[Never admit that you are wrong]
Medicine has always occupied an often uncomfortable space between science and belief. I remember when I started medical school the Dean of the medical school welcomed us to the main lecture hall. He told us how wonderful it was that we had chosen to become doctors, and waffled on for a bit about how we were the chosen few. He finished his speech with these words, which etched themselves into my brain… ‘Welcome to the brotherhood.’
Of course the parallels between medicine and religion have always been obvious to anyone who has eyes to see. The patient consultation as confessional. The use of long latin words that the patient cannot understand. The rituals and incantations of medicine have clear parallels with religion. Or would that be the other way round. You could go on and on.
It is easy to understand why many aspects of medicine and religion mirror each other. Particularly if we look at one very important aspect of religion. Namely, protection against terrible things happening to you. Humans, once they became aware of their mortality, very rapidly felt the need for protection against an unpredictable and dangerous world. Earthquakes, storms, crop failures, plagues, early death… that type of thing.
Very early on, religious leaders realised the power and status you could command if you claimed to be able to understand why such terrible things happened. And, more importantly, how to stop them. Build a big temple, pray to a god, don’t shave your hair, sacrifice a pig, don’t eat pigs…. give the priests lots of money, and suchlike. The people, in turn, were extremely eager to do these ‘right’ things in order to feel a sense of protection, a removal of fear.
Of course, none of this actually stopped anything. But when terrible things still occurred it was because you (you sinner) didn’t pray in the right way, or someone else (a heretic) was deliberately praying the wrong way and causing bad things to happen. ‘Find the heretic in our midst and burn them.’ Or whatever. A good idea not to have ginger hair or a club foot at such times.
Over time, a million and one reasons were developed by clever priests to explain why, despite all the incantations, gifts, temples built, and sacrifices, bad things were not prevented. However, there was one reason that could never be countenanced. Namely that the priests were completely wrong, and had no idea what they were talking about. For, if the priests were wrong then…well then, terrible things just happened and there was nothing you could do to stop them.
How frightening is that. Thus, it was not just were the priests desperate to keep their power that kept their religion going, the people were equally desperate to believe that the priests knew what they were doing. It could be described as a conspiracy of the willing. ‘I will protect you. Yes, you will protect me.’
It was usually only when plagues and earthquakes and lack of rain and suchlike went on for a prolonged period of time that the people rose up against the priesthood and bashed their skulls in. Usually to be replaced by the ‘new model priesthood’, with another bunch of newly discovered incantations. ‘The absolutely new true truth is revealed,’ rpt.
Then, luckily, along came science and we started to learn what caused bad things to happen in the first place. Earthquakes weren’t due to the displeasure of Gods. Infections were caused by viruses and bacteria and suchlike. More and more that used to be unknown, and terrifying, became explained and, at least in some cases, controlled.
As science advanced, and became the best way to explain the physical world medicine, which used to be a branch of the priesthood, moved towards becoming more scientific. However, one of the primary social drivers behind medicine remained ‘this is how the world works, and we can protect you from it’.
Thus, although in many ways, medicine became more scientific, it maintained of the key social functions previously carried out by religion. ‘We can stop bad things happening to you. You do not need to be frightened. If you do as we say’
This form of mutual dependency works extremely well when the medical profession really does know how to stop things happening, and the medical leaders know exactly what they are doing. However, there is a heavy price to be paid for establishing yourself in the position of ‘certainty’. A position of belief requirement.
Primarily, it becomes extremely difficult for you, or the rest of the brotherhood, to admit that you don’t know something? Or that things you have been telling people, or doing, are in fact useless or wrong. Because if you start doing that, you fear you may lose your hard won authority, control and respect. Equally, if patients no longer believe, or trust in you, or your advice, what then? Fear stalks the land. Metaphorical skull crushing looms.
This is why, if you are a patient who feels that your treatment has not worked as you were told it would, or should, you will not find an eager audience for your complaints within the medical profession. Equally if you question or refuse the sacrament, sorry treatment, your doctor is likely to become very angry with you.
Additionally, if a doctor cannot discover what is causing your symptoms, or they have no tests to diagnose you, you are likely to be told that there is nothing actually wrong with you. The medical profession cannot easily admit to ignorance. In such situations, the only explanation that can be countenanced is that ‘you are making it up.’ Unexplained symptoms become ‘somatisation’. Side effects from drugs, such as statins, are due to ‘nocebo’ effects.
A million reasons will be found as to why the treatment has not worked in your case. Or why you got worse. The only explanation that cannot be allowed is that the doctors are completely wrong, and do not know what they are talking about.
If you find a whole group of patients who feel that their condition is not being treated well, and you band together to get the medical profession to think again, you will run up against a brick wall. You will simply be written off as cranks, and dismissed. The priesthood does not take kindly to being exposed as wrong.
See under, treating thyroid patients like children.
Dr. Malcolm Kendrick 
Malcolm,
Now you ‘hitting the nails head’ to my opinion!
I have an old friend whom I talked out of taking his statins a few years ago and but now met his doctor who again convinced him to ‘believe’ in a new ‘statin medicine’ which would improve his artery walls. I just wonder what kind of holy water that medicine contains.
Thank you again, Dr Kendrick.
I am one of those patients who was told you just need to take this little pill for life and everything will then be fine, but everything was not fine.
So I had to go on to the internet and research and read books and talk to others suffering from the same condition. I now perceive the evolving self-treatment of my condition as a bit of an art with some faith thrown in.
As I progress, I have to learn to hear what my body is saying to me and decide how to proceed based on having faith in certain people who have written about the subject or have personal experience.
Shame the science didn’t work for me – life would have been so much easier!
Thanks, Dr Kendrick – an excellent, deeply perceptive, and very stimulating article. Any time you want a rest from medicine, you deserve a chair of sociology or anthropology! I’m particularly impressed by the way you diagnosed the system in operation: mutual dependence between doctors and patients, each needing the other for not entirely logical reasons. I’d like to draw your attention to a remark of the philosopher Nietzsche:
“How much truth can a spirit endure; how much truth can it dare? This became for me more and more the actual test of value. Error (the belief in the ideal) is not blindness; error is cowardice. Every conquest, every step forward in knowledge is the outcome of courage, of hardness towards one’s self; of cleanliness towards one’s self. I do not refute ideals; I merely put on gloves in their presence. Nitimur in vetitum: under this banner my philosophy will one day be victorious; for that which has hitherto been most strictly forbidden is without exception the Truth”. (“Ecce Homo”)
I kind of like Nietzsche, but he always seemed a bit too close to bonkers for me. I am more of a Montaigne man. Here is one of my favorites. ‘I prefer the company of peasants because they have not been educated sufficiently to reason incorrectly.’ Michel de Montaigne. [Genius]
Montaigne is also one of my old favourites – indeed an early probing mind!
Dear Dr. Kendrick, “I prefer the company of peasants because they have not been educated sufficiently to reason incorrectly”. Now that is one of the best descriptions of the so called profession of Endocrinology that I have come across. PR
Brilliant. Then I count myself exceedingly proud to be a peasant.
My Dad always used to say an Expert is someone who learns more and more about less and less until he/she knows everything about nothng at alll…..
The end of Montaigne’s life was an irony and tragedy. He lost the very thing he loved more than this other senses, the ability to communicate verbally. He was an avid story teller, which is why I like him also. His father wanted him to understand the common man which no doubt greatly influenced his future essays. I don’t have a favorite philosopher, for they all have something to offer as individuals. But Montaigne, although a Roman Catholic, did not believe in religious fanaticism. That is what I liked about him. I don’t either.
I shall never forget an undergraduate class in Philosophy I took at a Catholic University (I had attended Catholic schools all my life from elementary to graduate school) where the comely priest tried to teach us to think for ourselves. I recall that he asked us to compare and contrast Communism with Catholic faith. You would be surprised at the number of people (staunch Catholics) who almost branded the poor man a heretic by walking out of the room and reporting him. The assignment however scared me at first as I was raised to believe that communism equated with Godlessness. However, as I began to ponder the assignment I realized there were many similarities. The nuns and priests went into convents and rectories, they took vows of chastity (can’t figure that one out) for life. They were trained by the Catholic church, given meager stipends, room and board and free uniforms. We came to believe that they could live this way because they were more committed to the service of others than to free enterprise. They were lead to succumb to all the authority of this guy who was the pope and that he was, in fact, infallible. That was one I could never accept even as a child. Today it is utterly stupid to me, but this system actually worked quite well until we began to see a lot of treachery within the Vatican walls. Before that, Vatican II had a huge impact on the way Catholics worshiped. We finally knew what the priest was saying at mass since it was not in Latin anymore. This pope guy and many before and after him were no more infallible than my mailman. As some of the students began to march out of the room calling this sweet man names, I will never forget the sadness in his face when he said “You do me wrong…I am not saying that communism and Catholicism are the same thing!” The look on his face was heart wrenching. I wanted to cry for him. But I did the assignment and it was actually fun and quite interesting. He was just trying to have us look at our institutions from a different standpoint. It did not go over well for him. I got an A. And the pope is still not infallible…he is just a kindly, fatherly, benevolent leader we love and admire. It is not that complicated.
