Category: Medicine

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Selling the New Drug

How do the drug companies persuade doctors to prescribe their drugs? Well one company, Purdue, held over 7,000 seminars last year to “inform” doctors about “pain management”, which, of course, consists of prescribing its particularly powerful drug called “Oxycontin”. Why do the doctors go to these seminars? How about free weekend travel and hotel accommodations, to Florida and other lovely locales? (In December, United States attorneys in Maine, persuaded Purdue to stop paying for the doctor’s travel expenses to these seminars and it agreed do so.)

A spokesperson for Eli Lilly said that the company asked women and physicians about a treatment for PMDD and they told Eli Lilly that they wanted a drug with it’s own identity for this special problem. I’ll bet the same focus group told them they wanted to squander $100 a month on medicines that treat imaginary illnesses.

David Rubinow, Clinical Director of the National Institute of Mental Health, says “there is a very high degree of false positive self-assessments– women assume they are suffering from PMS or PMDD when, in fact, they are not.” If you were an investor, would you bet on that dynamic? I would.

Interesting side-effect: if Eli Lilly prevails– you can bet they are using all their influence to get “studies” that show that PMDD really exists– we will soon see court cases in which a woman claims that she shop-lifted or drove too fast or neglected a child, because of PMDD. The court will then hear that Americans spend more than $1 billion a year on treatment for this “disease”, even if it isn’t listed as one in the DSM, and will be duly impressed and find the woman not-guilty, or award somebody a hundred million dollars in damages or whatever. Then Eli Lilly will point to the court cases and say, “see– even our courts recognize that PMDD exists!” Thus you have self-fulfilling prophecy.

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Requiem for the Yanomami

Deep in the rain forests of Venezuela and Brazil, there once lived a people called the Yanomami. They farmed. They hunted. They had wives and children. They fought among themselves, village against village. They had life and death. They had Shamans who taught them about gods and magic and matter and spirit. They were completely isolated from the modern world.

They were, for all intents and purposes, a nation. They happened to live in an abstract, artificial political entity called “Venezuela”, but this meant nothing to them. And why should it have? White men from Europe came to the South American continent and proclaimed that God had given all of the land– and it’s peoples, as we shall see– to them. They set up governments. They demanded money from the people they identified as “citizens” so they could build armies and award each other medals. They invented guns and blades and poisons to ensure that no one would stop them from taking everything they wanted.

The Yanomami didn’t know anything about all this until the 1960’s when they were “discovered”.

Discovered.

Think about the arrogance of the way we Westerners use that word– as if they did not exist, or had no importance, until we “discovered” them. Think of how that word helps us think of appropriating a people, their beliefs, their culture, their technology, and, nowadays, their DNA. We discovered them. Now we can exploit them….

But I’m getting ahead of myself. An American scientist named James Neel, a geneticist, and an employee of the Atomic Energy Commission who took part in studies of the effects of radiation on people in Japan after World War II, found out about the Yanomami and decided that they provided an ideal field laboratory for his strange and rather Nazi-ish view of human evolutionary development. Now the word “Nazi” is tossed around all too carelessly these days, in reference to everyone from feminists to Alliance Party members, but, in this case, it is probably quite appropriate. Neel’s theories of human development provide a remarkably congenial intellectual framework for anyone advocating doctrines of racial superiority.

There is a mystery about James Neel’s role in studies conducted by the AEC on unsuspecting patients in a Rochester Hospital and prisoners in penitentiaries across the U.S. The AEC exposed these people to radiation in order to analyze its effects on them. I stress, the AEC did not obtain permission to do this.

Do you think that government agencies would never, ever do such a thing again? Ever?

No one has any convincing evidence that James Neel himself conducted these illegal and immoral studies, but he worked with the people who did. Has he denounced these criminals? I don’t know. No one will ever know probably– Neel is dead.

Anyway, at the AEC, Mr. Neel worked with a Venezuelan named Marcel Roche. Roche returned to Venezuela after the war and began conducting experiments, injecting radioactive isotopes into the Yanomami and then studying their blood samples. Yes, this man had been employed by the American Atomic Energy Commission. He worked for the United States Government. He helped us defeat those monsters, the Nazis. Then he went into the Venezuelan jungle and injected members of the Yanomami with radioactive iodine.

In 1968, Neel and a then-protégé named Napoleon Chagnon decided to immunize the Yanomami against the measles. The Yanomami didn’t have measles. The Yanomami had never been exposed to the measles. Until Mr. Neel decided to immunize them. There was an outbreak and hundreds, perhaps thousands of Yanomami died.

Mr. Chagnon argues that the idea of immunizing the Yanomami against the measles was the result of an altruistic desire to better their lives. Some medical scientists argue that a measles epidemic could not have been the result of immunization. Other scientists are not so sure. I’m not so sure. In fact, I think it’s rather insane to believe that the measles epidemic– the first ever in the the thousands of years of history of the Yanomami– just happened to coincide with the introduction of the vaccine, or, at the very least, with the introduction of self-seeking white adventurers, missionaries, and anthropologists, but was not caused by them.

