informed consent


Do some people become doctors just to earn a lot of money?  Yes.

Sigmund FreudDo some of them find out that it’s not as lucrative as portrayed in the media (based upon stereotypes at least 40 years out of date)? Hell Yes!

Psychiatrists are not normally schizophrenic — however there are two types.  One is the media stereotype “Talk Therapy” doctor.  These are nearly extinct. They exist mainly in Woody Allen movies and old TV series.  In fact, most of those are psychologists — not psychiatrists (but who knows the difference and who cares?).

The other type is what you chiefly find today — Pill Pushers.  Insurance and

Read more on Where Have All the Psychiatrists Gone?…

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My husband introduced me to the original “Star Trek” series and movies and of course the character I most identify with is Mr. Spock.

His famous catch phrase is “Humans are illogical.”

Children playing soccer taking a headerThat’s an understatement – and as a psychiatrist I often see those who are far, far past illogical.

One of the topics I have frequently commented about is perhaps the most illogical of all – SPORTS.

It seems there is always a story in the news about sports injuries and deaths, and it is well established that professional sports ruins the lives of the athletes who perform and the cities that finance these bread-and-circus entertainments for their fans.

Yet, sports fans are like religious zealots – they just don’t care about the wreckage and carnage as long as they get to drink heavily and act irresponsibly.

It’s even more of a tragedy when the athletes are not professionals – they are children.

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This is one of those stories that I find very difficult to write. My anger is great and clouds my mind. Yet if I do not, there may be some kind of eruption – tears, shouts, or pounding on the wall.

The headline in the Philadelphia Inquirer read, “4 ex-pharma execs face possible jail time.”

“Possible” jail time? This is murder.

Operating TableIn brief:

Synthes received FDA approval bone cement for use only to fill bony voids or defects in some parts of the body, but not in the spine.

In 2003 and 2004, the company is accused of having its representative train surgeons to use this cement for the very thing they were forbidden by the government to do.

For those who don’t know, many surgeries are performed by people who aren’t technically allowed to practice medicine.  A lot of times, people who didn’t complete medical school or people who have had their medical licenses taken away for various disciplinary reasons can get employment with a manufacturer of pharmaceuticals or medical appliances (like replacement hip joints) and will train doctors on how to utilize these new products.

This isn’t widely discussed and is shady, at best. It’s probably criminal, but that’s another column.

Synthes executives are charged with conducting illegal clinical trials in which 200 patients were treated for ways not approved by the FDA.

Of those 200, three died.

Read more on Getting Away With Murder — Cheaply…

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She was 32 and she looked tired.  She told me she had been abused in childhood.  A general physician whom I trust and who does a good job had sent her to see me, thinking she could be a little more relaxed and doing better with pharmacology.  We had not even talked about what kind.  This young woman was not sleeping well.  She made the interview easy as she already knew her diagnosis – post-traumatic stress disorder (PTSD).

Informed ConsentShe said the abuse had been both physical and sexual.  She still had an occasional dream or daytime thought about it.  She did her best to avoid the people who had done these horrible things to her.  Also she was “high strung.”  She confirmed that she tended to hyper-react to loud noises.  “I jump ten feet in the air,” she said.  So she had the three hallmarks of the diagnosis.  I am a woman with little faith in colleagues, so I always confirm the diagnosis.

I noticed, to my horror that the only medication she was receiving was Klonopin, also known as clonazepam, a half mg. twice daily.  Now she had been on nothing but this for many months.  I have a lot of troubles with drugs of this class: they are addictive, abusable, and at higher doses, which many people take sometimes, they can cause shakes or even seizures with withdrawal.  If she ever skipped a dose she would feel it.  Besides, they are central nervous system depressants, so they can actually cause someone go get more depressed. Read more on Informed Consent Is Your Legal Right…

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Life is fragile at best.  At worst it is undervalued.  Prolonging it and maintaining its quality is something most doctors have at least thought about.

Me — I was brought up by family values as well as institutional values to venerate the academic system as a seeker of truth, guardian of highest ethics.

I thought that the institutions that regulated clinical research, whether they were academic or not, were at least trying to be ethical in the face of mounting economic pressures from those who develop substances to be used for the human body, to prolong and maintain life. Some people still believe in this.

Some people, even some I can call “friend,” consider me a failed academic, someone who could have contributed more to society had she written more papers that somebody thought were good enough to publish in medical journals.

All of the above is unadulterated lies and total BS that has kept many competent minds devoting their lives to ideals that are later sold to the highest bidder.

I don’t think I have any lingering doubts that my running from academics, yelling and screaming, was the best decision I ever made.

blood transfusion

The story of Polyheme – developed as a synthetic substitute for human blood — is perhaps the worst example of human rights having been sold down the river for development of something of serious danger (if you believe the publically published academic results) and at best, unproven help (are they really keeping this kind of secrets from us so the company developing this junk can make money?) to either prolonging or maintaining life.

The story is complicated, but basically, here it is.

Read more on Substitute Blood — A Failure Of Clinical Ethics…

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As far as I know, every antidepressant has the same “black box” warning on its package insert, as reported by a reputable academic psychiatrist in a reputable journal a while ago.

Incidentally, he has, in this editorial type piece, effectively logged most of the “attacks” recently made upon psychotropics.  He advises the readers, presumably other psychiatrists or at least physicians of some sort, to do “nothing.”  This is the common way of academics, to wait and gather data.  It is not a common way of doctors, at least ethical or idealistic ones, who still scramble at any chance to save people.

black-box warning

For now let’s look at the warnings about antidepressants that have merited the special FDA attention. Except that it is in a “black box”  (has a black border like a funeral announcement) and there may be a couple of things added on relative to an individual brand, this is the disclaimer: WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of Major Depressive Disorder (MDD) and other psychiatric disorders.

Anyone considering the use of (Brand Name) or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Read more on Black Box Warnings — Read Carefully!…

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Here is a letter signed by prominent Irish psychiatrists saying that there is no evidence whatsoever that antidepressants cause homicide.

The “PLOS” or “Public Library of Science” is supposed to be an easier and gentler place to get science published, although the esteemed (foreign) colleagues who have done research with me on natural substances have informed me it is not so easy a door to enter.

Nevertheless, here is a very scholarly angle.  There is evidence that the prescription of antidepressants may engender aggression, violence, or homicide.

There is also an article cited by Dr. Peter Breggin in the Journal of Safety and Risk in medicine, to which I cannot seem to link anyone directly but a download is available through the wonderful people at this Irish foundation.  These folks are trying to bring forth the truth and the light.

Black Box Warning

Black Box Warning

I am now of the opinion that the academic ideal I once pursued does not exist, and is, if it exists, a pack of lies at best.

There are FDA black box warnings about antidepressants promoting aggression, but I am unaware of such warnings having ever stopped a colleague from prescribing any antidepressant.

Read more on Seeking Truth In Drug Research — And Getting Frustrated!…

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