Monthly Archives: July 2013
At the tail end of Stanley Kubrick’s satirical and brilliant 1964 anti-Cold War movie “Dr. Strangelove” the wheelchair bound German scientist (played by Peter Sellers) manages to stand up and take a step or two forward and then excitedly proclaim, “Mein Fuhrer! I can walk!” (This was reportedly an unscripted improvisation on the part of actor Peter Sellers) People in the throes of extreme excitement, passion or even religious ecstasy sometimes yell out to God, their mate or, in the case of Dr. Strangelove, to his leader (The American President whom he not infrequently calls “Mein Fuhrer” during the course of Kubrick’s cinematic masterpiece).
I suspect Sellers added the dramatic final touch not as an expression of the neurologic malady which landed his character in a wheelchair but, rather, as an upwelling of Dr. Strangelove’s impossible to suppress fascist sentiments and loyalty to Hitler.
In addition, I would offer a slightly different take on Dr. Strangelove’s outburst: I believe it was meant to represent the transcendent march of evil across time. That is, Seller’s was acting out the fact that evil, like death, haunts humankind and is impossible to totally suppress, manage or banish. Of course, we all know that those who do not resist and oppose evil not infrequently find their lives overshadowed by it.
The late writer-director-producer Rod Serling actually captured this theme very adroitly in a 1963 episode of the Twilight Zone titled “He’s Alive” (“He” being Hitler) that focuses on a “bush league Fuhrer” named Peter Vollmer.
Of course, we all are cognizant of the fact that evil permeates the human experience and has countless modern day incarnations. It is certainly one wheel that gets reinvented without ever showing much wear or loss of perpetrators and victims. Sometimes, though, the expressions are so continuous across time they appear to come out of some kind of historical-cosmic Xerox® machine. Click these links and reflect for a moment:
OK, so evil is perennial. What we can do about it? Laugh at and ponder comic portrayals such as Seller’s, yes, but never make the mistake of viewing evil people as clowns or easy to control (A mistake many German pre-Nazi leaders made with respect to Hitler and his cronies). But above all learn everything we can about the nature of evil and its subtlest expressions and then work to expose and oppose them.
How do you kill 12 million people? Evil then and now: Recognizing & containing it by Dr. Anthony G. Payne
The Science of Evil: On Empathy and the Origins of Cruelty by Dr. Simon Baron-Cohen
Copyright 2013 by Dr. Anthony G. Payne. All rights reserved.
Harvard Medical School’s Dr. Marcia Angell is the author of The Truth About the Drug Companies: How They Deceive Us and What to Do About It. But more to the point, she’s also the former Editor-in-Chief at the New England Journal of Medicine, arguably one of the most respected medical journals on earth. But after reading her article in the New York Review of Books called Drug Companies & Doctors: A Story of Corruption, one wonders if any medical journal on earth is worth anybody’s respect anymore.
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”
Dr. Angell cites the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard’s Massachusetts General Hospital. She explains:
“Thanks largely to him, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the Food and Drug Administration (FDA) for that purpose, and none of which were approved for children below ten years of age.”
Biederman’s own studies of the drugs he advocates to treat childhood bipolar disorder were, as The New York Times summarized the opinions of its expert sources, “so small and loosely designed that they were largely inconclusive.”
In June 2009, an American senate investigation revealed that drug companies, including those that make drugs he advocates for childhood bipolar disorder, had paid Biederman $1.6 million in “consulting” and “speaking” fees between 2000 and 2007.
“Two of Biederman’s colleagues received similar amounts. After the revelation, the president of the Massachusetts General Hospital and the chairman of its physician organization sent a letter to the hospital’s physicians expressing not shock over the enormity of the conflicts of interest, but sympathy for the beneficiaries: “We know this is an incredibly painful time for these doctors and their families, and our hearts go out to them.”
Biederman’s failure to disclose his Big Pharma payments to his employers ar Harvard (as is required for all Harvard employees) has been under investigation* for the past two years by Harvard Medical School, in as journalist Alison Bass describes this: “what must be the longest investigation in that school’s history”).
Dr. Angell’s article contains bombshell after bombshell, all gleaned during her tenure as NEJM editor. For example, on the subject of doctors who are bought and paid for by Big Pharma, she writes:
“No one knows the total amount provided by drug companies to physicians, but I estimate from the annual reports of the top 9 U.S.-based drug companies that it comes to tens of billions of dollars a year in North America alone.By such means, the pharmaceutical industry has gained enormous control over how doctors evaluate and use its own products. Its extensive ties to physicians, particularly senior faculty at prestigious medical schools, affect the results of research, the way medicine is practiced, and even the definition of what constitutes a disease.”
