一个医学叛逆者的自白 CONFESSION OF A MEDICAL HERETIC

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Confessions of a Medical Heretic

Robert S. Mendelsohn, M.D., 1979
Numbers in brackets correspond with page numbers in the Warner Books Edition, 198 .
Non Credo
!11" # do not be$ie%e in &odern &edicine. # am a medica$ heretic. &' aim in this book is to persuade 'ou to become a heretic, too. # ha%en(t a$wa's been a medica$ heretic. # once be$ie%ed in &odern &edicine. #n medica$ schoo$, # )ai$ed to $ook deep$' into a stud' that was going on around me, o) the e))ects o) the hormone *E+ ,, because # be$ie%ed. Who cou$d ha%e suspected that twent' 'ears $ater we wou$d disco%er that *E+ causes %agina$ cancer and genita$ abnorma$ities in chi$dren born to women recei%ing the drug during pregnanc'# con)ess that # )ai$ed to be suspicious o) ox'gen therap' )or premature in)ants, e%en though the best e.uipped and most ad%anced !1/" premature nurseries had an incidence o) partia$ or tota$ b$indness o) around ninet' percent o) a$$ $ow birth weight in)ants. 0 )ew mi$es awa' in a $arge, $ess 1ad%anced1 hospita$, the incidence o) this condition ,, retro$enta$ )ibrop$asia ,, was $ess than ten percent. # asked m' pro)essors in medica$ schoo$ to exp$ain the di))erence. 0nd # be$ie%ed them when the' said the doctors in the poorer hospita$ 2ust didn(t know how to make the correct diagnosis. 0 'ear or two $ater it was pro%ed that the cause o) retro$enta$ )ibrop$asia was the high concentrations o) ox'gen administered to the premies. 3he a))$uent medica$ centers had higher rates o) b$inding simp$' because the' cou$d a))ord the %er' best nurser' e.uipment: the most expensi%e and modern p$astic incubators which guaranteed that a$$ the ox'gen pumped in reached the in)ant. 0t the poorer nurseries, howe%er, o$d,)ashioned incuba$ors were used. 3he' $ooked $ike bathtubs with %er' $oose meta$ $ids. 3he' were so $eak' that it made %er' $itt$e di))erence how much ox'gen was pumped in: not enough reached the in)ant to b$ind it. # sti$$ be$ie%ed when # took part in a scienti)ic paper on the use o) the antibiotic 3erram'cin in treating respirator' conditions in premature babies. We c$aimed there were no side e))ects. 4) course there weren(t. We didn(t wait $ong enough to )ind out that not on$' didn(t 3erram'cin ,, or an' other antibiotic ,, do much good )or these in)ections, but that it ,, and other tetrac'c$ine antibiotics ,, $e)t !15" thousands o) chi$dren with 'e$$ow,green teeth and tetrac'e$ine deposits in their bones. 0nd # con)ess that # be$ie%ed in the irradiation o) tonsi$s, $'mph nodes, and the th'mus g$and. # be$ie%ed m' pro)essors when the' said that o) course radiation was dangerous, but that the doses we were using were abso$ute$' harm$ess. 6ears $ater around the time we )ound out that the 1abso$ute$' harm$ess1 radiation sown a decade or two be)ore was now reaping a har%est o) th'roid tumors ,, # cou$dn(t heip wondering when some o) m' )ormer patients came back with nodu$es on their th'roids: Wh' are 'ou coming back to me- 3o me, who did this to 'ou in the )irst p$aceBut # no $onger be$ie%e in &odern &edicine. # be$ie%e that despite a$$ the super techno$og' and e$ite bedside manner that(s supposed to make 'ou
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)ee$ about as we$$ cared )or as an astronaut on the wa' to the moon, the greatest danger to 'our hea$th is the doctor who practices &odern &edicine. # be$ie%e that &odern &edicine(s treatments )or disease are se$dom e))ecti%e, and that the'(re o)ten more dangerous than the diseases the'(re designed to treat. # be$ie%e the dangers are compounded b' the widespread use o) dangerous procedures )or non, diseases. # be$ie%e that more than ninet' percent o) &odern &edicine cou$d disappear )rom the )ace o) the earth ,, doctors, hospita$s, drugs, !17" and e.uipment ,, and the e))ect on our hea$th wou$d be immediate and bene)icia$. # be$ie%e that &odern &edicine has gone too )ar, b' using in e%er'da' situations extreme treatments designed )or critica$ conditions. E%er' minute o) e%er' da' &odern &edicine goes too )ar, because &odern &edicine prides itself on going too )ar. 0 recent artic$e, 18$e%e$and(s &ar%e$ous &edica$ 9actor',1 boasted o) the 8$e%e$and 8$inic(s 1accomp$ishments $ast 'ear: /,98 open,heart operations, 1.5 mi$$ion $aborator' tests, :5,5/ e$ectrocardiograms, :,:: )u$$,bod' x,ra' scans, /7,5;8 surgica$ procedures.1 Not one o) these procedures has been pro%ed to ha%e the $east $itt$e bit to do with maintaining or restoring hea$th. 0nd the artic$e, which was pub$ished in the 8$e%e$and 8$inic(s maga<ine, )ai$s to boast or e%en mention that an' peop$e were he$ped b' an' o) this expensi%e extra%agance. 3hat(s because the product o) this )actor' is not hea$th at a$$. +o when 'ou go to the doctor, 'ou(re seen not as a person who needs he$p with his or her hea$th, but as a potentia$ market )or the medica$ )actor'(s products. #) 'ou are pregnant, 'ou go to the doctor and he treats 'ou as i) 'ou(re sick. 8hi$dbirth is a nine, month disease which must be treated, so 'ou(re so$d on intra%enous )$uid bags, )eta$ monitors, a host o) drugs, the tota$$' unnecessar' episiotom', and ,, the top o) the $ine product ,, the 8aesarean de$i%er'= !1>" #) 'ou make the mistake o) going to the doctor with a co$d or the )$u he(s $iab$e to gi%e 'ou antibiotics, which are not on$' power$ess against co$ds and )$u but which $ea%e 'ou more $ike$' to come down with worse prob$ems. #) 'our chi$d is a $itt$e too pepp' )or his teacher to hand$e, 'our doctor ma' go too )ar and turn him into a drug dependent. #) 'our new bab' goes o)) his or her )eed )or a da' and doesn(t gain weight as )ast as the doctor(s manua$ sa's, he might barrage 'our breast,)eeding with drugs to ha$t the natura$ process and make room in the bab'(s tumm' )or man,made )ormu$a, which is dangerous. #) 'our are )oo$ish enough to make that 'ear$' %isit )or the routine examination, the receptionist(s petu$ance, the other patients( cigarette smoke, or the doctor(s %er' presence cou$d raise 'our b$ood pressure enough so that 'ou won(t go home empt',handed. 0nother $i)e 1sa%ed1 b' anti, h'pertensi%e drugs. 0nother sex $i)e down the drain, since more impotence is caused b' drug therap' than b' ps'cho$ogica$ prob$ems. #) 'ou(re un)ortunate enough to be near a hospita$ when 'our $ast da's on earth approach, 'our doctor wi$$ make sure 'our ?> ,a,da' deathbed has a$$ the $atest e$ectronic gear with a sta)) o) strangers to hear 'our $ast words. But since those strangers are paid to keep 'our )ami$' awa' )rom 'ou, 'ou won(t ha%e an'thing to sa'. 6our $ast sounds wi$$ be the e$ectronic whist$e on the cardiogram. 6our re$ati%es wi$$ participate: the'($$ pa' the bi$$. !1;" No wonder chi$dren are a)raid o) doctors. 3he' know= 3heir instincts )or rea$ danger are
uncorrupted. 9ear se$dom actua$$' disappears. 0du$ts are a)raid, too. But the' don(t admit it, e%en to themse$%es. What happens is we become a)raid o) something e$se. We $earn to )ear not the doctor but what brings us to the doctor in the )irst p$ace: our bod' and its natura$ processes. When 'ou )ear something, 'ou a%oid it. 6ou ignore it. 6ou sh' awa' )rom it. 6ou pretend it doesn(t exist. 6ou $et someone e$se worr' about it 3his is how the doctor takes o%er. We $et him. We sa': # don(t want to ha%e an'thing to do with this, m' bod' and its prob$ems, doc. 6ou take care o) it, doc. *o what 'ou ha%e to do. +o the doctor does. When doctors are critici<ed )or not te$$$ng their patients about the side e))ects o) the drugs the' prescribe, the' de)end themse$%es on the grounds that the doctor,patient re$at$onship wou$d su))er )rom such honest'. 3hat de)ense imp$ies that the doctor,patient re$ationship is based on something other than know$edge. #t(s based on )aith. We don(t sa' we know our doctors are good we sa' we ha%e )aith in them. We trust them. *on(t think doctors aren(t aware o) the di))erence. 0nd don(t be$ie%e )or a minute that the' don(t p$a' it )or a$$ it(s worth. Because what(s at stake is the who$e ba$$ game, the who$e ninet' percent or more o) &odern !1:" &edicine that we don(t need, that, as a matter o) )act is out to ki$$ us. &odern &edicine can(t sur%i%e without our )aith, because &odern &edicine is neither an art nor a science. #t(s a re$igion. 