Thank you for writing about the ADHD drug pushing. I educated myself on this agenda 26 years ago when some started recommending we get our 2-yr-old on ritalin because he was difficult. This drug marketing campaign continued throughout his childhood, with the public schools pushing hard, telling us his grades would improve. He never went on any meds, is grown and doing fine, in spite of all those telling us we were messing him up by not putting him on a Schedule II drug.
We had to stand firm against docs, teachers, friends and acquaintances. It's amazing the number of school staff that are willing to diagnose and recommend meds.
Yes it is! It’s also illegal, but the talk goes like this: “we’re not allowed to diagnose your child with anything, only a doctor is… but you should really take him to a doctor, wink wink nudge nudge”
A very interesting article, Doctor. I'm deeply grateful for 60 mgs of Ritalin ER every day. I have a moderate to severe traumatic brain injury, one of the effects of a suitcase bombing which nearly killed me when I was seven.
Because of the nationwide shortage of psychostimulants, I ran out of Ritalin ER eighteen days ago. Somehow, I survived the next ten days with a higgledy-piggledy combination of mostly ineffective Concerta, Buproprion ( which my system has a love/hate/hate relationship with ) and a few 10 mgs methylphenidate instant release tablets.
Thank God that eight days ago, a pharmacy I tried actually had the stuff in stock, and my good doctor was quick to get a prescription over to them. But it wasn't until two days ago that I started to feel my normally dysfunctional self. And I am getting anxious about what will happen in three weeks, when I need a new prescription. The pharmacist whose pharmacy had a supply of Ritalin ER is an immediately trustworthy, compassionate, and likeable fellow, and I'm going to be conducting a well tempered quasipolitical campaign starting next week to encourage him to be vigilant about his Ritalin ER supply.
Nothing else really helps, and Ritalin ER doesn't help all that much, but it's the pick of the litter for me. I do vape cannabis, reluctantly. As you may be aware, many military DAI survivors of the last twenty years claim that Big Pharma drugs did nothing for them, but that switching to cannabis made a remarkable difference. I wish it worked that well for me. It may be that I have not yet discovered the right chemovar, though I have after much trial and error found a way to use it in the nighttime which generally gives me an amazingly good sleep by my low standards. But I have never found the magic bud. ( I don't like the stuff, anyway. This probably means I'm the only American who doesn't like marijuana. ) My magic bud would stimulate me, possibly supplanting completely all Big Pharma drugs. I don't want to be stoned all day. I want to be energized so I can read more, watch many of the hundreds of films on my various watchlists, practice guitar and mess around with my keyboard, and maybe start to play poker on at least some Friday nights with guys from my church.
You would be hard pressed to convince my excellent neurologist that ADD isn't real. He has it, badly, but will not take medication for it because he says medication impairs his creativity. Perhaps I'm not the only patient of his who wishes he would reconsider. We respect him and are grateful for him, but he can be maddening at times.
A suitcase bomb at age 7! Wow, thank goodness you’re ok. Yes, I will definitely have to reconsider my stance if school bombings start to increase…
In a perfect world, without pharma making billions pushing the drugs, the very small minority of suitcase bomb sufferers could get the treatment they need, while rambunctious 6 year old boys would never even come close to getting a whiff of amphetamines. It’s an infuriating tragedy that every time doctors claim they must, must prescribe this stuff because of the extreme cases, they barely take a pause before turning around and handing the meds out like candy to middle schoolers. It’s so irresponsible and terrible and frankly will almost certainly end up hurting sufferers like you - whether from the shortages that overprescribing causes, or from a crackdown on all prescriptions that may come if America pushes back on this pharma madness. I’m so sorry you’re in this position!
I certainly agree with your neurologist about the medication impairing creativity. ..
I sincerely hope and pray you’ll be able to enjoy many a poker night soon!
What alarms patients about doctors is the awareness which many of us have that doctors are prone to going on kicks, and that medicine rarely seems to learn from its embarrassments.
As to the latter, as you know, until the 1990s, the unquestioned wisdom among doctors was that ( imagine schoolteachery, patronizing, overly kind voice ), "Ulcers aren't caused by what you eat, they're caused by what's eating you!" And you know how thoroughly the provincial Australian doctor and his assistant were ridiculed who proposed forty years ago that ulcers might be caused by h.pylori. They did eventually receive the Nobel Prize for Medicine, however.
