is more common; in the US, testing and aggressive treatment, especially removing the prostate if there is any sign of cancer, is standard.

Into this debate, there’s a new book titled The Great Prostate Hoax. The subtitle indicates the message: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster.

Prostate-hoax

The author is Richard J. Ablin, assisted by Ronald Piana. Ablin has credibility in this area: he discovered PSA in 1970. And he is appalled at the widespread use of the PSA test in the US. He says that as the discoverer of PSA,

I have been linked to the 30 million American men … who undergo routine PSA screening for prostate cancer. The result: a million needle biopsies per year, leading to more than 100,000 radical prostatectomies, most of which are unnecessary. (p. 4, emphasis in the original)

Richard-J.-Ablin
Richard J. Ablin

Ablin provides one key point that undermines the argument for testing: the PSA test is not a test for prostate cancer. It is only a test for the prostate specific antigen, in extremely tiny amounts in the blood. This is not the same as a prostate-cancer specific antigen. Ablin says that using the PSA test is roughly as accurate as flipping a coin. Furthermore, the level of 4.0 as a warning of whether there might be cancer is arbitrary: it was more or less picked out of the air.

Researchers have been searching for a prostate-cancer indicator, but haven’t found one yet. The next question is how the PSA test ever became accepted, given its dubious diagnostic value.

This is where “big medicine” comes in. The PSA test does have some value. For men being treated for prostate cancer, the PSA level is an indicator of whether the cancer has returned, and therefore of how effective treatment is.

For a company selling a PSA test, there’s not much money to be made in testing men being treated for prostate cancer. But there are big bucks in screening. In the US, this means tens of millions of men per year.

Ablin tells the story of how the US Food and Drug Administration (FDA), which licenses medical tests, was swayed by emotion over rationality in approving a PSA test. For example, one of the test’s advocates, Jim Wise, used this approach:

Queried on the suffering of countless numbers of men harmed by PSA false positives, Wise circled the wagons around his insular community – men who claim they were saved by PSA screening – in essence, seemingly implying that their lives outweigh the harms to other men produced by false-positive PSA results. This is the common emotion-based type of exchange used by advocates to promote PSA screening. It’s a kind of flag-waving patriotism that people are loath to challenge; we’ve seen the results of that sheeplike mentality. (pp. 66-67)

But there is more to the FDA story than emotional pleas. Corporate interests played a role. Some FDA advisory committee members tried to expose the scientific shortcomings of the PSA test, but corporate connections prevailed. Ablin describes the FDA advisory committee meeting in considerable detail, down to individual exchanges, revealing a system that is corrupt at several levels.

FDA-approved-199x300

FDA officials tried to cover themselves by issuing warnings about inappropriate use of the test, but their inaction sent a different message. The FDA did nothing about massive off-label promotion of the PSA test.

Advocacy groups were part of the promotion of PSA screening; many of them are sponsored by the companies. Before long, PSA screening became the basis for a massive commercial enterprise. Screening is only the beginning. False positives keep the money rolling in. Men are told their PSA might indicate prostate cancer and should have a biopsy. Then, quite commonly, cancer is detected in the prostate, and prostatectomy is recommended.

An experienced surgeon can usually do a good job, but many men opt for a much more expensive method using a robot. The surgeon is still involved, but using a complicated piece of equipment. Robotic prostatectomies have become the primary method used in the US, even though there is little evidence they are any more successful than conventional surgeries.

If radiation is the preferred option, the latest generation of high-tech treatment is proton-beam therapy, in centres costing over $100 million to construct. Without sufficient patients, these centres would go bankrupt.

Then there are the side effects of treatment, though they might be better described as the main effects: impotence and incontinence. Ablin offers some moving stories from men whose lives have been seriously damaged by prostate removal. Some of them feel their manhood has been lost.

smoking-impotence
and so does a prostatectomy

Because of impotence and incontinence, there’s an additional market in medical fixes, for example penile implants and bulbourethral sling surgery. Ablin quotes experts saying that half of urology practices in the US would go out of business if not for the steady stream of patients whose problems begin with PSA testing.