Revelations like this from medical profession insiders cast serious doubt on more than what’s printed on the pages of these medical journals.
Your physician reads these journals, treatment decisions are changed, care is affected, drugs are prescribed – all based on Big Pharma-funded medical ghostwriter-prepared journal articles from physicians who fraudulently claim to be the study authors. Then you walk out of your doctor’s office with a prescription for a drug that may or may not kill you, based on treatment protocols written by doctors like Biederman who are on the take from Big Pharma.
A very recent example of the sad reality over at the once-prestigious New England Journal of Medicine is their decision to publish a drug company-funded review article. This review attempts to discredit emerging research suggesting that many years of using Merck’s Fosamax or Procter & Gamble’s Actonel (both osteoporosis drugs in a class called bisphosphonates) could actually result in more leg bone fractures.
Not surprisingly, drug manufacturers of bisphosphonates are fighting back ferociously against this emerging (independent) research. A Merck-funded review paper published in the NEJM on March 24, 2010 concludes:
“The occurrence of fracture of the subtrochantericor diaphyseal femur was very rare, even among women who had been treated with bisphosphonates for as long as 10 years.”
Sounds promising for Big Pharma. But if you look very, very closely, the article’s fine print confesses:
“The study was underpowered for definitive conclusions.”
You might justifiably ask yourself why a medical journal would stoop to publishing a meaningless scientific paper that the paper’s own authors admit lacks any conclusion. Even more troubling than a journal article that was itself bought and paid for by Merck, is the conflict of interest disclosure list at the bottom of this NEJM article. It reads like a Who’s Who of Big Pharma.
Of the 12 study authors listed in the NEJM article, at least three are full-time employees of Merck or Novartis. Each one of the other nine admit owning equity interests in or receiving cash, travel expenses, or “consulting and lecture fees” from companies including Merck, Novartis, Amgen, Roche Nycomed, Procter & Gamble, AstraZeneca, GlaxoSmithKline, Medtronics, Nastech, Nestle, Fonterra Brands, OnoPharma, Osteologix, Pfizer, Eli Lilly, Sanofi-Aventis, Tethys, Unilever,Unipath, Inverness Medical, Ortho Clinical Diagnostics, OSIProsidion, or Takeda.
Why is the New England Journal of Medicine or any other credible medical journal accepting for publication articles submitted by paid employees of pharmaceutical companies?
As a cardiac patient, I’m gobsmacked by what appears to be this systemic corruption of not only medical journals who continue to publish what they clearly know is tainted research linked to drug marketing, but of the very doctors whom patients trust to look out for us. Since my heart attack in 2008, I take a fistful of cardiac meds every day, and I have no clue which of them were prescribed for me based on flawed research or tainted medical journal articles funded by the very companies that make my drugs.
And worse, neither do my doctors.
Happily, there are other decent physicians out there who, like Dr. Angell, are just as outraged as she is. Her targets are not just guilty of unethical conflict of interest – they are criminals who should be charged with endangering our health while padding their wallets.
Read Dr. Angell’s article from the New York Review of Books, called Drug Companies & Doctors: A Story of Corruption.
* NEWS UPDATE: “Massachusetts General Hospital Discloses Sanctions against Three Psychiatrists for Violating Ethics Guidelines”, July 1, 2011: The Boston Business Journal said today that three psychiatrists have been sanctioned for failing to adequately report seven-figure payments they received from drug companies.
Drs. Joseph Biederman, Thomas Spencer and Timothy Wilens disclosed the disciplinary actions against them in a note to colleagues. According to a copy of the note made public upon request by the hospital, the three doctors:
• must refrain from “all industry-sponsored outside activities” for one year
• for two years after the ban ends, must obtain permission from Mass. General and Harvard Medical School before engaging in any industry-sponsored, paid outside activities and then must report back afterward
• must undergo certain training
• face delays before being considered for “promotion or advancement.”
The three doctors have been under the political microscope since June 2008 when Senator Charles Grassley, R-Iowa, began investigating conflicts of interest involving clinicians. Biederman and Wilens have since admitted to accepting $1.6 million from drug companies whose drugs they were promoting; Spencer took $1 million.
Senator Grassley said, according to an online version of the Congressional record:
“These three Harvard doctors are some of the top psychiatrists in the country, and their research is some of the most important in the field. They have also taken millions of dollars from the drug companies.”
