Tuesday, October 30, 2007

The Demise of Medical Ethics and the Old School

The "Old School" has closed its doors forever. It used to be, back in the day, that even punks and bullies had a code of honor, and if you stood up to the bully, he would take his medicine like a man and that would be the end of it. Nowadays, they come back with their crew and machine-gun your entire family, or if the punk in question happens to be a doctor, he will come back with his crew and try to destroy your medical care by blacklisting you, or publishing your name on the Internet in the hopes that other doctors will deny you treatment, or simply to intimidate you into silence. The days when even enemies could treat each other with honor and respect and there were rules of engagement to be followed are over. Now, it seems, malignant narcissism is the rule of the day, and there is no limit to the depths of sleaziness and cant some people will sink to get revenge against someone for "dissing" them. Drive-by-shooting or medical sabotage, the goal, and the mindset underlying it, are the same.

Case in point: the author of Scalpel and Sword, a patient-bashing site by an "ER doc in Texas," has twice responded to my criticism of his hate-filled articles about chronic pain patients by revealing my real name on his blog and on other blogs. In his latest outing, he has called on ER docs in my area to be on their guard around me, as if I am some dangerous criminal. I don't need to explain to anyone who has been shut out by the "Good Ole Boy" network for speaking out what the effect of this is likely to be. Scalpel has boasted on his website of violating the HIPAA laws by blacklisting patients, and has admitted to making people in pain wait in the ER or denying them treatment altogether for failing to show him proper respect, so this kind of behavior is hardly out of character for him. There is a code of conduct among bloggers where we respect people's anonymity and right to confidentiality, as we often know the names, e-mail addresses and IP addresses of people who visit our blogs, even when they post anonymously. It's abundantly clear that Scalpel has no more respect for this code than he does for the right of his patients to confidentiality under the HIPAA laws, or their right to be treated with dignity and respect. It is a fundamental tenet of medical ethics that a doctor should respect patient confidentiality and should "do no harm" and it is readily apparent that Scalpel, like far too many doctors nowadays, has no respect for these standards. Though I am obviously not Scalpel's patient (thank God for small miracles), one would expect similar conduct from a true doctor even in non-medical contexts. Scalpel obviously disagrees.

Scalpel is also in violation of Google's Terms of Service/Content policy, which states:

PRIVATE AND CONFIDENTIAL INFORMATION: We do not allow the unauthorized publishing of people's private and confidential information, such as credit card numbers, Social Security Numbers, and driver's and other license numbers.
Needless to say, Scalpel has no respect for the policy under which Google generously allows him and other bloggers to express their views for free.

In his latest post, Scalpel is responding to my article entitled "More ER Asshattery" where I address many of the fallacies presented in his article on the numeric 1 to 10 Pain Scale and a related article where he proposes an alternate pain scale. He then responds to my criticism by revealing my real name and accusing me of having a "revenge fantasy" against doctors. I hope you will forgive me for not repeating my real name here or linking to the original article, as I obviously don't want to paint a roadmap to this info, though in fact any narcissistic ER doc with a little downtime in between abusing patients could probably find this info in the same manner Scalpel did:

Courtesy of [my name omitted], a chronic pain sufferer in [my state omitted] who used to be anonymously known as Redhawk but who now blogs under the pseudonym Payne Hertz. I won't link him, but with a little internet sleuthery you can find his whiny blog yourself, if you are so inclined. He thought I was on the wrong track with my pain scales, so he came up with this:

After which he quotes my tongue-in-cheek pain scale and accuses me of a revenge fantasy. While my humor may be a little offensive and over the top to some, it is just that, humor, and not a call to violence against doctors. No unethical, arrogant doctors were harmed in the production of Payne Hertz that I'm aware of, though Scalpel's ego has obviously gotten a good bruising. Interestingly, he posts a "revenge fantasy" of his own, though in fact revenge is no fantasy for him but a real life activity he engages in regularly, as evidenced by his blog and the behavior I am describing here. This is a guy who has boasted of inflicting pain and suffering on his patients and attempting to sabotage their medical care, and he is attempting to do the same to me.