From Ablin’s perspective, PSA testing is a gravy train for urologists and for drug and medical device manufacturers, with a seemingly inexhaustible stream of men entering the shadow of a prostate cancer diagnosis. Ablin calls PSA testing a hoax because there is no good evidence that it reduces the death rate and there is ample evidence that it causes a huge amount of suffering.

The Great Prostate Hoax is powerful testimony to the dangers of a profit-driven health system. It can be added to the growing body of writing about corruption in corporate healthcare, something that causes far more suffering and death than most of the hazards that exercise the public mind.

The book does have some limitations. It deals almost exclusively with the situation in the US, giving little attention to practices and debates in other countries. The US situation is important, to be sure, but insight into ways to control the PSA-testing juggernaut could be obtained by an examination of what is happening in countries where different attitudes and policies prevail. (For an Australian critical commentary on PSA testing, see Let Sleeping Dogs Lie?)

Another context for the book is screening for other conditions. A decade ago, H. Gilbert Welch wrote Should I Be Tested for Cancer? Maybe Not and Here’s Why, providing close scrutiny of the hazards of screening people with no symptoms. More recently, he and two colleagues extended their critique of screening to a wide variety of conditions, in a 2011 book titled Overdiagnosed: Making People Sick in the Pursuit of Health.

The implication of Ablin’s book is that any man without symptoms should be reluctant to enter the screening roller coaster. But is there anything else worth doing? Ablin doesn’t mention non-standard treatments of prostate cancer, for example hyperthermia, available in Germany. Nor does he mention the possibility of nutritional prevention. There is a considerable body of information about the possible benefits of selenium, zinc, fish oil, natural vitamin E and saw palmetto, as well as more general benefits from a diet with cruciferous vegetables. Hyperthermia and nutritional prevention are controversial, to be sure, but their hazards are far lower than conventional treatment.

For men concerned about their personal risks from prostate cancer, it is worth considering a range of information, about prevention, screening and treatment methods. In this, The Great Prostate Hoax is essential reading, especially to appreciate the intersection between science and politics. Ablin deserves the last word.

Medical industry profiteers have squandered trillions of health care dollars since the PSA test was first brought to the market. Given the utter failure of PSA screening, scientifically and clinically, why are we continuing to drain our health care system by repeating something we already know does not work. The late Albert Einstein defined insanity as doing the same thing over and over again and expecting different results. Repeating the same mistakes borne at the beginning of the PSA saga borders on criminal insanity. (p. 228, emphasis in the original)

Brian Martin
bmartin@uow.edu.au

An online mobbing

Tom Flanagan was mobbed online. His experience provides several sorts of lessons.

Tom Flanagan
Tom Flanagan

Tom Flanagan, a Canadian political scientist, worked for 45 years at the University of Calgary. He became a prominent public figure, appearing on television and writing columns for newspapers and magazines. He also had experience in the political system, having served as campaign manager for several politicians seeking office.

Along the way, Flanagan made some enemies. Much of his research related to First Nations and their claims over land, and he took a position contrary to activists in the area. Flanagan’s political leanings might be characterised as conservative: he had managed campaigns for conservative politicians.

On 27 February 2013, Flanagan gave a talk at the University of Lethbridge. Unknown to him, some First Nation activists attended and planned to use the talk to discredit him. They secretly recorded his talk and asked him a question about an extraneous topic, about which he had once made a passing comment: child pornography.

In the several hours it took Flanagan to drive home the next morning, a social media storm blew up, leaving his reputation in tatters. An extract of his talk, out of context, had been posted on YouTube with the misleading tagline “Tom Flanagan okay with child pornography.” Before long, he was widely denounced, including by Canada’s prime minister, Stephen Harper, for whom Flanagan had once been campaign manager, by the premier of Alberta, and by numerous mainstream media outlets, with front-page stories.

MacDougall tweet
A hostile tweet

Flanagan soon lost many of the connections he had built up over the years. The Canadian Broadcasting Corporation cancelled his contract and his own university put out a weak-kneed media release.

