Tuesday, October 12, 2010

In the information society no body thinks!

“Of the terrible doubt of appearances,
Of the uncertainty after all-that we may be deluded!”
Walt Whitman.
This morphologically young lady in her early 50s, let us call her Gita, called me yesterday in a great hurry and she was palpably agitated, to say the least. She was not even coherent. “I am truly down and feeling soooo low that I feel I have a serious problem. I feel very low after my evening walk.” I asked her “what happened?” She shot back,” my doctor told me my pressure is way high at 160/100. She immediately asked me to take a tablet, which I took.” “You must be feeling fine now” I interrupted her. “No, No, No. I am feeling worse now. My doctor told me after a couple of days that my pressure is still way above the normal at 130/80. Doctor gave me a new tablet and asked me to swallow it right there as she wanted the pressure to be around 110/70 as fast as possible.” In addition, my doctor asked me to urgently see a cardiologist to have a complete work up.”
“What happened then? I asked. “My doctor’s last advice put me off and I thought I better talk to you.” I could feel her in tears almost at that stage! To cut the long story short, I had to talk to her at length to counsel her and to convince her that the blood pressure reading that she was worried about was all in her mind! The reader might think it is very easy. It is easily said than done. I can assure you that it would have been easier to deliver a baby if I were pregnant than to successfully counsel an agitated fifty year old postmenopausal morphologically young lady to cool her down on the telephone.
Let us look at Gita in Toto to know her better. “Know your patient better than his disease,” wrote Hippocrates. He was dead right, I can tell you. Gita was educated in the US. Her husband, a brilliant and capable scientist was the one who put together one of the most successful business groups in India. She had two beautiful and intelligent kids. She also had a kushy job on hand. Theirs was a happy & perfect family. Fate willed otherwise! Her handsome, intelligent husband dropped dead one sad morning due to what doctors called a heart attack. Gita was devastated and shattered. One could understand. She came out of that reactive depression slowly but steadily and still does her job very successfully. She brought up the children like a true Indian mother and now they are both successfully placed in society. Her families on either side were a great help and so were her colleagues and her husband’s former colleagues.
Turning fifty, Gita felt lousy and having been an informed woman she was worried about her menopause. That needed counseling again. Right then both her children went abroad in search of greener pastures and higher education. Gita was outwardly ecstatic but in her inner mind (subconscious) was feeling lonely and forlorn. That mind of Gita was somatizing as “her feeling very low” which took her to her “good” doctor in the first place, more due to her family pressurising her. Rest is history. This sad story is all but lost for our modern medical business that tries to attack the palpable abnormal body parameter, which is mistaken for a disease, to be drugged ruthlessly. This morning, exactly 24 hours after yesterday’s traumatic experience, Gita is back to her usual self- confident, with a top of the world feeling, back on her job. The drugs are in the waste paper basket as she had to survive. “Thank you, Dr. Hegde, I feel fine. All in the mind-yes, yes, I now believe you.”
Let us examine the science behind this misadventure. A thinking American professor, a rarity in that country these days, Mary Tinnetti, had this to say about our obsession with a firm diagnosis and our disease concept. “The time has come to abandon disease as the focus of medical care. The changed spectrum of health, the complex interplay of biological and non-biological factors, the aging population, and the inter-individual variability in health priorities render medical care that is centered on the diagnosis and treatment of individual diseases at best out of date and at worst harmful. A primary focus on disease may inadvertently lead to under treatment, overtreatment, or mistreatment.”
The drugs are being pushed irrationally and the gullible doctors that depend on drug companies for their continued education and believe their advice 100%. Pharma lobby even gets research data manipulated. (JAMA 2010; 303(20): 2058-64.) “Speaking of Big Pharma’s big, bad influence, here’s more proof they’re not interested in playing on a level field. It turns out a controversial and dangerous hormone therapy that was all the rage a few years back was pushed in medical journals by writers who were paid by Big Pharma,” according to court papers found in August 2009 by the New York Times.
The Times also found that “in one case that seemed typical, the drug company paid around $25,000 to a third-party medical writing firm to generate one of these reports. That might sound like a lot of money to you or me, but its money well-spent for Big Pharma. In fact, these shady reports helped hormone treatments generate $2 billion in sales in 2001, just before that money train was derailed.” The whole thing looks like a stage managed effort to keep the best treatment method, change of mode of living, for chronic diseases like raised sugar, blood pressure, cholesterol etc. from practicing doctors as the Pharma company profits from life long drug treatments could be mind boggling.
Reminds me of the infamous Tuskegee experiment where 400 African Americans suffering from syphilis were observed from 1932 through 1972 withholding penicillin treatment just to record the natural history, symptoms and complications of the disease without their consent! Sir George Pickering, a doyen in the field of hypertension research, had this to say: “More people make a living off hypertension than dying of it.” This was written in the 1950s when there were hardly a couple of crude drugs for hypertension. What would he have said about our situation today? God only knows!
Right thinking people in the medical profession have a tough job on hand to try and get at the truth, which in itself is a daunting task, and then a greater hurdle to deschool society from their belief that modern medicine is a true science and there is a pill or surgery for every ill! The truth is that while there is certainly no pill for every ill; every pill is followed by a definite illness. Pills might thrill but could even kill. Change of mode of living-diet, exercise, mental tranquility in the midst of this maddening world running after the mirage called money, universal compassion and simple nature given immune boosters in vegetables and fruits should set right most transitory parameters. It is too late in the day to start deschooling society to reverse the trend and help hapless patients like Gita.

Saturday, October 9, 2010

There is nothing so terrible as activity without insight.

"Where governments and big industry are in cahoots it is to the detriment of the people."

