Home » Dispatches »

David, Goliath and Malcolm Gladwell


Malcolm Gladwell, whose latest best-seller is called “David and Goliath,” is incapable of writing anything as sharp as this riff from Agatha Christie’s autobiography:

“Only a year or two ago, standing on the mound at Nimrud, I watched the local bird-scarer, an old Arab with his handful of stones and his sling, defending the crops from the hordes of predatory birds. Seeing his accuracy of aim and the deadliness of his weapon, I suddenly realised for the first time that it was Goliath against whom the dice were loaded. David was in a superior position from the start —the man with a long-distance weapon against the man who had none. Not so much the little fellow against the big one, as brains versus brawn.”

People have begun to get wise to Gladwell. He hit the scene in 1997 with a big article in the New Yorker, “The Estrogen Question: How Wrong is Dr. Susan Love?”   Why, I asked a knowledgable friend, did the New Yorker publish a paean to hormone replacement therapy by a kid who knew nothing about medicine, let alone menopause. She replied: “He’s Jacob Weissberg’s roommate.”  (She assumed I knew that Jacob Weissberg was an editor at the New Republic, which was then a Triple-A farm club for the NYer.)
Susan Love, a distinguished clinician and UCLA professor, had been publicizing The Nurse’s Health Study finding that women taking Wyeth’s Prempro had a higher rate of breast cancer. Gladwell derided her warnings. His piece culminated in a plug for Eli Lilly’s new drug Raloxifene, which was about to be marketed as Evista. “Before very long,” wrote young Gladwell, “women worried about raising their breast-cancer risk will have the option of taking a different kind of hormone that doesn’t affect their breasts at all —or that may even protect against breast cancer.”

Raloxifene, Gladwell explained, represented “the next generation of HRT, the compounds known as serms (for ‘selective estrogen receptor modulators’).”  It was obvious that Eli Lilly, having made billions off its “selective serotonin reuptake inhibitor” anti-depressant Prozac, was reapplying the patter to its HRT drug. Gladwell scolded Love for not applauding the advent of serms: “You might think that it would be of enormous significance to Love, answering, as it does, her great worry about the potential side effects of HRT.” The lad’s tone was coolly condescending throughout. “What Love has done is recalculate the risk-benefit equation for estrogen,” he asserted, “which is fine, except that she consistently overstates the risks and understates the benefits.”

Gladwell’s defense of HRT was/is a textbook example of corporate damage control.

When the harmful effects of a product have been exposed by a study, step #1 is to cite other studies drawing favorable conclusions. To this end Gladwell quotes an epidemiologist named Trudy Bush: “I just reviewed the hormone/breast-cancer research from the last five years,” Gladwell quotes an epidemiologist named Trudy Bush: “I found four reports —two very large and well done— showing no effect, and I found another study showing that estrogen gave women significant protection against breast cancer. They’re all over the place.” Claiming that existing studies are inconclusive and that more research is needed sounds reasonable and usually gives the drug company 10 extra marketing years. In the case of Prempro, Wyeth only got five because the leaders of the Women’s Health Initiative had seen enough by 2002.

Step #2 is to attack the methodology of the revealing study. Gladwell faults the Nurses Health Study for “selection-bias problems. The estrogen users, for example, had fewer pregnancies, got their periods earlier, and have other differences with the control group which would lead you believe that they might have had a higher risk of breast cancer anyway. There is another possible complication: estrogen does such a good job of fighting heart disease that most women who are on HRT live substantially longer than women who aren’t.” (That’s Step #3, the Bold Inversion. Gladwell was probably spoon-fed by the same Lilly flack who reasoned that Prozac leads to suicide because it enables severely depressed people to overcome their lethargy.)

Step #4 is simply smearing the messenger. If a researcher’s professional credentials are unassailable, there’s always guilt by association. Just as Lilly (falsely) linked their foremost critic, Peter Breggin, MD, to the Scientologists, Gladwell puts Love in a vaguely disreputable “media-celebrity” category. “Her objection,” he writes, “is to the idea that postmenopausal women should rely on any sort of drug at all. This is where, sooner or later, you end up when you start down the path of people like Andrew Weil and Deepak Chopra and Susan Love.”