Several things about this storm of protest especially annoyed Flanagan. First, he had only made passing comments about child pornography; it wasn’t a topic he had carefully investigated. Second, he had been speaking to an academic audience, in his teacher role in which he tried to stimulate thinking about the topic, but his enemies had treated it as a political opportunity to catch him out and discredit him.

Third, his views on child pornography had been seriously misrepresented. He opposed child pornography, and had only said that penalties for merely viewing it (in Canada, a minimum of several months in prison) might be too stiff. Fourth, those who denounced him and his views had not waited to hear Flanagan’s perspective before rushing to make public comment.

Vulnerability to online mobbing

Mobbing is collective bullying. It’s when a group of people combine to attack a target by abuse, undermining, sidelining, defaming and otherwise causing harm to a person’s morale and reputation. Most commonly, mobbing occurs in workplaces, when a group of workers — usually including the boss, though not always — use verbal and physical methods against a fellow worker. Flanagan experienced a different sort of mobbing. His attackers were online, whereas his colleagues were largely supportive of him.

Flanagan in his book Persona Non Grata (discussed below) says several factors were involved in the online mobbing he experienced. One is that the news cycle has sped up enormously. Before the Internet, it would take a day or two for a story to be taken up widely. Now it can occur in minutes. In the face of a crowd baying for blood, politicians and public bodies did not want to wait a day for claims to be checked out. Instead, they made statements immediately to reduce the potential harm to themselves of being seen as sympathetic to Flanagan’s alleged views.

Another factor is that Flanagan had enemies who were unscrupulous. They set him up with a leading question, made a recording without telling him, produced a clip omitting context, posted it on YouTube with a misleading label and started raising the alert about it. Most people never acquire enemies like this. Flanagan, by being a public commentator who was willing to challenge orthodox views in some areas, was vulnerable.

A third factor in Flanagan’s case was moral panic, which is widespread alarm about an issue out of all proportion to its actual harm. In his book, Flanagan traces the evolution of moral panics over child sexual abuse, including claims about Satanic rituals at US preschools and claims based on recovered memories, in which innocent workers and parents were charged with crimes and some of them imprisoned despite lack of any material evidence. Child pornography, he says, is the latest version of this genre of moral panic. By making comments questioning the severe penalties for viewing child pornography, Flanagan entered territory in which the merest association with a topic can create a stigma.

keep-calm-and-morally-panic

Finally, Flanagan says online mobbing occurs because so few people check out the facts before passing judgement. Hundreds of people who didn’t know Flanagan personally were willing to condemn him without hearing his side of the story. Even worse, some individuals who knew him well, sometimes for many years, condemned him without hearing his side first. The rush to judgement overwhelmed their critical capacity: they assumed he was guilty as charged and apparently were afraid of being seen to support him, so they joined the attack.

Defending

Flanagan says that if he had been expecting an attack and had been closely monitoring social media, he might have been able to organise resistance at the very beginning and prevent the worst consequences. However, his attackers had operated surreptitiously. While driving home, listening to music, he received initial word of the media storm, but was not well placed to mount a concerted response. Anyway, why should someone like him — an academic who had just given a guest lecture at another university — have to be constantly monitoring social media just in case of adverse comments?

When he got home, he discovered the scale and seriousness of the attack and started responding. Luckily, he still had friends and supporters, and he was able to write explanatory articles in several influential publications. Furthermore, his colleagues at the University of Calgary were largely supportive. Flanagan, having been a campaign manager for several political candidates, knew quite a lot about media dynamics and management, far more than some others who have been targets of virtual mobbing. Even so, he felt overwhelmed, noting that a rushed response, while under siege and before he obtained full information, might make things even worse.

One of Flanagan’s sympathisers arranged an opportunity to write a book, and that is what he did. Before the end of the year, he finished writing Persona Non Grata: The Death of Free Speech in the Internet Age (Toronto: McClelland & Stewart, 2014). Flanagan had written many previous books, so he was quite capable of such a rapid yet considered response.

 persona_non_grata_book_cover.jpg.size.xxlarge.letterbox

Persona Non Grata

Flanagan’s book is a powerful account of his experiences and an indictment of his attackers. One thing that makes the book powerful is his clear, engaging narrative. His treatment is careful and measured, with some degree of outrage to be sure, but more along the lines of being a concerned investigation into a problem about which he has first-hand experience.

