Customer Reviews

Pharmacracy: Medicine and Politics in America

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This is a great book for laying to rest some orthodox but wrong ideas about our mental health. Szasz shows us that the orthodox way is not necessarily the right way. Certainly our own doctors are not going to blow the whistle on themselves, are they? This revolutionary psychiatrist shows us the real path to health, pointing us away from the wrong direction that the pharmaceutical companies have been leading us, and unfortunately, leading our doctors as well. It's a case of the fox guarding the henhouse.
Do you care that a psychiatrist is a doctor who prescribes drugs to change people's brains without ever actually examining those people's brains? Do you worry that nobody knows exactly what the long-term effect of these drugs are that we are now being given for bi-polar disorder, for attention deficit disorder, for depression or for anxiety; or even if they are really doing us more harm than good? Do you know how doctors today are becoming more and more controlled and subverted by the pharmaceutical industry? Do you think that unwanted behavior and unwanted feelings like anxiety and depression are diseases that can be cured by drugs? If you do, you should read the latest book by this world renowned psychiatrist.
"Psychiatrists have a long history of systematically validating fake diseases as real diseases, and getting away with it," says Szasz. They can get away with it because it serves everybody: the family whose medical insurance will pay only for certain diagnoses and not for others; the government officials who can allocate more and more federal funds for their universities and laboratories; and the doctors who can service many more patients in the "service station" atmosphere that has us all believing that everything can be made right with the right pill. The only person whom fake diagnoses and powerful drugs are not serving is the health of the individual who is having his birthright sold for a pharmaceutical mess of pottage.
We are confusing, warns Szasz, bodily diseases which are physiochemical phenomena located in the body and understood by cellular pathology with unwanted personal habits or behaviors which are located in the social context of society and understood by the interconnecting relationships. We are confusing the mind with the brain. And finally, we are confusing medicine with politics and social agenda. In so doing we are becoming less and less the land of the free and the brave and more and more the land of the mentally ill and deluded. Szasz makes a good case for a new look at the insidious subversion of our medical care by the politics of pharmaceutical managed care.

Dr. Szasz, now 81 years old, has done it again: explained what's going on in the minds of psychiatrists and their adulators from the Surgeon General on down. And why.

For example, he tells us how doctors are really paid and explains the corrupting effect of third party reimbursement by DRG (Diagnosis Related Groups)on the most important and the kindest thing any doctor can do: make an accurate diagnosis.

There are new insights, new quotes and the usual entertaining anecdotes and fastidious footnotes.

Psychiatric obscurantism is impacting every American every time he or she is misinformed: "Depression is a disease like diabetes - ask your Doctor about...." And that's just TV.

What kills me is how the parrots of psychobaffle preen themselves on their courage at having broken through the mind body barrier - as if obliterating one of childhood's most important lessons - that thinking doesn't make it so - is an accomplishment to squawk over: "Look Mom, I can fly."

How dumb can we get? Read this book and find out. The bamboozlement of Mental Health already is to the 21st Century what the propaganda of Communism and National Socialism were to the 20th. Immunize yourself now.

Dr. Szasz has been one of the clearest thinkers and writers for 50 years and this book is another brilliant facet to the immense diamond which is his life's work.

Pharmacracy

Do you care that a psychiatrist is a doctor who prescribes drugs to change people's brains without ever actually examining those people's brains? Do you worry that nobody knows exactly what the long-term effect of these drugs are that we are now being given for bi-polar disorder, for attention deficit disorder, for depression or for anxiety; or even if they are really doing us more harm than good? Do you know how doctors today are becoming more and more controlled and subverted by the pharmaceutical industry? Are unwanted behavior and unwanted feelings like anxiety and depression diseases that can be cured by drugs? If you think they are, please run as fast as you can and get this book. It could save your life.

I have read much that is enlightening by Thomas Szasz's iconoclastic approach to the politics of medicine and the medical profession more generally. Arguably, as a critic he remains the voice of the lone wolf in a sea of medical professional lemmings. In particular, he is psychiatry's, worse nightmare. Yet here in his introduction, even though he is still far from one of the medical profession's lemmings, I have begun to see a flaw in his avowedly Libertarian arguments that I hope is just political shortsightedness on my part.

The main point of the book is to get to chapter five where mental illness is defined as being to illness as an egg is to eggplant. Just as there is no egg in eggplant, there also is no illness in mental illness. No one knows either what a mental disorder or a mental illness is. The primary function of the DSM is to lend credibility to weak claims that certain behaviors are to be classified as mental disorders, and that such disorders are indeed mental diseases.

In contrast to his fine exposition on the lack of a scientific basis for psychiatry (as he notes on page 84 " In the end, we come down to the meaning of the term mental illness: If we use it to mean brain disease, then psychiatry would be absorbed into neurology and disappear...") we see him in the introduction charging medical ignorance to a government take over of healthcare? Go figure?

Throughout this book he makes a compelling case along the lines of the epigram at the beginning of the book by the famous Alexis de Tocqueville. To the effect that we Americans will trade in our freedoms for any hedonistically guilty pleasure so long as we do not have to take responsibility for having done so: Or, more importantly, so long as we do not have to take any responsibility for the consequences, of having done so. The author's suggestion is that we do this when we claim to be sick or have a disease that is in fact based on bad habits and lack of responsibility.

