FRIENDLY FIRE
Michigan Veterans Harm Reduction Summit
David Healy
Thanks to Derek Blumke for asking me here today. It’s a great pity not to be there in person. There is a fabulous group of speakers. Most of us sense that US Vets, more than any other group in society, may be able to move things forward in a way that can hugely help all of us.
A prerecording of the lecture is here along with text and slides below. This post goes hand in hand with Antidepressants and Homicide.
Slide 1: The usual story is modern medicine began in Europe with American doctors visiting European centers to learn how to do the job. This is wrong. Modern medicine began in Boston in the 1840s with the discovery of anesthesia.
Anesthesia brought ethical issues – can it be right to do wrong in a good cause? Can it be right to mutilate or poison?
Politics is Medicine on a Grand Scale was a famous phrase from the time – this talk could be called War is Surgery on a Grand Scale.
Slide 2: Anesthesia might not have created medicine had it not been for the American Civil War. Both sides, North and South had disbanded their medical corps before the War – there was no obvious need for medics in a War. But the North in particular recruited young men, who enabled by the availability of anesthesia and training on the job created modern surgery.
They were facing injuries never seen before from rifles and snipers – injuries from a distance rather than hand to hand combat – leading to shattered arms and legs where amputation was often the answer. These young men pioneered open chest, open abdominal and plastic surgery.
Morphine came into use – and syringes. Hygiene was put in place.
The Red Cross was invented along with battle-field triage and above all hospitals. What were called hospitals before were places you went to die – they might look after your soul but did nothing for your body.
This does not look like a hospital. This is Quincy. There are 17 Quincys in the US. This one is in Illinois on the Mississippi and this building was the second hospital there. When very few cities had hospitals, by the end of the War, Quincy had 5 hospitals. There were floating hospitals off the Carolina coast. Surgery happened near battlefields with the patient then moving to a network of hospitals behind the lines.
After the War, the Veteran’s Administration was set up – in great part to provide housing for troops disabled in the War.
The floating and converted hospitals were closed down, but the North began building substantial hospitals in every major urban area across the country. These did surgery. Medicine in the sense of giving drugs didn’t exist. By 1900 America had more hospitals than and was doing more operations than the rest of the world combined.
The US also created Casualty or Emergency Depts – on urban grids. Ambulances brought you to the closest Casualty Dept whether it was in a Jewish, Protestant or Catholic hospital.
America also eradicated Tuberculosis, the greatest killer, more effectively than anywhere else – long before any meds came along.
The Army with the least deaths from Disease or Injury won Wars. The Germans copied the Americans and beat the French. The Japanese copied the Germans, and in the 1904 War against Russia, Japan became the first country to have less troops killed by disease than by the enemy – and they beat the Russians.
Slide 3: Military input continued in WWI and WWII, with prosthetics and rehabilitation medicine, transfusions and fluid replacement, a use of vaccines and the management of dysentery.
This image shows traditional gender stereotypes but War changed these – men were having nervous breakdowns on the battlefield and women ran hospitals at home and did the surgery..
WWII led to antibiotics, anti-malarials, and an explosion of all the drugs we now have including antihypertensives, hypoglycemics, steroids, psychotropic drugs and others.
The American military introduced computers, which led to managers, the Internet, robots who now do most of our operations and increasingly the possibility to operate from distances which will be needed when we take to space.
America led the way in building health systems that worked. When I entered medicine, US healthcare was the best in the world and Americans had the best life expectancy in the world. You made going into medicine attractive for me. Until recently you figured you were doing the same for healthcare – but something has gone wrong.
See The Decapitation of Care – downloadable from Announcing a Birth.
Slide 4: We once viewed history as driven by the Gods. And then Great Men. But for a century our technologies have clearly driven history forward – especially our health history. Innovation is the new buzzword. If it’s innovative we assume it must bring benefits and we climb on board.
Innovation is a tricky word – as the rest of this talk will make clear. What happens when the innovative technique is a new form of propaganda? Are we guaranteed to get progress from this kind of innovation?
Slide 5: In 1982, Zelmid launched. the first of an innovative new drug group – the selective serotonin reuptake inhibitors (SSRIs). We had known for 20 years before this that previous serotonin reuptake inhibiting antidepressants could cause suicide and homicide. We also knew there was nothing wrong with the serotonin system in people with any nervous problems. See Madness, Normality and Antidepressant Dysregulation.