Chagnon also induced various Yanomami villages to stage little wars for Timothy Asch’s cameras, to provide documentary “proof” of his assertions about the innate violence of the Yanomami leaders. To ensure that the battle scenes would be vigorous, he gave gifts to villagers that he knew would arouse the envy of their “enemies” of the drama, to the point where real injury and death took place.

For these achievements, Chagnon was lauded around the world as a brilliant anthropologist.

Chagnon is still alive today. He is a retired professor “emeritus”. He disputes Tierny’s charges. So those of us without first-hand knowledge are left to sort it out. You have to read Chagnon’s arguments. They don’t reassure. Tierny, for example, alleges that Chagnon used his helicopter to brazenly flop into Yanomami villages, blowing the roofs off their houses and intimidating them. Chagnon doesn’t claim that he didn’t land his helicopter in the middle of the villages and blow the roofs off houses– he merely tries to convince you that the villagers wanted him to land near the houses, so they wouldn’t have to haul his equipment so far! Why, in heaven’s name, are the Yanomami hauling this self-seeking adventurer’s equipment up into their villages? Because they love him? Because he did so much for them?

Patrick Tierney also claims that Chagnon tried to become a shaman, and that he abandoned a village to the measles. Chagnon admits that he did behave like a shaman at least once, and did paint his body and wear feathers. He claims it was intended to persuade the Yanomami that the damnation and hellfire sermons of a local missionary should not be believed. Chagnon admits he left a village knowing that a man with the measles was there and that the villagers would soon return and were likely to contract the measles from the man. His response is somewhat lame: he thought someone else would make sure the infected man left the village before the Yanomami returned.

Tierney alleges Chagnon shot a pistol off every time he entered a village. Chagnon responds that he once fired a shotgun at a tree, when some Yanomami were threatening to kill him.

Terry Turner, professor of Anthropology at Cornell University, summarizes Neel’s views of Eugenics as follows:

according to his [Neel’s] eugenically slanted genetic theories, dominant genes (specifically, a gene he believed existed for “leadership” or innate ability”) would have a selective advantage, because male carriers of this gene could gain access to a disproportionate share of the available females, thus reproducing their own superior genes more frequently than less “innately able” males. The result, supposedly, would be the continual upgrading of the human genetic stock. Modern mass societies, by contrast, consist of vast genetically entropic “herds” in which, he theorized, recessive genes could not be eliminated by selective competition and superior leadership genes would be swamped by mass genetic mediocrity. The political implication of this fascistic eugenics is clearly that society should be reorganized into small breeding isolates in which genetically superior males could emerge into dominance, eliminating or subordinating the male losers in the competition for leadership and women, and amassing harems of brood females.

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The Casualties

I came across this plaintive little piece in a newsgroup on various pharmaceutical remedies for mental illness. I was struck by the fact that the man is an ex-marine, something he assumes should convey an image of power and integrity, but for me means nothing more than the cloak of institutional authority we append to schools for killers.

I was also thinking about the fact that our society, cruising along at this hysterical pace towards some kind of elusive manifestation of nirvanic technopoly… seems to be casting more and more casualties to the side.

It’s by a guy named Jim. He blames everything for his troubles, except that which is most directly before him and least obvious to him: our narcissistic culture of instant gratification and the mindless pursuit of wealth. He feels left out, lonely, and isolated. His problem is that he has become reflective and thoughtful. He thinks he should have some sense of purpose here, but he can’t question the assumptions that betray him, because he is so much the product of those very assumptions. So he tries the medications….

From a Christian perspective, it seems we are sent here on earth, to fail. We have our little victories, but inevitably we fall short of the grace of God. I think once we admit this, that we cannot fulfil all greatness, perhaps we can have a better perspective about going on with life. I have a disorder which has most recently been downgraded to bi-polar provisional. This because depression takes hold of me much more often than the manic high that we long for. I may have had this much longer than the past five years but was unaware because everything is relative-normalcy is only defined by those around us. I have done things that my ex-wife considered crazy, but from my point of view were, perhaps, necessary evils (I threw my landlord out once after warning him three times to leave) We all make our choices-whether we are in control of our faculties at the time of event seems to be the distinguishing factor of our sanity.

I was a recon Marine during the Gulf war. I was raised in utter poverty by a social outcast and an overbearing mother. I speak my mind as Marines do, but am not accepted in this practice by civilian people. I uphold a personal code of honor and integrity, but we live among those who do not. In my quest for truth and integrity-I become branded as strange. My wife has left, but she was never a very good person anyway. Her heart is cold and selfish. So….what do the afflicted do to lighten the burden even in the face of suicide as perhaps our only means of escape from the madness. I wish I knew. It is the fear of destoying my beautiful children’s lives by taking my own life that keeps me going-one step from homelessness, one step from jail, one step from insanity. I have no friends, though I consider myself a very nice guy. Strange as it seems, people consider me very good looking and well built too, but my personality seems to scare them off- though few if any people will offer a reason for their hurried departure. We live together but alone. I envy those who have close, good hearted friends. We all need them. AFter many different medications, I have begun to think that not only is there no cure to this thing, but no real relief either. We ride ’em high and ride ’em low and just hope we’re still breathing when the dust settles. Best of luck and God speed to all of us who suffer.