Now there is a great threat for global warming going to destroy mankind all over the globe. I am reminded of the global cooling threat published in the 1970s. Alarm bells rang loud and clear that we were in for the next ice age then! All that happened at that time was that the Northern Hemisphere ground temperatures had fallen by just 0.5 degree centigrade! Between 1964 and 1972 there was a decrease of 1.5% sunshine hitting the USA. It was said to have taken the globe “about a sixth of the way towards the ice age.” In Great Britain the cooling had shortened the growing season by just two weeks. They predicted then that the famine was imminent. Scientists and thinkers suggested covering the arctic ice cap with black soot.
Now the threat is opposite, it is global warming. We are very good at predicting the unpredictable future, as doctors. (BMJ 1991; 303: 1565-68) This world does not fit into our scientific logical thinking following the Laws of Deterministic Predictability. Uncertainty is the only certainty. Science changed in 1925 with Werner Heisenberg’s uncertainty principle. Although we still call physics as physics, it is not the same at all. Science has to change a lot and there is NO science of human being. The best support for this comes from that beautiful book by Edward Wilson- Consilience: The Unity of Knowledge- where he says:
“Without instruments humans are trapped in a cognitive prison; they are like intelligent fish wondering about the world outside, they invent ingenious speculations and myths about the origin of the containing waters, of the sun, the stars above and the meaning of their (own) existence. But they are wrong, always wrong because the world is too remote from ordinary experience to be merely imagined.”
Another great scientist, former Director of the Max Planck Institute in Munich, Hans Peter Durr, says it much more succinctly thus: “With instruments also mankind is in cognitive prison. Using science we now have sophisticated ignorance; but we are not anywhere close to the truth. The word world has a Germanic root “wer-ald” which means a world seen by human beings. That is not the reality.”
So much for the new future threat of global warming. This planet is such a small speck in the universe that the environment around will have its own controlling mechanisms. How do we otherwise explain the global cooling threat that our scientists posed a couple of decades ago to be turned upside down to the global warming threat so soon? It is worthwhile checking if this has any business interest at all driving it? We get prizes and Nobel very easily if we get on to the global warming bandwagon, sometimes even with wrong data!
A house holder driving a battery driven Prius to the supermarket will be undoing all the good that she has done to reduce global warming by buying beef! Cows mainly and sheep and other cud chewing animals-so called ruminants- are the worst polluters of this world and they contribute much more than all the carbon emitting industries and the motor vehicles on the road. The exhalation, the farts, and the flatulence and belching of these animals along with their excreta contain so much methane that can warm this planet much more. Measure per measure the cow’s fart can be twenty five times more potent in warming the planet compared to carbon emissions! We could ask all the people to eat only Kangaroo meat in place of ruminants’ meat as the former does not emit any methane, thanks to its peculiar digestive physiology. Wonderful world indeed! We have also ignored the evaporating water vapour from the seas warming the globe!
Even our therapeutic efforts seem to be based on similar sophisticated ignorance with all our instruments. I am reminded of what Goethe wrote in Faust, centuries ago:
“I have, alas! Philosophy,
Medicine, Jurisprudence too,
And to my cost Theology,
With ardent labour, studied through.
And here I stand, with all my lore,
Poor fool, no wiser than before.”

"A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty."
Winston Churchill.

Friday, August 27, 2010

Research in modern medicine

Modern Medical Science Research.

“Science is making models, mostly mathematical constructs, which with verbal explanations are supposed to work!” That was the opinion of one of the great brains in science, John von Neumann. Western science is lost in this mess and is searching for a better model for future research. A leading western scientist, Douglas C Wallace, writing in the famous Genetics Journal, has shown that the non-linear model of Asian medical systems like Ayurveda is more useful to human physiology and recommends those methods for future research! The mathematical base of modern medical research is linear while the human body is non-linear. All the research we have been doing has come to grief. “First, human diseases affecting a wide range of organs could result from systemic defects in energy metabolism and, second, hereditary human diseases could result from mutations in the non-Mendelian mtDNA. Consequently, mitochondrial biology and genetics become excellent candidates for expanding the anatomical and Mendelian paradigms to address the complexities of the age-related diseases, ageing, and cancer,” wrote Wallace. (Genetics 2008; 179: 727)

It was in the year 127 AD that a “great” teacher of medicine, Galen, wrote that the liver pumps blood around the system. For the next 1500 years all teachers and students everywhere wrote their research papers based on this premise. It was only in the year 1628 AD a thinking family physician in London, William Harvey, observing a fire hydrant working, thought that the heart pumps blood. Knowledge advanced after 1500 years. I ask the same question today. Is the heart a simple muscular pump? The answer is probably-NO. But who cares? If one reads my article in an indexed journal entitled is the human heart a simple muscular pump one would be shocked to know how far away from the target are we hitting. (medind.nic.in/jac/t10/i1/jact10i1p16.pdf) Many such wrong ideas are being taught and followed.

All that I wish to convey through this response is that many good THINKERS among students could do good research. No law will make any one a thinker!! If doctors confined themselves to curing the sick rarely, comforting them mostly, but to consoling them always, they would be doing a great service to the public. Good teachers and researchers are as important to a medical school as are good bedside clinicians. These two breeds, combined with a few thinkers who could do genuine research to take knowledge forwards, would be an ideal combination in medical schools to motivate students with different skills and interests. It will be foolhardy to expect all these three in one individual except very, very rarely.

Modern medicine is becoming unpopular in the west. In the year 1997 alone 629 million people took treatment from alternative systems of medicine in the west paying from their own pockets. This is more than the number of people that saw their family doctors in the same year, according to a survey done by Eisenberg and colleagues in 1998. (JAMA 1998; 280: 1569) India should take note of this as we have one of the best systems of health care in Ayurveda, especially for chronic illness syndromes. If this could be judiciously clubbed with the emergency care methods of modern hi-tech medicine, complementing each other, we could bring down the costs of medical care to almost one tenth of its present level with less ADRs as a bonus.

The future lies in emphasizing promotive health. We should change the present teaching in medical schools from the disease-centred education to that of patient-centred community based education. We should use statistics sparingly in medical research. One of the drawbacks of applying disease statistics to the healthy population is that the latter throws up a very high percentage of false positives, resulting in epidemiologists predicting the unpredictable, resulting in epidemics. The fear of an illness could help the illness to take a strong footing in a healthy person. Modern medicine has realized that the human mind plays a vital role in disease causation as well as its control. Hence there is a need for doctors to train themselves in human psychology and behavioral sciences. Health is one’s birth right. Diseases are only accidents. If one follows the correct rules of healthy life style, accidents (diseases) will be rare indeed!

If we are interested in getting better medical scientists in the future we should see that every medical school has a department of medical research with a decent budget, headed by some one who has done real good refutative research work published. S/he must be adequately compensated lest the person should look elsewhere for succor. The departmental work must be subjected to strict periodic auditing. Such teachers alone could motivate brilliant young students to do good research. Drug studies are NOT research in the true sense. Even if such studies are needed they should NEVER be funded by drug companies as is the case at the moment.

