Memo Board Quotes

One of my favorite stories is about a newly hired traveling salesman who sent his first sales report to the home office. It stunned the brass in the sales department because it was obvious that the new salesman was ignorant! This is what he wrote: “I seen this outfit which they ain’t never bot a dim’s worth of nothin from us and I sole them some goods. I’m now goin to Chicawgo.” Before the man could be given the heave-ho by the sales manager, along came this letter from Chicago: “I cum hear and sole them haff a millyon.” Fearful if he did, and afraid if he didn’t fire the ignorant salesman, the sales manager dumped the problem in the lap of the president. The following morning, the ivory-towered sales department members were amazed to see posted on the bulletin board above the two letters written by the ignorant salesman this memo from the president: “We ben spendin two much time trying to spel instead of trying to sel. Let’s watch those sails. I want everybody should read these letters from Gooch who is on the rode doin a grate job for us and you should go out and do like he done.

1. Understanding key ideas. I recently read an article in the Economist on declining marriage rates among women in Asia. I had no immediate use for the detailed statistics in that article, but I thought I might use them in the future to describe how demographic trends affect public retirement plans. So I skimmed it to learn the general trends. 2. Finding specific facts. At the opposite pole is reading closely for facts. When I’m preparing for a board meeting, I carefully look over the memos and reports related to the company’s quarterly performance. I want to be able to remember certain key statistics and substantive points to discuss with the board.

Lynum had plenty of information to share. The FBI's files on Mario Savio, the brilliant philosophy student who was the spokesman for the Free Speech Movement, were especially detailed. Savio had a debilitating stutter when speaking to people in small groups, but when standing before a crowd and condemning his administration's latest injustice he spoke with divine fire. His words had inspired students to stage what was the largest campus protest in American history. Newspapers and magazines depicted him as the archetypal "angry young man," and it was true that he embodied a student movement fueled by anger at injustice, impatience for change, and a burning desire for personal freedom. Hoover ordered his agents to gather intelligence they could use to ruin his reputation or otherwise "neutralize" him, impatiently ordering them to expedite their efforts. Hoover's agents had also compiled a bulging dossier on the man Savio saw as his enemy: Clark Kerr. As campus dissent mounted, Hoover came to blame the university president more than anyone else for not putting an end to it. Kerr had led UC to new academic heights, and he had played a key role in establishing the system that guaranteed all Californians access to higher education, a model adopted nationally and internationally. But in Hoover's eyes, Kerr confused academic freedom with academic license, coddled Communist faculty members, and failed to crack down on "young punks" like Savio. Hoover directed his agents to undermine the esteemed educator in myriad ways. He wanted Kerr removed from his post as university president. As he bluntly put it in a memo to his top aides, Kerr was "no good." Reagan listened intently to Lynum's presentation, but he wanted more--much more. He asked for additional information on Kerr, for reports on liberal members of the Board of Regents who might oppose his policies, and for intelligence reports about any upcoming student protests. Just the week before, he had proposed charging tuition for the first time in the university's history, setting off a new wave of protests up and down the state. He told Lynum he feared subversives and liberals would attempt to misrepresent his efforts to establish fiscal responsibility, and that he hoped the FBI would share information about any upcoming demonstrations against him, whether on campus or at his press conferences. It was Reagan's fear, according to Lynum's subsequent report, "that some of his press conferences could be stacked with 'left wingers' who might make an attempt to embarrass him and the state government." Lynum said he understood his concerns, but following Hoover's instructions he made no promises. Then he and Harter wished the ailing governor a speedy recovery, departed the mansion, slipped into their dark four-door Ford, and drove back to the San Francisco field office, where Lynum sent an urgent report to the director. The bedside meeting was extraordinary, but so was the relationship between Reagan and Hoover. It had begun decades earlier, when the actor became an informer in the FBI's investigation of Hollywood Communists. When Reagan was elected president of the Screen Actors Guild, he secretly continued to help the FBI purge fellow actors from the union's rolls. Reagan's informing proved helpful to the House Un-American Activities Committee as well, since the bureau covertly passed along information that could help HUAC hold the hearings that wracked Hollywood and led to the blacklisting and ruin of many people in the film industry. Reagan took great satisfaction from his work with the FBI, which gave him a sense of security and mission during a period when his marriage to Jane Wyman was failing, his acting career faltering, and his faith in the Democratic Party of his father crumbling. In the following years, Reagan and FBI officials courted each other through a series of confidential contacts. (7-8)

Howard suspected that researchers on the Paxil trial were not accurately coding these adverse events. According to a trail of faxed memos, at least two adolescent patients enrolled in the Paxil trial had been yanked from the study after threatening or attempting suicide. Yet on several memos submitted to Brown’s Institutional Review Board, Keller wrote that these teenage girls “withdrew during the acute phase for reasons of noncompliance.

