The Cult of The Credo: How a Beloved Brand Betrayed Your Trust 7 | 36

Behind Johnson & Johnson’s famous “Credo” lies a story of trust betrayed.

When a company’s values don’t match its actions, the impact can be devastating. Kim Scott and Amy Sandler speak with investigative journalist Gardiner Harris about his book, No More Tears: The Dark Secrets of Johnson & Johnson about the story behind one of the world's most beloved brands.

Watch the episode: 

No More Tears: How a Household Brand Betrayed Trust

Harris uncovers how a company once seen as the gold standard of integrity used its famous “Credo” to build emotional trust while covering up harmful practices—from baby powder linked to cancer to its role in the opioid crisis.

The conversation goes beyond one company, raising bigger questions about accountability, transparency, and the systems meant to keep us safe. It’s a candid look at how misplaced trust can cause lasting damage—and what it really takes to create a culture where honesty and responsibility come first.

Why You Haven't heard About It

• The smell of trust. “Johnson’s baby powder is the most extraordinary branding tool ever devised,” he said, describing the floral scent—“there’s jasmine in there, overtones of citrus”—as “the most distinctive smell on the planet” in the company’s own surveys. Because smell and emotion are tightly linked in the brain, he argued, “You have essentially been born with this brain worm that makes you think Johnson & Johnson… wonderful stuff.”
  
  
• The ‘credo’ and internal gaslighting. Harris described what he called “the cult of the credo,” in which meetings opened with recitations of the company’s mission about obligations to patients and families. “These conversations became this early warning system for managers to weed out possible whistleblowers,” he said. Employees who raised concerns could be labeled “not a good cultural fit.” He added that the company’s sprawling “family of companies” and constant reshuffling created job insecurity that discouraged dissent.
  
  
• The Tylenol case study. The 1982 Tylenol murders became a celebrated crisis-management case in business schools, often used to illustrate transparency and swift action. Harris calls that narrative harmful mythmaking. “The case study is wrong in almost every respect,” he said, alleging that Johnson & Johnson’s real conduct was “a series of appalling things,” and claiming the company “almost certainly knew who the killer was and didn’t tell the investigators.”

What Readers Can Do Now

Harris insists the book isn’t only an exposé; it’s a field guide for patients and families navigating a complex system.

• Ask about conflicts. “Ask your own doctors if they’re taking money from drug makers and device makers,” he said, noting industry payments to physicians total in the billions annually.

• Check the public database. He pointed listeners to the federal Physician Payments Sunshine Act website, which lists industry payments to individual doctors.

• Be cautious with over-the-counter painkillers. “I don’t think anybody should have extra strength Tylenol in their house,” Harris said.

Harris also offered several policy reform ideas:

• Change how the FDA is funded. “FDA needs to be a true regulatory body,” Harris said, arguing it should not rely primarily on fees from the industries it regulates.

• Create independent safety oversight. Drawing an analogy to the National Transportation Safety Board, he proposed a separate group to monitor the safety of already-approved drugs and devices.

• Use Medicare data for active surveillance. “It is appalling that those data are almost never used,” Harris said, urging systematic, real‑time analysis of outcomes.

Harris’s Prescriptions for Reform

Scott, a longtime skeptic of unfettered capitalism, pressed for reasons to hope. Harris’s answer was pragmatic: vigilance, transparency and pressure.

“There was almost certainly not a single American family that has not been affected by these various things that I talk about,” he said. But he emphasized agency, too: “I’m hoping to empower you to at least ask the right questions.”

Before signing off, Scott offered her own directive. “Buy the book. Read the book,” she said. “By the end of it, I felt like I had more agency, more ability to do something about this rather than less.”

Radical Candor Podcast Resources

• Gardiner Harris
• No More Tears: The Dark Secrets of Johnson & Johnson 
• The Weekly | A Secret Opioid Memo That Could Have Slowed an Epidemic | The New York Times
• A Devastating New Exposé of Johnson & Johnson Indicts an Entire System | The New Republic
• The Johnson & Johnson Cancer Drug Scandal That Encapsulates Corruption In Health Care | STAT News
• J&J Is Back On The Legal Warpath After Striking Out In Baby Powder Bankruptcy | Reuters
• Antipsychotic Drugs and Nursing Home Residents: What Do the Different Numbers Mean? | Center for Medicare Advocacy
• Empire of Pain: The Secret History of the Sackler Dynasty
• The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth 
• Physician Payments Sunshine Act (also known as the Open Payments program)
• Watch Cold Case: The Tylenol Murders | Netflix

The TLDR Radical Candor Podcast Transcript

[00:00:00] Kim Scott: Hello everybody. Welcome to the Radical Candor podcast. I'm Kim Scott. 

[00:00:08] Amy Sandler: I'm Amy Sandler. Today I cannot tell you how excited we all are to be talking with author and investigative reporter Gardiner Harris about what happens when a culture of silence and betrayal takes root at a company that created an emotional bond with its customers. He has written a book that we have all become obsessed with. It's called No More Tears: The Dark Secrets of Johnson & Johnson. A little background, Gardiner Harris has written for outlets, including the New York Times, the Wall Street Journal, the Courier Journal, and has done an amazing job holding powerful institutions to account, giving voice to folks who've been ignored. Gardiner, we are so excited to, first of all, to welcome you. Thank you for joining us.

[00:00:57] Kim Scott: Thank you for writing the book.

[00:00:59] Amy Sandler: Yeah.

[00:00:59] Gardiner Harris: Thank you for having me. I'm so grateful. 

[00:01:01] Amy Sandler: We are truly so grateful and I think the big question that we all wanna start with is why are we not all talking about this book? Why has it not been reported on? Why, for all of us at Radical Candor, and people we've been talking to, why are so many of the stories you're writing about, why is it the first time we're hearing about them? 

[00:01:19] Gardiner Harris: Right. Well, again, thanks for having me. I think one of the problems with the book is that I left daily journalism to do it and like I didn't do all of these stories in the newspaper beforehand. Books are really not normally a place for original stories, particularly original stories about one of the most iconic companies in the world, right? Johnson & Johnson is a member of the Dow Jones Industrial Average. It is one of only two corporations in the United States with a triple A credit rating, the other one being Microsoft, a company you know extremely well. It is the largest healthcare products conglomerate in the world. It is a household name and I am telling you stories about Johnson & Johnson that you have not seen anywhere else, and that is really discombobulating, I think for the media ecosystem.

[00:02:16] You know, I was a longtime employee of the New York Times, rose to become the White House correspondent of the paper. I was a longtime member of the Wall Street Journal. Neither paper has reviewed this book, and I think a lot of it is because they don't really know what to do with it. I'm accusing Johnson & Johnson of causing or contributing to the deaths of more than 2 million Americans. That's nearly twice as many Americans as have died in all the wars in American history. It's an extraordinary number. And again, like Purdue Pharma and the Sacklers don't come close that kind of criminal actions that Johnson & Johnson has done or the kind of body count.

