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Decreasing Jail Time, Treating Drug Abuse As A Public Health Issue

A couple of years ago, I served for several weeks on a grand jury for the Superior Court of the District of Columbia. Mine was designated a RIP (Rapid Indictment Protocol) jury, assigned to efficiently hand down indictments for small drug-related offenses. These cases usually involved undercover officers posing as customers making purchases from street dealers, or uniformed police stopping suspicious vehicles and searching them for drugs. Although rarely we heard testimony about defendants caught with thousands of dollars of contraband, the vast majority of offenses were possession of small amounts of marijuana, heroin, or cocaine for “personal use.” Many of the latter defendants had multiple such offenses, which had resulted in probation, “stay away” orders (court orders to avoid certain neighborhoods where drugs were highly trafficked), or brief stints in jail. Few, if any, had received medical treatment for their addictions.

After a few weeks of hearing these cases, my fellow jurors and I grew increasingly frustrated with this state of affairs. We felt like a cog in a bureaucratic machine, fulfilling a required service but making little difference in anyone’s lives. A young man or woman caught using drugs would inevitably return to the street, violate the terms of his or her probation or “stay away” order, and be dragged before our grand jury again for a new indictment. We openly challenged the assistant district’s attorneys about the futility of the process. They would just shrug their shoulders and tell us Read more »

*This blog post was originally published at Common Sense Family Doctor*

Drug Manufacturer Issues Statement Banning Drug Used For Lethal Injections

A friend sent me a press release a few days ago and I still find myself thinking about it. Here in the United States capital punishment is still legal in many states and is performed, frequently, by lethal injection. Prisoners sentenced to death have an IV placed in their arm which is then infused with the following three solutions:

  1. A barbiturate like Sodium Pentothal or Nembutal, used to induce anesthesia
  2. A paralytic like pancuronium bromide or succinylcholine chloride, used to stop respiration
  3. Potassium chloride used to stop electrical conduction in the heart

I remember a few years ago drug manufacturer Hospira, the producer of Sodium Pentothal, issued a statement that it disapproved of its drug being used in capital punishment.  But, that was as far as their opposition went and, although Sodium Pentothal is in short supply, they have not to my knowledge formally discontinued supplying Sodium Pentothal to doctors who might use the drug in lethal injection.   In 2010, the supply of Sodium Pentothal became limited and several states made the switch to Nembutal.

In response, Lundbeck, the producer of Nembutal, has issued a statement saying that they will no longer provide Nembutal to prisons in states where lethal injection is legal.  In this press release Lundbeck announces its new distribution system, saying: Read more »

*This blog post was originally published at On Becoming a Domestic and Laboratory Goddess*

Can Crime Be Linked To Cuts In The Mental Health Budget?

From the New York Times today we have a story entitled, “A Schizophrenic, A Slain Worker, Troubling Questions,” a horrible story about a mentally ill man who killed a social worker in his group home. The story highlights the defendant’s longstanding history of violence with several assaults in his past. He once fractured his stepfather’s skull and his first criminal offense involved slashing and robbing a homeless man. (On another post on this blog Rob wondered why the charges were dismissed in that case; from experience I can tell you it’s probably because the victim and only witness was homeless and couldn’t be located several months later when the defendant came to trial.) The defendant, Deshawn Chappell, also used drugs while suffering from schizophrenia. Before the murder he reportedly stopped taking his depot neuroleptic and was symptomatic. The news story also suggested that he knew he was committing a crime: he got rid of the body, disposed of the car and changed out of his bloody clothes. Nevertheless, he was sufficiently symptomatic to be found incompetent to stand trial and was committed to a forensic hospital for treatment and restoration. At his competency hearing the victim’s family thought that the defendant was malingering his symptoms, while the victim’s fiance was distraught enough that he tried to attack Chappell in the courtroom. The point of the Times article appears to be an effort to link the crime to cuts in the Massachusetts mental health budget.

So what do I think about this story? Read more »

*This blog post was originally published at Shrink Rap*

Woman Embezzles Money From Boys And Girls Clubs To Buy Breast Implants

A former executive assistant for the La Habra Boys and Girls Club was sentenced today to three years in prison for embezzling about $135,000 from the organization over two years, using some of the stolen money to pay for breast implants. Superior Court Judge Roger Robbins also ordered Lynette Rojas to pay $270,000 in fines and $165,113.08 in restitution to the club. But the 37-year- old La Habra residents appears unable to pay any of the money back, Deputy District Attorney Marc Labreche said. Rojas, who could have faced up to 20 years in prison if convicted at trial, pleaded guilty April 4 after Robbins agreed to sentence her to three years behind bars.

Lynette Rojas stole $135,000 from the Boys and Girls Club of La Habra and used part of the money to have breast implant surgery. She took a plea deal as opposed to going to trial. I wonder if her surgeon had to pay back the money she paid him.

*This blog post was originally published at Truth in Cosmetic Surgery*

A Classic ER Patient: A Poem

Classic presentation of the perfect patient

“What’s the problem? You’re the doctor,

why don’t you tell me!

I’m suffering an awful lot it must

be plain to see;

I’ve got back pain from that car wreck

back in nineteen sixty-five.

If I’d have worn my seat belt

there’s no way I’d be alive!

I’m out of my prescription and I

need help, I’m afraid.

I ain’t worried ‘bout the price, you see

I got my Medicaid. Read more »

*This blog post was originally published at*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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