Personally i think this is a very biased view of ‘religion’ and not at all commensurate with much more than a narrow narrative and uncharitable understanding.
Great article! Interesting time coming for MDs as much of the public are increasingly distrusting them on matters around diet, statins, blood pressure tabs, SSRIs etc etc. And there is a small growing band of enlightened MDs in their midst who ARE getting there! I think it all started with the expose on statins (take a bow!), the flawed theories of CHD, and diet. And now we know it’s all driven patents and profits. In South Africa, poor old Prof Tim Noakes will be tried by the church in a few weeks, for advocating a sensible diet!! Tipping point imminent.
Yes indeed! He is being sacrificed to the holy cow of grossly flawed nutritonal advice. There is a petition to support him, Unfortunately I am on the wrong computer to give the URL
Here’s the link – https://secure.avaaz.org/en/petition/Health_Professions_Council_of_South_Africa_Support_Prof_Tim_Noakes_in_his_quest_to_improve_eating_guidelines/?tTpEcjb
I have signed the petition.
Please do the same!
Malcolm,
This post is spot on!
I think your model extends way beyond medicine.
Thus we are told that we must sacrifice our efficient but sinful coal fired power stations to ‘save the planet’ – based on the most flimsy of evidence. Those who disagree are called deniers. Every time there is the slightest weather blip, pundits start intoning that this pattern of weather has the fingerprints of global warming! Weather blips that suggest the opposite trend – such as the expansion of ice in the Antarctic – are quietly ignored if possible, but when an ecology ship got stuck in the extra Antarctic ice recently, there were feeble attempts to blame that too on global warming!
The distinguished physicist, Freeman Dyson recently gave an interview in which he expressed serious doubt about global warming.
http://www.npr.org/2015/05/02/403530867/a-veteran-scientist-dreams-boldly-of-earth-and-sky
Look at the comments, some are incredibly disrespectful of this giant of physics:
“Why are you giving this doddering dinasaur free advertising for his upcoming book?”
High quality priests are also supposed to have a go at explaining everything. We are also fed a wondrous tale about the origin of the universe, and people claim to know what happened 10^-13 of a second after it all started! Those astronomers that doubt the modern interpretation of the red shift as distance (thus threatening to bring the whole edifice down), are also treated with as much hatred as is legally possible (the professional astronomer, Halton Arp was refused access to several large telescopes, and found it difficult to publish his results).
I now stop believing in any aspect of science whenever I discover that formerly respected scientists have been sent to the naughty step in this way!
I always find it difficult when contributors to this blog introduce the topic of global warming. However, I believe in all areas of uncertainty we must do our own research and form our own conclusions based on the best evidence we can find. I am currently reading up on carbon sequestration, as are many in California, where knowledge used correctly may be vital right now after four years of serious drought.
Back to the topic in hand, Great summary. Thank you,
Celia. I think there is a reason why contributors introduce the topic of global warming. I steer clear of the area (in my writing). I will only say that I find the techniques used by the Global warming advocates towards those who question them, to have a certain familiarity to me. Whenever I hear someone say, for example, ‘the science is now settled’ of words that effect, it creates a certain effect on me. Which would be the exact opposite of being convinced they are right.
I didn’t introduce this topic lightly – it is remarkably analogous to the stories you can read in Doctoring Data. If you are involved in this subject, I would suggest you try reading a sceptical book or two, or just ask your tutors why the ice in the Arctic is worthy of note, but the ice in the Antarctic is ignored (I am sure they will have a complicated explanation!).
Also ask about the ‘pause’. There has been no statistically significant global warming increase for about 18 years, whereas the predictions in the 1990’s were of a continued temperature increase for as long as we sinfully burned fossil fuels for energy. Don’t even think the flattening of the temperature curve has anything to do with the efforts of the green movement, because Greenpeace, no less, reports that China is opening an incredible new coal fired power station every week!
I got interested in this story after learning that the emails between climate scientists had been hacked and stored by WikiLeaks for all to read.
Imagine what it must like for a nurse or dietician to be told that saturated fat is good for you – denial is the obvious emotional response, but hopefully the truth comes out in the end – I think the truth about global warming mistake will produce the same denial, but the truth will come out eventually.
I wish the green movement would return to the REAL green issues – rainforest destruction, nuclear weapons, antibiotic resistance, and over population.
This is really what I came here to say but put far more eloquently than any argument I can make.
Science is a ideology, a construct which is only believed in because it answers most of our questions, explains most of our experiences. At the cutting edge of science problems can be seen; global warming, reconciling quantum and Newtonian theories, consciousness to name just three.
Non scientists are often surprised to discover that a significant number of scientists also have a religious/spiritual bent of some kind. This is because we know that science does not have all the answers not necessarily because we know that God exists.
Religion, science and medicine are different houses of cards each answering a need.
Excellent article by the way. Thanks.
Correction: People claim to know what was happening 10^-33 seconds after the big bang (the time when the inflationary energy was supposed to be converted into heat!) – my previous time was 20 order of magnitude too large 🙂
David, if you made it three weeks they’d still be no nearer knowing.
As a geologist I find it interesting that many laypeople don’t try to find some perspective in the matter of climate change – what used to be referred to quite firmly as ‘global warming’.
Of note is the fact that we are in considered to be in an ‘interglacial’ period i.e. between glaciations, and that the planet has not been this cold since the last set of glaciations 300 million years ago. In between the planet has been largely ice free with sub-tropical polar regions on occasion.
Like it or not the current low temperature Earth is the anomaly, not an Earth with temperatures 5 to 10 degrees higher.
We, as a species, may have some difficulties with this, but this is our problem because we have out-bred the available resources, or aspire to in the case of developing countries.
The planet will survive and there is nothing that humans can do, short of decimating the population, to prevent a warming back to ‘the norm’.
Spot on again. I spent years fighting a medical negligence case. No one was ever wrong. It was appalling. Reading your doctoring data prompted me to read a book that you mentioned. Mistakes were made (but not by Me) We all dodge responsibility. I worked in a doctors surgery for years. . Seen it All!! Even the attempted break dancing 🎶 at Xmas 😂 . Another good blog
Another good title, covering similar themes and written by a neuroscientist, is A Mind of Its Own: How Your Brain Distorts and Deceives, by Cordelia Fine. It’s very funny, informative and extremely well-researched.
Fantastic. Another analogy would be the Magic Circle. Once inside the greatest betrayal is to reveal how a trick is done. Magister Kendrick – beware!!!
Jerome. I am aware of what to beware of. I know they are circling, and I know they want to bash my skull in (metaphorically). At some point they probably will. Hey ho.
Brave man. Long may you be so.
That’s why you have so many admirers. La lotta continua
Sparta! When’s brunch?
Jerome,
Here is one of your comments that I thought was particularly insightful:
“What it does highlight, it seems to me, is that evidence based medicine has reached a point similar to what was happening in banking before the crash, which was relying on what turned out to be toxic debt packages tied up with complex mathematics. They bought the system down because certainly no ordinary investor and very few of those in the industry could actually understand them, let alone query them. And of course their one comprehensible message was what everyone wanted to hear.
I think it is fair to say that few doctors would feel competent to critique most meta-analyses let alone spot what CTT was doing with the data. What else is going on in those data bundles that the rest of the profession rely on to make prescribing decisions and who is responsible for verifying them?”
You should extend that into a full blog item because it says a lot about what is wrong with science nowadays.
Thanks for the comment and the idea is certainly something I’ve considered. I did have an exchange with one researcher who does understand meta analyses who tried to explain Baysian probability to me ( if you don’t know about it I won’t even try) but although I sort of get it I’m not at all confident I could explain it to anyone else.
However another area where meta-analysis have been used in an outrageously biased way is to attack the carefully done RCT showing benefit of B vitamins to slowly: the kind of brain shrinkage linked with Alzheimer’s. That I can explain and will be covering soon
Go for it. Baysian statistical analysis is a simple concept, but as usual the maths are a bugger. Essentially you sort of guess what the probability of something is before you start, then with each result this alters the probability. As you get more and more results the range of probabilities narrows down. It is said that doctors use Baysian reasoning every day. Patient comes through the door clutching their chest and panting hard. Probability is that they might have had a heart attack. Your first question? ‘Do you have chest pain?’ Patient ‘No, I’ve been running to get here on time, and I am trying to switch my phone off.’ At which point the probability they are having a heart attack reduces from about 90% to 0%. Next question. So, what’s the problem today? Start again.
