1 Boring Old Man

I’ve written about this before, but every time it comes up, it seems to bring a new wave of anger and disillusionment. The topic is the Pharmaceutical Industry buy out of Academic Psychiatry. On this blog, I spend a lot of time preoccupied with Industry, specifically the oil and finacial industries, influencing government. While that bothers me from afar, the Drug Company invasion of Academic Psychiatry is much closer to home, because it had a direct impact on my own life – leaving me uncharacteristically bitter about something that mattered to me.

Background: I started my medical career with an eye towards basic research, but during an obligatory stint in the military, found that I really enjoyed clinical medicine and so I changed specialties – retraining in Psychiatry and Psychoanalysis. My job was directing a Psychiatric Residency Program and teaching Medical Students. By the early 1980’s, the Chairman of our Department was retiring, and we got a new Chairman. I lasted about a year, then quit and went into practice. While it’s a long story, the essence is simple. I didn’t have any idea what the new Chairman thought Psychiatry was. All he talked about was pharmacology and biology. That wasn’t what I was interested in, so I changed directions. Actually, he lasted only a brief time himself, becoming Dean of the Medical School quickly, then leaving in a huff because the wouldn’t make him a Vice President. He’s now a Dean and a Vice President at another Medical School.

He was replaced by one of his former colleagues, Charles Nemeroff, who was a prominent drug researcher.  Nemeroff is now infamous for taking a wad of money from Drug Companies for promoting their products, exposed by the Senate Investigations of Charles Grassley [R-Iowa]. Nemeroff was removed as Chairman at Emory, and banned from NIH Grants there, but recently got around that by moving from Emory to the University of Miami. I’m way understating what a crook Nemeroff has turned out to be, and I’m leaving out how one of his proteges, Zach Stowe, was on the same gravy train, both promoting the GSK drug, PAXIL.

I don’t think about this much any more. At the time, it was a crazy-making thing in my life. I saw my profession which I loved turn into something trivial – picking drugs for symptoms instead of digging into the complexity of life that lay behind the human suffering we call mental illness. I left academic medicine feeling like I was a dinosaur at forty, replaced by a new breed of Medical Psychiatrists. I will admit to taking some consolation that the very people I fled have turned out to be Major League Liars and Industry Prostitutes, in it for the money.

Further Developments: So last night, I was watching a movie on television and a commercial came on that said something like this:

• If you took the drug PAXIL during pregnancy and
  
• Your child has a congenital heart defect [or any other birth defect] then
  
• Contact <some law firm> because
  
• You may be eligible for compensation blah blah blah

So off I go to the Internet where I learn that Dr. Nemeroff and Dr. Stowe, in their promoting PAXIL for pay, not only gave numerous talks about the drug, but also published a number of articles that were ghost-written by people paid by GSK. Worse than that, they implied that these drugs could be used safely in pregnancy, and it turns out that they can’t. There are apparently cardiac birth defects in the children of PAXIL users at a high rate and this was known early but ignored by these researchers. Here‘s just one of the many articles about this scattered all over the Internet. And here‘s one about Nemeroff’s getting his new job in Miami, using an old NIMH connection..

Thoughts: I wish I could just feel outrage about all of this. Unfortunately, what I feel is more like grief. The thing that interested me in Psychiatry was the long, arduous kind of psychotherapeutic work that is like archeology – going back into the past and trying to find the roots of neurosis. In the middle of my career, my specialty was changed into something I didn’t believe in – that there was a pill for every symptom. So I went about doing the thing I had learned to do on my own. It was a good career, but it wasn’t what I wanted to do. I like teaching, and the kind of high level dialog that comes with university life. I lost a lot of that in this story.

But more than that, I lived through a time when what I consider to be science was replaced by greed and corruption, masquerading as science. I almost feel guilty that I left, rather than doing something about it. I know that’s a ridiculous [and grandiose] thought. It hadn’t really happened yet when I left, but I could see it coming. I knew these people were up to no good, as did a lot of my colleagues – some of whom stayed. It helps me understand how those career government officials that left in droves when Bush got elected must have felt. They knew something was wrong, but were powerless to do anything about it. That’s how I felt – like what I’d spent my life learning was no longer valued, like the things I taught were out of date, like a dinosaur, obsolete.

It’s not lost on me that all of this started in the same period that I now write about with our country’s politics – the era of Ronald Reagan. It’s as if everything changed then. We "business-i-fied" and in the process seemed to lose what was important about us. I guess I think of it as the Trivialization of American Life. I sometimes wonder if my own personal experience contributes to the feeling of bitterness I have about all of this. Whether that’s true of not would not be for me to decide. But the deterioration of integrity seems pervasive to me. I sure don’t like it, not one bit…

Dr. Charles Nemeroff and Dr. Zach Stowe: But those are the reflections based on my own experience. The story of these two supposed researchers, however, transcends my own experience. They are criminals, as guilty as the person who robs a bank or runs a Ponzi scheme. They used their positions in an academic institution to popularize a widely used drug through lectures and publications for pay. Some of their purportedly scientific articles were ghost-written by people hired by the drug company itself. And it turns out that that drug is actually harmful to people when used as they suggested [a congenital heart defect is serious business]. Even after being censured and removed from his job, Dr. Nemeroff found a way to try to get back on the gravy train at another Medical Institution.