The Factories of Post Modernism

In the 1960s revolution was afoot. Antipsychiatry was born. The new revolutionaries targeted medicalization and claimed mental illnesses didn’t exist. Out of this cauldron, postmodernism was discovered. Postmodernism provided the basis for an ongoing guerilla war against capitalism and industrial society waged by social scientists, anthropologists and others trained in the humanities.

Science had led us to doubt the Bible, to doubt the stories of national identity and to doubt other stories that bound us together – and in so doing had led us into modernity. Now the message was that we should doubt science itself, which was after all just a bunch of stories – post-modernism. Just as science had once raised the question of whose interests our myths served, now post-modernism asked whose interests did the myths of science serve.

Finally in the 1990s science drew a line in the sand. The best account of this lies in the book Higher Superstitions. Perhaps to the surprise of most scientists – and why few people have heard of it – the Science Wars were over almost at the first engagement. When the bunkers in which the postmodernists had been hiding were examined, there was almost no-one there. The social scientists and others at whom these missiles were directed had apparently deserted the cause. One group were ironically seduced by a New Biology. In the 1990s, the Human Genome Project and developments in psychopharmacology catalyzed this New Biology. Academic social scientists, bioethicists and others rushed to be there at the birth of the New Man whose Star had arisen in the West. Another group vanished.

In the course of the Second World War, US Air Force planes flew into islands in the Pacific, disgorging all sorts of goods. Some of the islanders were so impressed by the appearance of these flying cornucopias that long after the military left they maintained the runways and control huts, beside which they continued to fly the American flag, in the apparent belief that the right appearances would lead to the right results. These were the Cargo Cults. For scientists reality is not a text that can be read one way today and another tomorrow. The ultimate defense of science has been that its planes fly. Science’s trump card against post-modernists is that having them in a laboratory would be the same as reproducing the airstrips and the US flag – we’d be left waiting forever for results.

But what we have now in healthcare increasingly resembles a Cargo Cult. Today’s drugs are less effective than yesterdays, treatment is now in some areas of medicine the leading cause of death, and life expectancy in the US – the country that consumes the most of the latest on-patent blockbuster drugs – is now lower than Cuba’s. Have the post-modernists slipped in unnoticed and taken over the laboratories of science?

We have all the appearances of science – controlled trials, a relentless quantification, and a stupefying recourse to statistics. And in the front row, we have anthropologists, bioethicists and others who are singularly ill-equipped to deal with statistics and issues of causality. There is no critique of what passes for ‘evidence’, and little exploration of the growing threat to all of us.

Meanwhile, the marketing departments of pharmaceutical companies have achieved what the post-modernists of the 1980s could barely have dreamt of. They rewrite the text that is the human body from year to year with afflictions such as osteopenia, erectile dysfunction and pediatric bipolar disorder that appear out of nowhere, creations of ghostwriters who practice to deceive.

Take Donna, for example. In marketing Zyprexa for bipolar disorder, in 2002, Lilly produced Donna, “a single mom, in her mid-30s appearing in your office in drab clothing and seeming somewhat ill at ease. Her chief complaint is ‘I feel so anxious and irritable lately’. Today she says she has been sleeping more than usual and has trouble concentrating at work and at home. However, several appointments earlier she was talkative, elated, and reported little need for sleep. You have treated her with various medications including antidepressants with little success….You will be able to assure Donna that Zyprexa is safe and that it will help relieve the symptoms she is struggling with”[1].

In the 1960s and 1970s Donna would have been seen as anxious, a poster case for treatment with Valium. In the 1990s, presenting with the same symptoms, she would have been seen as depressed, and in need of treatment with Prozac. Neither neuroscience nor any aspect of clinical science had moved forward by 2002 in a manner that might justify rediagnosing Donna as bipolar. But this doesn’t stop companies who are quite happy to read the vast majority of our problems one way today and quite another tomorrow.

When it comes to the hazards of Zyprexa Donna may suffer from, just as with the hazards of the Lipitor she may have to take because Zyprexa has raised her cholesterol levels, or the Celebrex she may now be on because of arthritis linked to Zyprexa-induced weight gain, or the Avandia she needs because Zyprexa has caused diabetes, Donna and her doctor will find themselves up against a radical skepticism. When it comes to the hazards of a pharmaceutical company’s drug, the rules of science do not apply and causality, it seems, can never be proven. A more succinct definition of the post-modernist credo cannot be found than the phrase “doubt is our product.”

