Kill Shot: A Shadow Industry, a Deadly Disease | Jason Dearen, AP Journalist / Author

Transcript Disclaimer: This transcript is generated using speech-to-text technology and may contain errors or inaccuracies.

Mike Koelzer, Host: [00:00:00] Jason for those who haven't come across you online, introduce yourself and tell our listeners why we're talking today. 

Jason Dearen, Author: Uh, my name is Jason Dearen. I'm an investigative journalist and author of the book Kill Shot A Shadow Industry, A Deadly Disease, which is about the 2012 fungal meningitis outbreak that was caused by contaminated steroid injections made at New England Compounding.

Was this 

Mike Koelzer, Host: purely an accident or was there something else going on behind the scenes on this? 

Jason Dearen, Author: It was not purely an accident according to the criminal courts and the way things happened afterwards. But if we back way up and kind of zoom out a little bit, what happened in 2012 was the result of a compounding pharmacy that was acting more like a drug manufacturer, which as you and your audience know is, is a no-no.

Um, and they were not, um, being as careful or talking. The necessary steps to ensure sterility in their clean room. And they were making high risk injectable drugs. And those two, you know, the cutting of corners and the lack of oversight, meaning people going in and ensuring that they were doing what they said they were doing in their promotional materials, which was, we are 7, 9, 7 compliant, us P 7 97 compliant.

We are a top, uh, state of the art, uh, clean room operation. None of that was true. They were cutting lots of corners and allowing for pathogens to invade their clean room undetected. And those ended up in drugs. They sent out to 23 different states and, and those ended up being injected into people's bodies.

Mike Koelzer, Host: All right. So it seems to me that we've heard more recently, like, I'm gonna say, I don't know, time flies, but seems like a half dozen years ago or something. You'd hear more about the difference between compounding and manufacturing. And you made a point of that. Both of them suck when you have dirty medicine.

I know that, but was that a bigger issue? It seems with this, 

Jason Dearen, Author: right? Yeah. It is a huge issue with this because what happens when you call yourself a pharmacy and not a manufacturer that pretty much exempts you and there are all sorts of. You know, kind of differences here, but just, if we're, if we're kind of boiling it down, it exempts you from FDA oversight, meaning pop in inspections, uh, you know, those types of things and you are instead overseen by your state pharmacy board.

Uh, and so the rigor with which, uh, facilities like this that are making high risk injectable drugs that compounding high risk injectable drugs are overseen depends on the state. Of course, yet they are allowed by law to ship their drugs, at least a certain percentage of their drugs, around the United States, from state to state.

So what you, what you end up happening is if a bad actor calls themself a pharmacy, but is kind of on the slide, making more drugs than they're supposed to under that guise and not following the one, um, patient per prescription, uh, which we saw with new England compounding center, they were using. uh, fake prescriptions, they were doing, you know, kind of batch prescriptions and back filling.

And those types of things that hospitals were, were also kind of allowing them to do 

Mike Koelzer, Host: the fact that you say there wasn't one per one or something like that. Right. Those kinds of laws were already in order. So that's where this was no accident as far as their business model, so to 

Jason Dearen, Author: speak. Right. So the business model was created to exploit.

The law as it existed, right in 2012. And so the law as it existed then, and it's changed a little bit, but not a whole lot since, but it has changed a little bit. So then if you call yourself a compounding pharmacy, you still need a one to one. And that was, that was kind of the main mechanism by which, uh, that was supposed to kind of cap the amount of drugs you could make.

Right. I gotcha. Yeah. So, but, and so what they did instead is they and others, we know this, um, now, because there have been other, you know, kind of larger compounding centers that have been, um, kind of discovered since then, but what they would use is these pre-printed prescription forms or these large faxed sheets, where a doctor could just sign once, but it would be used to fill all of these orders and then they would send those drugs to the ho a hospital or a clinic.

They would be administered. And then the clinic staff would later go and backfill in the names and then send those back over to the pharmacy. But in the case of the New England compounding center, The, uh, compounding pharmacy at the heart of, of, of this terrible disaster, they did that, but then they would also just make up names.

So, you know, after they hurt people, they would go in and they would find, they found all these fake prescriptions for [00:05:00] like Tom Brady and Liberi and Edgar Allen Poe. And, you know, they would just make jokes and, uh, really use themselves. Yeah. Yeah, because 

Mike Koelzer, Host: The first part probably got by maybe a loophole, you know, where they, yes, they were one per one, but it was one per one afterwards and this and that.

And they probably could have played dumb on that. But then, they started to get these aliases on there and it might have been covering their tracks, but that certainly was well. To put it lightly, not the intention. 

Jason Dearen, Author: Right. And that's where oversight comes in. Right. So if you had an active oversight mechanism yeah.

And you had an inspector coming in, you know, not calling beforehand, not needing a warrant or a, you know, kind of a search warrant or something like that. Um, but actually had, could come in whenever they wanted to and say like, Hey, okay, let, we're gonna look at your records. Like the FDA does with manufacturers.

Right. That's the difference. Right. And so in the case of compounding pharmacies, especially 5 0 3, compounding pharmacies, that's still kind of the way it is. And so if you want to kind of. As long as you're not hurting anyone. Uh, and that's usually how these places get blown up is that they, they they're, you know, they're cutting corners.

They're not being overseen, um, like a, like a drug maker, even though that's what they are. And then they hurt somebody and then it gets kind of, um, identified after the fact. And that's kind of the way the system works. Still today. Yeah. 

Mike Koelzer, Host: Especially when it's a pharmacy versus a manufacturer. 

Jason Dearen, Author: Right. You really see the increase in these types of business happened about 15 years ago.

Hmm. Uh, when drug shortages really began to kind of increase in earnest in the mid two thousands and gotcha. Those drug shortages, are you you're you and your audience probably know a lot of reasons for that, but they start, um, you know, from like 74, in 2006, up to 274 in 2012, right before this happens.

I remember that. Right. And so you see FDA will allow compounders to make these drugs, if they're on the shortage list, right. It allows compounders. And this became a really lucrative business opportunity that a lot of, uh, you know, people, uh, in, in the pharmacy business who were running these kind of compounding pharmacies that were doing one to one and making, you know, kind of an okay profit, they went from making an okay profit.

When we saw the New England compounding center in 2006, they made, you know, something like 14 million in that year . Before they killed all these people, they were on their way to making, you know, up to a hundred million dollars. Wow. And so they were, they were exponentially growing because to fill these shortages and hospitals in clinics, of course needed these drugs.

And so we were more and more desperate to find suppliers and people who seemed above board and could handle it. And, uh, and unfortunately, without anybody inspecting regularly, uh, these types of accidents can 

Mike Koelzer, Host: happen. Jason, I'm gonna be as generous as I can to a fellow pharmacist. And I'm gonna use that term loosely, but let's just pretend we're all in the same group with our certification.

Was there any benevolence in this, from the start or from the start? Did these guys say we can find ways to have real big loopholes as you look into these two pharmacists mainly. 

Jason Dearen, Author: Right. It was a much bigger, um, enterprise in that, but there were. Two kind of main culprits who were held to be most responsible by the criminal justice system afterwards, 

Mike Koelzer, Host: If you put yourself in their spot, when did these two guys, and I know that's subjective, but when did these two guys go crooked?

Was it before they started this? 

Jason Dearen, Author: So that's a really good question. And I think based on my reporting, what I can say is this, uh, Would say, as they started kind of following this model that was really created by PCCA. This business model was kind of created by PCCA, this big chemical supplier. I'm sure you're you and your audience know, um, who, um, have a big stake in this and kind of created the whole modern compounding pharmacy, right?

Hmm. They started looking at that at, and then, when the drug shortage started, they were telling themself, if you wanna talk about benevolence and they would say, publicly patients need these drugs and they're not getting them because they're in shortage. And so we are providing a service to sick people and helping them get the drugs they need to help, to be well.