While good research is refutative, all kinds of repetitive research must be shunned. Karl Popper once wrote that “knowledge advances not by repeating known facts but only by refuting false dogmas,” of which there are plenty in modern medicine today. The medical school should be proud of such a research department and should include that as a selling point in the brochure for prospective students. If this is genuinely pursued, a time will come when we will get a few good researchers in the world. They would make us proud. Outstanding research is only serendipitous. One can not plan such work in advance. That said I must warn that serendipity helps only those with prepared minds receptive to creative thinking. Let us work to get more prepared minds in the country and not legislate to have the usual IMRAD (introduction, material methods, results, and discussion type) research papers most of which are not even worth the weight of the paper on which they are written.
Sadly even in 2010 we do not have a correct science of man. Greta minds in western science, from the time of Galileo, were happy working on models for inanimate objects like in Physics and chemistry. Even biology does not have a model of its own. Human physiology is far, far away from reality with its linear model of the inanimate sciences applied to a dynamic human system with its all pervading consciousness. Man is but his mind, says Indian Ayurveda which has human beings classified into many gentico-constitutional types which take into consideration human consciousness as well. These classes could then be used for better RCTs; the latter at the moment compares only a small fraction of the phenotype of cohorts! One size fits all is foolishness in our present research. Individualised medicine has gone out of the window. Peer review is the enemy of progress as the peers can only deal with the known and if a refutative researcher wants to publish an out of the box thinking paper that would promptly go to the waste paper basket.

Let us think out of the box rather than use more complicated Latin words for new research with the same flawed science of man. “Intellectual integrity made it quite impossible for me to accept the myths and dogmas of even very great scientists, more particularly of the belligerent and so-called advanced nations. Indeed, those intellectuals who accepted them were abdicating their functions for the joy of feeling themselves at one with the herd.”
Bertrand Russell (1872-1969)

Wednesday, August 25, 2010

A difference is only a difference if it makes a difference.

Social injustice has everything to do with illnesses. Poverty is the mother of all diseases from common cold to cancer. A child born to a poor mother will have a very small hippocampus major, small pancreas, small vessels etc making that child get all killer diseases in the 30s; in addition, the small hippocampus unfits the mind for any intellectual pursuits.
It is not prevention that should be our motto but health promotion. Disease is failed health promotion. Prevention brings in screening in its wake which promotes disease mongering. Every human body is built to last as long as it can, thanks to the immune system. No one should try to be here for ever, as s/he will certainly not succeed, doctors and medicines notwithstanding. The immune system needs boosting on a regular basis to keep the person disease free. Modern medicine is not doing that. Clean water, air and food are of vital importance. One third of the world population lives on less than one meal a day. Nutritional immune deficiency syndrome (NIDS) is the biggest killer of children in poorer countries, deadlier than AIDS.
Poverty economics has to be learnt not in Oxbridge but in the slums of the poor countries. Then only one gets the true picture. It is akin to doing Dictator experiments of John List in real life situations which showed that mankind is not altruistic, unlike the controlled experiments of the 2002 Nobel winning work of Vernon Smith and Daniel Kahneman, showing humankind to be hard wires to be altruistic.
The medical profession, like all other professions, has become homo economicus. We, doctors, are not concerned with poverty eradication lest we should break our own rice bowl! Doctors can never survive without patients while patients could survive without doctors!

Hospitals and doctors have very little to do with health of the populace. More doctors and less health has been the finding of the 14 industrialised countries’ study. (JAMA 2000; 284: 483-485) Civil engineers, politicians, social workers, philanthropes, and the altruistic social organizations should be able to do something in keeping the health of the public. Food, shelter and water with a clean environment, coupled with economic empowerment and ethical education should do the trick to keep our immune system at its peak. Will the powers that be wake up to this reality please?

A dream for India.

ARISE and awake! Six thousand young children in this country of yours are dying every day for want of proper nutrition! There are around 67 million malnourished children in India, much more than the total load of Sub-Saharan Africa of 45 million! Where is our societal obligation-our dharma? We are a great nation praised by some of the great brains in the west like Voltaire, Einstein, Henry David Thoreau, Mark Twain, Max Mueller, Bernard Shaw, Adam Smith, Archibald Wheeler, Apollonius Tyaneus, Rudyard Kipling, Aldus Huxley, Ken Wilber, Victor Cousins, Arnold Toynbee, Will Durant, Ralph Waldo Emerson and many others. What has happened to us, the literate masses? Why have we become so insensitive to others’ plight?
With our proclivity for comforts and our greed we seem to delude ourselves in this monetary economy trying to ape the west which, in fact, seems to be looking to us for moral and spiritual guidance. Indians have a dharma, our obligation to fellow citizens. Dharma has nothing to do with religion. Even the word secularism is being abused now. True secularism simply means respect for other’s religion. There will be peace on earth if secularism is correctly understood.
Our educational system, completely distorted by James Babington Macaulay, is at the root of making our literate people to forget our own hungry brethren and live in a make believe world of the English educational system brought here to produce “a class of Indians who are Indian in color and blood but British in thinking, morals, ethics, and action.”
Hungry mothers who are pregnant produce children, if the latter survive the prenatal period, which are endowed with small vital organs like the heart, blood vessels, pancreas, brain etc. These children, if they survive infancy, do not become normal even if we feed them adequately afterwards, as was being done in the last ten years through the ICDS scheme of the government. The latter did not bring down the prevalence of childhood malnutrition in the ten years with thousands of crores of rupees spent.
We need to feed our pregnant women especially during the first trimester when the whole child is made in the womb. Nutrition of the pregnant mother coupled with good sanitary facilities in our slums and villages with toilets for every one will bring forth a new generation of healthy children.
Next curse on the hungry millions is the preset medical care system that is prohibitively expensive and not patient friendly. Poor can never access this system. We have thousands of well trained doctors in India many of whom had their training in some of the best centres in the world. If they could spare some of their very, very busy time to put together a new system of medical care which incorporates the emergency methods of modern medicine with the best inexpensive methods in many other systems of medicine after duly authenticating them through hard modern scientific methods of testing, our hungry millions could access the new integrated system to get well when they fall ill.
What surprises me is the attitude of the medical star performers, who proclaim from house tops and through the media that they are for the poor. The star performers could do a lot in this direction as they have easy access to the powers-that-be and could influence the decisions of the latter to put in place a poor-friendly policy to change the face of India. Demographics show that in the next 50 years 70% of the Indian population will be below 20 years! If that were so we can not afford to have such poor health for the majority of them, anyway. We have to act now and the star medical performers would do well to do their best.
The media, of course, couldn’t care less as the hungry are not sponsored by any wealthy organization! While the NGOs and the government bend over backwards to push vaccination down the throat of these hapless children not realizing that the vaccine needs good blood protein level to induce anti-body production to prevent the disease! The reason is not far to seek. Vaccines have their God fathers! Vaccines would be protective in well fed children but could be a curse to the malnourished child.
According to the figures from the Nutritional Institute of India there are more children dying in India due to NIDS (nutritional immune deficiency syndrome) compared to AIDS. While AIDS, which affects only a total of 40 million people in this world, gets all the limelight, NIDS is not even known by the knowledgeable people. Society needs to be deschooled from their firm belief that doctors and hospitals keep the people healthy, courts give us justice, and the police protect our honor. While all these three institutions are vital when one is ill, has had injustice done to him/her, or when one’s honor has been trampled with, they are of no use in normal circumstances.
Sleep not! Until you realize the dream of a hunger free India, nay hunger free world order. May truth prevail over untruth and mystery? Let India lead the world again. It was Arnold Toynbee who wrote that if mankind has to survive on this planet mankind will have to look to India for guidance! Twenty-first century belongs to India to lead the world to sanity.
(The writer is a physician, medical teacher, and researcher who retired as the Vice Chancellor of Manipal University in India, after having been a teacher of medicine and cardiology for well over four and half decades as also the Dean of a medical school for nearly a decade. An author of many books, he is the editor in chief of a new science journal from Laurel, MD, the Journal of the Science of Healing Outcomes. His co editor in chief is a world famous material scientist, Prof. Rustum Roy, of Penn State University.)

