So Long and Thanks for all the Fish portrayed doctors in a rather flattering light – the victims of a tragedy. They were portrayed as losing out in a Faustian bargain when they failed to realize the hazards in making all new drugs available on prescription only. The bargain offered them a chance to entrench themselves inescapably in healthcare as the only legal source of all treatments that worked instead of having to achieve this position because of their professional values or the benefits they, rather than their drugs, might bring to the table.
Forcing people into coming to see you rather than having them come because of something distinctive you offer turns out to have been a first unwitting step toward tyranny. In the process medicine has lost its soul.
Before 1962, the acme of the medical art lay in a concern for the safety of patients. Once doctors were made the conduit for new drugs, all of which were supposedly efficacious, they lost sight of safety.
Doctors now report as few as 1% of the fatal adverse events that happen on treatment. Doctors take 10-15 years after new and notable hazards of prescription drugs are first described to finally concede that these risks may be real. Even after treatment hazards come flagged up in Black Boxes, many doctors still deny that treatment could cause the problem. Many doctors have patients who are on 10-15 drugs at the same time and for indefinite periods, a recipe for treatment induced injury and death, so that unsurprisingly Pharmacosis – treatment induced injury and death – has become a leading cause of death.
But is the Lord of the Rings saga a better analogy for what has happened than the Faust story? Prescription-only privileges are the Precious that Gollum-Smedicine clutches tightly to itself, unaware that prescriptions are the key element in the route to power of the most powerful force on earth – the pharmaceutical industry.
The marketing departments of pharmaceutical companies focus in on the ring-bearers just as the Eye of Sauron focused in on Gollum and later Frodo. Once the Eye fixes on a ring-bearer, it hypnotizes him into submission. If any demur, it directs its Black Riders (Medical Academics) to enforce compliance with its Will.
At present the focus is to the tune of roughly $60,000 per doctor per annum in the United States. Under the intensity of this gaze doctors have learnt to shun the light of disclosure and are complicit in letting the industry get away with non-disclosure of clinical trial results. Doctors have visibly shrunk the way Gollum did.
In recent years prescription-only privileges have fallen into the hands of nurses and pharmacists – a set of hobbits. They are as yet less affected by the influence of Sauron. They still hope they can put things right.
The lesson from Lord of the Rings though is that Hobbits cannot save us. However good their intentions, they too succumb to the power of the Ring. In the end it was Gollum-Smedicine desperately trying to reclaim his Precious who tumbled into the chasm of Mount MooD and in so doing saved us all.
One Script to rule them all
One Script to find them
One Script to bring them all
and in the darkness bind them
in the Land of Mordough where the shadows lie
According to the College of Physicians and Surgeons of Ontario, it is expected that there will be approximately 340,000 preventable adverse drug reactions in the province this year,resulting in 240,000 physician office visits, 36,000
hospitalizations and 4,000 deaths. The proposed solution to this situation is electronic prescribing directly to a pharmacy. This is yet another example of the frightening change in medicine: give a pill, or better yet, several pills and your duty as a physician is done – and, better yet, it will save time and you don’t need to pay a great deal of attention to the patient. I predict that there will soon be recipes available for physicians: for a patient of x age, complaining of symptoms a, c and w, prescription 72B is called for. Email the pharmacy and the job’s done. Next patient please!
The leash attaching physicians to Big Pharma is getting shorter and shorter. The blandishments of the pharmaceutical companies may feel like a hug at first but so does a rope around the neck
This site is not for the faint hearted.
I had a rope around my neck on 21 July 2002, and I had a vision of myself hanging and I decided not to do it. I tried other means instead, because I was off Seroxat for eight weeks and was in a place no-one could appreciate.
A rope around the neck, how many have actually done it?
My god, how am I expected to live with this near curtailment of my life due to Seroxat?
Well, I will, and be damned the nasty, ruthless, cruel, villains of society.
Pharma and it’s geddon.
I can imagine going into a GP or ex-Psychiatrist and quoting this line “The marketing departments of pharmaceutical companies focus in on the ring-bearers just as the Eye of Sauron focused in on Gollum and later Frodo. Once the Eye fixes on a ring-bearer, it hypnotizes him into submission”.
