Marcia Angell Quotes

Few things a doctor does are more important than relieving pain. . . pain is soul destroying. No patient should have to endure intense pain unnecessarily. The quality of mercy is essential to the practice of medicine; here, of all places, it should not be strained.

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine.

Once upon a time, drug companies promoted drugs to treat diseases. Now it is often the opposite. They promote diseases to fit their drugs.

No wonder big pharma will do almost anything to protect exclusive marketing rights, despite the fact that doing so flies in the face of all its rhetoric about the free market.

As an example, companies would require researchers to compare a new drug with a placebo (sugar pill) instead of with an older drug.

[...] The problems I’ve discussed are not limited to psychiatry, although they reach their most florid form there. Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine. (Drug Companies & Doctors: A Story of Corruption, Jan 15 2009)

her family.” “And how long have you been a criminalist for the Scientific Investigation Division here in Los Angeles?” “Four years.” Gelfer had calmed down now and seemed

My favourite quotes, Part Two -- from Michael Connelly's "Harry Bosch" series The Black Box On Bosch’s first call to Henrik, the twin brother of Anneke - Henrik: "I am happy to talk now. Please, go ahead.” “Thank you. I, uh, first want to say as I said in my email that the investigation of your sister’s death is high priority. I am actively working on it. Though it was twenty years ago, I’m sure your sister’s death is something that hurts till this day. I’m sorry for your loss.” “Thank you, Detective. She was very beautiful and very excited about things. I miss her very much.” “I’m sure you do.” Over the years, Bosch had talked to many people who had lost loved ones to violence. There were too many to count but it never got any easier and his empathy never withered. The Burning Room 2 Grace was a young saxophonist with a powerful sound. She also sang. The song was “Somewhere Over the Rainbow,” and she produced a sound from the horn that no human voice could ever touch. It was plaintive and sad but it came with an undeniable wave of underlying hope. It made Bosch think that there was still a chance for him, that he could still find whatever it was he was looking for, no matter how short his time was. ---------------- He grabbed his briefcase off his chair and walked toward the exit door. Before he got there, he heard someone clapping behind him. He turned back and saw it was Soto, standing by her desk. Soon Tim Marcia rose up from his cubicle and started to clap. Then Mitzi Roberts did the same and then the other detectives. Bosch put his back against the door, ready to push through. He nodded his thanks and held his fist up at chest level and shook it. He then went through the door and was gone. The Burning Room 3 “What do you want to know, Bosch?” Harry nodded. His instinct was right. The good ones all had that hollow space inside. The empty place where the fire always burns. For something. Call it justice. Call it the need to know. Call it the need to believe that those who are evil will not remain hidden in darkness forever. At the end of the day Rodriguez was a good cop and he wanted what Bosch wanted. He could not remain angry and mute if it might cost Orlando Merced his due. ------------ “I have waited twenty years for this phone call . . . and all this time I thought it would go away. I knew I would always be sad for my sister. But I thought the other would go away.” “What is the other, Henrik?” Though he knew the answer. “Anger . . . I am still angry, Detective Bosch.” Bosch nodded. He looked down at his desk, at the photos of all the victims under the glass top. Cases and faces. His eyes moved from the photo of Anneke Jespersen to some of the others. The ones he had not yet spoken for. “So am I, Henrik,” he said. “So am I.” Angle of Investigation 1972 They were heading south on Vermont through territory unfamiliar to him. It was only his second day with Eckersly and his second on the job. Now He knew that passion was a key element in any investigation. Passion was the fuel that kept his fire burning. So he purposely sought the personal connection or, short of that, the personal outrage in every case. It kept him locked in and focused. But it wasn’t the Laura syndrome. It wasn’t the same as falling in love with a dead woman. By no means was Bosch in love with June Wilkins. He was in love with the idea of reaching back across time and catching the man who had killed her. The Scarecrow At one time the newsroom was the best place in the world to work. A bustling place of camaraderie, competition, gossip, cynical wit and humor, it was at the crossroads of ideas and debate. It produced stories and pages that were vibrant and intelligent, that set the agenda for what was discussed and considered important in a city as diverse and exciting as Los Angeles.