Absence of evidence Vs Evidence of absence.

“I am easily satisfied with the very best.” Winston Churchill.

It took nearly fifteen hundred years for the medical community to realize that Galen’s hypothesis of the blood circulating from the liver, propounded in 127AD, was wrong. It was in the 17th Century, William Harvey wrote his de Motu Cordis. (1628 AD) In the field of astronomy it took five Centuries for scientists to realize the folly of Ptolemy’s hypothesis that the sun goes round the earth. Copernicus, in the 7th Century, came on the scene to show that the earth, in fact, goes round the sun! Reductionist science that we follow in medical research does not work in the dynamic human system. Still we hang on to it despite evidence to the contrary as it has become a lucrative trillion dollar business. We presume, wrongly though, that the absence of evidence is the same as evidence of absence. Therefore, we refuse to accept anything that defies the reductionist statistical deductions. Evidence based medicine today has become evidence burdened instead.

Although I have been pointing this out time and again for the last four decades, medical scientists never took me seriously. The movement gained respectability when once the Institute of Medicine report in the US clearly showed medical interventions in the hospitals as the third important cause of death next only to heart attacks and cancer and the Adverse Drug Reactions as the fourth cause. (JAMA 2000; 284: 483-485) Now there is a world wide movement for establishing the right science in medicine of Whole Person Healing. This was practised for “times out of mind” in the ancient healing systems of Ayurveda. Newer scientific methods have been able to establish the validity of many other complementary systems of medicine like homeopathy, naturopathy, Siddha, energy medicines, faith healing, reiki, Qi gong, acupuncture, and fast wound healing methods of India and the Sufi saints, reconstituted water therapy et cetera.

The leader of the movement in the US, Professor Rustum Roy, the father of nano-science (not nanotechnology), a scientist of great repute, who had been nominated for the Nobel several times in the past. He, in his early 80s, is still the Evan Pugh professor of Solid State Emeritus at the Penn State University! Nano-science was born when, in the early 50s, Prof. Roy invented the sol-gel technique to extract nano-particles. Even now scientists in the field of nano-science use the same method. His paper on Sol-Gel technique is cited 65,000 times to date, a record of sorts! Interestingly, Prof. Roy is more interested in the Giga problems of mankind all over the world like poverty, hunger, ignorance and illnesses. He is using his scientific clout to help the poorest of the poor using his research acumen to solve those Giga problems.

Manufacturing molecules by altering the atoms is the basis of nano-science. One could make diamonds from coal and semi-conductor chips from sand. Having realized the futility of reductionist science in medicine Prof. Roy took upon himself the arduous task of scientifically validating the multitude of complementary systems of medicine personally using his rigorous scientific methods of scrutiny. Only those that passed his tests were included in the WPH movement.

His great faith in Ayurveda as the mother of all medical wisdoms made him to coax the Indian Council of Scientific and Industrial Research to organize a preliminary workshop on WHP in New Delhi some time ago. More meetings in the US followed the Delhi meet. One such was the first ever International conference on WPH for four full days at Tai Sophia Institute in Laurel, Maryland. Let us see how WPH works. In contrast to reductionism of organ based specialties, the science of Ayurveda, for example, takes into consideration the mind, body, spirit and the genome into consideration while treating patients. Ayurveda believes that all illnesses are born in the mind and grow in the body with the influence of the genes in a conducive atmosphere. For the healer it is not as important to know what disease one gets, as it is to know who gets a disease. The latter would answer the vital question that had been dogging positive sciences for ages, the answer to the question “why?”. Positive sciences could, at best, answer “how” or “how much” but not “why?” A conventional physiologist could answer how does the heart contract but not the question as to why does the heart contract? Space constraints do not permit me to go deep into the great science of Ayurveda.

Rustum Roy’s work on the structure of water (not chemistry: he is basically a chemist, though) opened the flood gates for homeopathy research. When a homeopathic drug is diluted in water thousands of times the final water might not contain any chemical entities of the drug but the drug would leave its foot prints in water by changing the structure of water. Reductionist science of water would have to be a combination of H2 and O. Both these atoms are volatile but water, a combination of the two, is far from volatile. This is the bane of reductionist science of medicine where we study a cell or an organ and project it on to the man and predict the unpredictable. This has led us to this sorry state of affairs where medicine has become a bane to society instead of the boon that it ought to be. Many scientific studies have shown the good effects of homeopathic medicines.