[My name omitted], I would love for you to try that out sometime. But my question for you is, if you are already at a "level 10" from your chronic mystery pain and someone were to hypothetically spray you in the eyes with pepper spray, stab you in the neck with a pencil, or break your elbow by vigorously hyperextending it, would that not bother you at all because you're already maxed out, or would your pain level go up to a 15 or so? Just wondering.

My advice to Scalpel would be to stick to what you know and continue to backstab your patients in the manner you're accustomed to. Direct physical confrontation with your latest victim might not be in your best interest, and you might find out the hard way what level 10 pain feels like.

Interestingly, in a classic case of projection, Scalpel quotes an ER nurse blog complaining of patients with "personality disorders" and how tiresome they can be:

I have seen a couple of people get out of control when they didn't get their narcs. I read an article in emergency medicine magazine that takes about a doctors role in treated chronic pain in the emergency setting. What's fascinating about it is that the author says that 50% of chronic pain sufferers have personality disorders or affective disorders. I can vouch for that. They wear you out, the people who come in for chronic pain because they are people who are neurotic and difficult to work with. Antidepressants have been found to be very helpful in these people, along with psychological help. They seldom get it.

It has been my personal experience reading and hearing hundreds of stories from abused chronic pain patients that those doctors who are most willing to play amateur psychologist by branding their patients with the "personality disorder" label are the ones most likely to be suffering from severe personality disorders themselves. After all, what kind of personality does it take to blacklist a patient and willfully sabotage his or her medical care because you perceived him to be manipulative or disrespectful to you, or to leave another human being writhing in agony by refusing to treat his pain? Or for that matter, to violate a blogger's right to blog anonymously? Maybe it's this kind of personality:
Their lack of self respect is even more damning. Because of it, nothing is beneath them. No lie is too mean to tell. No trick is too lowdown, dirty, and rotten to play. Things you or I couldn't stoop to, because sinking to that level would make us feel like we are wallowing naked on our bellies in sewage, narcissists glory in like mud-wallowing hogs. Ironic, isn't it? that such deep, unbearable shame makes one shameless? But it does.

...This is why every malignant narcissist has two middle names: one is "Abuser" and the other is "Slanderer."
Scalpel certainly fits the bill on all counts, particularly as abuser and slanderer and willing to low crawl where most people wouldn't dare to go, all because his ego got bruised.

Here is where Scalpel plunges the knife:

Indeed. If anyone reading this happens to work in an Emergency Department in [state omitted] and is unfortunate enough to come across this gentleman....you might want to guard your nuts.

This is an unequivocal attempt by Scalpel to libel me and sabotage my medical care, and an attempt to intimidate me into silence. I can promise you, it will have the opposite effect. It is sad that a doctor with a so-called code of ethics would feel the need to sink to this level, but this kind of thing happens all the time. If it weren't for the high prevalence of ruthless, amoral and egotistical doctors like Scalpel, Payne Hertz wouldn't exist. While I have no intention of sinking to his level by revealing his real name, location or place of employment, Scalpel might do well to heed the warning some other people have made to him about karma, because he's got a lot to lose if his real identity was ever revealed, and he most definitely has it coming to him. The next person he screws over might be a hacker looking for some payback.

28 comments:

deasucks.com said...

This is what I attempted to post on his blog, but he's moderating comments on the entry you referred to. My remarks may not show up, because he is a gutless scumbag:
You obviously value your privacy. You want to post your opinions here without worrying about real-world consequences, but when another blogger criticizes your opinions, you post his name and his location AND attempt to damage his ability to receive emergency care. Are you insane? Or just a pathetic little paper tyrant? Clearly you are also humor-impaired. Get over yourself.

scalpel said...

You idiotically published your own phone number on the internet, and I haven't posted that. You gave up your own anonymity by doing so. I didn't see anything in your repetition of the Google Terms of Use which forbids publishing your name. If such a clause exists, I'll gladly remove it. I definitely didn't publish your credit card numbers, Social Security Numbers, or driver's and other license numbers, so your argument seems pretty weak.