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Hospitals

The President of the University of Western Ontario was recently on the radio, explaining why his institution needs more money. He said that classrooms were filled to overflowing, and the residences were over-crowded– some students even had to sleep at professor’s houses. What an outrage! Mr. Harris better fork over some more money right now!

Then the reporter asked him a simple question– if you don’t have room for these students, why did you accept them? The president floundered briefly, then tried to explain that the University of Western Ontario believed so strongly in the rights of all students in Ontario to a post-secondary education, that it just had to squeeze them in, though they didn’t have enough room to accommodate them.

Hmmm.

Well, well. It’s nice to know that the University of Western Ontario is motivated by such lofty sentiments. One wonders how many homeless people they took in this week, or emergency medical cases.

I found this interview disturbing. I don’t happen to like Mike Harris, but I have some respect for the political process. It disturbs me that colleges and universities in Ontario might have so little regard for the rights of their students that they would use them, crassly, as pawns, in a little political game of showmanship. It looks wonderful in the news when the University of Western Ontario reports that they are over-crowded. The public is outraged, possibly. Possibly, they will demand that Mike Harris increase funding.

Possibly, they might ask themselves why colleges and universities continue to hike their tuition costs, year after year after year, in spite of the fact that average earnings for the average person have not increased at all over the past twenty years. The professors at the University of Waterloo are demanding a 20% increase in their wages. When asked who would pay for it, they insisted that students would not. Oh no– we would never force the students to assume that burden. They say they think the private sector should contribute.

Hmmmm.

And today it was reported that most hospitals in Toronto– 30 out of 32– are refusing to accept emergency patients. Most even refuse to accept critically ill emergency patients. We’re over-crowded! We have no beds! We have no monitors! We don’t have enough money or staff!

Mike, fork over the bucks.

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Just Say No

Universities in Canada got 60% of their funding from the government in the 1960’s. Now they get 40%. The rest comes from tuition and corporate donations.

The Corporate sponsorship is disturbing.

Apparently, according to the Canadian Association of University Professors, many of these agreements are secret, especially in regard to intellectual property rights. It was this kind of agreement that led to the University of Toronto trying to silence researcher Nancy Oliveri when her research showed that there might be harmful side effects of a drug produced by Apotex.

In a related story, a professor at McMaster University imposed a new policy on all researchers at that facility: no meetings with representatives of drug companies. Why? Because he felt that medical research was becoming compromised by the intermingling of the interests of the drug companies with those of the universities and the medical profession itself.

Perhaps the most laughable slogan of the entire 1980’s was pet phrase of Nancy Reagan’s: “Just say no to drugs”. Just say no to drugs? Ritalin! Valium! Prozac! Viagra! Lithium! Etc. Etc. Etc. We are the most drug-addled society on earth! Say “no”? And bring the stock market crashing down?!

Our society loves drugs. Institutions love them because violent patients can be sedated into harmless mindless sacks of inert flesh. Doctors love them because they provide convenient and speedy personality modifications to persistently annoying patients, and spare them the aggravating ordeal of actually trying to find a real remedy. Drug companies love them—naturally—because they provide incredible profits, since they can charge far in excess of the actual cost of the chemicals in the prescription, to cover—ha ha—research and development. Research scientists love them because drug companies provide them with millions of dollars to conduct research to arrive at just that conclusion (and if they don’t reach that conclusion—see above—the money is withdrawn).

So what’s with this “just say no” campaign? Well, you see, those poor inner city blacks don’t play by the rules. First of all, their drugs don’t include a healthy royalty to some large pharmaceutical firm (just imagine their apoplexy had Nancy Reagan added—”and let’s all try to do with a little less Prozac and Valium ourselves, shall we?”). Secondly, they haven’t developed this wonderful rationale of how stressed out they all are and how they’ve all seen so many psychiatrists and been to all the doctors and just can’t get over this severe depression that’s been limiting their ability to work, you know… The truth is this: in the U.S., blacks constitute 14% of the drug-using population, but they constitute 58% of those convicted for drug use. Look at those numbers carefully. Think of all the movies and tv shows you see about drugs and crime. Think about the reality. The war on drugs is the war on black America. And this war cost $18 billion a year (Harpers Magazine, November 1999). And it is the most one-sided debacle in U.S. history. It has been lost over and over again but America continues to fight it because it’s a winner as an election issue.

It is at moments like this I feel somewhat pessimistic about the human race.

There is a pretty good argument to be made that marijuana, especially, is illegal today because it provides the same sort of hit that Prozac and Valium provide, but at much, much less cost. In fact, you could grow it yourself in your backyard, if the police would let you. A similar argument could be made for cocaine. So, even though I feel pessimistic, I must admit that there are signs of hope. In seven states, voters have indicated, by substantial margins, that they approve the use of marijuana for medical purposes. Representative Bob Barr, in fact– he of impeachment fame– used some nefarious and obscure loopholes to prevent the results of the vote in the District of Columbia from becoming known. When it was finally released, 70% of the voters supported medical use of marijuana. But Mr. Democracy, Bob Barr, has blocked the implementation of the law on a technicality.