Hormesis, another new concept developed by Edward Calabrese, has shown how most drugs have a beneficial bio-positive effect on the body in very small doses while the same drug in larger doses (that we give in therapeutics based on the pharmacodynamic studies of reductionism) would be bio-negative. He showed it elegantly in vitamin C. Whereas the small dose of vitamin C in a tomato is bio-positive, the larger therapeutic dose, in the long run, would damage the system. It is also possible that there are hitherto unknown entities in the tomato that prevent the vitamin C to manifest its bio-negativity. This gives credence to the holistic science of Ayurveda also.

Qi gong, reiki, and even faith healing depend on the movement of bio-energy, the leptons of quantum physics, from the healer to the patient. The consciousness of the healer is as important as the vehicle that the healer uses (say a drug). Similarly, the consciousness of the patient should be more important in the final healing process. This was demonstrated by a psychiatrist from Stanford offering himself as the patient to study the quick wound healing methods of the Sufi saints in Iraq. He demonstrated that during the conference. Our own paper on Heart Rate Variability, using the latest computer two dimensional imagery and the wavelet quotient analysis, showed the principle of “mode-locking” (Edward Laurenz’s hypothesis) where organs work in tandem and not in isolation. Even the age old Placebo effect has now been scientifically shown to exist with chemical changes in the brain that could be proved by blocking the chemicals using naloxone to nullify the placebo effect.

The studies published in the leading medical journals on the power of intercessory prayer in the management of myocardial infarction does work on the principles of bio-energy transfer. In depth study of the brain by David Shannonoff Khalsa, professor of Neurobiology in San Diego, revealed extensive changes that took place in the brain during meditation. His published works on Kundalini Yoga in the management of intractable diseases like obsessive compulsive disorders, anxiety states, and epilepsy are an eye opener. There is now ample evidence that the whole person healing is the future of modern medicine.

Scientific enquiry into the claims of any system of healing should be the way forward. There should be no compromise about validating the claims of all the complementary systems. The scientist’s job is to take the wheat from the chaff and put together a new system of medical care delivery, the future modern medicine, called meta-medicine, wherein the best in all those systems are incorporated without bias. David Eddy, a cardiovascular surgeon at the Stanford in the past, had already shown the role of non-linear mathematics of chaos and fractals and holism in human physiology. (www.archimedesmodel.com) Modern medicine’s quick fixes are useful in emergency care although some of those methods have not been fully authenticated. For the majority of patients in the non-emergency set up the integrated system that is conceived above would bring down the cost of medical care significantly. This would make medical care reach the unreached. This would also bring down the incidence of ADR, the fourth cause of death these days in our hospitals. Let this new system do most good to most people most of the time.

We have started the World Academy of Authentic Healing Sciences in Mangalore, with the blessings of our parent body, the Friends of Health, headed by Rustum Roy at Penn. State University, continuing the good work that the latter does in the US. We have made considerable progress in the last couple of years wherein we have authenticated many new methods of easy cure for so many hitherto difficult-to-treat ailments. We have also started a new journal, Journal of the Science of Healing Outcomes, in its second year, publishing scientific studies after due super peer review by eminent scientists, including Nobel Laureates, who are on our editorial board.

Rustum Roy is the co editor in chief of JSHO (www.thejsho.com) with me as the editor in chief. We also have another centre for research in Chennai under the able leadership of Professor CV Krishna swami, where our friends have donated money to build our own research building. All our efforts have to be funded by well meaning philanthropes since we do not accept funds from the pharmaceutical and/or medical devices industries! Hope we will be able to put together a new system of inexpensive medical care that would be a boon to the common man. Absence of evidence is not, therefore, synonymous with evidence of absence.

“The means by which we live have outdistanced the ends for which we live. Our scientific power has outrun our spiritual powers. We have guided missiles and misguided men.”
Martin Luther King Jr.

Tuesday, August 24, 2010

Educare to Educere

(I initially wrote this just after the last autumn Swine 'Flu scare.
My questions are still to be answered in many areas!)

“The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.” William Arthur.
There seems to be a Tsunami in the medical field vis-à-vis the new “Swine” ‘Flu, an insult to that poor animal! Every article (and blog) tells us about it but does not answer many questions. I think this is an opportunity to ask those awkward questions. I am looking for answers, not knowing the answers myself.
I had trepidation to write this note up until I read about educere, like what Socrates used to practise, there was no “authority” defined as we read in Theaetetus: (written by Plato in 360 BC translated by Benjamin Jowett) “Well, my art of midwifery is in most respects like theirs; but differs, in that I attend men and not women; and look after their souls when they are in labour, and not after their bodies: and the triumph of my art is in thoroughly examining whether the thought which the mind of the young man brings forth is a false idol or a noble and true birth. And like the mid-wives, I am barren, and the reproach which is often made against me, that I ask questions of others and have not the wit to answer them myself, is very just-the reason is, that the god compels-me to be a midwife, but does not allow me to bring forth. And therefore I am not myself at all wise, nor have I anything to show which is the invention or birth of my own soul, but those who converse with me profit.” Every medical student (and scientist) would do well to read this advice of Socrates.
• Why was the WHO in such a great hurry to raise this to pandemic level?
• Multiple drug resistant tuberculosis has been spreading to all countries like wild fire; could kill millions if left unchecked reminding us of the great white death epidemic. Why is that not a pandemic?
• Where is the controlled study to show the effect of Tamiflu against the new “Swine ‘Flu virus, in our evidence based medical system?
• Has the new vaccine been tested against the virus in a large study? How are we certain that it will be effective? Is this vaccine safe to give to all age groups, especially when we are ignorant of its true validity? Primum Non Nocere.
• What happened to the millions of dollars worth of Tamiflu stockpiled for the imaginary pandemic of bird ‘Flu? The manufacturers must have had the last laugh last time.
• Will the linear projection of large deaths due to the imaginary dread of the new virus materialise? Do the non-linear universe and the human body follow the linear laws?
• If this whole fear mongering fails to materialise who do we hold accountable at the end of the day?
• Do we not know that fear, especially of millions in the world, might weaken their immune system?
• Does the host resistance play any role in the final outcome of the fight between the virus and man? If so, why are we not doing something to build good resistance against the virus?
• Why do we not accept similar untested, but inexpensive, remedies available in many other systems like the Chinese, Indian Ayurvedic and homeopathic systems? Russian scientists have demonstrated viral (and other germs) destruction using particular frequency of subtle energy non-invasively! Our positive sciences understand only 5% of the total energy in this universe while the large 95% needs to be explored for common good. Why are all those efforts classified as pseudo science? What is the definition of science, anyway? To me the present scenario looks like science is what accepted scientists think it is! Wetenschap is wat wetenschappers doen!
• All these, and many more questions, beg more questions than answers! Let not our untested expensive interventions be worse than the patient’s disease. Educational system was changed by the Romans from educere of Socrates’ time to educare of today, where the authority prescribes what the students should learn from outside! That is the bane of medical, nay, all sciences. Let us go back to educere from educare.
“Science is a kind of glorified tailoring enterprise, a method for taking measurements that describe something — reality — that may not be understood at all...One may even suspect that there is more to reality than measurements will ever reveal.” Michael Crichton (1942-2008.-Harvard trained medical doctor turned science fiction novelist).

