wisdom in his pages…

Posted on Monday 6 February 2012

Dr. Healy’s Pharmageddon is one of those books to be read, not summarized. It’s not that it’s filled with new information. He sees what the rest of us see, albeit from the position more interior than most – a neuroscientist who has been embedded in the scene. He writes about the primacy of the pharmaceutical industry, the corruption of academic medicine, the rise of the clinical research industry and the sequestration of their data, the deification of statistics, ghost-writing, etc – the things many of us decry and can’t seem to stop writing about. But what’s different about this book is first that Dr. Healy doesn’t stop with this obvious symptom list, he goes on to generalize these symptoms beyond the boundaries of psychiatry and mental health to the entire domain of modern medicine [and perhaps beyond]. While most of us remain preoccupied with the self-serving greed that lies just under the surface of these symptoms, Dr. Healy rises above [or gets underneath?] the obvious and tells us stories of how former attempts to keep this predictable human force [greed] in check in previous times have backfired and lead us to the present – the law of unintended consequences prevails [with a lot of help from a determined industry].

I keep saying that I’m not going to review the book, but it’s not because I don’t want to. It’s because even though I’ve come to see many of the same things Dr. Healy sees in my travels as a physician and psychiatrist, his explanations feel intuitively correct and illuminating while at the same time inducing a feeling of cognitive dissonance. My last post [on being a Medicine-Man…] seemed silly to me even as I wrote it, but it was an attempt to say something about the cognitive dissonance I feel after reading Healy’s book. I hardly think of myself as a Medicine-Man like Professor Marvel in the Wizard of Oz, but I feel like one in my current role in the clinic. The only resources available to me are short sessions and a prescription pad. That’s hardly the way I ever wanted to practice medicine. So my only choice is to be a good Medicine-Man rather than a bad Medicine-Man. I suppose the other choice is to stop volunteering, which seems wrong because those patients would go back to being on multiple medicines piled on by doctors who understand neither mental illnesses nor these medicines – doctors I know personally and like, doctors who are also working for free in retirement because they like people and want to help them [and do]. But the point here is that Dr. Healy’s book is editorial enough to make me aware that even in my retirement, I find myself being a part of the very thing I decry on this blog – being a Medicine-Man – something I largely escaped in my career.

David Healy MDAnother place Dr. Healy bores deeply into the problem is his take on medical science – specifically clinical trials, the sequestering of primary data, and the deification of statistics. I can only paraphrase what he has to say about all of this with an example from this blog. I started adult life as a mathematician with a math mind and graduate work in statistics during a hard science NIH fellowship. I can’t really escape that, so this blog is covered with graphs. I’m teased about that to this day by my friends – in that I can’t seem to talk without a pad and pencil making some kind of drawing, timeline, graph, etc. And yet you’d be hard put to find any comment about statistics in this blog except an occasional wise-crack about their misuse. And as I’ve gone through the FDA studies and publications in our literature, I’ve spent hours looking for the elusive primary data, to no avail. Statistical significance is not proof. Proof is something else. Dr. Healy makes this point in spades with example after example. I’ll forgo my version [because I’d probably start making diagrams and graphs]. He shows with narrative clarity how these tools of science have been perverted beyond recognition. He effectively takes on the whole enterprise of the clinical trials industry and its wierd science that has become a medical standard.

Estes Kefauver [D-TN]But where Healy shines even more brightly than usual is in his careful parsing of the history that’s lead us here – the history of how physicians became gatekeepers with the power of writing prescriptions, the rise and vicissitudes of the FDA, the story of the Kefauver Harris Amendment that was intended to insure efficacy, but has actually ended up perverting the very meaning of the term beyond recognition. He tells the story in a compelling way, so that the current trajectory of medicine, treating lifestyle and life rather than disease under the direction of industries with various motives makes very good sense [even though the cloud of cognitive dissonance hovers over each of his chapters because his analysis challenges so many current concepts]. His predictions are dour, because he fears that his solution – that physicians recall what they are actually for and reclaim their place – will be lost as the new doctors trained in these modern ways [Medicine-Men] take over and the old doctors fade away.