4ne de)inition o) re$igion identi)ies it as an' organi<ed e))ort to dea$ with pu<<$ing or m'sterious things we see going on in and around us. 3he 8hurch o) &odern &edicine dea$s with the most pu<<$ing phenomena: birth, death, and a$$ the tricks our bodies p$a' on us ,, and we on them ,, in between. #n 13he @o$den Bough,1 re$igion is de)ined as the attempt to gain the )a%or o) 1powers superior to man which are be$ie%ed io direct and contro$ the course o) nature and o) human $i)e.1 #) peop$e don(t spend bi$$ions o) do$$ars on the 8hurch o) &odern &edicine in order to gain )a%or with the powers that direct and contro$ human $i)e, what do the' spend it on8ommon to a$$ re$igions is the c$aim that rea$it' is not $imited to or dependent upon what can be seen, heard, )e$t, tasted or sme$$ed. 6ou can easi$' test modern medica$ re$igion on this characteristic b' simp$' asking 'our doctor Wh'- enough times. Wh' are 'ou prescribing this drug- Wh' is this operation going to do me an' good- Wh' do # ha%e to do that- Wh' do 'ou ha%e to do that to meAust ask wh'- enough times and sooner or $ater 'ou($$ reach the 8hasm o) 9aith. 6our doctor wi$$ retreat into the )act that 'ou ha%e no wa' o) knowing or understanding a$$ the !18" wonders he has at his command. Aust trust me. 6ou(%e 2ust had 'our )irst $esson in medica$ heres'. Besson Number 3wo is that i) a doctor e%er wants to do something to 'ou that 'ou(re a)raid o) and 'ou ask wh'- enough times unti$ he sa's Aust 3rust &e, what 'ou(re to do is turn around and put as much distance between 'ou and him as 'ou can, as )ast as 'our condition wi$$ a$$ow. Cn)ortuate$', %er' )ew peop$e do that. 3he' submit. 3he' a$$ow their )ear o) the witch doctor(s mask, the unknown spirit behind it, and the m'ster' o) what is happening and o) what wi$$ happen to change into respect)u$ awe o) the who$e show. But 'ou don(t ha%e to $et the witch doctor ha%e his wa'. 6ou can $iberate 'ourse$) )rom &odern &edicine ,, and it doesn(t mean 'ou($$ ha%e to take chances with 'our hea$th. #n )act, 'ou($$ be taking $ess o) a chance with 'our hea$th, because there(s no more dangerous acti%it' than wa$king into a doctor(s o))ice, c$inic or hospita$ unprepared. 0nd b' prepared # don(t mean ha%ing 'our
insurance )orms )i$$ed out. # mean 'ou ha%e to get in and out a$i%e and accomp$ish 'our mission. 9or that, 'ou need appropriate too$s, ski$$s, and cunning. 3he )irst too$ 'ou must ha%e is know$edge o) the enem'. 4nce 'ou understand &odern &edicine as a re$igion, 'ou can )ight it and de)end 'ourse$) much more e))ecti%e$' than when 'ou think 'ou(re )ighting an art or a science. 4) course, the 8hurch o) &odern !19" &edicine ne%er ca$$s itse$) a church. 6ou($$ ne%er see a medica$ bui$ding dedicated to the re$igion o) medicine, a$wa's the medica$ arts, or medica$ science. &odern &edicine re$ies on )aith to sur%i%e. 0$$ re$igions do. +o hea%i$' does the 8hurch o) &odern &edicine re$' on )aith that i) e%er'one somehow simp$' )orgot to be$ie%e in it )or 2ust one da' the who$e s'stem wou$d co$$apse. 9or how e$se cou$d an' institution get peop$e to do the things &odern &edicine gets peop$e to do, without inducing a pro)ound suspension o) doubt- Wou$d peop$e a$$ow themse$%es to be arti)icia$$' put to s$eep and then cut to pieces in a proeess the' cou$dn(t ha%e the s$ightest notion about ,, i) the' didn(t ha%e )aith- Wou$d peop$e swa$$ow the thousands o) tons o) pi$$s e%er' 'ear ,, again without the s$ightest know$edge o) what these chemica$s are going to do ,, i) the' didn(t ha%e )aith#) &odern &edicine had to %a$idate its procedures ob2ecti%e$', this book wou$dn(t be necessar'. 3hat(s wh' #(m going to demonstrate how &odern &edicine is not a church 'ou want to ha%e )aith in. +ome doctors are worried about scaring their patients. Whi$e 'ou(re reading this book, 'ou are, in a sense, m' patient. # think 'ou shou$d be scared. 6ou(re supposed to be scared when 'our we$$,being and )reedom are threatened. 0nd 'ou are, right now, being threatened. #) 'ou(re read' to $earn some o) the shocking things 'our doctor knows but won(t te$$ 'ouD i) !/ " 'ou(re read' to )ind out i) 'our doctor is dangerousD i) 'ou(re read' to $earn how to protect 'ourse$) )rom 'our doctorD 'ou shou$d keep reading because that(s what this book is about.
Chapter 1 Dangerous Diagnosis

!/1" # don(t ad%ise an'one who has no s'mptoms to go to the doctor )or a ph'sica$ examination. 9or peop$e with s'mptoms, it(s not such a good idea, either. 3he entire diagnostic procedure ,, )rom the moment 'ou enter the o))ice to the moment 'ou $ea%e c$utching a prescription or a re)erra$ appointment ,, is a se$dom use)u$ ritua$. 3he mere act o) de$i%ering 'ourse$) to the priest$' doctor and submitting to his wishes presumab$' bestows the bene)it. 3he )ee$ing is that the more exams 'ou ha%e, and the more thorough the exams, the better o)) 'ou($$ be. 0$$ o) which is nonsense. 6ou shou$d approach the diagnostic procedure with suspicion rather than con)idence. 6ou shou$d be aware o) the dangers, and that e%en the simp$est, !//" seeming$' innocuous e$ements can be a threat to 'our hea$th or we$$,being. 3he diagnostic too$s themse$%es are dangerous. 3he stethoscope, or examp$e, is nothing but the priest$' doctor(s re$igious badge. 0s a too$, it does more harm than good. 3here(s no .uestion that there(s a high degree o) contagion )rom the use o) stethoscopes )rom patient to patient. 0nd there(s a$most no )orm o) serious disease that cannot be suspected or diagnosed without the stethoscope. #n congenita$ heart disease where the bab' is b$ue, it(s ob%ious because the bab' is b$ue. #n other )orms o) heart disease, the diagnosis can be made b' )ee$ing the %arious pu$ses around the bod'. #n
coarctation o) the aorta, )or examp$e, there(s a de)icienc' o) the pu$se rate in the )emora$ arteries in the groin, 6ou don(t need a stethoscope to make that diagnosis. 3he on$' %a$ue o) ihe stethoscope o%er the naked ear app$ied to the chest is in the con%enience and modest' o) the ph'sician. 3here(s nothing that he can hear with the stethoscope that he cannot hear with his ear against the person(s chest. 0s a matter o) )act, # know some doctors who now put the stethoscope around their neck and don(t put the ear pieces in their ears as the' app$' the be$$ to the patient(s chest= 0t one time # used to think that was rea$$' terrib$e. Not an' more. 3he doctor probab$' rea$i<es, conscious$' or otherwise that the patient needs the stethoscopic examination because it(s part o) the sacred ritua$ !/5" rather than because it makes an' sense or does an' good. 0nd it can do harm, especia$$' in the case o) chi$dren. +uppose a mother brings her daughter in )or her annua$ exam. 3he chi$d has no s'mptoms o) i$$ness whatsoe%er. But the doctor uses the stethoscope and disco%ers a )unctiona$ heart murmur ,, a harm$ess heart sound )ound in at $east one third o) a$$ chi$dren at one time or another. 0t that point the doctor has to make a decision whether or not to te$$ the mother. Now at one time doctors used to keep this in)ormation to themse$%es. 3he' might put it in the chart in s'mbo$ic )orm so that nobod' but a doctor cou$d read it. Eecent$' doctors ha%e been taught to share this in)ormation with the parents either because o) their be$ie) in the patient(s right to know or ,, more $ike$' ,, because the'(re a)raid another doctor wi$$ )ind it and te$$ them )irst. +o the doctor te$$s the mother. 0nd whether or not he reassures the )ami$' that the murmur is innocent, both mother and daughter ma' suspect ,, perhaps )or the rest o) their $i%es ,, that something rea$$' is wrong= &other ma' then begin a trek to pediatric cardio$ogists who wi$$ take repeated EF@s, chest x,ra's, or e%en per)orm cardiac catheteri<ations to he$p the mother 1get to the bottom o) a$$ this.1 +tudies ha%e shown that )ami$ies o) chi$dren with heart murmurs tend to do two things: the' restrict their chi$d(s acti%it' and do not a$$ow them to p$a' in sports, and the' encourage them to eat !/7" more. Natura$$' these are the worst things the' can do= 3he' $itera$$' make cardiac cripp$es out o) their chi$dren. 3hough it(s a $ot more impressi%e than the stethoscope, the e$ectrocardiogram GEF@H is $itt$e more than an expensi%e e$ectronic to' )or the ph'sician. &ore than twent' 'ears ago a sur%e' re%ea$ed that the reports o) expert EF@ interpreters %aried b' twent' percent among indi%idua$s and b' another twent' percent when the same indi%idua$s re,read the same tracing at another time. 3ime o) da', recent acti%it', and man' other )actors besides the condition o) one(s heart can a))ect the readings. #n one test the EF@ de$i%ered a positi%e )inding in on$' twent',)i%e percent o) cases o) pro%en m'ocardia$ in)arction, an e.ui%oca$ )inding in ha$), and a tota$$' negati%e )inding in the rest. 0nd in another test, more than ha$) o) the readings taken o) hea$th' peop$e were gross$' abnorma$. 6et ph'sicians and other medica$ personne$ continue io increase rather than decrease their re$iance on the EF@ as a detector o) card$ac prob$ems. # ha%e a recurring )antas' o) a person $'ing in an intensi%e coronar' care unit a)ter su))ering a heart attack. Ie is per)ect$' com)ortab$e ,, unti$ he(s approached b' a nurse with a h'podermic s'ringe. +he exp$ains that his EF@ monitor has shown an irregu$arit' that demands immediate treatment. 4) course, she is not aware o) the studies that show the high degree o) error in e$ectronic monitoring e.uipment, or the studies that show the not !/>" in)re.uent $eakage o) e$ectricit' )rom one monitor to another in the same ward. &' )antas' patient protests and p$eads with the nurse: 1J$ease, nurse, )ee$ m' pu$se. #t(s a$so$ute$' regu$ar=1 3he nurse(s answer is that there(s no point in )ee$ing his pu$se. 6ou can(t argue with the machine. +o she immediate$' p$unges the need$e in his arm. 6ou can guess at the outcome.
