In right on the money…, I was talking about a "numb" feeling after watching Neal Parker speak for AbbVie last week [a deal-breaker?…]. I remembered another time I felt it. It was in January 2012 and I was at the trial in Austin Texas of Allen Jones and the State of Texas versus Janssen [AKA the TMAP Trial]. I had to leave before it ended, though unbeknownst to me, they were going to settle the day after I left and stop the trial [$158 M]. The last deposition I heard before I left was from Tone Jones, a former Janssen District Sales Manager who unlike other sales reps that had testified just answered the questions straight. Here‘s what I wrote when I got home from my notes [transcripts here and here]:
On what would be the final day of the trial, we saw a video deposition of Tone Jones. He was a District Sales Manager in Houston from 2002 – 2009. Tone was recruited to Janssen right out of college when he didn’t make it to the NFL [quarterback for Oklahoma]. Out of the gate, he was a different witness. The Janssen lawyers had approached him as with Ms. Moake – paid testimony, represent him in the deposition, said something about company loyalty as a previous employee. He was offended and said "no." Later, when he was approached by the plaintiff’s lawyer, they offered him nothing, and he said "yes."
He answered the questions in an unemotional, matter-of-fact way – and his answers were quietly damning, famously saying, "You can’t be a billion dollar drug in a 1% market." They showed a training memo from his top Sales Rep, Laura Haughn, that said: "Child and Adolescent Psychiatrists", "Provide with treatment under 13", "Most diagnosed with behavior disorders or mood disorders", "No indications!!!", "Sell on symptoms not diagnosis". Did they target Medicaid? "Yes". Why? "Big Payer". Did they target the Drug Utilization Board? "Yes". Did they target the Pharmacy and Therapeutics Committee? "Yes". Did he recruit speakers? "Yes". Did they downplay the incidence of Diabetes? "Yes". Even after the warning letter? "Yes". How often? "On every call". Were all sales messages approved by Janssen? "Yes". Were these sales directives local or national? "National". They showed him an organizational chart of the Janssen Sales Department and an email chain about selling Risperdal for children that traveled all the way to the top and down again. His testimony was delivered quietly, but it was devastating [and sounded truthful].
I had the numb feeling then. On the way to the airport. On the plane. Even after I got home. It may have been rage, or discouragement then too, but I think the more precise term would be cognitive dissonance. What he was saying throughout his testimony was so far beyond what I had imagined before that my mind couldn’t find a way to wrap around it. It was temporarily paralyzing. That’s how I felt watching AbbeVie’s Neal Parker. That’s why I watched it over and over. I did the same thing with the transcript of Tone Jones from the TMAP Trial back then – read it over and over. Something like, "Did he really say that?" "Did he actually say ‘on every call?’" Perhaps others aren’t so naive as I and would’ve had a different reaction, like confirmation of something they suspected all along. But I’m not others.
Wikipedia actually has a pretty good primer on cognitive dissonance – on the mind’s attempt to reduce dissonance through a variety of mechanisms because it is so uncomfortable. Physicians see it all the time as patients move from "I am healthy" to "I am very ill" when told of a hard diagnosis to hear – a chronic or fatal illnesses. I would expect that avoiding cognitive dissonance keeps a lot of otherwise right-thinking psychiatrists from seeing how messed up the world of psychopharmacology has been in recent years. Who would want to see that? I wonder if I would’ve seen it myself had I not started volunteering and seeing all the medications patients were on at the same time the Chairman of the Department I was affiliated with was being investigated by the US Senate for gross improprieties. I knew all the characters in the stories in the news. That kind of exposure makes the bells start to ring.