I share Healy’s alarm [though not all of his gloom]. The way things are now in medicine deserve every bit if his scrutiny and worry. It’s a mess – uninsured people everywhere creating a Caste System for the sick while focusing on taking statins and phosphates to prevent the statistical possibility of future unlikely problems; doctors and patients lost in a tangle between selling products and cost containment, preventive medicine, amazing new devices, and deteriorating healthcare. If there’s a conundrum to be found, modern medicine has its foot firmly planted in its midst. Something will have to change – and the direction of that change is not at all clear. But the best tradition of medicine in the face of diseases of unclear origin is to study them carefully, clarifying what can be understood, reformulating questions into increasingly precise packets for future understanding, focusing attention on the essential factors that have been overlooked, grappling with the increasing complexity and ambiguity of the exploration until the time when simplicity is justifed, and making sure that action is curbed until one is sure that the action does no harm, now and in the future. By that standard, Pharmageddon is a medical masterpiece. So, I’m going to read it again [maybe more than once] until the cognitive dissonance finally subsides. Maybe then I’ll be able to do that book review I can’t yet muster. There’s a wisdom in his pages beyond that available on a first sitting…
  1.  
    Joel Hassman, MD
    February 6, 2012 | 3:35 PM
     

    Is the book out yet, because I sought it on the net a couple weeks ago and was told it is available in March?

    What will be interesting and pathetic to learn at the same time is who will attack this expose just for the sake of ‘protecting’ medicine. It gets harder each week to hear patients tell me stories about care interventions by other providers that is hard to see the word ‘care’ be applicable to the intervention.

    I think it was Tom Gutheil who wrote back in 1998, the Journal of Psychiatric Practice for the Forensic column there, about reporting impaired colleagues, but the issue of impairment is not just about substance abuse or fraud, but also being clueless and refusing to accept standards of care that are appropriate and defendable. That is what bothers me in our profession at times too.

  2.  
    February 6, 2012 | 3:48 PM
     

    I pre-ordered it from Amazon and it said “due out in March,” but within days [January 26th], it was delivered by my local UPS truck here in the hinterland. This is from my “order history”:

    Order Placed: January 22, 2012
    Amazon.com order number: 104-2496749-9278608
    Order Total: $34.50
    Shipment #1: Shipped on January 24, 2012
    Delivery estimate:January 27, 2012

    I was pretty impressed!

  3.  
    February 6, 2012 | 4:04 PM
     

    Dr David Healy is actively on Twitter looking for media contacts in the U.S. to help promote the book:

    https://twitter.com/#!/DrDavidHealy/status/166243220148326401

    “Anyone have contacts in US media? Would love some help promoting Pharmageddon and RxISK.org. Many thanks. http://davidhealy.org/books/pharmageddon-is-the-story-of-a-tragedy

  4.  
    Stan
    February 6, 2012 | 5:38 PM
     

    http://www.progressiveradionetwork.com/the-dr-peter-breggin-hour/ Peter Breggin commenting upon David Healy today on his radio show “a biological psychiatrist that has stands behind some of the most barbaric practices in psychiatry today” shared this interesting & critical point of view when answering questions about the big picture of creating positive solutions & change.

    I would really like to see Micky, Peter, Bob Whitaker, and David have a public sit down or broadcast radio show of shared discussion/chat with us all. Just maybe the world renowned & influential Micky can do a little arm twisting and make it happen….:)

    Where is the common ground of formulating a platform of effective change to what we have today?

  5.  
    Stan
    February 6, 2012 | 6:05 PM
     

    addition to comment: It appears we’ll have to wait until archive broadcast for 2/6/12 is posted for listening..

  6.  
    February 8, 2012 | 11:33 AM
     

    David Healy calls for “making sure that action is curbed until one is sure that the action does no harm, now and in the future” but he does not take his own advice concerning shock treatment. He is a shock doctor, has run a shock ward in Wales, and wrote a glowing tribute to shock (2007). Healy has also attacked the psychiatric reform movement for years. David Healy’s ultimate solution (for depression for instance) is ECT, a treatment my husband Dr. Peter Breggin has documented as being closed head injury and an electrical lobotomy.