Remember the Kennard hypothesis? Dr Kennard herself was a responsible scientist who was dismayed that medicine would take her work with intentionally brain injured macaque monkeys, as fascinating and intriguing as it was, as essentially proof that, as one sensitive neurologist put it, "I can tell you one thing, you're much better off getting a traumatic brain injury at 7 than at 27!" Now, the Kennard hypothesis is dismissed by most pediatric neurologists and neuropsychologists as something which, through no fault of Dr Kennard's, could more accurately be called the canard hypothesis.
The Glasgow Coma Scale is still moving, but it's fatally stricken, and in a few years, last rites will have been pronounced.
You know well that though there is a considerable argument to be made for ketogenic diets, the food pyramid remains the Establishment approved guidon for the ideal American diet. Those Americans who do follow it, who eat baked potatoes, not potato chips, are prone to obesity, insulin resistance, and unnecessary premature death from cardiovascular disease. I haven't heard plans for a re - plotted food pyramid.
In 1984, there was a likeable weeknightly PBS talk show broadcast from Detroit, The Dennis Wholey Show. One evening the guest was an authoritative cardiologist. I think it was a phone caller, a young man, who asked the doctor about the advisability of eating eggs. The doctor glowered at the camera, thrust his finger at it, and snapped, "Let me tell you something: if you eat more than three eggs a week, you're asking for death from heart disease by age 35!" My too conservative estimate is that I have eaten at least 50,000 eggs in my lifetime. And here I am at 71, tapping out this reply to you.
I'm sure you know that your despised Ritalin was kept off the market by the FDA ( I presume ) for several years in the late 60s - early 70s period. I have the following on the authority of a former neurologist, who isn't the type to make lurid things up to entertain his patients: a neurologist who practiced in upstate New York had, on a hunch and persisting by intuition, been using Ritalin to treat his brain injured patients. He and they were delighted by the success they were having with it. The patients were terrified and the doctor incensed. He wasn't prepared to let them go. He began to smuggle Ritalin in from Europe and sell it to his patients at cost. God knows how many lives he rescued until Ritalin was put back on the market. As you know, he was risking not just his license but his freedom. He never got caught, and a number of people had their lives turned back to them to live. I will always be wistful that I wasn't this man's patient. Traumatic brain injury ought in most cases to be called "chronic brain disease," neurologists Brent Masel and Douglas DeWitt asserted in an article published in 2010. It becomes a chronic, degenerative disease in the vast majority of those who are not treated sufficiently immediately after the injury. My own life has confirmed their conviction. I wonder what my life would have been if in 1970, when I was trying desperately to be and failing to be a college student in Texas, I had somehow found my way to the neurologist in upstate New York? True, I was eleven years out from my injury, but knowing how steadily I have deteriorated my life away, I think it's possible I might at least have been stabilized.
Is chronic fatigue syndrome, the most inadequately and therefore cruelly misnamed disease in history, still called chronic fatigue syndrome? I do hope that today's medical Establishment no longer dismisses it as yuppie flu, or at least that they've stopped making jokes about their loser patients, my contemporaries, thousands of whom committed suicide because they couldn't be taken seriously by the doctors. If so, it's no doubt a deep comfort to the bereaved parents, spouses, and children who remain alive.
A brilliant doctor of about a hundred years ago once said sadly, "Posterity will forgive us our mistakes, but never our pretensions."
Having rehearsed some of medicine's embarrassments during our lifetimes with you, I'd like to talk a little about its penchant for kicks. One of its more vibrant ones is its kick against benzodiazepines. A few years ago, I heard a news report that researchers had concluded that if a person takes ninety doses of a benzodiazepine in his lifetime, he has a vastly increased likelihood of developing dementia. I screamed with laughter. I said to a friend, "****! I've taken ninety doses in a month!" I wasn't exaggerating. I've been taking strong doses of benzodiazepines for over twenty years. My brain, which had had enough trouble as it was, should have turned to tofu many years ago, but somehow, it didn't get the word.
This would be funnier if whichever board in my state which is empowered to do such things weren't conducting what one of my doctors has called "a reign of terror" against doctors who prescribe benzodiazepines in significant amounts. He went on to tell me of medical licenses being yanked arbitrarily from doctors who may have been perfectly responsible in prescribing them. It's one of medicine's current kicks around here, Dr Gaty. It's likely I'd do better on 4 mgs of clonazepam. My doctor is afraid to prescribe more than 3 mgs. I don't hold it against him.
I ask you and your readers to say just one prayer that I'll be able to get my Ritalin ER without interruption.