Monday, August 23, 2010

What is a teacher, anyway?

“The authority of those that profess to teach is often a positive hindrance to those who desire to learn.”

The younger generation today rarely follows our preachings; is more likely to follow our example. A good teacher, therefore, should be a good example to students. S/he should walk the talk. An ideal teacher is more like a midwife, who stands by the side of the pregnant mother in pain, coaxing her, cajoling her, empathizing with her and provoking her to deliver. It is the mother that eventually delivers. Similarly, an ideal teacher does not deliver her/his didactic lecture in the class as is the practice but, tries to get the best out of the student. The student should deliver (e=out; ducere=deliver). Swami Vivekananda once said: “Education is the manifestation of the perfection that is already in man.” Another great thinker, Dr. Alexis Carrel, a Nobel Laureate, had opined that: “no man could teach any man anything that he does not already know.” Looks strange but, is true scientifically.
The Gurukulas:
The Indian system of Gurukulas were almost followed by the Socrates method of trying to get the best out of the student which was prevalent even in west up until the time the Roman Emperors despised the idea of wiser citizens coming up endangering their own survival. Thus started the present curriculum type of education where the teacher is supposed to teach what the establishment thinks is right. In this system there is no place for the teacher to get the best out of the student outwith the syllabus. This is the reason why even great minds like Ravindranath Tagore refused formal education! I do not see any change in the near future as our present rulers (Kings) would want to perpetuate the same system for their own survival.
Pythagoras, the teacher of Socrates spent quite some time in India and there is some evidence that he even had a one to one meeting with the Buddha at that time. He must have imbibed the Gurukula system which influenced his teaching methods followed by Socrates, Plato and later Aristotle. It was Voltaire, the great French thinker, who wrote that:”while we were hunter-gatherers roaming the forest in Europe Indians had five Universities of International fame where scholars from all over the globe came to acquire wisdom. It does not behoove us now to either question their antiquity or their authenticity.” If one ponders over the educational system in India today one feels sorry for the students. Most of what is taught is information, very little of it is knowledge and rarely ever, if ever, any wisdom is generated in the students mind. In the era of World Wide Web and what have you one gets drowned in the midst of information, most of it is just noise. Occasional signal in the noise gets drowned in the same noise.
“Where is the wisdom we have lost in knowledge?
Where is the knowledge we have lost in information?”
T. S. Eliot, The Rock
British (US-born) critic, dramatist & poet. (1888 – 1965)

See what Socrates used to do according to Plato, his student as detailed in his book Theaetetus in 360 BCTranslated by Benjamin Jowett
“Well, my art of midwifery is in most respects like theirs; but differs, in that I attend men and not women; and look after their souls when they are in labour, and not after their bodies: and the triumph of my art is in thoroughly examining whether the thought which the mind of the young man brings forth is a false idol or a noble and true birth. And like the mid-wives, I am barren, and the reproach which is often made against me, that I ask questions of others and have not the wit to answer them myself, is very just-the reason is, that the God compels-me to be a midwife, but does not allow me to bring forth. And therefore I am not myself at all wise, nor have I anything to show which is the invention or birth of my own soul, but those who converse with me profit.”
Teachers’ Day Ritual:
The ritual of the teachers’ day is held every year on Late Dr. Sarvapalli Radhakrishnan’s birth anniversary. How I wish some of our present leaders had his wisdom to know the difference between true education for our future generation and the present avatar. The teachers’ day is more of a ritual to satisfy the rules rather than to ponder over the sorry state of education here. If any of the readers had read the PROBE 1997 report commissioned by the Government of India, one would be shocked to know that more than 47% of our primary schools in the four BIMARU States do not tech students; instead they use the schools for their own businesses!
When did the rot set in?
Some time ago a school boy in Bangalore injured his classmate using his air gun. When the story of a school boy in Gurgaon shooting his own classmate made news we ignored the same as an accident. The scene repeated in two other States and now it has come to our own backyard in Bangalore! Now we know that it was not an accident but it is endemic in our system threatening to be an epidemic if not controlled in time! With this incident we have been able to ape the American style even in crime in our younger generation. It is a routine affair in American schools these days. We are already ahead of the Americans in our food habits for the young, abandoning our time honored healthy diets completely inviting the American epidemic of obesity and precocious diabetes in the young. Where are we headed in our educational field?
Time is ripe now to go in search of the roots of our present educational system. In the 19th Century, there came a man to India on behalf of the British to study the Indian scenario vis-à-vis the best practices to be adopted by India. He was a young British member of the House of Commons hardly in his early 30s. Thomas Babington Macaulay, later Lord Macaulay, was in India for four years as the Chairman of the Board of Control of Colonies of the British Empire. He was the youngest member of the Board but was made the chairman as he was very close to the then Vice Roy, William Bentinck. Macaulay had an electrifying personality and he used to bulldoze his way through the Board to get his views accepted against the wishes of the majority.
It may not be out of place here to quote Macaulay to emphasize the role played by him in changing our wonderful educational system then prevalent. He had so much contempt for this country and its people that he thought that Indians were an inferior race! However, what he saw in India literally shocked him. He then devised a very ingenious plan to break India’s back by replacing her great tradition in education of “para” and “apara” vidya where every student gets to know about him/her as well as the world around him, the three Rs, thus enabling him/her to have self development as well as external development that today we think is the essence of education. This is a good lesson that we could learn from this intelligent but crooked man. If we could replace the present westernized educational system with the best part of our ancient Indian education, which was even praised by Macaulay in the House of Commons, we could change our younger generation for a better future.
Macaulay’s speech in the Commons on the 2nd February 1835.
“I have travelled through the length and breadth of India and have not seen a single person begging, who is thief. Such wealth I have seen in that country, such high moral values, people of such high caliber, that I do not think we would ever conquer that country unless we break the very backbone of that nation which is her spiritual and cultural heritage, and, therefore, I propose that we replace her old and ancient educational system, her culture, for if Indians think that all that is foreign and English is good and greater than their own, they will lose their self esteem, their native culture and they will become what we want them, a truly dominated nation!”
Some of Macaulay’s writings in the Board of Control minutes, that are available in the British Museum, would make even a skeptic to sit up and take note of the dangerous foundation on which our present educational system is built. Some samples would suffice. “We must at present do our best to form a class who may be interpreters between us and the millions whom we govern; a class of persons, Indian in blood and color, but English in taste, in opinion, in morals, and in intellect.” “A single shelf of a good European library is worth the whole native literature of India and Arabia.” “English tongue is that which could be most useful to our native subjects.” “What Greek and Latin were to us is English to the natives. Sanskrit literature is worse than our Saxon and Norman progenitors.”