[00:03:02] And of course when I was at the times, we felled entire forests writing about Purdue Pharma. And, and they have done almost nothing about Johnson & Johnson in the wake of the book because I think they don't sort of know what to do with this. I have grand jury files, I have extraordinary documentation for all of these claims, but they are so extraordinary, I think, that they've sort of let it go. They haven't reviewed the book. They haven't really dealt with the many claims in the book. And so it just kind of sits out there. And for people like you to kind of discover and go, wait a second. What? And, and as you have seen, you know, I have a whole website, I still need to work on this, of, of thousands of documents, internal documents to Johnson & Johnson.

[00:03:52] I interviewed hundreds of executives. You know, one of the great things in the grand jury files I got, and by the way, when I say I have grand jury files, I don't think the New York Times or the Wall Street Journal, or really any major media organization has had a single grand jury file in more than 50 years. You know, I was a White House correspondent. We got national security top secret documents fairly routinely. As you know, they show up in bathrooms at Mar-a-Lago. And, and in garages in Wilmington, Delaware. But no one gets grand jury files. They are the last truly secret institutions in the United States, and I have hundreds of them.

[00:04:32] Kim Scott: How'd you get them?

[00:04:33] Gardiner Harris: Well, I got them from people who could not believe how this company, this iconic company behaved. And so were willing to break the law and give me documents that could put them in jail, because this company has managed to avoid accountability for decades. And so I wanted to just sort of start this conversation by just giving you a, a kind of a waterfront. You know, this book, my main target is Johnson & Johnson, right, which is this iconic American company. But the secondary and tertiary targets are really first, the FDA is a, as you know, big target of mine. I sort of feel bad using that word, but the description of the FDA, that the FDA enabled and allowed all of these disasters and all of these deaths, it is almost totally captive to the industry it regulates. The second, the third set of targets is the American professional class.

[00:05:34] The lawyers, the doctors, there are thousands upon thousands of them who were bribed, took money from Johnson & Johnson. And as a result, allowed their patients to die or, or accelerated their patients' death because Johnson & Johnson paid them to do that. There were a lot lawyers who obviously lied under oath in countless proceedings in federal courts, lawyers working for Johnson & Johnson, outside lawyers, and they broke their oaths of office to do it. Then, you know, so the book really is sort of a question, and this is what we're gonna get into, about sort of American management. Johnson & Johnson has obviously been seen as a paragon of American management for a long time, and also sort of about American's capitalist system.

[00:06:27] How can a company like this go so bad and almost no one know about it? And all of these institutions that we think are protecting us, the professional institutions, the bar associations, the medical boards, the FDA, the Inspector General's office, and even American media are not really protecting us. So I tell story after story about some of these journalists have tried to tell some of these stories for decades, and in case after case, Johnson & Johnson called up the headquarters of that media organization, said they would pull their advertising if that story ran and the story didn't run. So really in reading this book, it's a dark, dark tale. I think I do have a lot of suggestions about how to improve things, how we can get kind of beyond this, but it's a story that questions a lot of what I think many Americans believe about their lives, the system of governance and even the economic system in which we live. 

[00:07:35] Amy Sandler: It, there is so much in this book. One of the things that I think makes this book so compelling, with your investigative journalism and reporting, is the storytelling. You paint a picture of so many different products that I think any American, let alone folks, you know, outside the US, can speak to how they or a family member have used this product, have an emotional reaction to a product. So before we get into the business related questions, the ethics questions, can you just talk about the range of products that you cover in this book? Because I think as people listen, their ears are gonna perk up at what we're talking about.

[00:08:15] Kim Scott: Yeah, it's remarkable. 

[00:08:16] Gardiner Harris: Well, I will do that and, and again, one of the points of this book is for readers to kind of begin to learn how to protect themselves against the standard ways that they're exploited in both American healthcare and sort of in our economic system. Because I tell stories about cancer and cancer is one of the most corrupt forms of medicine in the American healthcare system. And I describe why it's corrupt and how once you get cancer, you can protect yourself against it. Same thing with orthopedic surgeons, just sort of that specialty writ large in the United States in terms of the amount of money that they get from manufacturers and how that changes how they practice medicine. And so I'll just go through, obviously the first story I tell is baby powder and how a company kept hidden for 60 or 70 years the fact that it knew that this product contained asbestos and was poisoning the mothers and babies that it claimed to hold most dear. The second product I talk about is,

[00:09:23] Kim Scott: By the way, sorry, before we move off of that, there was this, there was a statistic, and I'm not gonna quote it 'cause I'll get it wrong, but there was a statistic, an estimate in your book about what percentage of ovarian cancers have been caused by Johnson & Johnson baby powder.

[00:09:36] Gardiner Harris: 15%.

[00:09:38] Kim Scott: And they knew for decades. It's like worse than cigarettes.

[00:09:42] Amy Sandler: And it was like the kind of stories, 'cause I used shower to shower for probably over ten years and I feel like I had maybe heard somewhere something about it. But it was not until reading your book that it really came to light that this product, and certainly obviously the baby powder, that these were not messages that were getting out to the American public.

[00:10:04] Gardiner Harris: And by the way, the FDA just held an advisory committee hearing on talc in which the FDA Commissioner, today's FDA Commissioner Makary, said that science has conclusively shown since, at least the early 1990s, that talc is cancer causing, that it contains asbestos. So he said, basically in public, he said it several times, that Johnson & Johnson has knowingly sold a carcinogenic product to mothers and babies since the early 1990s. So, and by the way, David Kessler, the great FDA, commissioner of the first Bush administration and the Clinton administration has said that the baby powder saga is the worst fraud committed on the food and drug administration for the food and drug administration's entire history. And it's a story that some people think they know, but I think I tell it completely and in a way that you have never heard.

[00:11:05] Kim Scott: Yeah. 

[00:11:05] Gardiner Harris: And again, I go through the proof that these executives and their lawyers knew what they were doing, and only since 1968 onwards. They knew that they were poisoning mothers and babies. They knew that this would lead to a jump in ovarian cancer cases. They knew that tens of thousands of women, at least, would die as a result. They kept it up. And the story I tell about baby powder is really the ladder down which Johnson & Johnson, which started the 20th century as a truly ethical company, and it was that ladder down which Johnson & Johnson decided to sort of descend. Because of course, if you're willing to poison mothers and babies, you're willing to do almost anything.

[00:11:54] And so I retell the story about the Tylenol murders both of you all learned when you were at HBS. And that HBS case study did terrible damage because it allowed Johnson & Johnson to sort of put up this smokescreen of ethical conduct. By the way, the case study is wrong in almost every respect. The lesson that the case study says is a lesson that sort of resonates with Radical Candor, which is if you're straightforward and you're honest with the public, even about disasters, and you pay the money that you need to, the public will reward you. The opposite lesson is the, is true. If you lie to the public, if you pay off the FDA commissioner, if you, at every step of this process, essentially do what the corrupt and, and worst thing, you will get away with it. And not only get away with it, but allow you to get away with countless other crimes in your future as well.

[00:12:54] Because Johnson & Johnson used that HBS case study to sort of, to essentially gaslight its employees so that that allowed them to then do the EPO story, the cancer story that we tell about how the most popular drug in cancer from 1990 through 2007, so basically the administrations of Bill Clinton and George W, that if you had a, a family member die during those periods, there is about a 50% chance that Johnson & Johnson caused or sped their death because they were given this drug. And again, the story tells the tale about how the entire cancer community, every single oncologist, every single cancer hospital was in on the crime and knowingly so, right? 