Slide 6: Arvid Carlsson, whom you see here, created SSRIs and Zelmid. Prozac was the fifth SSRI. He did this by listening to people like you tell him that older drugs acting on serotonin had a serenic effect. He recognized that like LSD, which acts on normal serotonin systems, SSRIs could produce good and bad effects. They would suit some of us and not others – even make some of us suicidal or homicidal.
Slide 7: We ran an experiment in this Unit 25 years ago to test Carlsson’s idea out. We gave Zoloft or a non-SSRI to healthy medical and nursing staff to see if they could pick out the serenic effect of an SSRI from other antidepressants. Arvid Carlsson was right but 1 in 10 volunteers became suicidal or homicidal.
Even more interesting, within 48 hours, patients in the unit who knew nothing about the experiment could tell which staff members were on an SSRI – they could tell by their body language and facial expressions. By observing us they knew more about what was going on in us than we knew about what was going on in them. They were better at looking more closely at us and other people than we were at looking at them.
It’s the same with you – you know more about these drugs than the people dishing them out to you. To adopt an old 1960s idea – the asylum has gone crazy.
Slide 8: Back in 1992, I chaired the launch meeting for Zoloft in the UK. I gave what seemed like an obvious talk. Serotonin is more primitive than Estrogen and if we now have drugs that act on it – we are going to hear things we have never heard before if we look and listen.
This is not the message Pfizer wanted. Their message was we know all about Zoloft. The only job for a doctor is to prescribe it and for a patient is to take it.
Slide 9: This is caught in this fabulous cartoon from 30 years ago. SSRIs can be good serenics but were never meant to be antidepressants – they have to be given in toxic quantities to show an effect in depression. But a benzodiazepine dependence crisis in the 1980s led companies to think it would be better to pitch SSRIs as antidepressants which doctors didn’t think would cause dependence.
So cases of Valium and Ativan had to be converted into cases of Prozac and Zoloft. Depression had to be reinvented as a Vitamin Serotonin deficiency that would be corrected by these little pills. Marketing – propaganda that is – had become so good Pharma could do this easily.
For pharma, the key thing is the consumer must have no side-effects. The consumer is the doctor. He consumes by putting pills in your mouth. Companies aim to make sure doctors don’t have a thought in their head not put there by them or their competitors.
Slide 10: Companies knew you who took SSRIs were going to have serious problems ten years before these drugs came on the market. In healthy volunteer studies, volunteers like Traci Johnson committed suicide – others became aggressive and hostile. This is all linked to a profound emotional numbing and akathisia these drugs cause.
The marketing challenge for companies was to get doctors to just not see the problems you were having on these drugs.
Slide 11: Propaganda has been an area in which the military have been particularly effective. What you need to remember is that through to 1980 the pharmaceutical industry was relatively new and small.
Up to 1989 or so, American soft power was greatest in the health domain. Helping pharmaceutical companies may have looked like a way to bring the free market to the whole world. Or maybe even then, the US military were aware of the looming risks of biowarfare.
Any way, Pharma learnt all about Fake News pretty quickly. It’s one thing to deploy Fake News in Wars but in Healthcare?
Slide 12: In a Pfizer 1990s trial, a man became so akathisic he poured gasoline on himself and set fire to it intending to kill himself. He died from his burns 5 days later and was coded as death by burns rather than death by suicide. The coding of adverse events in trials is the first act in the creation of misinformation. In this case, a paper trail lets me find out what the medical literature and reports to FDA don’t tell you – that this should have been coded as suicide.
Slide 13: In 2001 GSK published the results of Study 329 a study of Paxil given to depressed teenagers, in which after two weeks on Paxil one 15 year old ended up out on the street waving a gun around and threatening to kill people. He was picked up by the police and brought to hospital – there should have been a paper trail letting people know what happened but there isn’t for him or 3 other children taking Paxil in this trial.
FDA don’t know what happened in this case. See Children of the Cure. Industry had found and continue to use loopholes to hide events like this not just in antidepressant but in all trials.
Slide 14: In the studies bringing Prozac, Paxil and Zoloft to market, there was a serious excess of suicidal events on all 3 drugs and to manage this the companies moved suicidal acts from the washout phases of their studies into the placebo group claiming people in washout were on nothing, which was the same as being on placebo. This breached regulations but you can’t call it fraud because the companies say FDA saw exactly what we did and didn’t object.