By being clear, informative, calm and readable, Persona Non Grata will reach audiences who had never heard about Flanagan before and who would be unsympathetic to his political views. I wrote an article, “When you’re criticised,” on how to respond to attacks, recommending writing a response that is clear, calm and factual, and that is what Flanagan has done in his book.

One of the features of Persona Non Grata is a chapter on penalties for possessing child pornography. As he describes, he had never had more than a passing interest in this topic, but because a false representation of his views was the pretext for mobbing him, he started investigating further. He addresses various arguments and, while expressing his abhorrence at the production of child pornography, and his personal distaste for it, he affirms his previous tentative view that mandatory jail sentences for only possessing or viewing child pornography may be excessive. This is his careful, considered riposte to those who mobbed him.

Academic freedom

In the urgency of the initial online mobbing, the University of Calgary, Flanagan’s long-time employer, issued a statement that was pathetically weak. Flanagan was especially disappointed that an academic institution would put out such a statement without waiting a few extra hours to consult with him. So in Persona Non Grata, Flanagan devotes a chapter to academic freedom.

He gives one of the most cogent accounts of the arguments for academic freedom in the classroom that I have read. Most studies of academic freedom focus on research, inquiry and public comment. Flanagan, in giving attention to teaching, spells out the justification for academics being given the opportunity to teach what they want in the way they want, as well as to speak out on issues of public importance. He is well aware that academics are inhibited and constrained in various ways, and gives good reasons to continue claiming academic freedom as an important contribution to students and society.

Professors have to have room to discover what works well for them, in their discipline, with their personality, with their particular bundle of strengths and weaknesses. Typical undergraduate students at a large university will be exposed to perhaps three dozen instructors in the course of getting a bachelor’s degree. Out of those three dozen, they will probably find a small handful that seemed especially memorable and another handful that seemed like a complete waste of time or worse. But the variety gives all students a chance to find at least a few inspirational professors whose memory can be cherished for a lifetime. If that doesn’t happen, the student has been cheated. (pp. 162–163)

Flanagan tells about some of the students in his classes over the years, and what careers they have entered, many of them taking different political trajectories than Flanagan himself.

Conclusion

Quite a number of individuals have been caught in a whirlwind of online abuse and condemnation, which harms their reputations and careers far out of proportion to their alleged misdemeanours, as astutely described by one of the leading researchers into academic mobbing, Canadian sociologist Kenneth Westhues. Tom Flanagan has produced the most insightful and readable account available of what it is like to be a target of an online mob. In Persona Non Grata he has shown how to rise above the abuse and respond in a calm, reflective fashion that is the exact opposite of the way he was treated.

Brian Martin
bmartin@uow.edu.au

Thanks to Zoë Barker and Ian Miles for helpful feedback on drafts.

Pharmacrime and what to do about it

Is the pharmaceutical industry more dangerous than the mafia? Peter Gøtzsche thinks so.

PeterGotzschePeter Gøtzsche

Did you know that the third leading cause of death in western countries, after heart disease and cancer, is adverse reactions to prescription drugs? Did you know that large pharmaceutical companies usually control the trials of their new drugs, and sometimes manipulate the published results by misclassifying deaths, excluding some participants and not revealing studies that came up with null results? Did you know that some of people listed as authors of drug studies published in leading medical journals have had little or nothing to do with the research, have not written the papers, and are paid for their symbolic role? Did you know that several major pharmaceutical companies have paid fines of over one billion dollars for corrupt practice? Did you know that government drug regulators in several countries have become tools of the companies they are supposed to regulate? Did you know that hundreds of thousands of people have died from drugs when the company executives knew about and hid information about the hazards?

This information has been known to critics of large pharmaceutical companies — commonly called big pharma — for many years. There have been powerful critiques written by former editors of medical journals and as well as exposés by whistleblowers. Now there is a new book that puts together the case against big pharma in a more comprehensive and hard-hitting way than ever before: Peter C Gøtzsche’s Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare (London: Radcliffe, 2013).

