Editorial Note: This post continues from last week’s Persecution of Heretics. It’s about how only a Popular Movement with those suffering adverse effects on drugs speaking up can save us now. It adapts a talk given a month ago to the International Society for Ethical Psychology and Psychiatry in Los Angeles. It loses something without its slides. But it was recorded and may be put up on the web in due course. It was called:
Better to die on your feet than live on your knees
For the last 10 years I have regularly been asked whether things are getting better, with the interviewer anticipating an answer that, in response to efforts of Bob Whitaker, Peter Gøtzsche and others to spread the news about what industry has been doing wrong, ‘yes they are getting better’.
They aren’t getting better.
We are living in a New Censorship. This is an era when efforts to adhere to the norms of medicine and science by bringing treatment related adverse events to light risk being interpreted under trade agreements as an interference with the capacity of corporations to trade so that governments are all but obliged to shut down criticisms of corporations or their products.
In terms of adverse events for two decades the company response was that if controlled trials had not linked antidepressants to homicide or suicide then any links were just coincidental. Now that controlled trials have shown the link, the company response to very clear cases of treatment induced problems comes close to Holocaust Denialism.
So is it not time to speak up? Nope it’s not.
This lesson was brought home to me years ago by a PR person for Prozac delighted to inform me that I was doing more the sales of Prozac than anyone else or indications that when GSK were faced with a Paxil Causes Birth Defects labelling they figured this was a good time to sell Paxil.
So how do you puzzle Pharma?
Fairy tales
Most of us concerned about the many harms in healthcare we see around us see ourselves figure that if “our” experts have the opportunity to speak the scales will fall from the world’s eyes.
But even if a program about the antidepressants were stuffed full of all the good guys saying all the things that they really want to say in an uninhibited way, the average person watching will hear Cymbalta, Humira and Abilify and will not hear what went with those words.
They see experts on screen regard themselves as the good guys. They infer many more experts off screen whose views are endorsed by “our” government and by every government, and by my doctor.
Their response is:
“why is our government letting a minority view like this be heard, one that is going to scare patients away from treatment, cost lives, leave people untreated so that they are a drag on the economy and lead to industry dis-investment in our country? Why is our government letting this happen?”
Programs like this are a fairy tale of good guys and bad guys – when the world isn’t like this. A fairy tale where good triumphs – when the world isn’t like this. A world where when a girl says the emperor has no clothes, people pay heed.
The medical model
I recently caused grief to the makers of a documentary called ‘Bought’, which is a beautifully produced program about the corrupting power of Pharma, by asking them to omit the sections that had me in them even though I was very pleased with the material that was actually there. My problem was the context. It was anti the medical model.
Most of you in the room are critical of the medical model.
I’m a supporter of the medical model. I have never called for a drug to be removed from the market and I can’t envisage calling for the removal of any.
I turn down invitations to meetings with great casts of speakers – like Bob Whitaker – which are heavily slanted toward nutritional or alternate approaches. I have nothing against good nutrition or many complementary treatments – except in so far as these can be perceived as replacing medicine.
Why? I want to save medicine not set up an alternate shop. This is where the 99% are always going to be. If Pharma can portray any of us as part of the 1% it might do wonders for our niche status but it will be the end of any opportunity to make a meaningful difference.
The actuarial model
I’m not asking any of you to come over to the medical model, but I do want you to recognize that this is where most patients and most doctors are. That said, there are huge areas of agreement between all of you here and me – I think what most people are reacting with hostility to is not the medical model but the actuarial model.
We likely agree that most controlled trials in medicine rely on surrogate outcomes and that these are flawed endpoints, particularly within mental health. This applies to psychotherapy trials also.
We likely agree that close to 100% of controlled trials of brand medicines are ghost written these days and when these advertisements are embedded in guidelines and accompanied by a lack of access to the data from the controlled trials in question, this is very dangerous.
These controlled trials and quantitative approaches in general – whether drug or psychotherapy trials – have helped industry steer healthcare into a risk management domain, an actuarial domain that poses real risks to individuals. It locates the risks in you rather than the environment or the lack of services your hospital offers and tells the management that the risks in you can be fixed with a pill.