It might strike you as surprising that it is only recently in human history that drugs like Cocaine and marijuana have been made illegal. The prohibition of these and other “recreational” drugs coincides perfectly with the rise of the large pharmaceutical companies (who also tried to ban or hobble sales of herbal remedies).

Ah, you say—but aren’t those evil, illegal drugs addictive? Precisely. Why some of them are almost as addictive as, say, lithium. In fact, many of the heavy duty, most frequently-prescribed pharmaceuticals are at least equally addictive.

So what am I saying?

First of all, I am not saying that drug use is good. Get that clear. I don’t drink more than two or three beers a YEAR myself. I dislike anything that messes with your mind. And I certainly don’t use any prescription drugs and whenever I hear of someone who is depressed or disturbed, I hope they find some way to deal with problems that does not involve pharmaceuticals.

However, just as Prohibition of alcohol failed, the war on drugs has failed. And just as most people came to realize that Prohibition did more damage than good, people should come to realize that the war on drugs does more harm than good. The war on alcohol produced powerful criminal organizations that branched out into prostitution, gambling, and murder. Does that sound familiar?

As shocking as the idea sounds, the fact is that some countries have already tried legalizing drugs. In Holland, marijuana and hashish are freely available. And surprise, surprise, more adolescents try marijuana in the U.S. than they do in Holland!

That drugs like cocaine and marijuana should be legal? Well, think about it. Alcohol, in terms of sheer quantity, does far more damage to our society than marijuana. Yet it’s perfectly legal. In fact, it is downright easy for any teenager to get a six pack or a bottle of wine.

We did try banning alcohol once too. Of course, we all know how disastrous that was, and how it led to the development of powerful criminal organizations in North America that branched out into other forms of crime and plagued our society for years afterwards. Does that sound familiar?

Now, the U.S. Supreme Court, featuring embarrassingly second-rate minds like Antonin Scalia and Clarence Thomas, appointed during the twelve years of Republican Administrations between Carter and Clinton, have been steadily eroding constitutional rights protecting citizens from “unreasonable search and seizure”. Police in helicopters can now peer inside your windows, and officers can search your car just because they feel like it. What does this mean? In California, according to Harper’s, an elderly grandfather was shot twice and killed by police who burst into his house in a hail of gunfire searching for a suspect who had lived next door fifteen years earlier. In New York, a mentally retarded, menstruating young girl was dragged naked from the shower and hand-cuffed while police searched the house. Again, no drugs were found.

Nor were any apologies offered. Why should we apologize? We’re the police! We’re in a war on drugs! You don’t apologize to civilian casualties during a war!

And those two cases are just the tip of the ice berg. Under the Supreme Court’s relaxed rules on search and seizure, it has become very profitable for police to pull suspects over the side of the road, seize their cars and property, and leave it to the hapless citizen to “prove” that the property was not used for the purpose of drug-dealing. Not every citizen is smart enough to respond within the 10 days allowed, or rich enough to afford a lawyer, or patient enough to challenge the constipated U.S. criminal court systems. It’s easier, quicker, and safer to please guilty to a reduced charge and turn snitch, thereby providing the police with fresh leads on new property to seize.

It’s utterly incredible, contemptible, and outrageous. Why isn’t this on the front pages of the newspapers, the lead story on television?

Because there’s no sex.

Hollywood stars can afford lawyers.

Everyone has been convinced by successive administrations that drugs is the number one problem in our society and nobody– not Al Gore, not George Bush Jr., not Bill Bradley, not even John McCain– has the guts to stand up to his juggernaut of imbecilic brutality.

 

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Chirocrackpot

Chirocrackpot

The acupuncturists better get their acts together. Sure, they occupy a distinctive and respected niche in the panoply of alternative remedies, but, if they don’t watch their backs, they are going to get blown right out of the market.

The trouble with acupuncture is that it claims to actually cure you. You go for a treatment, or two, or five, and then the acupuncturist says, “are you better?”. If you are better, you’re done. You pay your bill and go back to your life. If you’re not better, they’ll suggest you try something else.

chiro.jpg (41520 bytes)

Miraculous? From a chiropractic brochure.

If I were an acupuncturist, I would make a few changes immediately. First of all, I would help form a strong organization of acupuncturists to sponsor “research” (he he he) to show that almost everyone suffers regular blockages of “qi” along those crowded meridians that run up and down your body. Then I would set up a “study” (ha ha ha) to show that people who receive regular acupuncture are healthier, happier, and sexier than people who don’t. It’s not hard to do. Read the polls. Ask the right question of the right people and you get the results you want every time! Heck, I would even claim that people who receive regular acupuncture get cancer 40% less often than people who only see a chiropractor. You think it might be hard to fudge that kind of data? Come on! Use your imagination!

Next, I would have special little free seminars on health, with treats, entertainment, and a clever speaker, to promote the virtues of weekly acupuncture. The real objective, of course, is not to provide information, but to acquire a large number of new patients. It is not necessary to tell even a single person at these seminars that he or she might not need acupuncture. Why, everyone does!