DeadlyMedicines

The bulk of the book is a critical examination of research findings concerning pharmaceutical drugs, serving to illustrate general points. For example, chapter 4 is titled “Very few patients benefit from the drugs they take,” seemingly a startling claim. Gøtzsche gives some hypothetical examples of how results of drug testing might sound encouraging but actually disguise a very modest effect, and how double-blind trials that are not properly blinded can give misleading results. He then cites studies of antidepressants to show that the actual situation is probably worse than his hypothetical examples.

Different chapters in the book deal with conflicts of interest, pharmaceutical company payments to physicians, drug marketing operations, ghostwriting of articles for medical journals and the inadequacy of drug regulators, among other topics. Each of these chapters includes case studies of particular drugs or company operations. Then come chapters about particular drugs, abuses and companies, for example chapter 14 on “Fraudulent celecoxib trial and other lies.” Gøtzsche exposes corrupt practices, including the hiding of trials that did not show a benefit, disguising adverse drug reactions, promoting a new highly expensive drug that is no better than an existing one, making false statements about the benefits and risks of drugs, applying pressure on drug regulators, and suppressing information about dangerous drugs on the market.

Gøtzsche relies heavily on published studies (including his own) to back up his claims: the book is thoroughly referenced, with numerous citations to articles in medical journals. Deadly Medicines and Organised Crime is in the tradition of rigorous and knowledgeable exposé. Some previous books along the same line include Marcia Angell’s The Truth about the Drug Companies and Jerome Kassirer’s On the Take. Angell and Kassirer had been editors of the prestigious New England Journal of Medicine.

Gøtzsche has impeccable credentials to write a critique of big pharma. He started his career working for a drug company, and saw dubious operations from the inside. He qualified as a doctor and then worked as a medical researcher for many years. Most importantly, he is a key figure in the Cochrane Collaboration, a group of medical researchers who scrutinise the full complement of studies of particular drugs, drawing conclusions about benefits and risks.

Undertaking a meta-analysis of drug trials seems like an obvious thing to do. What makes the Cochrane Collaboration significant is that it is largely independent of the drug industry. The industry’s influence is so pervasive that many trials are fraudulent or misrepresented, many publications are ghostwritten by company staff, and evaluations by drug regulators are biased due to company pressure. Being relatively independent of this influence makes an enormous difference.

As well as obtaining insights from his involvement with the Cochrane Collaboration, Gøtzsche has had personal involvement in trying to influence drug policy. Being from Denmark, on various occasions he has provided information to the Danish drug regulator on crucial issues, such as that a new drug is far more expensive than an existing one, but no more effective. Yet the regulator on many occasions has served drug company agendas by approving drugs, costing the government large sums of money and providing no added benefit to patients.

Here is Gøtzsche’s summary of problems with drug regulation.

We don’t have safe drugs. The drug industry more or less controls itself; our politicians have weakened the regulatory demands over the years, as they think more about money than patient safety; there are conflicts of interest at drug agencies; the system builds on trust although we know the industry lies to us; and when problems arise, the agencies use fake fixes although they know they won’t work. (p. 107)

In describing the unethical and damaging activities of the drug industry, with case after case of egregious behaviour, Gøtzsche sometimes expresses his exasperation. This comes across most strongly in the chapters on psychiatric drugs, many of which are useless or worse, cause addiction and massive damage, yet are widely prescribed due to massive marketing.

Gøtzsche’s book is filled with information and thoroughly referenced, yet perhaps its most striking feature is his claim that big pharma is organised crime, as indicated in the title. At first this may sound exaggerated, or just a metaphor, but Gøtzsche is quite serious. He looks at definitions of organised crime and finds that big pharma fits in all respects: the companies knowingly undertake illegal actions that bring them huge profits and kill people, and they persist in the same behaviour even after having been convicted of criminal activity.

At many points, Gøtzsche asks rhetorically what is the difference between the activities of big pharma in promoting addictive and destructive drugs and the activities of drug cartels producing and selling heroin.

organised-crime-cartoon

Calling big pharma organised crime is in a tradition of pointing to double standards in the way behaviour is labelled. The term “terrorism” is usually applied to violent acts by small non-state groups; some scholars have pointed out that many governments use violence to intimidate populations in way that fits the usual definitions of terrorism. They call this “state terrorism.”

