The Best Doctor

Whenever I hear someone talking about some surgery or cancer treatment or whatever that they had, they always assure me that the doctor who did the work was “the very best” there is at that specialty. Think about this: how often will someone tell you that the doctor they saw was “the very worst”? Never, right? But if someone is the “very best” that means that someone else out there, practicing medicine and making a living at it, is the “very worst”.

A Massachusetts study from 1996 found that 1/3 of terminal cancer patients received useless chemotherapy treatments in the last six months of their lives.

They were given a useless treatment with terrible side-effects by a doctor who undoubtedly was “the best there is”.

Harold Shipman

In Great Britain, if you took a sampling of 1000 women between the ages of 65 and 74 who see a doctor regularly, you would normally find a death rate of 4.5 per year.

Of 1000 patients of Dr. Harold Frederick Shipman, the death rate was 45 per year. He began his own practice in Hyde in 1992. He was caught this year.

Uh yes… the numbers are not the result of chance or coincidence. Dr. Shipman has been injecting some of his patients with a fatal dose of diamorphine. He seems to have murdered 300 this way. Yes, does seem like it took a little while for anyone to notice.

Sometimes he would go into a patient’s file and alter significant facts, in order to establish the “illness” of which the patient died at his hands. No one noticed because the families of deceased patients do not get access to the deceased’s medical records.

A few people over the years became suspicious. The police were even called. But when the police went to the General Medical Council, which oversees doctors in Great Britain, they told them that unless an official complaint was received they could do nothing.

Since Dr. Shipman never summoned an ambulance or called for a coroner after any of the suspicious deaths, there were no records except his own, and therefore, no details about the exact circumstances of death, except those which he provided.

The local health authority investigated and found nothing suspicious. Again, it appears that they relied on Dr. Shipman’s records to verify Dr. Shipman’s performance. There is no system in place to monitor the performance of doctors. Think about that. There is no system in place to monitor the performance of doctors. In other words, a doctor could kill 300 patients and no one would be the wiser. Well, yes. That’s what happened.

The first public reports of the investigation of Dr. Shipman were met with outrage by the citizens of Hyde who felt that a good doctor was being tarred with a broad brushstroke. Obviously, the good citizens of Hyde hadn’t noticed anything odd either. Here was a doctor who murdered patients with great frequency. The patient’s families were notified of the death. The bodies were cremated or buried. Nobody kept score.

The police finally seized Dr. Shipman’s medical records. Ah, but they didn’t obtain the proper paperwork beforehand and had to return them. Imagine the police seizing a knife or a gun from a suspected murderer, and then being ordered to return it to the suspect because they hadn’t said “may I”? To get around this little technicality, the police charged him with homicide. Then they were permitted to investigate.

Altogether, as I said, Dr. Shipman may have killed more than 300 women.

Sometimes he did the killing in his office and saw several more patients before reporting the death.

Now this may sound like a bit of stretch, but ask yourself this, in connection with Dr. Shipman’s offenses: how do you know that your doctor is doing a good job? I’m serious. I mean, you know that your doctor is not likely to inject fatal quantities of diamorphine into your veins, but if a doctor in a developed country can get away with doing this to hundreds of women over a period of ten years, how much less likely is it that your own doctor can get away with being completely incompetent?

In other words, who is keeping score?

You can read the sports pages every day to find out if Delgado is earning his millions for the Blue Jays. How many home runs did he hit? What’s his batting average? Is he making a lot of errors over there at first base?

Why don’t we have the same thing for doctors? It doesn’t have to be ridiculously detailed. Just a simple table of visits, total number of operations, drugs prescribed, x-rays, cures, improvements, and… deaths.

There were signs of trouble with Dr. Shipman back in 1976 when he was convicted of stealing drugs and issuing fake prescriptions. But he was able to pay a modest little fine and move on. This was his minor league record. Mediocre. Not expected to make the big leagues.

But he worked at it and re-established himself and went on to establish a new record: 300 murders. That’s about 287 more than Klebold and Harris at Columbine. How many Nightlines do you think they’ll devote to this story? How many Newsweek Covers?

How many people are going to throw up their hands and scream, “What’s happening to our society! We should have zero-tolerance for deaths at the hands of doctors!”

The Mythical Open Road

As you sit in your car in the middle of yet another traffic jam in almost any major city and stare at your white knuckles, think about those beautiful car advertisements.

Obviously, Ford and Toyota and General Motors are never going to show you where you will really spend all your time in their glorious automobiles. But just because it’s obvious doesn’t mean it doesn’t deserve a round of good old fashioned outrage.