I certainly haven't violated any HIPAA regulations, since you aren't my patient. I don't know why you would even mention HIPAA. Just another weak attempt at trying to be a bully, I guess. I really haven't written anything derogatory about you whatsoever. Can you say the same about me? I didn't think so. If you want to play tough, don't cry when you get a bloody nose.

Nor have I blacklisted you, libeled you, or tried to sabotage your medical care. I simply copied your offensive attempt at "humor" and shared it with a (much) wider audience. You were the one who posted that you would like to attack physicians, I didn't make it up. And I warned ER staff to guard their nuts, not to deny you medical care.

Perhaps you might learn a lesson from this about internet civility. Or perhaps you'll just continue with your persecution complex.

Whatever. You're a loser either way. An apology and a promise to not be such a douche would maybe be more effective than spewing more of your tough guy BS, but then again, even that might not be enough.

deasucks.com said...

"You idiotically published your own phone number on the internet, and I haven't posted that. You gave up your own anonymity by doing so."

"An apology and a promise to not be such a douche would maybe be more effective than spewing more of your tough guy BS, but then again, even that might not be enough."

Doctor, heal thyself. Get out of medicine and see a shrink. You are a vindictive prick with a God complex.

Anonymous said...

This scalpel guy is one turd I'd be happy to help you flush. I have a PI friend in Texas who's GREAT at dealing with trash talkers. He'll chew up "scalpel's" career and reputation, and the sweet thing is, there won't be a single thing he can do about it but watch and cry.

A former Iowa Private Investigator who is now a CP patient.

Payne Hertz said...

The idea that someone "gives up" their right to anonymity when they post their phone number is ludicrous. Does a woman give up her right not to be raped after she has consensual sex? You blog anonymously for a reason, so don't pretend not to understand why someone else might want to do so. The concept of respect for people's privacy is obviously alien to you, but you understand your own need for it, to the point you ban dissenting comments from your blog.

As for Google's terms of use, it clearly prohibits the unauthorized publishing of people's "private and confidential info." That obviously includes the names of anonymous bloggers. Things like telephone numbers, DD214s, employment records, medical records, etc, etc ad infinitum would obviously be other examples of things you can't publish but weren't mentioned on the list. This is just common sense. There are few internet message boards anywhere that will allow you to destroy a poster's anonymity. If Google allows that then shame on them.

You have publicly admitted blacklisting patients, which is both a violation of medical ethics and the HIPAA laws. Doctors do that for a reason and while I am not your patient and HIPAA doesn't apply to me, your motivation is the same: to enact revenge.You're not fooling anybody with this dodge.

As for libel or defamation, it is impossible to libel a pseudonym, because your internet presence is not a real person. I have a right to express my opinions on what you write just as you have the right to express your opinions on my writing. I have no objection to you doing that, here or anywhere else. But when you use my real name, my real location and you distort what I write by falsely claiming that I was calling for attacking doctors, rather than making a joke about the fact some physicians will never understand pain until they experience it themselves, then you are libeling me, and denying me the right to blog anonymously, and you are blacklisting me.

Payne Hertz is a pseudonym. You can write whatever you like about "Payne Hertz" because that is not a real person, just so long as it's truthful. You cannot write what you like about me. The issue here is your attempt to destroy my anonymity. The issue is your attempt to libel me by claiming I am calling for people to attack doctors, when I am doing no such thing and you know it.You have a lot of nerve telling me I need a lesson in civility. I don't think you would appreciate it if someone revealed your name or made a report of your behavior to your employers. I don't think they'd appreciate the negative publicity if somebody did that, which I sincerely hope they don't, as the right to blog anonymously is bigger than any dispute between you and me.

If anybody owes an apology here it's you. You should apologize for your inflammatory and derogatory comments about millions of people in chronic pain, as if these people don't have enough pain and loss and suffering in their lives without doctors like you adding to it like it's a big fun game.