ADD. Here's an irony. Whatever ADD, nonexistent thought it is, may be, I almost certainly had it when I was injured. If not, or if I had been properly treated for it, I probably would not have been running like a madman, against the screams of teachers who told us to stop, with my friends who were killed, out onto the playground where a lunatic with a suitcase bomb was waiting for us.
Speaking of medicine's embarrassing history, the history of neurology/psychiatry will make your hair stand on end.
Regarding benzos, well, you probably know Jordan Peterson's take on the matter, and I have lost terrible losses of very dear loved ones to benzos, so add me to the reluctant list. It's the same as opioids, which do indeed help a minority of true sufferers of chronic pain, and there's no denying that they truly, truly help - but I think opioids also kill more Americans each year than died in Vietnam, or something like that.
I'm afraid there's just no good answer, it's a hopelessly irresponsible, crooked, ignorant profession, and there seems to be no way to get chronic pain sufferers and traumatic brain injury victims the genuine help they need (to the extent that medicine even understands what help they need, which is basically still largely a black box) without also destroying the minds and lives of countless innocent people.
Doctor, it takes a man of excellence and honor to have written this. Thank you.
It's hilarious: I have said to people that there could be a book about medicine's fatuitities in the 20th century ( it would hardly be fair to start earlier ), the first volume of which would run 1,000 pages. Volume II.,1,500 pages, would cover the period between 1945 - 2000.
I had no idea that such a book, if limited to psychiatry and neurology, existed, and thank you for telling me about it. It has a new and eager reader in its immediate future.
My primary care physician is my neurologist. He's a terrific guy. I'm blessed to have him. Why is my former neurologist not my neurologist anymore? Because I sought some information from his former medical partner, who was my clinical neuropsychologist for eight years, the neuropsychologist in turn violated the doctor/patient confidentiality ethic ( as I understand it ) by telling my neurologist without my permission what we had talked about, and my neurologist kicked me out. Here's some "hopelessly irresponsible, crooked" stuff for you.
The woman who was in charge of medical records for my neurologist is a vacuous malignant narcissist. Tanya is also, by the measure of anyone with an eye, gorgeous. She could have been a Playboy centerfold when Playboy was still erotic. It was clear to me that she was interested ( euphemism alert ) in me. I was repelled by the emptiness I sensed in her, never said anything personal to her, was polite, businesslike ( one of the most barren words in the English language ).
To abbreviate, I realized when it was too late for me to do anything about it, that she had retaliated. She had sabotaged a claim I had for an upgrade in disability payments after the deaths of my parents. She had done this by not sending a single document to Social Security which even hinted that I had a neurologist, let alone why. ( This has cost me at least $150,000.00 by now. If it weren't for the amazing generosity of my church in supplementing my SSI, I couldn't have survived the last six years. )
At my next appointment with my neuropsychologist, we hadn't even sat down before I'd finished telling him the whole thing in one compact outburst of rage. He said, "I have been telling him for years that he needs to get rid of her."
So, my neurologist fired the woman for gross misconduct, right? No. He kept her in the same job! I never said anything because I needed my neurologist, who did try his best with me for many years. The mystery is why he kept her in the job. There is not a chance that my neuropsychologist would not have told my neurologist what had happened. Yet, he kept a woman who had done something which by anyone's reckoning is an antisocial act in the same job which she had used to commit the antisocial act!! I imagined he feared a lawsuit, but this made no sense to me. How could I have sued about something someone hadn't done, and which I couldn't prove? In any event, if it had been possible, morally, I, at least, never could have sued him. My conscience wouldn't have allowed it. Though he probably was legally responsible for anything an employee of his did to anyone on the job, my sense of honor would not have permitted me to sue him for something he couldn't have known. ( It was astonishing to my neuropsychologist and me that my neurologist couldn't see what she was before, but I ascribed it to occluded judgment aided and abetted by his untreated ADD. )
But obviously, he was scared of something, and just as obviously, his keeping her in the job was a silent gaslighting of me. In fairness to him, he must have supposed she wouldn't dare to do anything like that again. ( In the six months to a year after this happened, she looked terrified when she saw me in the office. Fortunately for her, I don't believe I have the right to execute people. )
But again, consider: HE KEPT HER IN THAT JOB!! "Hopelessly irresponsible and crooked," indeed.
Three years later, my state university's medical school sent results of GeneSight testing they had done on me to my neurologist's office. He didn't mention them at my next appointment with him, or at the one after that. My presumption was that the tests must have shown him nothing he needed to know. But at my next appointment, my curiosity made me say, "What about the GeneSight tests, Doctor?"