If the operations of big pharma are a type of organised crime, except killing many more people than the mafia, what is to be done? Gøtzsche has a chapter spelling out ways to bring drug testing and regulation under control. One important step is for all drug testing to be done by independent scientists, rather than by the companies that manufacture the drugs. Another is to disallow payments from drug companies to physicians, researchers, medical journals, and regulators. Gøtzsche draws an analogy: what would people think if judges received payments from prosecutors or defendants? It would be seen as corrupt, of course. Company payments to physicians, journals and regulators should be seen as corrupt too.

doctorPayment176

Gøtzsche’s recommendations are sensible and, if implemented, would transform the way drugs are used in society. If this happened, company profits would plummet, which means that companies will do everything possible to maintain the current system. As well as saying what should be done, there is a need for a strategy for bringing about change, and the strategy has to involve citizen campaigners as well as concerned researchers and physicians. Just as the movement against smoking has involved a wide range of campaigners and methods of action, so too must a movement against corruption in healthcare. Deadly Medicines and Organised Crime is not a practical manual for such a movement, but it is essential reading for movement activists, especially so they will know what they are up against.

For readers thinking about their own health, and the health of their friends and family members, Gøtzsche provides important messages. He suggests not taking any drug unless it is absolutely necessary, because benefits are minimal and there are always potential harms. In this category would be included antidepressants and drugs to lower cholesterol and high blood pressure, for example. If you’re going to take a drug, then it’s usually better to take an old one, because newer ones are probably no better, cost vastly more, and are less well tested for harms.

olderisbetter

If you want to know more about the drugs you take, seek independent advice. That’s not easy, because so many researchers, medical journals, physicians and regulators are in the pay of the industry. Reviews by members of the Cochrane Collaboration are a good place to start. So is Deadly Medicines and Organised Crime. Gøtzsche provides enough references for even the most assiduous reader.

Brian Martin
bmartin@uow.edu.au

 

I thank Melissa Raven for useful comments on a draft of this comment.

Learning from Snowden

A review and commentary on Luke Harding’s book The Snowden Files, with special attention to implications for leaking and whistleblowing

Snowden I want you cropped
In June 2013, spectacular revelations were reported in the news. A secretive US organisation, the National Security Agency, was carrying out extensive spying on people’s electronic communications. This spying was massive. The NSA, according to reports, was collecting just about everything imaginable: emails, phone calls, texts, you name it – from everyone around the world.

The revelations continued for weeks and months. The NSA was spying on US citizens in the US, apparently in violation of the law. It was also spying on foreign leaders. For example, there were reports that the NSA had monitored the personal mobile phone of Germany’s chancellor Angela Merkel, and the phones of many other political leaders.

The stories were broken by the Guardian, a well-known British newspaper and media group. The Guardian‘sinformation came from an NSA insider who had leaked vast amounts of NSA top-secret material. This was unheard of. The NSA did not have leaks.

Several days later, the leaker went public. He was Edward Snowden, a 29-year old NSA contractor who looked even younger than his age, and he was in Hong Kong.

Snowden said he had released the material because it showed the US government was carrying out massive surveillance, and that this needed to be exposed. He seemed to be sincere.

US government officials were furious. Snowden became a wanted man, and the full power of the US government was deployed in an attempt to arrest him.

If you’ve read Robert Ludlum’s novels about Jason Bourne, or seen the films based on them, starting with The Bourne Identity, you’ll have an idea of how surveillance capacities might be used to track down a rogue agent. Something similar happened in Snowden’s case, but this time in reality rather than fiction. The US government pulled out all stops, not to assassinate Snowden, but to arrest him.

The Snowden files

If you followed the Snowden revelations via news reports, like me, some of the basic points will be clear but how it all hangs together may not be so obvious. For a broader perspective, I recommend Luke Harding’s new book The Snowden Files: The Inside Story of the World’s Most Wanted Man (London: Guardian Books, 2014). Harding is a journalist for the Guardian and has obtained first-hand information on key events. Just as importantly, Harding writes in an engaging fashion. Parts of the book read like a thriller.

