The Doctor Who Fed Matthew Perry’s Addiction

Matthew Perry and authority bias. According to the Associated Press, a California doctor who illegally sold ketamine to Matthew Perry in the weeks before his death has been sentenced to two and a half years in federal prison. That happened earlier this week. Judge Sherilyn Peace Garnett emphasized that while the doctor didn't supply the lethal dose that killed Perry, he, he helped him on the road by feeding an addiction the actor had battled for decades. Sad story. 44 year old Dr. Salvador Plasencia knew Perry was a struggling addict. When Perry's regular doctor refused to increase his doses, Placencia stepped in illegally, even texting another doctor that Peri was a moron who could be exploited for money. He was led from the courtroom in handcuffs. The this case is more than a single doctor's crime. It's a study in authority bias, motivated reasoning, celebrity halo effects, and the psychological pressures that lead some physicians and all of us really, to bend or break rules for high status patients. And for Matthew Perry, who spent his life trying to stay sober, those biases may have erased the boundaries that could have saved him. Okay, what's the real message here? The doctor who really gave tons and tons and tons of drugs to Matthew Perry that ultimately, ultimately led to his demise is going to prison for two and a half years. That's great, but how did he get there? It's easy to say, that guy's awful. I would never do that. All of us sometimes fall prey to authority bias. Someone's rich, someone's famous, we have to place them, we have to give them what they want. It's an insidious bias that can affect anyone, including you and me. Let's look at this case in a little more detail. I, I generally don't find celebrity stories that interesting. And celebrity deaths I try not to spend a lot of time on. But I do think there are lessons to learn when it comes to how all of us, you and I, receive communication and the biases that affect us. Because there are some real biases. As I mentioned in the news read, authority bias is one if the average person or certainly if someone who said, hey, I'm a bricklayer and I want a bunch of drugs. Dr. Just for fun. It feels good. I bet this doctor would not just be giving unlimited prescriptions for ketamine or any drug to someone who came in as a bricklayer, who had sort of, you know, jeans, a dirty work shirt because they wouldn't be seen as an authority figure. In that case, the doctor sees themselves as the authority. Most people, when they see a doctor, they are sort of metaphorically looking up to the doctor as someone who knows more than they do about drugs and health. So they take the doctor's advice. And the problem of course is if you're Matthew Perry or Elvis or Prince or Michael Jackson, our society has put you so far above in terms of prestige, a typical doctor, that even the doctors fall prey to this, oh my gosh, look how this important person wants to talk to me. This important person wants my advice, this important person wants me to help them. Yes, I'll do whatever I can. It changes the power dynamic. And it's important for all of us to realize the potential for this authority bias to creep in. There's also a well known bias of the halo effect, where because someone is successful in one area, in this case Matthew Perry is a successful actor, we tend to think this person smart about everything else. Certainly Elon Musk benefits from the halo effect. He's done some things really well. He has taken a Tesla company, he took PayPal as a part of that team. He's had some huge successes. But a lot of people say he's a genius about everything. So we need to listen to him on issues involving transsexual rights, something he clearly knows nothing about. So that halo effect is a problem. Part of the bias is financial. Hey, this guy's rich. If I give him what he wants, he's going to keep paying me money. And there's just self interest. Most doctors, I think, have a bias in following the Hippocratic oath. First do no harm, first do what's in the best interest of the patient. But everyone has biases. And the financial incentives, the self interest to make more money is a part of that. That comes down to another bias. It's a little bit distinct, but I want to call it out motivated reasoning. If you've decided in advance, hey, I can benefit from this. Whether it's being able to say, oh, I'm this celebrity's doctor, or making more money, or just the excitement of being around a famous person. You can fall to the to the situation of motivated reasoning because you want something, you'll come up with reasons. Another bias comes in confirmation bias. Well, I gave this guy ketamine last month. Nothing happened. I gave it to him the week before. Nothing happened. I gave it to him two months ago. Nothing happened. Clearly this guy is fine. It's confirmation bias. It's looking for what you already know to be true. And it was true that when you gave this guy drugs before, seemingly nothing bad happened. So that's another type of bias, this confirmation bias. There's also the normalization of deviance. You break the rule once, maybe I shouldn't do this, you do it again, maybe I shouldn't do it. Each time you do it, it kind of becomes more normal, therefore seems less deviant. You just get comfortable with it. There's also a groupthink bias. Hey, everyone else is doing it. Everyone does these drugs, and it shouldn't really be illegal. And, hey, people do this for years. There's no it's a group think bias. There's also the sunk cost fallacy. That's where you put money into something or you've invested your time, your energy, your prestige, your reputation, something. It didn't work out, but you figure, well, I can't admit it now, I got to keep doubling down. Otherwise I'll never get that back. Even though you'll never get that back, the doctor may have thought, well, I've already been giving him drugs all this time. I got to keep it up to continue my investment in the relationship with him. Let me keep doing it. And that is a huge, huge problem. And this relates to the status quo bias. All of us are biased in favor of doing things the way we did yesterday and the day before. This doctor had gotten into the practice of giving these drugs. There's also just an overconfidence bias. You can argue doctors are especially susceptible to this. You've heard the expression doctors with a God complex. They sometimes do, in fact, save a life on the operating table, but that can make them feel like they have godlike powers when they really don't. So a doctor can have this bias thinking, okay, I give life, I don't take life away. So if I think it's appropriate to give this guy more ketamine, who are you? Or who is some regulator, who is some government busybody to tell me I can't do it? So that can lead to this sort of a bias that is harmful. So, yeah, I'm glad this guy got some real prison time. It is a problem of doctors who essentially kill people by giving them more and more drugs. Because when you are in pain, whether it is physical pain from your skull getting burned off, as happened with Michael Jackson, or emotional pain, as apparently Matthew Perry was in, you're going to want drugs now. I'm fortunate. I hope I'm not jinxing myself today. I've never experienced much pain of any kind in my life. So I haven't been tempted to want to go get heroin or any drug or coerce a doctor into giving it to me. But if I were in extreme pain, I don't know that I'd be any different. I would love some relief from that extreme pain. Doctors are supposed to be the adults. They're supposed to be the ones who say, yes, I realize you're in pain. I can give you something to help you, but I can't give you enough to keep you high permanently because that could kill you. It's not my job to make you feel good just for today, unless it's your last day of life. My job to keep you alive. And this doctor failed that test. And that's why I do think it's important for society to send a strong message by putting him in prison. Now, will he serve two and a half years? I don't know. Will it be a really tough, rough, dangerous prison? I don't know about that. But I do think a lot of other doctors are going to look at this and say, you know what? I'd love to give you this prescription for ketamine or anything else, but I don't want to see my reputation destroyed, my medical license taken away. Presumably this creates near financial ruin when you factor in the legal cost. He has received fines, loss of a medical license, and no ability to make money for two and a half years. That's a pretty strong disincentive to other doctors, which is exactly what we want.