To successfully promote a remedy, you must first, of course, promote the disease. For chiropractors, it’s “subluxation”, (even though Microsoft’s dictionary doesn’t recognize it as a word). For acupuncturists, I suggest “neuritis”. It sounds sufficiently familiar and medical to be convincing while possessing the all-important quality of nebulousness. All acupuncturists must use this phrase constantly, in reference to every pathological condition, in order to convince the public that everybody has always known that “neuritis” has always existed and needs to be treated constantly. Why, children get “neuritis” right at birth! They need to be treated within the first week or so, to head off cancer, and asthma, chronic fatigue syndrome.

One chiropractor on the web offers a free initial consult to anyone. That’s a great idea. He says that he will provide a careful assessment, and then let you know if you need treatment!

Ha ha.

Ever go to Speedy muffler for a “free” brake inspection? Did they ever tell you, “Well, everything’s shipshape. Can’t find a thing to fix.”? Never. They get your car up on a hoist and then tell you that they just “can’t” let you go without fixing those dangerously worn out or defective brakes or struts or shocks or whatever. That’s the idea. If you really want to generate some serious income, get your prospective client naked on the table under a sheet, and then tell him or her that you just can’t, in good professional conscience, let him walk out that door without a treatment for that terrible case of neuritis.

Do you think it will be hard to convince people that they have neuritis? Not at all. Simply ask the following questions slowly while staring sympathetically into the patient’s eyes:

Do you ever feel tired or irritable?
Any trouble sleeping?
Aches and pains that never seem to go away?
Headaches?
Ever feel sad or depressed? Or tired?
Do you sometimes feel a vague sense of unease or displeasure?
Do you get tired sometimes?
Ever sit down in a chair and not want to get up and jog two miles?

There you go. Just try answering “no” to all those questions? I’ll bet you can’t.

Finally, if you really have trouble convincing your patients to come in more often, follow this procedure: adopt a very serious, compassionate expression, look the patient in the eye, and tell him or her that you cannot, in good conscience, continue to compromise your professional principles. If the patient is not willing to come in at least once every two weeks, you will have to refer him or her to another quack…. Er… therapist.

Interesting stuff on chiropractors:

http://www.chirobase.org/01General/chirosub.html

In 1973, the U.S. Congress authorized Medicare payments for chiropractic treatments if subluxation could be demonstrated from x-rays. This threw chiropractic into a tizzy, because even though chiropractors take x-rays all the time and point out the “subluxation” to their prospective clients… well, the truth is that nobody can really see subluxations. When 20/20 took a set of x-rays to three different chiropractors and asked them to point out the sub-luxated vertebrae, they each picked a different one.

Yet, they have to show one in order to get paid.

Two years ago, in an attempt to “unify” chiropractic terminology, the Association of Chiropractic Colleges issued the following definition: “A subluxation is a complex of functional and/or structural and or pathological articular changes that compromise neural integrity and may influence organ system and general health.”

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So how about this: “neuritis is a complex of functional and/or structural and pathological changes that compromise neural integrity and may influence organ system and general health”.

Yeah. That about covers everything.

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I Went to See the Doctor

I went to see my doctor today. She has an office downtown in one of those little medical buildings, which she shares with several other doctors and a pharmacy. That tells you something about medicine right away. Not feeling well? Here—take a controlled substance.

The waiting rooms in doctor’s offices always seem to be full of women and children. You don’t see many men there. If you do, they are usually old. This is a well-known fact: women go to see the doctor way more often than men do. Why? Are they sick more often? Maybe it’s because the parts of the human body that are responsible for giving birth are unnecessarily complicated and need a lot of maintenance. The corresponding male organ seems highly resilient and durable. Or maybe men just never bother to get it fixed. Which is the truth? I don’t know.

My doctor is a female. This made me nervous when I made my first visit. But she put me at ease almost immediately by inviting me to undress and lay on the table while she strapped on a disposable glove. Then she invited the nurse in to watch, just to be sure I was feeling safe and comfortable. Hell, invite everybody in.

I found it a little strange. Equality gone amok? The nurse was in there to make sure that nothing “inappropriate” happened, or, at least, nothing inappropriate without a witness. This puzzled me. There were three possible inappropriate things that could happen. Firstly, the doctor might have assaulted me. Secondly, I might have assaulted the doctor. Thirdly, we might have had an argument—maybe about my high cholesterol—and assaulted each other.

We don’t usually worry about a female doctor assaulting a male patient. But we do worry about male doctors assaulting female patients. But it would be unfair to require a nurse to be present whenever a male doctor examines a female patient and not require a nurse to come in when a female doctor examines a male patient– everybody has to be equal– so the nurse comes in for everybody.

On the other hand, the nurse was also a female. Would it be considered appropriate for a male doctor to summon a male nurse to make sure nothing inappropriate happened while he examined a female patient? I don’t think so. What we have here is a conflict between two cultural ideals: equality and protection.

