Showing posts with label profit. Show all posts
Showing posts with label profit. Show all posts

Saturday, 1 October 2022

Burning, burning...

©FG
You tell yourself the citizens of the country sponsored your medical studies. With a fragment of the cost of what you really need to pay, for peanuts, you got a degree. Of course, it was no easy walk in the park on your part, either. All that midnight vigil, the missed outings with buddies and the humiliations at work by seniors later on in life were your sacrifices. You were convinced that your job description would read as crucial as a bomb disposal unit. Your vocation would turn the direction of the country, it seemed. Not to forget the stresses and guilty feelings that haunted you as your patients died in your tour of duty. You can but not complain about your predicament as it was entirely your decision to plunge head in. Some reverence comes with the job, nevertheless.

Those, however, were too few and far between. The same hands that express gratitude to you would be the same ones that point accusatory charges against you. You thought they were placing you on a dais like they do to their Gods, right? When they deified you, they meant you are supposed to be infallible, and when things go south through no fault of yours, they cannot blame God, so they blame you.

If you feel it is unfair to bear the brunt of such responsibility on your tiny shoulders, by all means, move on. They are others who would gladly take over until they, too, burned out.

You are expected to do what you say and say what you do. You are just a spoke in the wheel of life. Others can use you and abuse you. But you cannot. They can be dishonest or lie through their teeth to your face. They can connive to get a big profit out of you. They can make fraudulent claims. No, siree, you cannot do any of that. You are supposed to be the paradigm of virtue. It does not matter if businessmen abuse your good office to enrich themselves. After all, they have their eyes on the money, and you have yours on the soul. So you like to believe...

(P.S. The whole equation gets distorted when the medical studies are self-financed. It is no more of paying back to society but back to the coffers. Sometimes it is an investment. Altruism rarely is in the picture.)

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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“Be afraid. Be very afraid.”*