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.