Crusoe and Hans grew up together. Crusoe’s father encouraged her to believe she could do anything she put her mind to. Han’s father, Peter, was a story-teller who delighted both children with his stories, especially during the long evenings at the onset of Winter. He told them about the Microbe Hunters who discovered the causes of diseases and laid the basis for new cures.
But their favourite was the story of the Snow Queen. So scarily did Peter tell this that both children were certain that some Winter, the Snow Queen would sweep down and take one of them away leaving the other behind with a Mission to save whichever of them now had a sliver of ice in their heart.
Fairy tales
But fairy tales are just that after all. Both went to University, and became doctors.
Medicine had just passed through a glorious Summer that had led to the greatest harvesting of the benefits of new treatments ever recorded in human history. Life expectancies increased dramatically. Where once almost every family was blighted by the death of a child, now almost no family had a child who died. In some countries the treatments conferred such obvious benefits that governments made them available for free. A tyranny of fear had been lifted.
After qualifying their paths diverged. Crusoe immersed herself in the problems patients brought to her. For her every patient was different.
Evidence based medicine
Hans gravitated toward the most exciting new discipline – evidence based medicine. What could be better than ensuring doctors stuck to treatments that had been proven to work and stopped doing things for which there was no evidence. Patients’ stories might be interesting, but the evidence allowed you to pull back the veil of stories and glimpse reality. Patient improvement might be only a placebo response. They and their doctors might think they knew what was happening but be wrong.
Even when there seemed to be cast iron proof that a drug did something useful in a laboratory or at a bedside, Hans insisted on the need to test it out in hundreds of patients. He was adept at reeling off instances when laboratory breakthroughs have proven to be a mirage. Hard-hearted though it might seem to dying patients, he insisted on a proper demonstration that treatments worked.
The snow queen
Unlike some of his colleagues, Hans was not a fundamentalist. There was a passion behind his approach born of a recognition that Medicine was up against the wiliest of adversaries – the pharmaceutical industry – who thought nothing of the deaths of children in pursuit of profits unless those deaths compromised a profit line.
Industry was truly villainous, and in an effort to contain its capacity to injure people Hans was to the forefront of ensuring that the latest evidence was built into guidelines to which doctors would have to adhere. Frustrated at the slow rate of progress, he was of the view this could only be explained by the fact that some doctors even those who were involved in writing the guidelines were on the take. He became a crusader for Sunlight – bringing all and any payments to doctors from industry into the chilly light of day.
His career took off. He moved to Boston. He hadn’t seen or heard from Crusoe for years. There was an ocean between them. He became dimly aware that she had become critical of guidelines. She seemed to have drifted into a position close to homeopathy quoting obscurantist nineteenth century philosophy about there being an Art to medicine in knowing when to give a drug but an even greater Art in knowing when not to treat.
Medicine clearly had to be one thing or the other – an Art or a Science. The idea that modern medicine could be an art he thought belonged to an era that believed in fairy tales.
The clinic
Not having heard from Hans for over a decade, when she found a trip took her through Boston, Crusoe decided to surprise him. She found from his secretary that he had a clinic on Tuesday afternoons and joined the queue in the waiting room planning to walk in as his last patient.
She was early but had her iPad. The string of patients ahead of her after their appointments came back to the room to pick up waiting relatives, friends and belongings. She registered the low muttering of these returns. She could only catch snatches of the stories but there was no missing the disappointment.
“He told me there is no evidence that there is a dependence on these drugs – that my difficulties must just be the illness coming back”.
“He said I should stop worrying about the drugs. If I stopped the treatment and the illness came back that would be much more likely to cause harm to any baby we might have. If he had his way, pills would come stamped with an image of a pregnant mother precisely to stop people like me from misinterpreting what we find on the internet”.
“He told me that my hunch that my pills were causing me to drink were typical alcoholic denial and unless I got to grips with my alcoholism there was nothing he could do for me”.
“He told me that my idea that the medication he put me on to stop me smoking had caused me to have epilepsy was bizarre. Epilepsy is genetic not drug induced”.
“He told me that my conviction that the drugs had caused Shane to commit suicide was becoming close to delusional. I think we should leave before he detains me in a psychiatric unit”.
