Salesman turned student seeks a prescription for change

April 29, 2003 6:07 p.m.

As a pharmaceutical salesman, Michael Oldani rarely thought about what happened after he convinced a physician client to prescribe his company's drugs. He would simply move on to the next deal, one step closer to making his quota.

After nine years, under wearisome pressure to increase sales and at odds with his employer, Oldani left his job to move full time into academia. As he forges a new career as an anthropologist at Princeton, however, the pharmaceutical industry remains a core element of Oldani's professional life.

Oldani completed a master's in anthropology at the University of Wisconsin-Milwaukee in 1998 while still working as a pharmaceutical salesman and is now a doctoral candidate at Princeton, where he has examined sales practices in the drug industry and their effects on the medical community. His paper "Thick Prescriptions," which describes "the three-way gift cycle occurring in the medical marketplace between reps, doctors and patients," last year shared the Society of Medical Anthropology's annual award for best paper by a graduate student.

While continuing to incorporate his personal and scholarly knowledge of the drug business, Oldani is expanding his research. He is conducting fieldwork for his dissertation in Winnipeg, Manitoba, on the diagnosis and pharmaceutical treatment of fetal alcohol syndrome (FAS) and attention deficit hyperactivity disorder (ADHD) within the area's aboriginal community. Oldani won a U.S.-Canada Fulbright award to fund his research.

"The first part of my life in the pharmaceutical world was all about getting the drug written as a prescription. All I was concerned with for a couple of years at Princeton was the activity behind generating prescriptions. Now I'm looking at what happens once those prescriptions are in circulation," he said.

Oldani, a native of Kenosha, Wis., initially developed the project after conversations with members of his wife's family in Winnipeg, including a member of the Cree Nation who cares for foster children. "I said I was interested in pharmaceuticals and she said, 'A lot of our kids are on Ritalin, and we're not sure why.' That made me curious," Oldani recalled.

Through a grant from Princeton's Council on Regional Studies, he did some preliminary research in Winnipeg and found that Ritalin -- best known for treating ADHD -- was being prescribed frequently to aboriginal children for treatment of FAS. While the two conditions share many of the same characteristics and Ritalin is often prescribed to treat behavioral problems associated with both, FAS carries a much greater stigma, Oldani said.

His early findings raised questions about whether aboriginal children in Winnipeg's public schools were being improperly labeled with FAS because of widespread alcohol abuse in the area's reservations.

"A counselor or a principal may say, 'We think your child may have FAS. He needs to go to a doctor and be put on Ritalin before he can come back to school.' This is a phenomenon with young kids today who have behavioral problems in schools," Oldani said. "What I'm interested in now is how these categories are being racialized. Do the white kids get ADHD, but aboriginal kids without recognizable physical features of FAS still get that diagnosis? It's a really hard diagnosis to shake."

The full story is available in the Weekly Bulletin.

Contact: Evelyn Tu (609) 258-3601