{"id":39963,"date":"2013-09-12T23:53:45","date_gmt":"2013-09-13T03:53:45","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=39963"},"modified":"2013-09-12T23:53:45","modified_gmt":"2013-09-13T03:53:45","slug":"cognitive-dissonance-4","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2013\/09\/12\/cognitive-dissonance-4\/","title":{"rendered":"cognitive dissonance…"},"content":{"rendered":"
In right on the money…<\/a>, I was talking about a "numb" feeling after watching Neal Parker speak for AbbVie last week [a deal-breaker?…<\/a>]. 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<\/font><\/strong> [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<\/a>‘s what I wrote when I got home from my notes [transcripts here<\/a> and here<\/a>]: <\/div>\n
\n
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."<\/div>\n

<\/p>\n

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].<\/div>\n<\/blockquote>\n
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<\/em><\/a>. 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?<\/em>" "Did he actually say ‘on every call?’<\/em>" 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.<\/div>\n

Wikipedia actually has a pretty good primer on cognitive dissonance<\/em><\/a> – 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.<\/p>\n

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<\/a> 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<\/em><\/a> is a powerful force to be reckoned with…<\/div>\n","protected":false},"excerpt":{"rendered":"

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 […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-39963","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/39963","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=39963"}],"version-history":[{"count":6,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/39963\/revisions"}],"predecessor-version":[{"id":39969,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/39963\/revisions\/39969"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=39963"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=39963"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=39963"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}