The man had to know this day would come.

The fall of Joe Biederman began last summer when a Congressional investigation led by Iowa Republican Charles Grassley accused the famous child psychologist of failing to report more than $1 million in income from Johnson & Johnson and other drug makers.

At the time Biederman defended himself by saying his “interests are solely in the advancement of medical treatment through rigorous and objective study.”

So Biederman wasn’t saying much last week when J & J documents came to light showing he had lobbied the drug maker to fund a research center at Massachusetts General Hospital whose goal it would be to “move forward the commercial goals of J & J.”

Biederman is the man who almost singlehandedly put pediatric bipolar disorder on the map, in part by publishing many studies that were funded by drug makers. Diagnoses of pediatric bipolar disorder increased 40-fold between 1994 and 2003.

Biederman also happened to champion the use of expensive new antipsychotic medicines for this and other psychiatric conditions in children as young as 6 years of age, beginning at least 5 years before the FDA approved the drugs for this purpose.

The new medicines, so-called atypical antipsychotics include Risperdal, Zyprexa, Seroquel, Abilify and Geodon. J & J makes Risperdal. These drugs have nasty side effects including marked weight gain, metabolic abnormalities and tics. 1,200 children have suffered serious complications from Risperdal and 31 died.

The newly released documents were part of a routine filing made by lawyers representing individuals claiming to have been injured by the atypical antipsychotics produced by J & J, AstraZeneca and Eli Lilly. The filing ended up compelling Beiderman to testify under oath in the case. That will happen in January.

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When Gennady Rozhdestvensky found out the materials promoting his appearance with the Boston Symphony Orchestra didn’t show proper respect, he pulled out at the last minute. That left the BSO in the hands of a young assistant conductor and its genteel audience aghast.

The 77 year-old Rozhdestvensky is a towering figure in his field. He conducted Tchaikovsky’s Nutcracker ballet at the Bolshoi when he was 20 and went on to become the pre-eminent conductor during a golden era for classical music in the Soviet Union.

Rozhdestvensky’s brilliance was not lost on the Communist party. It flaunted him as a symbol of the regime’s excellence.

But that was quite awhile ago and now the maestro had pulled into Boston for a 4-night gig.

Then Rozhdestvensky, while out on a stroll, happened upon a promotional poster for his performance.  It gave top billing to the soloist, a cellist by the name of Lynn Harrell. Her name appeared in big print and was accompanied by a photo. His name appeared in smaller print.

How can that be?

The conductor tracked down a BSO marketing brochure. He opened it to find a page titled, “Artists who inspire.” His name wasn’t on that page. He then flipped to a section titled “Distinguished Conductors.” Still, no mention of the conductor. Rozhdestvensky finally found his name in a third section titled, “The Cello Shines.”

Who is that blasted Lynn Harrell anyway!

The maestro wasn’t going to take this sitting down. “I felt insulted by the actions of the (BSO) administration,” he told the Boston Globe. “I feel not only slighted but I suffered what is called in Russian a moral insult, and I’m free to take any actions to defend myself in public.”

That sent everybody ducking for cover at the BSO but Mark Volpe, its managing director did tell the Globe, “All of us at the BSO greatly admire Gennady Rozhdestvensky’s artistry. We genuinely regret that Maestro Rozhdestvensy decided to cancel his concerts this week.” 

Then he scrambled back to the foxhole.

Last week, the Institute of Medicine presented its 2008 Gustav O. Lienhard Award to John E. Wennberg for his contributions to evidence-based medicine, outcomes research and informed patient choice.

John Wennberg

Dr. Wennberg is the Peggy Y. Thomson Chair for the Evaluative Clinical Sciences and Founder and Director Emeritus of the Dartmouth Institute for Health Policy and Clinical Practice.

Wennberg became a household name in the 1980s when he and colleague Alan Gitlesohn began documenting marked variations in procedure rates from region to region, state to state and even physician to physician in the same locale. Wennberg was able to show that his findings were driven by physician preferences which were in turn based on their own anecdotal experiences rather than evidence from scientific trials. This research helped drive us toward evidence-based medicine and served as an impetus for legislation that created the Agency for Health Care Quality and Research.

Wennberg also founded, along with Al Mulley, the Foundation for Informed Medical Decision Making, a non-profit organization that provides objective scientific information to patients so they can participate more effectively in their own care.

Wennberg is the 23rd recipient of the Lienhard Award, which includes a medal and a $25,000 prize. The Award program is funded by a grant from the Robert Wood Johnson Foundation. Lienhard was chairman of the Foundation’s board for sixteen years beginning in 1971.

As part of last week’s bailout legislation, Congress passed a bill requiring insurers to provide mental health benefits equivalent to those for physical illness.

It would not have happened without Pete Domenici, the 76 year old Republican from New Mexico who will retire soon due to a progressive neurologic disease.

Domenici’s interest in mental health policy began after his daughter was diagnosed with schizophrenia. He spent time with parents in similar circumstances and heard tales of financial ruin resulting from inadequate insurance.

In 1996, Domenici stood before his Senate brethren to announce “now is the time” to pass mental health parity legislation. The bill passed the Senate easily and was folded in to a larger legislative package. It was then dropped during negotiations with the House, which had been lobbied by insurance companies.

Domenici then had to shelve the cause for years because his fellow Republicans controlled the House and opposed the bill. Another tragic setback occurred when, in 2002, co-sponsor Paul Wellstone (D-Min) was killed in a plane crash.

The bill picked up steam again in 2004 but it took 4 more years before Domenici had a passable bill with teeth.

