See accompanying MAiD in Canada and TRD.
Illustration: Lost in Medication © created by Billiam James
Canada put Medical Assistance in Dying (MAiD) legislation in place in June 2016. This allowed for medical assistance in dying in cases where death was reasonably foreseeable. In 2019, in Truchon v Attorney General of Canada, the Superior Court of Québec declared the “reasonable foreseeability” criterion unconstitutional. This decision forced a review of the original legislation.
The original legislation required an individual to have a “grievous and irremediable medical condition,” meaning that a person:
The review proposed to:
“retain all existing eligibility criteria but would remove the requirement for “reasonable foreseeability of natural death”. It would also expressly exclude persons suffering solely from mental illness”.
An amendment eliminating the exclusion of people with mental illness was proposed by Senator Stan Kutcher, arguing that mental illness is as real as physical illness, that it can lead to great distress and routinely leads to people attempting to take their own life.
The arguments against this amendment express concerns that people with mental disorders may be pressured to opt for death, essentially for the convenience of others and of services that are not adequately funded.
On February 10th 2021, the Therapeutics Initiative in Vancouver hosted David Healy from McMaster University in a webinar entitled Sex and Evidence Based Medicine.
The full lecture, with text and slides are available Here.
Post SSRI Sexual Dysfunction (PSSD) is one of a number of enduring sexual dysfunction syndromes that include Persistent Genital Arousal Disorder (PGAD), Post Finasteride Syndrome (PFS) and Post Retinoid Sexual Dysfunction (PRSD). These states are triggered by treatment and will endure for decades after treatment stops in most cases.
Enduring sexual dysfunction does not convey the horror of the conditions, which typically produce numb genitals, an inability to orgasm, a profound loss of libido and a more general emotional disconnection or anhedonia.
In the case of PGAD, women faced with the opposite problem of irritable or painful genitals resort to having the nerves to their pudendal area cut or to clitoridectomy to manage the discomfort. None of these options help.
There are no cures for these conditions. The distress is great. There are no remedies for the distress. Medical services do not recognize the conditions, even though as of 2020 drug labels do, and healthcare staff routinely ridicule patients adding to the distress. Aware that there are no cures and no prospects of a cure, some patients know to me have committed suicide. Others known to me have explored the possibility of medically assisted dying.
Pharmaceutical companies have known about the risks for decades. Regulators had reports of these conditions in the mid-1980s. Neither warned the public or doctors. As a result, hundreds of thousands have ended up taking antidepressants, isotretinoin (for acne) and finasteride (for hair loss), many very young, who in many instances did not need these treatments and might not have opted to take them if decently informed.
At present there are approaching 100 Canadians with known PSSD and over 700 with known PGAD and a further cohort of people with either PFS or PRSD.
This is a significant underestimate of the numbers who likely have these conditions but don’t yet know about them. PSSD and PGAD typically declare themselves when patients stop treatment and on-treatment sexual dysfunction continues and often gets worse.
Roughly 15% of Canadians take antidepressants (5 million people), a majority of whom do so because they cannot stop (c 3 million). If they could stop, many would expect the sexual dysfunction caused by being on treatment to improve but just the opposite is likely to happen for some people.
The Enduring Sexual Dysfunction Syndromes are serious and incurable physical illnesses.
They are not mental disorders. They are the physical consequences of treatments some of which are given for mental disorders and others for physical conditions.
The distress they cause appears to be as intense as is the distress caused by conditions that have hitherto led people to seek out MAiD when death is reasonably foreseeable.
There are at present no prospects of a cure for these conditions or for relief from distress. Well-intentioned efforts to help are likely to compound the problems and sap rather than support the resilience of those affected.
In addition to concerns about poor services that might push people toward MAiD, the Enduring Sexual Dysfunction Syndromes suggest another factor should be considered.
These illnesses result in part because the medical literature on on-patent drugs is ghost-written and there is no access to the data from healthy volunteer and clinical trials that were undertaken to bring these drugs on the market.
Access to the trial and related data might have made these hazards clear and made for different conversations between doctors and patients.
The distress patients with Enduring Sexual Dysfunctions experience stems not just from ridicule at the hands of healthcare personnel but from a profound sense of being deceived. This sense of being deceived underpins a perception that our institutions have no incentive to find a remedy. For pharmaceutical companies to research the problems would require an admission their treatments and practices cause the problem. Tobacco and recent finasteride litigations have shown they are unwilling to do this.
