Tuesday, May 30, 2006

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Don't Trust Your Evening News

During my twenty years in marketing I've learned that pretty much everything around us is manipulated and set up in a way to persuade us to buy something.

I have to admit that before I started my career in pharma I had no idea that corporate propaganda was so insidious. Like most, I saw the ads and the billboards and heard the radio jingles and thought that was pretty much what marketing was all about.

I was so wrong. Soon I learned how drug companies used ghostwritten articles signed off by big name doctors, placed in a prestigious journals, to achieve their marketing objectives.

I learned that nothing was as effective as a dinner meeting at which one drug company paid doctor facilitated a discussion with other doctors who simply got dinner. Prescriptions literally sky rocketed after those meetings and the company that invented them eventually went public.

I also learned how patient organizations, always in need for money was only too willing to become the well paid accomplice of the drug company, whipping up protests when the right drug didn't get reimbursement or acting as "experts" in front of congressional committees.

And, of course, after having watched product placement on American Idol we all now know that it isn't a coincident that glasses with Coke emblazoned on them are always in front of the judges. Perhaps it also shouldn't be surprising that the cars James Bond drives in his recent movies are not a coincident, but part of a carefully orchestrated media strategy for which the lucky company had to pay dearly.

Most of us think that the last bastion is the evening television news--it may be biased, but at least we get the news straight from the journalists without the Big Corporations pulling the strings.

Wrong.

Over a ten month period the Center for Media and Democracy (CMD) documented television newsrooms' use of 36 video news releases (VNR's) to find out how many of these corporate PR videos were used without telling viewers.

VNRs are pre-packaged "news" segments and additional footage created by PR firms. These VNR's are designed to be integrated into newscasts, and are provided free of charge to TV stations with the corporation hoping the TV station will air them. TV stations, strapped for cash and resources, often use this shortcut. Nothing in the VNR identifies who paid for the news release so viewers cannot know if the news segment they're watching was bought and paid for by a corporation.

CMD identified 77 television stations, from those in the largest to the smallest markets that aired these VNRs in 98 separate instances, without disclosure to viewers.

Collectively, these 77 stations reach more than half of the U.S. population.

The VNRs were produced by three broadcast PR firms for 49 different clients, including Pfizer, General Motors, and Intel.

CMD found that in each case these VNR's were used, the television stations actively disguised the sponsored content to make it appear to be their own reporting. In almost all cases, stations failed to balance the clients' messages with independently-gathered footage or basic journalistic research. More than one-third of the time, stations aired the pre-packaged VNR in its entirety.

Why is this bad?

It is bad because television remains the dominant news source in the United States. More than three-quarters of U.S. adults rely on local TV news, and more than 70 percent turn to network TV or cable news on a daily or near-daily basis.

The integrity of television reporting impacts the public's ability to evaluate everything from consumer products to medical services to government policies and when television stations use paid propaganda they cheat their viewers out of the ability to make informed decisions.

And finally, the Federal Communications Commission has "launched an investigation" of dozens of television stations, for airing corporate-sponsored and -scripted segments on news programs, without disclosing their sources. You'd think they'd have been on this case years ago, but not until embarrassed enough by a third party organization did they start to lift a finger. Oh well, press releases are cheap. I'd be soo surprised if anything actually comes out of their "investigation."

So, don't trust your evening news. You may simply be watching a disguised commercial.

Read more here.

And watch fake news from Pfizer here.

Monday, May 29, 2006

Baby Bird - 3

Here comes the third installment and blog about the the baby bird we found.

This is a link to the prior blog and pictures of how small he was when we found him.

As you can tell he's grown a lot and is now trying to fly, sitting on my finger. He kind of flies like one of those first airplaines, meaning he runs, flaps his wings, and manages a short jump in the air.

He continues to eat like crazy. But instead of eating every twenty minutes he is now OK if he gets a meal once or twice per hour. His favorite is moist dog food mixed with apple sauce.

The longest we've left him is a couple of hours. Apparently he got real hungry, since he managed to get out of what we thought was a safe cage, and was sitting on the front porch waiting for us when we returned home.

He made it clear he was not happy with our absence.

During the day we keep him in the back yard and he's free to run around as much as he wants to. So far he stays within a safe distance and jumps up on a finger when we ask him to.

Saturday, May 27, 2006

"Dr. Rost posts another brilliant blog entry"

As recommended by Truthspew.

"Dr. Rost posts another brilliant blog entry"

"You might recall Dr. Peter Rost - the man tossed out of Pfizer for pointing out the dangers of certain drugs. In any case, he's gone and written a poignant one about how when busted, corporate leaders suddenly turn pious."

Very kind.

Thank you Truthspew, "Spewing Truth in the face of lies"

:)

Friday, May 26, 2006

God's Men: Guilty, Guilty, Guilty!

Finally, it happened, Kenneth Lay and Jeffrey Skilling from Enron have been found guilty.

But then I noticed something about God and Ken Lay.

Ken Lay was quoted saying "I firmly believe I'm innocent of the charges against me. We believe that God in fact is in control and indeed he does work all things for good for those who love the Lord."

And I think it is perfectly fine if Lay believes in God.

But I find it strange that all these corporate chieftains, as soon as they get in legal trouble, they go running to God. It's not like they were having big prayer meetings in their corporations when they ripped off the small people. Well, of course I don't know that. But I think it is more likely that they were saying stuff like, "God, we're smart, and Jesus, how stupid those little people are."

Considering what Enron traders were caught on tape saying, it wouldn't surprise me if that was exactly what they said.

When a forest fire shut down some big transmission lines into California, cutting power supplies and raising prices, Enron energy traders were caught on tape shouting, "Burn, baby, burn. That's a beautiful thing."

Maybe they took their inspiration from that burning bush in the Bible, from which God's voice came. But I don't think God's voice came from those fires in California. No recording of that, anyway.

But the Enron czars are not the only ones going holy once they face legal trouble. Former Worldcom boss Bernard Ebbers wept as he was sentenced to 25 years in jail for his role in the scandal that brought down Worldcom. He reportedly said ""I believe God has a plan for people's lives, and I believe he had a plan for me."

I guess God's plan for Ebbers was jail.

And then we have Dennis Kozlowski, infamous boss of Tyco, best known for lavish spending of corporate money on $6,000 shower curtains and a toga birthday party for his wife with peeing ice statues. He didn't talk too much of God. But he called some of the expensive decorations used to remodel an $18 million apartment on Fifth Avenue that he had the company buy "god-awful" and told jurors that "I stuffed some of it in the closet."

Richard Scrushy had a different take on God. "God is good," he declared on June 28th, after a jury acquitted him on all of the 36 charges he faced in connection with a huge accounting fraud at HealthSouth

According to the Anniston Star, "Scrushy stopped attending his suburban white church when he was facing indictment and started preaching at predominantly black churches. He also donated more than $1 million to a black Baptist church that he joined shortly before his indictment. When it came time for his trial last year, Scrushy invited black pastors to attend and to sit on benches in the racially mixed jury's line of sight. One clergyman came forward earlier this year and said he was hired by Scrushy to round up black pastors to attend the trial and to provide public relations services in Birmingham, where the trial was held. To the astonishment of most legal experts, his ploy seemed to work. The jury acquitted him, despite the fact that five former HealthSouth chief financial officers who had admitted to cooking the company's books testified against Scrushy."

