Listen my doctor and you shall hear
Of the midnight ride of Paul Revere….
You know the rest. In the books you have read
How the British regulars fired and fled, —
How the farmers gave them ball for ball,
From behind each fence and farmyard-wall,
Chasing the red-coats down the lane,
Then crossing the fields to emerge again
Under the trees at the turn of the road,
And only pausing to fire and load.
For many many people from New Zealand through India and much of Europe to Canada, there is a certain pleasure in anything that conjures up images of British regulars (even if they were mostly German) being put to flight even if those putting them to flight were mostly English.
The Midnight Ride is a stirring poem that boys everywhere, except maybe England, respond to, the fact that it is part of second amendment mythology – the right to bear arms – notwithstanding.
In the wake of the recent Florida school shooting, John Stone who runs the Age of Autism website had a surprise. Many of the American respondents whom he thought he knew well from correspondence over several years and whom he respected for their views on vaccines and science had views on gun control that surprised him – they were in favour of the right to bear arms.
When people you respect, holding views you respect, present cogent arguments in favour of a position you had previously considered anathema, it can be confronting.
Should he have been surprised?
At first blush people on a site detailing the things that can go wrong with vaccines, the causes of concern with the science, and the injuries their children have suffered, look and sound very much like parents in the wake of a school shooting, who, surrounded by carnage, want the massacre to stop.
Several times in the last two decades, I have put it to American friends – “liberals” I guess – that one way to spread word about the risks of antidepressant induced suicides and mass homicides, like the Aurora killings, would be to enlist the NRA.
Having Wayne La Pierre up there saying its not guns that kill people, it’s the mind-altering meds that cause the problem, would be a coup that money couldn’t buy.
My friends react with horror. From their point of view, this hasn’t looked like a possible marriage. There is much more interest from the guns side.
Chances are however that many of the Americans reporting drug wrecks on RxISK feel just the same about guns as those reporting vaccine damage to Age of Autism. They likely to think the drugs are a problem, but guns are a rather good thing – for the bears and pests around the place. (The worst we have where I live is seagulls but there are times during the summer when an airgun looks appealing).
And, while there is a undoubtedly a liberal conspiracy to lump people in favour of guns together with anti-vaxxers, the most anti-gun people and organizations – like the Guardian or New York Times – are the most violently pro-vaccine, and among the most reluctant to say anything bad about a drug.
What ties a belief in guns, and drugs and vaccines together is efficacy. They all “work”. And we want things that “work” and would regard it as a denial of our human rights were we to be prevented from having agents to minimise the risks that we and our families face.
The overwhelming majority of us – the 99% – fall into this group.
There are then a small number of us who were probably reasonably pro guns or would be if faced with bears and seagulls, who have been injured by them, or horrified by the media coverage of the injuries of others.
And a small number who were pro-vaccine – otherwise we wouldn’t have gone ahead with the procedure – but who in the wake of injuries to our children are left rueing the day we took them to get the jab.
And a small number who were pro-drug, but have been badly injured and, seeking answers for what has happened, find that the pro-drug hype is all ghostwritten and there is no access to data that shows that companies and medical academics knew about the very harms that have happened to us or our families.
But too late. Our calls at that point to others to beware fall on deaf ears. In a risky world, our calls add to the risks, making the need for things that work more compelling. What’s the answer to a bad drug – a good drug. The more school shootings the greater the need for arms.
There is very little incentive for those injured by guns, and vaccines and drugs to unite. The injuries create silos rather than common cause.
Watching on almost parallel screens this week, Wayne La Pierre in the wake of the Florida shootings and a string of British Psychs (regulars) like Cipriani, Pariente and Wessely arguing for the miraculous efficacy of antidepressants, the similarities were striking. Who in their right mind would want to take away things that work from anyone? Who in their right mind would let them?
The NRA lobby is famous but they must envy the Royal College of Psychiatrist’s ability to get the message across. The RCPsych and a lot of British medicine have the SMC – Science Media Centre – getting into whose meetings is about as easy as getting into NRA headquarters uninvited. The SMC appear to control broadcasters like BBC and newspapers on both the right and the left. The BBC will happily interrogate the NRA vigorously but never mention the existence of SMC.
We, the 99%, go along with this medical neo-fascism because in a risky world, we want efficacy right up to a nuclear bomb.