Uh, and, and that's what started. They also, at the same time understood how to exploit the loopholes, the gaps in the oversight system, so that they can make more and more of these drugs at a big, bigger and bigger profit. So if you're really being bene. And you're really just trying to help the patient.

You're [00:10:00] not gonna be cutting corners because you know that cutting corners puts the patient at risk, right? It can add all sorts of terrible things to the drugs that they're putting in their bodies. So they did, they were doing, they were saying one thing publicly, the benevolent part, where helping patients, they need these drugs.

Hospitals need these drugs. They're desperate. Their shortages are increasing at the same time. The profits were so large and the opportunity so big that they cut corners to be able to make more and more drugs, more and more quickly. And that's without hiring the staff without expanding properly. And they're doing this all without the type of oversight you need as a drug manufacturer with all the processes.

And science that's involved in making sure that those drugs are safe, that you know, the QA and all of that stuff, that drug manufacturers are required to do by FDA. They didn't have to do any of that. Nobody was w minding the store. In fact, at the time that this happened in their, in, in 2012, the state of matches, Massachusetts had three pharmacy inspectors for more than like 1300 pharmacies or 1200 pharmacies.

Wow. And a number of those pharmacies were these new kinds of compounding pharmacies. They had no one, none of those three inspectors were certified to go in, to inspect a clean room. So even if they did show up, they couldn't go in the clean room to actually see what was going on there and understand or inspect it in a way that an FDA inspector could.

So that's what happened in this case is that you had all these kinds of this perfect storm, right? You have the drug shortages, the cutting of corners. And then the lack of oversight. And so you have people cutting corners and nobody catching them, uh, or, or, you know, holding them to account, um, then patients get harmed and that's what, you know, we had this terrible it's the largest, uh, outbreak or tragedy of its kind in, in us history.

Was there a very 

Mike Koelzer, Host: definitive line of them knowing. We are not a pharmacy. We're a manufacturer. I know. It's the one to one we talked about and that almost kind of seems like I'm giving these guys too much credit, Jason, but I've got an evil mind. So I've gotta think this through if I were in their shoes, you know what I'm saying?

Yeah. It's like, I can see saying, okay. Yeah, we're one to one. And then all of a sudden it gets busy and maybe we know we're gonna need another 20 of these on Monday. So let's make 20 up and all right, well, now that we have, 'em made up, let's see if we can ship 'em to the hospital because we know Monday they're gonna be sending it.

Was it that slippery slope, or do you think that they definitely knew they were getting away from the pharmacy and into manufacturing? I 

Jason Dearen, Author: I think they knew it and there is plenty of evidence for that, which is, and, and why they were, um, eventually convicted for, um, a, a lot of. Um, crimes, but the main reason is, there were videos that they had pharmacist, the president of the company, Barry Caden Cadden, who was a, uh, a pharmacist who ran this operation.

He made these videos, um, in 2006 where he was basically explaining to his sales staff, how they were fooling the FDA and how they were exploiting these loopholes and that, but, you know, but he, but he had the confidence and arrogance to believe that, you know, it was all just a bunch of red tape. They're just here to kind of slow us down and cost us money.

Right. We know what we are doing better than they do. We have all the answers to this. Sure. At the same time, in the couple of years before this happened, they did have an environmental monitoring staff or a woman named Annette Robinson who had no microbiology passed or experience, but who used to go around the clean room with little sponges and take samples and then put them in a dish and see if they grew anything and they would grow.

Uh, things, not only bacteria, but they, the, the year that they, um, ended up killing all these patients with mold contaminated steroids, they had tested positive throughout the year for mold hits in the clean room. And instead of, and I have all the emails showing this, but instead of, um, shutting down and cleaning the clean room and getting, you know, experts in there to get rid of this mold problem, they clearly had a mold problem.

Barry Cadden just blamed this cleaning company that he'd hired to come in and do the cleaning and said they were bringing in mold on their mops and all of these things. And the cleaning company was like, Hey, we, we have sealed mops each time we all, we, all we do is clean clean rooms for a living. We have mops that are sealed, and every time we come in, we only use the mop for this.

And the mold contamination problems, according to the company's own records were, were far, you know, kind of worse than, uh, wow. Then, then anything would let up instead of closing down. So he had many opportunities to close down the shop, make sure he got the mold under control and then [00:15:00] reopen, right. But that's not what happened.

So there are lots of different opportunities here, you know, if they were just kind of pharmacists trying to do a good job and just things got a little outta hand and kind of spun outta control. Um, right. But there is ample evidence that they made decisions, um, that were the wrong decisions for patients all along the way and that they knew they were, you know, kind of endangering people's lives.

Mike Koelzer, Host: Usually when we're talking to somebody about the important stuff, I could be like, where'd you read that? Where'd you get that from? Or I'm thinking, well, where'd you get that from? Okay. Wikipedia. And they got it from someone. And earlier when we were talking here, you mentioned reporting. This is weird talking to you because you're the reporter.

Bring us back. 

Jason Dearen, Author: Who are you? So I'm a journalist. I've been, um, a journalist now for, uh, almost, uh, 25 years. I work for the associated press. I'm on the national investigative team. What has 

Mike Koelzer, Host: Has your day job, Jason, been for the last 10 years? What do you do? You're on the phone. You're doing all the stuff that we see a reporter do in the movies, 

Jason Dearen, Author: correct?

Yeah. So I've worked for the Associated press. Uh, I've been a national reporter, um, for a number of years now covering, um, a lot of different stories, big stories. So, um, I was based in Florida for some years and I would go into the field, um, and do investigative reporting in hurricane zones. For example, looking at the inundation of toxic waste sites and seeing if, uh, it was, uh, contaminating the water in the local community, things like that.

Um, and AP would have a little boat for me to use and I would go around with other reporters and we would actually go to these places, not just on the telephone, but we would actually go into these places and, and see it with our own eyes. And talk to the community. Uh, the type of journalism that I do, um, is completely based on my own research.

I don't rely on other people. Now, when it, you know, when it's science or something like that, for example, in this book, I relied on a lot of documents. Um, so there was a criminal case against the people involved with N ECC. And that created a lot of evidence, um, meaning all of their emails over years, you know, back and forth what they were saying.

Those are dated and have a time, you know, when they said it, what they said, um, videos that they recorded audio and then dozens of interviews with people who were there at the time. So that's how I reconstruct something that happened in the past for my day job at AP. I will go and cover, um, lots of different types of stories.

Uh, you know, I was living in Florida when the Parkland, um, mass shooting happened at the high school, Marjorie stone and Douglas high school in Parkland, Florida. So I was there for that. A few years before that was the, uh, the mass shooting at the, at the, uh, at the gay nightclub in Orlando, the pulse massacre.

I covered that. And since then I have gone, um, onto the, uh, national investigative team. So now I work on projects that take, you know, sometimes months, maybe even more than a year. Wow. Um, where we investigate, uh, you know, various. And so this book, what came out of kind of, one of the, the, one of those projects that I started, um, I started looking into it when I was, uh, in 2017 when Barry Cadden, who I just, I mentioned earlier the head of N ECC.

Yeah. Um, and his chief pharmacist were on trial in federal court. And I started following the trial and I got interested in it. Wow. And I started looking into it and then I ended up getting a research fellowship at MIT. In Cambridge. And I, um, pitched that, uh, this book as my research project and they funded it.

So I left AP for two years and I went and, and worked on this book for, uh, it took about three and a half years, in total, almost four. Wow. And so I did it, um, kind of on my own, both at MIT. And then I went out and found a publisher, and then they gave you an advance to finish your research in reporting.

And I, I hired some help and then, uh, and, and wrote it. Um, and it came out in February, 

Mike Koelzer, Host: I think about your role. And I'm thinking of like the movie spotlight and Watergate and all this kind of stuff. And it's like, that's gotta be kind of weird as somebody who hires. An investigative reporter like you to say, all right, go investigate this.