[00:13:44] Kim Scott: That was like, that drug, somebody called it miracle grow for tumors.

[00:13:50] Gardiner Harris: Good for you, Kim. 

[00:13:52] Kim Scott: That stuck in my mind, will never leave my mind. 

[00:13:56] Gardiner Harris: Yeah. And to this day, by the way, a huge share of American oncologists continue to give it to their patients because it makes them so much money. And then I tell the story, of course, about antipsychotics and Risperdal. My former colleagues of the New York Times, the Wall Street Journal, routinely referred to the opioid crisis as the worst public health crisis in American history. It's not, it's not even close. That's the antipsychotic crisis. And more than a million Americans have died from this. And largely because Johnson & Johnson paid psychiatrists to use these drugs in wildly inappropriate ways.

[00:14:31] And you know, one of the, sort of almost the side stories that I tell is, why was COVID so destructive to American nursing homes in the United States? Well, a huge share of American nursing home patients are given antipsychotics. How do antipsychotics kill you? They make you more susceptible to respiratory infection, along with strokes and heart attacks. What is COVID? It is a respiratory infection. So, and again, this is a story that none of my colleagues have told. Why was COVID so bad in American nursing homes? Because Johnson & Johnson had been so successful in its criminal scheme to get nursing homes to use American anti-psychotics. 

[00:15:13] Amy Sandler: Can we pause on that one? 'Cause I will say my dad passed away at the end of 2020. He had Alzheimer's. Sadly, that is a disease that so many of our listeners, I'm sure have loved ones. What are the dangers of that medication? Why is it being prescribed? Can you just give us a little bit more info on that? 

[00:15:29] Gardiner Harris: So a top FDA official described this as mass euthanasia with plausible deniability and what antipsychotics. So antipsychotics are used in American nursing homes and there have been plenty of studies that show this, that as staffing costs rise, so do the use of antipsychotics. Was, 'cause what happens, as you know, Amy, somebody who has dementia or somebody who has Alzheimer's, they frequently wake up in the middle of the night and they're confused.

[00:16:00] They don't know what's going on. They cry out, and you need staffing to respond to those needs, right? Whereas if you knock them out, if you sedate them so that they sleep through the night, you need far fewer nurses or other staff on staff at night. So what American, and there are many American nursing homes that will not accept you unless you are on an antipsychotic for precisely this reason. So there are, you can go on this website of the Centers for Medicare and Medicaid Services, the most expensive program in the federal government, far more than the Defense Department, and they actually have, they will show you the nursing homes in the United States and the share of patients who are on antipsychotic. There's a little asterisk to that I can talk about, and there are many nursing homes in the United States where every single patient is on an antipsychotic because it's cheaper for them. 

[00:16:58] Kim Scott: And, and I think the part of this story and getting, sort of pulling on the thread of what's hard for a lot of people to come to grips with, is this systemic problem here. Like a lot of those nursing homes are owned by private equity firms. It's like the combination of the financialization of our economy plus this kind of corruption of the medical, like, it's, it's, it, it's breathtaking. 

[00:17:25] Gardiner Harris: Yeah. So then I, of course, I retell the opioid crisis as we were talking about before, and the story that everyone knows in this country is that Purdue Pharma and the Sacklers cause the opioid crisis, that Oxycontin, you know, what, sort of, alone caused this terrible crisis. And Patrick Radden Keefe's wonderful book, Empire of Pain. Patrick's book is in many ways the standard business book, right? Which is that Patrick told a story we all knew. My colleague Barry Meier, first told the Purdue Pharma story in two iconic landmark stories back in 2001. And what's amazing about Barry's stories is that he had every element that, of Patrick's book in those original stories, you know, 20 years before Patrick's book comes out.

[00:18:13] So Patrick does this wonderful retelling of a story we all know, that tells us that it was really Purdue Pharma and the Sacklers who caused this crisis. It's just not true, unfortunately. About one in ten bodies that showed up in morgues during the prescription opioid crisis, you know, we're now in the third phase of the opioid crisis, which is the Mexican fentanyl crisis. But in that first version of the crisis, about one in ten bodies that showed up had a Purdue Pharma, a Sackler product in their system. Six in ten had a J and J product in their system. J and J was far more important to the, the proliferation of opioids and this terrible crisis than, than Purdue Farm and the Sacklers.

[00:18:59] But Purdue Farm and the Sacklers were a tiny player. It was a one product company based in Bristol, Connecticut. It was not systematically important. It didn't have consultants in every major academic medical center across the country. It didn't have this army of lobbyists in Washington. It wasn't one of the largest funders of media organizations through advertising in the country. So it was just, it was a very soft target. So that's why you think you know the Purdue Pharma and the opioid story, it's not the case. The other thing that's kind of important to know about the opioid story is that a lot of these stories, I tell you, the Risperdal story, I will, I also tell you the story about metal on metal hip implants, vaginal mesh, Propulsid.

[00:19:49] In each one of these cases, these products offered zero benefit to people. Same thing with Johnson's baby powder. There's no medical benefit to Johnson's baby powder, so there's no way you can balance the risk of the asbestos contamination with something that might benefit you. Opioids have benefits. If you are in serious pain, there is no drug that will treat your pain merely as quickly or as effectively as opioids. So the opioid crisis is in many ways, of the nine crises and disasters that I relay in this book, even though there's a huge number of deaths, it's in many ways the sort of the least blameworthy, because again, it's kind of tough to separate out the patients for whom opioids were appropriate therapy and patients for whom it wasn't. Clearly Johnson & Johnson did this.

[00:20:41] It expanded opioids use to those with lower back pain, mild pain for which the risks of the drugs didn't balance out their benefits. But opioids have real benefits and that's why, you know, while everybody sort of thinks the top of corporate greed is Purdue Pharma and the Sacklers and opioids, I, I really kind of argue in this book that that's not it at all. What you think you know is completely wrong. So anyway, I, and I can talk about obviously the metal on metal hip implants, the vaginal mesh, you know, these guys attacked the, the, look, I, I tell several stories in which they knowingly killed babies, right? The Propulsid story is, is, is really the story that led me to do the book. And we can talk about that they went after preemies, they went after preemies and killed dozens of them. And so there are all these products like Johnson's Baby Powder in which they knowingly wounded infants and children. 

[00:21:45] Kim Scott: The most innocent people.

[00:21:46] Gardiner Harris: Exactly. But there are also all these products in which they targeted women's reproductive organs, you know? The baby powder. One I deal with just sort of almost as a sidelight, is the little blender that they used to do hysterectomies. And these were for these laparoscopic procedures. And the blender would go in there and chew up the uterus within a woman. And what they knew would happen is that if there were any cancerous cells in there, and as you know, endometrial cancer is really hard to diagnose. Roughly one in 300 women who got this procedure died because the procedure would splatter these cancerous cells all over a woman's abdomen and it would make it impossible to treat. And these women would die fairly quickly. And it's, again, they were one of the largest manufacturers of breast implants.