&' )antas' is not so )antastic as 'ou might think. 3here are e$ectronic monitors in 1ad%anced1 coronar' units that are e.uipped to e$ectrica$$' 1correct1 the heartbeat o) patients who, the machine decides, need a 2o$t. # ha%e heard o) cases where the machine decided the person needed a 2o$t when, in )act, he didn(t. Whi$e the e$ectroencepha$ogam GEE@H is an exce$$ent instrument )or the diagnosis o) certain kinds o) con%u$si%e disorders and the diagnosis and $oca$i<ation o) brain tumors, not man' peop$e are aware o) its $imitations. 0bout twent' percent o) peop$e with c$inica$$' estab$ished con%u$si%e disorders ne%er ha%e an abnorma$ EE@. 6et )i)teen to twent' percent o) per)ect$' norma$ peop$e ha%e abnorma$ EE@s= 3o demonstrate the .uestionab$e re$iabi$it' o) the EE@ as a measure o) brain acti%it', one researcher connected one in the standard manner to a manne.uin(s head )i$$ed with $ime 2e$$o and got a reading indicating 1$i)e.1 *espite the ob%ious possibi$ities )or error the EE@ is used as the primar' diagnostic too$ in determining whether or not a chi$d tru$' has organic $earning di))icu$ties, minima$ brain !/;" damage, h'peracti%it', or an' o) the twent' or thirt' other names assigned to this i$$,de)ined s'ndrome. *espite the )act that e%er' pediatric neuro$ogist in need o) pub$ishing a paper has reported some signi)icance o) this spike or that dip, there has been a tota$ $ack o) agreement on a %a$id corre$ation between an EE@ reading and a chi$d(s beha%ior. Ne%erthe$ess, this $ack o) scienti))c %a$idation has in no wa' inter)ered with the pro$i)eration o) EE@ machines and the sk'rocketing numbers o) EE@s per)ormed. # o)ten recommend to students in search o) a career the entire )ie$d o) e$ectroencepha$ograph' since it, $ike e%er'thing e$se connected with $earning disabi$ities, is a growth industr'. 3oda' educators, ph'sicians, and parents ha%e conscious$' or otherwise 2oined in a conspirac' to medica$i<e a$most a$$ beha%ior prob$ems. What happens is that a chi$d gets sent home with a note asking )or a con)erence. 0t the con)erence, the parents are to$d the chi$d might ha%e an organic brain prob$em, might be h'peracti%e, might be minima$$' brain damaged. Jarents and chi$d are hust$ed o)) to the doctor )or an EE@. 3hen, on the basis o) the EE@ ,, which ma' or ma' not be accurate ,, the chi$d is drugged into )itting the beha%ior mo$d that best suits tbe teacher. B' )ar, the most per%asi%e and dangerous dignostic too$ in the doctor(s o))ice is the x,ra' machine. Cn)ortunate$', because o) its re$igious signi)icance, the x,ra' machine wi$$ be the hardest )or doctors to gi%e up. 3he' know that peop$e are awed b' the doctor(s power to !/:" see right through their )$esh, to ga<e )irsthand at what is a))icting them, to see where the' cannot. *octors $itera$$' got drunk on this power and started using x,ra's on e%er'thing )rom acne to sett$ing the m'steries o) the de%e$oping )etus. &an' obstetricians sti$$ insist on x,ra's i) the' don(t .uite trust their ski$$ in determining )eta$ position b' pa$pation ,, despite the )act that chi$dhood $ukemia has a we$$, documented $ink with prenata$ radiation exposure. 3h'roid $esions, man' o) them cancerous, are now turning up b' the thousands in peop$e who were exposed to head, neck and upper chest radiation twent' to thirt' 'ears ago. 3h'roid cancer can de%e$op a)ter an amount o) radiation that is $ess than that produced b% ten bite,wing denta$ x,ra's. +cientist testi)'ing be)ore 8ongess ha%e emphasi<ed the ha<ards o) $ow $e%e$ radiation to both the present generaton and to )uture generations in the )orm o) genetic damage. 3he' ha%e imp$icated x, ra's in the de%e$opment o) diabetes, cardio%ascu$ar disease, stroke, high b$ood pressure, and cataracts ,, a$$ associated with aging. 4ther studies ha%e matched radiation to cancer, b$ood disorders, and tumors o) the centra$ ner%ous s'stem. 8onser%ati%e estimates peg the number o) deaths each 'ear direct$' attributab$e to medica$ and denta$ radiation at 7 .