I know exactly why this is on my mind tonight. I remembered today that Sunday, September 15th, is an anniversary of my biggest encounter with cognitive dissonance in my time on the planet. I was a southern boy who had been raised to know segregation was wrong. I’d even been involved in some fledgling protests in college. But that was an aside in my life. 50 years ago, I picked up a newspaper and read about the bombing of the 16th Street Baptist Church in Birmingham that killed four little girls. It was the same week I got on a train to start Medical School. By the time I got off that train, I was a different person and the world I lived in was a different place. Cognitive dissonance is a powerful force to be reckoned with…
“Neal Parker on AbbVie’s Mission to Discover New Diseases-David Healy:
http://davidhealy.org/neal-parker-on-abbvies-mission-to-discover-new-diseases/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+DrDavidHealy+%28Dr.+David+Healy%29
summation:
“Aginus Kalinus:
That means, yes. You say, yes. Adverse events might be commercially confidential.
Neal Parker:
Yes, but it’s very important to understand that does not mean that it can’t be released.
Aginus Kalinus:
You are aware that you are working in the health care industry? With patients and human beings?”
Now understand the level of spin you could place into clinical trials-this is to say pretty much anything you choose:
http://www.hhs.gov/ohrp/policy/engage08.html
My son was “targeted” intentionally to be “treated” with Risperdal, followed by countless other toxic drugs used off label and illegally billed to Medicaid, and as a result, my son has cognitive, neurological and physical disabilities–he was iatrogenically disabled long before adulthood, that is a real world outcome and an effect of successful marketing. I am secure in the knowledge that I did, and continue to do everything in my power to access appropriate treatment for both of my sons and myself, to be vilified by professionals who violated the ethics guidelines of their chosen professions and the law. I know that as long as I live I will continue to try to get him the help he needs and continue to care for him. Victims of psychiatry continue to pay for corporate crime and medical malfeasance, some will pay with their lives. I am grateful beyond measure for those like yourself who are working to change things, please remember the real victims are not the professionals who believed the marketing hype and as a result, failed to serve their patients ethically by remembering that their primary ethical duty is to serve their patient’s best interests by remembering to “First, do no harm…”I am haunted by horrific memories of witnessing my son being repeatedly traumatized, in effect, tortured; I kneew then, and know now, it had NOTHING to do with the ethical practice of medicine—he was simply a means to an end. Unethical business and medical practices are the illegal acts that are the foundation of the NON-evidence based treatment algorithms and protocols STILL in widespread use; and STILL vehemently defended by “doctors” of psychiatry. Apparently, that which best serves the interests of the APA, the AACAP, and their pill pushing partners in crime, is to pretend that how and why these algorithms were developed and marketed for standard clinical use is ethical if first the algorithms are magically transformed through a quasi-democratic process to “validate” them as evidence based practices. Most if not all of the leaders in public and privately funded psychiatric research are in fact criminals who became rich and/or famous (and infamous) by undermining the integrity of the medical profession, in order to market madness, and commit crimes against humanity. In truth, these “doctors” use their own innate biases, errors of attribution and medical authority AS evidence to declare their patients have unidentified genetic deficits and brain diseases which apparently makes it ok to lie about what is and is not known about what causes psychiatric symptoms, the nature of psychiatric diagnoses themselves, and the known risks and benefits of psychiatric diagnosis and somatic psychiatric treatments; using “standards of care” as a means of providing themselves with an affirmative defense against valid claims for damages for the iatrogenic injuries they recklessly inflict on their victims. It’s all done for the patient’s benefit, my aching ass! I wonder, do any of them seriously believe any of these unethical practices are ethically, medically, or legally justifiable? I’d be willing to bet cognitive dissonance can make an individual psychiatrist delusional enough to believe that subjective opinion actually becomes empirical “evidence” through consensus. Since they’re doctors, what they are doing in their professional opinion, is “effectively” diagnosing and medically treat people with diseases and impairments. The fact that their patients have no identified diseases or impairments upon diagnosis, but in fact develop drug-induced diseases and impairments as a direct result of the “necessary medical treatment,” (forced under color of law in some cases) is NEVER part of the conversation. If victims are spoken of by these heroes of psychiatry, it is usually in a manner that is not respectful or empathetic—It’s ok, they’re doctors providing “necessary medical treatment.”