It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments. Alternative Medicine — The Risks of Untested and Unregulated Remedies

The headline of a comprehensive exposé in The Guardian expressed the global shock among the scientific community at the rank corruption by scientific publishing’s most formidable pillars: “The Lancet has made one of the biggest retractions in modern history. How could this happen?”94 The Guardian writers openly accused The Lancet of promoting fraud: “The sheer number and magnitude of the things that went wrong or missing are too enormous to attribute to mere incompetence.” The Guardian commented, “What’s incredible is that the editors of these esteemed journals still have a job—that is how utterly incredible the supposed data underlying the studies was.” The capacity of their Pharma overlords to strong-arm the world’s top two medical journals, the NEJM and The Lancet, into condoning deadly research95,96 and to simultaneously publish blatantly fraudulent articles in the middle of a pandemic, attests to the cartel’s breathtaking power and ruthlessness. It is no longer controversial to acknowledge that drug makers rigorously control medical publishing and that The Lancet, NEJM, and JAMA are utterly corrupted instruments of Pharma. The Lancet editor, Richard Horton, confirms, “Journals have devolved into information laundering operations for the pharmaceutical industry.”97 Dr. Marcia Angell, who served as an NEJM editor for 20 years, says journals are “primarily a marketing machine.”98 Pharma, she says, has co-opted “every institution that might stand in its way.”99,100 Cracking Down on HCQ to Keep Case Fatalities High Referring to the Lancet Surgisphere study during a May 27 CNN interview, Dr. Fauci stated on CNN about hydroxychloroquine,

I AM INDEBTED ABOVE ALL TO DR. ARNOLD S. (Bud) Relman, with whom I share my life. Together we wrote an extended article about the pharmaceutical industry called “America’s Other Drug Problem—The Insatiable Greed of the Pharmaceutical Industry.” It was published in the December 16, 2002, issue of The New Republic, and received the 2002 George Polk Award for magazine reporting. In outline, the pres-ent book largely follows that article.

Domestic violence support groups and hotlines have multiplied since the Simpson case. There are now over fifty shelters in Los Angeles County alone. This is a very real step forward because without such resources victims often have nowhere to turn. I want to take this opportunity to applaud all the workers whose tireless efforts help the survivors of domestic violence. You save lives every day.

But the idea that features of our personality may contribute to the onset of pathology is anathema to many. In her still-influential 1978 essay “Illness as Metaphor,” the late filmmaker, activist, and brilliant woman of letters Susan Sontag—then a forty-five-year-old cancer survivor—flatly and forcefully rejected the possibility that ill health might signify anything beyond bodily calamity. “Theories that diseases are caused by mental states . . . are always an index of how much is not understood about the physical terrain of a disease,” she wrote.[1] To assert that emotions contribute to disease was, for her, to promote “punitive or sentimental fantasies,” to traffic in “lurid metaphors” and their “trappings.” She found this view especially distasteful because she perceived it as a way of blaming the patient. “I decided that I was not going to be culpabilized.”[2] Sontag’s acerbic rejection of the mind-body connection resonated not only in intellectual circles but also in some of the most hallowed centers of medical thinking. A few years later, the New England Journal of Medicine’s future first woman editor, Dr. Marcia Angell, cited it approvingly, deriding as “folklore” the idea that “mental state is a factor in the causing and curing of specific diseases,” a “myth” for which the evidence is at best “anecdotal.” Like Sontag, Dr. Angell espied in this line of thinking an insidious patient-blaming tendency: “At a time when patients are already burdened by disease, they should not be further burdened by having to accept responsibility for the outcome.”[3] I agree wholeheartedly that no one, ever, ought to be made to feel guilty for whatever transpires with or within their body, whether that guilt arises from the self or is imposed from without. As I stated earlier, blame is inappropriate, unmerited, and cruel; it is also unscientific. But we have to take care not to fall into an easy fallacy. Asserting that features of the personality contribute to the onset of illness, and more generally perceiving connections between traits, emotions, developmental histories, and disease is not to lay blame. It is to understand the bigger picture for the purposes of prevention and healing—and ultimately for the sake of self-acceptance and self-forgiveness. My intent in reframing Sontag’s perspective, then, is to offer a more helpful view. I empathize with her apprehension about being blamed for becoming ill, even as I see her refutation of the mind-body confluence as misguided and scientifically untenable. A clear and honest look at the biographical factors that can disrupt our biological well-being helps us respond intelligently and effectively to illness—or preferably, to mitigate the risks in the first place. This is as true for individuals as for society.