Double Down

Every book has a back story. In the following series of posts, I share some thoughts about the inception, development, and completion of my new book, Strange Trips: Science, Culture, and the Regulation of Drugs.

PART II

From Saskatoon to Glasgow

The second phase of writing my second book, Strange Trips, began in September of 2015. I signed a contract with McGill-Queen’s University Press and set to work. But it was far from straightforward.

I was a full-on member of the academic precariat at the time. And it was a difficult period – at least in a professional sense. I was juggling a lot of lectures at the University of Saskatchewan, looking after my kids part-time, and trying to stay engaged in my chosen field.

After my PhD viva in London (see my last post), I returned to Saskatchewan to work at the Health Quality Council. (It was a tremendous experience.) Then I began a SSHRC post-doctoral fellowship in 2011 and the time just flew right by. Seriously. It zipped by faster than I could have imagined and I wasn’t at all ready for the end of the way-station that was my postdoc.

From 2011-2013, I worked on my first book, A Prescription for Scandal: Conservatism, Consumer Choice and the FDA during the Reagan Era. I also stayed super busy with applying for countless academic jobs. (Really, it was a lot.) I certainly meant to focus on Strange Trips after I came up with the idea in 2010 (however ill-formed), but I ultimately focused on publishing my PhD dissertation.

Professor Erika Dyck at University of Saskatchewan was super helpful and the History Department hired me for short term gigs after I wrapped up my postdoc in 2013. (Whatever one thinks about short-term academic positions, I was satisfied with keeping one foot in the ivory tower. That said, there were definitely times when I built up resentment.)

In 2014, I published A Prescription for Scandal. I was extremely proud of it and it won a book prize. However, it didn’t lead to a tenure-track job. It was a really difficult moment and by 2015 I was questioning academia. There was a real high and low associated with that book.

It wasn’t easy. That’s for sure. I was such a wet-behind-the-ears neophyte…and I struggled to “sell” myself or engage with my colleagues via social media. I wasn’t a blogger back then. And I wasn’t on Twitter. Worse still, I didn’t have a good sense about packaging my work – how to write a book proposal or talk to acquisition editors with even a modicum of confidence.

But I had confidence in myself. I was also surrounded by a strong network of family and friends. To put it another way, I wasn’t alone. I had help. I was in a stable relationship. I had been (relatively) careful with money. A large family could babysit. I was lucky.

So I decided to double-down.

In early 2015, I kept teaching at the University of Saskatchewan.  I developed new classes. I stayed engaged. More than that, I didn’t stop writing. I wrote and wrote. I decided that I was not going to let the system “get me down.” At least for a little while longer.

Throughout the spring, I was in the midst of “turbulent time,” which is also a term I use in my book…

…but I honed my proposal and submitted it to MQUP. It was received positively! After some back and forth, a revised proposal, and a series of productive conversations, we agreed to work together. That was September.

Little did I know that I’d be moving to Scotland within the year.

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Top 5 Books that Inspired Me

Ken Kesey and Tom Wolfe. William James and Philip K. Dick. Welsh’s Trainspotting. Burroughs’s Junky. And DeQuincey’s Confessions of an Opium-Eater.

These are some of the authors and books that often come to mind when you bring up intoxicants in popular fiction and non-fiction. In thinking about the writing of Strange Trips: Science, Culture, and the Regulation of Drugs, it occurs to me that five works were particularly influential.

McGill-Queen’s University Press recently asked me for the top 5 books that inspired my while writing Strange Trips. I had a few thoughts. And you can check out my list over on the MQUP site.

The full article can be found here.

**

Here’s the best song I can think of with ‘Top’ in the title.

Lyrics:

Ridin’ down the highway
Goin’ to a show
Stop in all the by-ways
Playin’ rock ‘n’ roll
Gettin’ robbed
Gettin’ stoned
Gettin’ beat up
Broken boned
Gettin’ had
Gettin’ took
I tell you folks
It’s harder than it looks
It’s a long way to the top
If you wanna rock ‘n’ roll
It’s a long way to the top
If you wanna rock ‘n’ roll
If you think it’s easy doin’ one night stands
Try playin’ in a rock roll band
It’s a long way to the top
If you wanna rock ‘n’ roll

Then, yes: bagpipes!!