Diagnosis would probably be: woman in hypomanic state and delusional with grandiose ideas 🙂
I have been told that I’m non-compliant , that drugs are not made for a’la carte people like me and that I talk philosophy when the GP is a Scientist. Well I have a MSc. and know what science is about, but give me Philosophy and pursuit of wisdom any day.
I developed symptoms of Bipolar 4 years ago while on an SSRI (I do feel it was one of the triggers). I was told I was “non-compliant” when I refused to up my dose of Seroquel from 150mg to 200mg and had stopped Lithium for 2 days due to a medical problem which could have resulted in it becoming toxic in my body. One 200mg tablet resulted in anger bubbling to the surface fast and 150mg had me in bed until 2 or 3pm in the afternoon, which was hardly a “cure”.
I no longer take medication, except very occasionally. I stopped about 1 year ago but probably could have done with an expert to help with stopping. I’m now realising the dangers of withdrawal. Nearly 4 years ago I spent 1 month in hospital thinking that I had a “breakdown” but in hindsight, after meeting Psychiatrist/Psychotherapist Ivor Browne in Dublin a few months ago, I realised it was mainly withdrawal that I was going through. I had stopped all medication cold turkey 2 weeks before. I do feel that doctors need more education in the area of withdrawal. And that patients need to be more informed by their doctors. I admire the work of Professor David Healy in this area.
If a person learns to breath and manage stress it is half the battle. Buddhist Mindfulness Meditation is the way forward and a few other holistic approaches eg diet. And living life in the PRESENT. I try not to be seduced by the “high” (or to engage with the Ego) and realise I have a certain amount of control over my own biochemistry. While the scientific mind may find it hard to relate to, I am a believer in Energy Psychology eg bio-energy, Reiki and Emotional Freedom Techniques (EFT). If it works for me that is enough proof. I realise that everyone is unique, and what works for one person may not work for another).
Here are some nice meditations for anyone that may read this and be interested:
http://www.trainyourbrainmeditation.com/Starting_a_meditation_practice.html
My father had Alzheimers
– he was nearly 90 and on about 6 different drugs and put on Rispiridon first of all and then Seroquel.
My daughter has just left the care of the Bethlem Royal Hospial where members of Speak Out Against Psychiatry – surviving patients from the drugs staged a demonstration in protest at the shocking care and the fact that this research hospital could not seem to care less about patient welfare judging by the shocking research papers I have obtained. Instead of advertising for paid participants to drugs trials they use poor weakened vulnerable patients and get the funding no doubt from the drugs manufacturers. Clozapine is the chosen drug and you should see the reports on this! This hospital should be named Pharmageddon in my opinion. See Speak Out Against Psychiatry’s website. I think it is brilliant that your book which I have gives such an honest account. Now that I have seen these research papers I want the world to know about these.
Hang in there Annie! You are already among the winners, even if it doesn’t always feel like it on an average day. Each one of us who survives and thrives is a victory — especially those like you who have a rebel spirit and refuse to sit down and shut up.
All that is gold does not glitter
Not all those who wander are Chemically Imbalanced …
(sorry Mr Tolkien)
A very insightful post Dr. Healey.
As a “hobbit”, an advance practice pharmacist who has done some non-dependent prescribing drugs, I too felt the Eye of Sauron on me when it was perceived I had prescribing privileges or influence. I resisted the call for most of the time but even then, one time a physician mentor pointed out my undue reliance on one drug and its untoward downstream effects (never mind that other physicians prescribed inappropriately more often, he knew I would listen and learn).
It is also very difficult to wrest those under the influence of the Eye to see more clearly. This was and remains my most important role today. Physicians did not like me, were often rude, discredited me, or totally ignored me most of my professional life. However, it was said “I made them honest”….
Ann, it may be difficult, but find an interested pharmacist, preferably an independent one who could find you articles, steer you towards open and competent psychiatrists, navigate the medical system or formulate specialized drug concentrations for easier withdrawal. Good Luck.