Senator Kutcher was an ‘author’ on a famous study of paroxetine given to children commonly referred to as Study 329. The paper was ghostwritten. It is unlikely he has had access to the trial data other than the patients he himself entered into the study. Study 329 led New York State to file a fraud action against GlaxoSmithKline, the makers of paroxetine. Based on Study 329, the US Department of Justice later took an action against GlaxoSmithKline that in 2012 resulted in the then largest sum handed over to resolve a corporate case of this kind – $3 Billion (USD).
The process of ghostwriting articles and sequestering clinical trial data began in earnest a little over 30 years ago. Since then, the time between doctors becoming aware of and generally accepting that the treatments they use come with specific hazards has increased from roughly a year or two to several decades. For PSSD, PGAD and related conditions this interval between first description and recognition is now three decades and counting.
Canadian patients with Enduring Sexual Dysfunctions are certain to seek MAiD because of the distress occasioned by their condition. They have been put in this position by practices that prioritize commercial considerations over scientific, moral, or clinical considerations.
When considering MAiD for PSSD if this is the patient’s wish, perhaps doctors should be willing to support death by hunger strike outside the headquarters of the company making the drug that caused the condition, or the university/hospital that condones practices like those Senator Kutcher engaged in.
David Healy MD February 17th 2021.
This post is one of two attachments to a letter to 3 Canadian Members of Parliament.
For those new to the Enduring Sexual Dysfunctions – PSSD, PGAD, PFS and PRSD – there is a page about them on RxISK.org along with a good deal of published literature that can be downloaded. There are many additional posts on RxISK about both these conditions and Treatment Resistant Depression.
Copyright © Data Based Medicine Americas Ltd.
Some reflections: I lost a good friend to suicide earlier this month. She had a drug injury in August. She was tortured living inside her body. I validated her suffering but I did not support/condole suicide as an option.
I had a drug injury. I live every day with its impact. But, I have seen a substantial improvement in many my symptoms. There are not words to describe the degree of my suffering at the beginning. The first five years were hell. But I survived. And the last 3 years I’ve gotten things back that I didn’t think were possible to get back. I’m glad to be alive.
I think it’s important to validate the suffering of those who are drug injured. And the world needs to wake up to the fact that these injuries are enduring. However, for those that are trying to survive after a drug injury, I think we need to also convey that we can’t know with absolute certainty that the degree of suffering from the injury will always be at intolerable levels. Of course we can’t guarantee that there will be relief, but I think there is just so much we don’t know about the neurology of the drug injuries that we cannot always predict prognosis across the entire lifespan.
This is interesting. To see what Alan Cassels wrote in 2014
Youth under the influence
Mental health drugs based on biased sources
DRUG BUST by Alan Cassels
• The people’s briefing note on prescription drugs
Dr. Kutcher, a bit of a media darling in Canada, is supported by a long list of pharmaceutical companies. He has been a researcher, consultant and advisor to GlaxoSmithKline, Pfizer, Eli Lilly, Lundbeck, Wyeth-Ayerst, Abbott, Bristol-Myers Squibb, Janssen, Novartis, Organon and Boehringer Ingelheim – basically the laundry list of the world’s biggest drug companies.
While this distinction might not be helpful for your average doctor, it may make it slightly easier to dish out a script for Paxil (paroxetine, a major antidepressant) for kids tumbling into the ‘possible’ range. Speaking of Paxil, if you stick Dr. Kutcher, Paxil and “study 329” into the maw of Google, you’ll marvel at what emerges.
Superlatives aside, BBC called study 329, a Glaxo-funded study of using Paxil in kids, “one of the biggest medical scandals of recent times.” Kutcher co-authored the study and he and his colleagues concluded that Paxil is “generally well tolerated and effective for major depression in adolescents.” The reality is that the opposite was likely more true.
Revelations from court proceedings showed the drug was more likely to induce suicides in teens rather than prevent them. Nonetheless, studies like 329 and the researchers who wrote up the results helped Paxil turn into a mind numbingly huge blockbuster drug (sales of more than $11 billion between 1997 and 2005) even as it turned many people around the world into hardened anti-pharma skeptics.