Many of my medical colleagues see trials as the way to keep complementary, or or homeopathic treatments out of healthcare. This is what makes trials the touchstone of evidence based medicine, the one true article of faith, for many.
Most people are just concerned about the ghostwriting of trials and the hiding of data but I don’t think controlled trials work. Unless we are very alert, controlled trials get answers that can be deeply misleading as when a trial of antidepressants appears to show that these drugs that can cause suicide in fact save lives or thalidomide is safe and effective.
Controlled trials can be useful but they are mechanical exercises and not a substitute for thought. Unless handled with care, they generate ignorance not knowledge – and they aren’t handled with care.
Imprisoned
An equally serious problem is the fact that drug treatments that have supposedly been shown to work by controlled trials are made available on prescription only.
Prescription only status was introduced as a means to contain addicts. You must all sense that when you go to a doctor today, there may be pleasantries but you are essentially treated like an addict. The reality is so shocking that we manage to ignore it but there are times when ignoring it becomes impossible.
This managing of addicts model becomes a problem against the background of an apparatus that dictates what a doctor is going to do, marketing that is better characterized as propaganda, guidelines and a range of other pressures. Most doctors are at a point where it is close to impossible for them not to treat you with inferior, more dangerous and more expensive treatments. They do not have the freedom to treat you with what they might treat themselves with.
Mind, brain and power
Most of you here believe that in the mental health field managing the mental, or cognitive or psychological sides of clinical issues is more important than biology and drug treatment.
I don’t know if we are all mind or all body or some mix of the two – the question is irrelevant. What is relevant is who exercises power over us and we are entering a world where despite the rhetoric of the times about empowerment and recovery, those of us who attend doctors and the doctors we attend are increasingly disempowered.
It is becoming impossible to practice medicine, as you’ll see when I define what I mean by medicine.
The place where this becomes most apparent is in the domain of adverse events. Forty years ago it only took two to three years from the point that the drug was released to the market to a recognition of its major risks, but today it can take 20 or 30 years before these risks are recognized.
Forty years ago, at the height of the troubles between Ireland and England when the IRA were at war with England, four innocent Irish people were jailed in Guildford, leading to efforts by English people to get these innocent Irish out of an English jail.
In response, the most senior judge in Britain, Lord Denning, the Master of the Rolls, considering the situation said that the prospect that innocent people could have been jailed was so awful that even if they were innocent they should remain in jail so that public confidence in the law was not shaken.
This is a response rather like one imagines the response of the Bishops in the Catholic Church who, when faced with the scandal of pedophile priests, denied the reality of what was happening so that public confidence in the Church would not be damaged.
You might say we have seen where that ends but not so – Catholics are only questioning the Church now that it has lost its grip on them. The situation we are in medicine is more like that of foot soldiers in the armies of ISIL. When questioning leads to beheading, there’s not as much questioning.
We have managed to engineer a situation where in order to maintain public confidence in healthcare, the level of denial of adverse events on treatment is coming close to psychotic. In order to maintain the fiction, the “system” intimidates its agents – doctors – who slipped into this role by virtue of the fact that all these drugs are made available on prescription-only.
Getting engaged to a doctor
Medicine was a relationship where you bought certain problems to a person who had a medical training as opposed to a pastoral or other training.
You expected this person to exercise professional judgement on your behalf. They would neither be an agent of the State nor in hoc to private interests.
You expected wisdom from a good doctor – an ability to recognize that unhappiness after a birth was more likely linked to unhappiness in a marriage than to hormones. Someone who knew that children’s development varied and few if any children needed treating with drugs. Someone who would rarely recommend anything in pregnancy.
Someone who would review your lifestyle and situation and might know the issues facing your community and would often make recommendations about altering something in these areas rather than dispense a medicine in response to ticking a sufficient number of boxes on a standardized list of questions.
Unlike others you could go to who could do all these things, a medical person if faced with the right kind of problem could also use a poison. The magic of medicine lay in the ability to bring good out of certain bad situations through the use of a poison – or a mutilation in the case of surgery.