"GeneSight tests? When did you have GeneSight tests?"
The monster had struck again. Remember, I mentioned that she is a dullard. I never asked my doctor what she had done to keep the test results from him, or how she had been caught. Surveillance cameras? I don't know. I never saw her in that office again. He fired her. This was obvious to me because the anti - Tanya, a marvelous woman, Julie, was in Tanya's former corner at the next two appointments.
At the one after that, I looked at my doctor. "Tell me, is it true Tanya no longer works here?"
In a moment, his face jumped, his eyes popped. I'm not exaggerating in saying that he snarled in lupine - like ferocity, "YES!!!!!" His eyes dropped. He had been embarrassed by his eruption of rage. I sat there, staring at him. Over the next thirty seconds, a close mouthed smile spread across his face. At its apex, it made him look demonic.
"Holy sh*t," I thought. I broke the reverie he was obviously in by saying something. I can't deny that I was pleased he had killed the monster. She is a sociopath. I suppose she hadn't tried to destroy anyone else. But through the years, I did wonder how she had done it, how she had kept the GeneSight tests from him. I didn't want to ask him. I wanted to keep his goodwill. I live in an area which doesn't attract many first rate specialists. They can make a lot more money in the metropolis a hundred miles from here. And so it was that a year and a half ago, I made an appointment with my by - then former neuropsychologist to ask him a single question.
"How'd she do it?"
What's it called, word salad? That's what I got from him. Finally, I almost yelled, "You know what she did! And you know she sabotaged my Social Security claim!"
"You just THINK she did," he replied.
"Oh my God," I thought. "It's like Invasion of the Body Snatchers. It's like Chinatown. Everyone is corrupt now, everyone, no honor left in anyone anymore." ( I know that that isn't true, but it felt as if it were at that moment. ) A couple of weeks later, I received a letter from my neurologist's office. I wish I had kept it, but every word I have written is true, so please believe that the letter read like this:
"Your next appointment with Dr Kevin K. has been canceled. Do not try to make another appointment with Dr K. Dr Kevin K. will never see you as a patient again. Dr Kevin K. will under no circumstances see you, ( my actual name ), in a medical setting ever again. You are no longer a patient of Dr Kevin K. It is Dr K's. advice that you find another neurologist immediately. You are no longer a patient of Dr Kevin K. Dr Kevin K. will never give you another medical appointment with him."
It's funny, but the humor in it can't soften my disgust with the man. I do believe he is a good neurologist. He is also dishonest, and a coward. He is a contemptible man. He is the incarnation of what the three generations after the Baby Boomers think all we Boomers are, entitled, brattish, piggish. Do you remember the line from The Great Gatsby about Tom's and Daisy's way of leaving smashed up lives in their wake and assuming that other people will clean up the damage?
Dr Kevin K.
I enjoy your blogs, Doctor, as well as your frequent comments at Rod Dreher's Diary. You're one of the remaining good ones. I will exult in that book, and thank you again for recommending it. I hope you and the readers of this have found it interesting. I'm not sure whether it should be categorized under "Horror" or "True Crime."
Love this! I did, however, use some really funky prism glasses that were also intensely blurry demonstrate the visual effects of being impaired to my (addict) patient population once. Of course they loved trying to walk, falling down, acting like idiots and yelling, “It’s like a free high, DUDE!” Yep. Falling over and making a fool of oneself is SUCH a great comparison isn’t it?
Of note, I remember some in the field telling people that people who needed an antidepressant “were a quart low” on chemicals in their brains that “controlled” depression. Never saw data for that...
Love love love the pbs special. This is a perfect example of how the current media has everyone hoodwinked into believing they aren't just a bunch of partisan hacks. This type of stuff used to exist. Exposés and interviewing several different people from all sides of an issue. Slowly and then all at once with the availability of the internet they converged into an all out sprint to try to beat any truth making it to the public's ear and eye. Bought and paid for by corporate interests.
Interestingly and thankfully my children attend a small Catholic school where there were only 2 boys of just over 100 kids on vyvanse (both graduated this year) and neither started before middle school (I believe). Granted, some kids just don't make it in a private school if they are on the further end of behavioral problems but I am certainly grateful that neither parents nor teachers/ staff seem to be pro-med-to-make-my-life-easier.
Thank you for writing about the ADHD drug pushing. I educated myself on this agenda 26 years ago when some started recommending we get our 2-yr-old on ritalin because he was difficult. This drug marketing campaign continued throughout his childhood, with the public schools pushing hard, telling us his grades would improve. He never went on any meds, is grown and doing fine, in spite of all those telling us we were messing him up by not putting him on a Schedule II drug.