In the midst of the Industrial Revolution, the factories around cities like Sheffield were belching out so much smoke that the sun was blocked out and children famously developed rickets. The factories of industrial post-modernism are also belching out vast amounts of smoke and people are developing diseases from pediatric bipolar disorder to osteopenia as a result that will only clear when the smoke clears. These factories also contain a production line that turns out “North Koreans”, whose job it is to defend the system (see We’re all North Koreans now). They have a department whose brief it is to work out new initiatives such as the colonization of May Fool’s Day (see May Fools’ Day).

In the face of this we need to recapture the ability to say that an increase in mortality is an increase in mortality. We need to be able to recognize that little that glistens with statistical significance is therapeutic gold, and refuse to allow companies, their experts and regulators to stand common sense on its head (see Psychotic Doubt). Speaking out would be a way for doctors and scientists to demonstrate the “right stuff” (see We need to talk about doctors).

We need our media studies and other university departments on the humanities side of the fence to deconstruct industry rhetoric. Where are they now when science needs them?

A small band of women clustered around Leonore Tiefer have responded – and derailed company efforts to industrialize female sexuality. Other women, mothers, wives and daughters have done more than any doctors to get recognition of drug-related hazards.

They are up against the vanished post-modernists, who for the most part now have jobs in the marketing departments of pharmaceutical companies.


[1] Zyprexa. Primary Care Sales Force Resource Guide (2002). Zyprexa MDL 1596, Plaintiffs’ Exhibit 01926, page 7.

Readers can also view my blog posts (Factories of Post Modernism) and find further information at www.davidhealy.org or visit my Facebook page.

15 COMMENTS

  1. There are two sides to this coin. On the one hand we have a list of do nothing drugs that may have adverse side effects not tested by the established system, but on the other we have a regulatory system that says all drugs that come to market be shown safe. This means that drugs that may be very advantageous never get to market due to safety concerns in one regard, but other less robust drugs make it, albeit with more subtle side effects that are only seen in the long term.
    Big Pharm has become the bread and butter to science, but when that happens data is often stilted toward those hoops that must be jumped for approval and not for the true advancement of human knowledge necessary to end disease.
    Its a conundrum that won’t be easily solved.

  2. In other words we-and doctors in particular-should start using our common sense again instead of following “like sheep” everything the pharmaceutical industry and scientists are saying. On the other hand we should also stop denigrating everything science is teaching us. Life is really about balance and up and douwns and no, there is not “a pill for every ill”. Doctors have forgotten how to clean out a wound for example: they only know how to dish out antibiotics and it goes for everything. Just cleaning out the “wound” would have done it most of the time-no pills needed

    • Gee, what a novel idea, using your own common sense! After all, what we’re dealing with here is not rocket science. I feel you’re correct; people need to stop looking to “pills” to cure what is normal about living; life is not linear; it has it’s ups and downs, it’s arounds and arounds, it’s forward movement and it’s backward movement. Where did we ever come up with the idea that our lives should never have any difficulties or adversaties? Perhaps from the big ad campaignes of Big Pharma?

  3. The internet is full of evidence of Healy’s ridiculous support of electroshock.

    Take this for example, from just this year…

    http://www.huffingtonpost.com/dr-peter-breggin/electroshock-treatment_b_1273359.html

    Don’t kid yourself that the great Healy is going to engage with the plebs on this blog, he doesn’t even write exclusively for this blog. Each and every blog post you see written by Healy on Madinameric.com was first published on Healy’s personal blog, Madinamerica merely republishes/syndicates what Healy writes on his personal blog.

    So don’t bother assuming the great Healy is going to engage you here on Madinamerica.com in the comments section.

    Healy’s a died in the wool biological psychiatrist who pushes electroshock. He doesn’t impress me in the slightest.

  4. I suggest if you want to discuss electroshock with Dr. Healy, you might have a better chance of an exchange on his Web site, http://davidhealy.org/blog

    We can’t answer what Dr. Healy thinks about ECT by trading rumors among ourselves.

    Most of the psychiatrists, even the most outspoken reformers, reserve a place for medication and, yes, even ECT for treatment of very extreme cases. What the definition of “extreme” is, I don’t know, but the fact is none of our champions are ideologically perfect, except Robert Whitaker, and he’s never been put in the position of treating patients.

    ECT is a serious issue, but it’s clogging up discussions all over madinamerica.com that are not about ECT. C’mon, allow other conversations here, please.

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