The ads show the beautiful cars– almost always perfectly, minty clean– cruising all by their lonesome selves down endless stretches of awe-inspiring roads that channel through hills and valleys, mountains and rivers, prairies and open plains. What is most astonishing about these scenarios is that there are never any other cars on the road. Nobody. Nowhere. No trucks. No cars. No ugly, fat, disgusting, gas-guzzling Winnebago’s. Nada. What a wonderful driving experience. You bet.

It’s like when they show anorexic models eating diet yogurt. Right. You’ll look like that someday. Some day if you manage to kidnap Kate Moss and transplant your brain into her body.

Nobody is surprised if car companies want to show their products in the best light. We probably generally laugh to ourselves and continue to wait for the normally scheduled program to resume. But why should we put up with this crap? Why are we so damn passive? Why can’t we muster a little righteous indignation for the outright fraud perpetuated on the consumer by these ads?

Let’s not mince words: these ads are indeed a fraud. They are filled with lies and distortion. You will never ever get to take the drive that is being offered to you. It doesn’t exist anywhere in the civilized world anymore. Why not? Because every idiot on the planet wants that driving experience so they are all stacked up behind each other on the freeways grinding their teeth and wondering why everyone else doesn’t just get off the road.

Selling the New Drug

How do the drug companies persuade doctors to prescribe their drugs? Well one company, Purdue, held over 7,000 seminars last year to “inform” doctors about “pain management”, which, of course, consists of prescribing its particularly powerful drug called “Oxycontin”. Why do the doctors go to these seminars? How about free weekend travel and hotel accommodations, to Florida and other lovely locales? (In December, United States attorneys in Maine, persuaded Purdue to stop paying for the doctor’s travel expenses to these seminars and it agreed do so.)

A spokesperson for Eli Lilly said that the company asked women and physicians about a treatment for PMDD and they told Eli Lilly that they wanted a drug with it’s own identity for this special problem. I’ll bet the same focus group told them they wanted to squander $100 a month on medicines that treat imaginary illnesses.

David Rubinow, Clinical Director of the National Institute of Mental Health, says “there is a very high degree of false positive self-assessments– women assume they are suffering from PMS or PMDD when, in fact, they are not.” If you were an investor, would you bet on that dynamic? I would.

Interesting side-effect: if Eli Lilly prevails– you can bet they are using all their influence to get “studies” that show that PMDD really exists– we will soon see court cases in which a woman claims that she shop-lifted or drove too fast or neglected a child, because of PMDD. The court will then hear that Americans spend more than $1 billion a year on treatment for this “disease”, even if it isn’t listed as one in the DSM, and will be duly impressed and find the woman not-guilty, or award somebody a hundred million dollars in damages or whatever. Then Eli Lilly will point to the court cases and say, “see– even our courts recognize that PMDD exists!” Thus you have self-fulfilling prophecy.

Saraphim, Sarafem

Lying, scheming, scoundrels!

Eli Lilly is the drug company that makes “Prozac”. Prozac, used to treat depression, is patented, which means Eli Lilly can charge a fortune for each prescription because nobody else can make or sell it. Unfortunately– hold the tears– the patent on Prozac expires in August of 2001.

Hold the tears.

Prozac is one of those wonder drugs that doctors love to prescribe to people who come in and say they are tired and depressed and sad and unhappy and tired and don’t enjoy their lives and are miserable and unhappy and tired and so on and so on and since the doctor doesn’t have the time, ability, or inclination to make the person’s life any better– to find them better jobs or spouses or children or neighborhoods or families– he prescribes a happy pill, which alters the basic chemical balance in the brain– well, it makes you happy. Like pot, except legal. And about $100 a month, which, frankly, makes pot look like value for the dollar.

But– hold the tears– soon anybody will be able to make a drug called “Prozac” and will be able to sell it for less than Eli Lilly. Lilly, one of the most profitable corporations on the face of the earth, will have to actually begin charging something close to what it actually costs to make the drug, plus a little profit.

Prozac earns Lilly about $2 billion a year. I’m not kidding. I’m not exaggerating. The Washington Post said it: $2 billion! A year! What’s a greedy corporation to do, especially after all it’s contributions to election campaigns have failed to save it’s patent!

Well, by golly, never underestimate the imagination and creativity of the drug dealers. The “legit” drug dealers, I mean. Eli Lilly has just introduced a new drug– Sarafem– and a massive advertising campaign to designed to convince you that you’re sick even if you aint. And low and behold– holy pharmaceuticals, Batman!– Sarafem, in cute little pastel colours, is nothing other than– hold those tears!– Prozac, relabeled and packaged!