Thank you for standing up for him against those docs! I can’t imagine how difficult that must have been.
We had to stand firm against docs, teachers, friends and acquaintances. It's amazing the number of school staff that are willing to diagnose and recommend meds.
Yes it is! It’s also illegal, but the talk goes like this: “we’re not allowed to diagnose your child with anything, only a doctor is… but you should really take him to a doctor, wink wink nudge nudge”
Yup! The wink wink is infuriating! I only take my son to the doctor for a sports physical.
The ones we dealt with were straight up willing to tell us what was wrong and what meds he needed.
Yikes
A very interesting article, Doctor. I'm deeply grateful for 60 mgs of Ritalin ER every day. I have a moderate to severe traumatic brain injury, one of the effects of a suitcase bombing which nearly killed me when I was seven.
Because of the nationwide shortage of psychostimulants, I ran out of Ritalin ER eighteen days ago. Somehow, I survived the next ten days with a higgledy-piggledy combination of mostly ineffective Concerta, Buproprion ( which my system has a love/hate/hate relationship with ) and a few 10 mgs methylphenidate instant release tablets.
Thank God that eight days ago, a pharmacy I tried actually had the stuff in stock, and my good doctor was quick to get a prescription over to them. But it wasn't until two days ago that I started to feel my normally dysfunctional self. And I am getting anxious about what will happen in three weeks, when I need a new prescription. The pharmacist whose pharmacy had a supply of Ritalin ER is an immediately trustworthy, compassionate, and likeable fellow, and I'm going to be conducting a well tempered quasipolitical campaign starting next week to encourage him to be vigilant about his Ritalin ER supply.
Nothing else really helps, and Ritalin ER doesn't help all that much, but it's the pick of the litter for me. I do vape cannabis, reluctantly. As you may be aware, many military DAI survivors of the last twenty years claim that Big Pharma drugs did nothing for them, but that switching to cannabis made a remarkable difference. I wish it worked that well for me. It may be that I have not yet discovered the right chemovar, though I have after much trial and error found a way to use it in the nighttime which generally gives me an amazingly good sleep by my low standards. But I have never found the magic bud. ( I don't like the stuff, anyway. This probably means I'm the only American who doesn't like marijuana. ) My magic bud would stimulate me, possibly supplanting completely all Big Pharma drugs. I don't want to be stoned all day. I want to be energized so I can read more, watch many of the hundreds of films on my various watchlists, practice guitar and mess around with my keyboard, and maybe start to play poker on at least some Friday nights with guys from my church.
You would be hard pressed to convince my excellent neurologist that ADD isn't real. He has it, badly, but will not take medication for it because he says medication impairs his creativity. Perhaps I'm not the only patient of his who wishes he would reconsider. We respect him and are grateful for him, but he can be maddening at times.
A suitcase bomb at age 7! Wow, thank goodness you’re ok. Yes, I will definitely have to reconsider my stance if school bombings start to increase…
In a perfect world, without pharma making billions pushing the drugs, the very small minority of suitcase bomb sufferers could get the treatment they need, while rambunctious 6 year old boys would never even come close to getting a whiff of amphetamines. It’s an infuriating tragedy that every time doctors claim they must, must prescribe this stuff because of the extreme cases, they barely take a pause before turning around and handing the meds out like candy to middle schoolers. It’s so irresponsible and terrible and frankly will almost certainly end up hurting sufferers like you - whether from the shortages that overprescribing causes, or from a crackdown on all prescriptions that may come if America pushes back on this pharma madness. I’m so sorry you’re in this position!
I certainly agree with your neurologist about the medication impairing creativity. ..
I sincerely hope and pray you’ll be able to enjoy many a poker night soon!
What alarms patients about doctors is the awareness which many of us have that doctors are prone to going on kicks, and that medicine rarely seems to learn from its embarrassments.
As to the latter, as you know, until the 1990s, the unquestioned wisdom among doctors was that ( imagine schoolteachery, patronizing, overly kind voice ), "Ulcers aren't caused by what you eat, they're caused by what's eating you!" And you know how thoroughly the provincial Australian doctor and his assistant were ridiculed who proposed forty years ago that ulcers might be caused by h.pylori. They did eventually receive the Nobel Prize for Medicine, however.
