"Pesando shakes his head when he remembers how Thomas fired him. “You’re not a team player,” Thomas said. Being a team player apparently meant following orders. When I asked Pesando if the criticism stung, he said no, absolutely not. “Because I wasn’t a team player, right? The team is committing Nazi war crimes. Do I want to be a team player? No.”"

"Part of what makes medical training so unnerving is how frequently you are thrust into new settings in which you don’t really know how to behave. Nothing in your previous life has prepared you to euthanize a dog in the physiology laboratory, or help deliver a round of electroconvulsive therapy on a nonconsenting patient, or attempt an episiotomy on a sixteen-year-old girl without anesthesia. Is this normal? Are we supposed to be doing this? Maybe, but maybe not. It’s hard to tell. Your gut reaction is often a combination of anxiety, revulsion, and social discomfort. Most people learn to suppress that reaction. A rare few learn from it."

This is a good book to read for our increasingly surreal times. Elliot here pursues the stories of whistleblowers as well as the gross medical abuses they exposed. His aim is to try to understand, what motivates whistleblowers, but also, underneath, the perennial question of how people could be otherwise. He is (at least seemingly) upfront with his interests: he became obsessed with exposing the death of a young man on his campus undergoing an experimental trial into a psychotropic drug the researchers had a financial interest in. And he wants to understand why he couldn't let it go and why stuff like this happens in the first place.
To do this, he tackles some of the most well-known scandals - the Tuskegee syphilis trials, the Willowbank hepatitis murders - and a few I was less familiar with, including a very hard-to-read Karolinska Institute scandal; the Protocol 126 bone marrow experiments in Seattle; Dunedin's 'unfortunate' experiment, and a 1960s military trial which drenched cancer patients in radiation.
I'm not sure how much I buy any of his theories in the end. He has this weird thing with honor which doesn't seem to have unpacked a bunch of his own cultural bias in coming at. But honestly, it doesn't matter. He comes across as refreshingly human, and one who, like the whistleblowers he documents, is more interested in making a difference than being heroic enough to admire.
Perhaps the most interesting part of the book is how, despite most of these whistleblowers being radically different in personality, background and, to some extent, politics (lefties* were over-represented), they all talked about their experience as if they had not had choices. Their motivations were about who they were, the oft-repeated ability to look at self in mirror, the sense that the choice, if it was that, was between self-annihilation or a rejection of this.
There are clues for how to make it easier for people to stand up to horrors. A big one is the role of a support system, the higher success rate for those working in a group as well as the need for solidarity in the face of the inevitable attacks. All of these whistleblowers suffered career losses of significance - many were outright fired. They lost friends, money, status and comforts. There is no Hollywood endings here (and remember, all of the cases covered were eventually exposed, the actions 'vindicated' - it is shuddering to think how bad things are for those who never bring what they are seeking to light).
There is also much to ponder in how we got here. Elliot covers some of the basics, including Milgram's experiments and what the conditions those showed were that helped people resist (he annoyingly states that Milgram went on to test this - actually, Milgram made his tests increasingly likely to comply, obsessed with proving most people were bastards. The tests with most quoted result were after more than a dozen rounds in which most people did not electrocute). These include having another person in the room, and not having the authority of an Ivy League logo to back up the study. It is not the motivations of the arseholes who designed these murderous studies that linger, however, but the legions who have all of the reasons not to do anything about it. There are so many characters here who, once the practices of, I dunno, inserting fake broken organs into people, or blasting them with lethal radiation, or interfering to stop their late-stage syphilis being treated, have been exposed and the practitioners discredited, then say the equivalent of "yes well, I did think that was a bit off really" while protesting that they wouldn't have been listened to. Which maybe they wouldn't have - but the glory of our protagonists is that they would point out, it isn't the point. It isn't about the difference you make outside, it is fundamentally about the difference you make to yourself.
And it is important to remind ourselves that there are lines not to cross. Elliot makes the point that medical training inculcates young doctors into a set of values - one that includes taking power away from patients, and assuming that it is important to fake expertise rather than withdraw. It is by these degrees, he shows, that we get used to things that should horrify us. With Willowbank, while the wrongdoing that got the place was that they deliberately infected patients, the reaction that hit the news was simply from the journalist seeing the conditions the children were living in, an environment of filth and violence, in which rape was so tacitly accepted it had a nickname.
The book never implies there are easy answers to any of this. And repeatedly points out that the obsessiveness of whistleblowers can make them difficult friends, lovers and even witnesses. But it is an assertion of humanity, of how much it matters to continue to value yourself and others, that kindness and respect matter as values. Because without them, we might all end up watching kids get tortured for profit.
*In one of those things I think I had forgotten, there is a direct line from the Young Lords to the exposure of the Willowbank scandal, as the young doctors that worked with them in running a NYC hospital move across to Willowbank...