So hey, banking on God, actually may work. At least down in the South.

But only a few weeks ago, Scrushy found himself back in the courtroom, this time facing federal bribery and corruption charges.

We'll see if God helps him this time.

And then there's Frank P. Quattrone, a former technology investment banker, who made a fortune at Credit Suisse and was convicted of obstruction of justice based on an e-mail he sent out to destroy documents ahead of a federal probe. He is also a godly man, and tried to help the Northern California Innocence Project (NCIP), a nonprofit organization in California that defends wrongfully convicted people "He's a very religious man and was struggling for a long time to find meaning in what had happened to him," says Kathleen "Cookie" Ridolfi, executive director at NCIP and a law professor at Santa Clara University. "He believes that basically it was God directing his attention and saying, 'I want you to notice this issue."

In March 2006 a judge threw out Quattrone's obstruction-of-justice conviction because of faulty instructions to the jury, and granted him a new trial with a different judge. So perhaps God is with this guy, too.

Then we have John Rigas founder and CEO of Adelphia Cable. The 80-year-old elder Rigas received a 15-year sentence for the massive fraud that bankrupted the cable company and he became one of the more infamous corporate CEOs of recent years.

"If I did anything wrong, I apologize," said John Rigas in court, according to Bloomberg. "I did the best I can to correct it. If that means I have to go to prison, it's not where I ever expected to be in my life. Nor do I believe it's where I should be because of what happened. It's in your hands, and in God's hands."

God's hands gave him 15 years in prison.

And this makes me realize that it isn't just the government which has made a lot of money when sinners are brought to Justice. False claims act recoveries alone top $17 Billion Since 1986. That's a lot of money for the government.

But churches and synagogues may also have seen an upswing in CEO contributions during this time of corporate greed.

Never before have so many rich man offered so many prayers, and so much money to churches, with so little intervention from God. That's poor return on investment. But perhaps there's a reason for that:

"It is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God."
Matthew 19:24

Thursday, May 25, 2006

The FDA is Finished

The FDA is here to protect us and to ensure, among other things, safe drugs.

This is a tough task, a task which will often result in criticism.

And when the FDA is caught red handed making decisions that have nothing to do with science, and everything to do with politics and religion, the trust in the FDA effectively ends.

The FDA, as we know it, is finished, and here's why:

It was just revealed that two key Food and Drug Administration officials recently testified that former FDA Commissioner Lester Crawford took them out of the agency's normal drug approval process, in order for him to personally block over-the-counter sales of an important early pregnancy contraceptive or "morning-after pill."

We're talking about Crawford's decision in August 2005 to block nonprescription sales of Plan B even though the key agency officials wanted to approve them.

And who's behind this decision? The usual suspects. Conservative groups and religious fundamentalists have lobbied the FDA and the White House against nonprescription Plan B sales.

Religious fanatics argue that Plan B causes abortions, although the scientific truth is that the drug, when it's taken within 72 hours of unprotected sex, simply prevents pregnancy.

According to transcripts of the depositions, Dr. Steven Galson, director of the FDA's drug evaluation center, and Dr. Janet Woodcock, deputy operations commissioner, Crawford removed them from involvement in the agency's decision on Plan B.

Galson, who testified he was unhappy with the FDA's Plan B process, said: "What happened around that time frame is that Dr. Crawford, who was the acting commissioner then, told me that he was concerned about where we were heading because he knew that I was heading towards this recommendation [approval], and he told me that he was going to make the decision on what to do with the application."

He, he. Sounds different than when Galson motivated FDA's rejection of Barr's application for Plan B non-prescription sales earlier, in May 2004.

On May 6, 2004, Galson wrote in a memo: "Some staff have expressed the concern that this decision is based on non-medical implications of teen sexual behavior, or judgments about the propriety of this activity. These issues are beyond the scope of our drug approval process, and I have not considered them in this decision."

Right. The truth doesn't always get out, but sometimes it does.

So, in August 2005, Crawford blocked Plan B and said the FDA needed more time to consider a revised application from Barr to allow Plan B sales without a prescription to women 16 and older but with a prescription to girls 15 and under.

Dr. Susan F. Wood, the FDA's top women's health officer, then resigned in protest over Crawford's handling of this matter.

The end of the saga is that the drug is still not approved without a prescription and Dr. Crawford the former, eminent FDA czar, is now under investigation himself.

The criminal investigation of Dr. Crawford by a federal grand jury over accusations of financial improprieties and false statements to Congress, was revealed only a month ago. Dr. Crawford resigned in September 2005, less than three months after the Senate confirmed him as the permanent FDA commissioner, a position which he had held on an “acting” basis for a couple of years. He said then that it was time for someone else to lead the agency.

Yep, criminal charges can do that to you. Time to move on.

Question is when the clowns who are messing with our healthcare system and approval of vital drugs will be charged with their crimes.

"Whiny Whistleblower of the Year"

A month after Pfizer fired me, the American Council on Science and Health on December 30, 2005 announced that they had nominated me to “Whiny Whistleblower of the Year.”

In his nomination, Gilbert Ross, M.D., Executive and Medical Director of the ACSH stated that the biggest “Whiny Whistleblower” for 2005 was “the person who most outrageously defied his or her employer, regardless of loyalty, science, or even common sense.” Dr. Ross concluded “I vote for ex-Pfizer V.P. Dr. Peter Rost, an inept exec but a pretty good whistleblower. He provoked a federal investigation of his own company in 2003, alleging that Pfizer was responsible for the improper marketing of the synthetic growth hormone Genotropin.”

Of course it was with certain amusement that I noted that the magazine Mother Jones wrote about ACSH medical director, “Ross spent all of 1996 at a federal prison camp in Schuylkill, Pennsylvania, having being sentenced to 46 months in prison for his participation in a scheme that ultimately defrauded New York's Medicaid program of approximately $8 million.”

And I figured that perhaps it wasn’t a coincidence that ACSH had given me this fine award, since Pfizer contributed to ACSH, according to Corporate Donors 1997. But I didn’t have more recent data and I didn’t really know how much money Pfizer had given them lately. So since I've sued Pfizer for wrongful termination, my attorney sent ACSH a subpoena, asking for all kinds of interesting information that could be helpful at trial.

Clearly it would have been very easy for ACSH to respond and say that they hadn’t taken any money from Pfizer. But they didn’t. ACSH responded, “With regard to your request for confidential commercial information in terms of donations to ACSH, we cannot comply with this request if there is a possibility that such confidential information would be disclosed at trial.”

So I was just about to write a really funny posting about how this made ACSH look really guilty. But it didn’t work out that way. After we threatened to compel by going to court, we got a letter saying ACSH changed their mind and would give us everything we asked for, if we keep the stuff confidential.

