There has been a fascination recently with watching the orchestrated demonstrations of flag-waving enthusiasm for the regime that emanate from North Korea – the waves of people moving in synchrony like a shoal of fish. It’s difficult to know whether it is scarier to have the population behave this way and not believe in their leaders or have them behave this way because they do believe in their leaders.
North Korea seems unique. Having something like that happening here is unimaginable.
Over a year ago I attempted to bring the issues of violence on antidepressants and other psychotropic drugs to the attention of the American Civil Liberties Union (ACLU). ACLU has a distinguished record in helping vulnerable and marginalized groups cope with the power of vested interests. I thought they might be interested to get to grips with the certainty that there are people ending up in the criminal justice system at huge public expense who are innocent. People who are not guilty of the crime they are accused or convicted of by virtue of a prescription-drug induced intoxication. My phone calls and emails went unanswered.
ACLU it seems only want to hear about access to treatment. They want to ensure that everyone within the criminal justice system who could conceivably be deemed in need of mental health treatment gets access to psychotropic drugs.
Around the same time I had been lecturing on the issues of Antidepressants and birth defects. Antidepressants double the risk of major birth defects, double the rate of miscarriages (one of the biggest predictors of a woman’s future mental health), cause all kinds of other problems and now appear linked to learning disabilities/mental handicap/autistic spectrum disorder in the children born to women who take them during pregnancy. I thought the issues would be of interest to the women’s mental health movement and to feminist groups.
But the response from the women’s mental health movement, and in particular feminists, has been hostile. All they want to hear about it seems is a woman’s right to access treatment and getting as many women as possible on a psychotropic drug.
This is less surprising than it might seem when you take into account that pretty well the only issue that unites the most divided American legislature ever is agreement that consumers need to be able to access the latest drugs and medical devices at the earliest possible opportunity.
It’s difficult to avoid the impression that we are all North Korean now.
It’s harder to work out whether we are jiving in unison because we all hear the same tune and love it, or whether many of us keep step because we are scared. Listening to colleagues, especially from America, confess their fear to having their name put on documents questioning the benefits or noting the hazards of treatment, there is clearly a great deal of fear, almost – to pursue the North Korean theme – a new McCarthyism.
But it’s also easy to see where enthusiasm for the flag-waving comes from. The rallying cry is we want to Beat Cancer or Beat Schizophrenia. It would be un-American not to want to beat Cancer or Disease. This is exactly what pharmaceutical companies trade on – what makes them so profitable and what gives them such an inside political track. Beating Cancer or Disease means getting the latest high tech weaponry and deploying it with as much Shock and Awe as possible.
The latest doesn’t mean the best. It used to be the American way to put Men on the Moon and to produce the drugs that got people off their death beds and back to work before anyone else. But rather like the recent North Korean rocket that crashed soon after take-off Western drugs are increasingly more likely to kill than cure but we take them it seems in part because they create jobs (see Pills and the Man).
Philippe Pinel’s famous claim (see Pharmageddon) that “the art of medicine lies in knowing how to administer medicines properly, but that it is an art of much greater and more difficult acquisition to know when not to treat” increasingly to Western ears sounds very like Jacques Chirac the French President (aka the cheese eating surrender monkey) at the time of the Second Gulf War suggesting it might be wiser not to go to war. This is not the American way.
Pinel came up with his famous dictum in 1800 and like North Korea he seems slightly anachronistic now. It sounds paternalistic to have a doctor decide for you and distinctly un-American to have a doctor decide not to treat you. But what if we were to update Pinel to ‘If I have to live with a disease there is an art in knowing how and when to use potentially helpful drugs but probably an even greater art in knowing when not to use them’.
From this point of view things look different. It looks like there might be more than one way to Beat Cancer. Launching into an all-out assault with the latest cocktail of poisons is one way to go about it – a way that also makes a profit for drug companies and might give the public health authorities better cancer figures but may not be the way for me to beat my Cancer. A way that’s good for the North Koreans out there who are happy to strip all individuality out of medicine in favor of a national 5-year plan but not a way that fits Yankee individualism.
You have to feel that professional discretion is not much more welcome in the West these days than it would be in North Korea. This is a world in which the skepticism that gave rise to Evidence Based Medicine is to be treasured but is vanishing fast. Except when it shows drugs don’t work, Evidence Based Medicine can never tell me when it would be wise not to treat – paradoxically it always pushes toward treatment.
For me to beat my Cancer or Schizophrenia might mean focusing my energies on completing the projects closest to my heart rather than having my attention consumed by a project that suits Cancer, drug companies and other interest groups. Treatments will be helpful in so far as they help me meet my goals and harmful if I get bent out of shape to fit the goals of treatment.
It’s difficult to know whether what we are faced with at this juncture is Disease in its Ur-form co-opting companies and societies using the most sophisticated brain-washing to all but forcibly administer ever more chemicals to the population so that treatment induced death and disability has likely overtaken death and disability from Cancer or other major diseases. Americans are now falling down world life expectancy tables. Cuba overtook America in this league some time ago; will North Korea be next?
If we are not being stalked by Disease, the alternative seems even more problematic. In this case, companies are using the specter of disease to take as much money from us and from the public purse as they can possibly manage – with no regard for whether we might benefit. If they had some compunction and did not extend their rapacity to our children they might get away with it but Moloch-like they demand everything.
The most effective company propaganda, the line that has enabled them to body-snatch 10,000 doctors has been – “It’s the disease not the drug”.
Faced with the new leading killer – pharmacosis (see forthcoming blogs) – do modern Pinellistas need to say – “It’s the company not the disease”.
North Korea is an anachronism that can’t survive, so maybe there’s nothing to worry about. We will wake up from dystopia and normal service will resume. Or have we woken up from the 1950s and 1960s, which gave us a cornucopia of real cures and North Korea, to find normal service has resumed?