And just report back, like in 13 months with a story. I mean, how do they decide how long you get for these kind of 

Jason Dearen, Author: things? Right. So there's a, there's a process, um, that is, uh, a pitching process. So if you come up, you know, some things are driven by what's happening in the world. Right. Um, for example, the January 6th, uh, riots at the capitol in Washington DC, there's a lot of investigation.

I'm not currently looking into that, but there was a lot of investigation and at AP and other news organizations into, you know, what really happened that day. Yeah. And who was there and all that. Right? Yeah. So, and so that's, um, an event in the real world driving an investigation, but then there are all these other problems or issues out there.

Um, You know, uh, with the government, um, you know, whether it be corruption [00:20:00] or in the business sector or in, uh, in government that requires a lot of time and intense focus. And so what you'll do is you'll, you'll pitch an idea and say, I wanna look into compounding pharmacies, right? How many compounds? We don't know how many compounding pharmacies there really are in the United States.

They're not, they don't register with the FDA. There's no list anywhere. I mean, P CCCA and, um, the, uh, Alliance for pharmacy compounding have some list, but those aren't official, right? Those are industry groups. So, you know, can they be trusted? Can't they be trusted, um, as, as a journalist, you know, we'll, we'll cite that as one indicator.

Yeah. But, um, there's not an official registry, so let's investigate that. So then I, you know, just for an example, I would say, let's go, how many are there? And how many people have they heard? You know, are, are they hurting people, you know, are there, are there drugs that hurt people? Um, so I would pitch that.

Mike Koelzer, Host: In an example like that. Jason, how would that even come to your mind? Like how did this one in particular? I know there's a lot of great examples you could give us, but how did this one in particular come to your mind? Was it first, uh, flipping through some court cases or was it just out of the blue?

You're thinking how many compounding pharmacies there 

Jason Dearen, Author: are, or Barry, Caden and, and glenchen went on trial in 2017 in Boston, in federal court. And that trial because they'd killed 70 some odd people at that point, it's now grown to more than a hundred. Wow. Um, because their products did, um, they didn't personally kill them, you know, with their hands, but their products that they made did, they were charged with, um, second degree murder and acquitted on those murder charges actually.

What they ended up getting, um, uh, convicted for were kind of related more to like sending drugs in interstate commerce illegally and some of the more, um, kind of technical, um, cases. And they went to federal prison and they're, and they're now standing trial again for murder, but this time in state court in Michigan, where, uh, the most victims were located because 

Mike Koelzer, Host: of double jeopardy, they already got 

Jason Dearen, Author: acquitted of murder.

They got acquitted for murder in federal court. So the feds can't bring another murder case because of double jeopardy. Right. But the state can getcha. And is in Michigan. Uh, and so, yeah. Interesting. And, and I'm, I'll be following that case, but, so what happened was that their trial was occurring.

Um, I'd, I'd remembered this weird outbreak of fungal meningitis happening in 2012 and 2013. And it got some press coverage, you know, 60 minutes did a piece on it in 2013. Yeah. Um, there were a couple of, um, you know, there's some good, some good newspaper journalism, but it just kind of faded away and it was so big.

Interesting and traumatic event, a real tragedy that I just thought, how are the, how, how did this happen? That this just went away. And then there were in the, in the years, since the tr that tragedy happened, there had been these others, you know, there were this, uh, people who were blinded by an improperly compounded drug in Texas, uh, in 2017.

And then I looked on the CDCs website and would see, oh, there were all these other compounding errors that resulted in patient harm that didn't get reported. So I'm like, this is clearly a problem. There's something going on here. There is an issue with compounding pharmacies, making drugs that are hurting people, and we're not hearing about it, or is this a problem?

I didn't know. You know, so, but it was interesting enough to look into, so I began doing research and, and that's what led me to write this 

Mike Koelzer, Host: book in going through the internet and looking at some of the reviews and things. And I happen to be good at reading. My daughter is on that sometimes. And I, yeah, I got into it.

Somehow, all the reviews are talking. The depth of the story and so on. And you're quite a bit different than a three minute TV news story on this, you know, the deep investigation, what's the difference then between the deep investigation that might come out in a well, in the olden days, you know, a three page spread in the paper or something versus a book.

That 

Jason Dearen, Author: That's a great question. And what I love to talk about, because I'm really passionate about long form, uh, narrative storytelling and, and what you can do differently with a long. In a deep book like this, you can really put things in context and you can tell people's story in a much richer way. So I've written for newspapers, my entire career.

I've written long pieces for newspapers and short pieces for newspapers. And you can kind of, you know, get some of the basic facts out in a newspaper article, a longer piece. Maybe you can tell one person's story or a couple of people's story in a book or a long magazine piece, but specifically in a book, you can tell the stories of many different people.

So in my book, I go through the stories. I kind of take you through it step by step, how this happened. It was a mystery. People started dying. Doctors didn't know what was happening to these patients. They didn't know where their meningitis was coming from. What, what, what was this microbe? So I take you kind of through the eyes of the doctors who were discovering this problem.

And then they discovered that it was this [00:25:00] compounding pharmacy that was sending out these tainted drugs. And then you learn all about that con and what the book allows you to do. It really explores all of these different phases of a, of a, of a complicated story and then puts it in historical context. Why is this happening?

How was this allowed to happen? You can, you can explain that, you know, the, the laws, the loopholes that we discussed earlier, like why are those there? Is there a reason the law was written a certain way? I get into all of that in the book. There was, um, and, you know, cuz compounding pharmacy and compounding is needed.

Um, but it, and it's something that is important. Um, but uh, the way the law is designed allows for people like Barry, Kadin and other bad actors to kind of go undetected until somebody gets. Should that be the case? Um, that's a, that's a question, um, that, you know, needs to be answered should, should, should the law just stay the way it is and people can go and, um, you know, kind of until they hurt somebody go undetected or should they be more like traditional drug makers, should there be somebody going in and making sure they're doing what they say they're doing.

Um, and, and that's why that's the difference between a newspaper story or a short news story. And a long piece is that you can explore all the reasons for something happening, not just tell you that something happened. And that's what I really enjoyed about it. You're a 

Mike Koelzer, Host: literature major. You did that before you went back and did some investigative training.

Yeah. 

Jason Dearen, Author: English lit major in college. And then I got my master's degree in journalism from Columbia as part of the 

Mike Koelzer, Host: book you picturing, there's gonna be some people cuddled up there. Couch, you know, in the winter reading this and your gift to the world, these people are the story of when this turns into a film, is it the story and gets their blood pumping?

And it's not enjoyable because people die but enjoyable. The story's enjoyable. Is that part of the goal? And if it is part of the goal, is it just to get the truth out more? Or is there value that you as a human being want to give that gift to the world of just saying, I want to get, this is like a, oh, I don't know why anybody really does a job when they find meaning in it, you know, to really give like a heart to it.

Jason Dearen, Author: Yes. Um, to all of that, um, I here's, here's what I'll say. Uh, because I write non-fiction and I'm a journalist. The first thing for me is that, that I look for in a story like this, um, are two FA big factors. One is, why am I telling this story? What's the point, right? Why, why do this, um, I just don't want to tell.

A gripping story, just for story's sake. The whole point of an investigative journalist's role in society is to shine light on problems that are affecting people's lives. Right. Gotcha. And so this story of what happened in 2012, hadn't really been told, you know, in a way, and, and it was at this kind of, in my opinion, a very, it was an American tragedy.

So many people died, hundreds more were MADE and it was caused by a kind of a systemic problem and over oversight in, in the way that drugs are made in this country by compounding pharmacies. And so the story of this outbreak was so compelling and interesting to me, I thought this is a great way to talk about this issue that otherwise might be kind of boring, right?

Talking about law and especially for a general audience like pharmacies and, you know, um, and medicine and science. Um, but it had all of these amazing kinds of layers of a story that hadn't really been put together in a way that I thought could get people interested in a subject that I think is important, which is drug safety, specifically this kind of corner of the pharmaceutical industry and compounding.