My feeling is that elaborate maths is usually based on assumptions that nobody reads – such as that all the relevant distributions are Gaussian. That is part of the problem.
Then there is the fact that relying on meta-analysis lets one analyse (in principle at least) for smaller effects – but tiny gains often aren’t worth bothering about.
Meta-analyses focus attention away from the individual studies and their possible problems.
Finally of course, meta-analyses provide incredible scope for fudging, such as omitting a study because its results “Weren’t very promising”!
Baysian statistics sounds great until you realise that you can get any answer you want by adjusting the prior probability!
Please, please can I register with your medical practice if I live in Manchester? I just want a REAL doctor who will support me as I take the opposite advice given by the NHS to treat my rapidly disappearing IDT2 diabetes. Is that too much to ask?
Oh what a beautiful symphony of words! You had me in stitches… If only the medical profession could see the light. My saying: Religion was invented by Priests, for Priests.
I love your mind Doctor…
Keep it up, we might still get people to think…
I sent my Doctor your last Blog. Like water off the proverbial ducks back…
Cheers
Jon
Excellent stuff Malcolm. A wonderful analogy.
Amen! 😉
You are so right! I have long believed this and will shortly be encountering my own brick wall very soon!!
If you bash them long enough, and hard enough, the brick walls do fall. You need to be prepared (and be willing to stay the course), for a very long period of bashing. Especially when they start bashing back.
Oh that I am…ready! My four week wait for a doctors appointment has given me the time to prepare to give a good bashing! Thank you for your words!
Beautifully put, however, I think you have Inadvertently described how almost everything works. From governments to gas fitters.
A big AMEN to that Flyinthesky!!!
Yes, it’s just control. Keep the majority down and we will do well for ourselves. However, whose fault is it? They can’t sell us crap, if we won’t buy it! Trouble is most people won’t think for themselves, they’d rather just watch East Enders.
Brilliant analysis as always, Dr Kendrick! I visit my local medical religious centre as seldom as possible, usually only when called for a diabetic check up. Every time I go I am advised, strongly, to take statins and BP lowering drugs, for which the prescribing figures have recently been altered to bring more patients into the catchment areas. I have kept my blood sugar levels in the non-diabetic range by not following the religious doctrine ever since going LCHF. I wish you could reach more people to prevent so much suffering presently endured by unwitting patients doing what they are told by the medical religion.
I’m doing my best. Perhaps I should throw myself under a lorry load of statins.
Oh please don’t, Dr Kendrick! Just keep writing your witty exposes! ( can’t make my iThing put an accent on the e!).
When the printing press was born priests were horrified because Bibles in the native languages of ordinary people could be printed relatively cheaply in great numbers. The ordinary people might start reading it and interpreting it in a way the priests disapproved of. Society would fall apart and the world as the priests knew it would end!
In modern times the same type of beliefs can be seen in another context. Some doctors tell patients (thyroid patients are frequent targets) that they must not use the internet because it is full of inaccurate health information. Or they must avoid thyroid forums because they are full of cranks, or the stuff written on them is b*****ks. It’s amazing how many times that B word gets bandied around by doctors in connection with the internet, T3 and NDT. Another ploy is to tell patients they must only get their information from a website that the doctor approves of.
Then, after patronising and belittling the patient and insulting their intelligence, the doctor uses Google to look up the patient’s symptoms themselves. I’ve seen this scenario mentioned multiple times on thyroid patient forums.
Yes, I sometimes despair of my colleagues. Mostly great guys, and girls, who truly want to help people, but they often very poor insight into some of their own underlying motivations.
I’d like to pose a question you couldn’t possibly answer, What percentage of your profession do you think you represent? My experience based answer would be vanishingly small.
Most start their career with the best intentions but in short order become native and in thrall of their peers.
The old saying rings true, power corrupts and absolute power, doctors have near absolute power, corrupts absolutely.
I met some 20 consultants on my journey only one of which was at all interested in my perspective the rest were transmit only.
I couldn’t possibly answer.
An ounce of pretension is worth a pound of manure, S Jones.
Love it 🙂 Thank you
I wrote a blog myself which drew comparisons between the faith of religion and the new faith of medicine. Being an atheist, one of our strongest arguments against religion is that science is verifiable through facts and testing. That when it is wrong, it will admit that it is wrong, that there is excitement and challenge from being wrong, since that allows progress. Instead, we’re wending our way back to “Diabetes must be a curse from god and eating a raw carrot at midnight will appease him/her”. At least my practise don’t give me much of a hard time, they just refuse to look at my diet. And tell me that statins are there to improve plaque stability, not to lower cholesterol at all. Of course, when they see how high my cholesterol is, then they tell me I need to be on statins. *sigh*
I wouldn’t necessarily confuse science with medicine, or vice-versa. In fact I often feel I shouldn’t confuse science with science.
How true. Just glancing at current biological literature you can see that scientists view everything through the lens of “evolution,” which they no longer consider a theory, but as “settled science.” It seems to be innate in human beings, to continually search for the one true explanation for all of life. I have seen many “truths” bit the dust during my lifetime – one example, remember Freud?
Once again, an insightful blog into the mysterious closed world I used to be a part of, until the endless pressures broke my spirit and I retired from general practice. I didn’t come from a family of doctors and found the language of medicine and the rituals hard to understand, and always felt on the periphery of the ‘brotherhood’. Having worked hard and sacrificing much to become ordained (there’s that religious language again) I enjoyed a successful career in the priesthood as a GP, that is until I realised that I was not practicing the art of medicine, but prescribing drugs and surgery to patients in strict adherence to the law demanded by our high priests from NICE, chapter and verse. It had become a dark art with these pontiffs colluding with Big Pharma and politicians. To speak out and question their authority was tantamount to excommunication. No longer do I practice their liturgy and instead have been enlightened and found kinship with the vast number of like-minded doctors, scientists and those who contribute to the entertaining comments on this and many other hugely appreciated and informative blogs. It is an interesting analogy between medicine and religion: the zealous belief in their own ‘faiths’ without any humility towards other views and opinions. Arrogance and conceit. I await the attentions of the Spanish Inquisition.
Dr. Kendrick somebody sent me this link and ask that I comment. It is nice to see someone “across the pond” have the exact same thoughts about our profession. Ten years ago I change of heart about being a neurosurgeon. I decided to be part of the solution and not the problem. I asked myself a question: What if everything you had been taught you realized was deeply flawed and incorrect? Would I continue to settle on familiar or look for the extraordinary truth? Then I changed. I made my philosophy match my new stable of thoughts. Our attitude and mindset allows us to envision, contemplate and interpret each new challenge and the action we can take. Leader’s use that vision to help others crosses the finish line together. Recognize the remarkable individuals around you who can help you envision a world far beyond yourself today. Vision is the art of seeing things invisible but that exist. Envision the invisible for your tribe today.it appears you have decided to the same. You seem to be one of those individuals and I applaud you sir.
May I recommend the work of Daniel Kahneman of Nobel Prize fame (http://www.nytimes.com/2011/11/27/books/review/thinking-fast-and-slow-by-daniel-kahneman-book-review.html?_r=0) to all here?
He provides an excellent explanation of the underlying mechanism driving the inherent gullibility of members of the human species. Including our own, of course.
Clear comparison of religious faith and medicine, beakdown of pharmas role in maintaining the faith would be useful.
Check out the quinolone toxicity movement which has reached USA news due to massive advocacy. This antibiotic class are responsible for mitochondrial damage and horrific multisystemic damage, sometimes irreversible.
Well said Dr.. MK.
The same is true in the war on drugs. We have been lied to, again and again.
There is a startling gap between what we are told and what is really going on. Drugs are not what we have been told they are; addiction is not what we may think it is; and the drug war has very different motives to the ones we have seen on our TVs.
The banning of drugs and the subsequent war on drugs has ruined peoples lives and done great damage to society as a whole. And it’s not just the addicts that suffer and die, there is an even greater carnage that results from the chronic waring between the gangs and cartels that fight for control of the illicit trade. Not to forget the innocents that get caught in the crossfire.
But even as great and respected doctors and professors find the real causes of addiction, their findings are ignored simply because there is too much vested interest, and the powers that be cannot be seen to be wrong. I discovered recently that (for example) when Mexico was told to follow the U.S. in its war on drugs, they objected. The U.S. subsequently black-mailed them with threats to block all imports of medicinal pain killers. Mexico was left with no choice.