Slide 15: Pfizer did 4 studies of Zoloft in PTSD. The results for men in all 4 were negative. There was a minimally positive result for women in 2 studies, which let FDA approve Zoloft for PTSD. As you see here, articles were written on these studies claiming the drug worked well and was safe – articles aimed at Pharma’s favorite journal – The New England J of Medicine. On the left you see Author TBD – To Be Determined. These articles like all publications on on-patent drugs is ghostwritten.
This is a Recovered Memory Syndrome – memories of benefits that didn’t happen. The greatest concentration of Fake News on Earth centers on the drugs our doctors give us. The goal of successful propaganda is to be invisible and masquerading as science, this is invisible..
Slide 16: In 2001, GSK published Study 329 of Paxil in depressed adolescents claiming it worked well and was safe in a high impact journal that generated lots of sales. A year later they submitted 3 negative studies to FDA asking to be licensed in teenage depression. FDA agreed the studies were all negative but still agreed to license GSK to claim their drug works for depressed teens and also agreed not to mention this in the Paxil label. Why would FDA do this?
Well if they mentioned Study 329 was negative GSK might have been sued for fraud and no-one wants GSK or any pharma company sued for fraud. GSK in fact did get sued for fraud – Children of the Cure.
Slide 17: Here are the published adult antidepressant studies. The black boxes are the negative studies. The rest look so good you’d be tempted to race out and get on these drugs. Especially Zoloft which most experts say is the one to have – see the two white boxes 3rd from the right.
Slide 18: That was the published literature. Reports to FDA show over half of the antidepressant studies in adults and children are negative. One third of the previously published positive trials were in fact negative. Look at Zoloft. The regulations say there have to be two positive studies to license a drug – but there is only one for Zoloft.
Slide 19: Most of us figure FDA are here to look after us – the next best thing to having God keep us safe. They would not license a drug that causes suicide or homicide or serious sexual dysfunction – so if this is happening to you it can’t be caused by the drug.
But that’s not the case. The name Food and Drugs Agency tells you what is involved. FDA are regulators – bureaucrats. The reason Britain tumbled out of Europe started the day they joined when European regulators told them their favorite chocolate could not be called chocolate – it didn’t have the right amount of cocoa solids.
In the same way faced with a lump of yellow stuff that might be butter – FDA check it animal fat content. If the lump meets that a company can call their product butter. FDA do not say this is good chocolate or whether butter is good for you – when companies meet a standard FDA let them use words.
It’s the same with antidepressants. If a drug meets an agreed standard – 2 points on a Depression rating scale – FDA will let a company use the word Antidepressant. They are not saying this is a good antidepressant or antidepressants save lives – they don’t save lives. The trials indicate more people die as a result of SSRIs than are saved by them. Almost none of the trials used to license drugs, show the drugs saving lives.
Slide 20: FDA’s job is to keep the paper trail in good shape and preserved in the filling cabinets. It is not to look too closely at it and above it is not their job to think.
Slide 21: Company marketing aims at persuading Docs SSRIs are Magic Bullets that go to where the problem is and exterminate the enemy, leaving the rest of your patient’s body untouched with no interactions with any other meds. I could show you many more Images like this for medicines – the more precise our weapons get – like Cruise Missiles – the more Pharma love the imagery.
Managing the medical literature enables marketing to create narratives like this that take control from you and your doctor and hand it to pharma.
Slide 22: But when Arvid Carlsson created SSRIs he didn’t create a Magic Bullet – he made a therapeutic principle – that can be put to good use if we get the right principle for you.
Laxatives and constipation come in 4 different kinds. The skill lies in figuring which therapeutic principle suits you – something your grandmother and older doctors used to be good at. But once a company gets licensed to call their drug a laxative, their interest lies in getting everyone with constipation on it. They don’t care if you are also on the other 3 types, but you should care because this is how we get treatment resistant constipation.
Listening to you, Carlsson heard that SSRIs could make some people serenic – less anxious. One of several different ways to manage nervous problems – they suit less than half of those put on them.
Listening to you Carlsson heard that some folk with OCD do well with SSRIs but some don’t and become suicidal. Some of us said we did better when we stopped SSRIs and began smoking. So he ran a study of nicotine for OCD and found it suited some of us much better than an SSRI.