Remember the Kennard hypothesis? Dr Kennard herself was a responsible scientist who was dismayed that medicine would take her work with intentionally brain injured macaque monkeys, as fascinating and intriguing as it was, as essentially proof that, as one sensitive neurologist put it, "I can tell you one thing, you're much better off getting a traumatic brain injury at 7 than at 27!" Now, the Kennard hypothesis is dismissed by most pediatric neurologists and neuropsychologists as something which, through no fault of Dr Kennard's, could more accurately be called the canard hypothesis.
The Glasgow Coma Scale is still moving, but it's fatally stricken, and in a few years, last rites will have been pronounced.
You know well that though there is a considerable argument to be made for ketogenic diets, the food pyramid remains the Establishment approved guidon for the ideal American diet. Those Americans who do follow it, who eat baked potatoes, not potato chips, are prone to obesity, insulin resistance, and unnecessary premature death from cardiovascular disease. I haven't heard plans for a re - plotted food pyramid.
In 1984, there was a likeable weeknightly PBS talk show broadcast from Detroit, The Dennis Wholey Show. One evening the guest was an authoritative cardiologist. I think it was a phone caller, a young man, who asked the doctor about the advisability of eating eggs. The doctor glowered at the camera, thrust his finger at it, and snapped, "Let me tell you something: if you eat more than three eggs a week, you're asking for death from heart disease by age 35!" My too conservative estimate is that I have eaten at least 50,000 eggs in my lifetime. And here I am at 71, tapping out this reply to you.
I'm sure you know that your despised Ritalin was kept off the market by the FDA ( I presume ) for several years in the late 60s - early 70s period. I have the following on the authority of a former neurologist, who isn't the type to make lurid things up to entertain his patients: a neurologist who practiced in upstate New York had, on a hunch and persisting by intuition, been using Ritalin to treat his brain injured patients. He and they were delighted by the success they were having with it. The patients were terrified and the doctor incensed. He wasn't prepared to let them go. He began to smuggle Ritalin in from Europe and sell it to his patients at cost. God knows how many lives he rescued until Ritalin was put back on the market. As you know, he was risking not just his license but his freedom. He never got caught, and a number of people had their lives turned back to them to live. I will always be wistful that I wasn't this man's patient. Traumatic brain injury ought in most cases to be called "chronic brain disease," neurologists Brent Masel and Douglas DeWitt asserted in an article published in 2010. It becomes a chronic, degenerative disease in the vast majority of those who are not treated sufficiently immediately after the injury. My own life has confirmed their conviction. I wonder what my life would have been if in 1970, when I was trying desperately to be and failing to be a college student in Texas, I had somehow found my way to the neurologist in upstate New York? True, I was eleven years out from my injury, but knowing how steadily I have deteriorated my life away, I think it's possible I might at least have been stabilized.
Is chronic fatigue syndrome, the most inadequately and therefore cruelly misnamed disease in history, still called chronic fatigue syndrome? I do hope that today's medical Establishment no longer dismisses it as yuppie flu, or at least that they've stopped making jokes about their loser patients, my contemporaries, thousands of whom committed suicide because they couldn't be taken seriously by the doctors. If so, it's no doubt a deep comfort to the bereaved parents, spouses, and children who remain alive.
A brilliant doctor of about a hundred years ago once said sadly, "Posterity will forgive us our mistakes, but never our pretensions."
Having rehearsed some of medicine's embarrassments during our lifetimes with you, I'd like to talk a little about its penchant for kicks. One of its more vibrant ones is its kick against benzodiazepines. A few years ago, I heard a news report that researchers had concluded that if a person takes ninety doses of a benzodiazepine in his lifetime, he has a vastly increased likelihood of developing dementia. I screamed with laughter. I said to a friend, "****! I've taken ninety doses in a month!" I wasn't exaggerating. I've been taking strong doses of benzodiazepines for over twenty years. My brain, which had had enough trouble as it was, should have turned to tofu many years ago, but somehow, it didn't get the word.
This would be funnier if whichever board in my state which is empowered to do such things weren't conducting what one of my doctors has called "a reign of terror" against doctors who prescribe benzodiazepines in significant amounts. He went on to tell me of medical licenses being yanked arbitrarily from doctors who may have been perfectly responsible in prescribing them. It's one of medicine's current kicks around here, Dr Gaty. It's likely I'd do better on 4 mgs of clonazepam. My doctor is afraid to prescribe more than 3 mgs. I don't hold it against him.
I ask you and your readers to say just one prayer that I'll be able to get my Ritalin ER without interruption.