But those facts seem irrelevant when we invite Stan Kutcher
Senators amend MAID bill to put 18-month time limit on mental illness exclusion
LISTEN | Senators debate medical assistance in dying bill:
Nova Scotia Senator Stan Kutcher, a psychiatrist and Professor Emeritus of Psychiatry at Dalhousie University, discusses his efforts to amend the government’s legislation on medical assistance in dying. 9:58
This could really turn up something, the 3 Canadian Members of Parliament responses
ESDs and the Catch-22…
Now available on TI
[Feb 10] Therapeutics Initiative Best Evidence Webinar: Sex and Post-SSRI Evidence-based Medicine Dysfunction
Scroll down to view a video recording of the event.
To correct the balance, researchers need access to raw data
CBC News ·
Posted: Sep 16, 2015
his is the story of two studies – VIDEO 2.32
GlaxoSmithKline has never admitted wrongdoing. The journal that published
Study 329 has not retracted the paper.
Dr. Stan Kutcher, a professor of psychiatry at Dalhousie University in Halifax, was one of the authors of Study 329.
In an email to CBC News regarding the reanalysis, Kutcher said “this pejorative and biased paper was created by authors who, in contrast to acceptable scientific enquiry, had predetermined what they would report.”
Kutcher said he and the other original authors are drafting a full response.
Thank you for the link to this compelling lecture by Professor Healy.
I had not been successful in my earlier attempts to find the video. I have watched twice, shared with others and have no doubt that I shall be re-visiting the recording regularly.
The lecture on the T.I site has been censored. The most interesting slide removed and I think all the content that went with it.
The full lecture with all slides and text is here https://davidhealy.org/sex-and-evidence-based-medicine/
Added a comment – seems comments won’t be censored
1 second ago
David’s blog MAiD in Canada: Enduring Sexual Dysfunctions There is no time left to be shy if more people are not to be damaged through ignorance . Please read the post on David Healy blog and Rxisk Blogs
February, 19, 2021 | 11 Comments
Very powerful and critically important image, hence vital ‘take home message’ omitted from brilliant presentation.
This is such a complex issue, especially when dealing with its complications in a country other than my own.
I had to check to see exactly where we were at, here in the UK. As far as I can see, the first mention, in modern times, is that in 2014, Labour peer, Lord Falconer introduced an Assisted Dying Bill into the House of Lords – it proposed that terminally ill patients with life expectancy of six months or less be given the option of medically assisted death, subject to legal safeguards. It reached the ‘Committee’ level but then ran out of time.
In 2019, The Royal College of GPs announced that it was going to start a consultation with members, for their views on the same matter.
In February 2020, thirty doctors, academics and campaigners wrote an open letter urging the BMA to support assisted dying. The reply from the BMA in September said “We represent doctors and medical students who hold a wide range of views on physician-assisted dying. Since 2006 however, our policy position has been to oppose assisted dying in all its forms.”
A ‘recent poll’, how recent it does not say, conducted by National Centre for Social Research, found that 93% in the UK approved of, or wouldn’t rule out, doctor-assisted suicide if a person is terminally ill.
So, that is where we stand here in the UK. As a result, according to Dignitas statistics, twenty four people from the UK travelled to Switzerland for this purpose in 2018.
It is legal in the UK for a person to refuse treatment and for medical care to be withdrawn by doctors in certain cases – for example, if a patient is in a vegetative state and will not recover. As a family, we experienced this situation two years ago when one of our sons was in a road accident, survived two months or so without gaining consciousness and was then allowed to die – as it was ” the best outcome for the patient” in that situation.
I take the view that all life is precious. I find that others, locally, also feel this way. It is the view that first comes to mind I suppose because, under normal circumstances, we will all strive through thick and thin to stay alive. Hearing of others who find themselves in such pain that they find it so hard to carry on is difficult to comprehend. I don’t think they “want to die” but rather “cannot live” under their present circumstances. Suffering without a hope of recovery or even improvement is extremely difficult to endure and to support. Many who face changes in medication or medication doses time after time, faced with “professionals” who seem at a loss of what to try next can easily fall into this depth of hopelessness. Shane was there – with voices commanding all sorts of ideas, until David Healy came on board to change things completely. It is obvious, then, that in such cases “hope” was still there but remained out of sight until shown the light by a complete change of attitude to the circumstances as presented.
Turning to PSSD and TRD and we find ourselves in a different predicament yet again. Here we find groups of people, again damaged by medication taken as prescribed, who have been thrown aside – mocked in some cases and left to suffer without any support or hope of a better tomorrow. They do not look for pity but they do need our support. Rather than giving them the right to die, shouldn’t we be doing whatever we can to bring to others’ notice the suffering that goes on and to shake awake the powers that govern us to accept that something needs to be done urgently to put a stop to this suffering?
