Dispensing with the Truth.

Alicia Mundy St. Martin's Press www.stmartins.com 416pp., $24.95

Americans love their heroes. We have filled our national storybook with those we cherish: the dedicated doctor, the selfless scientist, even the government bureaucrat who vigilantly guards the nation from harm. We feel deeply betrayed when our heroes sell our trust in the marketplace.

In Dispensing with the Truth, released this month in paperback, investigative journalist Alicia Mundy tells a disheartening story of would-be heroes foiled by greed and incompetence. Leading doctors sold their talents and reputations to the drug industry. Medical journals and mainstream media outlets published studies funded by prescription drug makers. Pharmaceutical companies recruited lobbyists and members of Congress to keep the FDA at bay. The result: the death and injury of thousands of women and a handful of men.

The book looks at the marketing of a prescription drug--not a miracle medicine that saved lives from the scourge of disease, but "fat pills" marketed primarily to women desperate to look like models. Dr. Michael Weintraub ignited the diet-pill craze in 1995 when he wrote an article for Allure magazine about the weight-loss successes achieved by combining the existing drugs fenfluramine and phentermine. The combination became known as "fen-phen."

Whether Weintraub's study had been secretly funded by the drugs' manufacturers remains uncertain. There can be no doubt, however, that the fen-phen craze was "one of the most remarkably profitable pharmaceutical undertakings in the history of the United States." Those are the words of Alex MacDonald, a Boston plaintiff lawyer, in his opening statement at the trial for the wrongful death of Mary Linnen.

Linnen was a healthy woman who simply wanted to lose 25 pounds for her wedding. Her doctor prescribed fen-phen, manufactured by Wyeth-Ayerst, a division of American Home Products (AHP). After she took the combination for only 23 days, Linnen complained of dizziness and shortness of breath. An emergency room visit revealed primary pulmonary hypertension (PPH); the blood vessels carrying oxygen to her lungs were thickening and closing. She was slowly suffocating. In less than a year, she was dead.

Mundy uses Linnen's case as a framework. Wyeth had expected sales of fen-phen and Redux, a similar combination diet drug, to approach $1 billion a year. That kind of money can buy a lot of betrayal. The lawsuit revealed that, even as Wyeth was mounting a $53 million public relations campaign to promote the sale of the diet drugs, the company was compiling a growing list of users who died of PPH--and, later, some who died of severe heart-valve damage. Wyeth destroyed reports of fenphen-related deaths or buried them in the back pages of the company's "disclosures" to the FDA.

Amid the betrayal, the drama had its heroes: Pamela Ruff, a medical technician in Fargo, North Dakota, took it upon herself to investigate the unusual number of damaged heart valves showing up in echocardiograms. She discovered the link to fen-phen and fought to get the evidence reported to Wyeth and the FDA.

Dr. Leo Lutwak, an FDA obesity expert and self-described "dinosaur"--a relic from an age when the agency saw its mission as protecting the public--originally denied approval for Redux. He watched in dismay as the agency caved in. His efforts to call attention to the drug's dangers earned him a reprimand from higher-ups for failing to serve the interests of the agency's "client" pharmaceutical companies.

And there were the trial lawyers. Mundy shines a spotlight on plaintiff attorneys who relish the battle against corporate villainy to a degree that may appear unseemly to anyone but another trial lawyer. In addition to MacDonald, we meet Dallas attorneys Kip Petroff and Robert Kisselburgh and Philadelphia lawyers Michael Fishbein and Arnold Levin.

Mundy does an admirable job of telling this complicated tale. There are a lot of characters, some of whom vanish for a hundred pages then reappear in a different setting, so readers might want to keep a bookmark in the index. Although there are no footnotes, Mundy makes clear that she relied primarily on documents uncovered in discovery and used at trial. It is obvious that the plaintiffs and their lawyers helped her greatly.

Despite the complexity of the subject, the book sustains a pace rivaling that of a fictional thriller. Mundy sprinkles the narrative with wry observations, some that might be worthy of Raymond Chandler and others that simply fall flat. For example, after MacDonald castigates a drug company's position as morally bankrupt, Mundy adds, "There are no moral-bankruptcy courts." On the other hand, few descriptions of document inspection are as humorous as Mundy's portrayal, of MacDOnald and his cocounsel at Wyeth's offices.

Dispensing with the Truth is a memorable addition to the growing genre of journalistic exposes. It joins Outrageous Misconduct: The Asbestos Industry on Trial by Paul Brodeur and A Civil Action by Jonathan Harr and sets a new standard for intelligent, gripping work.

Jeffrey White is senior amicus counsel of the Center for Constitutional Litigation in Washington, D.C.