Aw, shucks. No more blogs making fun of ACSH.

But I guess there’s something good about that. At least it’ll make Pfizer understand that if they play ball instead of playing stupid when we ask for their documents, there’s a benefit to them too. It’ll make them look as if they have less to hide and that’ll make us all much happier. But then again, Pfizer may have more to hide than ACSH.

To read more about Pfizer's secrets, and what they do to protect them, see my blog $10,000 Fine If I Talk and Super Secret Secrets.

Build the Wall!

In Russia they used to say: The government pretends to pay us and we pretend to work. Well, in the U.S. we could say that our politicians pretend to stop illegal immigration and Big Business pretends they don't hire them.

Don't get me wrong. I'm not so sure that it is fair for one rich country to lock out the poor around them, just like the rich man builds walls around the castle he built with ill-gotten gains. The earth is here for all of us.

I should know--I am an immigrant who came here legally. I voted with my feet twenty years ago and it wasn't easy to get into the U.S. Some said it was impossible, unless you already had family here. But we made it. And even though I think this is a great country, and I was willing to fight my way through the worst bureaucracy on earth--U.S Immigration--I do think there are a few things that can be improved.

Like the Wall to stop Mexicans from entering this country.

Look at this picture from the New York Times/Reuters. Is this the best we can do to stop illegal immigration from Mexico? A flimsy, corrugated, tin foil?

I mean, if we really want to stop people, the technology exists.

This is what Israel is building:


















And this is what Russia built in Berlin to stop people from jumping out from behind the iron curtain:
So the technology is there, yet we don't build that wall.

Instead President Bush sends 6,000 National guardsmen to "protect" our border. Ha.

The Mexican-American border is 1952 miles long. That's three additional soldiers per mile. They won't even see each other. Assuming they are properly spaced and not holed up in some border patrol office.

The Iron Curtain was 4000 miles long, twice as long as our border with Mexico. And it was built a lot sturdier than our flimsy pieces of "wall."

So what's the matter? Why can't we keep people out when Russia was so good at keeping people in? And why is it so hard for people from Western Europe, who don't have half their family in the U.S., to immigrate legally to the U.S. and so easy for Mexicans to run across the border?

Simple. Because Big Business really wants cheap labor, not well-educated Europeans.

So Bush and the other politicians do their bidding. They pretend to want to stop illegal immigration, while they do everything to keep the status quo.

Big Business doesn't want a wall. They want illegal immigration. They don't want a regulated border, with regulated minimum wages and all that other stuff. They want scared Mexicans that can be deported at any time working for less than minimum wage. Disposable people building disposable products. So that's what Big Business gets from our politicians.

Make no mistake about what's going on here. The people on Capitol Hill still believe in the concept of "Give us your poor, your tired, your huddled masses longing to be free." They want the oppressed people to continue to come to us and they want to continue to oppress them. That's the real reason we have no real wall.

So I say: Build the Wall, a real wall and maybe we'll see real wages for our poorest immigrants. Maybe we'll see a functioning immigration program, with well educated people from around the world coming to us, and maybe Big Business will have to learn to do business in a lawful society, paying lawful wages.

Build the Wall. Bring it on!

Wednesday, May 24, 2006

The Andy Rooney of Pharma Bloggers

John Mack, who runs the excellent Pharma Marketing Blog also publishes Pharma Marketing News. This is a monthly e-newsletter with pretty unbiased presentation of facts, product reviews and coverage of the pharma industry.

In his most recent newsletter he did an interview with me about my blogging and all the strange phone calls I've been getting from recruiters who never have any job offers.

A quote from the interview:

The Andy Rooney of Pharma Bloggers

"What I try to do," Rost says, "is not just write a review about an article published in the press. I like to relate different things into the story. An example is the story about the drug industry falling off a cliff."

"Very often people are not shown the whole picture in the press. What I like to do is to take a number of bits of information and put them together to give people an overall perspective that they might not have received from the stories in the press."

In this sense Rost compares himself to Andy Rooney of the 60 Minutes news show--only better looking!

Download the newsletter and read all about this here, page 15-18.

Viagra for Children

I've been critical of some drug industry practices, I've been saying that me-too drugs don't always add much value, and I've said that many brand extensions and new formulations are just there to make more money for the drug company.

But there are also other, good, examples of what the drug industry does when they develop new indications and new drugs based on something they already have.

One example is Viagra for children.

Last year Pfizer got approval to sell Viagra, now named Revatio, to children. They tweaked the dose a tiny bit, 25 milligrams vs. 20, 50 and 100 milligrams for Viagra and gave the "new" drug a new look. Revatio is white and round, Viagra is a blue diamond.

Here's how the new drug works in children. Viagra increases blood flow (we all knew that, right?). But this isn't just something middle aged men are sometimes in need of, it turns out there is also a very deadly disease, called primary pulmonary hypertension, which is caused by constrictions in the blood vessels that supply the lungs.

Viagra dilates blood vessels, which promotes erections and dilates the vessels to the lungs which reduces blood pressure in the lungs. According to Pfizer, about 95% of young patients on Viagra survived 18 months, compared with the 65% survival predicted for the population with primary pulmonary hypertension.

Congratulations, Pfizer.

Tuesday, May 23, 2006

How to Sing the Blues

I believe copying is the best form of flattery. My favorite blog is PharmaGossip, I read it every day. And today PharmaGossip had something different, about blues.

The original web page is here. And here you can enjoy the music!

HOW TO SING THE BLUES

1) Most Blues begin, "Woke up this morning..."

2) "I got a good woman" is a bad way to begin the Blues, 'less you stick something nasty in the next line like,

"I got a good woman, with the meanest face in town."

3) The Blues is simple. After you get the first line right, repeat it.

Then find something that rhymes . .. . sort of: "Got a good woman with the meanest face in town. Yes, I got a good woman with the meanest face in town. Got teeth like Margaret Thatcher, and she weigh 500 pound."

4) The Blues is not about choice. You stuck in a ditch, you stuck in a ditch-ain't no way out.

5) Blues cars: Chevys, Fords, Cadillacs and broken-down trucks. Blues don't travel in Volvos, BMWs, or Sport Utility Vehicles. Most Blues transportation is a Greyhound bus or a southbound train. Jet aircraft an' state-sponsored motor pools ain't even in the running. Walkin' plays a major part in the blues lifestyle. So does fixin' to die.

6) Teenagers can't sing the Blues. (Well, except maybe Johnny Lang) Adults sing the Blues. In Blues "adulthood" means being old enough to get the electric chair if you shoot a man in Memphis.

7) Blues can take place in New York City but not in Hawaii or anyplace in Canada. Hard times in Minneapolis or Seattle are probably just clinical depression. Chicago, St. Louis, and Kansas City are still the best places to have the Blues. You cannot have the blues in any places that don’t get rain.