We accept that ALL who are prescribed these drugs do not suffer in this way – but shouldn’t the fact, that if it were EVEN ONLY ONE that goes through so much suffering without an acknowledgement, prick at our consciences?
If medically assisted dying became available for all of them, all that that would create is the possibility for another generation to suffer the same outcomes. A high number are already taking their own lives – we hear of the loss which is then almost immediately replaced by another sufferer. It is a vicious circle caused mainly because of a lack of transparency and acknowledgement of their conditions.
Having taken all of this into consideration, I still must finish with the fact that ‘life is precious’ – and each one of us has a responsibility to better the situation of all who we can support, so that they too can at least find that their lives are bearable and that “tomorrow” is worth waiting for.
(message received in response to the above)
Mike says :-
Your comment provides a balance to both opinions regarding assisted dying but also stresses that this option should never be used as a “treatment” for people who, like Shane, are suffering as a consequence of prescription drugs. This is an issue that NEEDS sorting as you say. However, I do think that any consideration of assisted dying as it applies to people suffering as a result of prescribed drugs should be thought about separately from the subject of assisted dying in general.
In my humble opinion, in the GENERAL situation, if an appropriate set of checks and balances can be agreed, then those who are in constant, unbearable pain, whether that be physical or mental, should be able to find release from that pain through an assisted, dignified and painless death. I know that’s how I’d want it to be if it was myself – or Coral – involved.
And yes, of course, there will be some who – because there is no current provision in UK – will struggle through their pain and may eventually and unexpectedly come out the other side with a tolerable life. In their case, if assisted dying was allowed, it would have cut short those additional days and months etc. of tolerable life. So there’s an argument against assisted dying.
However, the extra life gained by these people has to be set against the extended suffering of those for whom NO such good outcome occurs – and for whom the lack of an assisted, dignified death only means more months and years of agony.
As you say, there is no simple answer – the only thing I would say is that assisted dying will only be used to terminate seemingly unending suffering and agony – the only risk is maybe the loss of a few weeks or months of tolerable life for some. How can that be balanced against weeks or months or years of others’ suffering in agony?
I agree that more effort needs to be put into finding the CORRECT solutions to the suffering resultant from prescribed drugs. And in these cases, assisted dying shouldn’t be seen as a way of avoiding the problem – provided, of course, that such solutions ARE possible and that all that is needed is for an act of determination to bring them into play.
However, I don’t think we should be arguing against the concept of assisted dying in general – just in order to ensure that we obviate its use in these particular and special cases. As I said at the start – I think the two issues should be treated separately.
It would be great if the issues could be separated but in practice young women in their 20s in Belgium and Holland have recently been assisted in dying because of drug induced conditions. See sister post on RxISK.org MAiD in Canada: Treatment Resistant Depression. Pharmaceutical companies have every incentive to grow the number of people supposedly affected by TRD and no incentive to do otherwise. So while the issues in principle seem separate, in practice they are not.
The systems not trustworthy enough to allow assisted dying. Look at the drug harms caused and denied by the system, the people having Covid put down on their death cert when it wasn’t Covid that they died from. Until the system can be open, transparent and honest I can’t see how the assisted dying wouldn’t also be abused.
The drugs tearing people apart
Patrick D Hahn says
February 21, 2021 at 10:09 am
Adam Maier-Clayton was a young man from Windsor, Canada, who suffered from “Somatoform Symptom Disorder” and campaigned for assisted suicide for the “mentally ill” before ending his own life at the age of twenty-seven in a lonely motel room. His story was told in the BBC documentary “I have a mental illness, let me die.”
Adam was given at least five different psychiatric diagnoses and was prescribed no fewer than fifteen different psychiatric drugs. And yet, the BBC doco gives not a moment’s consideration to the possibility that his problems could have been drug-induced, even though his description of his distress, “It’s like my whole body is being burned from the inside by acid,” sounds suspiciously like drug-induced akathisia.
Doctors have always had the prerogative of burying their mistakes, but now some appear to be in an unseemly haste to do so.
The Drug Co.s have already done a pretty good job in ‘assisting’ patients to die, ably assisted by doctors ‘knocking-off” their patients.