These thugs got rich by harming society as a whole and targeting the most vulnerable among us. Defrauding ALL OF US and decimating medical assistance programs to pay for the criminal mistreatment and torture of our loved ones, our elderly and our Veterans… There are NO WORDS harsh enough. In my son’s case, it was ONLY psychiatrists who wrote the prescriptions for the teratogenic drugs prescribed off label for no ethical medical purpose; drugs which were then illegally submitted to Medicaid for reimbursement. What was done to my son is not unusual, but still done in standard practice in the real world. The psychiatric mis-treatment that disabled my precious son was NOT “medical treatment” it is Human Experimentation in violation of the Geneva Convention—a Crime Against Humanity. I’m a MadMother. who daily witnesses my 25 year old struggling to come to terms with what was done to him, struggles to overcome the direct adverse effects of psychiatric treatment, the drug induced cognitive and neurological impairments that were inflicted by a “lead researcher” who he has said “stole my intelligence.” There is no answer to the question he asked me in agony “How could they take so much from me Mom? The people who were supposed to be helping me, had no compassion for me Mom, they traumatized me over and over and over.” Jon McClellan should not be a doctor yet he is still Medical Director of the only children’s psychiatric facility run by the State of Washington. A facility that my son over 5 out of 10 years of his childhood from the age of 7 to 17. A facility that I was mislead to believe was a Hospital, when it is in fact a Research Facility. I know that harm doesn’t help; and I know that lying to me and my son was common, I assume it’s acceptable “professional behavior,” since virtually every social worker and psychiatrist we had to work with has purposely misled, or outright lied to us, with impunity. Some have in lied in Courts of Law, perjury is a felony crime; in three separate jurisdictions in the State of Washington–some have lied and immediately demanded my respect. This is more than cognitive dissonance, emotionally capable socioapathy or willful blindness—I suspect that all three are possibilities. Whatever it is, it’s widespread and seemingly allows some professionals to justify abuse of authority and criminal negligence and causes others to pretend not to see it, which allows the criminals to act with impunity. How is it possible to believe it’s acceptable to be dishonest with the very people you are purportedly helping? Had any of the dishonest professionals I have dealt with attempted to earn our trust or simply been truthful; they would have my respect.
Let’s remember, it was not only corporate thugs, but psychiatrists, who are STILL considered “leaders” and who claim to be heroes of psychiatry who wrote and marketed what are claimed to be, “evidence based” clinical care standards that STILL enable an ongoing criminal enterprise. Let’s remember, psychiatry’s unethical standards are STILL used, ensuring Medicaid fraud continues unabated.
There is an interesting article in the Sept. 7-8, 2013, WSJ print edition, page C5, The Experiment That Still Shock, Behind the Shock Machine by Gina Perry.
This is a recap of the 1963 Yale experiments involving people being told to shock others for not giving the right answer and their willingness to administer what is marked as a shock well above the danger level. Noted is this type of experiment would not be conducted today even though no single person was injured.
Ms. Perry’s drive was to look at the volunteers and then how the study protocols were ignored by those doing the testing. It becomes interesting when the testers become bullies not allowing the volunteers to leave the study. The testers themselves become the “authority.”
The article notes Ms. Perry’s anger at the experiment and her willingness to discredit the findings, findings hat have been duplicated in other experiments.
My take away from the article is we are still dealing with questions of authority 50 years on, and Mr. Parker represents only one facet of that willingness to set aside social norms in pursuit of obedience to an entity and goal.
Steve Lucas
More importantly, when we speak about what is right or wrong and what needs to be different, let’s remember those who cannot speak because they are too afraid, cannot speak because no one is listening, and those who will never speak again because they are dead. Let’s remember those who have been seriously harmed must be considered with compassion and should be encouraged to voice their pain so that they may heal emotionally. Let’s remember those with iatrogenic injuries need appropriate medical treatment to ameliorate the deleterious effects of psychiatric treatment and have a real chance of recovering from their iatrogenic injuries.
You can say that again, Becky.
And let us also remember that every FDA warning represents actual injuries to actual flesh-and-blood people, not just theoretical risk propounded by an overly cautious bureaucracy.