If you are an honorable man you will remove any references to my real name or location on your blog or ER Nursey, while leaving your comments intact. Even the courts have upheld the right of bloggers to post anonymously, a fact you would do well to consider on both moral and legal grounds. I doubt there are many reading this who would disagree with me that bloggers should be able to maintain their anonymity, though I suspect some would like to have your head.

Anonymous said...

Sean you're a pussy.

~Shari

scalpel said...

"As for Google's terms of use, it clearly prohibits the unauthorized publishing of people's "private and confidential info." That obviously includes the names of anonymous bloggers."

Well I reviewed the TOS myself, and I sure didn't see anything about not publishing the name of a blogger. Particularly a blogger who posted his own name and phone number already. I have screen captures of those blogs saved on my hard drive, btw.

But I did see that they specifically forbid posting threats of violence against persons or groups of people (like physicians, for example). And I don't think your lame after-the-fact explanation that you were just kidding is likely to be a very convincing excuse for breaking that rule, tough guy.

Maybe you'd better just shut the whole thing down and start over as someone else.

scalpel said...

Then I'll remove your name.

Anonymous said...

P.H.
I strongly suspect that scalpel is suffering from a variety of deep rooted psychological disorders. It's also apparent that he is ethically and morally challenged. In internet jargon, he is a cyber bully, while this is typically confined to the junior high set; there are a few 'adults' that partake in this juvenile behavior. When challenged or criticized, they are unable to intelligently debate or reply without resorting to abusiveness; name calling, threatening, ridiculing, and malicious behavior. When these tactics are not enough, they start playing dirty (publishing personal information etc). They can dish it out but cannot take it. No one is 'allowed to comment on his blog without approval, which gives another clue to some type of disorder. These types can usually be easily dismissed, as once they start behaving in such a manner, it erases all their credibility and they are summarily dismissed. Unfortunately, one of the lowest and dirty tactic is what he has already done; he'll stop at nothing because you dared to criticize. There's no way in hell he'll take it down. He's got way too much invested, and the concept of civil adult behavior is completely lost on him. I guess you should be honored that you have got under his skin enough for him to spend so much time trying to ruin you. I would have no trouble believing that he makes fun of anyone that he considers beneath him or an 'easy' target....children, mentally disabled, women, gays.
More evidence of his non-existent credibility. If a toothache makes him cry and go running for narcotics, one or two days in a cpp life would probably kill the guy. You can easily dismiss much of what he says about anything, he simply doesn't know what he's talking about. That this guy is a 'doctor' makes me fear for anyone walking into his E.R. unaware. At least there are good, decent and ethical doctors out there.
Be afraid Texas, be very afraid.
tc

Anonymous said...

"scalpel said...

Then I'll remove your name."

My friend Payne Hertz is not going to cave in to your pathetic attempts at blackmail.

On your blog you have only posted positive responses from your cheering section to make it look like there is no criticism of what you've done. Then you come here and attempt to justify what you've done with some really lame arguments.

Keep an eye on your rear view mirror, pal. Your bad karma is gaining on you and when it hits you're going to be pissing your pants and whining like a little girl.

Payne Hertz said...

"Well I reviewed the TOS myself, and I sure didn't see anything about not publishing the name of a blogger. Particularly a blogger who posted his own name and phone number already."

That's ridiculous. I didn't post my full name, nor did I post my phone number on this blog. I am a contact person for a support group, which is where you got that number, and most of us are willing to take the risk of posting our phone number right up until some sociopath decides to use it against us. It has since been removed. You had to do considerable research to find that site and my real name, and the fact that I might or might not give identifying info on one blog does not give you the right to violate my anonymity on another.If you catch your neighbor taking a shower with the window open one day, does she then lose any right to take a shower in privacy from then on? Your attitude is the moral equivalent of the rapist who says "she was asking for it."

So apparently, I was asking for it by posting my phone number, and therefore, what you did was justified. How can you rationalize your behavior this way?