- Does The Medical Profession Need To Wean Itself From The Pervasive Dependence on Big Pharma Money?
- Warning: Clinical Trials Funded by Drug Companies May Appear More Truthful Than They Actually Are
- Bioethical Journal: “How Drug Marketing Corrupts Every Part of the Scientific and Medical Network”
- How the “Shrink’s Bible” Can Make you Sick
- Harvard Cozies Up with Big Pharma
- Harvard’s Ethical Ultimatum to Doc: Give Up Big Pharma Moonlighting Jobs, or Lose Harvard Teaching Post
- Is Your Doctor a “Thought Leader”?
- Bad Doctors Earning Good Money from Big Pharma
- Doctor’s Kiss & Tell Tale: My One-Year Career As a Drug Rep
No doubt you’ve come across more than a few TV segments or Web items or both on the many eye-opening episodes from Paula Deen’s past involving racially insensitive words and deeds (The latest being a just released NY Times story at http://nyti.ms/12mBZaO). What I found troublesome in all this was the argument (rationalization) she offered a while back to the effect that the South she grew up in was in some ways a bastion of antebellum bigotry and thus by extension it is almost expected that folks who grew up in it would harbor such notions. Oh, don’t get me wrong, I’m sure this is true. In fact, I know this is true because I grew up in the South (Texas and Louisiana) during the very time Deen did. I am Southern born & bred and have ancestors on both sides of my family that go back to before the Revolutionary war in South Carolina, Georgia and Mississippi. My great, great grandparents and their offspring lived as citizens of the C.S.A. and some actually fought under the stars & bars as Confederate soldiers. However, my Euro-American father and American Indian (Choctaw) mother never used racist terms or tolerated racist jokes nor even once used the N-word. Not once. And while I heard this pejorative word tossed about by other Southerners as both a put-down of African Americans and as a way to defuse their own fears of (I gather) being upstaged by them, I wanted no part of it. So it follows that a Southerner can grow up around racist words & thinking and yet not wind up perpetuating them in word or deed. This lends me to be wholly unsympathetic to Deen’s attributing what she said and did in the past to exposure to what amounted to “acceptable bigotry”.
This Broadway hit gets a solid film treatment by director Norman Jewison, but that can’t make up for the weaknesses of the script (which were as true onstage as they are here). Jane Fonda plays a chain-smoking shrink sent to a convent to do a psychological evaluation of a novice (Meg Tilly) who gave birth to a baby and then killed it in her little room. Was it a virgin birth? A miracle? And what of the bloody stigmata that seem to spontaneously appear on her hands? Fonda also finds herself clashing with the Mother Superior (Anne Bancroft) over the line between faith and science. But writer John Pielmeier can’t flesh this out beyond an idea; in the end, the solution is a disappointingly earthbound one that even the strong acting in this film can’t elevate.
OK, so the film isn’t flawless and has garnered more than its fair share of “1 or 2 thumbs down”. With this said, I like this flick. Why so? In-a-word it lays in the fact Agnes the novice nun somehow manages to interact with the world thorough a lens of innocence. That is, the unjaded aspects of her being for the most part dominate her day-to-day existence and how she perceives life and those around her.
Hollywood nonsense, you say? I might have agreed with you if this were early 1999. But not afterwards. What changed for me? I spent more than four years in Japan living and teaching classes of Japanese young people from pre-school through doctoral level plus many corporate classes filled with adult working professionals. What I discovered was that virtually all the young folks were, well, in some ways “Agnes of God” like. Mind you, I was aware that there were exceptions and many expats I shared sake and chat with were quick to point out their bad experiences with pretty jaded Japanese characters. But on-the-whole even they agreed most Japanese people they had encountered while teaching and in society at-large exhibited less of the cynicism and sheer nastiness that appeared commonplace back in the US and the West in general (Some of these expats came from the UK, New Zealand and Australia).
My then girlfriend and later (2001) wife thought I was seeing her people through rose colored glasses. This changed once we moved from Japan to southern California in early 2003. Having left being the corporate world in Japan (18 years work for a major multinational corporation in Tokyo), she pursued her long held dream of becoming a marriage and family therapist. This journey took her through the MS in Counseling program at Cal State Fullerton (she graduated with honors) and internships at a number of places including the Salvation Army residential program in Anaheim. While doing an internship at MiraCosta College in Oceanside, she happened to counsel a number of Japanese students who had come to the US in order to obtain specific educational credentials in an English language environment. What she discovered — and made a point of mentioning to me — is that her Japanese charges were very “unjaded” compared to the American students she counseled. Maybe my glasses were not so rose-colored after all.