  7.  
    February 8, 2012 | 5:13 PM
     

    What I found interesing about the Breggin radio talk show is how Breggin did call him a “biological psychiatrist” and says Healy represents biological psychiatry “at its worst”. Being that most are on Twitter, Dr David Healy did respond to that and says it’s a quote he can now use.

    There will NOT ever be a coming together of like minds for one common goal if the KOLs clash and bash each other. One common ground we ALL seem to have is that psych meds ARE toxic, they ARE the only medical modality of care in the United States for mental health treatment, (which is not good imo) so therefore HOW can we all have a real discussion of such great importance when, for example, (listening to the radio show) Stan brings up this blog as well as Healy’s book and Breggin was quick to judge and ‘correct’ Stan, whom did not need correcting. (imo)

    NO doctor will ever be identical! thankfully there are some with open minds and who are willing to listen to patients and advocates and their horror stories of self or loved ones who have had reactions or been harmed by toxic psych meds.

    Frankly, I read, I listen and I take and leave bits here and there, info here and there, not all or nothing from one person.

  8.  
    February 8, 2012 | 5:18 PM
     

    The link for the call in radio show is

    http://www.progressiveradionetwork.com/the-dr-peter-breggin-hour/

    Archived 2-6-12 and the 3rd called about 15-16 minutes into the show brings up Healy, and Boring Old Man blog, and Breggin makes his remark about Healy.

  9.  
    Stan
    February 8, 2012 | 6:06 PM
     

    Why I found this particular foray somewhat disturbing is that “grassroots” appears to have a different meaning, or is taken in different context depending on the individual presenting the argument.

    Today I happen to see many opposition lone wolves (KOL’s) claiming a virtual patent upon the conscious of Psychiatry; When it’s become beyond obvious that there is little doubt about the unified common enemy.

    Pharmaceutical Corporate greed, power, and influence has polluted or tainted every treasured institution that we once could rely upon for some reasonable balance and scientific objectivity.

    The institutions of Medicine, academia, research, political corruption that permeates both coined conservative and progressive encampments, the supposed advocacy organizations that are nothing short of marketing fronts placating for drug company dollars, adding to unending stream of finely crafted media propaganda that now rules without ethically grounded parameters & is not bridled by the reigns of accountability.

    The pharmaceutical industry has crafted and implemented a seamless network of control, honed with a bottomless well of infused resources directed to a common goal & purpose. Pharma have and will continue to control the agenda and outcome until an organized opposition can be brought to bear against them.

    That is why I asked the question! Where is the common ground among are our leading voices? When will the fragmented voices/platforms come together as a acceptable & formidable force to meet head on this Goliath which now undoubtedly rules the day.

    One lone wolf can stand hollowing into the night sky bravely verbose in it’s splendor & intentions; yet , it’s a pack of wolves that creates a hunting force that can work in unified coordination bringing to bear the skills & cunning needed to bring to task a much larger common enemy in this historic battle for the hearts and minds of a our greater society.

  10.  
    February 8, 2012 | 9:23 PM
     

    This is Ginger Breggin. Folks, I was not criticizing Stan or anyone else other than Dr. Healy. Dr. Healy is the first person that I have criticized who presents himself as a part of the psychiatric reform movement. However, when he acts like he is a trusted reformer, it is important that people understand that in his heart and in his daily actions as a psychiatrist he implements the darkest side of the profession, brain damaging ECT. Further more he has a long history of attacking other reformers. It would be nice and indeed I have tried to simply ‘get along’ but Dr. Healy is a Trojan Horse. Let him inside our walls and at night the shock docs will come sneaking out and fall upon the people. Please see my more expanded remarks, with increased links, below. And please remember there are millions of people walking this earth with brain damage from electroshock.

    Dr. David Healy calls for “making sure that action is curbed until one is sure that the action does no harm, now and in the future” but he does not take his own advice concerning shock treatment. He is a shock doctor, has run a shock ward in Wales, and wrote a glowing tribute to shock (2007). Healy has also attacked the psychiatric reform movement for years. David Healy’s ultimate solution (for depression for instance) is ECT, a treatment my husband Dr. Peter Breggin has documented as being closed head injury and an electrical lobotomy.