8) A man with male pattern baldness ain't the blues. A woman with male pattern baldness is. Breaking your leg cause you skiing is not the blues. Breaking your leg 'cause a alligator be chomping on it is.

9) You can't have no Blues in a office or a shopping mall. The lighting is wrong. Go outside to the parking lot or sit by the dumpster.

10) Good places for the Blues: a) Highway; b) Jailhouse; c) Empty bed; d) Bottom of a whiskey glass. Bad places for the Blues: a) Dillard's; b) Gallery openings; c) Ivy League institutions; d) Golf courses.

11) No one will believe it's the Blues if you wear a suit, 'less you happen to be a old ethnic person, and you slept in it.

12) Do you have the right to sing the Blues? Yes, if a) You older than dirt; b) You blind; c) You shot a man in Memphis; d) You can't be satisfied.

No, if a) You have all your teeth; b) You were once blind but now can see; c) The man in Memphis lived; d) You have a 401K or trust fund.

13) Blues is not a matter of color. It's a matter of bad luck. Tiger Woods cannot sing the blues. Sonny Liston could. Ugly white people also got a leg up on the blues.

14) If you ask for water and your darlin' give you gasoline, it's the Blues.

Other acceptable Blues beverages are a) Cheap wine; b) Whiskey or bourbon; c) Muddy water; d) Nasty black coffee.

The following are NOT Blues beverages: a) Perrier; b) Chardonnay; c) Snapple; d) Slim Fast.

15) If death occurs in a cheap motel or a shotgun shack, it's a Blues death.

Stabbed in the back by a jealous lover is another Blues way to die. So are the electric chair, substance abuse and dying lonely on a broken down cot. You can't have a Blues death if you die during a tennis match or getting liposuction.

16) Some Blues names for women: a) Sadie; b) Big Mama; c) Bessie; d) Fat River Dumpling

17) Some Blues names for men a) Joe; b) Willie; c) Little Willie; d) Big Willie

18) Persons with names like Michelle, Amber, Debbie, and Heather can't sing the Blues no matter how many men they shoot in Memphis.

19) Make your own Blues name Starter Kit:

a) Name of physical infirmity (Blind, Cripple, Lame, etc.);

b) First name (see above) plus name of fruit (Lemon, Lime, Kiwi, etc.);

c) Last name of President (Jefferson,Johnson, Fillmore, etc.);

d) For example, Blind Lime Jefferson, Jakeleg Lemon Johnson or Cripple Kiwi Fillmore, etc. (Well, maybe not "Kiwi.")

20) I don’t care how tragic your life, if you own a computer, you can’t sing the blues.

$10,000 Fine If I Talk

There was something I forgot to tell you yesterday, when I wrote about Pfizer's Super Secret Secrets and how they didn't want me to see documents related to my own litigation against them.

They didn't just want to keep their most secret documents from me, and only give my lawyers access to files they would mark "highly confidential." They also want me to pay a $10,000 fine if I reveal anything from the less secret documents, marked "confidential."

$10,000 is a lot of money. It's going to be pretty much my annual income this year.

So I wonder, is this really fair? Do they have anything to fear from me?

Have I ever been convicted of breaking a contract? No.

Have I ever been convicted of leaking confidential information? No.

Have I ever been convicted of anything, anywhere? No.

Have I ever paid any fines for anything? No.

Uh. Maybe that was wrong. I think I had a speeding ticket about ten years ago. But that's not enough to treat me like I was a criminal.

So let's check out Pfizer.

Have they ever been convicted or plead guilty to anything? Yes, yes, yes.

Pfizer's division Warner-Lambert agreed to pay $430 million to resolve criminal and civil charges related to off-label promotion. Pfizer agreed to pay $49 million for defrauding the drug Medicaid rebate program. Pfizer is one of the few companies that have been forced to sign not just one, but two "Corporate Integrity Agreements."

Perhaps you wonder what a "Corporate Integrity Agreement" (CIA) is?

It is something very bad. Since the Justice Department can't put corporations in jail (the way they do this with regular criminals), they instead make them sign a CIA, in which the company promises never ever to commit the same crime again. And if the company just can't stop themselves, like Pfizer, they have to sign a second CIA, like Pfizer.

And the fines are astronomical if they violate this agreement. Pfizer has to pay a whopping $1,000 each day they violate the agreement.

So let's step back for a moment and compare notes. Pfizer makes $50 billion a year, and negotiated a deal with the Office of the Inspector General to pay $1,000 per day if they fall back into crime.

But Pfizer wants me, (who right now makes around $10,000 per year) to pay $10,000 if my tongue slips.

Pfizer, I've got a proposal for you: If my tongue slips (which it won't), I'll pay you the same amount, as a % of my earnings, as you pay the government if you fall back into crime.

Based on my current income, that comes to 0.02 cent for each infraction.

Pfizer, do we have a deal?

Helloooooo?? Anybody there?

Monday, May 22, 2006

Lies, Damned Lies and Drug Trials - 2

Back in April I wrote a blog for the Huffington Post about Lies, Damned Lies and Drug Trials.

If anyone doubted what my point was, please read today's story in the New York Times called "Why the Data Diverge on the Dangers of Vioxx."

It turns out that the sacred "first 18 months" during which time Vioxx supposedly didn't cause heart attacks (according to Merck) wasn't so sacred.

"The new data Merck submitted to the Food and Drug Administration earlier this month include what happened to the patients for a longer period after they stopped taking the drug. And in this presentation, the Kaplan-Meier chart — the one critics have seized upon — shows those lines starting to separate at around four months and remaining separate thereafter, although they do diverge more widely at the 18-month point."

NY Times continues:

"In The New England Journal of Medicine's response to the original manuscript, the editor, Dr. Curfman, asked the authors to remove the assertion "that increased risk was observed only after 18 months." Nevertheless, the 18-month finding was published as part of the article's main results. But Merck and the researchers continue to insist that the 18-month finding was a legitimate conclusion, based on the data that were analyzed. "

So here we go again. Things are worse than the company reported. Now we know you get a heart attack from Vioxx already after four months use. But let's not beat up on Merck. Perhaps they were just unlucky, and their scientist too sloppy to find this information right away. Or, maybe they had a hunch and tried to hide it. Who knows?

What we do know is that very rarely do companies hide good information and it is much more common for them to behave like five-year olds who just raided the cookie jar when they have bad news to tell. But even when they really try, big companies rarely manage to pull off the lies with the aplomb of a fiver-year old.

So what does the lead author have to say? He responds like a true five-year old:

"If The New England Journal didn't think this was an appropriate and satisfactory product, they didn't have to publish it," Dr. Bresalier said.

Drug Companies in Pain

The U.K. newspaper The Independent has written an excellent article about the pharma industry and I have selected a few sections to quote.

"The pharmaceutical industry is not fighting for its life. But it is definitely sick. "Gruesome" is how Mike Ward, an analyst at Nomura Code Securities, describes the state of the world's biggest drug makers in recent years."

Fits well with my comments in earlier blogs.