The fact that efficacy and effectiveness are two different things is a touch too complex for most of us – until we get to nuclear bombs, where if some of the public don’t quite understand why we don’t just nuke North Korea, the politicians do. Efficacy has its limits. Too much efficacy is not effective.
We can make a good case that every armed guard or teacher has efficacy but are they effective – are we more or less likely to reach 100 as a result as a result of them?
Somewhat unnoticed, we have reached a nuclear tipping point with drugs. Every drug we take might have efficacy but everyone now agrees that more than 5 different chunks of efficacy per day increases your risk of hospitalization and death. Reducing the efficacy chunks (drugs) down from 15 or 10 per day to 5 or less demonstrably increases your life expectancy and reduces the risk of being hospitalized. See HERE.
And guess what – life expectancy in the US, UK, France and Germany is either falling or any increases have stalled. This news is not on the front pages of anything. See HERE.
The fetishing of efficacy and denial of harms are something the NRA, APA (American Psychiatric Association) and RCPsych have in common. But if given a choice between having Wayne La Pierre or Simon Wessely or Jeff Lieberman in charge of the organization psychiatrists are members of, it should be a no brainer – Wayne is the man to have. He at least talks about a good guy with a gun. He doesn’t pretend nothing can go wrong. Wessely and Lieberman just talk about good drugs and in their universe nothing it seems can go wrong.
Simon and Jeff are leading the troops into an ambush – there are lots of people out there who want to get rid of the expensive middlemen between people and their drugs. The only thing that holds them back is its difficult to think of a more effective (not efficacious) delivery system than doctors.
Despite the formal similarities, the NRA and APA/RCPsych are not about to merge anytime soon. A long long time ago, after some ancient incident, an enmity was set between their seeds.
For the NRA, mental illness is a liberal plot and much too convenient to let go of. Incarceration of both shrinks and shrunk would be ideal.
The shrinks see the NRA as fascist and in the 1960s were comfortable saying this meant closet homosexuals and their message to democrats was we can treat both fascism and homosexuality. But the shrink reaction to the NRA is so violent that in 60s language you’d have to think they are latently homosexual. Amazing how sunk in ignorance such recent language sounds. Today’s comparison might be closer to fundamentalism. The more violent the reaction, the more you have to wonder if the shrinks secretly worry that beneath the skin they are just like the riflemen.
They are becoming ever more similar. The RCPsych now want to have a Nuremberg about something everyone knew since the 1960s – antidepressants ”work”. They have effects that certainly aren’t all in the mind. The new Cipriani hoop-la offers tenuous evidence of efficacy for the newer (post 1990) weaker agents across groups. There is no evidence for effectiveness – lives saved or people returned to work.
The fact antidepressants “work” is not something to argue about…
(other than to wonder about Andrea Cipriani, otherwise a charming man, being fully aware that the material on which his article is based is entirely ghostwritten and the complete lack of access to the data behind anything he is talking about; perhaps his endorsement of agomelatine and vortioxetine, drugs it is impossible to take seriously, is a wink to fact we are not supposed to take the article seriously)…
The question is when faced with someone on 8 or 9 drugs and needing to reduce their meds to 5 or less, assuming the goal is to help us live longer, or avoid being hospitalized, where would antidepressants rank in the pecking order of things to remove?
Or let’s say your patient is only on 3 meds now, when might a doctor think of adding in an antidepressant to the mix given that most people who start one never get off them? So when the person’s life later depends on adding another drug, the antidepressant will have pushed them into the 5 or more territory with the increased risks of death and disability that go with that.
I can make a case for treating melancholia with an antidepressant in these circumstances – but SSRIs and related antidepressants don’t treat melancholia. Be difficult to justify them.
Lots of doctors were little boys once, who read The Midnight Ride and could imagine themselves as Paul Revere. And it might have worked if they’d grown up to be a real live PR helping to rout British regulars rather than scared slaves to PR – ‘model’ doctors – a model being a shrunken replica of the real thing.
It might yet work out when a generation of doctors less likely to have Revere reveries and less hung up on potency take over.
But right now all too many doctors are Scott Petersons who, although armed, are not willing to go into a school where there is kid with a gun killing people.
Its time to man up – which may mean hand things over to women who when it comes to caring for those they love are a lot braver than men.Share this: