DavidBransfordMD Blog

Off Course, Hard Aground, and Sinking Fast

This past week, 2 major events captured my attention from different parts of the world..But extremely
important to me as an avid sailor and a clinical psychiatrist in independent practice for many decades.
As for the practice of psychiatry, a landmark court hearing took place in Austin, Texas and I relied heavily on a brilliant psychiatrist who attended the court hearing and maintains a powerful psychiatric blog with daily posts. Directly from his post at www.1boringoldman.com is an article that I am in complete agreement related to the “Selling of Psychiatry”
The Selling of Psychiatry from 1boringoldman blog
I also rely on so many other profession journalists and blogger advocates, but specifically – Ed Silverman of the Pharmalot.com post explains the court case in Forbes Magazine. General area of concern for me for years has been use of psychotropic medications in children without FDA clearance.

Perhaps it is far too great of a stretch, but the sinking of the Concorde and the current state of Psychiatry seem to have much in common, in my opinion.
Both are off course, bother utilize supposedly “State of the Art” techniques that are believed to be safe to the public, both lack competent leadership (APA Presidents, Ship Captains, etc) In the field of Psychiatry, Huge Managed Care Companies essentially restrict the psychiatrist to quick, 15 minute medication checks and totally overlook the need for a therapeutic alliance and talk therapy between patient and doctor. Far too much emphasis on medication, rather than time tested common sense and meaningful communication. With the Ship Wreck, I will wonder if too much attention was given to high tech navigation and so called “Dead Reckoning” was not utilized at all. “Dead Reckoning” in Psychiatry is a lost art, I fear…but was once the primary method of talking with patients – face to face -listening thoroughly to the patient’s story, and not depending on “high tech” scales and Pharma-Industry Developed screening techniques to determine which medication should be given.

On a positive note, in keeping with the hope that there will continue to be independent clinicians, I was greatly relieved to learn of the successful circumnavigation of a very determined teenager’s solo journey yesterday via Abbey Sunderland’s Blog. Several Years ago, I had followed Abbey’s posts as she began to solo her sailboat ‘Wild Eyes” around the World, but was dismasted by a rogue wave in the Indian Ocean..as her family and followers often expected the worst – until so many days later she was safely rescued. Much criticism was placed on the parents of both these girls for allowing them to be in extreme harm’s way….and many a post claiming the parents were simply exploiting the children for book and movie profits in the future. I see the girls as brave and using extremely good judgement, as they set out to Sea.Unfortunately, I see so much more danger for adolescents right here in the States with drug abuse, being victimized, abducted, teenage prostitution trafficking, and anti-psychotic medications for behavioral control, rather than for acute psychosis

Abbey
Sunderland's Blog

Visit on www.Twitter.com/ThinkShrink

It started at the beginning of the week, after months – perhaps years – of wondering about the State of Texas and a law suite against the manufacturers of an antipsychotic – risperidone. Primary issue is the question of whether the company had been promoting the medication for children – off label- against the FDA guide lines. For the State of Texas, were millions of dollars paid for this medication, utilizing a now questionable tool – termed TMAP. What makes this court hearing so unique to me is the primary fact that a blogger I greatly respect traveled down to the Courthouse in Austin, Texas – reporting via his blog www.1boringoldman.com daily posts of the entire process with his gifts of incredible analysis and descriptions. Also making it so unique, follow bloggers whom I so greatly value and respect followed along online as well. It was if we were all right there in the Court Gallery viewing the proceedings. Independent of the outcome of the trial, the support and online comments and input seemed to me to be unlike any of many Court Cases I have witnessed or testified in my Professional Career. Unlike my prior forensic work, it was not a commitment hearing, not a competency hearing….but addressing the huge questions of ethics, fraud, and -most of all- risk to the far too many children that were being medicated excessively and probably for the wrong reasons (behavioral control-rather than psychosis) On YouTube, I will place a link of an interview with an adolescent girl so you can hear her perspective. Not directly part of the TX case- but a far too familiar theme

I could continue with hundreds of videos, blogs, chat discussions, etc – but the issues have been discussed at length by so many well informed adults – but with no apparent public outcry over excessive medicating of Foster Kids. What strikes me on a poignant level is the courage and strength it has taken for professionals (Mr Jones) to be key “whistleblowers” I am by no means an expert in this field, but over a decade ago, I was tracking very closely the FDA and BigTobacco. I had read Dr David Kessler’s book, disclosing his work in investigating the issue of whether nicotine was addicting. I had viewed the special on 60″ – later made into a movie “The Insider” tracking the painful saga of Dr Jeffrey Wigand’s testimony to the Senate – at great risk to his life and his family. At the University of Minnesota, in the early 1970s, I was deeply committed to the field of physiologic psychology – working with my mentors at the U of MN, implanting electrodes into lab rat brains-and locating so called “Pleasure Centers” deep within the brain. Then testing different families of medications with the lab rats to see if there were different responses….(Thorazine was in the only family that “turned off the pleasure center”} While working with Dr Walter Mink PhD (nearby Macalester College) and Dr Warren Roberts, a new researcher arrived from the East Coast with the technology to work with nicotine addicted mice and later primates) It was both frightening and exciting to think of major break thrus in the field of addiction. But Phillip Morris recruited Victor, under the ruse of needing his expertise to develop a safer cigarette. He was given an incredible lab and numerous incentives, only to later learn Phillip Morris was only interested in maintaining the necessary addictive properties to keep sales moving forward (see here-I think it is worth it) If the youtube date is correct, the special begins tomorrow.

By the Way – helpful to learn how “natural” Cigarettes are to manufacture (view here –

If any doubt about the safety of cigarettes, simply view this “scientific” study More Doctors Smoke Camels than Any Other Cigarette ! lol
Why post about Big Tobacco and Whistleblowers?
I see not difference between BigTobacco and BigPharma in the techniques and fraudulent behaviors .. Both are in the business of attempting to deliver dangerous chemicals to humans, motivated souley by greed and profits. The Marketing of Tobacco may no longer be on TV, but the Magazines and other media still target our children… www.TobaccoFreeKids.org

Smoking really is still glamorous - yes?