I wondered whether the nurse was in the room to protect me or the doctor. I wanted to tell my doctor that if it was for my sake, I’d just as soon take my chances and not have a spectator. But I couldn’t think of a diplomatic way to say so. So the nurse sat there on a chair. She couldn’t actually read or anything like that. She had to watch. But everybody in the room knew that it would be embarrassing for her to watch too closely, so she just kind of looked in our general direction without actually seeming to see anything.

I think every doctor should be required to be a “patient” for one hour a week. They don’t always seem very sensitive to the patient. I’m always nervous as a patient. When I was a child, the only time we saw a doctor was to get a needle. If doctors are smart, they will change this. They will invite children to come in and play with some toys and watch the doctor do surgery or something. Make it festive and fun. Nowadays I’m not worried about needles, but I get nervous when the doctor tells me to undress and lie on a table and then she goes out of the room for fifteen minutes and comes back in with a nurse, “to watch”.

Back to my visit– after sitting in the waiting room for five minutes, a nurse came and fetched me and led me to one of the examination rooms. There was not much in this room. A few chairs, a desk, and a counter with a sink. There was a box of rubber gloves and a tube of petroleum jelly on the counter. And the examining table, a rather mechanical piece of furniture with a black vinyl cushion on it. The room was painted pink. The nurse left the door open and I was able to hear a woman in another room explaining her symptoms to the doctor. I think she must have just started talking about it without waiting for an official examination to begin, because the first thing the doctor did when she came into my examining room was close the door. Maybe the patient didn’t think anybody else could hear. I often act that way myself at work, talking on the phone in my cubicle. You get a false sense of security because you can’t see anybody else nearby, and you can’t hear them, of course, unless they are talking on the phone.

My doctor must have gone to some kind of conference on patient-doctor relationships. At my first visit, she was very “traditional”. I want you to do this and that and then I’ll have a look here and tell you what we’re going to do. At my more recent visits, it was more like “what would you like me to do? I recommend this, but it’s up to you. You tell me when if you want this or that checked.” She has a poster on the wall stating that she does not casually prescribe antibiotics, because over-prescribing antibiotics has led to some strains of viruses becoming resistant.

Generally, I enjoy visiting the doctor. I used to think that anybody being paid to care for you didn’t really care for you. Now I think that just because someone is being paid doesn’t mean they don’t want to do a good job. It’s all where you draw the line.

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Alternative Medicine

How many have you tried? I’ll bet you’ve tried a few. Almost everyone gets sick or injured on a semi-regular basis. Almost everyone feels lousy now and then. Almost everyone wants to feel better than they do. How many people ever say, “boy, I feel great” almost every day? Not as many as we wish.

There are almost as many alternative therapies around today as there were theories of psychology in the 1960’s. But what is unusual about the state of health care today is the way it has become a kind of smorgasbord, from which people pick and choose as they please, without regard for the theoretical, religious, or cultural foundations of each therapy.

Most of these therapies have links to the far East. Acupuncture drew some attention back in 1971 when American journalist, James Reston, had his appendix removed while traveling with President Nixon’s entourage on a visit to China. The Chinese surgeons claimed to use acupuncture instead of general anesthesia during the surgery to remove the damaged appendix. Reston wrote favourably about the experience in the New York Times.

The trouble with most of these remedies, in the view of many members of the Medical establishment, is that, by normal standards of scientific investigation, they don’t really work, and they are based on utterly fantastical theories about how the human body works. Acupuncture, for example, identifies “meridians” that extend along the body from head to toe, and are somehow related to certain medical conditions. By inserting very thin needles into points along these meridians, various ailments can be cured or pain alleviated. Western science has never found empirical proof of the existence of these meridians or any relationship they might have with, say, back pain, or hemorrhoids, or allergies. The acupuncturist argues, well, they must exist because acupuncture works.

There is, in fact, a good deal of anecdotal evidence that acupuncture can be effective in treating certain conditions. On the other hand, you can find anecdotal evidence to prove just about anything, and “scientific” experiments have been inconclusive, at best. It is unclear whether it has a placebo effect—it works because people think it works—or really works in some way unknown to medical science.

Some alternative remedies offer maddeningly mystical explanations of how they work. Therapeutic touch claims to modulate the patient’s energy field, detect imbalances, and then redirect the energy to locations in the body requiring healing. Oddly enough, practitioners claim that there is “scientific” evidence that it works. Reiki claims to draw the body’s own healing power back into itself, through the channeling of the reiki therapist. Massage Therapists claim that stern manipulation of muscles and skin releases toxins (presumably into the bloodstream where they are safely disposed of by the liver and kidneys). Chiropractors claim that manipulating the spine to eliminate points of “subluxation” frees up blockages in the nervous system, though scientists insist that nerves are not like water hoses, that can be “pinched” and choked off—they are more like electrical circuits, which can only be “on” or “off”. Iridologists claim to detect symptoms in the patterns of the iris. A bit like reading your palm, and about as convincing, to the scientific establishment.

Most people don’t care about the theoretical underpinnings of alternative medicines. They might not buy the explanation entirely, but it isn’t hard to believe that western science doesn’t completely understand the human body. Customers of alternative therapists are typically dissatisfied with traditional medicine. It hasn’t worked for them. They are willing to try anything in the hope that it will work. For cases of back pain or depression, acupuncture or massage can be a harmless diversion. For cancer or more serious problems, alternative medicine offers hope where none existed before. Chronic Fatigue Syndrome is so ill-defined and nebulous that almost any remedy can be advertised as a sure-fire cure.

