Is There a Doctor in the House?

The creatures outside looked from pig to man, and from man to pig, and from pig to man again; but already it was impossible to say which was which.

from Animal Farm (1946)

8/17/2006



Let me describe a situation I found myself in the other day:

Elevator doors open into a shabby vestibule. The unfriendly, life-weary face behind the counter asks me…no…tells me to take a seat. I look around and out of the twelve or so beige felt chairs that litter the area the only one available is under a tactless water color of some sort of sail boat whose stunning banality is only made bearable when I compare it to the truly dismal selection of pedestrian magazine titles neatly stacked in the brown Formica wooden rack next to my armrest.

I scan the faces of the other people sitting all around me. It was an interesting group. The majority of the bunch was shabbily dressed, unkempt, white men in their thirties. Men whose faces betrayed a complete lack of direction, cognizance or even interest. Men who were waiting to be told what to do and offer little resistance to the contrary. In other words, losers in that game called life.

But in between these emaciated glassy eyed zombies sat three young guys…they couldn’t have been more than 24…in obvious navy blue suits. Their laptops, freshly quaffed hair, cellular phones and ceaseless fidgeting were a statement. They were telling the world that they were not “one of them.” They were climbing the corporate ladder and one day would be on top of the world. Their energetic grins projected their misguided, self-appointed status of “Master of the Universe.”

After several minutes of observing the wanting, an authoritative figure comes marching out of a back room. I immediately tell he is in charge because of the surrendering desperation reaction of the serfs and the cloying deference of the jesters. This man obviously has what they all need, and every one in the room will do whatever it takes to get their “fix.”

No, I am not describing my sojourn to a “shooting gallery” under the Williamsburg Bridge. This was my latest visit to my Doctor’s office. And the man with the power was the doctor.


As soon as the doctor came out into the waiting area, he was swarmed by one of the suited guys who introduced himself as a drug pusher…I mean Pharmaceutical Sales Rep…and starts handing the doctor free samples. I believe his drug of choice that day was Propecia which is the latest stop-balding-vanity-pill that will answer all our problems. With the small boxes of drugs this pimp’s apprentice was also handing out “Money Back Guarantee” brochures explaining the wonders of Propecia for the doctor to give to patients. The brochures were in one of those little merchant display cardboard sleeves you would see in a bank with things like “Ask me about a low interest loan” written on it. I guess it is supposed to be displayed on the desk so it would be visible to patients during consultations.

Now let’s forget about the whole Willy Loman/Shelly “The Machine” Levine aspects of these sales people who at such a young age have tragically chosen a career path that will inevitably lead to disillusionment and disappointment. They are going to have to learn that for themselves.

Rather I want to focus on their function…that is to advocate, facilitate and expedite the use of narcotics with the result being the junkified vacant stares of all the other poor bastards sitting in that room.

Since when did doctors become salesman? I mean shouldn’t a physician’s decision on “writing script” be based solely on medical conditions and not sale promotions?

I admit Propecia sounds relatively harmless, aimed at middle aged men scared that they might actually die some day, but just for laughs I checked the Propecia Website and I found this little tidbit:

In clinical studies for PROPECIA, a small number of men experienced certain sexual side effects, such as less desire for sex, difficulty in achieving an erection, or a decrease in the amount of semen. Each of these side effects occurred in less than 2% of men and went away in men who stopped taking PROPECIA because of them.

Two percent? Not bad…AND their banging ability came back directly after they stopped using the drug. Sounds good but then I read this:

Women who are or may potentially be pregnant must not use PROPECIA and should not handle crushed or broken PROPECIA tablets because the active ingredient may cause abnormalities of a male baby’s sex organs. If a woman who is pregnant comes into contact with the active ingredient in PROPECIA, a doctor should be consulted. PROPECIA tablets are coated and will prevent contact with the active ingredient during normal handling, provided that the tablets are not broken or crushed.

Did I read that correctly, if a (even potentially) Pregnant Woman so much as touches the active ingredient, her unborn son loses his cock? That seems like a high price to pay just so her beau in a mid-life crisis can feel young again. Oh well, it’s probably worth it.

Besides, the baby might be ballless but I bet he would come out with a mane like young Elvis!

Now I admit that these two disclosures are nothing compared to some other drugs laundry list of “possible” side effects as they cure whatever it is you’re taking it for. (“Cotton Mouth,” “Sleep Deprivation,” “You will shit in your draws,” etc.) But still it strikes me as a completely unnecessary remedy to a “problem” that is actually just a natural part of life.

On the subject of hair loss, which advice is really in the best interest of the patient or, as he is being referred to more and more these days, the customer…

”Look, I know it is not the greatest thing in the world but you are getting older, and no magic pill is going to change that. But just because you are getting older and your hair is thinning doesn’t mean you’re dead! You are still the same person you were. You can still do all the things you want to do. You can still be happy.”

or

“Take this pill. You might get some hair back...but you might lose your penis.”

…and which one is in the best interest of Pfizer, Genentech or Dow?

Again, that’s just Propecia, the only pill I overheard being pushed. Who the hell knows what the other two were selling. OxyContin? Vicodin? Valium? Crack Rock?

Whatever it was, I am sure they will find a buyer.

Keep it Real
Larry