I take his point. In most cases it is a fair one.

But in the main it is not true and in any case, there is a problem with who he labels as the target of his attack. Throughout the author's treatise, the return address for the entity that has stolen our freedoms (in exchange for our own ignorance, shortsighted guilty pleasures, incompetence of our medical professionals, especially psychiatrists) has been the all-conspiring government. However, even a cursory examination of where we are in the current healthcare debate, including in psychiatry, will reveal that it is not the government that is calling the shots when it comes to who is stealing our freedoms, or to who is getting between us and our doctor's medical advice, however bad and unscientific that advice might be. Without exception it is always the insurance and pharmaceutical industrial-complex and their associated monopolies, and not the government that are doing so. Medical incompetence is not our first problem, medical corruption and medical greed trumps all other problems by a wide margin.

We, the American people have been lulled to sleep on the Libertarian mantra "It is the government that is stealing your freedoms," when in fact it is Aetna that has repeatedly gotten between me and my doctor when all five of them suggested that I needed to increase my Nexium dosage from one to two pills per day to control my reflux problem. (Reflux incidentally is a scientifically measurable disease.) Yet, since the insurance companies knew the pharmaceutical companies were charging an outlandish amount for the Nexium (over $400 for a 90-day prescription when the same prescription cost about $40 dollars in Canada), they of course were not about to agree to the medically required increase recommended by all five of my doctors. The same goes for psychotrophic drugs, which are administered according to the insurance schedule, and not according to a set disease progression or improvement. As the author carefully documents, many psychotrophic drugs are used on us as little more than a experimental palliative: the same as they would be used on guinea pigs. To call the profession of Psychiatry a science is just short of a scientific scandal.

Yes, we Americans do smoke cigarettes, eat bacon, Big Macs, overuse drugs, both those prescribed and those that are illegal, and drink alcohol and Coca Cola, and then make excuses after these make us fat, lazy and mentally unhealthy. But the larger problem in my view is not just this after the fact irresponsibility, but that in most areas, healthy food like, healthy medicine, has been strategically place beyond the reach of the average citizen and surely beyond the reach of most poor Americans, and done so precisely to maximize profits. It takes both knowledge, money and a heroic effort to find, buy and be able to maintain a daily diet of fresh, healthy foods and carefully tested medications. It takes the same to know whether or not one has a competent doctor.

Thus the author's thesis that people are making irresponsible decisions to define their bad behavior as a disease and thus to find novel ways to overly self-medicate themselves, rings hollow, since without exception there is an army of medical professionals anxious to play to our imagined concerns and steer us to the heaviest advertised, and often the least effective but most expensive medications, whether we really need them or not. I have so many examples of this that it would exhaust this review to list them.

Likewise, it is the insurance companies and the pharmaceutical industrial complex that is spreading money around Capitol Hill like so much male cow manure that is also getting between me and my Congressman and Senator: It is not the government that is doing this, for my elected Representatives, indeed are the government! It is the government that is being undermined and manipulated at every turn by the pharmaceutical insurance industrial complex to increase their bottom lines.

And finally, it is not the government that is taking my tax money and using it to pay the medical lobbyists, for expensive "getaways" to meaningless conferences, etc. It is not the government that is using my tax money to develop, and market poorly test, and then advertise Levitra. Cialis, Viagra, and other worthless "for profit only medications." Instead this money should be used to cure cancer. But in fact, for the last 50 years money for cancer research seems to have been dropped down a black hole. And guess where the large sucking sound with dollar signs around it at the bottom of that black hole comes from? You got it, from the same companies that are claiming foul when the American people are trying to level the playing field with a Public healthcare option.

Thus, I fail to see where the government is stealing my freedoms in this or any other case. But I do see where the food industry, the pharmaceutical companies, and the insurance companies continually conspire to circumscribe and circumvent my choices to better health at every turn, are constantly raising my medication and insurance premiums by a hefty 14% per year, and through their highly paid lobbyists, are corrupting the very foundation of our representative democracy. If anyone can show me how the government is doing a worse job of stealing my freedoms than the medical corporate vampires are, then I am, all ears. Five stars for the excellent science minus three stars for the wacky politics of medicine.

Szasz and the reviewers fo this book have obviously never suffered from nor known anyone who suffers from a serious mental illness. Far from being just bad or unwanted behaviors or 'fake diseases', mental illness is a devastating disease that ruins lives and often kills its victims.
After years of denial and attemps to control my own behavior, my life spun out ot control and I went from a respected professional in my community to a manic-depressive psychotic, roaming the streets delusional, completely out of touch with reality. It took commitment to the state mental hospital to give me some insight into my problem.
Thanks to the drugs that Szasz and others find so questionable, I am now able to lead a normal, stable life. Without the progress made in pharmacology in the last thirty years many people like me would be confined to mental institutions for extended periods or permanently.
This book is nothing more than a rant by an elderly doctor who needs to catch up with the real world. There is much still to be learned about brain function and the mechanisms of these disorders, but the fact that we don't have all the answers yet doesn't mean that they aren't out there. Or should I say in there?
Unless you don't want to be pulled back into the ninteenth century, steer clear of this book. Szasz is quackers!