And, um, and yeah, so it's both of those things. I mean, you look for a story that has to be readable otherwise, no one will pay attention to it. Right. So that's, that's number one. I mean, that's, that's also with a newspaper or a book or anything. You have to have something that hooks people into it, 

Mike Koelzer, Host: Especially nowadays you'd say, well, the newspaper article, it's only two minutes long.

I don't need to make it that interesting. It's like, well, yeah, you do in a world of 15, second TikTok 

Jason Dearen, Author: things. Right. And the cool thing about a book is it's a different audience, right? So people aren't looking for them, they're not on Twitter necessarily. It's a book. If you open a book, ostensibly it's because you want that longer, more in depth experience.

Um, and what's cool is. Just generally is that 10 years ago, or, you know, like in 20 10, 20 11, all, a lot of prognosticators were thinking that by now books would be dead. Right? Yeah. And the opposite has happened. Um, books have actually done really well, um, over the last couple of years and [00:30:00] surprised a lot of people.

And you know, there's a lot of conjecture for why that is. But one thing that seems kind of logical is that in the world, as the world has turned more towards these, you know, snippy, snarky sound bites and, you know, quick takes online yeah. Is that people thirsting or hungry for, uh, a more in depth, um, you know, kind of cerebral experience that.

And, and I think you saw see the rise of podcasts like this one, hopefully for, for your audience and others, is that people want to spend time with a subject and not just flip past it 

Mike Koelzer, Host: devil's advocate. Sure. Because you, and I talked a bit about this beforehand, about how we both enjoy the long form of podcasting, because it's not someone shoving a microphone in your face and saying, give me a 15 second positive clip or a 15 second negative clip.

All right. Devil's advocate. A book is boring. There's too much information you need to get to the point and all this stuff you're talking about. That's outside of the story. Even if some people like it, it's just useless. What's the reply that extra books are useless? What's the value in the length?

What's the value in just painting more to it with the 

Jason Dearen, Author: story. It's a deeper understanding. In my case of a non-fiction book, a narrative non-fiction book, it gives you a deeper understanding of what happened that you can't get in a shorter format. You just can't get it. It also, there's nothing more thrilling than a story that grips you and makes you want to turn the page for 300 pages, 400.

I mean, Steven King wrote a book called The Stand, which is fiction, but it's about a pandemic, right? Yeah. And I remember reading that book. I was a teenager with a very short attention span and I picked up that book and I read, I could not put it down. I couldn't put it down. Why, why not just say, okay, a bunch of people got a disease and they died and then the world ended at the end of the story.

Right, because that. There's something about going through the process of, of, of empathy that you get when you go through a long story with people. So in my case with this book, a lot of you could say like, oh yeah, you know, in 2012, a bunch of people died. They got these bad drugs and it was this pharmacy.

Whoa, crazy. That's so weird. Right? What you lack in that is you get, you get some facts. What you lack in that is really truly understanding what it all meant and the empathy that you get for all the different people, including the people who worked at this pharmacy, including the people who died, including the doctors who had to figure this out and the whole point of this industry and why it exists in the first place.

Um, you, you don't get any of that. Um, and when you read a story that's compelling, I wrote this. Because I wrote the book I wanted to read. Yeah. Which is, I love page Turners. I love a book that gets it. That tells a story in a way that keeps you learning and keeps you empathizing, keeps you discovering throughout the entire book and that's, and, and that feeling of discovery and, and of, of empathy with the characters is something you just can't get any of the, any other format.

Mike Koelzer, Host: I like how you put it down to a word empathy. All right. Cuz if I write more, I'm gonna put people to sleep. when you write more, you're gonna pull people in more. And I say, Jason, that's impossible. Cuz I'm that much of a long reader, give an example of either a character from the book or just make something up.

An example of where I might do something quick, where you might paint more of a story to pull someone in because of empathy from 

Jason Dearen, Author: the book, there is a character named Beverly Jones. Who's a scientist? You know, so she's a scientist. She, um, she works in a lab in Virginia in the original telling of the story in the newspaper.

She was never mentioned, or it turns out that this woman who worked alone in a lab in Virginia was the one who discovered and, and, and named the microbe that was killing people that had been shipped around in these drugs. She figured it out in her mind, like in, because of her experience as a scientist, there are all these scientists working at CDC, trying to figure out what is this thing, killing people.

And she had seen it before and her story was never told. And when you learn about her. Story in context here, you not only learn about her and her experiences and why she's important and why her story needed to be told, but you also learn about the role of people who work in these, in these public health labs and why their work is so important when something like a pandemic that we've all been through the last year, more than a year now, or something like this, an emergency like this happens.[00:35:00] 

So you, you get the not only kind of like the empathy of the character and working in isolation and obscurity yet driven because she knows what she's doing is very important. But then you learn about things like, why, why is what they do important? How does it help people? Why is it, why should we fund these things?

You know, a lot of politicians on, you know, in, in a certain way will make arguments about why we should cut, you know, public financing for this or that or whatever. Well, When people like this save a bunch of lives because they're doing science in the public interest. You learn why we should fund these things sometimes.

Mike Koelzer, Host: And as humans, we're kind of nosy, we like to stick our heads out rubber necks in an accident. Right. Even though we probably shouldn't sometimes, this gives us permission to almost gossip, like, all right, you've gotten into her character. And now as humans, we want the end of the story. So that's probably what kind of pulls you 

Jason Dearen, Author: along.

Yeah. You want the end of the story. And also, you know, writing and storytelling is, is, is, is really hard work. That's the thing. It's not, you know, you're saying like, if I try to do it or whatever, everyone can try to do it. You just have to have the patience and the, and the work. I mean, if you it's like anything else, if you love it and you wanna do it well, you just keep trying and failing and trying and failing and trying and failing, you know?

And I love that people read this book and come away thinking that they, they just. They respect the storytelling or they think the writing in certain parts is good. You know? And, and I really, that is great because I know how much work I put into it, not just into this book just to get this book done. But all the years before that of failing and other things that I tried to do, other, other projects that didn't make it.

Um, but I learned and picked something up from each of those. Another way to kind of grab you or grip you as a, as a writer, uh, that I'm, I was able to employ in this book and, and, and I think it's just like anything else, you know, if you, I wrote, like I said before, I wrote the book that I wanted to read and I think with anything you do, that's difficult.

it starts with just you wanting to do it because it's something that you love, that you enjoy experiencing. And I just wanted to write something that I would enjoy experiencing, and that's what I did with this book, but it was years and years and years of kind of like failure and trial and error and, you know, shorter pieces and learning what works and what doesn't on the page on how to treat a character and things like that.

That, that kind of got me to the point. So it's not like some, you know, kind of gift from the heavens or something like that. It's, it's, it's 

Mike Koelzer, Host: hard work an overnight success that took 20 years or something 

Jason Dearen, Author: like that. Yeah. It's just, it's really hard. And it's also just being stubborn, you know, everybody in something that's worthwhile, you know, and, and especially something like writing a book, I mean, you're just gonna hear no way more often than you hear.

Yes. When you have ideas or, you know, can I do this? Can, you know, people are gonna say like, who are you? Why, why would, why would you, you know, I'm not gonna give you a chance or whatever, and you just gotta. Kind of turn Def to those types of things and just keep going. Um, and I know, I know people who do that, you know, eventually you'll find your way.

You know, I 

Mike Koelzer, Host: tell my kids too, it's like, and you can remember this, Jason going back. It's like, we're living in a tremendous time in history. It's like the first time ever, especially for writing and podcasting and film we're in the first time ever, where there doesn't have to be a middle man. And I know the middle man has helped in your case with penguins.

So this helps you now of course, but right. I try to get across to my kids. It's like, now's the time. There's none of those old Hollywood guys that cause the whole me too movement. It's still there to an extent, but in the last 10 years, it's like that's been cleared away. The 

Jason Dearen, Author: gatekeepers have all been cleared away.

