Day: June 8, 2001

~ FmH

Haruki Murakami is the New York Times Book Review’s featured author, on the occasion of the arrival of Sputnik Sweetheart. Although the reviewer finds it “less ambitious than The Wind-Up Bird

Chronicle (which folds a devastating account of Japan’s occupation of

Manchuria into its paranormal plot), (it) offers an elegant distillation of

Murakami’s cool surrealism.” Links to reviews of his other books; an interview in which he discusses what Japan is reading with Jay McInerney; and first chapters of Sputnik Sweetheart and his new nonfiction piece on the Aum Shinrikyo nerve gas attack on the Tokyo subway, Underground, about which I’ve previously written. While we’re on the topic, Francie Lin wonders exactly what’s so compelling about him, in Threepenny Review: “Haruki Murakami writes the most bizarre novels—dark, cool, eminently

rational in tone, they are nevertheless populated with psychics and

monsters, and frequently cut with intermittent dreams, or dreamlike

facts, or memories of dreams that only achieve a measure of reality by

forming the basis of his characters’ uneasy lives. His stories have plots

that in summary make no sense, and yet while reading, you are

propelled along by a suspense so great that even the most fantastic

elements of Murakami’s underworlds appear to be merely the logical

pieces of a broader, more coherent intent. The sensation is not entirely

pleasant; a friend of mine once complained that Murakami novels were

laced with heroin, and this seems remarkably apt, for the books have a

kind of drugged, heady fascination about them that quickly becomes

addictive.”

~ FmH

An FmH reader comments on confirm.to:

“The confirm.to trick doesn’t add a hidden tag to the email, it sends

the email to the people working at http://www.confirm.to, and then they

re-send the email, adding a receipt request to it.

This also means that when you use it, the people at confirm.to have a

copy of the email you just sent. You may not want that. Not to

mention, it only works if the recipient has HTML mail turned on.

Most modern email programs already have a confirmation option built

into it. With Outlook, for example, you can click on TOOLS, and then

REQUEST READ RECEIPT to do the same thing. Eudora, The Bat, and most

common mail programs have this as a feature.”

~ FmH

Jury Awards $6.4 Million in Killings Tied to Drug: ‘A Wyoming jury has awarded $6.4 million to the family of a man who killed three relatives and himself after taking

the antidepressant Paxil.

Though many lawsuits have claimed that antidepressants in the same class of drugs, which includes Prozac and Zoloft,

have caused suicidal or violent behavior, this is the first case a plaintiff has won, lawyers in the case said.

Charles F. Preuss, a lawyer for the manufacturer, GlaxoSmithKline said the verdict on Wednesday was a surprise.

“This issue was raised in the early 90’s, and since that time all the scientific articles have concluded that these

antidepressants do not cause suicide or homicide or suicidal thoughts,” Mr. Preuss said.’ New York Times

When I heard that this suit was going to trial, I wrote here about how ridiculous it seemed. This verdict is just wrongheaded. Without establishing that the agitation was caused by the medication (which he had just begun the previous day) as opposed to the patient’s underlying psychiatric distress, the jury’s sentimental judgment on the pharmaceutical company’s liability seems to revolve around “the company’s failure to sufficiently warn doctors and patients that the effects of

the drug could include agitation and violence,” as the plaintiffs’ attorneys argued. They’re clearly going for the “deep pockets”; I’m no apologist for the pharmaceutical industry but the liability on this account, if any, belongs with the prescribing physician, who has the responsibility to be sufficiently informed about the medications (s)he uses, to provide informed consent to the patient to whom (s)he prescribes, and to adequately assess and followup.

It is one of my pet peeves that, as in this case, internists and other primary care MDs without sufficient mental health subtlety take lives into their hands by prescribing so readily for “depression.” The rest of the medical profession feels that what psychiatrists do is sufficiently arcane that comraderie with them is difficult; IMHO that should be more reason, not less, to refer rather than avoiding referring and trying to irresponsibly manage disorders for which they are ill-equipped and out of their depth (usually, with the usual medical hubris, without even realizing that that is so!) The drug manufacturers’ blame, if any, lies in targeting the primary care MDs so heavily in their marketing. If you promote the SSRI antidepressants as so easy to prescribe that any fool can do it, then any fool will. I emphasize that I know nothing about the specifics of the doctor’s actions in this case; my comments are generic. I’m mostly concerned because of the effect I’m going to see the publicity over this case having in my practice — on patients’ willingness to accept effective, safe and urgently needed treatments.

Juxtapose the above with the tragic mass killing of 1st and 2nd grade schoolchildren in a suburban Japanese elementary school. The “apparently deranged man” responsible for the act had an arrest record for attempting to poison students at another elementary school but had not been prosecuted because he was psychiatrically disturbed. New York Times