0s )ar as #(m concerned, these deaths are unnecessar', as is the host o) other a))$ictions attributed to radiation. 0 .uarter centur' ago # was taught in medica$ schoo$ that x,ra's o) !/8" the breast were practica$$' worth$ess. 0 recent sur%e' showed that things ha%en(t changed %er' much. Jh'sicians supposed$' trained to interpret mammograms were no more accurate than untrained ph'sicians in spotting breast cancer on mammograms. 0 sur%e' more than thirt' 'ears ago showed that as man' as twent',)our percent o) radio$ogists di))ered with each other interpreting the same chest )i$m, e%en in cases o) extensi%e disease. 3hirt',one percent o) them e%en disagreed with themse$%es when re,reading the same )i$ms= 0nother stud' in $9>> showed that thirt',two percent o) chest x, ra's showing de)inite abnorma$ities in the $ungs were misdiagnosed as negati%e. #n 19>9, thirt' percent o) the experts disageed with other experts on radiographic readings, and twent' percent disagreed with themse$%es when rereading the same )i$ms= 0 19: Iar%ard stud' showed that the going rate o) disagreement among radio$ogists was sti$$ at $east twent' percent. 6et x,ra's are sti$$ sacred in most doctors( and dentists( o))ices. Iundreds o) thousands o) women are sti$$ $ining up e%er' 'ear )or breast x,ra's, despite the we$$ pub$ished scienti)ic e%idence that the mammograph' itse$) wi$$ cause more breast cancer than it wi$$ detect= 3he ritua$ o) the annua$ x, ra', the pre,emp$o'ment x,ra', the schoo$ entrance x,ra', and the hea$th )air x,ra' continue. # hear about and get $etters )rom peop$e whose doctors pronounce them in per)ect hea$th, but sti$$ insist on a chest x,ra'. 4ne man to$d me about going to the hospita$ !/9" )or a hernia operation, where he was gi%en six chest x,ra's. 9rom the radio$ogists con%ersations, he got the distinct impression the' were experimenting with the exposure $e%e$s. 3his same man was gi%en thirt' x,ra's at a $oca$ denta$ schoo$ where he went to get a crown rep$aced. &an' doctors de)end their use o) x,ra's on the grounds that the patients demand or expect x,ra's. 3o that excuse, # rep$' that i) peop$e are addicted to x,ra's, the greatest ser%ice doctors might per)orm wou$d be to rig up machines that $ook and sound $ike rea$ x,ra' machines. 0 tremendous amount o) disease cou$d be a%oided. Bab tests are another part o) the diagnostic procedure that do more harm than good. &edica$ testing $aboratories are scanda$ous$' inaccurate. #n 19:>, the 8enter )or *isease 8ontro$ G8*8H reported that its sur%e's o) $abs across the countr' demonstrated that ten to )ort' percent o) their work in bacterio$og' testing was unsatis)actor', th$rt' to )i)t' percent )ai$ed %arious simp$e c$inica$ chemistr' tests, twe$%e to eighteen percent )$ubbed b$ood grouping and t'ping and twent' to thirt' percent botched hemog$obin and serum e$ectro$'te tests. 4%er a$$, erroneous resu$ts were obtained in more than a .uarter o) a$$ the tests. #n another nationwide sur%e' )i)t' percent o) the 1high standard1 $abs $icensed )or &edicare work )ai$ed to pass. 0 $arge sca$e retesting o) />, ana$'ses made b' //> New Aerse' $abs re%ea$ed that on$' twent' percent o) them produced !5 " acceptab$e resu$ts more than ninet' percent o) the time. 4n$' ha$) passed the test se%ent',)i%e percent o) the time. 3o get some idea o) what peop$e are rea$$' getting )or ?1/ bi$$ion worth o) $ab tests each 'ear, thirt',one percent o) a group o) $abs tested b' the 8*8 cou$d not identi)' sick$e ce$$ anemia. 0nother test group incorrect$' identi)ied in)ectious mononuc$eosis at $east one third o) the time. 9rom ten to twent' percent o) the tested groups incorrect$' identi)ied specimens as indicating $eukemia. 0nd )rom )i%e to twe$%e percent cou$d be counted on to )ind something wrong with specimens which were hea$th'= &' )a%orite stud' is one in which 19: out o) / peop$e were 1cured1 o) their abnorma$ities simp$' b' repeating their $ab tests= #) 'ou think these tests are shocking keep in mind that the 8enter )or *isease 8ontro$ monitors and
regu$ates )ewer than ten percent o) the countr'(s $abs. +o these tests indicate the best work o) the best $abs. With the rest, 'ou pa' 'our mone' and 'ou take 'our chances. 0nd 'ou wi$$ pa' more and more, because doctors practicing 12ust in case medicine1 are ordering more and more $aborator' tests. 0s $ong as these tests ha%e such an immense possibi$it' )or inaccurac', the on$' wa' to $ook at them is as sacred orac$es or )ortune te$$ing ritua$s: the' depend on the whims o) the deities and the ski$$ o) the magician,priest. E%en i) the deities are keeping up their end o) the bargain and 'our tests resu$ts are miracu$ous$' correct, there is sti$$ the danger that the doctor !51" wi$$ misinterpret them. 4ne woman wrote me that at her $ast routine examination, a test re%ea$ed b$ood in her stoo$. Ier doctor sub2ected her to e%er' possib$e test, inc$uding barium x,ra's, a$$ o) which pro%ed negati%e. 3he doctor did not gi%e up. 3hough the woman was in rea$ pain because o) the tests, he recommended )urther testing. +ix months $ater, his diagnosis was announced to a much weakened woman: she had too much acid in her stomach= Bab tests and diagnostic machines wou$dn(t be so dangerous i) doctors weren(t addicted to the .uantitati%e in)ormation these too$s pro%ide. +ince numbers and statistics are &odern &edicine(s $anguage o) pra'er, .uantitati%e in)ormation is considered sacred, the word o) @od, indeed, the $ast word in a diagnosis. Whether the too$s are simp$e, $ike thermometers, sca$es, or ca$ibrated in)ant bott$es, or comp$icated $ike x,ra' machines, EF@s, EE@s, and $ab tests, peop$e and doctors are da<<$ed into crowding out o) the process their own common sense and the .ua$itati%e 2udgment o) doctors who are rea$ diagnostic artists. +ca$es cause a$$ kinds o) troub$e in pediatrics and obstetrics. 3he pediatician weighs the bab' and gets a$$ upset i) the bab' doesn(t gain a certain amount o) weight. 0gain, he(s substituting a .uantitati%e e%a$uation )or a .ua$itati%e one. 3he important .uestions are: what does the bab' $ook $ike- What(s his beha%ior- Iow does he $ook at 'ou- What are his mo%ements $ike- Iow(s his ner%ous s'stem )unctioning- Eather than re$'ing on these obser%ations, !5/" the doctor goes b' the numbers. +ometimes a breast)ed bab' won(t gain as )ast as the doctor mistaken$' thinks it shou$d. +o he puts the bab' on )ormu$a ,, to the detriment o) both mother and bab'. Jregnant women a$so shou$d pa' no attention to the sca$e. 3here is no correct amount o) weight )or an' mother to gain. 0gain, the important e%a$uations are .ua$itati%e rather than .uantitati%e. +he shou$d be eating the right )ood, not mere$' 1correct .uantities1 o) an' )ood. #) she(s care)u$ about what she eats, how much she eats wi$$ take care o) itse$). +he($$ right$' be ab$e to ignore the sca$e. 8a$ibrated in)ant )ormu$a bott$es are another menace. 3he pediatrician te$$s the mother to make sure the bab' gets 1x1 amount at e%er' )eeding, and, b' go$$', she(s determined to stick to that goa$. +o at e%er' )eeding she ca2o$es, threatens, and in some wa' gets that exact amount out o) the bott$e and into the bab'. &ost o) the time the bab% wi$$ throw most o) it back up, an'wa'. 3he net resu$t is a $ot o) bad )ee$ings between mother and bab' ,, a $ot o) anxiet' and tension where there shou$d be $o%e and en2o'ment. Not to mention a good chance o) obesit' in $ater $i)e. 3emperature taking is %irtua$$' use$ess, too. 3he )irst .uestion a doctor asks a mother o%er the te$ephone when she ca$$s to comp$ain about an i$$ness is what is the chi$d(s temperature. 3his .uestion has no meaning because there are innocuous diseases that carr' %er' high )e%ers. Eoseo$a, )or examp$e, is a common disease !55" o) in)anc', abso$ute$' harm$essD 'et it )re.uent$' carries a temperature o) 1 7 or 1 >. 4n the other hand, there are $i)e,threatening diseases, such as tubercu$ous meningitis and others, that carr' no )e%er at a$$ or e%en a subnorma$ temperature. 3he doctor shou$d be asking )or .ua$itati%e in)ormation, such as how the chi$d is )ee$ing and what the