"Maybe you'd better just shut the whole thing down and start over as someone else.

...Then I'll remove your name."

Osama bin Scalpel finally presents his demands.

As I asserted in my article, your reason for posting my name was an attempt to intimidate me into silence. That much is abundantly clear now. You are nothing but a bully and a terrorist, who can dish out the venom on your hate site by the bucketful but can't handle even the mildest criticism without trying to ruin someone's life or shutting them down.I knew the risks I was taking starting this blog, as I have dealt with "doctors" like you before and know exactly what to expect. I refuse to remain silent about the epidemic of abuse and hate propaganda against chronic pain sufferers in this country, and where I see it, on your site or anywhere else, I will expose it. I'm sure you've been told this a thousand times, but you are definitely in the wrong profession. Do yourself and your patients a favor and find a profession where your interaction with other humans will be minimal. Take some of your giggling colleagues with you.

Anonymous said...

Scalpel said he would have rated his toothache pain the night he violated the law to get to his own ER as a 7-8. Yet he took vicoprofen & zofran, rec'd a nerve block from a dentist, gave himself an injected anesthestic provided by the same dentist friend & still needed an injection of demerol in the ER. All this from such a macho man who calls CCP's "pain weenies." I hope someday while you're speeding at 100 mph, like you claim to do all the time, your little sports car hits an armadillo & flips! I pray that no one else is killed or hurt but hope that you suffer injuries that will leave you in CP for the rest of your life. Of course there's no doubt you're life would be short due to your lack of pain tolerance so you would probably take your life. That would be fitting since you're non-treatment of someone in pain may have cost at least one person their life. I guess it would be another form of Texas Justice!!!

scalpel said...

7-8 is pretty bad pain, for which there was an identifiable (and treatable) cause, representing my only ER visit in 15 years. I didn't request narcotics; I would have been satisfied with an appropriate nerve block. Unfortunately, as I discovered, it's pretty hard to give oneself a nerve block. Patients in true pain show it, and they don't care what treatment is offered so long as it works.

But when mystery pain suffering drug addicts like yourself present repeatedly to the ER in no apparent distress with a "10/10" pain demanding large doses of specific narcotics and lying to the staff about your lost or stolen prescriptions and your unverifiable followup plans, you are occasionally escorted out by security and a diagnosis of "DRUG SEEKER" is written in your chart.kct

Anonymous said...

My pain is no mystery nor am I a drug addict nor do I show up at ER's for toothaches or to treat my pain. I've never lost a prescription nor would I ever allow someone to steal one! Nor do I violate laws, ethics or even unwritten rules honoring private info. The ACS Texas Pain Initiative was passed to protect pain patients from ignorant dr's like yourself. The Texas Pain Summit was held to figure out why Texas continues to receive poor grades in the treatment of pain even though safeguards were placed into legislation to assure pain patients would be afforded good treatment for their pain. The reason Texas continues to receive poor grades is because of assholes like yourself who think they are above & beyond the laws & ethics of the state & country. You have admitted yourself to denying treatment to people in pain & making them suffer in the waiting room. However, you find it necessary to violate traffic laws to get to your own ER to get an opiate despite already being medicated for a simple toothache! I've had exposed nerves in my teeth before doc & never went to an ER. I got a bottle of whiskey & called my dentist during office hours! You talk tough but you're a wuss!

scalpel said...

Once again, for the reading-impaired, I didn't go there seeking opiates. The physician on duty evaluated me and chose to administer them. I would have been satisfied with any effective therapy.

I have never denied an honest patient treatment for their pain, nor have I ever written such a thing.

There is no law that requires that physicians administer opiates to anyone. In fact, the opposite is true....it is illegal for me to prescribe narcotics to drug abusers or drug diverters. The Texas Pain Initiative is toothless and weak, probably much like yourself.

Anonymous said...

