The Midazolam Mafia !

Anonymous said...

So now we're known as the "Midazolam Mafia":

March 25, 2009 7:17 PM

Anonymous said...

Yikes. That thread is quite possibly the finest example yet of medical people's seemingly across-the-board belief that status as a doctor, nurse, or medical student immediately confers total intellectual superiority over people not involved in the medical profession.

The guy's comments are, of course, more of the (pathetic) same. Basically:

1. Since I am a medical practitioner, I know everything.

2. Since you are *not* a medical practitioner, you know nothing.

3. Midazolam is in no way unsafe.

4. If you think midazolam is unsafe, you're obviously crazy or suffering from some kind of pre-existing personality defect.

5. All persons who have been injured by midazolam and who (worse yet) dare to post comments critical of the drug online, are completely interchangeable, and—because they are therefore all somehow mentally defective to begin with (see point 4 above)—should be ignored.

6. In addition to being ignored, they should be ridiculed, discredited, and demonized, too. get the idea.

In a way, it's good that idiots like the author of the above-linked thread have blogs and see fit to post such comments, as it puts on continual public display the lack of empathy and near-complete social disconnect embodied by many members of the medical profession nowadays. Of late, medical schools seem to be cranking out only robots—the days of freethinkers in medicine appear to be long gone.

March 26, 2009 4:57 AM

 -Tim said...

Nice post by Anonymous "Yikes".

I would add that it is "fishy" that this person even bothered to blog in defense of his beloved Versed. He is hoist on his own petard.

The fact that the drug is "one of the most-utilized drugs in the country" does not automatically make it good - this is a basic logical fallacy we learned in high school.

It is odd that he finds the volume of similar stories odd.

He calls US the Mafia (thugs) when it is the medical folks who are clobbering US with the drug. I just don't see how he is the victim here.

He quotes a versed victim who, among other things, stopped breathing. This is no surprise since this is one of the dangers of Versed. I did not make this up - this is what the medical folks themselves say. Given this person's experience, it is no wonder they want to avoid versed. Hyperbole? Perhaps, but so what?

What is truly odd is that they pushed the drug on this person even after they refused - due to past experience. How calloused and unprofessional is that?

I could continue to rip this blog apart, but I'm sure the rest of you have some good points to add.

March 26, 2009 10:48 AM

Anonymous M said...

I did have to laugh when Matt of the hypocaffeinemia blog posts:

"Hyperbole, much?

There is no reasonable discourse path to take with such people. Each and every single one of them will claim that midazolam causes irreparable retrograde amnesia and post-traumatic stress disorder (discounting that midazolam and related drugs are actually used to treat PTSD), and significant chunk of them will claim they nearly died."

He accuses us of hyperbole, and then engages in it himself.

As for benzodiazapines being used to treat PTSD, I doubt that an ICU nursing student is an expert on the subject. I have talked to several experts on PTSD who feel that Versed is a "no brainer" to elicit a trauma response in someone with a history of PTSD. You can read what Dr. Jonathan Shay (someone who is an expert on PTSD) has written about benzodiazapines at

March 26, 2009 1:21 PM

Anonymous said...

The thread that the mental-powerhouse medical student posted on his blog is absolutely classic "don't listen to so-and-so because they're a conspiracy theorist" stuff. Not surprising, of course. I mean, whenever anyone tries to protect something near and dear to himself or herself from being exposed as the sham that it truly is, it's not too long before the whole "label as conspiracy theorist" tactic gets backed out of the garage.

It's simple. The first thing you do is, you identify a common characteristic shared by the people who you'd like everyone else to ignore. In the case of the above-linked thread, that common characteristic is disapproval and/or criticism of midazolam. Once identified, the common characteristic serves to establish interchangeability among members of the whole group. This way, you can conveniently dismiss the viewpoints of lots of people at once, without the pesky need to actually listen to (or individually respond to) the various valid things that each separate person is saying.

The author accomplishes this step in his first paragraph (and even before that, actually, in his thread title). He does so by deliberately choosing words and phrases that reduce any and all persons who possess anti-midazolam sentiment to a single homogeneous entity—for example, "mafia," "movement," "such people," "this society," etc. It's worth noting that this same mentality, when applied to skin color, is the very *definition* of racism—i.e., that all people who possess a particular attribute are exactly alike and can be thought of as a "whole," rather than as separate individuals. The author also reinforces the idea of interchangeability in his successive paragraphs, with statements like, "Each and every single one of them will claim...," "[their] story always seems the same," etc.