In a 2001 article by Gladwell extolling the anti-malarial effects of DDT, the woman who had gotten her science wrong was Rachel Carson. DDT, according to the man Gladwell touted as the great authority, “ought to be used as selectively as possible, to quell major outbreaks,” i.e., the present ban should be rescinded.

The massive, worldwide application of DDT had been promoted in the 1940s and ’50s by a Rockefeller Foundation functionary named Fred Soper who, according to Gladwell, “ranks as one of the unsung heroes of the twentieth century.” As it became clear that worldwide eradication was impractical ­because DDT-resistant mosquito strains had developed, Soper discounted all evidence of failure. Gladwell describes Soper losing his temper at one meeting in response to “talk that was impeding eradication —the doubting, the equivocation, the incompetence, the elevation of songbirds over human life.”

In 2002, as data from the Women’s Health Initiative confirmed that women taking HRT are more likely to get breast cancer, blogger Mickey Kaus quoted some of Gladwell’s putdowns of Love and asked if he stood by his NYer piece. Gladwell emailed: “i was waiting for someone to write that! okay, here’s my answer: kausfiles is quite right. i was wrong, and susan love ought to feel vindicated. this is the perilous–and, of course, fun– part of writing about medicine. every now and again, scientists discover something new that turns everything we all thought we understood upside down.”

This was a bizarre and revealing  response —as if what was at stake were Susan Love’s feelings, not the well-being of the women who started hormone replacement therapy or chose to stay on it thanks to his misleading New Yorker piece. Malcolm Gladwell, author of best-sellers, may know jack about science but he knows plenty about promoting ideas and products. If he regretted having advised women to take cancer-causing drugs, he should have seen to it that a retraction was widely disseminated instead of burying a comment on kausfiles, where it didn’t even warrant an item unto itself. And how about his “waiting” to be called out? Translation: “i was hoping no one would remember.”

Gladwell, a lightweight, is not entirely to blame for the damage his HRT article may have done. The New Yorker should not have run it in 1997 and had an obligation in 2002 to notify readers that their reporting on “the estrogen question” had been wrong. 


Support O’Shaughnessy’s

"From each according to their ability, to each according to their need." 

Our Entourage

Best newspaper in America Dr. Tod – The Movie The Society of Cannabis Clinicians was formed as a project of the California Cannabis Research Medical Group in the Autumn of 2004. Project CBD is a non-profit educational service dedicated to promoting and publicizing research into the medical utility of cannabidiol (CBD) and other components of the Cannabis plant. News and political analysis Dr. Lester Grinspoon, M.D. is Associate Professor Emeritus of Psychiatry at Harvard Medical School. Dr. Grinspoon was senior psychiatrist at the Massachusetts Mental Health Center in Boston for 40 years. Moving Sustainable Medicines Forward Consultant Newhead News Political allies Whole plant medicinal extracts Law Office Great artwork, incisive politics Omar CBD specialists

O’S Available Here

O’S First E-Book – Available Now!

Recommended Reading

Double-click to edit content...


Prop 215 Ballads – Fred Gardner’s CD Medical Cannabis Videos
"Fanatic freethinking, coupled with the impression that youth is intentionally being deceived by the State through lies."
—Albert Einstein, on his outlook at age 12.

The Second Column

Introducing the new O’Shaughnessy’s

Autumn 2015 cover

 A movie review is the cover story in our Winter 2015/16 issue.  Contents: U.S. weighs rescheduling as CBD-rich cannabis proves helpful to children with epilepsy and others. Nursing home staffers document a …

Real Dispensaries of New York

Bronx Botanica photo by Hiroko Masuike:NYT

A study of the herbal remedies being used by Latino and Caribbean immigrants in New York is the subject of a Nov.15  feature in the New York Times by Richard …

Next FDA director explains Big PhRMA ties


 Dr. Robert M. Califf, President Obama’s nominee to direct the Food and Drug Administration, “coasted through” a Senate committee confirmation hearing Nov. 17, according to Sabrina Tavernise’s account in the …

Rediscovered: lymph circulation in brain

Lymph-brain connection

Patrick Monk, RN, forwarded an article by a University of Virginia publicist describing the discovery of lympathic vessels in the brain by Antoine Louveau, Jonathan Kipnis and colleagues at UVA School of Medicine. …

Our History

THM 21_1

Steve Robinson, MD, audited a presentation by Beverly Mikuriya, MD, to the Rosmoor Medical Marijuana Education & Support Club in Walnut Creek on November 10.  The club’s  education coordinator, …

How Significant is Breyer’s Order in MAMM Case?