It seems to me that there are three possible conclusions to be drawn. 1) all alternative remedies are, by and large, a sham, and the success stories are not representative of the actual experiences of most users. 2) at least some alternative remedies work, even if we don’t understand how or why just yet, and 3) alternative remedies work because they are based on a holistic view of life that takes into account spiritual and psychological dimensions that western science ignores.

After experimenting with a number of different alternative therapies, and reading as much as I could about the others, I’m not really very convinced about the effectiveness of the remedies themselves. However, some of the therapists are very nice people. They pay attention when you tell them your problems. They express concern and compassion to you, and they might even touch you with their hands. Most people respond to a kindly word or touch. Most people feel better after a session with a masseuse or reiki practitioner because, hey, it might be the only kindness they’ve experienced that week in their lives.

But the truth is that most traditional medical remedies are tested fairly thoroughly by the scientific community and most of the methods they use are sound. Does a new drug cure certain types of cancer? Get a group of 500 patients and give it to half of them and give a placebo to the other half. After five years, is there a difference? Sure drug companies try to cheat, and sure doctors over-prescribe and do too much surgery. The difference is that the medical community, by and large, believes in open, systematic testing and authentication of therapeutic drugs and practices. Any two-bit medical student can get approval to challenge any long-held scientific assumption, as long as he can marshal some evidence in support of his position.

There have been very few of these types of rigorous studies performed on alternative remedies. For one thing, most practitioners seems to instinctively shy away from any kind of systematic testing of their remedies. Chiropractors in particular seem shifty and evasive about what the term “subluxation” means, and how it is detected on an x-ray. Investigative news programs love going “undercover” to expose inconsistencies in the way they diagnose ailments. While it is true that some of these investigative programs—20/20 comes to mind—are sensationalistic and manipulative, the chiropractors don’t make much of a case for themselves.

Just how many alternative remedies are there?

Aromatherapy
Reiki
Cranial Sacral Therapy
Touch Therapy
Energy Balancing
Acupuncture
Needle-less acupuncture (acupuncture lite?)
Reflexology
Homeopathy
Chiropractic
Ear candling
Massage
Tai Chen
Shiatsu Massage
Iridology
Colon Therapy

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Bloodletting

If you were really sick, do you think it would help if someone cut open one of your veins and drained about a quart of blood out of you?

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This was the preferred remedy of the medical establishment for at least 300 years. According to my history books, even the ancient Greeks may have practised it. They thought that sickness was caused by some kind of poison that got into your blood. The solution was to drain some of the blood out, so that new poison-free blood could take its place and dilute the effects of the poisons.

Now, you may wonder, how could so many people have been so stupid for so long? This remedy persisted well into the 19th century, in spite of absolutely no scientific proof that worked.

Now, I didn’t say there was no “proof” of any kind, that it worked. They did have proof. And it makes for an interesting object lesson in the meaning of “proof”.

This was the proof. Let’s say fifty people got seriously sick, from some kind of virus. Doctor Bloodpan comes to visit his fifty patients, one by one. If it’s a serious virus, given the circumstances of life in the 18th century, it wasn’t unlikely that more than a few of these fifty were going to die. And people knew that. They were petrified of all diseases in a way that people nowadays are petrified of AIDS.

So Doctor Bloodpan goes around to all his patients and drains a quart of blood from each and tells the family that it’s very serious and they must all pray. The family knows that a miracle is about as likely as a cure, so they do, fervently.

Well, Doctor Bloodpan is an incompetent idiot, so half his patients die. Does he go around announcing to all his patients that he is an incompetent idiot? No, of course not. He goes around and announces that he is a brilliant success: he has saved 25 lives! God be praised! And so he is.

Now, some skeptic comes along and says, “hey, what kind of idiot is this Doctor Bloodpan? If he would have just left most of these people alone, at least forty would have lived instead of just twenty-five.” And the families of the survivors go, “What, are you nuts? Doctor Bloodpan is a genius! He saved my husband!” And the families of the dead go, “Well, life is tough.”

Do you think it would be hard, under the circumstances, to convince people that Dr. Bloodpan is a hero? I don’t think so. Human nature is funny. When someone dies, we instinctively think we might have been responsible. We don’t often want to even raise the question, let alone make a public issue out of it. Would George Twentykids have lived if Dr. Bloodpan hadn’t drained the life out of him? Mrs. Twentykids, who screamed at him and called him a worthless fool on the very day he became ill, says, “oh no. It was God’s will.”