To do this requires vigilance on the part of the doctor and the patients and the patient’s family. It cannot be done where the fact that drugs are poisons is denied. It cannot be done in a culture in which drugs are regarded as fertilizers to be sprinkled as widely as possible and from as young an age as possible.
Because they are poisons and mutilations, as Philippe Pinel said two hundred years ago the doctor only becomes a true practitioner of the art when she knows when not to poison or mutilate.
Continued in Part 2.
Toni says
Interesting perspective. Some medications might be valid but some need to be banned. Would you continue on with medications that have been proven to be unsafe? There is example after example of drugs that have been rushed and pushed through clinical trials in the U.S. only to find the drug unsafe, yet it takes sometimes years to get off the market. The industry is corrupt. I do not like the medical model. Doctors being trained by pharma-backed med schools, reading pharma-backed professional magazines, being romanced by pharmaceutical reps making me too drugs for obscene profit (Dr. Marcia Angell). I am but a lay person but I know more about Cymbalta than most M.D.s because I lost a family member to this vile drug. I administrate a group on Facebook with over 700 Cymbalta victims and survivors where chilling stories are shared. The death, long term physical injury, divorce, lives destroyed by this drug goes beyond the pale. You can keep the corrupt medical model and I will continue working with people like Dr. and Ginger Breggin, Ann Blake Tracy, Dr. Kelly Brogan, Chemist, Shane Ellison and others. Besides the brain, gut, liver, etc. damage these have all been proven to be no better than placebo (yet a lot more dangerous). I respectfully disagree, some drugs need to be banned and most of them are the psychotropic kind.
Dr. David Healy says
Toni
Thanks for this. Please read Better to Die RxISKing it (Part 2) which will run tomorrow or Friday. The bottom line is this – whatever we people say they believe, the key thing is what people in fact do and RxISK is all about getting people to do something – to wake up from the 50 year slumber that PharMaleficent has put them in and say Wait a minute, this drug has caused this and this etc
On this score it would be wonderful if you could get some or all of your 700 to file RxISK reports on the problems Cymbalta has caused them. The Night of the Living Cymbalta RxISK story we have has attracted a huge amount of comment and will feature in a legal case I am currently involved in that might offer a vehicle for you and others to get a message about this and related drugs to a wider world
David
Toni says
Thank you for your response. I will post your statement in the group and see what goes. Best wishes on success with your efforts.
Bruce G Charlton says
When you are correct, as you are, 100 percent correct, but are overwhelmingly outnumbered by people who are wrong – people do not care enough about it to self-correct; then the prospects for winning are extremely small.
The situation is analogous to being a real Christian in this modern world where secular Leftism is almost totally dominant – even/ especially among the leadership in the major Western churches.
The answer is analogous too – the real Christian nowadays necessarily focuses on saving individual souls (one at a time) rather than ‘converting the nation’; and real doctors/ psychiatrists likewise need to focus on ‘saving’ individual patients (one at a time) however and wherever they can – since they cannot beat the forces massed against them.
(Note: the Roman Catholic problems you describe came *after* the Leftist ‘reforms’ of Vatican II, overwhelmingly among the advocates of Vatican II, and were covered up by the dominant ‘liberals’ of the church. Furthermore, those mass media journalists who have exposed (and also misled and lied about) the paedophilia, did so while concealing the overwhelming sexual orientation of the abusers. Thus, what was objectively an indictment of theological and sexual revolution has been spun by the mass media as an indictment of ‘traditional’ religion. I say this as someone neither a past nor present Roman Catholic, nor a Roman Catholic apologist – these are just the facts.)
Robin Clarke says
You appear to be indicating that 99% of people trust their doctors and their advice. Is there any evidential basis for such a high number? The only review I’ve seen is reported as follows.
“reported in the Oct. 23 issue of the New England Journal of Medicine:,
Overall, 58 percent of Americans agreed with the statement: “All things considered, doctors [in your country] can be trusted.”
That compared with three-quarters or more of the populations in countries including Switzerland, Denmark, the Netherlands, the United Kingdom and France.”