The whole world has fallen on your head. Can it get any worse than that? How do you bounce back from that?
As the Drug. Co’s ride this out with the assistance of doctors and the whole shebang, there is something very febrile about this colossus
If no-one puts two and two together, that an SSRI can lead to violence, suicide and homicide, people like Stan Kutcher will always come ‘out-of-the-closet’ all fires blazing …
David Stofkooper’s mother Elra emailed to say:
In the Netherlands the medical assistance in dying is organised quite well. But in the case of persisting post SSRI- adverse effects it will still be troublesome. Most of the time psychiatrists don’t recognise this condition. It will be demanded to seek other treatment first.
In the Netherlands just as everywhere, these PSSD- patients are told by psychiatrists that they perhaps have bodily illusions, are obsessive or are depressed and so on. All kind of diagnoses instead of the conclusion that they have persistent adverse effects of the prescribed psychiatric drugs.
Knowing this, David did not even want to seek medical assistance in dying. He had allready been hurt too often by psychiatrists who didn’t believe him. I think if he had met only one psychiatrist who really listened to him, believed his complaints and was willing to support him, it really would have made a big difference. Perhaps even with a different outcome, we’ll never know. So the awareness amongst psychiatrists and patients remains of utmost importance as well as research.
We’ll keep on the fight here, in the Netherlands. Thanks for your continuous efforts.
Elra’s point here about the risk of someone with PSSD, PFS or PRSD – or many other drug induced conditions – being diagnosed with somatoform disorder or somatic delusion disorder or something like that is all too true. It happens a lot. There is absolutely no basis for a diagnosis like this but the problem we have is that unlike Tardive Dyskinesia there is nothing visible for us to point at.
Back in time, if it was me say diagnosed in this way, my ‘family’ would meet the doctor as he left his clinic and invite him to come on a trip with us to a quiet spot. There he would have his kneecaps broken with something like a baseball bat or maybe a bullet from behind.
We now live in a world of due process but no lawyers anywhere are prepared to pick this issue up. We need to find a Third Way – perhaps a hunger strike outside a doctor’s clinic which was the other Irish way to deal with an issue like this
When I first viewed the video there was no warning , not been censored Since yesterday?
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Thank you Dr Healy #PSSD Post SSRI Sexual Dysfunction
Just for the record, the video on davidhealy.org is whole and intact
The video on the T.I site is or was missing the Stormy Daniels slide
There is no message there about censoring – but this slide did upset some people
My elderly mum who was with me for nearly three months during each crucifying Seroxat Withdrawal armed herself with a baseball bat and a revolver, nearly driven mad with frustration. We pitched up to the appointment with The Psychiatrist. I was a five stone weakling by this stage, hunger having long gone on strike …
She demanded to speak to him. He said he wouldn’t.
She absolutely insisted.
“I want to know what is wrong with Annie”
She came out of his office, none the wiser.
Then she was back to batting the GP.
When this GP, who had had me in her home on an Island for a week watching me syringing out the Paroxetine liquid – as my blood went cold as I saw her standing square-footed in her kitchen as I looked at her reflection in her dressing table mirror.
Running in to my sitting room as my mum became increasingly exasperated with packets of Fluoxetine coming out of her handbag “you need this”.
This was when a very heavy penny dropped.
The Psychiatrist had warned about blood levels and Seroxat when stopping Seroxat, hence his advice to switch to Fluoxetine and had decided he had no reason to see me again.
He left his letter in the ‘capable hands’ of the GP.
Sitting there like a ‘time-bomb’, how many of them had rifled through my records…becoming increasingly tatty…
He saw me again and again as the GP did not surrender any information, in and out of hospitals, the Seroxat dose upped to 40 mg.
“I did notice you weren’t given Fluoxetine” said the owner of the practice prior to his departure to Nova Scotia, keeping on his practice as his ‘life-boat’… and charged me £99, the invoice at the ready…
As nice as ninepence, I don’t think so,
I was so nearly there with a law-suit, totally flummoxed that my lawyer needed a further GP to rifle the records …
a back alley or a country walk, seems entirely reasonable …
Elra – I am very sad to hear what happened to your son .I have lost friends in the same way that led to your son’s death -and am one of the countless number of people who have experienced serious harms from being diagnosed behind my back as depressed and somatising symptoms years ago. Nothing much as changed. I eventually had a massively life changing operation after insisting on seeing a different consultant not attached to the group who were frankly on the verge of driving me mad.