mother has noticed in his beha%ior. 3he re$iance on numbers is simp$' to %a$idate the who$e process )or re$igious purposes. Because it is mere$' a use$ess ritua$, mothers shou$d answer the ph'sician(s .uestion about temperature b' sa'ing, 1# don(t knowD # ha%en(t taken it.1 4r, 1# don(t ha%e a thermometer in the house.1 4) course, the doctor then thinks the'(re kooks or hea$th nuts or menta$$' de)icient, so # te$$ mothers instead 2ust to pick out a )ictitious number. #) 'ou rea$$' want to command the doctors attention, pick out a high number, 1 7 or an'thing within the rea$m o) credibi$it'. 3hen i) the doctor comes o%er and )inds the temperature is norma$, right on the button 98.;, 'ou can sa', 14h, it was so much higher be)ore=1 #) the doctor doesn(t be$ie%e 'ou, the on$' thing he can accuse 'ou o) is misreading the thermometer. 6ou can e%en %o$unteer that remark b' sa'ing, 1# might ha%e misread the thermometer=1 3hen, once 'ou get b' the sacred .uantitati%e barrier o) the thermometer, 'ou and the doctor can mo%e on to more important things. 4ne o) the common dangers o) going in )or an exam is that 'ou($$ be used )or purposes other than 'our own. 6ears ago, a)ter becoming !57" director o) an outpatient c$inic # )ound out that one o) the routine .uestions asked o) mothers was 1#s 'our chi$d toi$et trained-1 E%er' bo' who was not toi$et trained b' the age o) )our was separated out and re)erred )or a uro$ogica$ workup, which inc$uded, among other things, a c'stoscop'. 0$$ these )our,'ear,o$d kids were being c'stoscoped= # immediate$' e$iminated the .uestion about toi$et training. #t didn(t take $ong be)ore # got a ca$$ )rom the chairman o) the uro$og' department, who happened to be a )riend o) mine. Ie was %er' angr'. 9irst he to$d me # had done the wrong thing e$iminating the .uestion and, thereb', the uro$ogica$ workup. Ie said it was important to do this kind o) examination in order to )ind the rare cases in which there might be something organica$$' wrong. We$$, o) course that was nonsense, because a$$ the rare cases can be identi)ied b' measures that are )ar $ess dangerous than a c'stoscop'. 3hen he to$d me more about what was going on. 3he rea$ prob$em was that # was destro'ing his residenc' program because in order )or a residenc' to be appro%ed b' the accrediting authorities, the residents ha%e to per)orm a certain number o) c'stoscopies e%er' 'ear. #n this case it was around 1> . # was taking awa' his source o) c'stoscopies, and # got into troub$e o%er it. 3his is true )or other specia$ties, too. #n order to ha%e a cardio$og' residenc' appro%ed, the resident must per)orm a minimum,number !5>" ,, 1> , / , > , whate%er it is ,, o) catheteri<ations e%er' 'ear. 3here is a great tendenc' to take peop$e o)) the street and identi)' them as needing a cardiac catheteri<ation= Because o) the increased danger o) being used )or the doctor(s own purposes, it(s best to regard an' doctor who does research or teaching as potentia$$' harm)u$. 0s )ar as #(m concerned, a doctor treating a person shou$d be a treating doctor. Bea%e the research and teaching to someone who is identi)ied as a researcher or a teacher. When a doctor mixes ro$es he has to be extreme$' care)u$. 0nd so does his patient. Natura$$', the most sinister and dangerous u$terior purpose 'ou expose 'ourse$) to is the doctor(s need to recruit patients. Without the ritua$ o) the checkup, internists wou$d ha%e troub$e pa'ing the o))ice rent. Iow e$se can the doctor ensure a stead' supp$' o) sacri)icia$ %ictims )or the 8hurch(s other sacraments without the examination- 3he @ospe$ said man' were ca$$ed and )ew were chosen, but the 8hurch o) &odern &edicine has gone that one better: 0$$ are ca$$ed and most are chosen. 0nnua$ ph'sica$s were once recommended )or such high,risk groups as industria$ workers and prostitutes. Iowe%er, toda' man' doctors recommend that e%er'bod' ha%e at $east one a 'ear. #n the $ast )i)t' 'ears o) regu$ar checkups, howe%er, not a shred o) e%idence has emerged to show that
those who )aith)u$$' submit $i%e an' $onger or are an' hea$thier than those who !5;" a%oid doctors. Because o) the de)inite risks in%o$%ed, #(d sa' those that sta' awa' are better o)). #n no uncertain terms, 'ou(re at the doctor(s merc'. 3he )act that 'ou(re there in the )irst p$ace means 'ou don(t know how 'ou are or what is going on with 'ou and that 'ou want the doctor to te$$ 'ou. +o 'ou(re read' to gi%e up a precious $ibert', that o) se$) identi)ication. #) he sa's 'ou(re sick, 'ou(re sick. #) he sa's 'ou(re we$$, 'ou(re we$$. 3he doctor sets the $imits o) what(s norma$ and abnorma$, what(s good and what(s bad. #) 'ou cou$d re$' on the doctor(s conception o) norma$ and abnorma$, sick and we$$, submitting to him wou$d be scar' enough. But 'ou can(t re$' on it. &ost doctors are unab$e to recogni<e we$$ness, simp$' because the'(re not trained in we$$ness but in disease. Because the' ha%e sharper e'es )or signs o) disease than )or signs o) hea$th, and because the' ha%e no conception o) the re$ati%e importance o) signs o) both in the same person, the'(re more apt to pronounce 'ou sick than we$$. 0s $ong as the doctor is in contro$, he can de)ine or manipu$ate the $imits o) hea$th and disease an' wa' he chooses, narrow$' or broad$' ,, depending on his intentions and interests. #n this wa' he can manipu$ate the amount o) disease. 9or examp$e, he can de)ine high b$ood pressure as an'thing abo%e or within the high range o) norma$. 0nd he can treat it according$' ,, o)ten with %er' power)u$ drugs. *isease can thus be de)ined to encompass sma$$ or $arge !5:" numbers o) the popu$ation. #) he measures 1 chi$dren(s height, he can state that an' chi$d standing at either extreme ,, in the $owest and highest one, two, or )i%e percent ,, is 1abnorma$1 and re.uires )urther testing. Ie can set his outer $imits o) norma$ b$ood or urine %a$ues or e$ectrocardiogram readings so that a certain percentage o) each popu$ation is $abe$ed possib$' abnorma$, re.uires )urther in%estigation. #) he were se$$ing $axati%es, he wou$d tend to de)ine constipation in such a wa' as to inc$ude the great ma2orit' o) 0mericans, b' sa'ing that i) a person doesn(t ha%e a good bowe$ mo%ement once a da', he or she is constipated. 4n the other hand, i) he(s interested in the truth, he wou$d sa' that i) a person has norma$$' )ormed bowe$ mo%ements, it doesn(t make a di))erence i) the' ha%e them once or twice a week. 3hat puts a$most nobod' in the 1sick1 categor'. 3he doctor can de)ine sickness e%en where no sickness exists. 0)ter a$$, among those 1 chi$dren measured )or height, among those b$ood, urine, and e$ectrocardiogram measurements, someone has to be at the extreme high and $ow ends o) the sca$es. 0nd there are %er' )ew peop$e in whom a batter' o) thirt' or )ort' tests wi$$ not re%ea$ at $east one 1statistica$ abnorma$it'1 which can then $ead to an entire series o) potentia$$' damaging and disab$ing medica$ e%ents. 6ou ha%e to consider ,, and beware o) ,, the doctor(s se$) interest. *octors a$most a$wa's get more reward and recognition )or inter%ening !58" than )or not inter%ening. 3he'(re trained to inter%ene and do something rather than obser%e, wait, and take the chance the patient wi$$ get better a$$ b' himse$) or go to another doctor. 0s a matter o) )act, one o) m' ke' pieces o) sub%ersi%e ad%ice to medica$ students is this: 3o pass an exam, get through medica$ schoo$, and retain 'our sanit', a$wa's choose the most inter%entionist answer on a mu$tip$e choice test and 'ou(re more $ike$' to be right. 9or examp$e, suppose somebod' sa's to 'ou that the patient has a pimp$e on his nose, and asks what shou$d 'ou do- #) the )irst answer is watch)u$ expectanc', wait and see what happens )or a )ew da's, that(s wrong, re2ect that. But i) one o) the answers is cut o)) his head and hook him up to a heart $ung machine, then resew a$$ the arteries and gi%e him twent' di))erent antibiotics and steroids, that answer is right. 3his piece o) ad%ice has carried more o) m' students through %arious crucia$ examinations, inc$uding nationa$ boards and specia$it' exams, than an' other $esson.
