My dear, remarkable father of blessed memory was no mere a musician. He was a Harvard-trained composer and arranger, played that complicated organ at his temple for fifty years, and was very, very serious about music.
In fact, he was so serious that only “serious” music could be played in our household. After all, he was a classmate of Leonard Bernstein, and studied under Aaron Copland and was one of the few fellowship students allowed to attend lectures by the great Stravinsky.
Now THAT’S serious!
As such, I missed out on popular music while growing up. I was not allowed “American Bandstand” after school. I was not give Beatles records. We didn’t even watch Elvis on Ed Sullivan.
Filed under Panic Attacks by on Apr 29th, 2011. Comment. 
It took me a while at first to realize that everyplace I saw a green cross, it was going to be a medical marijuana facility. After all, the green cross is some kind of an international symbol for a “druggist,” for someone who sells prescription drugs (primarily) as prescribed. In France, as well as in Canada, I remember following such signs to get a prescription filled.
This one substance, this marijuana, is unique in a couple of ways. First, it is the only prescription drug that has never been required to be tested for safety or efficacy. Second – there is no government oversight as to quality or purity.
Marijuana seems to be something that people want first, then figure out a reason for later. The results are not exactly what I consider beneficial. Read more on Medical Marijuana Can Become Big Business…
Filed under Substance Abuse by on Apr 4th, 2011. Comment.
Here are some phrases that you might not expect to hear sweet, friendly Dr. G use very often:
“No, there is no way in hell I am going to renew that prescription as written.”
“Read my lips. No more oxycodone. We gotta get you into a rehab, sweetie.”
“Sure, you can see another doctor. I don’t know how long it will take to get an appointment. If I am your doctor, you go on a tapering schedule. Today.”
“If I did what you want, I could kiss my license goodbye. I am not prescribing outside my specialty and certainly not this crap. Yes it is crap. I am sorry you don’t like how I talk, but it is crap. I can start getting you off it.”
These are all things I have actually said. Usually loud, yelling over the patient. Read more on Pill Mills Are Death Traps — Marginally Legal…
Filed under Addictions, prescription drugs by on Mar 28th, 2011. Comment.
Ahh – 19 years old! It is a magical age. At least it has been my experience in public mental health clinics.
You see, almost without exception any male of 19 years who appears in my office – is a really messed up and sometimes just, plain rotten fellow.
I don’t know what it is about 19.
One of the typical cases – though legally an adult — was functionally a kid, living with his parents and acting out the same kind of adolescent rebellion that most go through at 14 or 15 and out-grow by 17.
Oh, he had it all — One of those cylinders in his earlobe, spreading a hole from a small piercing to the size of a basketball. He told me it was “tribal.” He was a music major at a local, broken down branch of the state college. He wanted to be a performance artist.
Filed under Substance Abuse by on Mar 7th, 2011. Comment.
I was making one of my rare but periodic attempts to watch commercial television. Sometimes I amaze myself that I have not given up, especially when I saw a few minutes of “the View.” I mean, someone has to get in there and promote stereotypes about women, and they are doing an incredible job, what with asking women involved in politics about bathing their babies or something.
Claire Danes in "Romeo + Juliet"
I admittedly learn a great deal from the commercials.
Like Claire Danes — whom I used to consider a Shakespearean-quality actress — does not seem to be getting any good roles, because she did this incredible commercial, where her eyelashes and face were photographed every couple of weeks. Admittedly, after four to six weeks, she had pretty lush looking eyelashes compared to week 1.
Here is the prescription drug— yes prescription drug — she was advertising. On the website they have Brooke Shields, too.
Filed under prescription drugs by on Mar 2nd, 2011. Comment.
The idea of science attempting to study or explain the interaction between doctors and drug reps seems strange.