Have there been any signs at all of optimism in the Netherlands? You seem to come up against all the same brick walls as in UK. If one country could make a breakthrough it would help all I hope. The media are part of the problem but have written to Paul Thacker as he has written a piece in thebmj which is not at all naive and unusually open
Ths is it :-Feature
Tracking down John Bell: how the case of the Oxford professor exposes a transparency crisis in government
I read your stunning article in thebmj – I am circulating it as much as possible .
I write to ask for your help with raising awareness of the issue above. (MAID in Canada) People are becoming more and more pessimistic about finding a cure – but even before that stage although the condition is medically recognised they are being fobbed off and eventually seriously harmed by adverse effects of SSRIs – including sexual dysfunction which is not openly warned about by prescribers.
If you would care to contact Professor David Healy at McMasters university his details are firstname.lastname@example.org Or you are more than wecome to respond to me initially and I will forward to David.
With many thanks for your own article which provides important information for us all,
I am curious as to who found the ‘infamous’ slide 9 offensive. Was it Trump supporters? Feminists? Prudes?
Trump has been ruthlessly satirised, and pilloried by the world and its wife for years, so it can’t be that. Do Feminists feel Women who work in the Sex Industry are being put down?Stormy Daniels strikes me very much as a woman very much in control of what she does, who she has sex with and one of the few people attempting to stand up to Donald Trump. So is it Prudes?
Oxford Dictionary:Prude, A person who is or who claims to be easily shocked by matters relating to sex or nudity.
‘The sex was so ambiguous and romantic that none but a prude could find it objectionable.
Similar:Puritan, Prig, Killjoy
The Medical Profession is sadly full of Prudes, Prigs and Killjoys, none more so than Psychiatry.
How can a person, especially a young person feel OK about discussing PSSD, PGAD, PFS if they are confronted with Prudes, Prigs and Killjoys
Our 16 – 25 year olds are exposed daily to extremely graphic pornography. They also have a street vocabulary that goes beyond, medical terms relating to matters sexual. Those working in this area need to recognise and understand this.
Sent by a person who would prefer not to be named :-
A North Walian said :-
I have spent some time pondering over some of the issues raised and there are many but so much seems to be linked together! It’s the sort of topic you discuss endlessly with college friends and hope fervently that you never have to think about it seriously, ever.
Physical and mental health is finely balanced but there does seem, to the non medic at least, times when one seems to take centre stage, so to speak. Advances in medicine, treatment and care might help to make the lives of some people more bearable whilst they endure very distressing situations suffering great pain with no hope of improvement. Some people seem to have the mental strength to remain positive, those who struggle might cope better with better care.
Some of those who suffer with mental health issues might perhaps improve with the correct help and support? There could be times when their judgment would be seriously impaired.
Therefore, although I do not categorically oppose MAiD I would not like to see it introduced in this country (Wales) – life is precious and to administer a lethal dose would be a terrible burden for someone to live with.
Heaps of praise for your A1 Comment
The doubting of the Doctor v Patient
My Doctor was a woman older than me, I was 51. She came out of retirement for a last stab at doctoring when she saw an advert for a position in a village which she could do as it came with accommodation as she lived on an Island.
Prude – full marks to Anne-Marie with alcohol
“She said she had a glass of wine but I suspect it was more than that”
I took a bottle of wine as a present for her when she invited me to stay with my daughter and five guinea pigs. We took the piggies in their hutches and built a run in her garden –
“We don’t drink” she said
She lived with an alcoholic as her partner.
During that week she was called to stay for two days back to our village.
We were left in her house with an alcoholic.
After all her insults to me with Seroxat “pull yourself together”
she completely changed tack
Most people who come to this surgery just need a day out shopping she would say.
After a long gap with no permanent owner of the surgery she told me that she knew someone in the \North of Scotland who might just like to take on this surgery. Enter Mr. Nova Scotia…
Dr. Nova Scotia said to me, everyone with depression suffers from brain zaps…
Spend some time with doctors, in their time, and you will learn an awful lot – as Richard Bentall on the Life Scientific choking on his brother’s suicide and Simon Wessely dripping on about death threats – each to their own…
It’s not until you delve in to each, giving you a problem, that you learn that generalisations will never work and this is the mistake everyone is making….
If all is not going terrifically well with your doctor, maybe time to try a different tack … probing…
in to their private lives …