[00:22:39] They refused for decades to follow how women did on their breast implants. And of course, finally last year, the FDA finally put warnings on breast implants that they do indeed cause a rare form of breast cancer. But you know, why are we just now finding out about it now? Because Johnson & Johnson refused to do what they promised to do by following women. And then there's Ortho Evra, the birth control patch, where they lied to the FDA about the amount of estrogen in this patch. It was twice as much estrogen as they said. They essentially sold a product that was like the original pill sold in the early 1960s. Thousands of young women had blood clots, strokes, heart attacks, thousands died.

[00:23:27] They knew about this. They lied to the FDA about it, and it took years for them to sort of admit what they'd actually done. So the story of Johnson & Johnson is a story of a company doing exactly the opposite of what we believe about them, because of course, we all think that Johnson & Johnson's the most ethical, the most forthright company on the planet. And it's just the opposite. And it's a really interesting tale how it got there.

[00:24:04] Kim Scott: It is so interesting, Gardiner, because when Brandi sent me an email about the book, uh, and I am, I would say like wide open to the message. I'm a skeptic about the way that we practice capitalism right now. I've gone down the rabbit hole on the problems of capitalism and why we need better regulation. I worked in the federal government. I worked at the FCC and coming to grips with some of the terrible things we unleashed. Uh, so I've been thinking a lot about this, but as soon as I got an email that said, you know, this makes the Sackler family look like nothing. And, and I was skeptical by the way of the credo challenge. In Radical Candor, I wrote a little bit about it because you would think I'd be, oh yeah, I gotta read this book right away. And my first instinct was, oh no, this can't be right. Like so deep is, I mean, luckily Brandi persuaded me to overcome my prejudice. But like so deep is this idea that this is a good company and that the Sacklers were a bad apple, but the system is okay. It's not okay. 

[00:25:12] Gardiner Harris: Yeah. Well, you know, I tell the story about how that happened, which is that Johnson's baby powder is the most extraordinary branding tool ever devised. At its height, half of all American babies had their bottoms dusted with Johnson's baby powder. It has this extraordinarily distinctive smell that comes from this floral, 200, you know, there's jasmine in there, overtones of citrus. Johnson & Johnson's own surveys show that it is the most distinctive smell on the planet. As a baby, the best thing that happens to you is when your mama comes to you and coos with you and wipes your bottom of this horrible stuff that somehow got there, right? And, and so along with this wonderfully loving moment comes this smell. And as we all know, who've done any brain work, the smell is the one sense that is most closely associated with emotions. 'Cause the two parts of your brain, the smell center and the emotional core, are right together. So it's why like when you smell a distinctive smell, it's the one thing that can bring back memories like nothing else.

[00:26:19] Kim Scott: It's Proustian, right. 

[00:26:20] Gardiner Harris: Right. Exactly. Proust, I quote Proust in the book about this. 

[00:26:24] Kim Scott: Yeah. 

[00:26:24] Gardiner Harris: And so you have essentially been born with this brain worm that, that makes you think Johnson, when you think Johnson & Johnson, you think wonderful stuff. And it used to be, by the way, the Johnson & Johnson executives, invariably for decades, they would, when they would give their speeches, they would say, when I say Johnson's baby powder, how many of you can just smell it? And the whole room would light up. And it was almost like, it was almost like they'd been hypnotized. And so whatever followed, whatever they said, subsequently the room just accepted in a way that they, and Johnson & Johnson knows this, they, there are these internal analyses that I quote that Johnson & Johnson has, that many companies have rational trust, Johnson & Johnson has emotional trust. And it's why I decided that I had to do a book, because I did a couple of these stories in the Times over the years, and everyone would say to me, oh, well maybe they did one thing wrong here, Gardiner, but it's a great company. I mean, you just could not penetrate this.

[00:27:28] Amy Sandler: You almost have to like counteract all of that programming. It's so interesting, when we teach Radical Candor, you know, one of the things Kim said was that, you know, for why is it hard to challenge directly? Well, how many of you got a message when you were 18 months old? If you don't have anything nice to say, don't say anything at all. So it's like we're having to go against that wiring. We have the smell wiring, the emotional connection. And then for Kim and I, you referenced the Harvard Business School case study. This was an example, and my background was in executive communication, so I went through my adult career thinking this was an example of how to handle a crisis. And so not only do we have to give up our lived experience of the emotional connectivity, we have to give up what we've learned.

[00:28:12] And then we have to give up believing all of these institutions were actually doing what they thought they were doing. And so I just, there's, there's so many pieces to this puzzle. The individual stories of people who, you, you mentioned about oncologists or orthopedic surgeons. I mean, I have had great fortune to, to have great care from, from a variety of medical professionals, let alone, you know, people I love who are in these professions who are doing such good work. So I'm loathed to kind of paint a whole profession with a, with that brush. But I'm just curious, like what is it in the examples of people in those professions, what are the incentives that causes someone to go from a hippocratic oath and a wanting to do the right thing, into actually starting to, you know, be motivated by different incentives?

[00:29:06] Gardiner Harris: I'm sure you've talked about it a lot, conflicts of interest, right? Which is, you know, there's been any number of people who have pointed out that when your pocketbook depends upon you believing something, you will believe it fiercely, right? And so many of these people are indeed wonderful people, in the way, one of my favorite ways of demonstrating how conflicts of interest work is to reference this great study that was done in 2000 at University of California San Francisco Medical School. They surveyed residents about whether they thought money and gifts from pharmaceutical sales representatives influenced their own prescribing and whether they thought that these gifts influenced the prescribing of their colleagues. And of course, 20% conceded that maybe their own prescribing might be influenced, but 80% thought that their colleagues,

[00:30:00] Kim Scott: Said no.

[00:30:00] Gardiner Harris: Yeah. And this is that Garrison Keillor, you know, we're all, you know, above average here sort of idea. And that is that money corrupts even good people. And the story of EPO in particular shows just how corrupting that influence can be. Because this was a drug, EPO, how we all know EPO is really about Lance Armstrong, most people know that Lance Armstrong and his team used EPO to dope and win seven Tours de France. You know, it's this product that increases the number, your body's production of red blood cells. So if you're a high level aerobic athlete, like bicyclists, it, this wonderful thing, it'll, it, it's like, you know, if you use EPO it's like you've been, you know, working out on, on, on the top of Everest, you know, because it, it sort of turbocharges your blood with red blood cells and allows you to much more efficiently get oxygen to your muscles. And so it's a great doping mechanism. But, but the real use of EPO, the largest use, and it was by far, it was by the way, the largest single expense of the federal government during the height of its use. Not building aircraft carriers, not, you know, all the things you think about. EPO was the single

[00:31:23] Kim Scott: For, EPO for cancer patients.