(rolleyes)
Regardless, why resort to dirty tactics? Do you not realize how this makes you look? A whiny bullying small little tyrant.
Your accusations are easily dismissed as rubbish; your behavior clearly shows your intent. The way you went about obtaining personal information shows you to be a malicious small minded bully. Your actions are reprehensible.
I believe the giggling colleagues are more commonly known as sycophant hyenas, dismissed with a wave of a hand...it's not worth the time it takes to read it.
There is such thing as poetic justice, You just might experience a little mystery pain yourself someday. You are a pathetic loser, scalpless. Get a life, you desperately need one.
t

Anonymous said...

They say things are bigger in Texas but I think your big mouth is making up for smaller parts of your anatomy. You went seeking opiates & that's why you went to your ER. That's why you had your friend give you an anasthetic. You are the weak, toothless coward!!! As for the Texas Pain Initiative, it was set up by much more prominent & respected members of the medical community than yourself, which you are neither. The American Cancer Society has done more for patients than you could ever possibly dream of helping & their name is on the initiative. I guess you think cancer patients are "pain weenies" too! You have some serious issues & you should call your friend the shrink to open his doors for you after hours so he can shoot you up w/ something & have your ass committed somewhere in the Texas panhandle!!!

Anonymous said...

Hey ethically impaired scalpless, endlessly refreshing your page to get more hits on your counter doesn't count. Besides, haven't you ever heard of quality over quantity? In this case, it's a perfect fit!

Anonymous said...

Cancer patients > dickless mystery pain faggots.

Anonymous said...

It's troubling to see that you have at least one ignorant supporter of your beliefs Scalpel. Or did you just make an anonymous post to make it appear so? My pain, as well as cancer pt's pain, is well documented on MRI's, CT's, EMG's & other tests. My mystery pain worsened when I let doctors operate on my spine! Since you & your supporters are spineless cowards, it's no wonder you think such pain is a mystery!

Anonymous said...

Scalpel: Just because you & your supporters, if any really exist, aren't knowledgeable enough to understand diseases like Fibromyalgia, RSD, CIDP & others, don't make them "mystery" diseases.
There is sufficient medical evidence re these diseases & the pain each causes. It's an insult & very worriesome that there are doctors like yourself w/ preconceived concepts that these CPP's are dug seekers, drug abusers & drug addicts. These patients' suffering is much worse than your temporary toothache which was easily fixed w/ a root canal. Their nerves continue to send pain thru their bodies day & night w/o end. Yours has ended & you again talk tough but these people & yes, they are people, spend every hour of every day in constant pain. These people don't lose their meds because they are their lifeline. Many have sought other avenues so they wouldn't have to deal w/ assholes like you. However, the pump, SCS's, epidurals, PT & other procedures & so called therapies haven't worked so well & in many cases, only made the pain worse. Many of the CPP's that you stereotype do not use an ER for pain but are treated by pain specialists & teams that understand their medical conditions. You couldn't deal w/ your toothache pain for a couple of days. Imagine it lasting the rest of your life. Then you will understand chronic pain!

Anonymous said...

I find it interesting Scalpel that when you had your toothache, you wondered if it might have been caused by TN. This is a mystery disease according to you but it was real when you thought you might be affected w/ it! There are many conditions besides the others already mentioned that cause CP. Thse illnesses are cancer, rheumatoid & osteo arthritis, degenerative disc disease, Fabry Disease, CMI, GBS as well as many others. However, to you all CPP's are "pain weenies." This is very disturbing. There isn't a surgery or cure for many of these conditions. Luckily, there is a surgical procedure for your issues, it's called a lobotomy! I suggest you get one immediately!!!

Anonymous said...

This topic can never die!

Anonymous said...

Not as long as there are docs like Scalpel who have preconceived concepts that lead to the undertreatment of pain in this country. There are too many people, again I remind you, people, suffering, because of this. These CPP's never did anyone any harm. They are just trying to survive w/ a medical condition that causes alot of suffering. Yet, Scalpel & others link them to abusers & addicts. They take narcotics to treat their medical conditions, not to get high!

CP PI said...