Nicotine can be a therapeutic principle for OCD. What about safety? Its seems no more likely to cause cardiac problems in men and premature death than SSRIs do and much less likely to cause weight gain, diabetes, bone fractures, sexual dysfunction and most other problems than SSRIs. Taking a good cigar and glass of wine every day as our poison is probably less likely to harm us than the growing cocktails of poisons we increasingly take every day.
Therapeutic principles hand the narrative back to us. Only you – not FDA, your doctor or companies – can compare the benefits and hazards of nicotine and SSRIs for you. No one else should get in the way of you doing this.
Slide 23: Let me give you another way to look at it. You hope your doctor is like the pilot in the middle who if she spots something going wrong on she reports it and the powers pay heed to her because they know that otherwise neither she nor her colleagues will fly again. She has an incentive to put things right – if you don’t get from New York to Seattle – she isn’t going to either.
The lady on the right is a banker. At the time of the financial crisis she and her colleagues were selling us mortgages they knew could explode in our faces and destroy our lives – but got paid if they kept quiet.
The doctor on the left is like the banker not the pilot. She has a fiduciary duty to you and should know, the grenade she is handing you is likely to blow up in your face and might destroy your life. But as long as she keeps quiet, and especially if she refuses to take your side and agree that some drug has harmed you – she will continue to be paid. She has no incentive to do the right thing.
She is in a state of moral hazard. You cannot depend on her. She is the weakest link in the system and perhaps your way put things right.
Slide 24: The man in the middle never had any nervous problems. Mildly stressed about his taxes, he was put on an SSRI. During the week on the SSRI you can see him begin to wonder is he going mad – will he end up locked in hospital. His wife gets friends who know him in to help her work out what to do – they see the most agitated man they have ever seen – pacing up and down, tearing his hair out. He has akathisia. No one expects what happens next. On the 7th day he wakes up gets a mallet and batters his wife to a pulp.
He is brought to hospital. The SSRI is stopped, and he returns to normal. I write a report – he is not guilty and should be let walk free from court. His lawyers have a better idea – take a plea deal. He gets a year. He went into hospital with everyone where he lived figuring he was innocent. He comes out a convicted murderer and has to leave where he has lived for 50 years and even move country.
The gun on the right is James Holmes – the Aurora Batman killer. A shy inhibited university student whose psychiatrist puts him on Zoloft. He becomes disinhibited – begins to flirt with women and buy guns. He keeps a diary where he records his growing Manic Delirium. He tells his doctor she would lock him up if she knew the thoughts in his head – she says he is responsible for his thoughts. He shoots 12 dead and injures 72 others.
Many other details point to his Zoloft causing this and I write a report saying he is not guilty. But his public defenders don’t use it – they likely agree with the prosecution that one juror says he shouldn’t be executed. For lawyers that is a victory for them. Not for him – maybe not for you.
Slide 25: Pfizer were unlikely to want my report to come into evidence. It contained things like this. Thirty years before Aurora, Pfizer ran a healthy volunteer trial in a group of women – all of whom became agitated on Zoloft. Their diaries noted growing agitation and aggression. Every single one of them dropped out by 4 days in – the control group were all fine.
Slide 26: Pfizer concluded Zoloft clearly caused all this. SSRI type drugs are well-known to cause problems like this. The reports from the volunteers are reliable.
Patient began to verbalize feelings
of killing other people and then himself.
Patient looked more anxious and depressed than at baseline,
even though this was not reflected in Hamilton Scale.
Slide 27: Here is a snippet from an SSRI clinical trial. The usual rating scales showed this man had a good response, but the doctor talking to him realized what was going on in him was at odds with what the rating scales said.
How often does this happen in SSRI clinical trials – in up to 1 in 20 people. In our Zoloft healthy volunteer trial – it was 1 in 10 and in Pfizer’s Zoloft healthy volunteer study it was everyone.
Slide 28: Nicholas, Thomas and Emily and their mother Marilyn. Marilyn had been viewed by all who knew her as Superwoman, Chief Nurse in a busy Chicago hospital Ward, wife to an over-busy, increasingly not there doctor, juggling 3 children, involved in many community projects. After Emily’s birth she was unhappy at weight gain. Prozac, which then had a reputation for weight loss didn’t help. A stimulant helped her lose weight and feel better
In 1998, worried she and her husband were drifting apart she consulted Dr Hubbard. Both agreed this was not a problem a pill could solve. Weeks later, as she was still stressed, he suggested Zoloft could do no harm. Over the next few months the dose was increased 4 times – after each increase she slept less well, was more anxious, despite a benzodiazepine being added and had other signs of SSRI toxicity.