[00:31:24] Gardiner Harris: For cancer patients, right? And that's because Johnson & Johnson, and I've heard that McKinsey actually helped them come up with this idea. Johnson & Johnson decided, hey, originally EPO was sold just for patients who were getting kidney dialysis. Because when you get to kidney dialysis, your blood gets outta your system. It goes through these filters and it, and the filters often destroy red blood cells. So people who go through kidney dialysis are often anemic. Anemia is often a measure of your number of red blood cells. So the first idea was, we'll give this to patients on kidney dialysis. They'll need fewer blood transfusions. Blood transfusions come with their own risks. Johnson & Johnson invested in this in a complicated deal, and Johnson & Johnson got all sales outside of kidney. And that's when Johnson & Johnson decided, why don't we sell it as sort of a, kind of a pick me up for all cancer patients, you know, because chemotherapy can lead you to become anemic and weak and all this sort of stuff. We'll give them a, sort of a boost of, of red blood cells with this, it'll be great. The problem,

[00:32:32] Kim Scott: But they didn't need the red blood cells, right?

[00:32:34] Gardiner Harris: They, they, right. So the thing about chemotherapy is that your red blood cells almost immediately replenish themselves as soon as you're done with that particular regimen. And so it wasn't really necessary. But Johnson & Johnson, what they did was they made this very expensive and they told oncologists, look, if you prescribe this drug to your patients, you're gonna make a huge amount of money. And so very quickly, EPO became the most popular drug in cancer. And what happened is that oncologists on average made about $300,000 in their practices, and they made about $300,000 exclusively on prescribing EPO to their patients.

[00:33:14] It roughly doubled their income. Now, there was nothing that EPO did, in fact, we later learned that Johnson & Johnson knew the entire time that this would kill these patients rather than help them. But what Johnson & Johnson also did is it added about 15% extra EPO to each vial of EPO. The way oncology drugs are reimbursed is that doctors tell Medicare and private insurers, look, I bought a hundred milligrams of this drug. This is the price of the drug. Give me this amount of money. What Johnson & Johnson did was give doctors 115 milligrams of this drug so that they could treat some of their patients with freebies. So not only would they get the, there was always a gap between what they actually paid and what they billed Medicare.

[00:34:06] But then of course, that gap goes to 115% when they're getting free drug. So in almost every cancer hospital in the country hired what is known as compounding pharmacies. And these are these pharmacies that essentially repackaged EPO for them. So the way you know that these hospitals were knowingly engaged in huge amounts of insurance fraud is that they hired a company to repackage EPO. The only reason to do that is to be that much more efficient about billing for free product. And, and you know, I have the grand jury files on the EPO investigation, and they called in some of the CEOs of these hospital systems and said, what are you doing hiring compounding pharmacies to repackage EPO?

[00:34:57] And these guys all had their lawyers there and they said basically, I can't recall, I can't recall. They called in the compounding pharmacy companies, which of course, there's no crime for them to repackage on their behalf. The compounding pharmacy companies just willingly said, oh yeah, we repackaged it for them so they could charge you for free stuff. So hundreds of billions of dollars was stolen in insurance fraud, and just so happens, nobody really cared, but about 500,000 patients were killed as well. 

[00:35:33] Kim Scott: It's, it's staggering. It's hard not to be left speechless by these stories.

[00:35:38] Gardiner Harris: And, and these sort of incentives are all over the healthcare system now, right? I mean, I would argue that all of this stuff is getting worse, not better. The, you know, I wrote, I was around before the computerization of health records, you were around then. Remember when you went into your doctor's office and there was this huge array of colored files behind the nurse's desk. And they would get down your particular file and you'd go into the doctor and he'd write it in. Well, nobody has that anymore. It's all digital. The selling point for digitization of healthcare records was that you could then take these records with you. Your doctors could have coordinated care. Things like, what are known as ACOs, or accountable care organizations, could be set up where all of your care is managed as one, and also poor medical care could be caught by administrators because they'd see the digital records.

[00:36:33] What's actually happened is that the digitization of healthcare has allowed for the proliferation of small but clear corrupt practices across the healthcare system, where these top administrators can sort of tell, for instance, you know. I'll just, you know, randomly, if you had pancreatic cancer, you are gonna get eventually a biopsy of your pancreas. And it, you know, depending upon whether the cancer is in the front of the pancreas or the back of the pancreas, will show you whether you're likely to live or not. But these surgeons have begun to do biopsies of the stomach, of all kinds of surrounding organs, that in 99% of the patients is not needed and adds just a little bit of risk to the patients. But each one of those biopsies is a separate, what's known as an ICD 10 code, or you know, it's a separate billing code.

[00:37:29] And those sort of practices basically become standardized across systems because of the digitization of records, where the administrators can say, look, your colleagues are making us twice as much money as you because they're doing these other procedures. Now, those procedures raise the risk for the patients. They don't really add any benefit for the patient, but it's a small risk. You can be persuaded to do it and you are, and, and that sort of small level corruption, with a small c, has become endemic across the healthcare system. I mean, you know, many of the people I talk about who are in these grand jury records, you know, these people get citizen of the year awards. These hospitals are seen as paragon of ethics, and yet they participated knowingly in a criminal conspiracy that cost 500,000 lives. 

[00:38:26] Kim Scott: And I can imagine as a doctor, like what happens to, is there's plausible deniability.

[00:38:33] Gardiner Harris: Absolutely.

[00:38:34] Kim Scott: It can't, like you, you hear one thing and then you say, but this would never be happening in the world in which we live. Johnson & Johnson wouldn't do this. The FDA wouldn't allow it. Maybe that's wrong. And so you, you know, you, you go down the path, you convince yourself. And this patient is feeling so lousy and maybe this will help them feel better. 

[00:38:56] Gardiner Harris: Absolutely.

[00:38:56] Kim Scott: Um, like that's,

[00:38:57] Gardiner Harris: And why not believe them? You, you are programmed to believe them and it just so happens by believing them, you get another $300,000 that year.

[00:39:07] Kim Scott: Yeah. Yeah. There's, there's an incentive to believe what is convenient to believe.

[00:39:12] Gardiner Harris: Absolutely.

[00:42:05] The story I don't tell in the book is the real reason I did this book. That was that my own son was born early. He spent several days in the NICU. It was a harrowing experience, and as a dad, you're just like, oh. And suddenly this little tiny being has it's hands wrapped around the taproot to your soul. I mean, you had no idea. And you know, this child of mine was in this incubator and I was distraught, like I had not been destroyed, and I lost my mother. I had all kinds of, my grandparents, I had all kinds of death. My best friend had died, but nothing like this had really hit me. And finally he came home, he was fine, but a few, this is back in the day where there was no such thing as paternity leave. So as soon as he got home, I went back to work. 

[00:43:08] Kim Scott: Yeah.

[00:43:08] Gardiner Harris: And within days, got a sheif of documents from some sources showing that Johnson & Johnson had for years targeted NICU units to sell this heartburn drug called Propulsid, which on the one hand, it knew didn't work for babies, on the other hand, knew that it in rare cases killed them. And I just was looking at these documents like, and I, as, as I say in this book, I, I grew up in Princeton, New Jersey near Johnson & Johnson's headquarters. A lot of the executives live up in Princeton, send their kids to fancy private schools, I went to the public school there. But we all grew up with this idea of Johnson & Johnson is the ideal American conglomerate that does well on the one hand, but also does good on the other.