0s a patient, once 'ou submit to a ph'sica$ examination, 'our doctor might interpret minor abnonma$ities ,, rea$ or bogus ,, as pre,conditions o) some serious i$$ness, re.uiring, o) course, serious pre,inter%ention. 0 minor )$uctuation on a b$ood sugar test might be interpreted as pre, diabetes, and 'ou($$ get some medicine to take home. 4r the doctor ma' )ind something ,, ma'be a stra' tracing on the EF@ caused b' a passing 2et p$ane ,, that $eads him to be$ie%e 'ou ha%e a pre, coronar' condition. 3hen 'ou($$ !59" go home with a pre,coronar' drug or two, which whi$e )ighting 'our pre,condition wi$$ mess up 'our $i)e through striking a$terations in beha%ior and menta$ status, inc$uding b$urred %ision, con)usion, agitation, de$irium, ha$$ucinations, numbness, sei<ures, and ps'chosis. &a'be 'ou($$ get a prescription )or 0tromid +, a cho$estero$,$owering drug, which, besides possib$' $owering 'our cho$estero$, cou$d a$so gi%e 'ou one or more o) these side e))ects: )atigue, weakness, headache, di<<iness, musc$e ache, $oss o) hair, drowsiness, b$urred %ision, tremors, perspiration, impotence, decreased sex dri%e, anemia, peptic u$cer, rheumatoid arthritis, and $upus er'thematosis. 4) course 'our doctor is not $ike$' to read 'ou this $ist )rom the prescribing in)ormation that comes with the drug. 0nd he(s e%en $ess $ike$' to te$$ 'ou the contents o) the paragraph that(s set in a b$ack border: 1#t has not been estab$ished whether drug,induced $owering o) cho$estero$ is detrimenta$, bene)icia$, or has no e))ect on the morbidit' or morta$it' due to atherosc$erotic coronar' heart disease. +e%era$ 'ears wi$$ be re.uired be)ore scienti)ic in%estigations wi$$ 'ie$d the answer to this .uestion.1 What kind o) person wi$$ take that drug a)ter reading that in)ormationWhat must be the most common pre,treatment )or pre,disease is what happens when 'ou go in and the doctor )inds 'our b$ood pressure a $itt$e high. #gnoring the )act that 'our h'pertension might be temporari$' caused b' 'our %er' presence in the o))ice, 'ou($$ most $ike$' !7 " $ea%e with some sort o) anti,h'pertensi%e drug. 3hough 'ou($$ recei%e $itt$e in the wa' o) re$ie) )rom it, 'ou might get something e$se: side e))ects ranging )rom headaches, drowsiness, $etharg', and nausea to impotence. #n 19: , the 8oronar' *rug Jro2ect Eesearch @roup )ound that these drugs produced an excess number o) ad%erse e))ects such as non,)ata$ in)arction and pu$monar' embo$ism ,, and that these e))ects were not outweighed b' an' trend towards reduced morta$it'. *octors started hawking the importance o) the ph'sica$ examination during the *epression o) the 195 s ,, )or a$$ the ob%ious reasons. 9or the same ob%ious reasons, dentists are beginning to hust$e peop$e into their o))ices )or routine checkups. # got an announcement the other da' )rom an estab$ishment denta$ organi<ation that e%er' chi$d shou$d be examined on his third birthda' b' a dentist and on his se%enth birthda' b' an orthodontist. 3hese exams certain$' wi$$ not do %er' man' chi$dren an' good, and the' wi$$ de)inite$' do most o) them harm. Not on$' )rom the mercur' po$$ution characteristic o) denta$ o))ices, the sacramenta$ x,ra's, and the Io$' Water )$ouride app$ications ,, but )rom the treatments themse$%es. 3he sharp denta$ exp$orer that dentists use to examine teeth has been shown to actua$$' inocu$ate %arious bacteria )rom in)ected teeth to hea$th' teeth. 4rthodontia is sti$$ a m'sterious and unpro%en art. We know that a $ot o) peop$e get into gum prob$ems $ater in $i)e because o) orthodontia ear$' in $i)e. We a$so know that !71" a $ot o) peop$e who are recommended )or orthodontia and don(t get it )ind that their teeth straighten out a$$ b' themse$%es. 0$though the recommended exams most probab$' won(t do 'ou or 'our chi$d an' good, the' certain$' wi$$ be good )or the dentist or orthodontist. 9rom m' experience, doctors ,, and dentists, especia$$' ,, got %er' de)ensi%e about the regu$ar checkup. #(%e known dentists to re)use to see patients in emergencies because the person hadn(t
been in )or a regu$ar checkup within the past six months. 4) course, this attitude gi%es doctors and dentists the right to p$a' the big game in medicine, B$ame the Kictim. Eather than admit that their sacraments are use$ess, the magic nonexistent, the' can a$wa's te$$ 'ou that 'ou came to them too $ate. 6ou can ne%er go to the doctor too soon, most doctors wou$d c$aim. 0nd most peop$e seem to be$ie%e that. 6ou must rea$i<e, howe%er, that the mere act o) submitting to the diagnostic procedure imp$ies that 'ou(re asking )or treatment, at $east as )ar as the doctor is concerned. #n no uncertain terms, i) 'ou show up, 'ou(re asking )or it. 6ou(re asking to be exposed to the who$e range o) sacramenta$ treatments, )rom aspirin to ritua$ muti$ation. 4) course, the doctor is going to tend towards the more intense )orms o) sacri)ice, since these increase his sacred stature. +ome $ean so hea%i$' in that direction that the' miss comp$ete$' the $ower extreme o) possibi$ities. 0 'oung )riend o) mine took up the cha$$enge o) a 144,mi$e bic'c$e race, something he(d ne%er done !7/" be)ore. 0bout a third o) the wa' into the race he(d a$read' made up his mind that he wasn(t trained )or this sort o) punishment ,, but some passing c'c$ists 2eered at him )or his s$ow pace. 3hat made him angr' and he %owed to )inish the race, which he did. 3he next da' he woke up and cou$d hard$' mo%e. Iis knees had taken the brunt o) the punishment.Ie was in such discom)ort that he went to a doctor. 0)ter examining him and taking x,ra's, the doctor $et him know that he had either gonorrhea or some kind o) cancer o) the knee. &' )riend, who had to$d the doctor about the 1 , mi$e ride, asked whether that didn(t ha%e something to do with his condition. 3he doctor said, 1Not at a$$,1 and wanted to re)er him to a specia$ist. 4) course, m' )riend didn(t e%en bother to take the re)erra$ home with him. #n a matter o) da', his $egs were as good as new. +ome doctors b$ame the patients )or demanding treatment )or conditions that wi$$ take care o) themse$%es, the' use the excuse that peop$e show up wanting antibiotics to knock out co$ds, or power)u$ and dangerous anti,arthritics )or mi$d 2oint sti))ness, or hormone pi$$s )or teenagers to )ight acne or sti)$e growth. # don(t accept this excuse. Jatients demand a $ot o) things such as more considerate care, more natura$ hea$ing techni.ues, and discussion o) a$ternati%es ,, and doctors rare$' gi%e in on these issues. #) 'ou want to de)end 'ourse$), 'ou(%e got to understand that the doctor(s standards are di))erent )rom 'ours and that his are no better. !75" *octors aren(t considerate o) the )act that their %er' .uestions imp$' the need )or treatment. # counse$ doctors not to te$$ patients about harm$ess heart murmurs, $arge tonsi$s, umbi$ica$ hernias ,, a$most a$$ o) which wi$$ disappear b' the sixth birthda'. # te$$ doctors not to ask mothers o) three,'ear o$d bo's whether or not the chi$d is toi$et trained because that automatica$$' makes the mother think there(s something wrong with her chi$d i) he(s not toi$et trained. 3here are $ots o) other attitudes and strategies 'ou need to $earn i) 'ou want to de)end 'ourse$) against the dangers o) the diagnostic procedure. 4) course, i) it(s an emergenc' such as an accident, in2ur', or acute appendicitis, 'ou ha%e no choice. But these situations account )or on$' )i%e percent o) medica$ situations. #) 'ou ha%e no s'mptoms at a$$, 'ou(%e got no business going to the doctor in the )irst p$ace. #) 'ou do ha%e s'mptoms, i) 'ou are sick, then 'our )irst de)ense is to become more in)ormed about 'our prob$em than the doctor. 6ou(%e got to $earn about 'our disease, and that(s not %er' hard. 6ou can get the same books the doctor studied )rom, and chances are he(s )orgotten most o) it. 6ou can )ind books written )or $a'men on 2ust about e%er' disease 'ou(re $ike$' to ha%e. 3he idea is to )ind out as much about it as possib$e so 'ou can discuss 'our prob$em on an e.ua$ ,, or better ,, in)ormationa$ )ooting with the doctor.
Whene%er a $ab test is prescribed, $ook up the test and )ind out what it(s supposed to show. 0sk the doctor what the test is supposed !77" to demonstrate. 6our doctor won(t te$$ 'ou this, but i) 'ou do 'our own detecti%e work, 'ou($$ )ind out that the simp$e tests such as the b$ood counts, urine ana$'sts, tubercu$in tests, and chest x,ra's are so contro%ersia$ and di))icu$t to interpret that their use)u$ness is extreme$' $imited. 6ou shou$d a$so tr' to )ind a $ab which maintains a high degree o) accurac'. #) a $ab won(t ta$k about its rate o) errors, scratch it o)) 'our $ist. #) a $ab boasts per)ect or near per)ect accurac' be suspicious. But keep asking .uestions. Iow do the' know the'(re so accurate- #s the accurac' certi)ied- B' whom- 6ou might ne%er )ind a $ab that satis)actori$' answers a$$ 'our .uestions. #) 'ou do, insist that 'our doctor use that $ab. 6ou might ha%e tough going here because a $ot o) doctors ha%e a )inancia$ interest in certain testing $aboratories. #nsist. #) 'our doctor does a$$ his own testing, ask the same .uestions that 'ou wou$d ask a $ab. 9ina$$', i) a serious course o) treatment hinges on the resu$ts o) $ab tests, ha%e them done again at another $ab. E%en i) 'ou ha%e to ha%e them done again at the same $ab, ha%e them repeated. 