ADD. Here's an irony. Whatever ADD, nonexistent thought it is, may be, I almost certainly had it when I was injured. If not, or if I had been properly treated for it, I probably would not have been running like a madman, against the screams of teachers who told us to stop, with my friends who were killed, out onto the playground where a lunatic with a suitcase bomb was waiting for us.
it sounds like you may have already read it, but you might really enjoy this book:
https://www.amazon.com/Desperate-Remedies-Psychiatrys-Turbulent-Illness/dp/0674265106
Speaking of medicine's embarrassing history, the history of neurology/psychiatry will make your hair stand on end.
Regarding benzos, well, you probably know Jordan Peterson's take on the matter, and I have lost terrible losses of very dear loved ones to benzos, so add me to the reluctant list. It's the same as opioids, which do indeed help a minority of true sufferers of chronic pain, and there's no denying that they truly, truly help - but I think opioids also kill more Americans each year than died in Vietnam, or something like that.
I'm afraid there's just no good answer, it's a hopelessly irresponsible, crooked, ignorant profession, and there seems to be no way to get chronic pain sufferers and traumatic brain injury victims the genuine help they need (to the extent that medicine even understands what help they need, which is basically still largely a black box) without also destroying the minds and lives of countless innocent people.
Doctor, it takes a man of excellence and honor to have written this. Thank you.
It's hilarious: I have said to people that there could be a book about medicine's fatuitities in the 20th century ( it would hardly be fair to start earlier ), the first volume of which would run 1,000 pages. Volume II.,1,500 pages, would cover the period between 1945 - 2000.
I had no idea that such a book, if limited to psychiatry and neurology, existed, and thank you for telling me about it. It has a new and eager reader in its immediate future.
My primary care physician is my neurologist. He's a terrific guy. I'm blessed to have him. Why is my former neurologist not my neurologist anymore? Because I sought some information from his former medical partner, who was my clinical neuropsychologist for eight years, the neuropsychologist in turn violated the doctor/patient confidentiality ethic ( as I understand it ) by telling my neurologist without my permission what we had talked about, and my neurologist kicked me out. Here's some "hopelessly irresponsible, crooked" stuff for you.
The woman who was in charge of medical records for my neurologist is a vacuous malignant narcissist. Tanya is also, by the measure of anyone with an eye, gorgeous. She could have been a Playboy centerfold when Playboy was still erotic. It was clear to me that she was interested ( euphemism alert ) in me. I was repelled by the emptiness I sensed in her, never said anything personal to her, was polite, businesslike ( one of the most barren words in the English language ).
To abbreviate, I realized when it was too late for me to do anything about it, that she had retaliated. She had sabotaged a claim I had for an upgrade in disability payments after the deaths of my parents. She had done this by not sending a single document to Social Security which even hinted that I had a neurologist, let alone why. ( This has cost me at least $150,000.00 by now. If it weren't for the amazing generosity of my church in supplementing my SSI, I couldn't have survived the last six years. )
At my next appointment with my neuropsychologist, we hadn't even sat down before I'd finished telling him the whole thing in one compact outburst of rage. He said, "I have been telling him for years that he needs to get rid of her."
So, my neurologist fired the woman for gross misconduct, right? No. He kept her in the same job! I never said anything because I needed my neurologist, who did try his best with me for many years. The mystery is why he kept her in the job. There is not a chance that my neuropsychologist would not have told my neurologist what had happened. Yet, he kept a woman who had done something which by anyone's reckoning is an antisocial act in the same job which she had used to commit the antisocial act!! I imagined he feared a lawsuit, but this made no sense to me. How could I have sued about something someone hadn't done, and which I couldn't prove? In any event, if it had been possible, morally, I, at least, never could have sued him. My conscience wouldn't have allowed it. Though he probably was legally responsible for anything an employee of his did to anyone on the job, my sense of honor would not have permitted me to sue him for something he couldn't have known. ( It was astonishing to my neuropsychologist and me that my neurologist couldn't see what she was before, but I ascribed it to occluded judgment aided and abetted by his untreated ADD. )
But obviously, he was scared of something, and just as obviously, his keeping her in the job was a silent gaslighting of me. In fairness to him, he must have supposed she wouldn't dare to do anything like that again. ( In the six months to a year after this happened, she looked terrified when she saw me in the office. Fortunately for her, I don't believe I have the right to execute people. )
But again, consider: HE KEPT HER IN THAT JOB!! "Hopelessly irresponsible and crooked," indeed.
Three years later, my state university's medical school sent results of GeneSight testing they had done on me to my neurologist's office. He didn't mention them at my next appointment with him, or at the one after that. My presumption was that the tests must have shown him nothing he needed to know. But at my next appointment, my curiosity made me say, "What about the GeneSight tests, Doctor?"