“When a nation of high intellectual attainments undertakes to superintend the education of a nation comparatively ignorant….we are forcing on them mock-learning…..”
Now is the time to do radical surgery on our existing educational set up to revamp it to bring out a class of people, eventually every Indian citizen, who is Indian in thought, in action, in opinion, in taste, and in intellect and not British! It is also time to show them the rich literature of every single Indian language, some of which are much richer in content and are older than the English language. English has borrowed quite a lot of Indian words in the new Oxford dictionary of Indian English. In contrast to Macaulay’s contempt for India and Indians let us see what the great people of other countries had to say about Indian education.
Macaulay did succeed in his mission. Even after 60 years of “so called” political independence we do not seem to have intellectual independence to think with an Indian mind. We are still the slaves of western thought. It is because the mind of every child that goes to the conventional school today gets fettered and never free to think, just the opposite of what Gurudev Tagore wrote in the Geetanjali-“where the mind is free”. The gun culture of America will automatically be replaced by the universal compassion emanating out of the wisdom of our inner self in the ancient Indian educational system if only we could change our educational system.
As was pointed out by Macaulay the back bone of every culture is its educational system. While we insist on our being Indians first what are we hesitating to give the future generation the correct education that can root out the greatest cancer in our society-corruption? The root of corruption is the competitive ethos of western education for the impressionable mind of a young child in school where the child is encouraged to compete with others and not with itself. The former is only mediocrity while the latter is excellence. The former makes the child either proud or jealous, the two deadly poisons that slowly kill mankind. The latter makes the child excellent and altruistic.
We need not throw out the western education system lock, stock and barrel. That would be like throwing the baby with the bath tub out of the window. Let us devise a new educational system that incorporates the wheat from both the systems excluding the chaff in either. Unlike what most people think the progress of a nation does not depend solely on its economic growth or its technological superiority; it depends on the development of its people physically, mentally, spiritually and culturally to make them happy and contented. Man with his greed and proclivity for comfort would otherwise rob this universe of all that is needed for the future development. Healthy nation is a happy nation.

Need based higher education:
The present educational system is job oriented and examination centered. That does not let the child develop himself to be an ideal citizen with the complete awareness of his social obligations. The present generation does not seem to be bothered about its collective responsibility to society at all. We can not blame them for that. The educational system does not inculcate that in them during their time in school. With our demographic figures likely to throw up 700-800 million children looking for education in the next fifty years, we lack the necessary infrastructure in addition. Higher education at the tax payers’ cost is out of the question but primary education is the responsibility of the government. Primary education of the right variety would bring forth a generation of Indians truly Indian in thought and action.
“I am beholden to Indians as it is they who taught us how to count, without which there could have been no progress in science.”
Albert Einstein.

Lateral thinking, the foundation of progress.

Thinking out of the box, otherwise called lateral thinking (Pensamiento Lateral, in Spanish), is the need of the hour. Although defined as unusual and apparently faulty technique, it is our savior today what with all the myths doing rounds in every area of human endeavour. The present civilization reminds me of what Shakespeare wrote centuries ago:
“But man, proud man,
Dressed in a little brief authority,
Most ignorant of what he's most assured,
His glassy essence, like an angry ape
Plays such fantastic tricks before high heaven
As makes the angels weep.”
William Shakespeare (1564–1616), in Measure for Measure.
No body seems to want to bell the cat in our present delusion with falsehood and distorted thinking, lest s/he should cross swords with the rich and the powerful in every area. Mankind seems to be in a deep slumber driven by advertisements, which are the legal way of selling unethical and dangerous ideas to the public. Power-muscle, money, or intellectual- seems to be the boss.
The scenario reminds me of a new reverse evolution of mankind from man to monkey after having evolved from the monkey to man for millions of years, according to the theory of evolution of Darwin. Even though there are gaping holes in the Darwin’s theory, the neo Darwinists want us to believe that theory. There are academic departments trying to sell the idea. If the idea is that good and is an all time truth, why do we need any one to sell the idea?
One telling example will suffice in the development of our eye from a depression in the skull of lower mammals. To form one rod or cone in the retina we need thousands of biochemical reactions, none of which, individually, has any survival benefit motive. If Darwin were to be alive today he would have written about the reverse evolution in society of man’s behavior, based on what Shakespeare wrote, as seen above.
Science, a laudable effort to understand Nature by man, has now been turned into a greedy business with patents and intellectual property rights. Scientific research frauds are the order of the day with skeletons stumbling out of every major player’s cupboards daily. Serendipity alone rules the roost in every discovery. Today there is a very thin line between science and religion as both have become power crazy!