Doctors seem receptive to beautiful sales reps
So I checked out the original article that had been reviewed as objective science. I put it all together. I decided that none of the studies that were slopped together to make this meta-study were going to impress me. I can’t remember seeing anything that looked scientific as I poked around. We are talking about “naturalistic” studies here. Doctors really don’t seem to want to believe that anyone can control their thinking. Some might get contrarian and avoid prescribing things that are too aggressively presented. Maybe others do succumb. The idea that the drug reps bring a lecturer and somehow useful information might be exchanged is idealistic at best. Let us switch from science to reality. I remember the muscled male French drug reps they sent to me in the hospital. I remember when the dean of the medical school married a gorgeous female drug rep — a sort of midlife-change direction marriage — leaving behind someone who had once been described to me as a barracuda like entity. Read more on Influence Of Drug Reps On Physician’s Prescribing Habits…
Filed under big pharma by on Jan 12th, 2011. Comment.
I could not believe it when the patient asked me about ketamine. I had just seen an episode of “House, MD” on one of those cable super-stations the night before and it dealt with this weird drug. I told my husband about my experiences with it during my surgical career. Then, the next day, this patient brought up the same rare drug. When I looked at him closer, it became believable. He was old enough — in his sixties — that in the swinging sixties he had surely been one of those “knowledgeable” druggies who pride themselves on knowing all about everything that could give one a buzz.
Hugh Laurie as TV's Dr. House
This type of person is a sort of lay-pharmacologist — someone who knows not only how each drug made someone feel, but sometimes even about class of drug and mechanism of action. Of course, this type of expert would seldom know terribly much about what the FDA thought or felt about these drugs. “I heard it works pretty well and faster than anything on depression,” he said, “and I am kind of depressed and the standard antidepressants, the crap like Prozac and Zoloft aren’t worth taking and don’t do anything. But they say that stuff works fast on depression.”
Yes, he knew his stuff so well that he may even have read some kind of FDA reports or something. Still, ketamine is not the kind of thing you can dish out in a county clinic in Noplace, California. If you want something exotic, try a university psychiatry or pharmacology department, or call or email the National Institutes of Health. I could offer the standard stuff, but not ketamine. Not me, not there.
Filed under depression by on Dec 24th, 2010. Comment.
I’ve heard people say this about something that is a waste of money, “You might as well just flush your money down a toilet.”
That isn’t always the best way to dispose of something – even excess money.
Recently there was a major national “event” where people take back and dispose of drugs free of charge. It was supposed to have something to do with publicity. Since I am constantly trying to be the most up-to-date of anyone who prescribes psychotropic drugs, I have to conclude that the publicity is unlikely to have been extremely effective. My patients sometimes exchanges prescriptions with friends or family — or steal them — and when I tell people they are only intended for the person whose name is written on the label, they get angry at me. Read more on Disposing Of Old Prescriptions Is Tricky…
Filed under prescription drugs by on Sep 28th, 2010. Comment.
Rarely do I see a poll or study that lines up so perfectly with what patients tell me as this study showing that plenty of women have no interest in sex. Whatever creator you believe in, with a seemingly infinite sense of humor, has given males a sexual response that sometimes looks or sounds like little more than a simple spinal cord reflex.
Although I will admit that I am sometimes a bit surprised at what the cues are, there seems to often be something unlikely that provokes the pleasure response pretty directly. Two of the strangest – and yet most common – things men tell me that are “turn-ons” are seeing a woman’s fingers with deep red fingernail polish resting on her blue-jeans leg warmers; and watching a woman bend over to fix the sink (yes – fully clothed). Read more on Lack Of Female Desire? Throw A Pill At It!…
Filed under big pharma, prescription drugs by on Sep 23rd, 2010. Comment.
He was 50 and he told me right up front, “I need more of the medications the other doctors give me. You can just renew them for me; that is why I am here.”
That’s probably the second most common thing a patient says to me. The most common is, “Why didn’t my other doctors tell me that?” No, I don’t just renew prescriptions, I explained to him. I told him that I need to get to know my patients, so that I can make sure that I give them the correct medications.
“I don’t want you to do that,” he said to me. “All the other doctors just give me renewals.” I told him I didn’t much care, that was not how I worked, and if he wanted renewals he would have to tell me how he was doing. Read more on Self-Medicating On Pot And Booze As A Life Plan…
Filed under Substance Abuse by on Sep 14th, 2010. Comment.