Rheuminations: Fraud Casts a Pall on Medical Research

Simon M. Helfgott, MD

If you have the good fortune of finding yourself with 36 hours of spare time over the summer months, I suggest you spend it watching the riveting television series Breaking Bad. It is an epic saga about Walter White, a Caltech-trained organic chemist turned dissatisfied high school teacher who is diagnosed with stage IIIA nonsmall cell lung cancer. After accompanying his brother-in-law, a Drug Enforcement Agency agent, on a drug raid, Walt decides that “cooking” methamphetamine would be a quick way for him to quickly amass a substantial financial nest egg for his family. What makes this series so gripping is watching the transformation of Walt from an affable chemistry teacher into a ruthless, evil man.

We learn that his expertise is in the field of crystallography, and along with some of his Caltech colleagues, he had started a biotechnology company. However, after suspecting that his colleagues were stealing his ideas and claiming them as their own, he abruptly quit the enterprise. Armed with his tiny buyout, he relocates to Albuquerque, N.M., where he begins anew as a high school chemistry teacher. Only years later does he discover that the true value of his stolen intellectual property was in the hundreds of millions of dollars. Don’t feel too sorry for Walt. In his new occupation, he quickly makes up for lost income.

Watching Breaking Bad is highly addicting. No wonder it is among the most binge-watched shows on Netflix. According to the show’s creator, Vince Gilligan, “this is not a show about evil for evil’s sake. Walt has behaved at times in what could be regarded as an evil fashion, but I don’t think he’s an evil man. He is an extremely self-deluded man. We always say in the writers’ room, if Walter White has a true superpower, it’s not his knowledge of chemistry or his intellect, it’s his ability to lie to himself. He is the world’s greatest liar. He could lie to the pope. He could lie to Mother Teresa. He certainly could lie to his family, and he can lie to himself, and he can make these lies stick. He can make himself believe, in the face of all contrary evidence, that he is still a good man.”¹

When I watch Breaking Bad, I am reminded of those people who, like Walt, are really great at self-deception. They may have started their careers full of good intentions, but over the years, they go astray. One such person is a neighbor of mine, a seemingly thoughtful psychiatrist who was found guilty of having inappropriate relationships with several of his patients and was banned from medical practice. Another is a former colleague, a member of my division who was found guilty of first-degree murder. The victim was his wife. Fortunately, among physicians, such egregious acts are fairly rare events. More often, the crimes being committed by doctors are related to financial misbehavior. As the stock market has boomed and Wall Street profits have soared, the lure of easy money can be overwhelming. There are many stories of doctors being entangled in the web of pecuniary mischief spun by medical billing fraud or by insider trading.² That, however, is a story for another time.