You're right. There are still gatekeepers, but the, but the rules of the game are changing. Uh, and depending on the medium that you're in, I mean, you know, now more than ever before you could, I. The rules of the game are, are changing. And they'll probably end up in my opinion, this is totally just my opinion.

They'll probably end up somewhat changing back to the old, there are always going to be gay gatekeepers and taste makers in the media. You know, people who have access through their own privilege or wealth or connections or whatever. And, and, and they're just gonna get more attention. Yeah. Because they're more connected, but if you have a voice as a writer or a podcaster, and you are really interesting and entertaining now is the, is a, is a time that you can really find an audience and do it yourself in a way that you couldn't, you know, 30 years ago, 40 years ago, you know, when I was growing up in the 1980s, um, in high school, you know, I I'm 50 now.

So I was, I was growing up in the eighties, um, and 90. You know, if you wanted to, to put out a radio show like you're doing with, with me right now, an interview show or something, you would have to go and get into [00:40:00] radio and there's like four companies, right. For sure who they are, they either gave you a chance or not.

And so, yeah. Now, I mean, you know, if you are good at this, um, and you know, you have an audience, you have people who are enjoying what you're doing and you're growing. I'm sure you can. Um, you can, you can kind of create your own thing. Um, the same is not so true with books. Uh, you know, you can self-publish and people do, and I think people are successful, um, doing that, but the vast majority of books are still, there's like five big publishers and they're, and, and the vast majority of, you know, kind of the best seller lists and, and stuff like that from, you know, the big books.

Yeah. Because they have a big marketing machine. Yeah. Right. That can, that can get it in front of these big audiences. So. And 

Mike Koelzer, Host: probably the steps. Let's say you had to go through steps one through 10, you know, or a hundred to get to where you are now. I think we can go from 1, 2, 3, 4, and then, and then lean into the fifth one.

You know, you think about these people like Justin Bieber, that kind of worked up through two. Well, he couldn't be as successful as he is now by being just on YouTube. But the last step maybe kind of welcomes you and, or pulls you in from some of the work you've done. 

Jason Dearen, Author: That's right. I think before the gatekeepers even controlled who got a chance to impress.

Yeah. Right. And now you can go out and if you get those followers on. uh, the big companies are gonna come Colin because that's how they find people now, you know? Yeah. I mean, you can look at a lot of the, uh, the, you know, since Justin Bieber, a lot of the newer artists, um, and I am going to not say who they are because I'm old and don't know.

But, um, I do know just from being involved in, um, in, I, I, I love music and I still listen to new music just to, you know, know what's going on. That a lot of those people end up, they post their first, um, stuff on YouTube and that's how they're discovered. Yeah. Um, and that, wasn't something that, you know, um, I could do when I was growing up.

Um, so yeah, it is, it is, it is great. Um, but unfortunately publishing still is, you know, if music and podcasting radio, um, are, you know, kind of the forefront, um, publishing is still, you know, making these, uh, products made of paper yeah. That is printed. Um, and you know, people, people also spelled the death of printed books.

Right. It was all, oh, everybody's just gonna read eBooks. Well, turn, guess what turns. People really like books. They like books on their shelves and their houses. They like them piled up in the corner. They like to hold a book. That's even kids, plenty of kids who still love books. They don't wanna just they're on their devices so much.

You get 'em a book and they'll, you know, sometimes they'll get engrossed into it if it's a longer book, sometimes not, but they still love books. Um, and I don't think that's changing anytime soon. 

Mike Koelzer, Host: No, they like to pick 'em up or get 'em even through the mail. Well, you think of movie theaters. I mean, movie theaters were supposed to be gone by now.

Well, why would you have a movie theater when you can watch it at home? They don't need those. No place should exist. That sells for $10. Hm, buckets of popcorn and $5 pops, boy, there they go. Bigger than ever, 

Jason Dearen, Author: right? Yeah. We'll see if the pandemic changes that, um, you know, people being in a, in a room together, but yeah, that's true.

I, I, I agree, um, that I, you know, I can't wait to get back to the movie theater. Um, and, uh, and my wife and I are both really excited 

Mike Koelzer, Host: for that. You're right on that, Jason, because even though I say, yeah, the gatekeepers aren't there and we're agreeing with that, and then you talk about the publishing and so on.

It's like, yeah, it's like in theory, anybody can sell stuff online, but unless you're Jeff Bezos, you're gonna have a hard time marketing that. So, I think you're right, that there are that conglomerate of things. So it's gonna be hard. It's hard, but it's possible probably more than the 

Jason Dearen, Author: past. Yeah, I think that's right.

I think it's possible. And, uh, the, you know, the, the big companies are still going to, um, control all of the outlets, um, for it, but, um, , you can still, you don't, if you can post something online and that finds an audience, um, that's power, uh, and, and that's where we are now. So that's the big difference.

Mike Koelzer, Host: There's probably more than I'm not thinking of, but between, let's say audio and ebook and hard copy. What is the spread so far in your book? As far as percentages with those. 

Jason Dearen, Author: Definitely the hardcover book has sold, you know, I mean, as far as I can tell, looking at the numbers, I think it, you know, probably 80 to 85% has been hardcover books.

No kidding. Yeah. Um, and the next would be the audio and then the E really surprising to me as well. Yeah. And I mean, that's preliminary. Um, but you know, and so, you know, my book's not like a New York Times best seller. It's, you know, kind of like most books out there, it's finding its audiences, um, through word of mouth and, you know, interviews like this.

Yeah. Um, and, um, so far it's been, people have been wanting to read the book. Um, and, but I read the audiobook myself. Um, I'm [00:45:00] really proud of it. People seem to really like it. It's got a lot of great reviews online as well. So if that's more of your thing, I highly recommend it. Um, you know, it was funny. I was deciding this was my first book.

Um, I had never obviously recorded an audio book before. Yeah. And when they asked me to do it. The publisher. I also had the option of whether I wanted to hire an actor to do it. Sure. Uh, and I don't listen to a lot of audio books. I read books. Um, and so I reached out to my, you know, community, uh, and asked, Hey, what do you prefer?

And everybody, by a vast majority said, uh, I, the author reading the book is a million times better than an actor. It always is. The author just gets it. They know the flow, they, you know, they understand the story better. And so I said, Hey, I'll do it. Um, and it's cool. They actually pay you as an author to read your own book.

Um, your publisher will give you a little bit of money. It's not, oh, is that right? Yeah. It's not like a ton, but it's nice. You know that for your time. So I went into a studio, it took me about three days, maybe a little more than three days to read it. And I loved it. Uh, I loved the process. I thought it was really fun.

Uh, it's a lot of work. Um, but it is, it's one of those things where, you know, when you write a book, especially something that takes years to put together, there are parts of the book that you did. You know, a couple of years ago, and then you, yeah. And then you kind of come back to it through editing and then you go, and then you, you know, you have fact checking, you know, I hired a fact checker for this because it's non-fiction so I had to make sure, yeah, all the facts were right as best as I could.

And, um, I also had a science degree. I was mentioning to you earlier. I think I had a science reviewer, a doctor and epidemiologist from CDC, former CDC. I had a pharmacist who's also, uh, works for the national association of boards of pharmacy as a compounding, um, expert. And, um, she goes in and does inspections for, uh, for N a P.

And she, um, she reviewed the book for pharmacy act accuracy, and you have all of these things, but then, you know, you're going from bit by bit through your book. So when I was able to read it in the studio again, I was able to reconnect with the book, like right before it came out. And I thought that was really cool because it was like, you know, you, you write it in pieces.

And then you edit it all together. And then like another year goes by, before it comes out. And this gave me a chance to kind of, after like eight months, I hadn't read the book. I hadn't thought about it. I was moving on to other things and it allowed me to kind of reconnect with it before it came out.

And that was really helpful. Um, especially when doing things like this, 

Mike Koelzer, Host: You might do this out loud anyway, when you prove it. I imagine actually saying it out loud. I mean, that's gotta be like a different dynamic there even than you probably don't have too often 

Jason Dearen, Author: huge as something I learned, um, from a veteran reporter when I was first starting out, I used to see him take his articles and go back to the newspaper library where we used to have libraries yeah.