Snowden Files

The Snowden Files covers Snowden’s early online presence, his patriotism, his work for the NSA, his gradual disillusionment due to observing dubious activities carried out in secret, his collection of NSA files and leaking of them to the Guardian, and his experiences as a fugitive. In between the Snowden narrative, Harding tells about the massive spying operations carried out by the NSA and its partners, especially its British equivalent GCHQ. He also tells how the media – especially the Guardian – handled the biggest leak in history in the face of implacable hostility from intelligence agencies and top politicians. Snowden was incredibly brave and shrewd, but so were quite a few others in the story.

Lessons for whistleblowers

Here I offer a few lessons for whistleblowers based on Snowden’s experiences. Although few whistleblowers reveal information warranting international headlines, every effort at speaking out in the public interest is important and hence worth doing as well as possible.

Leaking is revealing inside information, typically to media or sometimes to interested groups. A lot of leaks are from top politicians and bureaucrats. These leaks are everyday operations intended to manipulate public opinion for political or personal purposes.

However, when someone leaks information in the public interest, for example exposing corruption or dangers to the public, top managers typically treat this as a serious breach of trust. Leakers are often called traitors. The double standard is stark: it’s okay for bosses to leak but not for employees.

Whistleblowers are people, typically employees, who speak out in the public interest, and most of the time they reveal their identity immediately, such as when they report a problem to the boss or some internal body. Unfortunately, this is disastrous much of the time: the whistleblowers are attacked – for example ostracised, denigrated, reprimanded, sometimes dismissed – and furthermore their access to information is blocked. As soon as their identity becomes known, they have limited opportunities to collect more information about wrongdoing.

For these reasons, it is often advantageous for whistleblowers to remain anonymous, and to leak information to outside groups, especially to journalists or action groups. The leaking option reduces the risk of reprisals and enables the leaker to remain in the job, gathering information and potentially leaking again. Furthermore, stories based on leaks are more likely to focus on the information, not the leaker.

snowden wbs are heroes

Lesson 1: be incredibly careful

Snowden leaked the most top-secret information of anyone in history, but it wasn’t easy. The lesson from his experiences is that to be a successful leaker, you must be both knowledgeable and incredibly careful. Snowden had developed exceptional computer skills. He was leaking information about state surveillance, and he knew the potential for monitoring conversations and communication. He took extraordinary care in gathering NSA documents and in releasing them. When he contacted journalists, he used secure email. When meeting them, he went to extreme lengths to screen their equipment for surveillance devices. For example, before speaking to journalists, he had them put their phones in a freezer, because the phones might contain monitoring devices.

Few whistleblowers need to take precautions to the level that Snowden did: his enemies were far more determined and technically sophisticated than a typical whistleblower’s employer. Nevertheless, it is worth learning from Snowden’s caution: be incredibly careful.

Lesson 2: choose recipients carefully

Snowden considered potential recipients for his leaks very carefully. He wanted journalists and editors who would treat his disclosures seriously and have the determination to publish them in the face of displeasure by the US government. He decided not to approach US media, which usually are too acquiescent to the government. US media have broken some big stories, but sometimes only after fear of losing a scoop. The story of the My Lai massacre, when US troops killed hundreds of Vietnamese civilians during the Indochina war, was offered to major newspapers and television networks, but they were not interested. In 2004, US television channel CBS initially held back the story about abuse and torture of Iraqi prisoners by US prison guards at Abu Ghraib prison, at the request of the Pentagon, finally going to air because the story was about to be broken in print.

new-york-times-building-380x285Snowden didn’t approach the New York Times

Snowden decided instead to approach the Guardian, a British media group with a history of publishing stories in the public interest, despite government displeasure. It was a wise choice.