**

Happy St. Patrick’s Day, folks! Here’s another appropriate song for a ‘Top 5’ post

 

London Calling

Every book has a back story. In the following series of posts, I share some thoughts about the inception, development, and completion of my new book, Strange Trips: Science, Culture, and the Regulation of Drugs.

From London to Saskatoon

The first phase of writing my second book, Strange Trips, began in 2010.

It was a brisk London evening on February 28th and I was up far too late. My PhD viva was the next day and here I was watching the Olympic Men’s Hockey Final – the United States versus Canada.

The Canadian team, thanks to Sidney Crosby’s overtime goal, ended up winning a tight game and I went to bed enervated. The next day’s examination was a success and I passed with minor corrections.

(Who’s to say how the viva would have turned out if that gold medal game had gone differently?)

After the day’s trials, I caught the Tube home and had a nice evening. My celebrations that night were relaxed and forward-looking. A good friend Morgan – who worked for Groupon at the time – asked about what happened next. Now that this phase of my life was complete, what were my prospects? Did I have a good crack at an academic gig? Did I want to stay in a university-setting?

I told him that I wanted to stay in the academic game, but that it was rough. Seriously rough. The market was constricted in the wake of the recession. I had published a few pieces, but nothing off-the-charts amazing, at least relative to other excellent peer scholars. I told him – honestly – that it would be a real f—— slog and that I was up for it!

We headed off to some pubs in Muswell Hill and continued chatting. Morgan discussed his passion for photography and video and music, while I blathered on about potential writing projects. Morgan told me about street photography and I told him about starting up a book about drugs that were (or could be) both evil and angelic.

That was how Strange Trips started. In North London. In Muswell Hill.  The night of my PhD viva.

It would take another nine years for the book to come to fruition!

Ultimately, The following day I got on a flight to frigid Saskatoon, Saskatchewan where I was working and living. While a book idea had formed, I still had some student loans to pay off and it was time to get back to work.

***

So “London Calling” also serves as a section of my book.

In writing about heroin in hospice care and end-of-life care, I discuss how medical knowledge was transmitted between London-based physicians and Canadian doctors.

Thanks for reading!

***

Dr. Strange and Strange Trips

Lucas Richert on the relationship between superhero Dr. Strange and his newly released book called Strange Trips: Science, Culture, and the Regulation of Drugs.

**

In 2016, the film Doctor Strange was released to moderate acclaim but much fanfare. It was considered Marvel’s trippiest film to date. Critics praised the hypnotic visuals (for being next level Inception) and its mind-bending, time-twisting ending. They also praised Benedict Cumberbatch’s full-on arrogance, and Tilda Swinton’s performance as the bald Ancient One.

One critic argued that the film provided “a thrilling existential dilemma in which its flawed hero’s personal search for purpose dovetails beautifully with forays into the occult New Age realm of magic and sorcery where Doctor Strange ultimately finds his calling.” Another critic noted that the movie was “basically a reboot of Iron Man, only with a lot more prettier things to look at while you’re stoned.” A third and final reviewer noted how the film was grounded in “the mind-expanding tenets of Eastern mysticism” but was “different enough to establish a solid niche alongside the blockbuster combine’s established money machines.”[1]

In 1963, when comic book readers were first exposed to Dr. Stephen Strange, he wasn’t terribly likable. Serious and with silver-streaked hair, Strange was middle-aged and aloof. He was a different kind of hero. There was no super strength nor a billion-dollar trust fund to draw from; he had no callow jokes and there was certainly no unadulterated patriotism. Alex Pappademas has done a great job in writing about him for  the website Grantland (when it still existed, that is).

Strange wasn’t a puncher. He solved problems and defeated villains by entering dreams, jettisoning his physical body, and studying (yes, studying) his library full of ancient magic books for hours upon hours upon hours.

As he once put it, “I have truly gained the greatest power of all. That which the fountainhead of all other power…I have gained the gift of knowledge.”[2] His rise to become the Sorcerer Supreme, the sole protector of the earthly realm, was predicated on learning and revising – occasionally cramming the night before – magical and mystical techniques.

***

So how does Dr. Strange relate to my new book, Strange Trips?  

Prior to becoming a thoughtful and magical superhero, Stephen Strange was at one time the finest surgeon in the United States, as obnoxiously arrogant and money-driven as he was brilliant. He was a personification of free-enterprise medicine and the biomedical model in action.

