"Life is always a tightrope or feather bed. Give me the tightrope"
- Edith Wharton, 1926
I wrestled with the decision to become a medical writer. Although I felt the role to be worthwhile, I was uneasy. This response was due to an apparent clash of values, the unconscious beliefs that put ‘heart’ into our decisions. My dilemma was, is it right to profit from the ill health of others?
I am not alone with this question. Commercial healthcare has been debated by the US Institute of Medicine, investigated by journalists,,, and parodied by a game in which “to succeed in a world where crippling illness is good for business”, you must “…master both engineering and your conscience!”. Clearly then, for many, the balance between making money and delivering compassionate care is a tightrope walk.
This conflict isn’t logical. New medical insights need highly skilled innovators to develop these concepts into revolutionary medicines – and these businesses need to balance their books. The Association of the British Pharmaceutical Industry’s (ABPI) code of practice demands that the sector’s operations are “…professional, ethical and transparent”.
I understood that my conflicted values could be reconciled in the right context. However, that context is crucial. I needed to find a medical communications employer with ‘heart’.
Some months later I applied for a role with LEC, the brand communications arm of OPEN Health. According to their website, they “employ great people, do fantastic work, excite our clients, have fun, and make money”. At interview, my potential new colleagues laughed often, showed great ease with each other and were clearly proud of their work. I heard that David Rowley, one of OPEN Health’s founding partners, has tea with every new recruit. In just over 5 years the business has grown from ~14 to over 300 people: that’s a lot of tea...
Once in post, my line manager asked me about my values: she admitted to being motivated by relationships. Quite soon, I experienced what she meant: the agency hit a dangerously busy ‘blip’ which our MD assured us would “…never become our normal”. Under this pressure I witnessed the team become greater than the sum of its parts, and deliver a miracle. And although tired, I stayed late and arrived early without complaint – because I didn’t want to let down my colleagues.
Weeks later my personal ‘normal’ changed overnight, requiring that I relocate back to the northeast of England. However, because UK medical communication agencies are mostly London based, I braced myself for another career change.
My MD, with great humanity, validated my choice, then paused, saying, “Leave this with me”. Then next day she introduced me to a colleague, an MD from Succinct Medical Communications, OPEN Health’s medical communications agency. She had grown their ‘North’ office from scratch into a team of 7 in barely 2 years. Agreeing for me to join them in Newcastle was a bold decision, because my writing mentor works remotely. My new MD assured me that we would, “…make our internal communications work, and adapt them until they do!”. This felt like another miracle.
I have been warmly received by the team, and we are developing our processes with willingness and humour. I have come to believe that we can walk the values tightrope and find a balance. And as we seek to do this, perhaps we will in time be known for our ‘heart’, and find that ‘everyday miracles’ have become our ‘normal’.
View of the Skylon tower from the 52nd floor of the London Hilton. The photographer, Peter Rood, witnessed this man’s high-wire walk as a ‘regular performance’.Image: Peter Rood, 2012 (Wikimedia Commons)
 Gray, BH (ed) For-Profit Enterprise in Health Care. Committee on Implications of For-Profit Enterprise in Health Care, Institute of Medicine (US). National Academies Press, Washington DC, 1986. Available at https://www.ncbi.nlm.nih.gov/books/NBK217906/pdf/Bookshelf_NBK217906.pdf. Accessed January 2017.
 Law, J. Big Pharma: how the world’s biggest drug companies control illness. Constable (UK), 2006.
 Bass, A. Side effects: a prosecutor, a whistle blower and a best-selling antidepressant on trial. Thomas Allen & Son (Canada), 2008.
 Healy, D. Pharmageddon. University of California Press (US), 2012.
 Goldacre, B. Bad Pharma: how drug companies mislead doctors and harm patients. Fourth Estate (UK), 2012.
 Big Pharma game. Available at http://www.bigpharmagame.com/. Accessed January 2017.
 Prescription Medicines code of Practice Authority. ABPI Code of Practice for the Pharmaceutical Industry 2016. Association of the British Pharmaceutical Industry, 2016. Available at http://www.pmcpa.org.uk/thecode/Documents/Code%20of%20Practice%202016%20.pdf. Accessed January 2017.