If Watson and Crick get the idea of DNA structure in one of their dreams, there is some energy that puts that thought in the head in sleep. That energy is otherwise called nature or God, depending on one’s beliefs. How on earth does that thought become Watson’s or Crick’s intellectual property to be used for making money? Thank Heavens; people like Einstein, Heisenberg, Thomas Alva Edison and their ilk did not patent their findings. If they were to do that life would have been that much more expensive for the poor man on the street.
Every single chemical molecule that is studied by the greedy industry becomes their patent for a certain number of years and they have the sole right to sell that to the gullible public at their own fancy rates. If one looks at the NPVr (net present value risk adjusted) for any drug today one would be shocked to know that the profit margin could be in thousands of times of their investment! All this happens because we have made science ride piggyback on technology to let the greedy make hey when the sun shines, thanks to the myth of intellectual property rights. Is the human kind hardwired to be altruistic, as shown by Vernon Smith and David Kahneman in their 2002 Nobel winning study called the “Dictator Experiments?”
“No” says their own colleague John List! On the contrary, the truth is that human kind is hardwired to be greedy (homo-economicus) as shown by Professor John List, at the Chicago University’s economics department. Using the same Dictator experiments with a little alteration in the protocol, John proved his point and also his life’s experience. John did one simple modification in that he told the subjects in the Dictator experiments that they will not be observed by the researchers during the experiment. This little change brought out the real truth. When not observed, every subject cheated, unlike when every subject was altruistic under the watchful eyes of the researchers!
The Nobel committee did not want the truth and John did not get any credit for showing the truth, probably had trouble for him in the department for proving his seniors wrong! True culture is what one does when no one is looking, was the opinion of Henry David Thoreau. That is the essence of India philosophy as well.
Walt Whitman rightly said “that character and personal force are the only investments worth anything.” Unfortunately, what has happened to the world now depends on what Voltaire once said: “every man, as to character, is the creature of the age in which he lives. Very few are able to raise themselves above the ideas of their times.” Let us try and raise ourselves above that curse.
“Truth is bitter”, wrote Aristotle, “it can only influence half a score of men in a century while false hood and mystery drags millions by the nose.’ The scene had not changed centuries later when Winston Churchill wrote that “a lie gets halfway around the world before truth has a chance to get its pants on.”
This blog site would try to bring forth a truth in every area. It never tries for the truth. Let us start with the science of man, which no great scientific master in the past bothered to unravel. They all excelled in exploring the science of inanimate matter which was much easier. Physics and chemistry did just that and biology started riding on the back of those linear sciences.
In the 12th Century when medicine was accepted as a science by the Universities in Europe, medical leaders also accepted the existing science of linear mathematics of physics and chemistry which has resulted in much misery for mankind today. The existing science of medicine uses the linear laws for a non-linear dynamic system-a round plug in a square hole indeed. Manaeveam manushyaanaam, man is but his mind, avers the ancient Indian wisdom. Western science has not been able to grapple with human consciousness which is what man is all about. Let us start from that point for future discussions in this blog site. “Knowledge advances, NOT by repeating known facts, but by REFUTING false dogmas,” wrote Karl Popper, one of the all time greats among British thinkers. We have a very big job on hand to do just that.

What are health and health mongering?

Define Health:

Health is enthusiasm to work and enthusiasm to be compassionate.

Absence of disease, to be a part of the definition of health, is unscientific, to say the least. All of us have millions of our body cells dying everyday to be replaced by new cells. In the process some cells might fail to die at the appointed time (apoptosis) and they mutate to become rogue cells. These are the beginning of a cancer. Most, if not all, of those rogue cells eventually die a natural death if one has a compassionate mind AND TAKES A HEALTHY DIET. RARELY ONE OF THE rogue cells COULD DEVELOP INTO CLINICAL CANCER AFTER A GAP, long or short. So if we can screen every one for the presence of rogue cells all of us will be patients. There will be no well person at all.Our curse today is the disease concept. Diagnosis is the biggest disease in the faulty organ based medicine. Human body is a bundle of jumping lepto-quarks and disease is only altered energy pattern that needs to set right.  The disease concept is outdated, to say the least (Am. J. Medicine 2004; 116: 179.)

To be healthy one must have a healthy mind filled with universal compassion. Discomfort in itself is not illness. Stephen Hawking has one of the worst diagnoses attached to him which should have killed him decades ago according to our textbooks. But he still has enthusiasm to work and to be compassionate and so is healthy. A criminal might have a strong body but he is not healthy as he has no compassion.

  The new definition of health, therefore, is the one given above.

What is health mongering?

There is an all round effort at disease mongering all over the world to make money from the gullible public! (*PLOSmedicine article by its editor Ray Moynihan. ** The book Disease Inventors by Professor Jorg Blech *** What doctors don't get to study in medical school book by Professor BM Hegde)

To counter that kind of an effort, I have started this new effort. I am a vendor of good health to do most good to most people most of the time through this effort. Health is one's birth right. Nature has endowed us with a robust immune system that will protect us against all illnesses under ideal circumstances. Since we do not live in an ideal environment we need to take special care to remain healthy. This site will eventually hope to inform the readers about those simple methods. Let me remind the readers that most complicated problems in the world have very simple solutions most of the time!
This word is my invention and needs patenting.

Health expectancy Vs Life expectancy:

Another misleading term in modern medical literature is the statistical term Life Expectancy which many people (even the most educated good people) think is synonymous with Life Span. Nothing can be farther from the truth. Human life span has been brought down by all our efforts to date what with our spoiling our air, water, food, hi-tech medical efforts etc. Life expectancy is the number of years a new born baby could expect to live on this planet. This number depends fully on the peri-natal fatalities which used to be prohibitively high when we became independent in 1947. Today, thanks to better living standards, hand washing while delivering babies, better nutrition and literacy and information, the perinatal mortality has fallen drastically. That pushes up the statistical term Life Expectancy very much. The modern hi-tech has very little, if any, role to play in that effort.

Health Expectancy is a new word (neologism) created by me to denote the number of years a new born healthy child could expect to live without the help of doctors, medicines and surgery. As of now it is the lowest in the USA (JAMA 2000; 284: 483-485) and highest in India!

With these explanations the future blogs will become easy to understand. Let me have as many comments as possible. It was Winston Churchill who once said that "He has right to criticise who has a heart to help"!