Showing posts with label pharmaceuticals. Show all posts
Showing posts with label pharmaceuticals. Show all posts

Saturday, 7 May 2022

A nation addicted?

Dopesick (Miniseries; 2021)
Disney plus.

The medical fraternity has an uphill task. Too often than not, they have not lived up to their promise. The public cannot be blamed if they get the impression that this noblest profession has been infiltrated with financial gains, deviating far from what Hippocrates and ancient healers had in their minds. Medical professionals are looked upon as conniving smooth talkers who are just out there to cheat their clients blind through incomprehensible jargon and careful wordplay.

In the 1950s, thalidomide was hailed as the next best thing for pregnancy-related nausea and vomiting. Advertisers were out on a limb trying to sell it as a safe drug until the American courts banned its production after being linked to causing babies to be born with defective limbs (phocomelia). Then joining in the fervour in wanting to vaccinate the nation against poliomyelitis, the medical-industrial giants went on a crusade to produce a polio vaccine. Cutter Laboratories in California inadvertently had live active viruses in its vaccine instead of the live attenuated ones. Consequently, 120,000 children were injected with the Cutter vaccine, resulting in 40,000 recipients getting iatrogenic 'polio-like illness', 55 having permanent paralysis and 5 deaths.

From the Framingham studies to WHI studies, people have been painted with the same narrative by the medical business industries. Backed with scientific statistics, media presence, legal backing, bottomless financial wells and the medical professionals at their beck and call, Big Pharma can sell ice to the Eskimos. A Tamil proverb says, 'at the mention of money, even a corpse would open its mouth in awe'. In modern life, everyone and everything has a price. There is nothing like a bit of palm greasing would do.

Ad for thalidomide

Doctors often try to keep up with the latest advances in medical sciences via peer-reviewed articles and carefully conducted research. When research is tainted with grant money obtained by the drugmakers and vested interest is involved, one cannot get unbiased findings. The doctors are caught in the centre. They are in the unenviable position of bridging between the patients, who trust their good doctors and the vulture businessmen. The patients like to think that their doctors would put the patients' interest foremost, not the manufacturers', whose main appeal is showing profitability to their shareholders.

Doctors often try to keep up with the latest advances in medical sciences via peer-reviewed articles and carefully conducted research. When research is tainted with grant money obtained by the drugmakers and vested interest is involved, one cannot get unbiased findings. The doctors are caught in the centre. They are in the unenviable position of bridging between the patients, who trust their good doctors and the vulture businessmen. The patients like to think that their doctors would put the patients' interest foremost, not the manufacturers', whose main appeal is showing profitability to their shareholders.

In a world that constantly values material things over altruistic causes, it is easy for one to fall into the trap of materialism and have his soul sold to the devil. After all, they start their professional careers as debtors and spend their whole professional life trying to pay them off. Do they not deserve a little comfort in life after slogging their whole life through? 

If the recent pandemic taught us anything, it at least re-emphasised the fact that there are two sides to the story. What is accepted as the gold standard does not stay such for long. It gets 'oxidised' and loses its sparkle for new metal to emerge. First, the scientists posited that lockdown was necessary to curb transmission to avoid strain on the medical services. They promised that vaccination would help to hasten herd immunity. Then the scientific community suggested that a second dose was necessary to maintain immunity. The basic consensus about herd immunity suddenly took a re-definition. The classical dictum dictated that it is not the individual immune status that mattered but the whole community. If formerly 80% immunity was considered sufficient to ward off illness from the community, the 21st century warranted each individual to be mandated to have the vaccine, carry a vaccine passport and denied individual liberty if he decided that the whole exercise was bunkum.

Cutter polio vaccine
If all that was not enough, somebody decreed a third booster dose and maybe a fourth dose for the most vulnerable in society. The literature search for this topic becomes more perplexing. For every point substantiating a particular subject matter, there would be many opposing points depending on the type of media the issue is discussed or who is sponsoring the journal.

Almost like an afterthought, everything is off - no lockdown, no mask, no travel restrictions, no vaccine passport. I guess the financial gains from a lab-made virus have run thin.

Pain has always been thought a form of body self-defence. Injury to a specific area of the body triggers chemical substances within the vicinity to restrict the part's movements to curb further damage. Pain has always been accepted as a normal body response to trauma or inflammation. Ancient societies had even linked a virtue to this body response. Penance has been carried out to appease the divine forces. Life miseries have been assumed to be a test of faith, and the Lord's suffering on the Cross has its special meanings in Christianity.

However, to modern society, pain is a meaningless annoyance that they can do without. Perhaps, the comforts of life have turned mankind into fragile mimosa pudicas. In the 1990s, alleviating pain was the pharmaceutical industry's primary concern. The problem with oral pain medication is that the most effective of the pain reliefs are the habit-forming addictive narcotic analgesics. Purdue Pharma somehow convinced everybody, including the FDA, that their slow-release narcotic formulation, Oxycontin, is unique in minimising addiction. Addiction was determined to be less than 1% through dubious inpatient studies!