We think we’re so much smarter today. Well, consider this:

Many people, even today, are reluctant to call a doctor, probably for good reason. So when a person gets a virus, he waits and waits before seeking help. Inside his body, the virus is strongest in the first few days. Soon, his body’s built-in defenses take over and anti-bodies form, attacking the virus. This is about the time the person feels worst, so he makes an appointment to see the doctor. The appointment is in a day or two. By the time he goes to the doctor, he is already getting better. Does the doctor say, “Hey, you’re already getting better. Go home and have a nice nap.”? Oh no. The doctor, thinking back fondly upon that excursion to the Bahamas paid for by some big pharmaceutical company, happily prescribes some drugs. The patient takes the drugs but his anti-bodies have already pretty well defeated the virus. A few days later, he feels great. He says, “boy, those drugs work fast!”.

I have a feeling that a few hundred years from now, we will look upon surgery and drugs the way we look upon blood-letting today. As some absurd relic of superstition and ignorance.

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Health for Profit

Imagine your doctor telling you this:

Well, Bill, you have a very serious illness. In fact, if we don’t do something about it, you’re going to die. Fortunately, we have a cure. It costs $1 million. Do you have it? No? Oh, that’s too bad. Well, it’s been nice knowing you. Please give my best to your family.

Unimaginable, right? No doctor would ever say that. Never. What the doctor would say would be more like, “Well, Bill, we better make an appointment with our team of surgeons, anesthesiologists, oncologists, anthologists, and scientologists, and get you into surgery as quickly as possible so we can save your life.” Yeah, that’s more like it. The doctor cares about you. He is working hard to save your life. Nobody is going to let you die. Then all those doctors and hospitals would just send their bills to your insurance company.

In Canada, they would send their bills to the provincial agency in charge of health care (OHIP, where I live). There would be no need to check with them before hand: other than some cosmetic surgeries and exotic experimental treatments, pretty well everything is pre-approved. OHIP would then pay the bill. Done.

In the U.S., however, they would have to negotiate with your HMO or your insurance company and arrive at an agreed upon treatment plan. The doctor gets paid for doing surgery, not for keeping you healthy. He wants to do as much surgery as possible so he can retire early. But the insurance company or HMO wants to keep their money so they can pay it to shareholders and reward their top executives with mind-boggling salaries, private jets and country club memberships, and numerous vacations. They will do everything they can to keep from having to pay for your surgery. “Well, it’s not as if Bill is really all that well-liked anyway…”

Christian doctors, who hold an incredibly high regard for human life of course, charge only a modest amount, even if they know they could get a lot more. Ha ha.

The cost of medical treatment is a reflection of a number of factors, including scarcity and necessity. The U.S. has opted for a free enterprise model. Supposedly, all those doctors and hospitals will keep their costs real, real low, because they have to compete with each other for patients. So hospitals advertise the odd special: “New stem-cell leukemia treatment– was $350,000, but marked down, this weekend only, to $285,000. Folks, these are close-out prices!”

A kidney transplant can be a regular bargain at $120,000, if there are no complications. And that doesn’t include all the drugs you need afterwards.

Treating someone who’s been in a serious accident can cost $80,000! Just for a few hours in OR! That sounds a bit pricey for me. Couldn’t I try the emergency room at St. Mary’s? I hear they give coupons.

Well, where does the $350,000 come from? What exactly do you get for $80,000? Who gets most of the $120,000?

Well, look at a hospital. It’s got offices, computers, janitors, cooks, nurses, receptionists, presidents, vice-presidents, administrators, human resources staff, training staff, support personnel, vision statements, and so on. Some of the money goes to doctors, of course, and they’re probably over-paid (compared to teachers, at least), but they don’t get anywhere near the $350,000 total. I’ve seen some medical catalogues: hospitals pay big bucks for equipment that looks like it ought to be a lot cheaper. A little plastic tube costs $14.00. It looks like you could get it free at Wendy’s with a Kid’s Meal Cheeseburger.

Well, the reason these medical tools are so expensive is volume. They don’t make enough of them. I think everybody should own their own surgery kit. If they sold enough of them, the price would really come down.

Then we could just rent a surgery room somewhere, hire a doctor for, say, $250.00 an hour, and do the operation there. That would be true free enterprise. And why should only doctors have the right to do surgery? What if you knew somebody who was really good at it? I’ll bet the competition would really reduce the costs.

I’ll bet you could do the kidney transplant for less than $3,000. Instead of nurses, you could have your aunt or grandmother come in and tidy up, change the sheets, hand the instruments to the doctor, and count sponges. Instead of filling out ten zillion forms and arguing with your HMO, you could just give the doctor your car, or a year of yardwork, or your stereo.

A big, big problem is that about half of all the medical treatment in North America goes to terminally ill elderly patients. An 86-year-old guy with bad kidneys gets some heart pain, so we zap him into surgery and perform a triple by-pass. Because he’s old and weak, he’ll take about three months of constant care to recover. A week after he starts walking again, they’ll find cancer or something, and do some more surgery. There goes the family inheritance. So this guy worked hard for fifty years, got married, had kids, contributed to his employee pension plan, bought insurance, bought a house as an investment, scrimped and saved and invested and wasted not… only to get sucked dry by doctors in the last six months of his life. It’s like some kind of horrible, dirty trick they play on all of us. You think you’re getting ahead, but THEY, whoever they are, the holders of wealth in our society, get it all back from you in the end. Your children and your children’s children have to start all over from scratch. That sucks.