Today in Ciudad Juarez, the bullets are sprayed across the city with the cheerful abandon of wedding guests tossing confetti.
I also recently discovered that the U.S. now imprisons more people for drug offences than Western European nations imprison for all crimes combined. No human society has ever before imprisoned this high a portion of its population. It is now so large that if all U.S. prisoners were detained in one place, they would rank as the 35th most populous state of the Union. The Justice Department estimates that a quarter of a million people are raped in these prisons every year. That’s the number of rape victims, not the number of rapes.
We really do live in a world that’s drowning in a sea of madness.
Of course if a theory doesn’t pan out as predicted a paradox or an anomaly can be invoked, the theory is not wrong- just needs a bit of work (massaging). In the case of religion, should a disaster or bad luck occur it’s the work of that well known paradox of religion; the devil, not the all encompassing compassionate entity.
Time to get The Citadel down from the bookshelf again…
[i]The Citadel is a novel by A. J. Cronin, first published in 1937, which was groundbreaking with its treatment of the contentious theme of medical ethics. It has been credited with laying the foundation in Great Britain for the introduction of the NHS a decade later.[1] In the United States, it won the National Book Award for 1937 novels, voted by members of the American Booksellers Association.[2]
For his fifth book, Dr. Cronin drew on his experiences practising medicine in the coal mining communities of the South Wales Valleys —as he had for The Stars Look Down two years earlier. Specifically, he had researched and reported on the correlation between coal dust inhalation and lung disease in the town of Tredegar. He had also worked as a doctor for the Tredegar Medical Aid Society at the Cottage Hospital, which served as the model for the National Health Service.
Cronin once stated in an interview, “I have written in The Citadel all I feel about the medical profession, its injustices, its hide-bound unscientific stubbornness, its humbug … The horrors and inequities detailed in the story I have personally witnessed. This is not an attack against individuals, but against a system.”[/i]
http://en.wikipedia.org/wiki/The_Citadel_%28novel%29
I should read it.
Polycyclic: three years on, thank you for recommending The Citadel. I have just finished reading it (found it last weekend on a shelf of secondhand books in a castle we were visiting). It’s a wonderful book and still surprisingly relevant.
I am definitely suffering from ICDITYDHI (I can’t diagnose it therefore you don’t have it) disease. Unfortunately there is no ‘specialist’ in this field. So I am UTCWAP……
I have long since concluded that ‘qualifications’ are merely ‘entrance exams’. If you pass these ‘qualifications’ based on my/our self-imposed/regulated opinions, you can join our club.
I have encountered so many ‘qualified’ people over the years who actually know diddly-squat, and have very often dished out downright dangerous advice, that I now prefer to give them an extremely wide berth and work things out for myself.
There are heaps and heaps of highly intelligent unqualified people out there who have more common sense in their little fingers than the whole of the ‘expert club’ put together (present company excepted) and they are the ones whose opinion I would rather consider.
Dear Dr Kendrick
Thank you my experience down to a T …
Mark
Dr Kendrick,
Another brilliant expose of the medical/pharmaceutical establishment Thank you!
You have outlined my reasons for using the term ‘allopathic medicine’ because, as you describe, it demonstrates the mindset that believes in drugs as the sole solution to any condition while ignoring the adage that we are what we eat.
Examples of this are deficiency conditions which seem to be considered only as acute clinical diseases; as binary conditions where one is deficient or not rather than as distributions which they are. Another example is ROS (reactive oxygen species) which the literature shows are involved in many pathological conditions yet a possible solution lies in natural anti-oxidants. How common is there a medical request for a test to check the total anti-oxidant capacity (TAC) of blood?
i am not against medical and surgical therapies as such. There are many well-tested and effective excellent therapies and procedures. Dr LeFanu’s book ‘The Rise and Fall of Modern Medicine’s brilliantly shows the benefits of early research (pre-1970s penicillin, cortisone, transplant etc.) but which following the involvement(take-over???) of Big Pharma in clinical research scientific integrity has gone by the board and has been replaced by money and ‘status’. Books, such as your own and those of Angell, Gotzsche, Smith, Goldacre, et al, and US fines on Big Pharma clearly demonstrate the corruption andack of integrity of the medical/pharmaceutical establishment. And what about the Polderman affair and the EMA guideline based on flawed (non-existent???) research and the fact that guidelines are written by unnamed ‘experts’ without reference lists?
With respect to ROS I learnt today that the EU has banned the use of a claim of “anti-oxidant” that natural products such as Vit C have. So much for ROS research! Is this because Big Pharma has nothing that may correct ROS?
Mike, it was not so long ago that people lived to ripe old ages without a bunch of pills on board. My father never so much as took an aspirin. The same went for my mother and her sisters. Those that took the most medicines are beyond repair. So WTH is going on? When my dad passed away from cancer, I was so surprised and tried everything to save him. He had one surgery and from there…his body went downhill. He was the healthiest older man I ever knew and his doctors marveled at his good health with no medications at all. He loved gardening. I just read a blog from Dr.Seneff talking about “Round Up” and how it should be banned. Round Up was one of the chemicals he used the most to get rid of weeds. His love was gardening and being outdoors. Now, I guess I understood what my own mother knew for years by instinct. She told him often to get rid of all those chemicals. There was a long wing on the house that was just for him. He stored gardening tools, and all those chemicals in that wing. He was constantly outside pruning and cultivating flowers. I am of the opinion now that the chemicals may have been his undoing. I never heard him complain of pain until he was diagnosed with cancer and he was gone in three months.
We can all go crazy pondering what is the right or wrong thing to do. The fact is…we just can’t be so obsessed that we stop enjoying life. But, I do in fact recall many older persons in my family who were sharp minded and lived to be in their nineties. I don’t see that anymore. I have seen more cancers and deaths from heart disease in younger and younger people. Something ain’t right. I really get tired of trying to figure it out sometimes. But, I have to know the truth, if there is one!
Once uponce a time humans were independent creatures. Self-sufficient, self-confident. They had ultimate control over their own lives. They learned at the feet of ancient tried and trusted wisdom.
If they believed in and worshipped God, it was out of respect and gratitude for his provisions and his love and wisdom, not out of fear or trembling.
But they were not satisfied with what they had and despite being told they would suffer, they went ahead and wanted Kings and Leaders. But Kings and Leaders become elevated and develop a desire to control. Religion forgot that respect and loyalty has to be earned rather than demanded, and also developed an elevated stature and desire to control.
This whole system is about control. We are greater/more intelligent/richer/qualified/educated than you, therefore we will control you. In our opinion, we know more about this subject than you. You are not allowed to have your own ideas/opinion/viewpoint, because, in our opinion, it is wrong. Get back into your corner you peasant……
A great and timely post for me. As many people here know, once you start questioning one thing, e.g. the medical system, you find yourself questioning everything. I’ve become particularly concerned with EMF/RF issues, and the manipulation of politics and the media. The problem is, that you end up sounding like some ‘nut-job’ conspiracy theorist. Then I think, just because it’s a conspiracy doesn’t mean it’s not true. According to the dictionary a conspiracy is: a secret plan by a group to do something unlawful or harmful. I guess the questions is, did they know that it was unlawful or harmful, or was it an accident. In my opinion, often someone does know, but is skilled at duping/manipulating others. Sigh, my brain is spinning. I need to get out more!
A brilliant summary, thank you.
And speaking as one of those ‘child’ thyroid patients, I should add that even when I have risked my life taking drugs I had to buy online, & categorically proved that what I needed all along was thyroid hormone, they still aren’t prepared to admit they were wrong. Where did human compassion go?
If you have a problem with Statins and your Doctor “says all tablets have side effects ” WHO DO YOU THEN GO TO, what do you do next. ????
Who cares what your GP/Consultant says, it’s your body, your health, take control back and research and learn for yourself. They are just people, no more intelligent than you and somehow they have got placed on a pedestal. Who cares what your cholesterol level is – it doesn’t matter.
Maybe some GP’s have it right – a friend’s father (in his 80’s) went to his GP this month with some symptom. His GP’s advice was ‘Go home, do not come back unless it is an absolute emergency. Stay well away from doctoring for as long as you can, just keep on doing what you have been doing!’
You teach him or her, Peter Cannon. Then, if you are mistreated, hit the road Jack. Find someone who is willing to work with you on a solution. Focus on the solution.
Re the similarities between the brave new world of modern medicine and the “science” of climate change. What annoys me is we don’t see (or have access to) the raw data in either case. The raw data is held and “adjusted” by either the pharma companies and their lackies in the case of drug data, or the boffins at the University of East Anglia et al in the case of climate data.