FDA and soon the medical fraternity bought the Purdue Pharma story wholesome. Doctors followed the sciences, and the scientists' recommendations were good enough. Pretty soon, doctors become more and more liberal with their prescription of Oxycontin for their patients' even the mildest of pain.


In an effort to treat pain adequately, the American Pain Society, in 1996, classified pain as a vital sign to monitor (after pulse rate, blood pressure, respiration, temperature). They even have a visual assessment chart to quantify pain to administer adequate analgesics. Interestingly, pain is very subjective, and patients tend to overscore the pain they feel, making doctors overprescribe. Purdue was not complaining. The demand more Oxycontin increased. The previously unmentioned subject of tolerance to Oxycontin came to light. Pretty soon, America saw a spate of drug-related violence. Many states with mining industries, including the Appalachian region, saw a phenomenal increase in break-ins into pharmacies. Drug addicts even started snorting Oxycontin. It piqued the interest of a particular DEA officer and a few lawyers in the AG office of the State of Virginia.

This miniseries is a dramatisation of one of the events that started the fall of the domino in the trust of the medical institution. It tells its narration with the journey of a dedicated small-town doctor who is duped by the drug company to widely prescribe and use the drug for himself. He spirals down the bottomless pit of drug addiction. He almost kills a patient and loses his medical licence. 

Part of the story involves a young Appalachian girl in the same town who was prescribed Oxycontin for a mining injury. Another part tells the moral dilemma of a drug sales representative for selling drugs with questionable benefits. Then there is the question of family dynamics within the board of Purdue Pharma.

This type of misinformation is not exclusive to the medical profession. What would a client think when his case gets dragged till it reaches the Court of Appeal and wins? Is there a hidden agenda for the lawyers to prolong his representation for more lucrative remunerations? Despite all the contributions from philanthropic members of the congregation, why is it that houses of worship are perennially short of cash and demand contributions?

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Thursday, 6 June 2013

Practising medicine in medical practice?

Side Effects (2013)
A new thriller involving the medical profession and how the medical professionals, pharmaceutical companies and the patients themselves upset a system of healing which is portrayed as a wishy-washy pseudo-science where treatment seem to be dictated by the drug companies' promises and patients' choice rather then the medical professionals taking the lead. Everybody wants a good life, hence to need to cut corners and dump ethics and professionalism. Of course with Hollywood, you must have extramarital liaisons and even same sex affairs! And they say Bollywood is masala....
Emily is ecstatic to usher in her husband who is just released from jail after 4 years for insider trading. She seem to be listless, not enjoying intimate time with her guy. One day, she hit her car purposely on a concrete wall and is hospitalized for  concussion. Dr Banks (Jude Law) is the assigned psychiatrist to treat her.
Her past medical history revealed that she had been treated by a Dr Seibert (Catherine Zeta-Jones) as a teenager for depression.
After a series of failed treatment and side effects with a plethora of anti depressives, Emily is prescribed Ablixa which is shown to have tremendous positive effects on her daily life. A minor side effect, somnambulism (sleep walking) is passed off by Dr Banks as a harmless side effect.
One day, Emily stabs her husband to death in one of this sleep walking episodes. This episode opens a can of worms - Banks is shown to be an overworking overloaded doctor, unethical doctor who allegedly had an unsavoury conduct with one of his female patients. His partners decide to terminate his partnership and his wife walks out on him with his stepson. Dr Seibert, who had suggested to Dr Banks about using Albixa actually had discovered the side effect of sleep walking.
Emily is found not guilty on reason of insanity. Dr Banks loses more than just his reputation and has to go on spree to discover the truth.
To cut through all the mumbo jumbo, Dr Banks discover a complex plot between Dr Seibert and her lesbian girlfriend, Emily, to use the side effect to kill off her husband who had deprived her of a luxurious life.
In the end, Dr Banks is reunited with his wife and her son from a previous marriage.
A disturbing observation that is also seen here is how pharmaceutical companies have clout on doctors' decision to prescribe a particular drug. As a grateful Pavlov's dog, the doctors, many of whom are nicely padded with the companies freebies, free lunches, sponsored conferences in places remotely linked to medicine like Las Vegas, feel compelled to oblige for services rendered! The business minded world has pushed advertisement of drugs to the limit that patients themselves feel that a particular other medicine would be better in their condition, just because so-and-so is using it and feels better. It looks like the doctor is just a lame duck sitting there just to receive the brickbats in case something goes wrong.
fictitious drug!
Gone are days where the paternalistic role of doctors is treasured and given utmost credence. Now, he is just another employer in the 'system' with vested interest!
If being pelleted from all sides is not enough, in Dr Banks' case, it appears like he also has to do things to please his wife and stepson. Even though he is the only breadwinner of the family at the time of crisis, the dynamics of his family dictates that he is longer the head of the family. Even in crisis, his wife is not standing by him but rather she walks out on him. The husband in present day modern family is just a castrated tiger who has not only been domesticated but has lost his majestic roar and respect. He seem to living a life just to keep his subjects (family members) contented and provided for....Kabish? capisce? Comprende? 

“Be afraid. Be very afraid.”*