When a fellow physician told Strange that a patient wished to thank him for performing an operation successfully, his response was: “I can’t be bothered!” Lighting a cigarette coolly, Strange added, “Just be sure he pays his bill!” And worse still, Strange refused services to anyone without resources to cover the costs. “Sorry,” Strange heartlessly told a potential patient as he examined X-Rays, “if you won’t pay my price, I can’t help you! Find another doctor!” Whoa.

Kwame Opam suggested (rather inelegantly but accurately) that Strange had an “asshole streak.” Joshua Rivera argued that he was pretty unique.

However, Strange’s life was irrevocably altered after a single-vehicle collision and the resulting nerve damage in his all-important hands. Everything went downhill. His career was over; he would never perform surgery again.

Yet, Strange was unwilling to give up. Having heard whispers of a miracle physician, a mystical being who could cure any health problem, Strange travelled abroad. In a state of desperation and anxiety, he ventured to India to seek out the Ancient One, even though it was clear he was doing so for greedy and selfish reasons. Only after a period of introspection and a series of trials (including saving the Ancient One’s life) does Strange realize the error of his ways and begin his spiritual conversion; essentially, his transition from a Western-trained doctor to a different kind entirely.[3]

Dr. Strange’s first appearance in the comic book world was in December 1963 and other real-life doctors were contemplating mysticism and the medical model.

In November of that same year, Harvard divinity-school grad Walter Pahnke published the results of his “Good Friday Experiment,” in which volunteers were dosed with psilocybin in Boston University’s Marsh Chapel. Timothy Leary and Richard Alpert, who both held doctorates in psychology and supervised the experiment, were dismissed from Harvard that same year. Not without some irony, it was Andrew Weil, the future alternative-health celebrity doctor, that told The Harvard Crimson about the nature of Pahnke’s research.

Timothy Leary and Allan Ginsgerg

(I was lucky enough to learn more about Leary and Pahnke at the Psychoactive Substances Collection at Purdue University. You can read about it here.)

By the beginning of the 1960s, LSD and other hallucinogens had become well-known substances within bio-medical research circles, but had yet to influence mainstream society in any significant way. And as the 1960s wore on, the capacity of researchers to establish quantifiable and verifiable results became ever more puzzling.[4]

(Of course, there’s tremendous discussion now about the return of these types of medicines. See below.)

While counterclaims – that LSD produced madness, for example – were perhaps over the top, medical researchers still found themselves caught in a moral panic over the value of LSD.

Sandoz, undoubtedly worried about its reputation, temporarily suspended production of its LSD supplies in 1963. Richard Alpert, for his part, set off for India in 1967, and there he found the conditions for his own spiritual conversion. After training under Hindu holy man Neem Karoli Baba in India, Alpert was renamed Ram Dass. By 1970, he was trying to influence medicine and society more broadly through his promotion of psychedelics and, bizarrely, in 1970 he told an audience of health professionals that they could learn much about caring for the sick from Dr. Strange and the comic book Strange Tales in which he featured!!

***

Dr. Strange embodies several important lessons about medicine and health – many of which play out in the pages of my book.

Most obviously, he blends science and culture.

Beyond that, he captures, firstly, the economics of American medicine. Strange was once all about the money, whereas many physicians were adopting a more activist role in society, intensifying their participation in such social practices as parenthood, early childhood education, poverty, and the wider economy.[5] In 1964, for instance, the Medical Committee for Human Rights (MCHR) was founded after an enhanced “medical presence” was requested by activist organizations in Mississippi following the murder of three civil rights volunteers. MCHR’s national membership had by 1971 grown to 10,000 health workers across the country, and one of the dominant principles of the group was that health activism – and not just mental health activism – was a vital national concern. These interventionist impulses represented the “therapeutic ethos” of the Great Society.[6]

Secondly, Strange also represented the medical tourist in action. When he sought out cures for his damaged hands in India, he was by no means an innovator. The practice harkens back to ancient times when pilgrims and patient-consumers journeyed long distances to visit mineral waters or healing temples.