In the case of the most profitable drugs of all time, the raw data on statins is held by the CTT and access to the raw empirical data is denied. In the case of “climate change” data, access to the raw data is also denied. The University of East Anglia allow access to “adjusted” data only. I can “adjust” any data to back up any theory or “belief” I may want to promote.
Holding back raw, empirical data and simply publishing “adjusted” figures ain’t science.
If the raw data supports a thesis, logic would dictate that it it would be published in its entirety.
They don’t only adjust the data, they make some of it up (or rather use computers to guess the answer). This is because the “global temperature” is based on the average of an arbitrary set of temperature measuring stations, set up for meteorology. If a station becomes disused, they synthesise the data it would have produced by various computer algorithms. They basically have to do this, because the numerical value of the average is obviously dependant on the set of measurements available.
It is also worth noting that the whole temperature rise since say 1960 is less than 1 deg, and the measurements are made with thermometers that can’t resolve much finer than that!
I am frustrated by the modern attitude that data can be adjusted for any number of systematic errors, after which a supposedly valid signal can be extracted out of what looks like overwhelming noise. Also, rather like the statin saga, tiny signals can be inflated by extrapolating over a sufficiently long time scale, or in the case of statins extrapolated to compute the number of ‘lived saved’ over a population of 10 million people.
The root of the problem is that various science establishments – such as the UEA – get their money because of the climate scare – just as others get their money from Big Pharma. That doesn’t mean that climate scientists are told to lie, any more than proponents of drugs are told to lie (though perhaps there are exceptions), but career minded scientists discover that papers that agree with the consensus are easier to publish.
I’d like to see science and activism totally divorced – so you simply can’t be part of the scientific effort, and also appear on TV banging the drum for policy changes. If you do research on the therapeutic effects of statins (say), you would be allowed to write them up in the science literature, and talk about them at conferences, but you would not be permitted to campaign in the media without forfeiting your role as an impartial scientist. At the moment, the temptation to tweak your results (and for a lesson on how to do this, read Doctoring Data) to enhance your campaigning career, is overwhelming.
Thank you so much. You are a support system that allowes my feet to walk the earth again.
Dr. Kendric. I have a serious heart condition and belong to a facebook support group with 1,500 members. I am medically trained, spend a lot of time researching my condition and pass some of this information to the group. I occasionally question a diagnosis or treatment or lack of. When I do a get a lot of personal abuse. I have been expelled on one occasion for having dangerous views.
One post of mine this week produced much venom. I had suggested that long term use of PPIs could cause severe magnesium deficiency and that may be causing or contributing to the severity of heart failure. One woman said that as she was under the care of a specialist heart failure unit so it could not happen and that it was it was dangerous and irresponsible of me to suggest otherwise. Another woman left the group in protest calling me a disgusting person and likened me to the “criminal” Andrew Wakefield who’s ideas have led to the deaths of thousands of children!
I expect to be burnt at the digital stake in the near future!
Keep up the good work. When the flak is at its greatest, you know you are over the target. You are right about PPIs and magnesium by the way.
Stuart Firth,
I admire the courage of all members of the ‘medical church’ who dare to challenge the basic dogmas, like you and Malcolm. The risk of being officially excommunicated is here obvious and the cost is often high.
As you, I have got the most serious heart condition since 16 years now, with my ‘close to death’ experienced heart attack, and have during these years developed an almost complete distrust of medicine as a discipline of science. By going alternative medicine (magnesium supplement being a small part of that) I am now in a surprisingly good shape when taking the seriousness of my condition into consideration. Contrary to you I am, as a researcher of metallurgy, not a part of your “Brotherhood” and don’t really risk anything by being heretic. By embracing belief in the “Devil” – alternative medicine – I suspect that my health has been restored as far as this has been possible.
I think a present part of my alternative medicine approach is the now chopping of the firewood with fervour. I have been working a couple of month on the trunks now and have a few more days of work to finish.
Thanks for sharing 🙂
As neat a demonstration of the medical brain washing of the unfortunate population that I have seen. May be directing them to Dr K’s “DOCTORING DATA would help.
Excuse my ignorance. What are PPls?
They are Proton Pump Inhibitors. They are used to reduce stomach acid. There are many e.g. omeprazole, pantoprazole etc. They have brand names such as Losec. Some can be bought over the counter in the UK. I have seen an increasing number of people develop dangerously low sodium levels on them. They also lower magnesium levels and can block vitamin B12 uptake in the stomach. I think they are horribly over-prescribed. Mind you, I think that about almost every drug.
Re PPIs
I didn’t know about the low sodium levels.
Just a thought, but people with CF are often prescribed them. People with CF also excrete about 5X the normal amount of sodium in their sweat. Could be exacerbating things.
Possibly. But I have seen tens of patients with hyponatraemia with the only clear cause being PPIs, you don’t need to have CF. I check sodium levels on any confused elderly patient on PPIs now. I should start measuring magnesium.
Malcolm,
Also with magnesium I have capitulated in front of the overwhelming complexity involved in our physiology. Here as everywhere there seems to be a lot of controversy in medicine.
When you measure the magnesium in a blood sample – is that relevant to start with?
I am sure magnesium is hard to overprescribed. As a matter of my present overly cautiousness I now take a daily and significant amount of some kind of ‘natural’ magnesium. One third of us going LCHF, though, tends to get cramps, happened to me and taking the magnesium supplement for sure resolved the problem. Wouldn’t ever dream of consulting a ‘medicine man’ about such trivialities since I am quite sure he would not have shown any interested in the kind of ‘quackery’ I am doing to myself. I had that expressly blown straight in my face when I met my last (?) ‘famous’ cardiologist, now two years ago.
Since they are prescribed to reduce excess acid, it would be good if someone could find a way to titrate the dose so that it adjusted the pH into the desired range.
From what I have been able to find out, in the US the average intake of Mg is way below even its RDI. I do not know about UK but I do know that soils after centuries of cultivation can be Mg deficient, the result being the food grown can be deficient.
The following may be of interest:
http://pi-bill-articles.blogspot.ca/search/label/magnesium%20deficiency
http://pi-bill-articles.blogspot.ca/search/label/magnesium
Dr. Kendrick, loved your blog so much. Wrote a long response, then could not get into my account. Oh well. In the case of these PPI’s can a physician do injections of B12 directly into the stomach? I have heard of this practice as I had a good friend whose body could not absorb B-12. Her mother did as well. She and her mother both have to have B-12 injections directly into the stomach. Just wondering if you have heard of this practice and if it is indeed a common practice.
Never heard of it. You can just get IM injections, or spray it under your tongue. Injections into the stomach seem… to put it polititely. Nuts.
I seem to recall way back in about 1990ish, when Omeprazole could only be prescribed by a consultant physician, and came in a large plastic pot containing just 7 capsules….suggesting very tight control.
I have come across people taking them continuously for years, simply on a repeat prescription basis from GP.
What is CF?
When I was nursing, 30 odd years ago, by injections “in one’s stomach”, patients meant subcutaneous injections into beneath the loose abdominal skin.
It also probably doesn’t help that salt has been so demonised. So much so that some of my friends are terrified of the stuff, scanning all ingredients for sodium levels before letting anything pass their lips. I often innocently ask if they are as worried about the chloride levels?? You put me on to that little gem in a previous post.
Indeed. Na…Cl. Cl is good for you, but Na is bad. Trying to separate them out before eating salt might well be the most dangerous thing of all. I predict a few large explosions. Just as dangerous with KCl unfortunately. BTW a saline drip contains 9g of salt per litre. Do these doctors not know how dangerous salt is? Someone should tell them.
??Na bad? Explosive?
Fergus,
Here is a great article about salt that you might want to share with your friends:
http://www.scientificamerican.com/article/its-time-to-end-the-war-on-salt/
Thanks David, will do.
I am sure that the stress this family suffer because of their obsession with salt will cause them many more health problems in the future.
I am so grateful/excited that following a recent BBC Radio broadcast, I found your books. I no longer feel alone, or to put it another way ‘permanently wanting to slap everyone repeatedly with a wet Kipper!’
My new rheumatologist sacked me as a patient (following the retirement of my previous rheumatologist who I had gained support from for the last 19yrs) His reasons: His job is to manage patients on drugs, as, he said, You refuse to take any drugs, I see no reason why I or any other consultant in this department should continue to see you’
NHS care, it just gets worse. I happened to say to my husband a few weeks ago,
‘That mainstream medicine is just like religion in the Middle Ages, it’s all about control’
I just want to read your books aloud to friends, so that I can share your insight and Laugh Out Loud moments. Who knew I could laugh so much. Thank you
The complete idiocy of the situation is perfectly summarised with the saline drip and feeding patients’ food in hospital. A doctor will happily administer 9g of NaCL over a couple of hours directly into a patient’s vein. This simple action can very often SAVE a patient’s life (in the context of “extending”! 😉 ). But yet, the food menu the very same patient is presented with to pick something to eat from will have “salt reduced” items because of the “dangers” of salt. Go figure!