[00:43:56] And as I did this, one of the first big controversies I did when I was at the Wall Street Journal was the AIDS in Africa story. The antiretroviral drugs had been developed in the United States. The American makers of that had set the prices at somewhere between 15 and $20,000 a year. No way anybody in Africa, or very few people in Africa, were gonna be able to afford it. So we were gonna see an entire continent die. Huge controversy comes up and basically this controversy leads the American pharmaceutical industry to allow Indian generic companies to make these drugs essentially for free. And once my friend Hamid of Cipla, uh, gets the price of the triple cocktail down to below a dollar a day, they know that there's enough money to save the continent.

[00:44:42] Well, the one holdout of that controversy was Johnson & Johnson, one of the largest makers of AIDS drugs in the world, and just told the rest of the world to take a hike. We're not gonna allow our drugs to be copied. It's not gonna be part of this. Now, there were enough other drugs that Africa was saved, but if it had been up to Johnson & Johnson, Africa wouldn't have had a chance. And I just, I remember just being like, what? How is this possible? And then I have my experience with my own son and these documents and realizing that my son could have been one of those targeted, had he been born three years earlier. And then I, this story about the sales rep in the airport that I tell in the book.

[00:45:22] Which is that, you know, I was, I was on a ski trip in Colorado and had one of those layovers that we've all had at Chicago's O'Hare airport, and ended up sitting next to this sales rep who told me this horrifying story about selling  Risperdal. And suddenly her nephew gets in a fight at the playground. He's prescribed  Risperdal by one of her favorite doctors. The child blows up, right? Because children on Risperdal gain on average a pound and a half of fat every week. And that, of course, adds, within four or five months, you're talking about 30, you know, 40 pounds and an 11-year-old, 30 or 40 pounds of fat. They, they're a bowling ball and, and this happens to her nephew.

[00:46:09] Meanwhile, Johnson & Johnson has done this terrible thing that I, as far as I know, has never happened, which is that FDA mandated that Johnson & Johnson send to doctors a warning that Risperdal could cause diabetes and other metabolic problems, which, you know, again, read massive weight gain. Johnson & Johnson does just the opposite. Sends letters to doctors saying, Risperdal doesn't do this. All of its competitors do. If you're worried about this problem, prescribe  Risperdal. And of course it takes, you know, the FDA about, about a year to kind of get around to do anything about this.

[00:46:45] But finally, the FDA sends another warning letter and said, if you persist in this, we're gonna prosecute you and fine, but finally, Johnson & Johnson sends a new warning saying that we'd lied before, but during this time, I meet this woman. And she's, she's distraught because she has been told by her bosses that she needs to tell all of her doctors, you know, Risperdal doesn't cause weight gain when she is watching her nephew blow up. She tells me she's gonna quit. And I tell her, you know, let me do a story about it. And, you know, she leaves my card on the, on the bar and I never see her again. But that's where the, the book really starts. 

[00:47:27] Kim Scott: I think that one of the things that people can take away is that when you notice something like this, even if you don't wanna go public, talk to the people, talk to people, like the more that, I mean you, because even though she wasn't a source, she had a huge impact on your decision to write the book. And so good for her for talking to you at this bar. You know, it doesn't sound like, you know, that doesn't sound like the solution, but sometimes just talking to someone, and maybe even just a stranger who doesn't even know who you are, might feel safer than talking to someone who, you know.

[00:47:58] Gardiner Harris: Yeah, I mean, you and I, we had an exchange before our conversation and, you know, arguably, I think Johnson & Johnson's unique skill, the one thing that Johnson & Johnson does better than anyone else is completely gaslight its employees. One of the great questions that, Kim, you sort of asked me to answer at some point in this conversation is, how did they get away with this? Right? How did they persuade, you know, these are, the stories that I tell, by the way, are the largest, costliest, and deadliest criminal conspiracies in American history. Nothing else is close, you know? Not Tyco, not Enron. All the big frauds that you sort of think of are tiny specs compared to myriad ones that Johnson & Johnson prosecuted, right? 

[00:48:50] Kim Scott: Yeah. 

[00:48:50] Gardiner Harris: You know, and got away with, right? And, and, and how is it that this company managed to persuade hundreds of its own employees, thousands of these doctors to go along with these clearly, obviously, criminal schemes. And it's because they are spectacular at gaslighting everyone about their own ethics. As you know, Kim, the sort of the management thing, management lessons coming out of this, is that, you know, Johnson & Johnson created this sort of cult of the credo. You know, we would pronounce the credo, they call it the credo, which is this, you know, the first real mission statement, right? That is, you know, our first obligation is to mothers and fathers and, and doctors who use our products. And, and every corporate meeting starts with a credo discussion. And there's this whole kind of, again, cult, as many employees described to me about how the credo informs our decision making. And so it's, in many ways, these conversations became this early warning system for managers to, to, to be able to weed out possible whistleblowers before they blew the whistle, because of course people would sort of say, well, wait a second, you know? The credo said this. And we're doing that.

[00:50:13] And that instantly became a way for them to sort of say to these employees, you know, this really isn't a good cultural fit like, uh, you know, we are all credo focused and you really aren't getting the credo, so maybe you shouldn't go. And then the other thing of course is the Johnson & Johnson has noticed the Johnson family of companies, it's a conglomerate. It's got 150 different subsidiaries. And so there is this profound anxiety and unease amongst employees there because the company was always closing, shuttering, and starting various subsidiaries and basically firing everybody in the subsidiary and forcing them to reapply for their jobs. So if you had ever expressed any unease about some of the company's conduct among any of these disasters, and by the way, you know, the original manuscript, my original manuscript was twice as long with a whole lot more products and a lot more detail. My editors were like, Gardiner, I mean, no one is gonna be able to read this stuff. And I, I think they were right. So I have a huge amount of other material. And so they were able to sort of keep this vast, you know, these vast conspiracies, that's really the only word for them, and the vast number of co-conspirators in line by, on the one hand, this sort of cult of the credo. And on the other hand, this constant churn of subsidiaries that they could bid out anybody. 

[00:51:41] Kim Scott: Yeah. So everybody's afraid of being fired. And so they're not gonna speak up and then they give them the opportunity to speak up and those who do are out. 

[00:51:49] Gardiner Harris: Exactly. 

[00:51:51] Kim Scott: Um, it's, and so, I mean, it's the, the credo. I never knew that's how you said it.

[00:51:56] Gardiner Harris: Yeah, I know. Well, someone is from Johnson & Johnson, when they say, they call it the credo instead of the credo. Yeah. 

[00:52:02] Kim Scott: But anyway, it's like the ultimate manipulative insincerity, right? That's what, that's what it's, that's that's the way it's been used.

[00:52:10] Gardiner Harris: You talk about in your book that it is the ultimate version of that, you know, third leg of the fourth leg that you talk about in your book.

[00:52:18] Kim Scott: Amy, you were going to say something. 

[00:52:19] Amy Sandler: I was, no, I was just gonna say, first of all, I'm curious if J and J has responded to your book, so I wanna make sure that we bring that out. But just as we were talking about manipulative insincerity, and there is a pattern of this sort of doubling down on the lies, what insights do you have though about why there were so many times when they could have come clean and the facts were presented and they kept lying or doubling down on it? What is underneath that? Is that just endemic to this company? Or is there something larger about human nature that you, you have some wisdom for us?