Crusoe walked in less jauntily than she had planned. Had she not known it was Hans she might not have recognized him. Flinty was the word that came to mind.
A drink?
For a moment he had no idea who she was. Once he recognized her, he greeted her teasingly:
“What’s this I hear about you having gone over to the Dark Side?”
“Come out for a drink and a meal and I’ll tell you all about it”, she said.
He had a series of committee meetings he said but he could skip one and give her an hour – it was so good to see her. She really should have told him she was coming.
To win some, you have to lose some
Quizzing him over a drink on how his patients responded to him, he told her that he suspected that time would show he was wrong in some cases but even on cases that once worried him he’d stopped feeling a long time ago. If the patients had been injured by treatment they would suffer less if he denied a link to treatment.
If someone who had been injured came to doubt the system and think that their injury could have been avoided, or that the system was going to acknowledge the injustice, it might lead to despair and who knows even suicide.
If patients on treatment or still to enter treatment came to doubt the system it would be too appalling a vista to contemplate.
Better leave it to people like him to negotiate with regulators and drug companies dispassionately. He was now in a position to do just this – a position he would never have been appointed to had he been too outspoken. And the companies were slowly coming round – they are registering their trials and making more data than ever before available.
Through the looking glass
There was even talk of nominating Andrew Witty for a special award – Nobel Prize might be a step too far for some people to take but even that artificial barrier would have to fall sometime.
“You do know that you’re killing more people than you’re saving”, she said.
“Don’t be silly”, he responded.
“Well life expectancies are falling, and drug induced death might even the leading cause of death now. That’s not because of the chemicals – the chemicals have always been risky. It’s because the information that makes it possible to use a chemical as a medicine has never been so toxic.
“Sorry”, she said, “that I didn’t get to Peter’s funeral. He was so pleased when you brought him over here to Boston.
“He got the best possible treatment,” he said.
“Oh I’m sure, given the treating team knew who you are, that he was being treated perfectly according to every guideline for diabetes and hypertension. But you know if you wrote a guideline for treating a Peter the first thing you’d have to put in is to half the number of whatever medicines he is on. I hear he was on twenty-one when he died”.
“So what do we do – do we go back to the day when some doctor arbitrarily decides what to keep in and what to leave out?”, he asked.
“Well when it all comes down to dust, you believe in placebos. You call them RCTs but they are really placebos – mumbo-jumbo. You force people to believe in a system rather than to question it and make it better”.
“And”?
said Crusoe’s partner afterwards.
“The Snow Queen is far more formidable and wilier than I ever suspected”, she said. “Maybe I should have dropped some anti-freeze in his glass of wine”.
Illustration: The Heart of Medicine, © 2013 created by Billiam James
And I still sit here seven years on unemployable with a record that blocks me from doing anything. Does anyone care “no” not the doctor’s, not the Mhra, not the drug companies, not the health dept, not the government, no one cares. It took someone that was ill to do the research something the professionals should have been doing. Doctors are over rated there not the gods they make themselves out to be. The forensic psychiatrists and Doctors I saw in custody didn’t have a clue, why are these people in those jobs, they were more than useless.
‘Why are they in these jobs?’
Think you already know the answer really, deep down. Sometimes, to hide abuse inflicted by the Govt itself under experiments so horrific including on children, that even today both the US and UK govts are still in complete denial. And those experiments were carried out on civilians too, and not so very long ago. ECT was also given & to children to hide the truth. The meds help people to stop remembering.
Just quietly know that there are people who know the other bits of the story that the best doctors are often not told, because it’s classified. The ones who do know are part of the arrogant sector who would also rather keep it secret. I kind of follow why Dr Healy treads how he does but ECT leaves permanent scars too, esp to those who were damaged at so tender an age by it.
Believe me this is no fairytale.
Shall we go back to basics ? Merry Christmas everyone.
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Crusoe’s piercing blue eyes would suffice for the lack of anti-freeze.
“No, no no…Hans, ” she mused, “Repeating history is a banal and sophmoric treatment for this human suffering.”