The thing I’ve never understood is that Doctors seem unaware of their own bias. In psychotherapy (well good psychotherapy at least) all training hammers the therapist to be aware of their own ‘junk’ they are bringing to the relationship – to be aware they have blind spots. Issues of transference and countertransference etc … and yet doctors seem to assume they are ‘rational’ and the patient is ‘irrational’.
As a female patient who is bright, will challenge, will turn up with peer reviewed articles from the Lancet and BMJ and will argue my corner, I have noticed a great shift in their attitude towards me. When I was a slim and pretty passive and compliant patient recently diagnosed with Graves disease (before I knew better!), they were kind, solicitious, knee patting, there, there, and passed the tissues.
When i became fat, nearly bald, had googly eyes, and was desperately sick on the ‘cure’ I got ‘come come, this is all very emotional’ as I was insisting the treatment hasn’t worked. My GP (against my – by then – very good endo’s repeated emphatic reports) tried to tell me I had ‘Bi Polar 2’ as my ‘blood results were fine’ and when I asked him and the practice manager ‘what clinical training he had to make that diagnosis’ or for that matter, what endocrinology training he’d had they were almost apoplectic with rage … (the answer was none by the way 🙂 )
I thought the point of science (so my PhD leukaemia researcher friend tells me) was to constantly question the hypothesis. And yet it’s more akin to them having a map of how they think the world is, they look out of the window and see a hill that isn’t on the map. Instead of saying, hmmmm maybe my map is wrong??? They say, get me a JCB, we need to move that hill!
I have never wanted a doctor to have all the answers, what I want is a doctor who will admit they don’t know, who is open minded, who is always questioning. Alas these doctors as you rightly point out are burnt at the stake as heretics …..
The essential response is 99% of doctors don’t impart their own considered wisdoms they retail someone else’s.
There’s a lot of truth in, if a doctor hasn’t read the medical literature he’s uninformed, if he has he’s misinformed. It isn’t about to change anytime soon either.
It’s the prime emotive that feeds the beast, fear and the more you threaten it the more it will try to frighten you.
Oh for an edit function, It’s quite easy to frighten people with a few long words, a few loaded charts and statistics, it’s much harder to become immune to it.
I try to choose my ‘Maverick’ doctors with care. You, of course, Dr Atkins (and now Phinney, Voleck, Westerman, Noakes – with a nod to the undertaker, Banting) on diet, Dr Brownstein on Iodine, Dr Carolyn Dean on Magnesium, Dr Bernstein on diabetes. You all share certain qualities – you have taken on medical establishment and ‘the status quo’ quite fearlessly – and possibly at great personal risk – and you are all talking complete common sense, well thought out, reasoned, rational and backed up by personal experience.
I was on PPIs for years, never really considered it a problem, until I embarked on the Atkins diet, and just as Dr Atkins predicted – GERD spontaneously disappeared, and quickly, probably in less than a week. The thing that bemuses me about my doctor (he is relatively young, kind, concerned, caring) – but never listens – ever! How will they ever learn from patient experiences when they are so dismissive? I suppose they never will. The scary thing is feeling like you are ‘going it alone’, but the good thing is re-gaining your health.
But when you get that feeling that your doctor has no idea what he’s talking about, with certain aspects of your health, how can you ever trust his opinion on anything?
There’s the problem right there: “how can you ever trust his opinion on anything?” Once a lie is retailed you unconsciously question every other possible truth. The principal theme of this blog is the statin question, personally I think that’s the tip of the iceberg but then I am a consummate conspiricist. I, it’s not an easy life, am inherently inclined to question everything, I can’t help it that’s me.
One of my life rules: Beware expert opinion as the principal beneficiary is often the expert.
One of my greatest issues with GPs is it isn’t a pick and choose you have to accept the plainly wrong with what’s right and because they can plausibly get you to accept the right you have to accept the wrong.
I’ve damaged my knee doctor, ok we’ll get to that, I notice from my records that we don’t have your cholesterol level on file and by the way you’re three months overdue for your smear test.
We might as well book you in for a, fasting, blood test, all the time you are having this consultation I will be evaluating as to whether you need ant Alzheimer’s assessment, no we don’t know what it is, what causes it or how to fix it but it is cash in the till.
You have to have the determination and research in hand to evaluate everything. The fact that we have to do this is a travesty in it’s self
Expert: x is an unknown quantity, ‘spurt’ is a drip under pressure. Heard this years ago seems even more relevant today somehow.
My problem is that once I stopped believing in the “experts” for one thing (current food guidelines in the US), then I was on a slippery slope where I stopped believing in “experts” for everything. I am a “adherer”, which means I adhere to eating, taking pills, etc., without fail. In other words, given the advice to eat a low fat diet, I did it with gusto — kept my fat less than 10% of my calories, ate very high carb, etc., and did this for years. Then one day I tried the Atkins diet (don’t remember why) and after several weeks of heck, woke up one day and felt fantastic. Not only that, but the constant, driving hunger I had was dramatically reduced. How could this be? Didn’t the experts tell me I needed a lot of grams of carbs per day just for my brain to run? Being an adherer, it took me years to finally convince myself that the experts were wrong in this area.
But once I did, then I had a hard time believing any experts. I no longer believe or know whether statins (or any other drug) is good, whether vaccines really work (I no longer get a flu shot, for instance, due to poor scientific studies in support of getting one), etc. I’ve even started believing in things like apple cider vinegar (my wife thinks it cures everything), extracts of berries to reduce or prevent colds, taking vitamin D, etc. None of this has support from mainstream “experts”.
These kinds of beliefs tend to ostracize you. When I go to work and eat my nearly all fat diet, people flip out and can’t believe I’m doing that (as they woof down their “low fat” but highly caloric bagels and the like). I tell them that everything they believe they know about diet (and exercise) is unsupported by scientific evidence, but they can’t believe it’s true. How could it be true, when all the “experts” believe the opposite?
I’m really glad Atkins is working for you, but many thyroid patients on a ketogenic diet get more hypothyroid not less, patients with NO thyroid really do need some carbs to feel well. Dr Chris Kresser has many articles and podcasts about this (he’s a good functional med doctor in the states) – I don’t eat a lot of carbs and the carbs I do eat are not dense, and I eat around 60g a day but my few forays into ketogenesis rendered me flat on my back in days. I think the thing is, whilst I agree that if you eat the food pyramid you’ll end up looking like a pyramid, and clearly sugar and not fat is the bad guy, we are all different, and there must be some room for trial and error and finding what works for each person as a whole. http://chriskresser.com/7-things-everyone-should-know-about-low-carb-diets/
I know just what you mean Bob. You end up not trusting anyone and your friends (especially if they worked in the medical profession) think you’re just plain barmy and/or irresponsible. I remember watching a TV programme a few years ago that ‘proved’ the Atkins Diet was not only no good, but dangerous too. Now even the media are reluctantly admitting that actually it’s probably ok. Once our eyes have been opened to the dishonesty and deceit we are fed by the media and the medical profession (not all obviously) we just have to – as the saying goes – plough a lonely furrow. Re the flu vaccine, I knew a dear old gent who did as he was told and went for his annual jab. He died two weeks later – of flu. Makes you think.
You can’t beat this for a study in Blame the Patient. 1min55secs is instructive. The Endocrinologist we love to hate declares this circa 1915 patient restored to health by thyroxine. Except that she wasn’t given thyroxine. She had been given five hormones inthe form of sheep thyroid gland – T1, T2, T3, thyroxine and Calcitonin. Still, why let the truth get in the way of a good story? http://vimeopro.com/thyroidvideos/american-thyroid-association-video-recordings/video/97982033
Lorrain,
Thank you again for linking a ‘great’ overview presentation on this subject.
To me this was a true ‘look behind the curtain’ where the ‘high priests’ dwell.
The main message I got from this self-confident guy was that “I know!”, “I am a man of science – medical science!”, “The patients should trust your verdict – don’t fear confrontation – you are the ‘master’ – the ‘medicine man’!” and “Don’t even listen to well read patients of any sort who continue to complain; they truly need psychiatric care, not any ‘quack alternatives’.”
This self assured attitude reminds me of my ‘last’ confrontation with my own ‘famous’ cardiologist as well as the subtitle of this blog.