Dr Hubbard thought he had helped when they got to 200 mg and she reported feeling less concerned about the divorce. Her husband at this point was openly dating another woman.
On March 4, 1999, Marilyn called the Emergency Services to tell them she had tried to kill herself and had killed her children – could they come to the house?
On remand, Marilyn was tanked full of drugs. Interviewed by experts who had no expertise on drug related issues, she mentioned it would be better for her husband if she and the children were just no longer around.
No-one explored if Zoloft’s sexual dysfunction and libido killing effects might have made a tricky marital situation worse. No-one asked for the drugs to be stopped to see what she was like.
Illinois did not then allow a Prescription Drug Induced Defense. The jury were faced with a choice between a bitter woman who killed her children as revenge on her husband or mental illness.
The prosecution had an easy job. They asked all her friends had anyone noticed any signs of mental illness. No one had. The only person who said anything different was her father who said that for the last few months she was not the daughter her family knew.
The defense did not have the possibility to introduce the Pfizer documents you’ve just seen or the fact that Zoloft did not meet FDA standard for approval.
It took several years for her to get the meds stopped – she was fine of them. It took a decade for her to think Zoloft might have played a part. She has now been in jail for a quarter of a century.
Marilyn didn’t get a Fair Trial. I don’t think you could either and if you can’t get a Fair Trial, you can’t be getting Good Care.
- Would a jury accept that the NEJM and other leading journals publish nothing other than ghostwritten deeply misleading articles on meds. That the greatest concentration of Fake News on Earth centers on the drugs your doctor gives you.
- Would a jury like you believe that FDA would let a drug that can cause homicide on the market?
- Will jurors be able to credit that Dr, Hubbard, your doctor, who seems a nice man will say what you hear him say because his lawyer has told him – blame the drug because doctor if this person walks you may be charged with involuntary manslaughter.
Slide 29: When recruited you were mentally and physically fitter than the rest of the population. All things being equal, even if some of you are now fitted with prostheses, that should still be the case. But it’s not. Why not? And what can you do to put it right?
Slide 30: This slide brings out how you are being disabled. Healthcare costs are ballooning and industry have a simple message – it’s because you wait too long to start treatment. We should put people on meds to manage their risks from years beforehand.
It might be fine to eliminate junk food and salt and get fit but taking drugs that are more dangerous than nicotine and alcohol when well is not a good idea.
Very few medicines save lives the way Surgery does – because – as Goldman Sacks say – Saving Lives is not a Good Business Model for the pharmaceutical industry.
The surgery you get still mostly fixes something wrong. You get given meds when you are healthy. If put into the 6 week trials that bring these drugs on the market, nicotine and alcohol would likely have less side effects than almost all of what you guys are increasingly given.
Bisphosphonates to thicken bones cause the most serious fractures you can have – a not unsurprising result of abnormally thickening bones.
Statins – to supposedly keep your arteries young – don’t save lives and cause serious muscle problems.
Antihypertensives – that very few people need. Unless you have severe blood pressure problems these won’t save lives – they will keep your doctor happy but not you.
Anti-Allergy or Asthma Drugs like Singulair – which cause depression, suicidality, homicidality, dependence and other neuropsychiatric problems.
Antidiabetics – these sound like they are giving you some control. They aren’t. Read the leaflets – they will tell you not to go on a keto diet or try to lose weight while on these drugs because this can cause hypoglycemia and dementia. You think you are taking control but you re giving up control when you start any of these meds.
Psychotropic drugs – you’d be better off taking nicotine or alcohol than your current cocktails.
Slide 31: I’m Irish and we have always been pro-America. I went into medicine because in the 1970s going into the 1980s, you had the best life expectancy in the world and there was a real sense you were making the world a better place physically and mentally.
In 1980, you began to be given prescription drugs when healthy rather than ill, and life expectancy began falling and has been falling ever since. This graph is all before Covid. First you fell below other wealthy countries but now you’ve fallen behind Cuba and lots of other countries.