Hans was sure he had stiffled Crusoe’s idealistic reverie with one of his close ended questions. Now he was drawn to attention as though transported back to university.
Crusoe was quick to accept the challenge to answer neither- “yes” return to the old days or “No” finish our days on the calmer seas of the status quo.
“Who’s going to treat this pernicious ailment our colleagues seem to have developed from years of overexposure to PHarma? Hans, haven’t you noticed these chaps are far worse off than their unwitting patients?”
“Hard not to notice”, Hans agreed, sheepishly grinning. Maybe he hadn’t abated her fairy tale logic after all…
Crusoe waxed more serious than Hans had ever seen her–
“It will require the united efforts of healthy healers and their grateful patrons to attend to finding the cure for PHarma. Rather like a malignancy, that lot!”
Now Hans was laughing.
Even better than anti freeze? Crusoe wondered.
“So, then … what?”, Hans managed to ask, recovering his compsure, but still very much amused.
“What… then? We all set about finding the antidote for greed?” Hans laughed (again)
Crusoe felt her spirits dropping, as her cheeks flushed from a mix of anger and embarrasment.
Struck by a feeling Hans almost remembered— was it compassion? Maybe. He pulled himself back into a somewhat deferrant posture, and sincerely asked:
“Could there even be such a thing? An antidote for greed, I mean”.
“Yes, I think there is such a thing as an antidote for greed- an actual cure, a reversing of the poison. The first ingredient is working hard for the sake of others’ happiness- making their well being the prime thing. The reward is seeing the evidence of the infinite value within our own lives– It’s not a potion, Hans– not for sale. And the part you will like best: no one can put a patent on it– available without prescription!”
There it was. That magic from somewhere back in their long ago had put an impish grin on his handsome face.”
” Let’s commence with compliling the evidence then. Shall we?”
The first trial of Crusoe’s antidote would be run at a Christmas party she was escorted to by Hans– in the lavish Chestnut hill mansion of one of Harvard’s most celebrated child psychiatrists, the bedazzled childhood companions infused a small gathering of HMS alumni with a secret potion.
The Snow Queen?
Took to her bed with a wicked migraine….
.
Merry Christmas David. Good story.
Excellent story, Dr. Healy. And well-done KT bar the door on your denouement!
Merry Christmas to Dr David Healy and team.
Thank you to KT bar the door for helping him back on the right road. Guess even some of the best need help sometimes!!
Hope the other psychiatrists all get better soon 😉
The best thing is to keep well away from psychiatrists if you want a peaceful life because the only tool to their trade is a prescription pad and a set of jump leads, you may end up in prison or worse dead. Your just a cow to be milked and a toy to be played with, they give no more a toss about you and your problems than the man on the moon.
Hi Anne-Marie
Sorry to hear about your plight. I know it will be of little consolation but things in UK have been no better. Difference is one extremely abusive consultant psychiatrist in the East Midlands, has left a legacy of abuse in my county that no-one is brave enough to deal with, just white wash after white-wash. The consultant, has left a catalogue of disaster going back 25 years.
I’m genuinely on my own with it. Isolated because even staff who may have wished to speak out, are too afraid to, (Wow, irony there hey, since we’re the ones supposed to be timid and weak-minded)? My abuse goes back to an episode in childhood, cleverly covered up by the consultant 25 years ago. I’ve recently over the last three years found out what it was all about, I tried to hint earlier.
People who may have talked got bought out, most people at the end of the day, will go for a payoff and take the money instead of having the strength of mind to keep speaking out despite all the odds.
Until such times that the message is made very clear to all that in effect what they are doing is failing those already hideously abused by the system and that a person’s worth should be defined as more than just their ability to do work, I see little change.
Best Wishes
There is a personal sacrifice involved in blowing the whistle , and some potential for loss of professional standing as well. I don’t think everyone who chooses not to speak out strongly to expose injustices in the mental health field is necessarily weak, timid or on the take. The sad truth is that the personal and professional sacrifices made by many of us outspoken renegades did nothing to resolve the root of the problem.
Often times it is not possible to know how high up the corruption goes until one has lost everything, but the passion for protecting the dignity of the lives of those who are most vulnerable.