But despite the fact that this boy was clearly suicidal and required hospitalization, he was not included among the patients listed as having developed serious adverse effects in the published 2001 Paxil study. Other patients were similarly miscoded. One was a fifteen-year-old girl who had been withdrawn from the Brown study site in 1995 after becoming combative with her mother. According to internal university documents that Howard gave me, Brown researchers knew that this girl had become suicidal after taking Paxil. In a memo to the Institutional Review Board dated October 30, 1995, Martin Keller wrote that this teenager, who had been enrolled in the study in June 1995, “was hospitalized on 9/15/95 due to becoming very combative with her mother and threatening suicide.” Yet instead of coding her behavior as an adverse effect related to Paxil, Keller in his memo says she was “terminated from the study for non-compliance.” The Brown investigators may have coded her as noncompliant because she had stopped taking Paxil before having her meltdown. But they shouldn’t have, according to several clinicians familiar with the study. The Brown researchers should have included all adverse effects experienced by their patients, regardless of what may have caused the problems. As a Harvard Medical School biostatistician later told me, “You shouldn’t try to make these subjective attributions and exclude patients who don’t fit into your thesis.” As research has shown, the SSRI antidepressants can cause serious side effects, including suicidal behaviors and hostility, weeks after people stop taking them.

According to a memo that Keller himself wrote to the Brown Institutional Review Board on January 30, 1995, this patient (number 70) ingested eighty-two Tylenol pills in an apparent overdose attempt on January 19. Patient 70 was admitted to a hospital and terminated from the study shortly afterward, according to Keller’s memo to Brown IRB. Yet this teenage girl was not included in the group reported to have experienced serious adverse events while in the study. Instead, in another memo that Keller had written to the Brown IRB in 1995, she was described as having been terminated from the study for being “noncompliant.” In an even more mysterious turn, patient 70 was described in GlaxoSmithKline’s final report of the study as being a twelve-year-old boy. This boy was enrolled in the clinical trial a month after the teenage girl identified in Keller’s memos as patient 70 overdosed on Tylenol and withdrew from the study. The boy with the same patient number was removed from the study on March 22, 1995, after developing tachycardia (rapid heartbeat) while taking the tricyclic antidepressant known as imipramine, according to the company’s final report. There was no mention in the company’s posted final report or the 2001 journal paper that the original patient 70 was a young girl who had ingested eighty-two Tylenol pills in a clear bid to kill herself.

a slender, artificial Christmas tree with a solitary string of lights. He watched them blink to the tune of some Brazilian carol, and despite his efforts not to, Nate thought of his children. It was the day before Christmas Eve. Not all memories were painful. He boarded the plane with teeth clenched and spine stiffened, then slept for most of the hour it took to reach Corumba. The small airport there was humid and packed with Bolivians waiting for a flight to Santa Cruz. They were laden with boxes and bags of Christmas gifts. He found a cabdriver who spoke not a word of English, but it didn't matter. Nate showed him the words “Palace Hotel” on his travel itinerary, and they sped away in an old, dirty Mazda. Corumba had ninety thousand people, according to yet another memo prepared by Josh's staff. Situated on the Paraguay River, on the Bolivian border, it had long since declared itself to be the capital of the Pantanal. River traffic and trade had built the city, and kept it going.

Soon after he came on board, Clark, a cigarette dangling from his lips, signaled a seismic shift in the BBC’s news policy when he announced to his staff, “Well, brothers, now that war’s come, your job is to tell the truth. And if you aren’t sure it is the truth, don’t use it.” In an internal memo, he wrote, “It seems to me that the only way to strengthen the morale of the people whose morale is worth strengthening, is to tell them the truth, and nothing but the truth, even if the truth is horrible.