[Marxism] RE: Marxism Digest, Vol 7, Issue 33

["Tony Abdo" <gojack10@xxxxxxxxxxx>]

A few comments below about what Lou's nurse friend's comments..

<<(This is from an old friend who saw "People Say I'm Crazy" with me. She
has read the Marxmail thread on schizophrenia and this is her reaction.
She is a psychiatric nurse in NYC who is working on a doctorate in
nursing.
Hi Louis,
Interesting discussions.

Most folks don't seem to realize that no one is promising a cure, just a
decrease in the bothersome, debilitating symptoms.>>

This is not true at all.  Proimises of cures are made all the time regarding
the problems of depression, schizophrenia, and other psychiatric conditions.
 In fact, each day hundreds of thousands of individuals are given promises
that psychotropic medications will eliminate pretty much, what are seen as
troublesome behaviors of one type or another.

The downsides of these medicines are almost always ignored.  The constant
prattle in the press is that a new medicine has just come out, or is in the
process of being worked on, that will soon be the grand breakthrough of what
is always labelled a biological or chemical defect of some sort in the
individuals being treated.  The worst aspect of it all, is that these
medications are often pushed as a cure all for others to give out, or
recommend to the elderly and juvenile portions of the population.

To say that the medical system does not promise cures is disingenious, IMO.
The medical system intervenes in much more behaviors than just cases of
major depression and schizophrenia, too.  And in almost all cases, the
intervention is almost totally pharmoceutically oriented, not because it
works so well, but because it is so specific and confined.  Most people are
told that a pill or two will  principally CURE the conduct/ condition they
seek relieve from.

Most of the meds distributed are also poorly monitored.  There is nothing
that leads one to believe that all the psychotropics out there have had a
net benefit, despite their prevalence of use.   The liberals in the system
would have people believe that the US is undertreated due to the chaos of
health care delivery. There is some truth to this, but also there is a great
lie.   The US is overtreated at one end of the spectrum, and undertreated at
the other end, for those people trying to get some access or relief from the
pharmaceuticals used in medicine.

<<Docs and nurses monitor for side effects all the time in the hospital.>>

This is not always the case even within the hospitals.   And it certainlky
is not true on the outside.  To say that this is the case, is to seriously
underestimate the [roblem of side effects and unintended consequences of the
drugs being constantly distributed.

<<All drugs have
potential side effects. It's a matter of risk vs. reward. A newer drug
Abilify, seems to not put weight on. Resperidone and Seroquel has been
shown to add weight although not to the extent of Clozaril or Zyprexa.
There is no magic pill and people are aware of potential side effects.
Sometimes a new side effect pops up.>>

It is a case of risk vs reward.  But capitalist medicine has a terrible
record in monitoring and balancing these risks and benfits.  Take the recent
turn around on prescribing estrogen to women.   There are many other such
cases where complete turn arounds in standards have occurred.  Thirty years
ago, nurses were told to not wear gloves while providing patient care.  Now
you are considered crazy and suicidal if you don't.  The list is very long
here.

<<With and without medical intervention people with schizophrenia have
many co-morbid conditions. Some happen because people have difficulty
getting out of bed, brushing their teeth, attending to hygiene, shopping
for nutritious food, self medicating with street and over the counter
drugs/alcohol, chain smoking, and poor social skills because of the
illness. These things lead to dental disease, skin breakdown, adult
onset diabetes, drug and alcohol addiction( vulnerable people are often
taken advantage of by people who prey on the vulnerability and take
their money for drugs) (some residents in long term adult homes are
sociopaths and take advantage of the people with schizophrenia-predator
vs prey).>>

This is not the problem.  The problem is that the medical system and society
itself takes advantage of people with psychiatric problems.   Reality is,
that most people have some co-morbid symptoms of those who suffer with
severe major depression and schizophrenia.   And it has become very tempting
to the medical system to constantly slide from treating the severly ill, to
the more mildly effected population that is only semi delusional, or
chronically depressed but functional to some degree.  Especailly when well
covered by insurance of some sort.

<<Of course some meds cause diabetes, liver disease, gum disease etc.
Patients should be monitored for these conditions. Patients on Clozaril
must take a weekly blood test and the white blood count must be within
normal limits or the drug company/pharmacy will not dispense the
med-possible, deadly bone marrow depression. That's why the ideal is a
comprehensive treatment team--psychiatrist/therapist(MD or RN),
internist, dentist/dental hygienist, social worker, day treatment
program where someone can go during the day and re-learn social skills,
and decent housing, and most important--family support.>>

Yes well...  This is an ideal set up to work in to some degree.  But is not
reality for 99.99% of those getting treatment in the US.

<<Insurance is a big issue. That's why we need parity. Your health
insurance will pay for all you need if you broke your leg but probably
would not pay for your needs if you were to become depressed and
suicidal. Check out your mental health benefits.

On the good side there are some drug companies that give meds for free
to needy people. One of the sites is http://www.needymeds.com. Not
absolutely sure of the URL.>>

Please... This is akin to the tobacco companies providing free cigarrettes
to the needy.  It is just a perpetuation of an imbalanced, messed up
delivery system from which these companies profit from.

<<Many practitioners keep people in meds by giving them the samples when
they can't afford the meds.>>

How noble NOT!  These are the same folk that bottleneck access to the drugs,
by charging astronomically for one to get access to getting a prescription
for them.

<<Where I work diagnosis is not given out lightly. Treatment teams meet
and go over the symptoms, history, contact family and friends, private
MD, (with the patient's permission), observe behavior and patients
participate in an initial treatment plan with the symptoms that will be
targeted during their time in the hospital. No one is discharged without
followup care including housing, if needed, and day treatment if needed.
Insurance issues are dealt with. Emergency Medicaid is obtained if
needed etc. We try our best.>>

This gives one pause to ask the medical question... How many treatment teams
are necessary to screw in a light bulb at the hospital.  Nursing stations
today have about three times the number of staff bumping into eachother and
crowding the station.  It is a mess throughout the system.  Physically,
there has been such an expansion of 'treatment team', that treatment
providers are literally stumbling over each other in the center of their
little worlds.  And yet daily, less real treatment seems  to be actually
delivered!

<<Health care is a business in this capitalistic society.I am always
trying to get patients and families involved in mental health advocacy
groups and to lobby their legislators.>>

Advcoating that the doped outlobby the dopers is not really a strategy for
success.  This nurse is liberal minded and has her heart in a good spot, but
her view is too colored by the unreal idealism promoted for those at the
top, and by those at the top.

Tony Abdo

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