In Memory of Dr. Joel Hochman from Texas

(If you’re one of those people who gets offended when people speak ill of the dead, you shouldn’t read any further.)

I was a patient of Dr. Hochman’s for about 8 years before his death. I found him on the internet through his pain association, the National Foundation for the Treatment of Pain.

Most doctors use the term “chronic” pain, so when I read about a doctor using language from Texas’ Intractable Pain Act, that’s who I chose when first seeking opioid therapy. Yes, I had taken opioids and lots of other drug treatments before that time, but mostly as short-time fixes (like the times my right shoulder froze and I was unable to lift my arm because of the pain).

Dr. Hochman’s first office was really an old house in the Heights, an area in Houston that had seen better days. His office was typical of all doctor’s offices, with Lexapro and other Big Pharma labels everywhere you looked. During my 8 years as a patient, Dr. Hochman moved his office twice, each time further away from me. The drive in big-city traffic was not pleasant, and usually rather nerve-wracking… it took me days to prepare and days to recover.

His girlfriend was the office manager, although it seems weird to define an older woman that way. She seemed like a tough cookie, but Dr. Hochman was obviously the boss. I witnessed many occasions when he was rude to her, belittled her, talking down to this woman who was his girlfriend and employee. In the end, the thing I remember most about him is that he was a misogynist and a bully.  (And now I sound like a disgruntled patient, which I guess I am.)

Dr. Hochman is not the first psychiatrist I’ve seen in my pain career — at least a psychiatrist is not another pain “specialist” wanting to inject me with something. I admired Dr. Hochman for running the NFTP, for his way with words, and for fighting back. I read everything he wrote (which seems to have disappeared from the internet, and I didn’t think that was possible). And even though I couldn’t afford it, when he asked, I “donated” to his foundation with the purchase of a lapel pin sporting the group’s logo. But, funny story, even though I paid for the pin, I never received it. Like a year later, I happened to mention it, and he reached into a drawer filled with leftover pins, finally completing the transaction. As with almost every other pain association, the NFTP eventually went out of business.

Of course his prescribing habits were controversial — including for his use of multiple opioids. He was a big prescriber of Oxycontin, and I had to try many different dosages of this drug for some time before the side effects (mostly nausea) convinced Dr. Hochman to allow me to lower it. Hydrocodone always worked best for me, but the added Tylenol was a problem. At one time, I asked for and received a prescription for hydrocodone without the acetaminophen, which had to be filled at a compound pharmacy. (Thankfully, I had good insurance.) But as with many other failed attempts to find relief, the compounded hydrocodone just increased my nausea. (For which I was then prescribed many different anti-nausea medications.)

For the first couple of years, I had private insurance that Dr. Hochman accepted. And then COBRA, which I’m not sure is worth the price.  But not too long after I finally became eligible for Medicare, he opted out (at least for this patient) — meaning I paid over $200 every month without the ability for insurance reimbursement. (Looking back, Dr. Hochman’s practices seem more like those of a drug dealer than a doctor. But I guess that’s what doctors are — legal drug dealers.)

Dr. Hochman had low overhead for his practice, so I didn’t think it was odd that he and his girlfriend drove fancy, new cars. His choice of car fit his ego, although I’m surprised both of them could fit in that compact space. Dr. Hochman and his girlfriend also took lavish trips, to far away places like Africa and Venezuela. Photographs of all the places he’s traveled to covered his office walls, along with the art he brought back. Somewhere in the back of my mind, I realized he had been bought and sold by Big Pharma — but I didn’t care. Desperate for pain relief, I would have begged at the horned feet of the devil.

I remember being forced to pay for internet service when Dr. Hochman decided to put his patient records online.  (In the video commercial for Pain Practice Liability Association, he mentions this software as part of his pitch.)  From then on, I had to enter my daily pill counts online, with his software.  And I watched every month as he just copied his notes from the previous month to do another update.  (Which was an improvement, considering his handwriting was — yeah, you guessed it — atrocious.)  Yes, I emailed him about the errors in his reports, but he never changed the records.  I’m sure they’re still floating around in cyberspace somewhere.

One of Dr. Hochman’s favorite types of therapy was shaming, like this: “Look, my patient Greg is in a wheelchair, makes a great living selling machine parts on eBay, and plays the guitar. He’s a lot worse off than you, so why can’t you be like him?”  The way Dr. Hochman talked, it was like most of his patients were doing just fine, and I was the only hold-out who was suffering.

Hard to blame Dr. Hochman, really, for running out of ideas to treat pain. It’s not like he had a lot of “standard” options to choose from. But, after my monthly appointment, there were so many times I just went home and cried after suffering through one of his egotistical or shaming tirades. I didn’t know it at the time, but one of the reasons for these outbursts appears to have been his nurse. It seems that she enjoyed reporting everything a patient may have said to her, filtered through her own perceptions, of course. And come to find out, she was also a chronic pain patient of Dr. Hochman’s (who appears to have idolized her legal drug dealer).

I asked Dr. Hochman about marijuana on a few occasions, but although he didn’t really diss the leaf, he didn’t recommend it either. His attitude was, well, where you gonna get it?

As much as I appreciate the work that Dr. Hochman did — and what he had to put up with to do it — this doctor is one of the reasons I now dislike all doctors. The way I was treated by his office after he passed away didn’t help, and was especially cruel.  There’s nothing like the doctor crawl, begging and pleading for other doctors to treat you.  (Mine took me all the way to California, but that’s a story for another day.)

I let my desperation for pain relief cloud my judgment, and continued seeing a doctor I personally disliked because he was one of the few doctors that prescribed the drug treatments that worked. And to be fair to Dr. Hochman, most of his practice consisted of pain patients who had tried everything else — the bottom of the barrel, so to speak; the hardest patients to treat. He was willing to try just about any drug, and even though he was financially compromised, allowing patients access to all of those options was rather heroic.

Doctors aren’t saints, just human beings like the rest of us. Dr. Hochman did a lot of good while he was here, and I’m thankful for that. But he abused my trust in the medical profession and used my desperation against me. Just like an underground drug dealer can abuse my trust in people, also using my desperation for pain relief as a tool for financial gain and to rip me off.

Now, more than ever, it’s easy for pain patients to be abused by their doctors. Be careful out there, folks.

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