And everything. And he would pace through and read his story aloud. So he wasn't bothering other people. And it was kind of quiet back there. And I was like, what's he doing? you know why? You know, so this whole book I'd already read aloud 20, 25 times writing it is that right. And I do that with my feature, uh, investigative articles.

And now I have a new one. That's finally gonna be, uh, publishing in the next couple of months with AP. And it's so helpful. You're right. You, you cannot like as a reader, the flow, like if you want, if you want your work to have a rhythm. Yeah. If you want it to flow so that people can read it easily and it's not, you have to read it aloud.

It, you, all those little kinds of errors or stops and starts are where things aren't quite working or don't make sense. You don't pick up. When you read silently, you pick 'em up when you read it 

Mike Koelzer, Host: aloud. I don't do as much anymore, but I used to do some oh little posts years ago, and then maybe some blog posts, but I actually had to read my stuff backwards.

Say every word allowed backwards. Now it's better with, you know, Google and the spell checks and the word checks and that, but it wasn't until then that I would pick out, you know, two THE'S in a row, you know? Right. Or, or something like that until I actually got out of the habit of just the speed reading 

Jason Dearen, Author: it through.

Yeah. And when you're telling a story that's complicated, like this one is too, you have to, um, you have to take people through it in a way that, uh, so it unfolds. And, and that it's easy to understand, but also kind of grips them in right. And, and brings them in. And so you really get that, um, you know, whether it's working, what you're doing or not is working when you read it aloud, that just, it just comes through.

It's just, you can hear it. It's loud and clear. And if you can say it in a way that is smooth, that means that it's gonna read smoothly. So yeah, it's a great tool. Everyone should do it in every type of variety, especially if you have an important email that you're sending to your colleagues or your boss, and you wanna make sure that it's, you know, that you're getting it just right.

Just take a second and breathe and read that thing out loud and it will make all the difference and [00:50:00] maybe 

Mike Koelzer, Host: even do it out loud in the morning, the next day. 

Jason Dearen, Author: yeah. Don't yeah. If you have time, don't send it. Wait . When 

Mike Koelzer, Host: you read the book, is there anything different that was in audio that you said, I would've maybe written this different as an audio book than as a.

Written book or are they exactly the same? Is there anything you wish that you'd say, you know, knowing this part's audio, maybe I would've done more of this. If I knew that this was gonna be 

Jason Dearen, Author: read, I think generally I would've said yes to that, um, for a lot of different types of projects, but two things, because I read this aloud as I was writing it so much, it already had kind of an audio quality to it.

Gotcha. But two, there was a lot of dialogue that I was able to get into this book, like scenes where people are talking to each other because they were recorded or they're in email, back and forth, or they did videos or it was, I was there like an open court or something like that. And I was able to get it down.

And so, um, what I really tried to do was make this read more like, kind of a. Like a novel, uh, where I could, um, and that translates really, you know, that kind of dialogue. Yeah. The scenes with dialogue translate really well to audio. And so, um, with this book, no, I mean, I think I really, uh, I really got that kind of audio quality in it.

Um, you know, some of the more historical sections, like step back, like, you know, there's a little bit about the history of, of compounding and pharmacy and why it exists and the law, but I kept those sections kind of, you know, in, in areas where they, they kind of come and they're punchy and, and, and pretty short, that's kind of what we were talking about earlier.

Like those types of sections I wanted to give you the information, make it interesting. Um, make it read well, but not belabor the. Not get bogged down. You knew you could lose someone there. Yeah. And I mean, it's important context, but you also have to have, like, you know, you're talking about drug shortages, right?

I didn't wanna write 20 pages. You could write 20 pages of drug shortages is really important stuff, but, uh, I wanted to make sure people got it understood why I was saying, telling them at this point in the book, like, Hey, you, you just need to know this real quick before we get back to the interesting part of the story, you know, the character driven part of the story.

And, um, yeah, I think for the most part I did that, um, in a way that I'm happy. 

Mike Koelzer, Host: I'd probably want to make some stuff up as I went through, not facts, but just stuff about the people I'm asking this jokingly. But I, I imagine that could have been tempting that you'd wanna throw in like a cuss word or something.

When there really wasn't one there to add depth to that 

Jason Dearen, Author: character. You gotta be careful of that in everybody, especially when you're writing a story like this as a journalist, um, you are a human being who, and you want to, you, you do, um, you know, and as experienced as I am, I can still make mistakes. I'm still imperfect.

And so I didn't leave it to chance. Um, I hired somebody, uh, fact checker, uh, who does this for a living and is very good at it. And it's an uncomfortable experience because you realize how much you get wrong. Um, when you, when you do these books. And so she, over six months, put me through the paces, put every page, every line through the paces.

And if it is. Wasn't provable, meaning it wasn't in source material. It wasn't in an email. It wasn't in a document. It wasn't in my notes, you know, from an interview. Um, it wasn't in a video. If it wasn't there or provable, I had to take it out. And, uh, and that's what I did. And, you know, there was a, there was a number of those types of things because you just cruise through and you're, you're trying to get to another section.

Um, and even with the experience that I have as a journalist, um, and at AP, you know, your editors do that, uh, as well. Um, you know, I write, um, I've written narrative style features for, um, you know, the news as well. And yeah, you, you know, you do wanna like to smooth it out sometimes, but you can't. And, um, you know that, and you know that if you get caught doing that, your credibility, um, will be greatly.

Diminished. Um, and all it takes in my business is one major screw up like that. Or, you know, you just kind of take liberties with something and somebody discovers it and you're finished real. You really are. There's no second chances. Um, and I would say just like a pharmacist, right? If one of your, if you make a mistake that hurts somebody, maybe, maybe it doesn't ruin your career, but it certainly doesn't, um, enhance it.

Um, and that's the same in. Yeah. There's 

Mike Koelzer, Host: Probably things that I wouldn't even think that you had to fact check, like you could say, well, as he was doing this, he took a long breath and adjusted his, you know, glasses or something. It's like, well, Jason, he didn't wear glasses. You know, that kind of thing. 

Jason Dearen, Author: Yeah.

Yeah. I mean, those are the types of mistakes you're you? That, um, terrifies me because you want the people who were there who experienced this. Yeah. Who knows it to read the book and not go, ah, this guy. So there was one, I will point out one thing that was in the book that made it through that, um, I will be fixing for the, uh, and this is how the sausage is made.

So, um, [00:55:00] since we're on this topic and it's a small detail, but it's something someone noticed. Um, yeah. And I, and my fact checker didn't catch it and I'm sure there's a couple more. Um, but you know, luckily it's a small, not an important detail. Um, so, uh, it's one near the end of the book. I'm talking about one of the federal prosecutors, as he's learning about.

Um, about the, uh, the case and it, this case that he's gonna start investigating, he'd grown up. And I say across the river from where his office was in DC. Um, and it's not across the river, it's up the river. And it's a little thing. Right. But, my friend who, uh, who read the book, who lives in DC was like, oh yeah, it's actually up the river.

But when you look at the map, it actually looks like it can be across the river because the river snakes like that. So it's a little thing. It's a little thing. It's not like, you know, gonna. Change the meaning of the book or the scene, but it's those types of things that, um, for me are important.

Um, I want to get them all right. And I try, I did everything I could in this book to do that. Um, but you know, a couple will squeak through, but I know, and I'm confident for the most part that it's, it's been through its paces. And so I'm, um, you know, it's been out there in the world now and read by quite a few people.

Um, and I haven't, and you are always kind of like, they'd say something. Yeah. Especially the people who I write about, you know, you can only fact check so much and they've all been, um, happy with the accuracy of it. I'm especially a scientist who is very particular about that type of thing. 

Mike Koelzer, Host: It reminds me of the journey song.