Yet, in recent years, international medical tourism has blossomed in Asia, India, and elsewhere, raising significant questions about patient choice, global competition, and the various costs involved; some critics maintain that medical tourism widens the gap between social classes and creates even greater health disparities, even as the quality of the health care in destination countries is challenged. By contrast, proponents suggest that such tourism exacts pressure on expensive in-country health care facilities to lower prices and foster social/economic development, while at the same time acting as a revenue stream to fund existing services. This rendering holds medical tourism as a leveler of disparity.[7] Either way, patients have adopted medical tourism to get their hands on drugs or have their hands fixed, as in the case of Dr. Stephen Strange. (Daniel Beland writes about medical tourism here.)

Finally, Dr. Strange epitomizes the rise of alternative medicines and the contested nature of medical knowledge. Sometimes this means quackery. Sometimes not.

Strange’s career trajectory, in short, showcases the move from a biomedical model to a mystic or shamanistic one. Through Strange we may view shifting perceptions of how medical recommendations are established and codified, treatments determined, and medicines agreed upon. No longer a licensed surgeon, Strange still healed the sick, just through different means. Histories of “alternatives” to the medical mainstream, which might include traditional Chinese or Eastern medicine, faith-healing, and toe-twisting, have much in common with LSD, ecstasy, and magic mushrooms.[8]

And the 1960s gave greater momentum to “other” or “outsider” medicines that ultimately conflicted with learned medical traditions, which were inextricably linked to scientific progress.[9] In 1963’s AMA: Voice of American Medicine, the author proclaimed how doctors in the US had heroically fought against nostrums and quackery. Much like superheroes, physicians in the American Medical Association never “hesitated to reveal the most sordid aspects of the business” and expose the “graft and ravages of the nostrum vendors.”[10] Published the same year as Strange Tales hit newsstands, Andrew Weil alerted Harvard authorities to the “Good Friday Experiment,” and Sandoz cut off supplies of LSD to researchers, the book failed to discuss the spectral line that separated different kinds of medicines. It was and remains a fine line demarcating legality and illegality, acceptance and demonization.

***

Dr. Strange did not make it into my book. Some topics make it. Others don’t. Just like Dr. Strange and you and I, books themselves go through strange journeys.

However, the topics of economics, medical tourism, and alternative medicines are all included.  The context in which scientific and medical evidence is produced plays a significant role in how a drug and medicine is assessed. For Dr. Strange, this process provided “the greatest power of all…the gift of knowledge.”

***

Sources and a big ‘did you know?’

[1] Alex Stedman, “Early ‘Doctor Strange’ Reviews: What the Critics Are Saying,” Variety, October, 2, 2016, accessed November 20, 2016, http://variety.com/2016/film/news/doctor-strange-review-roundup-1201898171/.

[2] Alex Pappademas, “Career Arc: Doctor Strange, Marvel’s Uncastable Sorcerer Supreme,” Grantland October 24, 2014, accessed December 1, 2016, http://grantland.com/hollywood-prospectus/career-arc-doctor-strange-marvels-uncastable-sorcerer-supreme/.

[3] Ibid.

[4] Erika Dyck, “‘Just Say Know’:  Criminalizing LSD and the Politics of Psychedelic Expertise, 1961-68,” in Ed Montigny, ed., The Real Dope: Social, Legal, and Historical Perspectives on the Regulation of Drugs in Canada (Toronto: University of Toronto Press, 2011): 169-196.

[5] Gerald Caplan, Principles of Preventive Psychiatry (New York: Basic Books, 1964); John A. Talbott, “Fifty Years of Psychiatric Services: Changes in Treatments of Chronically Ill Patients,” Review of Psychiatry Volume 13, John M. Oldham and Michelle B. Riba, eds. (Washington, D.C.: American Psychiatric Press, 1994), 93-121.; Matthew Smith, Hyperactive: The Controversial History of ADHD (London: Reaktion Books, 2012), 89-91; Sandra Bloom, Creating Sanctuary: Toward the Evolution of Sane Societies (New York: Routledge, 2013), 111-117.

[6] Brian Balogh, “Making Pluralism ‘Great’: Beyond a Recycled History of the Great Society,” in Sidney M. Milkis and Jerome M. Mileur, eds., The Great Society and the High Tide of Liberalism (Amherst and Boston: University of Massachusetts Press, 2005), 163. For recent and authoritative works on the Great Society, see: Julian E. Zelizer, The Fierce Urgency of Now: Lyndon Johnson, Congress, and the Battle for the Great Society (New York: Penguin Press, 2015); Gary May, Bending Toward Justice: The Voting Rights Act and the Transformation of American Democracy (New York: Basic Books, 2013). See also: John Dittmer, The Good Doctors: The Medical Committee for Human Rights and the Struggle for Social Justice in Health Care (New York: Bloomsbury Press, 2009).