"Over the past five years, the world's top five drug makers have shed more than £60bn in market value"

Right, and over the next five years they will lose even more.

"The number of new drugs that major pharmaceutical companies are bringing to market, meanwhile, has stagnated"

Stagnated? That's too kind. The number of new drug approvals have dropped from 50 each year to just 20 in the last ten years.

"Meanwhile, the industry's image is still in the gutter. A recent report in the Public Library of Science journal alleged that the sector was populated by "disease mongers" that exaggerate ailments or conditions to inflate the markets for the drugs they invent. "

The Harris Poll in the U.S. shows the same trend. Less than 10% of U.S. population thinks the drug industry is generally honest and trustworthy.

"The [drugs giants] recognise that a lot of the innovation coming out of biotech companies is not something they are necessarily good at," says a director at one biotechnology company. "That is changing the model."

That's pretty tough. If you're not good at doing what you're supposed to do--invent new drugs--what are you good at?

"They are so fat, it's unbelievable," says the biotech director. "There are enormous costs that have to be stripped out of these companies."

An area to cut: Executive pay, anyone agrees? Check out Pfizer CEO's $83 million retirement package after he presided over stock drop of 40%.

"Growth in America, so long the engine of the industry as the world's largest medicines market, has dropped dramatically in recent years amid rising public scrutiny of prices and perceptions of pharmaceutical company "profiteering"."

So finally, judgment day is coming.

"But the drugs giants themselves have contributed to the stagnation, becoming more conservative in new development. This resulted in fewer truly novel drugs, just as governments cooled to "me-too" treatments that are only incrementally better than those already available."

Are these the same companies in need of high drug prices for "research?"

"Companies have woken up to the changed world and refocused on internal research and development . . . The problem, however, is that developing new drugs takes years - so the suffering, it seems, is still far from over for the big pharmaceutical companies."

And that is true for Big Pharma shareholders as well.

I suggest dumping drug stocks before the bottom falls out over the next five years. And no, I don't know which ones will be bought up, buck the trend, and soar short-term.

Full story here.

Super Secret Secrets


As many of you know I filed a wrongful termination lawsuit after Pfizer fired me six months ago. Before trial the two parties are legally bound to exchange all documents relevant to the case. We have sent our documents to Pfizer, but we have not received anything back.

In fact, Pfizer appears to be in a state of panic about what we have asked for. We thought it was pretty simple, so we just requested documents and e-mails written by senior Pfizer managers with my name on them as well as material related to my termination and references to possible illegal acts.

Pfizer has now asked us to agree to a “protective order” before they turn over any documents.

They are so afraid that their secrets will get out that they want to designate some documents not just “confidential,” but “highly confidential,” and according to the proposed protective order those documents would only be accessible to the outside lawyers, and to Pfizer's lawyers. Not even I, as the plaintiff, would have access to them, nor would the individual defendants at Pfizer have access to those documents.

But there is one exception.

Jeff Kindler is not only a defendant but also Pfizer's General Counsel and head of Pfizer's legal department. The way the protective order is written he would be exempt and would have access to all documents, but his co-defendants at Pfizer would not.

Among the defendants kept in the dark would be Ms. Karen Katen who is also a Vice Chairman and in charge of the entire Pfizer Pharmaceutical business. She makes more money than Mr. Kindler, has more power, and has been with the company much longer.

Perhaps you might also be interested in knowing that Katen and Kindler are both competing for the job as CEO when Dr. McKinnell retires.

The last part is pretty interesting. Essentially, Pfizer’s legal department, led by Jeff Kindler, Vice Chairman of Pfizer, is saying that there are certain documents he doesn’t want to show to Karen Katen, Vice Chairman and President, Pfizer Human Health.

Hmmm, I wonder what Jeff Kindler doesn’t want Karen K to ? Is he playing  in their internal comp? Uh, I think the Pfi censo are gett into my com.

             .         .

  .

     .       .

                   .

Saturday, May 20, 2006

The Blind Company

Bausch & Lomb, the company which has worried itself sick, because many of its customers went blind after being infected with an eye fungus, is happy again.

"The C.D.C.'s conclusion that the MoistureLoc formulation was the only product with a statistically significant association with reports of Fusarium keratitis in the cases they have evaluated should put to rest any further speculation that other products may also be implicated," Bausch & Lomb's chief executive, Ronald L. Zarrella, said in a statement.

(Ronald is the guy who looks like a chicken when he waves his arms on commercials and tries to get customers who have not already gone blind switch to another one of his products.)

Uh, maybe they weren't that worried about those blind customers, maybe they were worried about their other products and their bottom line . . . and maybe that's the reason they risked the eyesight of all their customers for three months after they pulled the lens cleaning solution in Asia.

I used Bausch contact lens products for 20 years, before I had Lasik eye surgery, and I'm mad.

Bausch & Lomb: We care. About ourselves.

Read more here.

Not enough sick patients? Change the definition of sick!

High blood pressure is a good example.

When I went to medical school in the late 80s, doctors were taught that normal blood pressure was the patient's age plus 100, over 90. So if you were 60 years old, a blood pressure reading of 160/90 (160 over 90) was considered normal.

These guidelines reflected the fact that the systolic blood pressure (the higher number) rises with age because blood vessels narrow and become more rigid.

Since then more and more stringent guidelines have been developed, until we were told that a normal adult blood pressure was 120/80. Anything else was high blood pressure and should be treated.

But that just went out the door. According to the new "official" guidelines, 120/80 puts you in a new disease category called "prehypertension" and at increased risk for heart attack, stroke, or kidney disease.

65 million Americans have high blood pressure under the 120/80 definition. This has resulted in a $17 billion market for blood pressure drugs.

But—and here’s the beauty in the new guidelines—another 59 million Americans are right on the borderline and prime candidates for treatment if the new definition is accepted by doctors. You do the math and you’ll understand that a few champagne corks are popping at drug company headquarters.

Friday, May 19, 2006

Bausch & Lomb Damage Control

Yesterday evening I watched the Bausch & Lomb CEO on his recent commercial or maybe I should say damage control appearance on television.

I thought that maybe he would warn all the people who still use the contact lens solution which has caused so many people to go blind. See my blog here on what happened. And maybe he would apologize to the people who lost their eyes, and maybe he would have big signs with "warning" symbols.

Boy was I disappointed. After a one sentence opening about the fact that Bausch had recalled the product, he spent the rest of his time strutting around and waving his arms like a chicken, trying to get customers to switch to Bausch's old lens solution. If you didn't know there was a big problem with his product you could almost have missed the whole point of his appearance.

I have to admit, after watching that video, I start to get the feeling that maybe it wasn't a coincidence that this CEO didn't take the product off global markets until three months after he recalled the lens solution in Singapore and Hong Kong.

Sad.

Thursday, May 18, 2006

Profit vs. Eyeballs

On March 3, Bausch & Lomb received a phone call from Dr. David S. Chu, a specialist in cornea diseases. Three of his recent patients had a fungal infection that could make them blind; the infection could actually force him to remove the entire eye.