At the very least, there seems to be at least a modicum of real world evidence that my original observation was spot on: The Japanese were and are on-a-whole less jaded (“more innocent”) than Americans.
Were Americans less jaded in the past? It seemed that way to me when I was a youngster. TV and movies in the late 1950s into the 1960s tended to reflect a certain un-worldliness (Less cynical, less nasty). This began to go out the window with the advance of the sexual revolution, Vietnam and all that entailed, and the general rejection of authority and conventional ways among many young folks of that era (including moi).
Can we ever recapture what we lost short of embarking on a 2nd childhood (individually and collectively)? Is the genie out of the bottle for good? Is there any way to truly be “as wise as serpents and as gentle as doves” (Rabbi Yehoshua’s admonition). Good questions, I think. We American Indians (Choctaws) have a saying that goes like this: “The dog you feed the most becomes biggest”. By this token if we as Americans feed ourselves on jaded & cynical things such as pornography, greed, pride, and other vices then the dogs that will steer our sled (lives) will be these vices. On the other hand, if we feed virtues and starve vices, well, we just might find ourselves less jaded and “wicked”. And while we may not become a nation of “Agnes of God” characters or even Japanese-like, we could inch a little closer to it.
Dr. Anthony G. Payne
Copyright 2013 by Dr. Anthony G. Payne. All rights reserved.
http://www.sciencedaily.com/releases/2013/07/130716144037.htm – Steering Stem Cells With Magnets
http://www.medical-hypotheses.com/article/S0306-9877(04)00010-6/abstract – My 2003 paper titled “Using immunomagnetic technology and other means to facilitate stem cell homing” (Medical Hypotheses, Elsevier UK)
If you belong to a faith tradition or religious perspective that views the fusion of sperm and egg as marking the advent of a human life, you are probably very unlikely to modify your stance. As one who grew up in the Bible belt among Protestant fundamentalists and evangelicals (upwards of 90% of my family), I know where you are coming from. There is black & white, with grey being a species of unacceptable compromise that is akin to bedding down with evil incarnate.
If you happen to belong to the “B & W’ contingent, perhaps you buttress your antiabortion convictions like many aspects of your most cherished religious beliefs with borrowings from the world of science and medicine, however tenuous some of these may be. As you may know or at least have heard, many religious beliefs are not testable and thus lie outside the purview of science. For example, the religious concept that every human has a soul or spirit imputed by the Almighty at conception or thereafter is not something that can be tested and verified or refuted using the tools of science. There is no laboratory assay that will disclose or measure something that is held to have no material substance as we know it and which is not physically manifest in cells or tissues or such.
For believers who hold that ensoulment (i.e., spirit is imputed) occurs at conception, and (who) refuse to consider even slightly modifying this perspective in light of contrary biblical reasoning, there exists an impasse that cannot be readily breeched (If at all). When enough people embrace such a spin on what constitutes viable human life, their collective influence on the direction state and even federal legislation takes is felt (Some would argue disproportionately so). Of course, the courts have weighed in to keep even majority sentiment from what they conclude impinges on or overrides the Constitutional rights of the minority.
Many scientists regard the convictions of those who hold that viable human life begins at conception or during the very early stages of development as both presumptuous and naive. Many religionists and theologians agree. Among those who happen to hold fast to a belief that a fertilized egg is entitled to full status as a viable human, the use of blastocytes or very early stage embryos constitutes a species of murder. Some even go so far as to decry those who take exception to their faith-based beliefs as being immoral or amoral.
Does the truth lie somewhere between the strictly secular and the sacred? Most of us probably harbor a feeling that somewhere in all this – lurking in the facts of biology and the world of polemics and logic, ethics and religion – there is an answer that will win the day. If this is the case, it is quite obviously going to take time for such a truth to fully emerge.
Many have asked me, “What is your spin on what constitutes viable human life?” Being as I have a foot in both worlds – which is to say religious belief and science – it seems logical to suppose that I would be able to offer up a “faith and science-friendly” opinion as to when viable human life begins. Well, yes, I do have something to offer up for consideration though the only thing I can be 100% certain of is that my opinion will be contested by people on both sides of the “great divide”. With this in mind, here is my spin – informed by biology, of course.
