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January 28, 2008

Lies of Omission (Personal, Historical Logical)

The last entry called attention to two items published recently in lay media by an accomplished academic physician who is simultaneously Professor of Medicine at Harvard Medical School, the resident medical expert for the New Yorker Magazine, and frequent contributor to several prestigious newspapers. In addition, he’s published several books for laymen on what might be called the art of clinical practice. One of the items mentioned above had appeared last Spring in the New Yorker; the other was his review of a book by a fellow Harvard professor on what was billed as  “ Mind-Body Medicine,” and from the description, is an examination of the role played by emotions in medical outcomes.

I was critical of Doctor Groopman in both instances for essentially the same reason: what he rather carefully never mentioned. The New Yorker article focused on the very controversial condition now known as Bipolar Disorder (formerly Manic Depressive Psychosis). Under its new name, its incidence has “exploded” in parallel with the influence a new psychiatric nosology (system of classification) being developed for the Diagnostic and Statistical Manual. In addition to being diagnosed far more, BD is also being recognized and aggressively treated at younger and younger ages, as documented by the infamous case of Boston resident Rebecca Riley  and a Frontline special, The Medicated Child (produced by Boston’s WBGH).

I was critical of his book review for omitting any mention of the endocannabinoid system. Given his recently avowed interest in neurobiology, signal transduction, and neuronal growth, there’s no way he could have been unaware of the ES. Nor,for that matter, could have the authors of the academic article cited to call attention to the ES been unaware of two facts: cannabinoids are what make “marijuana” psychoactive; and despite their remarkable safety, human research involving them is strictly forbidden by the drug war.

What had struck me in the earliest histories gathered from pot smokers was how they had tried alcohol, tobacco and marijuana as adolescents and then become chronic pot users in patterns that were far more medical than “addictive.” What is so striking about how contemporary society deals with the drug war is the care with which those with something to lose avoid even implicit criticism of our destructive, futile, and blatantly unscientific drug policy.

As for medical luminaries who shy away from even implicit criticism of the drug war, whatever happened to “Primum non nocere?”

Doctor Tom

Posted by tjeffo at January 28, 2008 04:35 PM