Don't stop believing, but it says he's born and raised in south Detroit and I'm from Michigan, but I didn't know this, but they said there's no south Detroit, south Detroit's Canada, you know, but I read it and they said, well, yeah, it works. And people enjoy it, you know? But if you live in Detroit, you're like, well, there's no, yeah, 

Jason Dearen, Author: There's no south Detroit.

That's a guy I'm from the San Francisco bay area where I lived, uh, most of my life. And, uh, that's where journey's from. Oh, uh, so that was somebody from San, the San Francisco bay area writing about, uh, Michigan. Yeah, exactly. And that's what happens. Exactly. Yeah. 

Mike Koelzer, Host: I know this was certainly investigated, but it's a book, you know, and it, it doesn't hit fiction, but it hits that stuff that lends itself.

Well, fiction, do you get the itch for that? 

Jason Dearen, Author: Not right now. There are so many real non-fiction stories that are just incredible out there. I've always just really loved reading this style of nonfiction, you know, they call it narrative non-fiction. Um, whether it be like, you know, Truman Capote or I more, you know, the people more kind of modern that I really love are, uh, writers like Lawrence Wright and Elizabeth Colbert, David grand, these guys that write for the New Yorker.

Most of 'em Michael Lewis, who did like, you know, uh, Moneyball and oh yeah. All the big money and, and all those, like those are, um, John KRA hour or Sebastian. I mean, there's so many of them, but there's just so many, um, so many kinds of heroes out there who do this type of work, and I've always really been drawn to it.

I just, you know, with the time I have left on this planet, I think I can fill it up with doing more non-fiction stories that, and that said, who knows though, maybe someday I, it would be kind of nice as you're saying, to be able to, to write a scene, um, from my brain and not have to worry about fact checking everything.

I mean, good fiction writers do that too, because if you get a detail like that wrong, and even in a fiction story, it bugs people as well. Yeah, 

Mike Koelzer, Host: sure. There's fiction about that. Right. Well, I mean, there's far out fiction, but there's fiction. That's kind of like real to life fiction. Of course. There's always like the Hamilton book was very popular 10 years ago before, whenever, before they made it into the musical.

Maybe you have a little bit more freedom with historical fiction 

Jason Dearen, Author: maybe. And I think, um, you know, what's cool. People can take your work of non-fiction and they can do something that inspires them, but that's fiction. Right. And so, yeah, that's, that's kind of cool, you know, like, so it happens all the time.

You write a article or, or a, uh, a book and you see them made into a, a feature film like spotlight, for example, spotlight was based on the articles of one of my colleagues here at the, oh, is that right? The Associated Press Michael ES, he left the Boston Globe and is now at the Associated Press on the investigative team with me.

But, um, but the movie was a fictionalized account of that real thing that happened. And it just allowed them to tell the story in a way that they couldn't, if they just, you know, 100% did like a documentary or something, 

Mike Koelzer, Host: fictionalized. 

Jason Dearen, Author: Yeah, like a fictionalized account or a, um, or scripted, they call it scripted, you know?

So you write a script op that's based on the facts of, of the, of the non-fiction version. Um, yeah, that happens all the time. I mean, you know, there's, there's a million different, um, examples out there 

Mike Koelzer, Host: Are there books that somebody would look at and they would hold your book up mm-hmm , you know, kill shot versus something else.

And is it very clear that yours is true to the spot checker where someone else it's like, oh, I didn't, I didn't know. This had a little bit of fluff 

Jason Dearen, Author: in it. If you go into a bookstore and you look at the books, one's gonna be in the [01:00:00] non-fiction section and one's gonna be in the fiction section. So that's one way they get around it.

I gotcha. They do it like that, but also, um, you know, you have to make it clear in the marketing materials and stuff. That it's a, that it's an, uh, a work of journalism and not a fiction. I mean, I think the line can also get really blurred there with the marketing, because, you know, I mean, unless you're really closely paying attention to something, you can mistake a book that looks like a novel for a novel until you open it and start reading.

And then, you know, like in the case of my book, if you thought it was a novel, the minute you read the very first page, there's a note for me saying this is a true story. So you'd have to like, get past that and be like, wow, this is a crazy story. I can't believe he just made this up out of his head. Um, because there's like so many markers.

So I think you just have to be careful with that. 

Mike Koelzer, Host: I 

watched the movie a couple months ago, vice about Dick Cheney. 

Jason Dearen, Author: Right. 

Mike Koelzer, Host: And I'm watching it. And in the movie, there's a part in there where Cheney meets Scalia when they're both like 25 years old and they talk about the future and what's gonna happen when they both get to this position of power.

And I'm like, crap. I didn't know that he did some dirty stuff. And I'm not saying he didn't do some dirty stuff, but at the end of the movie, they say that meeting was fictionalized. Well, at the beginning too, they said it was a fictionalized thing, but I didn't know they were gonna do that. 

I 

Mike Koelzer, Host: I'm gonna have to read now on IMDB like what's fictionalized and not before I watch these fictionalized movies.

Jason Dearen, Author: Yeah, no, I see what you're saying, what you're getting at. That's frustrating. I, I, I agree with that. I don't think, um, I think when you're blending the two, uh, it can be, it can be problematic in that way that you are telling people. You know, kind of, this is in the realm of kind of a true thing. A me, you know, a guy Scalia and a guy Cheney but clearly that's a fictionalized movie.

They're just using these real people, but yeah, it is, it can, uh, it can be confusing to people and probably not helpful, um, in, in terms of, uh, certain people's trust of what's fact. And what's not, um, you know, and I think that comes down to just in this time we live in, uh, it's really important to choose trusted sources for the, where you get your information.

And then once you kind of have that core, that, that, that foundation then maybe you can, you can branch out in your 

Mike Koelzer, Host: book then. So you're combining the science of what happened, the investigation. You're also combining the desire to pull the reader in through empathy. Keep that story going. What is your goal?

Reading this book, when they're done reading the book, what should they be thinking? 

Jason Dearen, Author: The best thing that this book can do is to, uh, alert patients to this part of the pharmaceutical industry that they probably didn't know anything about and have them start asking questions about it, because if you're going to be putting or allowing people to administer drugs that are made at a compounding pharmacy, that isn't a 5 0 3 B or that doesn't have some sort of track record of, of sterility or cleanliness, um, you should know you, that's all you should know.

And I think people should come away from this, just emboldened to ask those questions of their doctors, uh, or their pharmacist. Um, if they, if they can, you know, if they're at the hospital, ask the doctor to ask the hospital pharmacist. I think that's the main thing. The other thing is I want people to come away with an understanding of what happens when.

These loopholes in the system, in the legal oversight of, of the, of the industry are exploited by bad actors. You know what that really looks like, um, not only for the industry, but for the patients, for public health professionals, epidemiologists who have to respond and figure this out. Um, because you know, there's no, again, there's, there's very little oversight of this sector.

So, uh, the information has to come basically from the compounding pharmacy. And if they're not being honest, um, that creates a whole other problem. So understand also the complexity of, of, of the problem. There is an issue here and I'm just trying to shine some light on it. Um, get a conversation started, but in the meantime, patients just can start asking questions and, and, and educate themselves so that when they go to the doctor and need these drugs, um, they, they know a little bit more about where they're coming 

Mike Koelzer, Host: from years ago.

It was illegal for a pharmacist to write the name of the product on the prescription. You know, you had to get authorization from the doctor to be able to do this. And so there was like a blind trust for medicine and some of that's been now removed in certain professions, but I think medicine still has that.

We can't trust what we see on the internet all the time. But there's ways though, to have this conversation that you could never have before. [01:05:00] 

Jason Dearen, Author: That's right. And it's important to develop a kind of system for forgetting facts to help you. And that as a patient, what I learned in reporting this book is that it doesn't stop and end with, you know, kind of, uh, buying a house or a car or anything else.

It's also with being a patient. Um, and it's okay to ask questions, you know, it's okay. To, to, to question your, your medical providers, you know, maybe you're at a hospital or, or a pain clinic, and you're gonna get an epidural steroid injection for your back. Yeah. Prior to reading kill shot, you went in there and you just said, cool.