If you had told me in 1980 that this would happen I’d have thought that’s just not possible. And what’s happening is worst of all for Vets because we figure we need to give as much of the very best treatment as possible.
Slide 32: Until recently, the most solid finding in the social sciences was the people in their middle years claimed more disability benefits than younger or older people because they had muscle or skeletal injuries from hard physical labor. In the last decade this has changed. Now 18-35 year olds claim more disability than any other age group. Diagnoses like ADHD, Autistic Spectrum Disorder, Depression, Bipolar Disorder all disable them. The meds to go with those diagnoses also disable them.
You were once a Band of Brothers – a team – with a bunch of different skills shared out among you. These differences between you – between us – have been converted into illnesses and are being medicated
As a result, national debt in most countries in escalating rapidly and unsustainably and social security systems across the Western world are on the verge of collapse.
Slide 33: Being stuffed full of meds is risky and dangerous. It takes real skill to defuse this Hurt Locker situation. Who is the skilled person who is going to do it? You are.
When it comes to being on meds – you are in a privileged position and the person most capable of doing the science. Any doctor or whoever you turn to for help needs to work with your observations – not his or hers. Science is about coming to a consensus – as a jury does in a legal case. It is not about converting you to something the system the doctor works in wants you to end up thinking.
You need to insist on the validity of your hunches and if you are not being listened to and worked with on your terms – change doctors.
Slide 34: The last thing you need is Sanctuary Trauma – a term UK Vets introduced me to. Increasingly if we have a problem and turn to the people we are told is there to help us, they turn out to be our greatest problem. This doesn’t just apply to Vets – it applies to all of us these days.
You didn’t sign up to defend the least free market on earth. To defend a lie. What can you do?
Maybe call into Eric Rubin’s office, the editor of the NEJM, who gets $750,000 per year it almost seems in order to leave his backbone outside his office door. You might tell him he is contributing to the deaths and injuries of Vets and needs to up his game.
You might visit get Governor Pritzker in Chicago who has been sitting on Marilyn Lemak’s clemency case and get him to engage. You can tell him – this is not just about the fact that she didn’t get a fair trial, its about the fact Vets can’t get fair trials and if you can’t get a Fair Trial you can’t get good clinical care either – the two go hand in hand. Suggest to him, there might be votes in this.
This all about reconfiguring a System that worked pretty well till about 30 years ago. You might want to Aim Higher that Rubin or Pritzker.
To adapt a phrase beloved of the NRA, drugs don’t kill and injure Vets – prescribers do.
Prescription only was invented in 1914 to manage Heroin and Cocaine addiction. It now treats all of us as though we are addicts. It makes even someone like me feel I am doing something wrong when I go to a doctor. This is not the way to treat free citizens.
SSRIs are already available over the counter. Many antihistamines are SSRIs and can cause all of the problems that the antihistamines we call SSRIs can cause. You manage these just fine.
You stop a medicine that isn’t suiting you pretty quickly if it doesn’t suit you – uninhibited by some doctor who insists you have to keep taking them for weeks before you will feel the benefit – a doctor who might double the dose of a drug that’s poisoning you something you would never do or he would never do to himself – a doctor who gets reimbursed for keeping you on meds.
This doesn’t mean that you need to get rid of a doctor you like and trust. It means if I don’t make my money from controlling your access to these drugs, I have to make it from really providing you with something of real value – like honesty. Like what I really think of stuff you’ve been researching and are thinking about taking – or whether I really think the reaction you’ve come to me to check out is linked to your meds.
If we are working together using your experience and research, you can make my job a lot more fun and interesting. You are giving me a chance to look and listen and learn in a way I don’t have if my job forces me to tank you full of meds I would never take myself.
Aim High and really Shake the System – it needs shaking. American’s used to be good at systems – its time to fix this one. It’s time to Make America Honest Again. It’s not that you are any less honest than anywhere else – we are all in the same boat but American Vets are one group who might be able to get a beacon of liberty shining again.
Prior Veteran Posts
There have been a series of prior posts linked to Veteran’s issues on davidhealy.org and RxISK.org. The US based ones have been written by Johanna Ryan and the UK ones have stemmed from our links to Trixie Foster.
- Dependence Day
- Is it the Drugs or the War? Yes.
- Because Veterans are Worth It.
- What Would Batman Do Now?
- If you Wake At Midnight
- Sanctuary Trauma
- Fertility, the Moon and the Military
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