Tuesday, October 27, 2009

Thursday, 7:45 a.m., Conway Doctor's Lounge

I walked in with my coffee cup, behind an elderly gentleman in a white coat. The Conway doctor's lounge is less industrial than the one at the big hospital in Little Rock: cushioned chairs, flat-screen television, and did I mention the food? Cabinets, fully stocked refrigerator, counter tops overflowing. There is a cozy computer nook. A mustached, middle-aged man was sitting at a round table, eating a sausage biscuit. He remarked, "This guy is selling books. He's gonna sell a lot of books."

I assumed that his comments were directed towards the older man, since I knew neither of them. But the older gentleman marched resolutely into the men's room, seemingly oblivious to his remark. I walked over to the coffeepot, finding it difficult to resist societal decorum. I stared at the television. There was a post-college aged man, with blandly conventional good looks, discussing economics on the television. A broad band at the bottom of the screen advertised the title of his book, and a phone number. Curiously, at one corner, cursive script spelled the names "Denise" and "Sara." I decided reluctantly to engage. "Why do you think that guy is going to sell books?"

"Just wait. Wait a second and watch. You're gonna see in just a second."

As I poured my coffee, hoping I remembered correctly that the brown pot held caffeine, the camera shifted to two young blonds in skimpy outfits, large breasts spilling out of fluorescent yellow and blue spaghetti strap tops, solving the mystery of the cursive script on the screen. They stared open-mouthed at the aged frat-boy - seeming to yearn for knowledge. The doctor continued, "And these women are so stupid! He just explained to them that the government was giving away money for cars. And they didn't know! That was over a couple of months ago."

I silently questioned the women's stupidity. This was television. Probably scripted. Just because they were blond and big-breasted didn't mean they were stupid, and didn't know about Cash for Clunkers. They didn't seem any less intelligent than the guy peddling his wares. But who knows.

The doctor introduced himself. "I'm Kent Riley. Are you one of the new radiologists?" I told him I recognized his name from some of the surgical reports, and remembered talking to him on the phone. I explained that I was a pathologist rotating in Conway three or four days a month. I smiled and shook his hand, stating my name.

He said, "Can you believe this marketing? What they are doing these days? I just got out of a six thirty meeting. Do you know that these guys are grading us? The insurance companies, I mean. They are grading us. Unbelievable."

I was confused. "Do you mean grading as in our performance?"

"No! They look at Web M.D., and look at what people are searching. What the patients are curious about. And they grade us, according to how much money they can make from us. By looking at our specialty. Outrageous!"

I looked at the buxom blonds on the screen, and thought that plastic surgeons are probably graded pretty high. But I didn't bring this up. This was a professional atmosphere. I had just met this man. And we had already alluded to breasts, once. That was enough.

Instead I said, "Well, did you read that expose in the New York Times a couple of years ago? The one that talked about how drug companies were whisking off family doctors to large conferences, all expenses paid, and marketing anti-psychotics to women with depression? They showed videos of typically depressed women making typically depressed statements, and then resolution upon taking the drug. So millions of women were taking anti-psychotics, because they were complaining to their family doctors about feeling sad, lonely, and frustrated with life."

I remember reading that article, and thinking about my clients I worked with in college, at the home for schizophrenia. Many of whom suffered from extra-pyramidal symptoms, from first-generation antipsychotics. Restlessness. Resting hand tremors. Involuntary muscle spasms of the tongue, eyes, and mouth. I imagined a large body of small-town women, drooling and twitching uncontrollably while trying to make their kid's breakfast. A league of soccer-mom zombies. I realize that the second-generation antipsychotics have less side effects, and a couple of years ago, this is probably what was being pushed. But does this make the deception any less devious? Troubling? Downright wrong? I imagined the fat cats making the money, spending it gleefully and remorselessly. Drug companies, insurance companies, it's all the same.

So I told Dr. Riley, "I am no longer surprised, by what anyone will do for money." He stared at me, without comment.

I started for the door. He said, "Hey, it was nice to meet you."

I smiled. "You, too. See you around." It's always nice to put a face to a name.

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