Sarafem is for women suffering from PMDD. You don’t know what PMDD is? You don’t?! Shocking. How could you not be aware of an illness that is so absolutely scientifically proven that is has an official acronym? Read the magazines! Watch television! See your doctor! Ask her if you might be suffering from PMDD.

PMDD is “PreMenstrual Dysphoric Disorder”. That’s right. Phew. First of all, breathe a sigh of relief if you are a man. Since you aren’t as likely to stuff yourself full of chemicals in the first place, you can relish another opportunity to save yourself some money, because “Sarafem” costs as much as the old patented Prozac– about $100 a month. It is reported that women take Sarafem every day.

Every day! I find that stunning. Prozac is not a little pep pill or aspirin. It is a powerful psychotropic drug. And doctors and the pharmaceutical industry just blithely go about trying to persuade as many normal young women as possible to tamper with their brains.

Well, by golly, why does it cost so much? I’m glad you asked. If Prozac is no longer a patent medicine after August 2001 and anybody can make it….!

Ah– the loopholes! You see if an existing drug can find a new application, the patent on the new application of the existing drug can continue, in this case, until 2007! So while anybody can now make and market “Prozac”, only Eli Lilly can make and market Sarafem.

Yahoo! Now all we need to do is find an illness!

Now how do you find an illness? Well, in the United States, the APA (American Psychiatric Association) sort of officially defines mental illnesses. It puts out this huge book called the “DSM” which is like the Bible of mental health. You might remember a few years ago that the DSM has decided that most every energetic two-year-old is afflicted with a mental illness. Most parents have the good sense to know that their child is merely a two-year-old. But, hey, where’s the profit in that? And do “most” parents really know this? The statistics on the use of Ritalin do not encourage this assumption.

The importance of the DSM is that insurance companies use it to determine whether or not they will pay for treatments. If it aint listed, it aint covered. Of course, it is then in the interests of the health industry to ensure that almost everything is listed, so that therapists, doctors, and pharmacists can be paid.

In other words, what the DSM has actually become is a shopping catalogue of real and imagined complexes.

Anyway, we have women with periods. Periods, by all accounts, are uncomfortable and annoying. In short, they sometimes make women feel bad. Now, most people accept that PMS exists– a kind of moody irritable stage of the monthly cycle just before the period– and that drugs that alleviate the feelings of bloatedness and… whatever.. make some sense. Some.

But even the DSM doesn’t believe that PMDD really exists. It is listed in the appendix as a condition that is “under evaluation”. That doesn’t stop Eli Lilly from running advertisements that suggest that that lousy feeling you have while pushing a heavy shopping cart in an ugly grocery store with three kids screaming at you for candy can actually be blamed on an official, registered, scientifically validated “disorder”. See your doctor. Women do. They see the ad, they see their doctors, their doctors prescribe, Eli Lilly gets rich.

How can they get away with this? Well, the good old Food and Drug Administration in the U.S. has decided that Lilly’s opinion matters more than the DSM’s. It has approved Lilly marketing the drug for a non-existent disorder.

What we have here is something that, like Hyper Attention Deficit Disorder or Hyper Disorder Attention Deficit or whatever it’s called, defines normal but unpleasant conditions as a “disorder”. That is the dream disease for the drug companies because everyone has it. We have a limitless number of potential customers. All we need to do is convince them that they’re sick. And Sarafem advertises itself as the only official remedy for PMDD.

What we need are ads that show the same external conditions that the Eli Lilly ads show– tired women, ugly stores, muzak, incoherent labels, over-priced candy, noise, dust, rude clerks– with a text that runs: “Does your life stink? Try changing your life.” One thing you could do is join an organization that fights companies like Eli Lilly.

And hold the tears.

The Irvings Sink a Ship

There is a myth out there that a lot of your tax money goes to welfare cheats. True. Here’s one of them:

About 30 years ago, the Irving Corporation (a big Maritime oil company owned by the Irving family) accidentally sunk a barge loaded with PCBs in the St. Laurence River. When government scientists discovered that it was leaking deadly PCBs, the Irvings said, “surely you don’t expect us to pay for it?”.

The government raised the vessel for $45 million, cleaned up the PCB’s, then gave it back to the Irvings for a pittance, $5 million.

Why has no one been arrested? Why aren’t the Irvings sitting in jail? Why haven’t the RCMP seized the Irvings’ assets in order to sell them to pay the bill?

Because the Irvings are not like you or me, my friend. They are rich. They know politicians on a first-name basis.

Now that’s the way to do business! Thank you Mr. Chretien, now we’ll just resume our profiteering, if you don’t mind…