Uneventful Days── On the Quiet That Reviewers Protect

01I Went Looking for a Memory of Being Thanked

I have spent a long time reviewing promotional materials (= the explanatory brochures and similar pieces we hand to physicians and pharmacists). The other day, a younger colleague in my department asked me, "Is this work rewarding?" I thought for a moment and answered honestly: "I'm searching my memory right now for a time I was praised."

It would be a lie to say there has been none at all. After we got through an audit, or handled an inquiry from the authorities well, a boss has thanked me. But I can hardly recall the people who made the materials, or the MRs in the field (= the sales representatives who visit medical institutions), ever saying, "Good thing you stopped that one."

Our work goes like this: the committee chews it over, sends it back, has it fixed, and finally passes it. Over and over. And our finest result is a day when nothing happens. No findings arrive from regulators or industry bodies. Nothing appears in the monitoring program (= a government-commissioned system in which deviant sales activities are reported anonymously). No complaints come in from healthcare professionals. That is a perfect score for a reviewer — and on a perfect day, nothing shows up in anyone's field of vision.

I don't think this is anyone's laziness. It's a habit of the system. Most companies measure results as a line going up. A sales graph is visible. A launch date sits on the calendar. But an accident that didn't happen is recorded nowhere. Work that deserves recognition stays sunk below the waterline.

02When Eyes Do Turn to Us, It Tends to Be on the Bad Days

So when does the company look at its reviewers? In most cases, when a deviation occurs. A deviation means a material was used without passing review, or wording that broke the rules went out into the world. There are, of course, executives who talk with their review departments regularly. But I suspect more companies are the other kind.

In a deviation investigation, the department that made the material is questioned first. Then, with equal force — sometimes more — the reviewers are questioned too. "What was review doing?" The corrective-action report demands submission of review records, and the logs (= the record of who checked what, and when) are traced back and examined.

I don't take this as anyone's malice. A lookout stands at a post, and that makes the lookout visible. Before the accident itself, the lookout is questioned. That is the kind of place we stand in. Nor do I mean the department that made the material is the villain.

Still, this position quietly wears down a reviewer's spirit. The days that go well turn transparent; only the days we stumble take on color. Keep at it long enough, and it would be strange if the fatigue didn't accumulate.

03Electricity, Water, and Anesthesiologists

Nobody walks home thinking about electricity. Nobody gives thanks each time they turn on a tap. Things taken for granted are noticed to have existed only on the day they stop. When an earthquake cuts the power or the water, the whole town is in an uproar — though the day before, no one had mentioned either.

Medicine has people in a similar position: anesthesiologists. The lead role in surgery belongs to the surgeon, and it is usually the surgeon the patient remembers. The anesthesiologist puts the patient under, guards breathing and blood pressure throughout the operation, and brings the patient safely awake. The better it goes, the less impression it leaves.

There was, in fact, a reported case of a hospital where the anesthesiologists resigned all at once over problems with their working conditions, and surgery became impossible. The gravest part was the effect on patients who had been waiting for operations. Their chance at treatment was taken away. By the time it was clear that this work had been the foundation, it was too late. It is a story that could happen in any organization.

04Before They Are Gone

What if the same thing happened at a pharmaceutical company? This is only hypothetical. What if the reviewers, worn out, quietly left? Or, even if they stayed, kept grinding their spirits down?

Deviations do not surge on some particular day. They increase little by little, and surely, in proportion to how much the reviewing eye has weakened. And on the day the first outside finding arrives, the company realizes: that quiet had not existed on its own. Nor is the company the only one in trouble. So are the healthcare professionals who pick up those materials, and the patients beyond them.

I did not write this to talk about compensation. I am not asking for an award. I only hope that executives, and the people who make the materials, might pause and ask themselves: who is holding up our "uneventful everyday"? Is the review department adequately staffed — when did we last check? Does our yardstick for evaluation include "what was prevented"? For those already doing this, a chance to check again is enough.

And if you happen to pass a reviewer in the hallway, one sentence will do: "Thank you for always watching over things." With that one sentence, work that ordinarily sits below the waterline surfaces for a moment. Better still if that word becomes a doorway, and the conversation reaches as far as staffing and how evaluations are done. Then the reviewer can go back, tomorrow again, to the transparent work.

If this piece becomes the occasion for that one sentence, it was worth writing.