    See:

    Healy attack of psych reform movement, for example”
    1. “there is no comparable protest against the use of antipsychotic drugs”
    2. “seems that the critics are behaving according to the romantic illusion that if they can just abolish ECT, mental illness will disappear”

    There has been a long and detailed attack by psychiatric reform figures against antipsychotics, antidepressants and other psychiatric drugs including Dr.Peter Breggin who published first medical text detailing documented damage by psychiatric drugs 1983, resulting in black box labeling of antipsychotics for Tardive Dyskinesia

    Other major psychiatric reform figures documenting damage done by psychiatric drugs have included Dr. Loren Mosher, Dr. Joseph Glenmullen and more; including protracted reform work by many psychiatric survivors of ECT, insulin shock, involuntary confinement and psychiatric drug treatment. These survivor advocates have included Judi Chamberlin, Rae Unzicker, Leonard Frank, to name a few. Many professionals and reform advocates from the earlier years are documented by Dr. Breggin in his book Toxic Psychiatry: Why Empathy, Therapy and Love must Replace the Drugs, Electroshock, and Biochemical Theories of the “New Psychiatry”

    Healy’s ECT book is a glowing tribute to shock within which he recommends shock for depression.

    Breggin (and other published resources) documenting damage of ECT: http://breggin.com/index.php?option=com_content&task=view&id=40&Itemid=52
    Video of invited presentation by Dr. Breggin on the damaging effects of ECT at the NIH Concensus Conference on ECT.

    Dr. Breggin’s most recent medical text (2008) on damage of ECT as well as damage of psychiatric drugs and role of FDA documents the damaging effects of electroshock including examination of animal studies that do show damage is done by ECT.

  11.  
    Joel Hassman, MD
    February 8, 2012 | 9:55 PM
     

    ECT is not a black and white issue. Just like abortion is not as well. There are times where there are legitimate indications, times where it is not warranted, and a sizeable gray zone where both patient and provider have to sift through the risk/benefit profile for some time before the best decision can be hoped to pursue.

    It is interesting to read that Healy is a pro-ECT advocate though. It is tough to decide what is more invasive at the end of the day, ECT or ongoing medication use. Again, not black and white to me.

  12.  
    February 8, 2012 | 11:21 PM
     

    I appreciate knowing all presentations of information that’s for sure. At the end of the day for me, I know I would not have ever approved of ECT for my daughter’s care (no one has ever suggested it) and I know she is also negatively affected permanently by psychiatric medicines which are chemicals that short circuited her brain.

    Big picture is pharma funds research, sponsors studies, pays doctors to speak and train other doctors with a slant to rx their medicine…ppl are injured daily by psych meds, and kids as young as toddlers are on antipsychotics, this has got to stop and someone has to speak up.

    Healy has written a good post on the antidepressant suicide studies referenced in another post recently on this blog in comments…more reading to do.

  13.  
    Stipemaster
    February 9, 2012 | 6:34 PM
     

    This is the the first comment that I’ve read on Pharmageddon and I will certainly be buying it when it’s published. Healy’s work never disappoints on any level and I’ve seen nothing in this blog to make me think that Pharmageddon deviates in any way from this norm. What a shame this isn’t actually a book review that could be posted on Amazon and so help open up his work to a still wider readership.

  14.  
    Neil Carlin
    February 18, 2012 | 1:23 AM
     

    Regarding modern day ECT treatment – I wonder how many of the critics have actually witnessed a treatment, have any understanding of the current medical device technology and/ or have personal experience with the often positive, life saving results.

    As a medical engineering technologist, I have witnessed more than a few treatments. The film “One Flew Over The Cuckoo’s Nest”. may be an accurate depiction of ECT in times past. But today with modern anaesthesia the only way a physician knows if seizure has been induced is by analysis of the machine’s EEG recording.

    A couple of years ago I spoke with a young man who had just finished a course of ECT treatment – I asked him how he felt – he said he was still troubled and “at least I do not have the urge to kill myself”.

    Breggin needs to understand that severe emotional suffering cannot always be fixed with empathetic talk therapy.

    It is about properly informed choice.

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