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.


  1. brilliant. it is doctors like you who should promote ayurveda as a concept of wellness. please carry on.


  2. I am glad there is at least one sane voice like yours in the field of medicine.
    A thought that comes to my mind is, once a medical graduate/post graduate starts in his profession (or shall we call it "business"?!), is there any prescribed mandate for him to update his knowledge or he has to depend on the 'info' given by the drug industry with vested interests to keep going in his profession. Even in the babudom of government, officers are supposedly sent for refresher courses to re-tune them with the latest trends and equip them with 'modern' knowledge.
    If medical council of India, which is supposed to be the leading light for medical professionals, is headed by people like the previous incumbent, what more can we expect? Even driving license is given for specific periods and is to be renewed at specified intervals! Let us ignore the mallpractices in grant of DL for a moment; at least there is a laid down procedure there. Can you please throw some light on this?

  3. I hope that your efforts to bring sanity into the medical profession will succeed, though the prospects seem very bleak in today's world of crass commercialisation. Even a layman would logically think that, mother nature that allows man to be born, would also provide the wherewithal for his survival. Man should go back to nature. The cogent reasoning in your article, backed by your wealth of knowledge and experience in the medical field, should help the public to adopt this idea.

  4. Can't help agreeing with Dr.Hegde, albeit with a sense of remorse that it is the profession I practice. Of course it can be done in a much better way with use of minimum pharmaceuticals and maximum life style modification, which still is what most text books advice as the first line of management. Gita unfortunately met a more pharmacologically oriented doctor . Our orientation and approach definitely needs to be changed

  5. Today Doctors are like mobile companies...make your weakness an illness..Dr. Hegde always is right..from his words like ' imaginative diseases like hypertension and cholesterol'..if you care your body much..the more doctors are going to make your medical bills high..thanks for that blog Dr. people must realize..how????

  6. The mirage called money- How right he is!
    I have been thinking about the tool called money for many years now. I have written the conclusions in my website www.YouTakeResponsibility.com.
    We need local currencies to escape from this state of slavery.