3he most important wa' to sub%ert the diagnostic procedure )or 'our own protection is to ask the doctor .uestions. #n some cases, he($$ answer the .uestions. 3hat(s the rare exception. #n most cases, the doctor wi$$ get upset. 0sk the .uestions an'wa' ,, short o) getting 'ourse$) thrown out o) his o))ice. 9rom his attitude !7>" and his responses, 'ou can 2udge him as a human being and get an idea o) his expertise. Luestioning can come in hand' to protect 'ourse$) )rom x,ra's. 4) course, the best protection is no radiation at a$$. Breast x,ra's )or women under )i)t', women with no s'mptoms, and women with no histor' o) breast cancer in their )ami$' are un2usti)ab$e )or the detection o) breast cancer. 0nd the'(re o) dubious %a$ue to a$$ other women, since the breasts are especia$$' sensiti%e to x,ra's. 0n' woman can a%oid x,ra's mere$' b' te$$ing the doctor she thinks she might be pregnant ,, whether she is or not. +ometimes, as happened to the wi)e o) one o) m' co$$eagues, c$aiming 'ou(re pregnant wi$$ pro%oke them into re.uiring a pregnanc' test, too= &' )riend(s wi)e a%oided that b' te$$ing the nurse,in.uisitor that she wanted her husband to per)orm the test since this was her )irst bab' and the' wanted to keep as much o) the e%ent to themse$%es as possib$e. +he ne%er had to get the x,ra'. 6ou can get awa' with a simi$ar p$o' b' mere$' sa'ing 'ou want 'our own doctor to per)orm the pregnanc' test. 3hen, re$' on bureaucratic inertia to keep the .uestion )rom e%er coming up again. 0 woman who is pregnant, or who truth)u$$' thinks she ma' be, shou$d make her condition c$ear b' speaking up $oud$' to an'one who tries to aim an x,ra' machine in her direction. 0n' doctor or dentist who insists on need$ess$' radiating a pregnant woman shou$d ha%e his $icense pu$$ed. !7;" 3echni.ues )or a%oiding x,ra's can range )rom p$a'ing dumb ,, *o # rea$$' need a$$ those x, ra's, doc- ,, to persuasion and ca2o$er'. +ometimes these wi$$ work but 'ou shou$d be prepared to resort to direct cha$$enge and con)rontation. +ometimes a doctor wi$$ ha%e 'ou p$aced on a cart to be whee$ed into the x,ra' room. 3his is a t'pica$ p$o' to de$iberate$' humi$iate, depersona$i<e and demean per)ect$' capab$e men and women and trans)orm them to doci$e, cooperati%e, accepting, manageab$e patients. #) this e%er happens to 'ou, 2ump o)) the cart and stand on 'our own two )eet. Exercise responsibi$it' )or 'our own hea$th. 0n' disabi$it' 'ou su))er )rom 2umping o)) the cart wi$$ doubt$ess$' pro%e $ess than the e))ects o) the x,ra's. 4nce 'ou(%e made known 'our pre)erence )or a%oiding x,ra's, i) 'our doctor sti$$ wants 'ou under the gun, here are the .uestions 'ou shou$d ask: What are 'ou $ooking )or- What is the $ike$ihood
that 'ou wi$$ )ind it using the x,ra's- 8an 'ou )ind what 'ou are $ooking )or b' a sa)er method- 0re 'ou using the most modern and we$$,maintained machines with the $owest possib$e dose o) radiation- Wi$$ 'ou proper$' shie$d the rest o) m' bod'- #n what wa' wi$$ the x,ra's change m' course o) treatment- When was the $ast time 'our machine was checked )or sa)et'- Feep asking .uestions unti$ the doctor exp$ains the situation in such a wa' that a$$ows 'ou to make an in)ormed choice. #) 'ou decide that 'ou must ha%e the x,ra's, submit to on$' the speci)ic photos !7:" necessar' at the time. *on(t $et either 'our doctor or the radio$ogist shoot extra photos 1as $ong as 'ou(re on the tab$e.1 3o )u$$' protect 'ourse$) )rom 'our doctor, 'ou must $earn how to $ie to him. 3his is not such a strange maneu%er, rea$$', since an'one who has $earned to sur%i%e pro)essiona$ bureaucracies has $earned to decei%e pro)essiona$s. 6ou $earn to $ie to schoo$ teachers .uite ear$' in $i)e, since the purpose o) going to schoo$ isn(t to $earn but to end up with a credentia$ at the end. 3hen 'ou do a$$ 'our rea$ $earning outside o) schoo$. # ad%ise medica$ students to $earn the arts o) h'pocris' and dup$icit', 2ust as +outhern b$acks once $earned the art o) shu))$ing. +hu))$ing was the )ine art o) appearing to be acti%e and obedient when in rea$it' 'ou were nothing o) the sort. 3hat(s what 'ou ha%e to do with 'our doctor. #) 'ou are a mother who wants to breast)eed, )or examp$e, 'our doctor wi$$ a$most a$wa's be against it, e%en i) he sa's he doesn(t care one wa' or the other, because doctors know nothing about breast)eeding. What do 'ou do when 'our doctor weighs the bab' and )inds it hasn(t gained as much weight as his chart sa's it shou$d- What do 'ou do when he te$$s 'ou to start hot dogs at two weeks o) age- &' )a%orite image is that o) the obstetrician waiting, and as the bab' emerges )rom the womb he sticks a hot dog in its mouth to get it started on so$id )oods and to create an ear$' dependence. We$$, when a doctor te$$s 'ou to start so$id )ood such as cerea$ or )ruit or an'thing e$se at one month !78" o) age, 'ou can tr' arguing with him since 'ou know what(s best )or 'our bab' better than he does. 6ou can simp$' re)use to do it, in which case he($$ get hu))' and probab$' )ire 'ou as a patient. 6ou can tr' to persuade or ca2o$e the doctor, on the assumption that he(s a rationa$, caring human being. #) 'ou tr' that, good $uck. 4r, 'ou can shu))$e. *on(t te$$ the doctor an'thing but 6essir. #) he has gi%en 'ou a six,pack o) )ormu$a to take home and start the bab' on, throw it in the trash at 'our ear$iest con%enience. +imp$' continue to breast)eed 'our bab'. When the next checkup comes around and the doctor puts the bab' on the sca$e, 2ust te$$ the doctor how the chi$d(s en2o'ing his cerea$ and )ruit. 3hen the doctor wi$$ $ook at the sca$e and te$$ 'ou the bab'(s doing 2ust )ine. Cn)ortunate$', in some medica$ situations 'ou reach the point where 'ou can(t $ie to the doctor. #n obstetrics, the doctor gets a chance to see what 'ou(re doing. Ie can check on 'ou with the sca$e and en)orce his dangerous ideas o) $imiting the amount o) weight 'ou gain during pregnanc'. &' women wi$$ bring a $ist o) what the' want and don(t want to the obstetrician on the )irst %isit, 3he'($$ te$$ him the' don(t want to be sha%ed, no episiotom', ana$gesia, induction o) $abor, and so on. 3he doctor wi$$ nod his head. 3hen, in the )ina$ moments o) $abor, she($$ )ind out that she(s getting them an'wa'. 6ou can(t rea$$' expect a woman in $abor to sa' no to whate%er her doctor sa's she needs. !79" 3hat(s wh' it(s crucia$ to sub%ert the process and get the 2ump on the doctor as much as possib$e be)ore the situation gets critica$. 0)ter 'ou(%e asked 'our .uestions, don(t take it )or granted that 'ou can trust the doctor(s answers. 8heck out whate%er he sa's. 0gain, read a$$ the sources 'ou can )ind. 6ou ha%e to know more about it than he does.
*octors in genera$ shou$d be treated with about the same degree o) trust as used car sa$esmen. Whate%er 'our doctor sa's or recommends, 'ou ha%e to )irst consider how it wi$$ bene)it him. 9or examp$e, i) a neonato$ogist te$$s 'ou that high risk nurseries impro%e the sur%i%a$ rates o) babies, )ind out i) he works )or a high risk nurser'. Whene%er 'ou get a second opinion that is di))erent )rom the )irst opinion, 'ou shou$d go back and con)ront the )irst doctor with what the second doctor said. Jeop$e don(t o)ten do this because the'(re a)raid o) the anger and hosti$it' o) the )irst doctor. #t(s %er' %a$uab$e to test the doctor this wa'. #t(s a good idea to e$icit that anger and hosti$it' because that might change 'our attitude towards the doctor, 0nd towards doctors in genera$. Whene%er 'ou ha%e to make a decision regarding a medica$ procedure, 'ou shou$d seek out and ta$k to peop$e 'ou regard as ha%ing wisdom. 0t one time, i) 'ou go back )ar enough, doctors were wise, cu$tured peop$e. 3he' knew $iterature and cu$ture and were marked b' sagacit' and consideration. 3hat is not the case an'more. Jeop$e who ma' be a !> " source o) in)ormation and counse$ are peop$e who ha%e had the same experience as 'ou, peop$e with the same s'mptoms or disease. 3a$k o%er 'our prob$em, whate%er 'our doctor te$$s 'ou it is and whate%er 'ou think it is, with )riends, neighbors, and )ami$'. 9ind out what their doctors sa'. *octors te$$ 'ou not to do this, not to $isten to opinions 'ou hear in the butcher shop or the grocer' store or the hairdresser(s. 3he' te$$ 'ou not to $isten to re$ati%es and )riends. But the' are wrong. 3he'(re protecting their sacred authorit'. 0s a matter o) )act, 'ou shou$d ta$k to )riends and re$ati%es, peop$e who $i%e around 'ou, whom 'ou know and trust, at the outset o) 'our s'mptoms. 6ou ma' )ind 'ou can do without the doctor.
Chapter 2 Miraculous Ma he!

