Imaginaries of Writing and Pain: The Backstage of a Ghostwritten Paper

Ghostwritten medical papers are a cornerstone of pharmaceutical marketing. We trace how one manuscript written under the instructions and supervision of opioid producer Mallinckrodt was produced and eventually published in a medical journal to present a marketing message. We systematically analyse an archive of internal communications made public after litigation through the lens of Ricœur's work on imaginaries. Along his first analytic axis, we show how the ghostwriting process shapes and reshapes identities, ascribing agency and portraying social order. Along the second, legitimacy was constructed by the expert voice of a peer-reviewed article 'authored' by researchers, but written by backstage medical writers. Third, the result was a twisted phantasmagory of both academic writing and pain management. Professional medical writers generated an imaginary of pain management to expand the prescription of opioids by redefining pain categories and reassigning agency and responsibility of actors in pain treatment. Meanwhile, backstage writers also reproduced an imaginary of scientific writing, with efficient writing as an editorial service that misrepresents authorial contribution and responsibility. We suggest that Ricœur's analytic scheme could also be used to disentangle technoscientific imaginaries in other settings.