Hey scalpel, how is life in Houston? Texas Medical Center treating you well?

It only gets more fun from here on out, son...

Ari said...

I used to be seen by a pain management specialist. I'm also a medical professional, so I see it from both perspectives.

You write almost as if you think every person with chronic pain is some kind of saint who never, ever abuses narcotics or exaggerates the amount of pain they're in. I'm here to tell you that's not the case. I see people who have more prescriptions from docs than you can shake a stick at, and not a single one of those doctors knows about the other. They've got contracts with doctors saying that they won't accept narcotics from any other source, but then go and doctor shop their way around town (and sometimes county or state). Fentanyl patches and Percocet for breakthrough pain from their main pain management doc, some Vicodin and Soma from someone else, MSContin from yet another physician and in the meantime a couple of ER or Urgent care visits for injectible meds.....it all adds up.


I know what it is to be in constant pain. I know what it is to have a doctor be suspicious of your motives for being seen in the ER or urgent care clinic. I also know that not every person who claims to have chronic pain actually IS in pain. There are a lot of malingerers out there, and I think that you should acknowledge that fact. Failing to do so...well, it doesn't do much to further your cause with the general public, now does it?

By the way, I don't think that Scalpel has done anything to violate HIPPA or any other confidentiality agreements - or the Google TOU. No, I'm not coming out in his defense. I just don't like melodrama and histrionics, period.

Payne Hertz said...

On Mar 20, 2008, at 8:31 PM, Ari wrote:

"I used to be seen by a pain management specialist. I'm also a medical professional, so I see it from both perspectives.

You write almost as if you think every person with chronic pain is some kind of saint who never, ever abuses narcotics or exaggerates the amount of pain they're in. I'm here to tell you that's not the case."

How do you know that a patient is exaggerating their pain? Are you a deity, that you can tell how much a pain any particular person is in, or do you just imagine yourself possessed of this ability? My vote is for the latter. You act as if every person complaining of pain is an evil sinner who lies, exaggerates, and manipulates, and is prone to outbursts of "melodrama and histrionics," those two being favorite buzzwords of the empathy-impaired. Numerous studies have shown that the rate of narcotic abuse and addiction among chronic pain patients is actually very low (between 1 and 3 percent), with almost all the studies I've seen defining anything less than 100 percent perfect compliance as evidence of "abuse."

Studies done by the workers compensation insurance industry, which surely has an incentive to inflate the numbers, show less than 2 percent of claims being paid out due to fraud, and even there, the fraud is not that workers are faking an injury, but that they are claiming an injury received off the job was received on the job. So once you get past all the self-serving bullshit offered up by a certain class of doctor, true malingering and narcotic addiction are actually very rare. The real problem is not an epidemic of drug-seekers and malingerers, but that the medical profession is filled with far too many arrogant, judgemental, stick-up-the-ass puritans who see any expression of human suffering, human emotion or human weakness as evidence of an incurably corrupt character that must be punished with denial of medical care and as much abuse and humiliation as is legally permissible, which in our sick society, is often quite a lot. Then of course you have sociopathic scumbags like Scalpel, who openly boast of his violation of medical ethics and the delight he takes in screwing many of his patients over. People like this do not belong in the medical profession; they belong behind bars.

"I see people who have more prescriptions from docs than you can shake a stick at, and not a single one of those doctors knows about the other."

They may not be aware that this is illegal. Although I am well-informed enough to know better, at no point did any doctor anywhere ever tell me that I was only to get my scripts from him until I was made to sign a "contract" at the VA. When I tried to clear some prescriptions another doctor wanted to give me with my doctor to find out whether taking them would violate my contract, my doctor got angry and started yelling at me to "do whatever you want," at which point I told him to lower his voice and maybe read the contract he made me sign so he'd have a clue what my responsibilities were under it. When doctors themselves don't know the rules or don't explain them to patients, it is unreasonable to expect patients to know them.