The heart begins beating at three weeks of gestation and the first neural reflex is manifest at eight weeks (and consists of hand withdrawal in response to stimulation of the fetal lip region). During weeks 9-13 the first brain waves appear and are discernible using special medical instrumentation.
Given that death is defined (in part) as a cessation of both heart and brain wave activity, one could argue conversely that to be alive in any meaningful sense beyond mere biological existence (A petri dish bearing a cell culture has biological existence, after all) begins when both heart and brain are operational – week 9 onwards.
Interestingly, in my own faith tradition which is informed by lines of moral & ethical reasoning in Rabbinic Judaism, the fetus generally becomes a viable human life after day 40 of gestation. In the ancient Jewish context, the fetus is deemed to be little more than water until “quickening” occurs, about 40 days after insemination. “What Do Orthodox Jews Think About Abortion and Why? By Judith Shulevitz – Orthodox Jews on Abortion. If we take week 9 as our bench mark — the heart and brain being recognizably functional – then the fetus would be deemed viable from about day 63 onward.
Applying this definition of when human life becomes viable, it follows that embryos from conception to week 9 or so are “pre-viable” or “proto-viable.”
Now is this to say that embryos prior to week 9 are “fair game”? Say, that we can create embryos strictly for the purposes of harvesting their tissue and/or stem cells for medical research or other applications? These embryos aren’t viable, so why not? Well this brings us full circle to religious and ethical concerns. Rather than belabor that in this op-ed piece, I would direct readers to an excellent treatment of this subject in this posted article: Jewish Virtual Library – Abortion
OK, so we don’t create embryos to harvest, how about using intentionally aborted fetuses as a source of tissues or embryonic stem cells for research or medical application? As one fellow actually said to me, “Hey, Doc, they are going to die anyway, so why not get some good out of them for sick and ailing people”. To my mind, this comes uncomfortably close to the arguments advanced by physicians and scientists who performed hideous experiments on human subjects in Nazi concentration camps. This very line of reasoning was, in fact, used as a defense by some of the physicians being tried for war crimes in the 1946 “Doctor’s Trail” in Germany). Granted, there is a world of difference between elective abortion and the intentional dispatch of life at the hands of doctors (such as the late Nazi “Angel of Death” Dr. Josef Mengele and his ilk) who abandoned universally acknowledged medical ethics in the service of the state. But even so, harvesting aborted fetuses from any source does strike many folks in America as constituting a form of callous utilitarianism that can’t help but bring to mind some of the most egregious polities and activities in the Nazi bio-state – or perhaps the fear that our country is headed in the direction of making prophecy of the classic sci-fi film “Soylent Green” – or both. And even if the intentional abortion of a fetus before week 9 were universally embraced as morally and ethically acceptable – in no way offensive to humankind or the Almighty – there remains something hauntingly “predatory” about utilizing material from intentionally terminated “pre-viable” human material.
All things considered, it seems unlikely that access to abortion will prove a genie that can be returned to the proverbial bottle (This side of the US becoming an authoritarian or police state run by pro-life factions at all levels, that is – something the majority of Americans would vehemently oppose). And while restrictions on the direction embryonic stem cell research and use takes will likely continue to be a legislative and ethical tug-of-war between various factions, a return to an outright ban on government provided/sanctioned embryonic stem cell lines seems unlikely. This leaves what is being played out now at the political level: That is, the fact many state legislatures such as my own native state of Texas in 2013 are leaning towards placing considerable restrictions on access to abortion services. This gambit may succeed especially in states dominated by a traditionally conservative majority although I predict any such this legislation will be eventually overturned by the Supreme Court as being unconstitutional.
Perhaps my life-at-9-weeks-on criteria should be thrown into the abortion access deliberations mix. Let’s revisit it:
Given that death is defined (in part) as a cessation of both heart and brain wave activity, one could argue conversely that to be alive in any meaningful sense beyond mere biological existence (A petri dish bearing a cell culture has biological existence, after all) begins when both heart and brain are operational – week 9 onwards
Of course, I am not actually advocating that my definition (above) be transformed into new legislation or such that is imposed on all women across the land. But for women who come out of conservative faith traditions what I have laid out might help them in deciding at what point-in-time during a fetuses’ development abortion constitutes an ethical or moral misstep. For those who find my approach reasonable, use of a “morning after” pill constitutions no sin nor does an abortion prior to week ten (10) post-conception.
In the final analysis, the whole matter comes down to personal choice informed by the unique constellation of social and life factors & players that characterize each woman’s life.
© 2013 by Dr. Anthony Payne. All rights reserved.