They had all used Bausch & Lomb's ReNu brand lens cleaners.

It was soon discovered that Bausch had agreed to stop selling its ReNu brand cleaner in Hong Kong and Singapore already in February.

But Bausch didn’t tell American consumers about that.

According to the New York Times, “the federal Centers for Disease Control and Prevention said it had confirmed 122 cases of the fungal infection, 15 possible ones and 60 still under investigation in 33 states and territories. Bausch customers make up the vast majority of those affected. No official reports exist on the health impact of the outbreak, but a Florida woman has lost an eye and scores of other patients have undergone restorative corneal transplant surgery that has left them with astigmatism and other impairments.”

From February 2006, until May 2006, Bausch continued selling a product which could make your blind.

But wait, there’s more.

In a filing with the F.D.A. already in December, 2005, Bausch reported 15 infections in Hong Kong among MoistureLoc users but claimed “there were no indications of problems with the product.”

On May 15 Bausch finally withdrew MoistureLoc, a $100-million-a-year product, from global markets, and they are stepping up efforts to persuade lens wearers to use an older ReNu version, MultiPlus.

Dr. John Bullock, a former ophthalmologist who is currently an epidemiologist at Wright State University in Dayton, Ohio, and who was one of the first to report a possible outbreak to regulators, said, according to NY Times, "I want to see more evidence, but if a patient asked me now whether to use MultiPlus, I'd say throw it away."

And what does Bausch say?

"I wish we had made the decision the first day not to sell or use it," Angela Panzarella, vice president for global vision care at Bausch, said.

Read the entire story here.

My Cheating Friend - 2

A few days ago I wrote a blog about “my cheating friend.” She’s a woman who’s been married for ten years and suddenly had her first affair. Only she discovered what she’s been missing and now she wants to meet the new man again.

Last night she called me. She told me that she’d seen my blog and read the comments. Then she broke the news. “And my husband saw what you wrote, as well.”

She paused.

“Are you OK?” I asked.

“Well, I know that I agreed that you could write about some of what I told you, if you changed the details, so no one would know who I am. And I thought it might be interesting to read what people said . . .”

“Was there a problem?”

“You could say that,” she continued. “My husband told me over dinner that he’d seen your blog and I almost suffocated on the food in my mouth.”

“Oh no. . . what happened?”

“I pretended that I suffocated on my food, which I did. He doesn’t suspect anything. He just said he was happy that the story wasn’t about us.”

I have to admit that I felt pretty uncomfortable at this point. So I tried to tell her that she couldn’t go on like this and she couldn’t live a lie. She agreed and said that she felt very guilty, really terrible.

But then she stated, “It doesn’t matter. I have to see that man at least one more time. It’s not just the sex. When I’m with him he makes me feel so special. He validates my feelings, and he cares and is so tender. I feel this deep connection that I haven’t felt in years. We have so much in common. If you hadn’t experienced this you wouldn’t understand.”

I asked her what would happen now.

She told me that she’d set up a second rendezvous with the young gentleman she couldn’t stay away from. There’s a medical conference in Santa Barbara this weekend, and she is going away for two nights without her husband and she plans on meeting her lover there.

“Aren’t you the least dissuaded by the comments you read on my blog on Huffington Post?” I asked.

“Those people are right. I should run. But I just can’t. Don’t you see; I may only experience something like this once in my lifetime.”

I’m not sure if she believed that herself. I could tell that her brain told her one thing and her heart simply didn’t care. She was hoping for the impossible. I asked her to call me after the weekend, when she returned from her trip and her meeting with her new lover, if she wanted to talk.

I knew one thing, whatever she felt it was more addictive than crack cocaine.

The Baby Bird

A week ago we found a baby bird in the front yard. This is what he looked like.

We didn't think he would survive, so we took him inside. I wrote about this on my Huffington Post
blog and received lots of responses and advice.

Most people thought it was a good idea to keep him and we did.

It turns out we have been able to feed him and he is alive and growing every day.

But it is hard work. We have to feed him ever half hour with a puree of dog food . . . and then he's happy. Actually he is most happy when we hold him in a tight little bundle in our hands.

This is what he looks like now.

And by the way, I don't need an alarm clock anymore. Every morning at 6:30 he wakes us up with his pleading for breakfast.

Wednesday, May 17, 2006

Why Drug Companies Promote Off-Label

The Pharma Marketing Blog has one of the best posts written in a long time about off-label drug company promotion. You can find it here.

"The market for ED drugs is not nearly what the drug marketers in these companies thought it would be (see "ED Drug Sales Limp")."

"Another piece of evidence I have that there may be more off-label promotion of ED drugs comes from the book "Selling Sickness." The author points out that a prominent urologist -- a paid consultant to Pfizer -- said he was a "strong believer" in taking Viagra on a daily basis to "prevent impotence."

"Several industry conferences are devoted to off-label promotion by pharmaceutical companies. The term "promotion," however, has now been dropped in favor of "usage" as in the "5th Annual Off-Label Usage Conference."

"Whenever the pressure is high to meet sales numbers -- especially to meet Wall Street expectations -- there will be a danger of crossing the line into illegal off-label promotion, even if it is called by another name."

One Scary Picture

Real Reason for Expensive Drugs:



Source: Forbes, Robert Langreth and Matthew Herper, "Pill Pushers."

You still believe drug prices go up so you'll get better research?

Key Words for 2006

Some of these words are brand new, other have been around for years, all are key to survival in 2006:

1. BLAMESTORMING: Sitting around in a group, discussing why a deadline was missed or a project failed, and who was responsible.

2. SEAGULL MANAGER: A manager who flies in, makes a lot of noise, craps on everything, and then leaves.

3. ASSMOSIS: The process by which some people seem to absorb success and advancement by kissing up to the boss rather than working hard.

4. SALMON DAY: The experience of spending an entire day swimming upstream, only to get screwed and die in the end.

5. CUBE FARM: An office filled with cubicles

6. PRAIRIE DOGGING: When someone yells, or drops something loudly in a cube farm, and people's heads pop up over the walls to see what's going on.

7. SITCOM: Single Income, Two Children, Oppressive Mortgage. What Yuppies turn into when they have children and one of them stops working to stay home with the kids.

8. SWIPEOUT: An ATM or credit card that has been rendered useless because the magnetic strip is worn away from extensive use.

9. XEROX SUBSIDY: Euphemism for swiping free photocopies from one's workplace.

10. PERCUSSIVE MAINTENANCE: The fine art of whacking the crap out of an electronic device to get it to work again.

My Cheating Friend

I have an old friend from the time I lived in Los Angeles. She is married but doesn't have any children. We don't see each other very often nowadays since I live outside New York, but we talk quite often, always have. Her husband is nice and they both are very happy in their marriage. Or so things appeared.

A few days ago she surprised me with an unusual phone call. Actually, first she sent me an e-mail and said she really had to talk to me.

I have to admit that I was curious what this was about.

She didn't beat around the bushes. Basically she gave me a twenty-minute phone confession.