I trust that my doctor and the clinic are getting the drugs from a reputable source. Right? Yeah. And the Dr. May even believes that because oftentimes they don't, it's not their job to procure the drugs. Right. They've got a pharmacist or somebody else doing that. So after reading this book, I think the difference would be that what I'd like to see is that you say like, okay, doctor, you know, where is this drug that you're injecting into my spinal column?

Where did this come from? Is this an FBA approved drug? Or is it a compounded drug? He says, oh yeah, we work with this compounding pharmacy out off I five or whatever, you know, called blah, blah, blah. Um, okay. You know, do, are they, um, are they a 5 0 3 B facility? Do they have, you know, regularly? Yeah.

Oh yeah. They are. They're registered. Um, they're regular. Oh, okay. Great. So that gives you. Confidence that that is gonna be a drug. That is, it goes through a process that is, uh, ensuring that it's, it's, it's clean, right. That it's a good drug. Um, but they can't give you those assurances, then you know that, and you can make the decision based on yourself, whether you feel safe.

I mean, you know, I really hope that just people come away from this realizing that there is more to our drug supply than just everything safe. 

Mike Koelzer, Host: People don't even know the old edges well. They don't know what they don't know, but I mean, that's more true than ever. It's like, they don't even know how to.

they don't even know the first thing about something. So how are you gonna question something except, uh, just this overall question of, well, I, I don't know. I guess I'm just trusting. You gotta trust someone, you gotta trust a doctor, but they don't even know the vocabulary or anything for this. And this at least gets some knowing that there's potential problems out there.

Jason Dearen, Author: Yeah. And that's why I had a pharmacist, uh, at the end of the book. Um, there's a list of questions that you can ask your doctor. So it's not, you don't even have to devise them yourself. There's a great, really handy list of questions. They're very detailed. So you probably won't even have to go into that much detail, but it's there.

If you, if you depend, you know, everybody's kind of has a different level of, um, curiosity about these things, right? You know, some people are just like, I don't care. Doctor says it's safe, it's fine. And other people are not like that. They're the polar opposite. They wanna know everything, you know, and this gives those types of people and everyone in between kind of, um, some ideas about how to ferret out some of this information.

If you're concerned about it, You can also choose not to be concerned, but you should at least know, uh, what the reality is before you make that decision. Right? 

Mike Koelzer, Host: Know that there is at least a concern out there whether you wanna make it your concern or not. 

Jason Dearen, Author: That's a different story. Exactly. There's lots of things to be concerned about.

You know, this is just another one. 

Mike Koelzer, Host: exactly. Assuming this was a good enough experience to do it again. What experience do you carry into this next book that you learned from this one? Yeah, 

it's 

Jason Dearen, Author: a great question. I think the big thing, well, a couple things, I mean, on the practical side, releasing a book about a medical tragedy during a really big medical tragedy was, um, , you know, kind of interesting.

It could have gone either way, right? Yeah. It could have been like, people are fatigued and I think it's, um, it's it, would've been interesting to see whether the, if this came out at a different time, like what the reaction would've been from. Right. So I've had a lot of, you know, kind of interest from, especially from like pharmacy, pharmacists and pharmacy groups and, um, patients and, and victims, but just generally in the general public, I think there would've been a little more bandwidth for, for it to have these discussions than there is now because people are getting, you know, a book called kill shot came out when people are getting their vaccine shots.

Right. And so, oh, even though it's not about, you know, People like you or a pharmacist, you know, know the difference between these things. But I think there was a little bit of concern from a marketing perspective, ING. So just thinking a little bit more like that I think is, um, is helpful. Um, when you're putting something out in the marketplace 

Mike Koelzer, Host: And in this case, it was like, all right, this is a two year epidemic, but in most cases you might be able to escalate or pull back the press.

If you know, something just happened a week ago, it's only gonna be a two week story or something like 

Jason Dearen, Author: that. Right. Well, and you know, what's cool about a book though, at the same time is books live for quite a while, for sure. Um, and so, you know, this will be out there for years. Yeah. And, uh, and the world will, you know, kind of move on and God forbid, if there's another compounding disaster, you know, that may get interesting.

And, but something like that, uh, is something to think about. Sure. Um, but from a writing perspective, I think, um, you know, I think it would just be. I, [01:10:00] I may wanna do something a little bit different, um, the next time around, just because I've done a book like this, um, in, in meaning in format, uh, you know, this is kind of like a thriller that takes you through this event, you know, through the eyes of people who, who lived it.

Um, and some who didn't make it out the other side, um, You know, I'm really interested. I love really well written biographies. So at some point, um, I may wanna find somebody who, whose, um, story hasn't been told. Um, who's an interesting character from history, um, or, you know, maybe even a living person who yeah.

Um, who I, who I wanted to, and then you can really just focus on kind of like one person in the time in which they lived. So you, you know, you're researching kind of like the time in which they lived, so you can put them there in a way that's interesting to the reader, but then also you really get to focus on one person in their life.

And their life. And we're in this book, you know, there were our number of characters and, um, and it was great, but it might be fun. Just kind of sit with one character and really get into that one character, right. Over the course of, you know, a few hundred pages. 

Mike Koelzer, Host: Have they come to you yet to make this into a movie?

Jason Dearen, Author: No. Are you expecting that? Uh, well I hope so. Um, I think, yeah, I think it'd be a great movie. There's been interest. Um, but nothing, you know, kind of, um, decided yet these things take a long time. I don't know if a movie will eventually be made, but you know, people will, um, oftentimes option a book so that they can basically option is they, they lock it up for like a 18 month period so that they can try to develop a movie script or something without competition.

Um, so something like that might happen. Um, that would be great. Um, and I think, you know, a feature film or even a documentary or something like that would be a really cool way to get the conversation about this tragedy and the issues that it shines light on. Yeah. Um, out there in a different way to a bigger audience.

And so I. That's something that I hope will happen. And I think, I think it will. 

Mike Koelzer, Host: I like that take on it. Probably the readers of the book would watch it, but some people that might not crack open a book would be the audience for that 

Jason Dearen, Author: too. Yeah. And if it's made for something, like Netflix or one of the streaming services, maybe they do something, somebody does something for that and that's a whole different way people can experience this story.

So, yeah, it'll be interesting to see, um, you know, we're, I'm working on, um, a number of different things to see if they can happen, but, um, hopefully, uh, you know, when something happens, I'll, uh, I'll publicly announce it. So people know to look out for it. We 

Mike Koelzer, Host: talked about the no middlemen, but that brings up a point there too, about the, well, you know, the Netflix or Amazon prime or something where you kind of have a movie, but they're not as big of a middlemen as they, they used 

Jason Dearen, Author: to be.

Yeah. There's so, so many streaming services now and they're growing by the day and they all. stories. Yeah. So for people who create, um, stories for a living, it's been a pretty good time, but at the same time, you know, like you want, uh, anything that you do to have a quality, a certain quality it's an interesting time.

Um, but you know, you're also seeing, I think a lot more stuff being made, um, yeah, that isn't, isn't necessarily of the greatest quality. And so that's something you have to, you know, there's a little bit of a delusion going on, I think, because there's just so much, so it'll be interesting to see, um, how that all shakes out over the next few years, for sure.

Mike Koelzer, Host: That makes me think. Yes. Instead of a movie, it could be a Netflix series and I could be like an episode eight or so when we did the 

Jason Dearen, Author: podcast, there you go. Done 

Mike Koelzer, Host: mark. That well, Jason, what a pleasure. Thank you so much for your time. I really enjoyed talking to you on this. 

Jason Dearen, Author: I enjoyed it as well, and I hope your audience will, uh, enjoy the book and thanks a lot for having me kill 

Mike Koelzer, Host: shot and they can get it anywhere, anywhere.

Perfect. All right, Jason, we'll talk soon. Okay. Have a good one. All right. Thank you. Bye.