Remarkably, a week before the bill passed, Domenici wasn’t sure if it would. “Either it happens or it doesn’t,” he told the Wall Street Journal. “I’ve done the best I could. This is a tough one that should have been easy.”

This week’s Fortune magazine includes its annual list of the 50 most powerful women in business. The remarkable people on the list include Sunoco’s Lynn Elsenhans, the first woman to run a major US oil company and Google’s Marissa Mayer, who at 33 oversees thousands of engineers and is the youngest woman ever to make the list.

Congratulations to the women in health care who made the list:

Angela Braly, President and CEO of Wellpoint
Susan Desmond-Hellmann, President, Product Development, Genentech
Colleen Goggins, Worldwide Chairman, Consumer Group, J & J
Carrie Cox, EVP and President Global Pharmaceuticals, Schering-Plough
Melanie Healey, Group President, Global Feminine and Health Care, P & G
Dierdre Connelly, President, Lilly USA, Eli Lilly
Sherilyn McCoy, Worldwide Chairman, Surgical Care Group, J & J
Gail Boudreaux, President UnitedHealthcare, and EVP UnitedHealth Group

Already this year we’ve seen meltdowns in the housing and mortgage markets, skyrocketing foreclosure rates, the collapse of major investment banks and federal bailouts of Fannie Mae, Freddie Mac and AIG. And it’s only September!

Into these headwinds, John McCain spits “the fundamentals of our economy are strong!” It seems everybody but Top Gun knows what happens when you spit into the wind.

The crises have devastated millions of US households. 86% of those polled by ABC News last week said the economy was “not good.” GDP growth, anemic as it has been, is artificially propped by last spring’s one-time fiscal stimulus.

Now, unemployment is starting to accelerate. There are worrisome declines in retail and automotive sales, and there’s more debt out there than people can count.

Maybe Top Gun means we won’t crash and burn like the Great Depression? That’s true because modern economic shock absorbers do work. The recent surge in commodity prices helped US mining and agriculture interests, for example. The weakening dollar contributed to a hike in exports. Now these trends have faded and inflation worries have faded with them.

Maybe we’re not headed towards Great Depression II, but it’s time for some real Straight Talk from McCain: if current policies continue, we’re looking at years of little or no growth at best.

Yes Sara Palin was brilliant last night. But the content of her speech contained some nasty insinuations and code words that, although they may have sailed over Palin’s head, will not be missed by the very folks she was charged to seduce.

Specifically, Palin derided the Big O’s experience as a community organizer on the South Side of Chicago. In that role, Obama worked with people who had been left behind when steel plants closed or who had otherwise lost work.

As David Plouffe points out, community organizing is how regular folks respond to out-of-touch politicians and their failed policies.

Plouffe reminds us that for decades, ordinary people have forged their own versions of the American dream by driving change from the bottom up. Community organizing is what drove the women’s sufferage movement, labor rights and the civil rights movement for example. It’s going on today in churches, veteran’s clubs and many other venues. Do the Republicans understand this?

Sadly, Palin’s gaffe comes as no surprise. Her speech was after all, written by a speechwriter for George W Bush.

Controversial VP pick Sarah Palin didn’t just lance a festering boil of Republican angst last night. She dazzled. She was poised, self-assured, in command and not only that, she was accessible and likable.

She proved to be pretty adept with a shiv, too  (“I have actual responsibilities”).

To be sure, hers was an easy test-she read a speech (more about that shortly) before a crowd that desperately wanted her to succeed. Going forward, we’re likely to see her in similarly controlled situations as she takes time to brush up on her world maps and McCain’s changing policy positions.

Tougher tests will come when she faces the media or her opponents. There is also the risk that a story or two about her Alaska shenanigans will grow legs.

Still, Sarah Palin did save the game for McCain and his party, at least for one night. That was impressive! Congratulations to her.

In parrying with the media about his controversial VP pick, John McCain repeatedly claims that his vetting process was thorough. What does this tell us about McCain’s judgment? If his sole intent was to shake up the race for President, then the man is a genius.

The mommy blogs for example, have gone nuclear over the pick. It’s about time we let a breast-feeding mother decide whether to send troops into harm’s way! They appreciate what it means to lose a child.

Meanwhile, the media keeps digging up stuff on the mystery woman. She once got a speeding ticket! She might be a secessionist! She played hoops back in the day and had a nickname on the court, Sarah Barracuda!

When Palin tries to lock him down on defense, will the Big O still be able to hoist that Sweet Lefty J?

With the Sarah Palin tempest threatening to spin up to a Cat 5 at any moment, it is remarkable that Palin herself has gone underground. It’s been 48 hours since we last heard from her. Sarah Barracuda needs to step onto the court and start playing the game.

So how does Top Gun McCain select Sarah Palin to be his running mate when he’s been pasting the Big O for his lack of foreign policy experience and Palin has yet to even stare down a seal poacher in the Bering Strait? It isn’t obvious from this video (filmed before the announcement), in which Palin appears disinterested in the job.

Who is this person?

McCain must believe Palin can galvanize the Republican base, a group that thanks in part to his nomination hasn’t been this glum since William F. Buckley made it through puberty. That’s because the other commonly posited explanation for McCain’s selection has to do with Palin’s gender, and that one makes no sense at all.

McCain can’t actually believe that Palin’ll deliver the Disenfranchised Females For Hillary demographic. Palin opposes Hil on just about every position that matters and Hil, in a moment of prescience, had just two days earlier exhorted supporters to vote for the Big O, a man who sees the world pretty much like she does.

The way things played out in Denver, I don’t see McCain making hay out of a gender play.