[00:52:53] Kim Scott: Or the system of capitalism. 

[00:52:54] Amy Sandler: Yeah. 

[00:52:56] Gardiner Harris: I think, John, the story of Johnson's baby powder is such an extraordinary story, and I think it really explains a lot of this. In our back and forth, before we talked, Kim, you talked about how James Burke the, the executive in charge of that is widely seen, I mean, Reagan gave him the highest civilian honor possible. He has long been seen as, if not the most ethical business executive, one of the top five. There are awards named after him, and it's very clear he knew exactly what was going on with Johnson's baby powder. You know, he completely changed a lot of processes at Johnson & Johnson to protect that franchise and the company writ large from these disclosures. He is not even close to being in the pantheon of ethical business leaders. And I think what possibly happened is that the 1982 Tylenol poisoning scare, Johnson & Johnson did a series of appalling things. And by the way, there's a really good Netflix documentary about the Tylenol murders, I happen to be interviewed in, in that documentary, that sort of retells that tale. And they don't even go into all the details about how almost certainly the FDA commission at the time was being paid off by Johnson & Johnson, obviously illegal.

[00:54:15] Kim Scott: And they knew, right? That this guy, this guy in their, I mean that was what was, I mean, Burke must have known that.

[00:54:21] Gardiner Harris: They almost certainly knew who the killer was and didn't tell the investigators who this person was. So I think what happens is they kind of get away with murder, right?

[00:54:31] Kim Scott: Literally. Not just kind of, they literally get away with murder.

[00:54:35] Gardiner Harris: Are feted as amongst the most ethical people on the planet. And I, and, you know, if you take the cops entirely away from everywhere. Are we all gonna turn into shoplifters? Like if there is no possible consequence for you going into the store and you just taking stuff and putting it in your bag. How many of us are gonna go into stores and take stuff and just put it in our bag? And I think these guys were not only able to go in the store and take everything and put in their bag, but then they were showered with praise and money as a result. And I think that kind of impunity, that engenders a, a sociopathology, which is the only way you can kind of describe Johnson & Johnson post 1982, was that it was, it was a sociopathic organization.

[00:55:32] And, and, and there is really no evidence that it isn't still, right? I mean, again, in the baby powder case that finally the FDA, finally, does its own test of baby powder in 2019 finds asbestos. Even though FDA has now confirmed that mothers and babies are being poisoned by this consumer product, the FDA doesn't make an announcement, tells it privately to Johnson & Johnson, gives Johnson & Johnson roughly a week to get some sort of statement together. And in that week, Johnson & Johnson employees get together and have these marathon meetings about what to do. And there's this woman, Carol Montandon, who's a Johnson & Johnson executive, I believe to this day. She writes like 80 pages of notes of all these meetings. And those notes talk about FDA and blackmail in coercion and, you know, what are they talking about?

[00:56:29] Well, she is, she is deposed a year later. Just a year later. And, and when you, you wrote blackmail about FDA, what were you saying? I don't recall. When you wrote coercion, what were you saying? I don't recall. And the lawyer's like, is it normal for you to talk about blackmail and coercion when talking about the FDA? No. By the way, this book, fine tooth comb, multiple lawyers, you know, we are charging obviously one of the great American companies with participating in 2 million deaths, with causing 2 million deaths. I will tell you that there are foreign arms of my very large publisher who refuse to publish this because of the legal risks associated with it. So I am so grateful for Random House, for being brave enough to do it. The charges are searing and extraordinary and we can only do it because of the extraordinary care that we took with all of these documents and interviews. And we have proof. 

[00:57:36] Kim Scott: Yeah. I think one thing that people can do is buy your book and read it. So, so I'm gonna hold up my screen. There it is. Try to buy it. Yes. There you go. No More Tears. It is, it's a really sobering book. But you also offer, at the end, a lot of hope about how we can create, you know, we need capitalism constraints. We need, we need real regulators who have real teeth. We need real rules of the road so that, so that greed doesn't, you know, isn't the only thing people are pursuing. And so that people are not rewarded for pursuing greed, you know, at the expense of all other concerns. Yeah, deadly greed. That, that, so that people don't have an incentive to overlook the facts because,

[00:58:27] Gardiner Harris: And we, I just wanna be clear, there was almost certainly not a single American family that, that has not been affected by these various things that I talk about. 

[00:58:36] Amy Sandler: So I think for me, that's the big takeaway is that, I said this should be required reading for every civilian, every MBA, every MD, everyone, just as a professional, you know, Brandi, sharing just her own stories. I, I really think it touches everyone and it is shocking to me that we're not hearing more about this book. So I did feel like we had an obligation to get it out there.

[00:58:59] Gardiner Harris: The the, the one that really comes back to me when I give book talks is Tylenol. You know, Tylenol is, by far and away, the most dangerous over the counter medicine. Nothing else comes close. More people die from Tylenol than all other over the counter remedies combined. And, and, and it's a mess. And of course, one of the reasons it's so dangerous is that it's sold as so safe. And, and it's that when, when people read that in the book, they're like, wait a second, you know, I had no idea. And, and it, and, and it's one of the like, I don't think anybody should have extra strength Tylenol in, in their house.

[00:59:34] Kim Scott: That was one of the things I did when I finished your book is I went and threw it away.

[00:59:37] Amy Sandler: Me too. And I had a bias of like, I have to have the brand name thing and I'm like, I'm good. 

[00:59:42] Gardiner Harris: The FDA has sort of acknowledged that forever, but you know, again, in a sign of the FDA's powerlessness versus Johnson & Johnson, you know, has refused to backtrack its approval of extra strength Tylenol, although it now will not allow prescription drugs to have anything more than the regular strength 350 milligrams in, so it is the only pill where the over the counter medicine has nearly twice the amount of drug as the prescription medicine is allowed to have.

[01:00:18] Kim Scott: It's astounding.

[01:00:19] Amy Sandler: Okay. Back to the hope.

[01:00:20] Kim Scott: Okay, hope.

[01:00:21] Amy Sandler: Give us a little hope, Gardiner.

[01:00:23] Kim Scott: What hope do we have? Everybody can throw away their extra strength Tylenol and,

[01:00:28] Amy Sandler: Yeah, that's one step.

[01:00:29] Kim Scott: Buy other kinds of band-aids. 

[01:00:32] Gardiner Harris: Well, so I think there are, you know, look, FDA needs to be a true regulatory body. It needs to, right now most of FDA's funding comes from the drug and device industries. And FDA officials routinely go to these industry conclaves and say that FDA's most important customer is the industry. FDA officials say this, they do not say that the American public is their most important customer. They say that the industry is the most important customer. You can say, and you know, I live in San Diego, it's a biotech hub. There's a lot of small biotechs here. I'm not saying that FDA does everything that every industry player asks them to. If you, if you're a small player and don't have the kind of political muscle that J and J has that you know, they'll mess with you.

[01:01:25] Kim Scott: You're not getting any love. 