[Never admit that you are wrong]
A big problem is that we hate uncertainty. Not knowing the outcome makes us more anxious then knowing the outcome even when the outcome is bad. I have had patients tell me they felt less anxious after receiving biopsy results that were positive for cancer then before the biopsy results were back.
So in the face of that fear of uncertainty people turn to those who declare they know. The relief of uncertainty is the driving force. That drives medicine and religion (not spirituality which is based more on ones experience of transcendence, but I don’t want to go off on tangents).
Even scientists are not immune from this fear of uncertainty. People of all sorts want to confirm hypotheses, even scientists. Keeping the mind constantly questioning is a rather demanding discipline, at least it is for me.
Yes, of course it can be demanding. However, it is far more demanding to try and ‘row back’ from certainty when new evidence emerges. I try to put everything into three places. Probable, possible, unlikely. Certainty requires faith/belief, and should not really impinge on scientific thinking.
The threat of death does tend to make most of us pretty irrational. Because I sit most of the day hunched over a desk, sometime I get sore ribs. I had a particularly bad case of it today and worried I was having some serious heart issue… It was on the wrong side of course.
Margar vorgolis (or however you spell it). Sometimes I wish I could swallow it down and announce that ‘I know what to do to live longer.’ But then I know that I don’t, really.
In defence of GPs, there is a lot of pressure from the government in the form of targets. “You appear to be well, we need to more more tests until we find something”
Also this certainty thing. Sometimes patients doen’t like to be told “I don’t know”. Doctors who are human, tune into this and oversubscribe.. So there are lots of different reasons why the whole thing is a bit of a mess.
I would be delighted by a doctor who said ‘I don’t know but let’s find out because I believe you’ … that’s all I ever wanted. The first one who interupted my desperate explanation to say ‘whoa, whoa, I believe you’ reduced me to noisy sobs of utter relief!
Very perspicacious article. On a good day I will have ceased >=2 people from their statins, a bad day 0 or 1. Also, I don’t believe in climate change. I try to model healthy psychology and living- not too sure I succeed. Getting the LCHF message to the 70% of punters it relates to has given my practice some impetus!
Simon,
I take it you are a GP.
I know someone who was given statins after a heart attack, and they seem to be causing her a great deal of pain. I know there is evidence that statins are mildly beneficial in such circumstances, so I wonder if you would positively advise anyone to take statins.
My feeling is that thee is no point in taking something that might extend your life a little bit, if it also spoils your life. I am sure chemotherapy is worse, but the idea is to take that for a short time and then be cured!
I wonder what the experts here think about this concept:
http://www.dailymail.co.uk/health/article-3077507/Everything-think-know-diets-wrong.html
The suggestion is that a lot of our health problems – including obesity and diabetes – are the result of the microbes in our gut – some people have a better set than others.
Another thought provoking article Dr Kendrick, thank you.
Your recent post about the poor treatment of hypothyroid sufferers inspired me to get some private lab work done. I have been symptomatic since my 2nd child was born. About once a year for the last 12 years I have dragged myself into the GP, only to be told ‘tiredness’ was only to be expected, maybe I was depressed, maybe I was stressed, maybe I was anything other than hypothyroid (All other symptoms such as the inability to be warm, a swollen tongue, hair falling out, eyebrows thinning, strange yellow pallor, deafness completely ignored). Every couple of years I’d get a blood test & the results would apparently be ‘normal’ apart from showing desperately low ferritin. This would always prompt the receptionist, for it would be the receptionist who’d give me the results, to suggest I take some iron. No suggestion of how much or for how long, just that I might like to take some. So, I paid for my own tests & the results came in yesterday. Sure enough my TSH is over the acceptable range, my FreeT4 is only just within range, ferritin is as ever crashing through the floor, as is B12 and so on. The lab kindly said I should be investigated for hypothyroidism & so I am due to see my GP tomorrow & try and get some treatment. I feel anxious about the appointment & am trying to think how to present my findings without being seen as ‘difficult’.
However, I also have a brother who is a GP and I know how heartily annoyed he gets by “Google GPs” who think they know everything. He is scared witless of being found negligent and sued & follows all of the BMA / NICE recommendations to the letter to cover his ar$e. I know what a long haul it was for him to qualify & I do understand how the rise of the ‘instant expert’ must be very irritating, when you spent 5 years at med school & did all those hideously anti-social hours & gruellingly long shifts as a junior house officer. I also know he is expected to see & diagnose a patient within a 7 minute time slot, which doesn’t really allow much time for a proper investigation of systems either.
So, I don’t blame the GPs, I blame the regulatory / governing bodies, I blame the increasing litigious culture and I blame big pharmaceutical companies who have more influence than they should with the regulatory bodies in medicine. No good ever comes of science being sponsored by those who seek commercial gain.
Well said, Nigella.
I think many GPs feel the safest course is to follow NICE guidelines even when they don’t agree with them. I felt that recently when my GP said I met the criteria for blood pressure medication and I responded by pointing out that the research showed that it didn’t do any good. I think my doctor was pleased that I refused the medication, but if I’d been less confident or less well informed I’d now be taking the stuff (and perhaps suffering the side effects).
I wanted my doctor’s opinion and I couldn’t get it. I got the ‘official’ response instead combined with a sort of nod and wink approval of my decision. That means doctors are sometimes knowingly harming patients but staying on the right side of NICE. Statins, of course, are a primary example. I think we should also acknowledge that many GPs aren’t prescribing statins in the numbers NICE recommend and are trying to do the right thing. I think we have a situation where GPs do much that is right, sometimes get it wrong and sometimes harm us because it’s safer for them. What an overly medicalised mess.
I don’t blame the 5 GPs who refused to treat me for the guidelines that they are given; what I blame them them for is the rude, arrogant, insulting way they spoke to me & the way they categorically refused to listen to my symptoms, feelings or experiences. That is just plain wrong; whatever the damn ‘guidelines’ I deserve to be treated like a human being.
Here, here Carolyn, sadly my experience of many ‘medical staff’ recently due to obvious thyroid symptoms
Tricia 😢
Antipsychotics create psychotics as much as law creates sinners.
“For, if the priests were wrong then…”
This reminds me of the story of the Jewish man talking to his Rabbi. He asked why it was that, even as a deeply religious man, if he dropped his toast it always landed butter side down. After a moments thought the Rabbi answered “You must be putting the butter on the wrong side of the toast!”
Great article – as always.
Ray
Just this morning, on the ITV news, was a segment on “over-medication” and how, perhaps, lifestyle changes/adjustments might possibly be all that is required in some cases – I wonder what the backlash will be from the medical fraternity???
In Pulse Online today : GPs to develop list of unnecessary interventions under scheme to tackle overtreatment.
http://www.pulsetoday.co.uk/clinical/prescribing/gps-to-develop-list-of-unnecessary-interventions-under-scheme-to-tackle-overtreatment/20009953.article
A quote from the article :
“Led by Dr Aseem Malhotra, from the Academy of Medical Royal Colleges, the ‘Choosing Wisely’ campaign will encourage GPs to discuss potential harms of treatments with patients, as well encouraging patients to ask if tests are really needed.
By autumn, each of the colleges will submit a list of the top five tests or procedures that are of ‘questionable value’ and will advise doctors on stopping using them.”
I’m betting that the FT3 test will be one of the ones that gets the chop. After all, the patients are already being told that FT3 levels are unimportant, and taking T3 is dangerous. So if this is the attitude, why test for it? After all, there is never a need to check for secondary or tertiary hypothyroidism – it is so rare! *Sarcasm*
Aseem is a good guy. If he gets it wrong, he will listen.
good to hear he’s a good bloke but I thought instantly also that it’d be the T3 test and also T3 drugs! I also shouldn’t wonder if the hard won iron, B12, sex hormone tests that patients manage to wangle out of their doctor in desperation might get the chop – savvy patients get copies of the results as an NHS ‘normal’ (for e.g. my ferritin of 5, told all was normal, endo insisted on an iron infusion to my GP’s annoyance) is not the same as ‘normal to feel healthy’ also fall by the wayside. Now doubt they’ll continue churning out cholesterol tests. I do all my own blood tests privately now through Blue Horizon, you dont even need a doctor to order them and you don’t need to inform your GP) – however, not a luxury I can afford for ever and some can’t afford them at all …
I think the “Choosing Wisely” initiative is a very helpful one if it works and everyone collaborates.
It says a number of things quite clearly such as doctors should not consider NICE guidelines as tramlines because decisions need to take account of individual patient circumstances and the wishes of the patient. It wants decisions to take account of both the benefits and harms of each intervention and the preferences of each patient. Obvious points but this is clearly not happening in many cases.