"GeneSight tests? When did you have GeneSight tests?"
The monster had struck again. Remember, I mentioned that she is a dullard. I never asked my doctor what she had done to keep the test results from him, or how she had been caught. Surveillance cameras? I don't know. I never saw her in that office again. He fired her. This was obvious to me because the anti - Tanya, a marvelous woman, Julie, was in Tanya's former corner at the next two appointments.
At the one after that, I looked at my doctor. "Tell me, is it true Tanya no longer works here?"
In a moment, his face jumped, his eyes popped. I'm not exaggerating in saying that he snarled in lupine - like ferocity, "YES!!!!!" His eyes dropped. He had been embarrassed by his eruption of rage. I sat there, staring at him. Over the next thirty seconds, a close mouthed smile spread across his face. At its apex, it made him look demonic.
"Holy sh*t," I thought. I broke the reverie he was obviously in by saying something. I can't deny that I was pleased he had killed the monster. She is a sociopath. I suppose she hadn't tried to destroy anyone else. But through the years, I did wonder how she had done it, how she had kept the GeneSight tests from him. I didn't want to ask him. I wanted to keep his goodwill. I live in an area which doesn't attract many first rate specialists. They can make a lot more money in the metropolis a hundred miles from here. And so it was that a year and a half ago, I made an appointment with my by - then former neuropsychologist to ask him a single question.
"How'd she do it?"
What's it called, word salad? That's what I got from him. Finally, I almost yelled, "You know what she did! And you know she sabotaged my Social Security claim!"
"You just THINK she did," he replied.
"Oh my God," I thought. "It's like Invasion of the Body Snatchers. It's like Chinatown. Everyone is corrupt now, everyone, no honor left in anyone anymore." ( I know that that isn't true, but it felt as if it were at that moment. ) A couple of weeks later, I received a letter from my neurologist's office. I wish I had kept it, but every word I have written is true, so please believe that the letter read like this:
"Your next appointment with Dr Kevin K. has been canceled. Do not try to make another appointment with Dr K. Dr Kevin K. will never see you as a patient again. Dr Kevin K. will under no circumstances see you, ( my actual name ), in a medical setting ever again. You are no longer a patient of Dr Kevin K. It is Dr K's. advice that you find another neurologist immediately. You are no longer a patient of Dr Kevin K. Dr Kevin K. will never give you another medical appointment with him."
It's funny, but the humor in it can't soften my disgust with the man. I do believe he is a good neurologist. He is also dishonest, and a coward. He is a contemptible man. He is the incarnation of what the three generations after the Baby Boomers think all we Boomers are, entitled, brattish, piggish. Do you remember the line from The Great Gatsby about Tom's and Daisy's way of leaving smashed up lives in their wake and assuming that other people will clean up the damage?
Dr Kevin K.
I enjoy your blogs, Doctor, as well as your frequent comments at Rod Dreher's Diary. You're one of the remaining good ones. I will exult in that book, and thank you again for recommending it. I hope you and the readers of this have found it interesting. I'm not sure whether it should be categorized under "Horror" or "True Crime."
That’s too kind of you, and that’s a crazy story! I’m so sorry you had to deal with all that, just wow.
Love this! I did, however, use some really funky prism glasses that were also intensely blurry demonstrate the visual effects of being impaired to my (addict) patient population once. Of course they loved trying to walk, falling down, acting like idiots and yelling, “It’s like a free high, DUDE!” Yep. Falling over and making a fool of oneself is SUCH a great comparison isn’t it?
Of note, I remember some in the field telling people that people who needed an antidepressant “were a quart low” on chemicals in their brains that “controlled” depression. Never saw data for that...
I remember those!
Love love love the pbs special. This is a perfect example of how the current media has everyone hoodwinked into believing they aren't just a bunch of partisan hacks. This type of stuff used to exist. Exposés and interviewing several different people from all sides of an issue. Slowly and then all at once with the availability of the internet they converged into an all out sprint to try to beat any truth making it to the public's ear and eye. Bought and paid for by corporate interests.
Interestingly and thankfully my children attend a small Catholic school where there were only 2 boys of just over 100 kids on vyvanse (both graduated this year) and neither started before middle school (I believe). Granted, some kids just don't make it in a private school if they are on the further end of behavioral problems but I am certainly grateful that neither parents nor teachers/ staff seem to be pro-med-to-make-my-life-easier.