[7] Hao Li and Wendy Cui, “Patients without borders: The historical changes of medical tourism,” University of Western Ontario Medical Journal (Fall 2014): 20-21. See: I. Glenn Cohen, Holly Fernandez Lynch, and Christopher T. Robertson, eds., Nudging Health: Health Law and Behavioral Economics (Baltimore: Johns Hopkins University Press, 2016); Jill R. Hodges, Ann Marie Kimball, and Leigh Turner, eds., Risks and Challenges in Medical Tourism: Understanding the Global Market for Health Services (New York: Praeger, 2012).

[8] Janice Dickin, “‘Take Up Thy Bed and Walk’: Aimee Semple McPherson and Faith-Healing,” Canadian Bulletin of Medical History 17, no. 1 (2000): 137-153; Charlotte Furth, “The AMS/Paterson Lecture: Becoming Alternative? Modern Transformations of Chinese Medicine in China and in the United States,” Canadian Bulletin of Medical History 28, no. 1 (2011): 5-41; Barbara Clow, “Mahlon William Locke: ‘Toe-Twister,’” Canadian Bulletin of Medical History 9.1 (1992): 17-39.

[9] Charles Rosenberg, “Pathologies of Progress: The Idea of Civilization at Risk,” Bulletin of the History of Medicine 72 (1998): 714-30.

[10] James G. Burrows, AMA: Voice of American Medicine (Baltimore: Johns Hopkins University Press, 1963).

***

Did you know that Benedict Cumberbatch was not the first actor to play Dr. Strange?

Video: Lucia Romero at Cannabis: Global Histories

Points: The Blog of the Alcohol & Drugs History Society

Editor’s Note: You can see Lucia Romero discuss her work on grassroots mobilization for access to medical cannabis in Argentina below. This builds on her post, published Tuesday, and wraps up our content from the excellent Cannabis: Global Histories conference. All videos were produced by Morgan Scott of Breathe Images. Enjoy!

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The Right to Try

“Right to Try” (Again): A history of the experimental therapy movement

 

In recent weeks and months, momentum has increased on Capitol Hill to craft “right to try” laws that would profoundly change the medical landscape. The national legislation will allow terminally ill patients more access to experimental therapies (drugs, biologics, devices) that have completed Phase 1 testing. Powerful pharmaceutical and biotech concerns have been largely quiet. The Trump administration, for its part, has underlined the issue, not only in the State of the Union Address but in VP Mike Pence’s active support.

Critics in academia and medical circles argue that the proposed “right to try” legislation would undermine public health and circumvent Food and Drug Administration (FDA) oversight, while supporters argue that severely ill patients ought to have more freedoms to take experimental pharmaceutical products. Current reportage of the movement has rightfully referenced the HIV epidemic, the film Dallas Buyers Club (2013), and the drive for improved access to unapproved drugs in the 1980s. However, these are not the only ways to view contemporary deliberations about the nation’s drug regulatory architecture.

The right to try movement – and any legislation – embody long-standing struggles about the most appropriate treatment for public and individual health. These struggles have pitted mainstream medical practitioners against interlopers, and regulators against drug companies.  Compassionate language about desperate patients with few options has run alongside intense legal wrangling, consumer activism, and prolonged discussions about the validity of medico-scientific data.

THE FULL POST CAN BE FOUND HERE

 

And a song called ‘Try Again’!

 

Supple bodies, healthy minds: yoga, psychedelics and American mental health

Supple bodies, healthy minds: yoga, psychedelics and American mental health
Abstract.
Much discussion about mental health has revolved around treatment models. As interdisciplinary scholarship has shown, mental health knowledge, far from being a neutral product detached from the society that generated it, was shaped by politics, economics and culture. By drawing on case studies of yoga, religion and fitness, this article will examine the ways in which mental health practices—sometimes scientific, sometimes spiritual—have been conceived, debated and applied by researchers and the public. More specifically, it will interrogate the relationship between yoga, psychedelics, South Asian and Eastern religion (as understood and practiced in the USA) and mental health.

The full article can be read here.