Every good doctor knows that the root cause of an illness must be known if a cure is to be rendered. It isn’t likely that the remedy for the ills created by ‘psychiatry’ will be discovered by a renegade who preaches from a pulpit inside of an ivory tower.
I once saw a forensic psychiatrist at the solicitors office he looked like the spitting image of younger version of Paul Nicolous the actor. He came along in his convertible mg like he was a celebrity. Well I sat there feeling very puzzled and confused but desperate for him to find out what was wrong with me but he was more interested in flirting and joking with the solicitor than analysing what was wrong with me. I walked away feeling let very down, alone and even more puzzled and confused than when I went in and my reckless behaviour continued. I then went on to meet several more forensic psychiatrists that were even worse than him, not one of them was of any help to me at all a total waste of tax payers money. The government want to cut back on spending in the criminal justice system and want to only pay out by results, well this is an area they should be looking at. These psychiatrists should have known my behaviour was a side effect of medication they could have changed things for me but I believe they are quite happy to have people like me in the system going around and around in circles because it probably suits their pocket.
So… what kind of training did these fabulously-well-to-do, dashing psychiatrists receive ? I wonder…
if you know that you are posting comments on the blog of the psychiatrist who has laid bare the well trodden path to academic medical corruption?
I post here to let people know how others are really being treated by the profession. How would you feel if you had been stripped naked and assaulted by police officers in cells because you are in a confused and disorientated state due to the shit that’s been prescribed to you and then to get told told its your own fault by the so called professionals, to be slandered in the national papers, to lose your job and to end up in prison. Don’t judge others until you have walked a mile in their shoes. I have had psychiatrist lie to me, laugh in my face at what’s happened to me and offer me the same type of drugs that caused my original problem. I think I have every right to feel angry and to not like them.
Don’t allow what they have done to you break you, Ann-Marie, there own guilt of what they have done, and still do will eat them up in the end, karma will always win, and you have found your Karma now, by telling your story, and making yourself heard, life is for living, don’t let them take one more day, or hour
of yours, Eat well, Sleep well, and surround yourself with love, and remember once a story has been told it can never be untold, that’s how all change starts, with an inspiring story. Happy New Year 🙂
As a practitioner of Nichiren Buddhism for the past 25 years, I have found that the best way to describe “karma” is to simply say:
If you wonder what causes you have made over many past life times, look at what is now manifest in your life.
If you wonder what the future holds, look at the causes you are making now!
The key is “now”– making the best use of one’s life despite the pain and suffering that may have occurred in the past.
The tenets of Buddhism capture the significance of everything being in a state of continual flux– always changing. Moment to moment each of us has the potential to change even our most deeply engrained life tendencies.
The tenets of Buddhism are difficult to grasp for most of us Westerners, because of the total absence of concepts of fixed duality, like good and evil. The Buddha would condemn an evil action, but not deny the innate human capacity for change.
Punishment/reward doctrines are the basis for monotheistic religions. Buddhism teaches the “middle” way – to transform suffering to joy by acting for the sake of others– for causes bigger than our own lives. Not unlike the spiritual paths of many great humanitarian leaders of non-Buddhist religious backgrounds, and many ordinary people who become champions for a worthy cause, rather than bitter, disgruntled victims.
This response is nothing more than a brief descriptive explanation for ‘karma’ and the life philosophy that the term implies. 🙂
Thank you Samantha and KT. bar.the.door. I know both you mean well but I don’t totally believe in Karma either. There is also the reality of survival. Who wouldn’t be bitter and disgruntled if they are struggling to meet their daily needs because they cant get a job, because of their record, because of the drugs. I can survive my past but I’m finding it hard to survive my present. I’m sorry but I just cant avoid sounding bitter, angry and disgruntled.
No offense intended, Anne-Marie. I , like you, have been posting from my experience and understanding. Not judging you at all, really.
I would like to add that I do have the up most respect for David Healy he is one of a few that has really gone out of his way to help people how could you not respect and admire him. I am sorry for any offence caused by my last comments sometimes it is hard to see the good through all the bad but I am also aware that there are many very good Doctors to who do care about their patients and this must never be forgotten.