Hot on the heels of establishing interchangeability among all persons who disapprove of midazolam, this future medical fascist wastes no time in satisfying the next basic criterion of good propaganda—namely, to link negative and/or undesirable attributes or terms to the group being discussed. That is, to demonize the group. He does this throughout the thread, in a variety of ways.

For starters, by including a still image from The Simpsons to depict the group (before the text of the thread even begins, no less) the author is implying that the group about to be discussed—i.e., those who disapprove of the use of midazolam—is not a group to be taken seriously. Alternately stated, it is one to be laughed at, as a cartoon might be laughed at; a joke, if you will.

Then, not even out of his first paragraph, he ups the propagandist vibe of his thread exponentially by italicizing the word "against" in the phrase, "There seems to be an underground movement against the use of midazolam"—pretty much implying that such a sentiment amounts to out-and-out heresy. The italics basically say, "Can you believe that a viewpoint as ridiculous as this could even exist?!?" In the same phrase, the adjective "underground" likewise serves to demonize. It says that anyone who possesses an anti-midazolam sentiment is not mainstream, or reputable; rather, he or she is "underground," or disreputable. The author gets a lot of mileage, as well, out of the five letters of the word "mafia," because the word simultaneously serves three purposes in the thread—specifically: (1) as already explained, it pools all of the anti-midazolam folks together into a single, uniform blob; (2) it demonizes said folks by carrying a negative connotation, i.e., it equates them with a criminal organization; and (3) since, in this instance, the word's "criminal" definition is not actually being applied in its literal sense, the word instead carries a certain lightheartedness that is more or less a reapplication of the "Simpsons cartoon" tactic already discussed above—i.e., it is a subtle statement that the group should not be taken seriously.

Some other demonizing phrases that the author applies to the group include "not quite articulate," "fishy," as well as his statement that there is "no reasonable discourse path" to take with people who are against the use of midazolam. The implication being, of course, that all such people are unreasonable. The same holds for his reference to the "less dramatic members of this society"—which in turn implies that all persons opposed to midazolam are somehow "dramatic" to begin with (translation, yet again: not to be taken seriously). Each and every one of these demonizing phrases serves exactly the same purpose and says exactly the same thing—basically, "this viewpoint is so stupid that I'm not even going to grace it with a response—and neither should you." Which, of course, is an extremely convenient approach to follow when you have a ton of perfectly valid questions to answer, or points to respond to. In other words, simply sidestep responding altogether. Indeed, if one clears away all of the thread author's personal bashing of folks who disapprove of the use of midazolam, it quickly becomes evident that he does not offer a single piece of authoritative information—not a one!—to refute any of their claims.

He also does not stop merely at demonization; he extends his propaganda to include outright ridicule. Many of his "editorial" comments, such as the parenthetical one in his following statement, illustrate this ridicule:

"...causes people to forget their children growing up (actually claimed!)"

So, with a single adverb and exclamation point, this jerk casually denies the validity of (and, in a fine testament to his apparently low level of social and emotional maturity, makes light of) a complete stranger's very real and very deep mental suffering. Suffering that he—despite the fact that he, himself, I am quite certain, has never consulted its bearer about—is somehow completely sure could NOT have been caused by a potent brain-disabling drug. Now, to me, THAT sounds a little, uh, "fishy."

In the end, this medical student's thread begs a fairly obvious question. Namely, if the whole idea of being against midazolam is such a "fringe" sentiment—that is, one possessed only by a small group of "psychos" who want to "ruin the party" for all the people (patients and medical practitioners alike) who supposedly "love" midazolam—then exactly why would the guy feel any great need to attempt to discredit said psychos' claims? After all, if midazolam's supposed status as a great and safe drug were as ironclad as he and many other medical practitioners evidently want the world to believe, what need would ever exist for this type of damage control?

March 29, 2009 11:23 AM

1 comment:

mdrn said...

Received versed way back in 1990 for a colonoscopy and wound up with a blood clot in my neck, hospitalized on heparin injections for a few days and 18 months of coumadin. Have a colonoscopy every three years and absolutely REFUSE any versed even tho almost 100 percent of the medical pros seem to defend the drug and all refer to it as the drug of choice esp. For colonoscopies. By the way, I am a registered nurse and am abit concerned by the defense of this drug. Now know just why it is used so often for procedures not requiring deep sedation, it makes the patient totally compliant with absolutely no memory of the procedure. While I will concede that this is beneficial in promoting patient compliance for repeat colonoscopy screens, there is definitely an air of evasiveness with the risks of this drug. As with ALL pharmaceuticals, there is a risk/benefit ratio, but as this drug is so convenient to the ease of completing the test I know, as a heath care professional, that full disclosure about the down side of this med is NOT being disclosed.