Lesson 3: be persistent

Snowden decided to approach the Guardian, and not just anyone: in late 2012 he contacted the Guardian‘s freelance columnist Glenn Greenwald, noted for his outspoken stands critical of US government abuses, especially surveillance. Snowden sent Greenwald an anonymous email, offering disclosures and asking Greenwald to install encryption software. However, Greenwald – resident in Brazil – was busy with other projects and didn’t get around to it. So Snowden created a video primer for installing the software just to encourage Greenwald to use it. However, even this wasn’t enough to prod the busy Greenwald to act.

Snowden didn’t give up. In January 2013, he next contacted Greenwald’s friend and collaborator Laura Poitras – a fierce critic of the US security state, and a victim of it – who he thought would be interested herself and who would get Greenwald involved. It worked.

Snowden+Guardian

The lesson is to be persistent in seeking the right outlet for leaks – and to be careful and patient along the way.

Lesson 4: improve communication skills

Snowden is a quiet, unassuming sort of person. He might be called a nerd. Contrary to some of his detractors, it was not his desire to become a public figure. Despite his retiring nature, Snowden knew what he wanted to say. He refined his key ideas so he could be quite clear when speaking and writing, and he stuck to his message.

Most whistleblowers need good communication skills to be able to get their message across. (In a few cases, leaking documents without commentary might be sufficient.) My usual advice is to write a short summary of the issues, but this isn’t easy, especially when you are very close to the events. Being able to speak well can be just as important, if you have telephone or face-to-face contact with journalists or allies. Many people will judge your credibility by how convincing you sound in speech and writing. Practice is vital, as is feedback on how to improve.

Lesson 5: make contingency plans

Snowden thought carefully what he wanted to achieve and how he was going to go about it. Initially he leaked selected NSA files to journalists to pique their interest and demonstrate his bona fides. After all, who’s going to believe someone sending an email saying they can show the NSA is carrying out massive covert surveillance of citizens and political leaders? After establishing credibility, Snowden then arranged a face-to-face meeting, to hand over the NSA files and help explain them: many of the files were highly technical and not easy for non-specialists to understand.

After the initial stories in the Guardian and the ensuing media storm, Snowden knew that it would be impossible for him to remain in hiding. The US government would do everything possible, technically and politically, to find and arrest him. So Snowden decided to go public, namely to reveal his identity. This would help to add credibility to the revelations by attaching them to a human face.

He did not anticipate every subsequent development: it was not part of a plan to flee Hong Kong and end up in Russia. Even so, Snowden anticipated more of what happened than most whistleblowers, who are often caught unawares by reprisals and stunned by the failure of bosses to address their concerns and of watchdog agencies to be able to protect them.

The lesson from Snowden is to think through likely options, including worst case scenarios, and make plans accordingly.

mountain-climbing-300x225
Is this your escape plan?

Lesson 6: be prepared for the consequences

Snowden knew that leaking NSA documents would make him a wanted man. He was prepared for the worst scenario, arrest and lengthy imprisonment. He knew what he was sacrificing. Indeed, he had left his long-time girlfriend in Hawaii, knowing he might never see her again. He made his decision and followed it through.

So far, Snowden has avoided the worst outcomes, from his point of view. He might have ended up in prison, without access to computers (his greatest fear), perhaps even tortured like military whistleblower Chelsea Manning. Still, living in Russia – an authoritarian state, where free speech is precarious – is hardly paradise. Snowden is paying a huge price for his courageous actions. He knew he would, and he remains committed to his beliefs.

Whistleblowers seldom appreciate the venom with which their disclosures will be received. It is hard to grasp that your career might be destroyed, and perhaps also your finances, health and relationships. It is best to be prepared for the worst, just in case. Being prepared often makes the difference between collapsing under the strain and surviving or even thriving in new circumstances.

***

Reprisals are only partly directed at the whistleblower. The more important audience is other employees, who receive the message that speaking out leads to disastrous consequences.

Snowden has provided a different, somewhat more optimistic message. He has shown that the NSA is not invincible: its crimes can be exposed. He has shown that careful preparation and wise choices can maximise the impact of disclosures. He has stood up in the face of the US government, and continued unbowed. Although few whistleblowers will ever have an opportunity like Snowden, or take risks like he has, there is much to learn from his experiences.

Brian Martin, bmartin@uow.edu.au

This post is reproduced from the July issue of The Whistle.