This is what happened. She said she really liked her husband, but that sex had been boring for the last ten years. He was simply too lazy to make it interesting and she felt he was very selfish in bed.

Six months ago she met this young, good-looking pharmaceutical sales rep who visited her HMO clinic. He was always very attentive, ten years younger than her, and she didn't think much of it, at first.

After a while she noticed there was something in the air when they met and one day he asked her out after work. Her husband usually works late and she figured the drug company could well afford to pay for dinner so she agreed.

She told me this young sales rep made her feel like a million bucks and that they had more in common than she'd ever expected. They shared secrets; everything from their mutual experience with some illicit drugs in their youths to their love of certain music.

It apparently got pretty late and he asked her to follow him for a nightcap at his hotel. This is a guy who travels a lot and covers a large territory in Southern California. Soon it was midnight and she didn't know if it was the drinks, his bright beautiful smile, or her loneliness which made her accept an invitation to his luxurious hotel room.

She stayed in his room for two hours. That's where she kind of stopped her story.

She concluded her tale saying that she had never before in her life experienced anything like what she experienced in that room. He had done things to her no man had ever done before, he had explored places no man had ever found. She said she was going to die happy and that this was the sexual experience of a lifetime.

Now to the problem.


She still loves her husband, but she thinks he is boring. She was even thinking aloud about the possibility of having an ongoing affair, just to satisfy her physical cravings. But she really didn't want to leave her husband.

The young guy has a family himself, married only two years.

I asked if she thought he'd done this sort of thing in past, and she agree that he probably had. So I told her, there's really no future for the two of you. This is not going to be the last time. He won't leave his wife and if he does, next time he'll cheat on you. People don't change. That's one thing you learn managing people.

She knew that, she's a smart girl. But she told me she had to see him again; she just had to experience this thing again. She said she'd have to lie to her husband, because she didn't want to break up with him, but if he couldn't give her what she craved, she had to get it somewhere else. Something that had been long lost had awoken inside her, she said.

I knew she really called just to talk to someone she trusted, to share her experience and to maybe get some advice.

But this one was a really tough one.

Is it fair to cheat when you don't get what you crave at home? Of course not. Any good, long-lasting marriage is 90% hard work and determination and 10% passion.

Could I understand that she had a life-altering experience? Yeah, I could.

Too often in life we want to eat the cake and have it too. That doesn't work well when we are five years old and even less well when we are adults and we hurt both ourselves and others. Reality is that once you cheat, everything changes, forever.

So, to my dear friend in L.A., my advice for you is to make a choice.

Life is all about choices, even tough ones.

Is the Drug Industry Falling Off a Cliff?

Pfizer is the world's largest pharmaceutical company with about $50 billion in sales, so let's use this company as a benchmark for Big Pharma's future.

As we look at Pfizer we'll soon find something very interesting. Pfizer's CEO Hank McKinnell is revealing in the recent Fortune 500 issue a well guarded secret within Pfizer called "The Cliff". According to Forune, this was the point in time when "key patents were due to expire, and there were far too few potential blockbuster drugs in the early-stage pipeline--Pfizer was approaching a period of steep decline. For everyone privy to the report, including McKinnell, then a VP, a single page stood out. On it was a graphic that forecast a whopping 33% drop in Pfizer's revenues over a three- to four-year period starting around 2003. "We called it the cliff,"says McKinnell. "

At the same time as McKinnell makes this revelation, Pfizer Vice Chairman David Shedlarz told investors, at the annual Deutsche Bank healthcare conference in Boston, when asked about Lipitor sales (the key reason Pfizer sales may fall off the cliff), that "to assume that they will fall off a cliff, that's not a realistic assessment."

And Pfizer executives' talk about a non-existent cliff continues. "I think we feel comfortable that, while it's going to be one heck of a challenging year, we don't believe there's a cliff or trap door we're going to hit," Peter Brandt, executive vice president of U.S. pharmaceuticals, said at a Morgan Stanley conference last week.

So what is going on here, is there a schism between Pfizer's CEO and his management team?
Hardly.

This is what is really going on: CEO's don't like to talk about the fact that their sales are about to fall off a cliff. Pfizer's CEO is no different. That is, until he started getting challenged by virtually every major newspaper a few weeks ago, after Pfizer's most recent proxy statement showed he'd get a $83 million pension. The problem is that during McKinnell's tenure as CEO, Pfizer stock has fallen more than 40%, so now he wants to explain himself and the fact that it isn't really his fault that Pfizer stock has fallen off a cliff, but that everyone inside Pfizer knew the bad things that would happen a long time ago. And I'm sure he's correct about this.

Funny thing, though, I don't remember reading about Pfizer telling all this to Wall Street back in the days when McKinnell found out about this dire prediction. But there is no question that McKinnell wants you to know about "The Cliff" now and the fact that during his stellar leadership "The Cliff" has been avoided. Except if you look at Pfizer stock, which really fell off a cliff, but that's a minor technicality. The Fortune magazine states that, "as McKinnell is concerned, you can't begin to judge him until you understand what is known at Pfizer as "the cliff."

The Fortune 500 article also says that, "Pfizer's shares have lost about 40% of their value since McKinnell took over as CEO in 2001, vs. a 19% drop for pharma as a whole, due to an industrywide R&D drought. McKinnell raked in some $61 million in salary and bonuses in that period, during which the S&P 500 index rose 5%."

So clearly McKinnell has to respond somehow, and he dusts off that old report no one at Pfizer wanted to tell Wall Street about, as far as I know anyway, because then Pfizer stock would have fallen off the cliff more than ten years ago.

But clearly, apart from explaining that McKinnell did a terrific job during the past five years when Pfizer stock fell off the cliff, management really don't want invstors to think that sales will continue to fall off the cliff.

So, Pfizer's CFO tells investors that there is no cliff coming up for the $14 billion blockbuster Lipitor. And Patrick Kelly, who heads up Pfizer's U.S. operations, is quoted saying "It won't be like a light switch, where you pull the switch down and all Lipitor sales go away. It'll be more like a shade."

As for me, I'm simply astonished that all the people on Wall Street who make more money than McKinnell can be so stupid that they didn't see all this coming. It is not like patent expiration is similar to rocket science. Then again, maybe they did see this coming and simply stuck the Pfizer stock to small investors.

Good investment advice: Stay away from Pfizer and Big Pharma for the next five years. We will learn of many more undisclosed "cliffs" during that time period. According to IMS, half of U.S. pharma sales will lose their patent protection in that time period. And Big Pharma isn't spending the majority of high drug prices on research, but on advertising, marketing and selling.

A prescription for disaster.

Want to Become a Doctor?



Source: The British Medical Journal.

The Delusion Of Happiness

"Life, liberty and the pursuit of happiness" is one of the most famous phrases in the United States Declaration of Independence. It is listed as one of the "unalienable rights" of man.
And yet, true happiness is often elusive and grief and misery fills the void.

