I once saw an influential doctor that had interacted with so many aggressive and angry PFS that he became very prejudiced against us. This really hurt us because he has since had a big impact.
I showed her the NZ regulatory body page that says doctors should inform patients about the risks of post finasteride syndrome. I didn’t accuse her of such, I don’t know her background or what she actually believes or why. I don’t think she’s getting paid from Merck. But I’ll see how she responds to my reasonable request, if at all. If she is unreasonable, we can always report her to the NZ regulatory body for spreading dangerous information which I think is more effective than posting erratic comments on her videos.
She responded within a few hours thanking me for my message and apologizing for the controversy. She read through the NZ Medscape page and several articles to learn more about the condition. She also immediately took down the video on YouTube and said she will update her website shortly.
I’m not happy that these kinds of videos continue to pop up, but doctors can’t know everything about every condition. Over time we will win because the truth is on our side, but its helpful to stay calm and keep the bigger picture in mind as we continue to shine a light on the dangers of Propecia.
Feel free to share her email reply to you if you would like. I was almost happy reading it. She sounded very confused by the comments that were appearing
The sad part is that she claimed to be unaware of PFS. There’s obviously a lack of proper communication of this condition to doctors. Some burning questions are how and why. This isn’t a passing case of high blood pressure during treatment we’re dealing with.
Best to save the energy for fighting those who vehemently deny when confronted with evidence.
"Thank you so much for taking the time to email me. I was completely unaware of this condition and have read several papers about it this morning. I also appreciate the medsafe link you included.
In no way did I want my video to be so controversial, and it explains the many nasty comments that I got! Although, the individuals didn’t explain why they were so angry. I’ve taken the youtube video down and will update my website information accordingly. I’m sad to hear this happened to you and I wish you the best for the future."
She later followed up and mentioned she’s reconsidering her dutasteride video and will maybe fix that too.
A few years ago, I came across a kind of life lesson called Hanlon’s Razor which says “never attribute to malice that which is adequately explained by stupidity”.
There are lots of stupid people in the world and even lots of smart people who are ignorant about many things and make mistakes.
I can’t say I always live by this rule because I can get very angry, but when I am able to assume good faith people the outcomes are usually much better like in this example. I just figured she’s a GP who doesn’t specialize in any of this and treats a million conditions, she’s maybe prescribed this drug a few times and most definitely hasn’t seen any real life case of PFS, and if I suggested that her website may be inaccurate because she hasn’t heard of this condition and provided solid evidence, she would respond favorably which she did.
I get really worked up over the hair transplant surgeons though who should absolutely know better and who I think are really icky people in general. Not as good at persuading those guys because they’re in total denial.
Sure, that’s valid when said people do not benefit from being “stupid”. When they do, it is malice. In fact, it is evil in its purest form. The medical community at large - especially dermatologists, urologists, hair transplant doctors, and the pharmaceutical industry - all benefit from being stupid about Finasteride.
In general, malice and stupidity both lead to the same result - suffering. It can be argued that sometimes they are distinct causes, but where they definitely overlap is when 1) one has a special interest in being stupid or 2) one has a special responsibility to others of not being stupid.
Another way to look at this is through Arendt’s “The Banality of Evil” paradigm, which I think leads to the same conclusion.
<<Can one do evil without being evil? This was the puzzling question that the philosopher Hannah Arendt grappled with when she reported for The New Yorker in 1961 on the war crimes trial of Adolph Eichmann, the Nazi operative responsible for organising the transportation of millions of Jews and others to various concentration camps in support of the Nazi’s Final Solution.
Arendt found Eichmann an ordinary, rather bland, bureaucrat, who in her words, was ‘neither perverted nor sadistic’, but ‘terrifyingly normal’. He acted without any motive other than to diligently advance his career in the Nazi bureaucracy. Eichmann was not an amoral monster, she concluded in her study of the case, Eichmann in Jerusalem: A Report on the Banality of Evil (1963). Instead, he performed evil deeds without evil intentions, a fact connected to his ‘thoughtlessness’, a disengagement from the reality of his evil acts. Eichmann ‘never realised what he was doing’ due to an ‘inability… to think from the standpoint of somebody else’. Lacking this particular cognitive ability, he ‘commit[ted] crimes under circumstances that made it well-nigh impossible for him to know or to feel that he [was] doing wrong’.
Arendt dubbed these collective characteristics of Eichmann ‘the banality of evil’: he was not inherently evil, but merely shallow and clueless, a ‘joiner’, in the words of one contemporary interpreter of Arendt’s thesis: he was a man who drifted into the Nazi Party, in search of purpose and direction, not out of deep ideological belief. In Arendt’s telling, Eichmann reminds us of the protagonist in Albert Camus’s novel The Stranger (1942), who randomly and casually kills a man, but then afterwards feels no remorse. There was no particular intention or obvious evil motive: the deed just ‘happened’.
This wasn’t Arendt’s first, somewhat superficial impression of Eichmann. Even 10 years after his trial in Israel, she wrote in 1971:
“I was struck by the manifest shallowness in the doer [ie Eichmann] which made it impossible to trace the uncontestable evil of his deeds to any deeper level of roots or motives. The deeds were monstrous, but the doer – at least the very effective one now on trial – was quite ordinary, commonplace, and neither demonic nor monstrous.”>>
If I have to make a grand philosophical conclusion based on this reasoning, far beyond the scope of the present issue, I would argue that man is inherently and fundamentally evil.
I have been told by one doctor that one of the main characteristics of a delusional disorder when it comes to health issues is that when the person with the delusion has his theory about his health problems questioned by another person, he reacts angrily or aggressively.
So yes, everytime someone reacts in an aggressive or angry way to an opinion of a doctor, the doctor is likely to check the box “mental disorder”. It is a terrible way to approach a doctor. We don’t have a delusion but many doctors will try to match what they see with what they know.
You can also think about it the other way around: if you have a strong opinion about something and someone comes at you very aggressively telling you that you are wrong you will certainly not change your opinion.
This doctor would have benefited from continuing to prescribe Propecia to telemedicine patients but when I addressed her civilly and respectfully, she was responded empathetically and willing to reconsider her position and made the changes we wanted her to make. When she received angry comments, she felt attacked, and closed comments on that article. When people feel emotional, their minds quickly close up and they cling to their positions so its really a matter of making sure you understand what makes them emotional and addressing them in a way that doesn’t evoke an unpleasant response.
Genuinely surprised at this outcome. Thank you for approaching her in the even handed and genial manner you did. I confess I suspected the worst motives of her.