Susan
The use of antipsychotics in patients such as your father is not only unforgiveable, it’s without any purpose other than to sedate so that staff don’t have to spend time attending to the patient’s wants and needs. In addition to working with persons who have various cognitive/dementing disorders, I do a considerable amount of consultation for adult patients with developmental/learning disorders and have become familiar with the work of Dr Mark Hauser of Harvard Medical School. His recommendations for assessment and treatment of these difficult to treat adults are among the most rational and sensible as well as being quite clear about important issues. They are as applicable to the elderly with dementias as for those “dually diagnosed” i.e. Low I.Q. and psychiatric disorder. For example: “Psychopharmacologic Treatment.
The use of medications should be reserved for appropriate target disorders and syndromes. Medications should not be administered to the patient simply as a response to staff anxiety. To avoid this common pitfall, the psychiatrist may need to confront staff expectations skillfully, explaining that although “we all would want to have a medication that would treat the symptoms without side effects,” such a medication does not exist. Emphasizing the possible environmental causes of problem behaviors can also help reduce the demand for indiscriminate prescription of medications. When antipsychotic drugs are used for non-specific sedation, the danger is that their use will be continued indefinitely, resulting in preventable side effects.”
This site is pure gold……………
Thanks, Johanna, for a witty piece directed at me, and thoughtful, too.
In ten years, I can honestly say that not one person, private or professional has actally said I am winner. I felt like a winner today; I almost felt like I did ten years ago before I was befuddled with Seroxat, Valium, Ativan, Propanolol, Prozac, Diazepam; I really, for the life of me, do not understand how I let all these professionals give me all these drugs in the course of two years and then wanting to give me even more, and then amazed that I ditched the lot in one foul swoop. And guess what? I survived without them and I am now determined to be even better and bolder for it and I am looking forward to calmly, boldly, sensibly and intelligently using my new clarity to outwit the misfits who put me assunder.
Perhaps, after ten years I am finally cleansed and detoxed.
Clean from prescription drugs. I cannot believe I was there, in the land of far, far away, where Shrek lives – a monster, alienated from society because he is different; but he is kind, compassionate, loving and brave. Where was my Fiona when I needed her. Inside myself. Am I really back. That would be something.
The battle for supremacy by drug manufacturers is not new as is noted by Avorn in the New England Journal of Medicine, July 19, 2012. The makers of “patent medicines” were not even required to list the contents of the products up until the early 1900s. The Wiley Commission, intending to introduce laws governing the production of medicines, “desired to have the new law go into operation with the least possible disturbance to business and with the least possible inconvenience to the [patent medicine] manufacturers and dealers of the country” (1906). This may have been the first appearance of the Eye of Sauron.
Lack of awareness of adverse effects by physicians is not new either.
Avorn says: In 1938, Grabfield argued that deficits in physicians’ knowledge contributed to the drug-safety problem, noting that the teaching of pharmacology and preventive medicine “is deficient in most schools. After graduation it should become the concern of the legally constituted health authorities to keep the physicians under their jurisdiction continually conscious of these pitfalls of therapeutics. . . .Education, continuous and unremitting, is the only practicable method of breaking down the hold that proprietary medicine has upon the medical and lay public.”
Has anything changed?
http://ia600503.us.archive.org/0/items/sketchoflifeofel00ston/sketchoflifeofel00ston_djvu.txt
Boston Public Library
1842
Elizabeth T. Stone
Charleston McLean Assylum
Pretence of Insanity
This was a riveting read, Irene, and hope you find it.
Even then the drugs were playing with the mind.
So no change there then.
A randomized trial described in the Canadian Medical Association Journal might lend itself well to the prescription practices surrounding antidepressants and other psychotropic meds. (CMAJ July 30, 2012) In the study, nine family practice teaching units either provided usual care (control group) or underwent a shared decision-making training program (intervention group). The 4-hour training program taught providers to better communicate to patients the odds of having a bacterial acute respiratory infection, as well as the risks and benefits of using antibiotics. Some 350 patients with acute respiratory infections were then evaluated. Patients in the intervention group were significantly less likely to choose to use antibiotics after their evaluation, compared with controls (27% vs. 52%). “Two weeks later, quality-of-life scores and the need for repeat consultation did not differ between the groups. The shared decision-making program enhanced patient participation in decision-making and led to fewer patients deciding to use antibiotics for acute respiratory infections. This reduction did not have a negative effect on patient outcomes 2 weeks after consultation.”
Let’s substitute “depression” for respiratory infection and “antidepressants” for antibiotics and see what happens, shall we?