"They've got contracts with doctors saying that they won't accept narcotics from any other source, but then go and doctor shop their way around town (and sometimes county or state). Fentanyl patches and Percocet for breakthrough pain from their main pain management doc, some Vicodin and Soma from someone else, MSContin from yet another physician and in the meantime a couple of ER or Urgent care visits for injectible meds.....it all adds up."

Firstly, those so-called "contracts" are nothing but a form of extortion, which I have written about elsewhere on the blog. Secondly, where patients are forced to doctor-shop, most of the time it is because their pain is not being adequately treated by their doctors, which is true in over 50 percent of cases. To deny someone adequate medication then fault him for breaking the rules to get it is as morally bankrupt as denying someone the right to drink water, then faulting him for taking a glass without your permission. Thank God the medical profession hasn't found a way to make water prescription only, lest we see an epidemic of "water-seekers" flooding emergency rooms. The simple fact is, *all* drug-seeking, manipulation, exaggeration and other suspect behaviors arise directly out of the medical professions monopoly over the stronger pain medications, coupled with a refusal to prescribe adequate amounts of that medication due to exaggerated fears of regulatory scrutiny, anti-human puritanism, and outright sadism and depraved indifference to human suffering. None of these problems would exist if people could just treat their own pain (and for that matter, their addictions) without a permission slip from a doctor, which was the way things were in the 19th Century in this country and most of the world until the medical profession was given the keys to the gate, with the results being an utter catastrophe to people in pain and the American public in general.


"I know what it is to be in constant pain. I know what it is to have a doctor be suspicious of your motives for being seen in the ER or urgent care clinic."

Ten brownie points and a cookie for not adding the requisite: "...but I don't let it bother me."

"I also know that not every person who claims to have chronic pain actually IS in pain. There are a lot of malingerers out there, and I think that you should acknowledge that fact. Failing to do so...well, it doesn't do much to further your cause with the general public, now does it?"

If you actually read my blog, you would see that I certainly acknowledge the existence of such persons. Failing to get your facts straight before launching into a venomous tirade hardly increases your own credibility, now does it? What I question is whether the extremely exaggerated and often cookie-cutter descriptions of "drug-seeking" and "exaggeration" by the medical profession accurately reflects the reality of the situation, and I can tell you based on studies and my own personal experience listening to and reading the horror stories of hundreds of pain patients detailing the abuse, humiliation and hostility they have encountered from doctors that it surely does not. The majority of people in pain report being falsely accused of drug-seeking and exaggeration at some point in their journey through the nightmare of chronic pain "treatment" in America, and the majority have also been denied treatment altogether or given inadequate treatment. The fact is, far too may doctors are little more than ignorant, black-hearted bastards stereotyping most if not all of their patients as drug-seekers and fakers based on nothing more than pseudo-science, their own personal arrogance and lack of human empathy, bigotry and medical folklore. To treat every pain patient as a potential drug abuser is nothing less than a form of institutionalized bigotry as evil and insidious as any other form of bias.

"By the way, I don't think that Scalpel has done anything to violate HIPPA or any other confidentiality agreements - or the Google TOU."

I never claimed he did. What I said, is that he has openly boasted of violating the HIPAA laws by blacklisting patients, and what he did by revealing my name was in a similar vane. As for Google's TOU, he is clearly in violation. In either case, I suspect most people with any shred of common decency recognize Scalpel's behavior as the act of a low-life, sociopathic scumbag too immature and full of himself to tolerate any criticism. The SUTA puritans will of course rush to his defense as they reliably do any form of abuse and degradation they encounter from people they perceive to be superior to themselves.

"No, I'm not coming out in his defense. I just don't like melodrama and histrionics, period"

You are not exactly condemning it either, are you? As for what you like and don't like, in the unlikely even that I should ever give a rat's ass what you or anyone else in your "profession" likes or dislikes, forgive me if I don't consider it worth my time to inform you. I have found that trying to explain common decency and right conduct to a stick-up-the-ass puritan is as productive as trying to discuss the finer points of the Dow Jones with an ape.

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