It says that “it is an ethical imperative that every doctor and patient understand the difference between absolute and relative risks, to protect patients against unnecessary anxiety and manipulation.”.
It uses words like “Doctors health illiteracy is well documented” and that the guideline committees
should produce tools which help medics to understand and share decisions on the basis of best evidence. No more of this “do as I tell” you since it makes it clear that patients should be encouraged to ask questions.
It also has a go at the way GPs are paid which is a major criticism of the present system since this encourages them to pile on the pills.
It also warns about wasting their time by including silly things in the lists.
I would have liked them to have included a reference to the ignorance of the NHS/Civil Service administrator as well and perhaps mentioned the problems with the multiple use of drugs too.
I hope this works. I think it is a very important initiative. Alas it often takes a long time to change attitudes and practices.
I am very grateful to Dr K for this blog it has really helped my understanding of the way things work (or don’t) in medicine.
Hi Dr. Kendrick. I thought you might find this study interesting. While feeding pythons increase their cardiac mass by 2x by increasing levels of 3 fatty acids: myristic acid, palmitic acid and palmitoleic acid. When injected into mice, the same benefit was seen.
Click to access python%20heart%20fatty%20acids2011.pdf
I was an R.N. for many years, trained in England then moved to Canada, a total of 45 years of mostly I.C.U. and C.C.U.
Things have changed a lot since the 60s, Doctors were truly treated as gods and many acted like it, no one ever challenged them, or if you did, that was it, severe reprimand and maybe loss of your job. Some were capable of truly awful behaviour…..one surgeon in my training hospital delighted in throwing bits of the patient he was operating on at one of the nearby nurses, whether an appendix, or a leg, whatever he chose. That sounds outrageous now, but although rare at the time was still tolerated by the authorities. Another had a background in research and why he decided to become a “real” doctor god only knows but he was a menace to his patients, refusing to listen or to believe what we nurses were telling him and making some awful decisions, a very arrogant stupid man, who was not confronted by his peers. We nurses put our concerns in writing several times, nothing was done. But my experience of the profession in general, is that the vast majority are very hard working and dedicated people, very much more approachable and less arrogant than before, and doing an almost impossible job yet still managing to be kind and considerate. But there are still a number of total jerks, very often the less capable ones, and they are often the most arrogant. An example of this was a G.P, I had a few years ago. I’d gone back to see him after having an X Ray and pulmonary function tests when I developed shortness of breath. As I sat down he asked me what I was there for, without checking my notes. I said “shortness of breath’, and his reply was ‘you’re out of shape’. just assuming that a sixty odd year old woman, about 10 lbs too heavy, was automatically out of shape I said ‘no I’m not’, which irritated him, and and he said ‘just how do you know that?’ So I reminded him about the tests I’d had, he checked the screen and just said “oh. You have idiopathic pulmonary fibrosis, I’ll arrange for you to see a specialist’. No apology, no sign of concern. I changed my doctor of course.
I do think that the influx of more women into the profession over the past forty odd years or so has had a big effect, I cannot think of any female physician that I have worked with, who was arrogant and intimidating, even bullying. Sorry guys, forty five years of working with your profession has shown me that. , I also think, like Nigella, that it’s mostly not the G.Ps who are the problem, it’s the regulatory bodies, and even the professional organisations. But it’s really a shame that doctors in general are so very reluctant to do anything about the ‘bad apples’ in their midst.
Your story reminds me of a conversation I had with an elderly nun who was a retired nurse. She recalled that she worked in a private hospital. The gynaecologists were always friendly and polite, the cardiologists were arrogant and rude. I thought that was very interesting.
In the US, I have (or had) a primary care physician who is female. She refused to order an HBA1C test (when I had a fasting blood glucose over 100 in US units, which is out of range) and instead wanted to put me on statins. She said that there was “too much testing”, yet she was willing to have me pay for a statin for the rest of my life.
Instead, I ordered my own HBA1C test and also a VAP cholesterol test (which breaks down lipoproteins into factions), which I had to pay $300 US for. I learned my HBA1C was 5.4 and I had “mixed” pattern of lipoproteins, somewhere between large and fluffy and small and dense.
Now, I think the HBA1C (hemoglobin A1C, not sure what this test is called in your country, but it’s an estimate of average blood sugar level over about 2-3 months or so) is the more important test. Since I’m also insulin resistant, I’m trying to figure out a test to track that (if one exists). I say these are the most important, as I have certain conditions with which high insulin levels/insulin resistance is associated. Those conditions have dramatically decreased since I’ve adhered to a low carb diet.
Anyway, women doctors are just as bad as men here, in terms of believing the party line without asking whether that line is correct.
Bob,
As far as I understand ‘being unhealthy’ today is all about being stuck in the ‘metabolic syndrome’. This is equivalent to being insulin resistant; the reasonably hard endpoint of having followed the official dietary guidelines with 50 – 70 % carbs for many years.
The LCHF type of living seems to be the obvious way out of this syndrome but it is a hard fight. Some fasting periods may help you to break out.
I’ve been prompted to reacquaint myself with the story of US physician, Alice Stewart, as told by Cordelia Fine in the book I mentioned in an earlier comment, A Mind Of Its Own, specifically the chapter titled ‘The Pigheaded Brain’.
Alice Stewart conducted research into childhood deaths from cancer. In 1956, she published a report which surveyed a large number of such cases and showed clear evidence that just one x-ray of an unborn child doubled the risk of childhood cancer. It took 24 years for US medical authorities to recommend that pregnant women should no longer be routinely x-rayed. Stewart was vilified by her professional colleagues, even to the extent of being described as ‘senile’. Fine discusses at some length why this kind of behaviour occurs and describes experimental demonstrations of biased evaluation of evidence. Among her many pithy remarks – well worth reading – she says, “Like any information that pokes a sharp stick at our self-esteem, evidence that opposes our beliefs is subjected to close, critical and almost inevitably dismissive scrutiny.”
Correction: Alice Stewart was actually British, though she carried out important work with US colleagues after her formal retirement. She lived to a ripe old age, so she was able to see most of her results confirmed and her conclusions vindicated.
BobM. In my post my comparison of male and female physicians was not about their competence or willingness to really listen to patients, but the pompous, arrogant and intimidating attitude of many doctors when I was a young nurse 40 years ago, I’m not sure of the actual numbers but it was probably close to 100% male. Consultants and specialists were the worst. This doctor-worship was handed to them on a plate by the public and they came to believe in it. Just the memory of those ward rounds with the consultant and his retinue doing the rounds, the patients at attention in their beds, nurses standing around and no one saying a word unless spoken to while the god accepted the homage as his due, well it ticks me off still. I’m not male bashing although it may sound like it, this was my experience and that of all nurses at the time. Of course not all were like that, but plenty were and although things have changed a lot you can see how it still survives in the talk by Dr. Weetman to the American Thyroid Association in the link that Lorraine sent. As more women entered the profession things improved a lot.
I think part of the arrogance problem is the free at point of use principle, you don’t get to vote with your wallet.
Maureen, it’s interesting to hear your experience from that time and I know you’re not attacking men. Medicine at that time was male dominated and doctors received a high degree of deference, which fed the arrogance of some. I think it was self perpetuating in that we put doctors on a pedestal and they began to behave accordingly. In the past I think we wanted to see doctors as supermen (and women) with magical knowledge and powers to heal.
My mother and grandmother were nurses and they hated the way some doctors and consultants spoke to them, but I’m now talking about the 1960s and 70s. Respect is a good place to start, but I don’t like deference and it’s bad for the person receiving it. Things have changed for the better and more women in medicine have helped that process. I can’t remember the last doctor at my local practice who I regarded as arrogant. I’m glad to say that I’ve avoided hospitals and I don’t know if the same degree of progress has been made there.
Yours is such a great blog! Refreshing.
I have an elderly male relative who went to the the doc because he felt a lump in his side. She said it was nothing but do an X-ray anyway.
Lump was cancerous. He’d had lumps in his lungs removed a few years ago and had been pretty well since. Into clinic and was told that the lump had been a small pea at the time of the lung surgery 4-5 years back.
Each year he’d gone to get an X-ray and was told he was clear. Ah…
It has taken six months for him to be at the point of just about being given an appointment to get treatment which will be radiotherapy.
A question was asked of the Doc. Why was it that the pea had moved onto a lump if the Doc was aware of it and it had been monitored. Doc adamant that it had been monitored. Can a pea become a large fist sized lump in 8 months? Unlikely.
I’m sure he’ll be fine after his five treatments.
Lastly, given that smoking is now a minority sport does the increase in non-smoking lung cancer actually be down to particulates etc. has it always been down to particulates and has smoking been a red herring?
Thanks
Pete