[01:01:26] Gardiner Harris: Yeah. You're not getting any love. But what, I tell a story in the book about 2012, the FDA was about to face a disaster because the industry refused to re-up these, these five-year funding mechanisms. And the FDA commission of the day, Margaret Hamburg, called the J and J CEO and asked him to save the FDA. He then did save the FDA, saved FDA's medical officers from being fired, uh, got the rest of the industry to go along with this bill, used J and J's massive, uh, army of lobbyists to get Congress to pass it.

[01:02:10] And, um, he was then being investigated for criminal conduct around, uh, Risperdal. The company was in the midst of negotiation, negotiating a massive fine. And despite all that, the, you know, he is not charged criminally, FDA, which was then investigating Johnson & Johnson's metal on metal hip implants, its vaginal mesh, instead of requiring that they be withdrawn, they allowed Johnson & Johnson to just sort of stop selling them, which meant reduced hugely Johnson & Johnson's liability for it. And then when Johnson & Johnson loses its first baby powder case in 2014, the FDA suddenly cooked up this statement saying that Johnson's baby powder is safe.

[01:02:58] They suddenly cooked up a statement saying Risperdal was safe in children. They suddenly cooked up a statement saying, you know, opioids are safe. Like each sort of place where Johnson & Johnson became vulnerable from a liability and courtroom perspective, suddenly FDA was there to endorse Johnson & Johnson's decisions and statements. So, you know, Johnson & Johnson basically bought and sold the FDA and the FDA has been saving Johnson & Johnson ever since. 

[01:03:29] Kim Scott: So regulatory capture is certainly a big part of this. So, obviously the FDA should not be funded by Johnson & Johnson. It needs to be funded by the taxpayer. By, by, by public entities. How do people who are listening to this, how can they raise their voice and make the, I mean, do you write to your Congress or my Congress person. I may not be happy about it. But I'll do it. Like what do we do? What do we do to like raise awareness? 

[01:03:58] Gardiner Harris: Well, first. Be careful yourself. Ask your own doctors if they're taking money from drug makers and device makers. The industry to this day gives American doctors directly somewhere between 2 and $3 billion in cash. That money clearly influences their decisions and often leads doctors to do dangerous things. And you need to, and by the way, you know, as a result of that moment in the airport at O'Hare, I did write a series of stories about antipsychotics in children. Those stories ended up spurring a Senate inquiry that then led to the Physician Payment Sunshine Act, which is this website that you can find on CMS, that if you put in your doctor's name will tell you the payments they have gotten over the last five years from various drug makers.

[01:04:50] Kim Scott: So we'll drop a link to that in the show notes for people listening who want to check their doctors. 

[01:04:55] Gardiner Harris: So go check that out. Um, and I think you should, you know, even if it's a, uh, if it's a good friend or something, you should tell your doctor, stop doing this. It, it's really a bad practice. And this is particularly true in orthopedic medicine. The amount of money that these orthopedists make from these schemes is just appalling, often in the millions of dollars. So that's another thing. And I think also, you know, I propose that when airplanes crash, the FAA is not asked to investigate. 'Cause the FAA approved those planes to begin with. There's an independent group called the NTSB that investigates, on the National Transportation Safety Board. I think FDA's culture is sort of lost.

[01:05:38] I think they have become so identified with the industry that that's where they are. I think we need to create a separate organization somewhere between FDA and CMS that has oversight of already approved drugs and devices and tracks their safety. We have an enormous amount of information in the federal Medicare program that could be used to do active surveillance of drugs and devices and how they're operating. And we just don't do it because FDA doesn't want to hear it. It just doesn't, it's already approved these drugs, then they become disasters afterward. It's just bad news for them. And so medicines get approved and even when they're shown to be dangerous, the FDA often does absolutely nothing about it and that needs to stop.

[01:06:25] Kim Scott: Yeah, and it seems like Medicare, Medicaid or could be part of the solution 'cause they have the data. They just need to share the data.

[01:06:31] Gardiner Harris: It is appalling, appalling that those data are almost never used in these sort of surveillance efforts. 

[01:06:38] Kim Scott: Yes.

[01:06:39] Amy Sandler: Well, one thing I'm really taking away from this is, you know, we might not feel like we can change a whole system, but we can do our own research. We can share our stories. I mean, I was really touched Gardiner by you sharing your story about your son, so thank you for that. And how those individual stories can take us out. There is so much institutional and emotional trust that we've given to this company and to these institutions and I think just sharing our stories also seems like a really powerful way to start to make some change, both with our physician friends as well as our, our friends and neighbors. Um, Kim, any, any last note before we close?

[01:07:14] Kim Scott: You can read the book, buy the book. Buy the book. Read the book. It is a great book and, uh, I mean I certainly, it was, it's a big drink of water, but it is really also a, a powerful read. And by the end of it, I felt like I had more agency, more ability to do something about this rather than less. So buy the book. Read the book. 

[01:07:36] Gardiner Harris: There at least it will give you some questions to ask when you're in the doctor's office or when you're there with your loved one in the hospital. Each one of these products is from a very different part of the healthcare system and we all have dealings with each one of these parts of the healthcare system at some point in our lives. I'm hoping to empower you to at least ask the right questions. 

[01:08:00] Kim Scott: Thank you so much for, uh, shedding light on all of this and for writing, I know writing a book like this is a labor of love, so thank you for doing it. 

[01:08:09] Gardiner Harris: Alright, well thanks for having me. 

[01:08:10] Amy Sandler: Oh, thank you so much. So again, please do get Gardiner's book, No More Tears: The Dark Secrets of Johnson & Johnson, wherever you get your books. To see the show notes, you can go to RadicalCandor.com/podcast. You also can watch this episode as a video on YouTube and Spotify. As we always say, praise in public, criticize in private. So please do rate and review us if you like what you hear, wherever you're listening. If you've got feedback for us, um, we suspect you might, please do email us podcast@RadicalCandor.com. Again, this information is empowering, so we encourage you to check out the book, to read it, to share it, and to keep asking those questions. Thank you so much, Gardiner. We're very grateful.

[01:08:53] The Radical Candor Podcast is based on the book, Radical Candor: Be a Kick Ass Boss Without Losing Your Humanity by Kim Scott. Episodes are written and produced by Brandi Neal, with script editing by me, Amy Sandler. The show features Radical Candor co-founders Kim Scott and Jason Rosoff, and is hosted by me, still Amy Sandler. Nick Carissimi is our audio engineer. The Radical Candor, podcasting music was composed by Cliff Goldmacher. Follow us on LinkedIn, Radical Candor the company, and visit us at RadicalCandor.com.

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The Radical Candor Podcast is based on the book Radical Candor: Be A Kickass Boss Without Losing Your Humanity by Kim Scott.

Episodes are written and produced by Brandi Neal with script editing by Amy Sandler. The show features Radical Candor co-founders Kim Scott and Jason Rosoff and is hosted by Amy Sandler. Nick Carissimi is our audio engineer.

The Radical Candor Podcast theme music was composed by Cliff Goldmacher. Order his book: The Reason For The Rhymes: Mastering the Seven Essential Skills of Innovation by Learning to Write Songs.

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