Daniel Gilbert, however, in his book "
Stumbling on Happiness" cites studies which indicate that most people who endure major traumas (wars, car accidents, rapes) return successfully to how they felt before the bad things happened to them.

Actually, many of them report that they ended up happier than they were before the trauma. It appears as if the human mind is regulated by a thermostat that resets us to our emotional baseline, irrespective of the difficulties we go through.

Partly this miracle is due to the fact that our brain has a merciful ability to forget. The memories, the feelings, the pain; they all slowly fade away until those emotions are no longer at the surface. It doesn't mean they are gone, but simply that they are no more ever present. And that allows us new happiness.

According to Gilbert we are not very imaginative. And we are particularly bad at imagining how we will think or feel in the future. Not only do we not have enough imagination and understanding of ourselves, but we also lack the logical thinking to objectively analyze our past patterns and behaviors and predict how we will react.

This is the reason the things we anticipate will give us joy don't always appear as joyful when they happen, and some of the things we fear turn out not to be as bad as we envisioned. Of course, some really bad things we fear turn out to be terrifying beyond our wildest imagination, if they do happen, but we are mostly able to heal again.

We "expect the next car, the next house or the next promotion to make us happy even though the last ones didn't and even though others keep telling us that the next ones won't."

In fact, we all participate in a giant rat race, thinking we will become happier if we achieve more, which helps society evolve, but as individuals we don't become any more satisfied.

Our basic happiness (or lack thereof) appears to be almost genetically predestined. And any interruptions, such as grief and sadness, go through a predictable healing cycle just like wound healing goes through several physiological stages.

Dr. Elisabeth Kubler-Ross, a Swiss psychiatrist worked with terminally ill patients in the 1960's which resulted in the establishment of a "cycle" that she found each patient went through upon learning of their imminent death. This cycle doesn't just apply to people who are about to die, but the brain reacts the same way to various types of grief and trauma and the Kubler-Ross cycle has been taught to innumerable medical professionals:



The first reaction is shock. The universal first reaction to hearing bad news is, "No."

The second stage is quickly followed by denial. "This can't be happening."

The third stage is anger. This anger may be directed at God, nature, or luck.

The fourth stage is bargaining. The person hopes that God, or a miracle, or forces of nature, or science, will extend their life or salvage the situation.

The fifth stage is grieving. This is usually the longest lasting stage of the cycle and is marked by deep depression and mood changes.

The final stage is acceptance. Once this stage is reached, the person can move on. There is peace and the person can start functioning again, or die in peace, if that was what the grief was about.

In "healthy grieving," and depending on the severity of the situation, this grieving process may take
from weeks to many months and sometimes years. It is a process and every grieving person needs to go through this. There aren't any shortcuts, just like there aren't any shortcuts when we have broken a bone. It needs to heal the way the body does this.

So how can we be happy when at any moment everything we cherish can be taken away from us? The answer is that in a way our lives are a long, ongoing, delusion. David Gilbert asks, "How do we manage to think of ourselves as great drivers, talented lovers and brilliant chefs when the facts of our lives include a pathetic parade of dented cars, disappointed partners and deflated souffl├ęs? The answer is simple: We cook the facts."

We delude ourselves into thinking that we are safe, that the next promotion will make us happy, and that nothing bad will happen. Because if we didn't feel that way, we'd be filled with terror and then we couldn't function.

"If we were to experience the world exactly as it is, we'd be too depressed to get out of bed in the morning," Gilbert writes. "But if we were to experience the world exactly as we want it to be, we'd be too deluded to find our slippers."

Scott Stossel, in his New York Times
review of Gilbert's book, writes that "Interestingly, the clinically depressed seem less susceptible to these basic cognitive errors. For instance, healthy people can be deluded into greater happiness when granted the mere illusion of control over their environment; the clinically depressed recognize the illusion for what it is. All in all, it's yet more evidence that unhappy people have the more accurate view of reality -- and that learning how to kid ourselves may be a key to mental health."

So our normal state of happiness may really be a complete delusion. And the fact that people drink to forget their sorrows or pop "mother's little helpers," is just an attempt to regain equilibrium and jump back into the ongoing delusion we're all living in.

Then again, while the pessimist may be right more often, the optimist has a lot more fun. So if given a choice, I'm all for deluding ourselves, be happy, and live a much more satisfying life than any non-delusional pessimist could ever hope for!

Important Legal Disclaimer

This blog is designed to be provocative, confrontational, irreverent, mocking, impertinent, flippant, impudent, bold, enlightening, naughty, mischievous, funny and tongue-in-cheek. If you have no humor or if you are a boring person you are not supposed to read this blog. If you read it anyway you do so at your own peril, but please do not use the reply function because then we'll all get bored.

Please do use the reply function when this blog makes you really, really mad or happy. Those are the uninhibited comments we love and you'll regret the next day.

If you are a lawyer and read this you can never use this blog in a court of law, since it does not always contain a full statement of facts, or even facts, but you can use it to entertain your fellow lawyers. And if you are an entertainment lawyer, feel free to call me because I need a gig or a speaking engagement.

You can expect to encounter generalizations, simplifications, hypothecations, exaggerations, inflations, fabrications, but mostly a lot of truths no one ever had the guts to tell you before. (The last part I wrote, my lawyer made me put in those other words.)

These are my opinions only, and most statements have been carefully researched, but that doesn't mean you will receive a fair and balanced picture of any issue. If you did, this blog would turn into a boring legal paper.

And by the way, I'm not engaged in rendering medical, legal, business, or other professional services on this site--I'm just having fun. I'm a former physician and pharmaceutical marketing executive expressing my understanding of life, business, legal, and other matters and I make no representation or warranty, express or implied, with respect to the sufficiency, accuracy, or utility of any information contained in this blog.

In short, if you need a life or other expert assistance, the services of a competent priest/rabbi/imam/shaman/accountant/doctor/shrink/lawyer or whatever you are into should be sought.

And if you need a life, perhaps that's no ones fault but your own. So stop whining. We all know that life is tough and then you die. That was a fabrication. I didn't really mean that, because I do know that some people need compassion. My wife tells me she needs more of that, so I'm sure there are others just like her. Boy -- am I lucky that she still puts up with me.

And I promise to be very serious sometimes and irreverent other times. It just depends on the mood I'm in. And I really like big companies, CEOs, politicians, doctors, lawyers, firemen and fuzzy animals, in spite of my comments. I also like trolls. They can be warm and cuddly. I have lots of friends who are all those things -- unless they stopped being friends after reading my musings.

This disclaimer may be updated anytime and is presumed to part of any past or future postings. If you didn't find it it's your own fault.

This blog may contain copyrighted ((c)) material. The fair use of a copyrighted work, for purposes such as criticism, comment, news reporting, teaching, scholarship, or research, is not an infringement of copyright. This constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C., § 107 of the US Copyright Law. This material is distributed for nonprofit educational purposes. If you are the copyright owner and you disagree with my use of your copyrighted material, please let me know and I will replace such material with a note saying that you are a censor, book burner and evil person.