Embracing your inner opportunist

Patricia 1How far over the speed limit do you drive? Come on. No one drives it exactly. One mph? Two? Me, I allow myself up to about nine under normal circumstances.

How fast does someone else have to drive before you’re happy to see them get a ticket? If they’re going much more then ten mph over, I feel like public safety is being preserved. Less, and I rant about how we live in police state. Let’s face it. We all push the rules, and we all have our own particular definition of when enough is enough.

In my novels x0 and c3, I crafted villains who were clearly evil. In y1, I opted for someone easier for me to understand. He’s a man who pushes the rules, just like we all do, and a man who knows how to profit well from the little opportunities that his rule bending provides.

I put him in charge of marketing at a pharmaceutical company, not because I dislike prescription drugs or the companies that make them. I have had plenty of reasons to be grateful for modern medicine. But I do know that there is a lot of grey area in selling medication, regarding both the doctors who write the prescriptions and the eager public who watches the ads on television. Just like everywhere else, rules can be bent.

Doctors can be encouraged to write frequent off label prescriptions, something intended by law to be rare. They can feel slightly obligated to preferentially prescribe a new drug in spite of its not fully understood side-effects, and they can be encouraged to do both of these and more with travel, food, honorariums, and gifts. Most people in the medical profession are at the very least decent and well meaning, and they will truthfully insist that they cannot be bought for the price of a lunch.  I am sure that they can’t, and I made the same argument when potential suppliers took me out to lunch in my profession.

raising 3So how many lunches for how many people in the office does it take to have an impact? The folks in marketing are trying to find out. How lavish do the gifts have to be? Should we be ignoring the fact that the product itself has a unique capability to effect the health and happiness of others in a way that only medication, with all its side effects, can?

My villain in y1 is a very fine opportunist, happy to push those boundaries further each day, and glad to pay the nuisance fines slapped against his firm when he goes a little too far. Just the cost of doing business he tells his staff, ignoring the dangers of the products he makes and sells.

I got far enough inside this guys head to make myself squirm, before I let him spiral out of control and engage in the equivalent of doing 70 mph in a school zone. That way I knew that my readers would all be happy to see him caught and punished in the devious way I had intended all along. Before he turned ultra bad, however, I hoped that my reader would squirm a bit as well, and think about the fuzzy boundaries between playing the game well and doing harm.

(Please like writer Patricia Polacco’s Facebook page and the page for Raising Ecstasy, the sources of these two clever images. Please see my x0 blog for a post about crafting villains that are unambiguously evil from the start, and see my z2 blog for an upcoming post about my tale of researching racist groups in America.)

Side effects of a quick fix

“We live in a world where everybody wants a quick fix for their problems,” said Dr. Sasha Bardey, a psychiatrist who is a  co-producer of “Side Effects.” an upcoming film staring  Jude Law and Catherine Zeta-Jones. This new thriller, due out Feb 8, mixes murder and psychiatric medicine and you can read about it in the New York Times here.

It interests me because this is a combination I explored in the novel y1.  The shape-altering young hero of my book finds himself entangled in a murder devised to hide some of the unsavory secrets of a unscrupulous fictitious pharmaceutical company. Director Steven Soderbergh, on the other hand, will be telling the tale of murder committed as a side effect of prescription drugs intended to treat depression.

Check out the trailer for the movie here.

 

How happy is your brain?

From Crystalinks.com

From Crystalinks.com

My other blog includes occasional posts about telepathy because the hero of my other novel, x0,  is a budding telepath.  Last night I made an attempt to understand how telepathy might be possible without requiring magic that defies the laws of the known universe. (Please understand that I have no objection to law-defying magic.) I realized that much of my arguement came from my research for y1 into the workings of the human brain. Zane, the hero of y1, is a student of neuroscience because he desperately wants to understand how he can alter his appearance. Once he begins working for a pharmaceutical company dedicated to mental health issues, however, other aspects of the brain begin to intrigue him.  Like, what happens in your brain when you are happy?

A brain works by chemistry and by electrical impulse, and it directs hundreds of chemical substances called neurotransmitters that travel in-between the brain’s cells, delivering messages about thoughts and feelings. I share Zane’s amazement that such a system even works, much less with the precision that it does.

We do know that different substances deliver certain kinds of messages, like a FedEx that only does books or a UPS that exclusively delivers clothing. One of these messengers, serotonin, generally likes to blab to the nearest neuron about anxiety, mood, sexuality, and appetite. Another, norepinephrine, appears to focus on delivering messages about fatigue, alertness, and stress. Dopamine likes to communicate about motivation and reward. The theory behind antidepressants is that the neurotransmitters that like to communicate about feelings should be linked to a person’s happiness. So when people are depressed perhaps it is because they do not have enough of these particular messengers running around to spread the joy.

medicineThe very first antidepressants created in the ‘50s tried to raise the brain’s levels of serotonin and norepinephrine, to play with this mental message system. A second class of anti-depressants was based on inhibiting the enzyme that breaks down these guys in order to leave more of the good stuff in the brain. Basically the same idea. Next came the less side-effect-plagued successor, known as selective serotonin re-uptake inhibitors (SSRI), the most frequently prescribed antidepressants today. First developed in the ‘70s, and continuously improved upon by different pharmaceutical companies, SSRI’s work by stopping the process of reuptake, a fancy name for when a responsible neuron absorbs the neurotransmitter it has sent out, to take the messenger back off the streets once the message has been sent. The theory here is that by keeping the sending neuron from doing its re-absorbing, more of this “happy” chemical stays running around the brain. Again, the same idea.

From Wired.com

From Wired.com

While it sounds great to say that taking this medication is “fixing chemical imbalances in the brain,” the problem is that no one gets to do experiments on a live human brain. Thankfully. And dead human brains don’t send chemical messages and can’t be depressed. Neither really can animals, at least those generally accepted for grisly lab experiments. So no one actually knows whether depressed people have less serotonin in their brains. Or whether they reabsorb it too fast without medication. In fact, no one knows how much serotonin a generally joyful person has. Can one really have too little? Or too much? Because a few antidepressants lower serotonin levels, and they appear to work too.

Trying to figure out what makes for a happy brain is complicated even more because there is no way to tell how much these medications change a person’s serotonin levels, because there is no way to measure those levels in a live human. Which means that, in the end, the only evidence we have that serotonin levels might be related to human depression at all is that in more cases than not, the medication works.

Is it working because it is based on an accurate analysis of how chemicasl in our brains keep us happy? Or not?  That will be subject of another post.

Depressed Toddlers? Really?

One of the villains in y1 is the zealous CFO of a pharmaceutical company who is anxious to reap the profits from over-medicating his new target demographic, children.  I did a fair amount of research on this subject because I wanted to make sure his tactics were believable, and also because I wanted to be careful not to malign the use of medicine when it was genuinely needed and beneficial.

It is true that by the time I finished writing y1, I personally found the vastly increased use of medication to control behavior and emotional issues in children to be disturbing. Every once in awhile, I still run across an article that makes me shudder. A friend recently sent me this article from Science Daily published in 2010. In a nutshell it discusses the idea that even toddlers can be depressed and it talks about the difficulty of the diagnosis because depressed preschoolers often act normal and may not even appear particularly sad.  However, researchers assure us, methods are being developed to ferret out those difficult to locate symptoms. Are you shuddering yet?