And I suspect going down further. Health stores now sell far more vits and herbs than they used to, Shoving Goetzche’s book in my 87-yrs mother’s face appears to have eventually liberated her from the notion that the doctors are her friends. Yes, the professions are more ‘policed’ than ever, but the public isn’t. And a system built on people being terrorised into lying has its fragilities. One nurse got obviously nervous when the subject of whether I’d have a vaccine came up (required to get a honorary res fell certification). And in a chat at local hospital, an nhs receptionist said under her breath “Have you considered homeopathy”…!
Anon. says
I wish you well in your quest to save medicine. As for me, having lost my precious child to Zyprexa, seen horrible end-of-life care given to people close to me, and having lived through a long, naive, yet heartfelt period of trying to “save medicine” in my own way, I have sympathy for your goal yet no energy for it. While I am happy to donate to “The Foundation for Excellence in Mental Health Care” (which includes being able to designate the donation to RISKx.org -which I did), I have enthusiasm for alternatives to Western medicine( which has stolen so many of our loved ones away under the guise of “helping”). Shunning prescription drug ads by not watching television is just one of the many strategies I must employ to keep my own mental health intact and feel that I have something to offer both those that I love and the world at large. When one lives with the knowledge of the continuing slaughter of innocents, watching while the medical profession in general “goes along to get along”, and while the media, the academy, and governments permit themselves to be bought by BigPharma, plus having suffered such a devastating personal loss, one must navigate the shoals of despair in a careful way. Shunning Western medicine and exploring alternatives to it gives a sense of power back that was completely taken away.
That said, my surviving child is alive thanks to penicillin. Though she is deaf as a result, she is leading a kind and brilliant life. So I know there is a place for Western medicine in certain circumstances. However, I must leave any reform that can be achieved in it to others.
Brooks says
The pharmaceutical companies are so horribly corrupt and get away with it because of all the money backing them. I took an SSRI (fluvoxamine) and now have permanent sexual dysfunction. I cant wait until I pass the bar so that i can represent all of the PSSD victims in a class action lawsuit, of course as soon as I do I know that I will wound up dead from some mysterious circumstance.
Carla says
Erin Brockovich- Inspiring Movie
This movie always inspires me.
Her determination and sheer perseverance, are a living testimony that anyone can achieve especially, when they don’t give up.
Her passion was to help people who had become severely ill by making those who had done wrong, pay for their mistakes.
A ‘greedy’ water company, was not following protocol.
Through their NEGLIGENCE, the locals drinking water, had become contaminated.
She was going to get down to the bottom of what was happening and make that water company accountable.
That water company was scre*ed when Erin came on the scene.
She had to have proof and evidence that the water company was doing the wrong thing.
What if there was a similar twist to that story and someone exposed greedy drug companies by bringing the dead forward, as proof and evidence.
That would be the first in history where someone’s experience speaks for the dead.
As far as I am concerned, if someone harms someone, that individual or individuals should be held accountable.
Big pharma, may have the upper hand at first, however, it takes a ‘little ordinary person’ to expose their ‘dirty little secrets!’
If you think you can bury something, think twice.
You have all made a BIG MISTAKE by messing with someone who knows the workings of your secretive dirty games.
Mastering how corrupt organizations work, is an art in itself.
You are not as ‘squeaky clean’ as you think you are!
Just when you thought, NO ONE would ever make the connection, some one, who you underestimated, put the pieces together.
The law may have protected you but not for long!
Moral of the story:
Never underestimate the power of a little person.
They will make sure that corruption is exposed and make your day a living nightmare.
Just like you made mine, a LIVING NIGHTMARE!
For the sake of all the innocent people who have died or been maimed, it is better to save face and come forward now.
It is not about the money.
It is about what you have done to each and every individual.
It is about their lives, their families and the quality of life, they will never truly have.
PS:
There is a common thread going on here.
It is not coincidental when innocent people die from cerebral aneurysm, coronary thrombosis or some other sinister death.
Those ‘poison of a python’ pills that are ‘deemed safe’ are killing innocent people.
What if big pharma are manufacturing random flawed batches?
I know, because it happened to my husband and I.
It is not coincidental and it is not coincidental when it happens to others.
It is not something that just happens!
Omission of information = FRAUD
We also have to be concerned about the food and water we drink.
Also the products we consume.
It impacts every one and everyone should be concerned.