Sunday, December 26, 2010


What is cheating?

The answer seems to be very simple at the outset, - you promise something and do something else; offer something and give something else; and there are so many ways of cheating from that poor fellow shouting from the top of his voice at the street corner and the corporate spending even 40% and over of their total turn over on advertisements to sell a brand, - is that not? But the more you go deeper into this social malaise, the more amazing ways of cheating you discover .

We have a lot of god men and gurus around us promising eternal peace. You listen to one single lecture of this spiritual preacher, almost instantly you become a devotee of this man (or woman - there are many ammas) offering you eternal peace of mind. Most of them have abundant knowledge of scriptures, added with excellent oratory skills, sometimes with superb hold on the language/s. That makes you, especially the educated ones, an ideal prey of this person. I am yet to see a god man/guru without a spin of huge wealth, all the time preaching the worthlessness of wealth. I call them cheats, because it is absolutely impossible for any human being, however high on the spiritual levels, however learned of the scriptures, to give you peace of mind or bliss, enlightenment or whatever you wish to call it. Because the very thing you call it - peace, bliss etc., - is a creation of the mind, non existent, an illusion for which you do not need anybody to give you. If not, you are the one and only person who can give it to yourself!

Less said about spiritual cheating, the better. So coming to the intricacies of social cheating - there is gold mine of research in the field of politics to discover unimaginable forms of cheating - I take up the matter of psychiatry that offers abundant opportunities to the really competent psychiatrists not only to cheat unsuspecting public, and become super rich, but also earn a great name and fame in the society, - immediate, extended and even international societies. I have known one such person.

U.G. Krishnamurti, who recently passed away in his nineties, in a very competent and alert, witty and forthright state of mind as ever, once said in an interview to a reputed psychiatrist that ".... there is not much of a difference between you as a practicing psychiatrist and me as a patient. We both have similar irrational thoughts. The difference that puts you outside a mental asylum and me inside it is that, you suppress your thoughts, I don't!...". I am a taker of this comment.

There are problems, some on trivial matters which you blow out of proportion, and some real serious, sometimes even life threatening mental problems. But the basic thing in approaching a psychiatrist in the hope of getting a solution to the problem is your trust in the abilities of the trained counselor on the basis of his fame and name and to some extent the propaganda that gets spread in the society with or without intentions. Depending on his competence, the psychiatrist comes to know of the level of trust the patient or his attenders have in him, in the very first meeting. Please try to follow me; the moment I come to know of the exact position I have in your mind, the level of trust you have in me, I am easily lured into safely cheating you. As a psychiatrist, I also come to know of your paying capabilities within no time at all. Above all, I also know that it is more of the trust that solves your mental problem than the drugs I prescribe, many a time. Of course, in chronic cases of dual and multiple personalities and schizophrenia, drugs play almost the entire part of treatment. But whether chronic mental cases can be cured is debatable.

Long back, to my question, one psychiatrist told me -" Yes, almost all the depression cases are fully curable just through proper counseling, without or minimal use of drugs. But that is a time consuming process. In advanced countries like America, patients pay exorbitantly for the time of a counselor so that he may take only one or two patients at a time; but here in India, people neither have the time nor they pay that kind of money for the time they take of the counselor. And that makes usage of drugs a primary need in the treatment". Does that suggest earning is primary in psychological treatment, or for that matter the entire medical profession? Why should the time of a professional medical man cost exorbitantly? Why then should there be that Hippocratic oath a medical student is forced to take right in the beginning of his learning? Is that not a farce? And is it not possible to evaluate the time of a professional judiciously?

Now consider this. Most, if not all of psychotic drugs are habit forming with varying degrees and period of intake. Of course, they say that the modern drugs are not habit forming. There is also authentic report that research in psychiatry has seen a sea change in recent times. But I consider even this as a matter of trust, for, there were similar promises, nay, research reports in the past too, about habit forming properties of psychotic drugs. For example when Alprazolam first came into the market as a non-habit forming tranquiliser, prescriptions switched over to it from earlier forms of drugs that were known to be habit forming. This was over 20 years back, and I know people who started taking an alprazolam brand with humble 0.25 Mg strength with good effect, over 20 years back, do not get proper sleep even with 1.5 Mg - 6 times of the initial strength, today, and 20 years of continuous use with increased strength is certainly an addiction, not just habit, is that not? And alprazolam brands are practically sold across the counter (ATC) without a prescription in this country. Think about other more potent drugs.

Coming back to trust and cheating, having been a medical distributor for over ten years, I have known the ratio between an end user's cost (MRP) and a distributor's costs, let alone manufacturer's. It is anywhere from 25% to 75%, a major portion of the margin going to the prescribing medical practitioner in the form of kind and cash incentives. Most of the psychotic drugs fall under higher margin bracket, even over 75%. Most of the psychotic drugs are habit forming, necessitating life time intake. Trust makes the killing in this process of money spinning. Trust cures, if at all. Trust also makes prescribing a necessary part of cure even if they are not needed in many cases. And all this makes a competent psychiatrist an ideal, legal and scrupulous cheat! And the person sticking to true ethical norms is thrown out of business, out of the very system mercilessly within no time, irrespective of the part he plays in the system. Antipropaganda is the most handy and the most effective weapon the unscrupulous elements in the field successfully use against him. Again, in this antithesis too, rumours or trust makes the killing.

The system that generates several lakh crores revenue in this poor country, is more to blame than individual. With full knowledge of this fact I have written this blog. Yet, I refuse to refrain from calling a cheat a cheat!

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