Wear Clean Draws  (because there’s 5 million ways to kill a ceo)

Yesterday, I was scanning a file I keep of books people on discussion lists have mentioned because I’m going on vacation and, this time, I want to have plenty of books to read — which I failed to do last year. I consoled myself with a copy of Zizek’s latest, In Defense of Lost Causes, a big, fat, doorstop of a book that kept me plenty occupied on the plane flight to see sonshine.

This year — whee! — I decided to treat myself and blow money on a real, live vacation. I’m not visiting family. I am going somewhere to relax but listen to the ocean waves lap against a sandy beachy in front of me. Namely: I’m headed to the Outer Banks.

Wheeee! I’m so excited I can’t believe it. Last year it was my very first paid vacation, ever, in my lifetime. Srsly. 20 years of working and I’d never had a paid vacation because I worked in industries where there was no such thing or I worked for a company too small to offer bennies and when I fought for them, I got canned.

So, fuck a duck. Sure, I’ve saved a lot of money. But it’s nothing compared to where I should be at this point in my life. Still, you only live once and what the fuck. I’m going to do something totally extravagant. I’m sure in the grand scheme of things it’s nothing compared to what some folks spend. I figure we’ll end up dropping 2 grand.

Anyway, scanning the books at the indie book store, I spied a book on my list: Our Daily Meds by Christine Petersen.

I just finished the first couple of chapters and this book is awesome. It’s about the way the pharmaceutical industry and physicians end up creating maladies that can be treated with drugs that are not proven to be especially effective — sometimes depression medication is no more effective than the placebo, which I’ve heard before.

I had heard plenty about the ridiculous marketing that goes on, and even understood it first hand. Years ago, in another life, I was a sales rep at a hotel. I sold banquets, rooms, wedding receptions, conferences, and the like. In order to collect the commission, I had to work when the event was being held. So I worked 80 hour weeks most of the time. I worked a base of 55, because the boss declared us “managers on duty” which meant we had to be at work at 6 a.m. to be a “manager on duty” and greet business customers with coffee and donuts, to gather leads about their company and if we could possibly sell their company our conference and meeting services. Or, we’d have to be around evenings, poolside, to booze them up with cocktails and get them to give us contact information for their corporate event planners or the names of VPs who might want to set up a weekend retreat.

Weeknights, my steady clients were pharmaceutical company reps who would put on the fanciest dinners we had, free bar, for the doctors in town. There there were told about the latest drugs being pedaled and why they should sell prescribe them to patients. This was in the late 80s/early 90s.

I used to talk to the reps and learned that they made mega-good money — better than beer, wine, and liquor sales reps who made decent cash. So, I would angle for a way to get a job with such companies. Being there for the event, I listened to the marketing spiels.

Soon, i became pregnant. One day, visiting my doctor, she had me wait in her office, bedecked with pigs of every kind because people learned she loved pigs. She was a very large woman who wore birkenstocks to deliver, which mortified my mother, who thought it unsanitary (mom was studying to become a nurse that year.) Being very large, she embraced the big proudly to signal that she embraced her size proudly. Being in the medical profession, she was not just overweight. She was obese. She didn’t care and didn’t care about the way the rest of the medical professional treated her. And with that, she was going to collect pigs and proudly display them, taunting everyone who would dare mock her size.

Charlotte normally didn’t have people in her office. But this time I was in there for some reason, taking a gander at all the pigs and flipping through all the literature. I was stunned to see marketing piece after marketing piece — outright packets of marketing material and press packs, not to mention all the advertising in medical journals.

In graduate school a few years later, I wasn’t surprised to learn that physicians got their knowledge about medications and treatments from such marketing material.

Petersen’s book focuses mainly on the era after the late 80s/early 90s, when the HMOs emerged to reign in medical spending. Everyone at the time wondered what would happen, sociologically speaking, to physicians who were being treated as if they were no more than worker cogs in the vast HMO machine. There were horror stories of HMOs deciding treatment plans, undermining physicians’ treatment plans, and one outraged physician after another.

What no one wondered in sociological circles that I was aware of was what would happen once doctor’s paychecks declined b/c of the HMO effect. Well, what happened was: physicians became targets of big pharma. They started paying them ‘consulting fees’ to become consultants for the company, traveling to conference, small gathering, wherever to pitch their sponsor’s drugs. They were rewarded on the basis of their prescription rates, with some companies outright paying for things like brand new offices for a doctor just because he had a great prescription track record and indicated there was more where that came from.

Petersen writes about the crappy testing procedures where you don’t have to prove anything much to get a drug approved. Oh, they worry about side effects, but apparently it is cake to get a drug approved even if only 30% of patients are actually helped by the drug.

One drug, for over active bladder — a malady Petersen convincingly argues was wholly fabricated by the pharma companies — was well known for causing people to hallucinate and, basically, lose their minds. Some people were diagnosed with Alzheimer’s. Turns out that, especially in elderly folks (who happen to be more incontinent), the drug causes the onset of Alzheimer’s-like disease.

Nice, huh?

so, the pharmaceutical industry creates maladies and diseases, treats them with drugs that are ineffective and/or repackaged and higher priced versions of one that already exists or offers no improvements on drugs that already exist. Then, those drugs actually cause new problems. People who take heartburn medication end up having high blood pressure which gets treated with statin drugs which have still more side effects.

Christ, I thought it was a crime when my mother in law was prescribed 17 different kinds of meds. Apparently, that was old school Today, the elderly have an average of 30 prescriptions each year.

This is a fucked up country. These pharma companies are making something like an 18% profit. This is unheard of in other industries. I have forgotten the stats, but the cost of actually creating a drug is something like 15% of the cost of the drug. And then she ran some numbers to indicate that even after r&d, marketing, etc. they still had plenty of money.

I will continue to read this book and report more, but give a shot. It will be hard to read I suppose if you are on medication. It can be scary to learn how many side effects there are. It will also be controversial because so many people feel they have been helped by drugs that have been found to be ineffective for most people or found to be horribly over-prescribed.

E.g., ambien is really dangerous. It can cause people to do crazy things like walk in their sleep, eat an entire loaf of bread in their sleep, even get in their cars and drive — and not remember any of it. It also causes some people to lose their memories and slowly lose their minds. It is also wicked addictive and should never been taken for more than a few days at a time. And yet the marketing downplays this and even subverts this knowledge, which is provided in the adverts and commercials — but is, again, subverted by the very text and mis en scene of the commercial. It can also cause withdrawal insomnia, worse than the insomnia the person had that was the impetus for the ’script in the first place.

Crazy!

I’m going to go read more, but do enjoy this book if you get a chance.