We had asked if US District Judge Charles Breyer’s order blocking enforcement of the injunction closing down the Marin Alliance for Medical Marijuana would similarly block DEA participation …

Real Legalization

Prop 19 -73

From Dr. Michael Aldrich October 23, 2015    The best initiative ever was CMI 1972 —the California Marijuana Initiative. It told the government what it could not do …

Reform CA ‘Legalization’ Should Protect Workers’ Rights

clerical workers

Dale Gieringer, the director of California NORML, has played an active role in drafting the Reform CA “legalization” initiative. I had objected to a provision in the current draft …

Nixon on Jewish Psychiatrists


Lester Grinspoon, MD, forwards this one-minute public service announcement (made by HOBO founder Howard Bowler) with a confession: “The Jewish psychiatrists (Norman Zinberg and myself) are responsible.” It sounds …

‘Chinese Medicine’ and the Nobel Prize

Tu Youyou in the 1980s photo by Yang Wumin

The 2015 Nobel Prize in Physiology or Medicine has been awarded to three scientists who developed anti-parasitic drugs from compounds found in herbs and soil —William C. Campbell  and …

Researchers urge medical marijuana over opioids to treat neuropathic pain

Ringo Hula Buda

By Mike Hager in The Globe and Mail, October 9  Canadian doctors should use medical marijuana instead of frequently abused opioids to treat patients with neuropathic pain and a …

Cannabis can be a Subsitute for Alcohol (news flash!)


From Paul Armentano, NORML Deputy Director September 29, 2015.  Patients who possess legal access to cannabis frequently substitute it in place of alcohol and prescription drugs, according to survey …

DEA Today


USA Today, renowned for its sports section but underrated for its investigative reporting, has exposed the Drug Enforcement Agency’s culture of lawlessness (which Rep. Jason Chaffetz politely calls “a …

Veterans’ Suicide Epidemic is Lucrative for Therapists

Friends from the 2/7 the funeral of Eduardo Bojorquez. Photo Todd Heisler, NYT

By Fred Gardner  September 21, 2015    Marine Corps veterans have formed their own suicide-prevention network for reasons laid out in a very powerful article by Dave Philipps in yesterday’s New …

Squirrel Days (Dustin Costa has published a novel!)

Squirrel Days

from NexGenInk, September 24, 2015 Author Dustin Costa is in his eleventh year of a ten year sentence for marijuana manufacture and distribution. He got the mandatory minimum …

“Releaf” for Lake County Fire Victims

"Valley Fire" in Lake County

By O’S News Service  September 24  A Santa Rosa company called Care By Design is providing $200 worth of CBD-rich cannabis free to qualified fire victims. Their sister company, Absolute …

The truth about Paxil (better late than never)

David Healy by Jon Morris:NYT

From O’S News Service September 16, 2015    An unbiased team led by Dr. David Healy has repeated the study that Glaxo-SmithKline submitted to get FDA approval for Paxil …

CBD for Schizophrenia —’proof of concept’ data positive

GW logo

September 15, 2015 GW Pharmaceuticals Announces Positive Proof of Concept Data in Schizophrenia LONDON, Sept. 15, 2015 (GLOBE NEWSWIRE) — GW Pharmaceuticals plc (Nasdaq:GWPH) (AIM:GWP) (“GW,” “the Company” …

What’s Your Handicap?

Lucido listening

From O’S News Service August 29    Golfers taking part in the “420 Games” were the subject of a story by Eric Kuhli in today’s Oakland Trib.  About 100 people …

Sativa and indica genetics gap quantified

sativa indica contents

By O’S News Service August 29, 2015 It has long been assumed that the difference between plants considered by cultivators to be Cannabis sativa and plants considered C. indica was the result …