!>1" # can sti$$ remember how, ear$' in m' medica$ career, # ga%e intra%enous penici$$in e%er' )ew hours to chi$dren who were su))ering the agoni<ing s'mptoms o) bacteria$ meningitis, and then watched miracu$ous changes occur hour b' hour. 8hi$dren who had been on the %erge o) death reco%ered consciousness and began to respond to stimu$i within a )ew hours. 0 )ew da's $ater those same chi$dren were back on their )eet, a$most read' to go home. Jatients with $obar pneumonia a$so wou$d endure terrib$e agonies. 3he' wou$d enter a crisis o) high )e%er, se%ere cough, gasping )or breath, shaking, chi$$s, and extreme chest pains. +ome reco%ered, but man' died. When penici$$in came a$ong, peop$e with $obar pneumonia no $onger went through a crisis period. #nstead, !>/" the )e%er, cough, and other s'mptoms reso$%ed within da's. Jeop$e who wou$d ne%er ha%e $e)t the hospita$ a$i%e packed their bags and wa$ked out. # ,, and other doctors ,, tru$' )e$t that we were witnessing and working mirac$es. 3hings are di))erent toda'. &eningitis and $obar pneumonia are uncommon. E%en when a doctor does come up against such a $i)e,threatening condition, the treatment is so routine that it is main$' carried out b' a nurse or a medica$ technician. Whi$e the )ascination with the mirac$e remains, these drugs that were once extreme$' %a$uab$e are now extreme$' dangerous. &an' doctors prescribe penici$$in )or conditions as harm$ess as the common co$d. +ince penici$$in works a$most exc$usi%e$' against bacteria$ in)ections, it(s use$ess against %ira$ conditions such as co$ds and )$u. Jenici$$in and other antibiotics do not shorten the course o) the disease, do not pre%ent comp$ications, and do not reduce the number o) pathogenic organisms in the nose and
throat. 3he' do no good at a$$. What the' can do is cause reactions ranging )rom skin rish, %omiting, and diarrhea to )e%er and anaph'$actic shock. #) 'ou(re $uck', 'ou($$ on$' be one o) the se%en to eight percent o) peop$e who su))er a rash ,, a$though a much higher percentage o) peop$e su))ering )rom mononuc$eosis ha%e gotten a rash when gi%en ampici$$in. 9or the un$uck' )i%e percent who get serious reactions to penici$$in, the picture o) a !>5" patient in anaph'$actic shock is not prett': cardio%ascu$ar co$$apse with c$amm' skin, sweating, unconsciousness, )a$$en b$ood pressure, disturbance in heart rate and rh'thm. #t eeri$' e%okes images o) the %er' diseases which penici$$in was designed to cure. B' no means is penici$$in the on$' %i$$ain. 8h$orom'cetin is a drug which is e))ecti%e in a certain t'pe o) meningitis caused b' the I. in)$uen<a baci$$us, as we$$ as in diseases caused b' t'phoid and simi$ar germs. #n such situations, ch$orom'cetin is o)ten the on$' antibiotic that wi$$ work. But ch$orom'cetin a$so has the not uncommon )ata$ side e))ect o) inter)ering with the bone marrow(s production o) b$ood. When a person(s $i)e is at stake an'wa', this is an acceptab$e risk to take. But i) a chi$d su))ers nothing more than a %ira$ sore throat, is the non,re$ie) ch$orom'cetin wi$$ bring worth risking depression o) the chi$d(s bone marrow which wi$$ re.uire mu$tip$e trans)usions and other therapies, none o) which wi$$ guarantee comp$ete reco%er'- 4) course it(s notD 'et doctors do prescribe ch$orom'cetin )or sore throats. 3etrac'c$ine became so popu$ar in outpatient c$inics and o))ice practices that it became known as the houseca$$ antibiotic. #t has been wide$' prescribed )or chi$dren as we$$ as other age groups because it is e))ecti%e against a wide %ariet' o) organisms and because it(s side e))ects are not considered dangerous. But there is a )air $ist o) ad%erse reactions which the in)ormed person might not choose o%er the drug(s non,use in situations it wasn(t designed !>7" )or an'wa'. 0 more )ormidab$e side e))ect is that the drug is deposited in the bones and teeth. Whi$e no one knows exact$' what tetrac'c$ine does to the bones, hundreds o) thousands ,, perhaps, mi$$ions ,, o) parents and chi$dren know that it permanent$' stains the teeth 'e$$ow or 'e$$ow,green. 3hough 'ou might )ee$ that(s too high a price to pa' )or the dubious e))ecti%eness o) the drug in re$ie%ing the s'mtoms o) a common co$d, man' doctors do not. 3he current rationa$i<ation )or the drug(s use in such situations is the suspicion that a chi$d who appears to be su))ering )rom a co$d might actua$$' ha%e a m'cop$asma in)ection. 3he %ast ma2orit' o) chi$dren with a common co$d ha%e no trace o) this sort o) in)ection. 3he C.+. 9ood and *rug 0dministration )ina$$' woke up to the widespread o%eruse o) tetrac'c$ines in 19: , when it re.uired a warning on a$$ packages o) the drug: 13he use o) drugs o) the tetrac'c$ine c$ass during tooth de%e$opment G$ast ha$) o) pregnanc', in)anc' and chi$dhood to the age o) eight 'earsH ma' cause permanent disco$oration o) the teeth 'e$$ow,gra',brown. 3his ad%erse reaction is more common during $ong term use o) the drugs, but has been obser%ed )o$$owing repeated short term courses. &a$)ormation o) tooth ename$ has a$so been reported. 3etrac'c$ine, there)ore, shou$d not be used in this age group un$ess other drugs are not $ike$' to be e))ecti%e or are contraindicated.1 Whether this warning has done much good is hard to te$$, since doctors %er' se$dom read !>>" package inserts on drugs. E%en i) the' do, warnings do not usua$$' stop them )rom using the drugs when the' )ee$ $ike it. Jarticu$ar$' when the warning on the insert, $ike the one )or tetrac'c$ine, doesn(t rea$$' make it c$ear enough that these drugs carr' side e))ects which merit their use on$' in critica$ situations.
4ne o) those risks is e%en more grim than that o) the side e))ects: superin)ections. When an antibiotic )ights one in)ection, it ma' encourage an e%en worse in)ection b' a strain o) bacteria that is resistant to the drug. Bacteria are remarkab$' adaptab$e organisms. +ubse.uent generations can de%e$op resistance to a drug as their ancestors are exposed more and more. Jenici$$in in moderate doses once easi$' cured gonorrhea. Now it takes two $arge shots o) the antibiotic to treat it, and it(s sometimes necessar' to use additiona$ drugs= 3wo new strains o) gonorrhea recent$' were disco%ered in the Jhi$ippines and in West 0)rica ,, strains which tota$$' destro' penici$$in(s e))ecti%eness. 4) course, &odern &edicine has a stronger drug read' )or the stronger gonorrhea bacteria ,, spectinom'cin. +pectinom'cin costs six times as much and has e%en more side e))ects. &ean whi$e, the gonorrhea bacteria ha%e de%e$oped a strain which is resistant to spectinom'cin, too= 0s the batt$e esca$ates, the germs grow stronger whi$e the patients and their pocketbooks grow weaker. 0$$ o) which wou$d not happen i) doctors recogni<ed that antibiotics ha%e a p$ace in the practice o) medicine ,, a se%ere$' $imited p$ace ,, !>;" and i) the' en)orced that restriction. 0 person ma' need penici$$in or some other antibiotic three or )our times during his or her entire $i)e, at times when the stakes are worth the risks. Cn)ortunate$', doctors ha%e seeded the entire popu$ation with these power)u$ drugs. E%er' 'ear, )rom 8 to 1 mi$$ion 0mericans go to the doctor when the' ha%e a co$d. 0bout ninet',)i%e percent o) them come awa' with a prescription ,, ha$) o) which are )or antibiotics. Not on$' are these peop$e duped into pa'ing )or something which has no e))ecti%eness against their prob$em, but the'(re set up )or the ha<ards o) side e))ects and the risks o) dead$ier in)ections. 3he doctor, once the agent o) cure, has become the agent o) disease. B' going too )ar and di))using the power o) the extreme on the mean, &odern &edicine has weakened and corrupted e%en the management o) extreme cases. 3he mirac$e # and other doctors were once proud to take part in has become a mirac$e o) ma'hem. #n 189 , *r. Eobert Foch deri%ed a substance )rom tubercu$osis bacteria which he c$aimed wou$d cure the disease. When he in2ected it into patients, howe%er, the' got worse or died. #n 19/8, a drug ca$$ed thorotrast was )irst used to aid in obtaining x,ra' out$ines o) the $i%er, sp$een, $'mph nodes, and other organs. #t took nineteen 'ears to disco%er that e%en sma$$ doses o) the drug caused cancer. #n 195:, chi$dren who recei%ed a new antibacteria$ !>:" drug died because the drug was contaminated with a toxic chemica$. #n 19>>, more than 1 )ata$ and near )ata$ cases o) po$io de%e$oped among unsuspecting peop$e recei%ing certain $ots o) the +a$k %accine which contained presumab$' inaci%ated po$io %iruses. #n 19>9, about > chi$dren in @erman' and 1, e$sewhere were born se%ere$' de)ormed because their mothers had taken tha$idomide, a s$eeping pi$$ and tran.ui$i<er during the ear$' weeks o) pregnanc'. #n 19;/, a cho$estero$,$owering drug, triparano$, was remo%ed )rom the market when it was acknow$edged that the drug caused numerous side e))ects, cataracts among them. &ost o) these pharmaceutica$ back)ires were corrected either when the drug was remo%ed )rom the market or when the manu)acturing error was disco%ered and tighter contro$s were estab$ished. 3he contro$s ha%en(t been tight enough though, because drug disasters $ike these are going on e%er' da'. 0ctua$$', the on$' apparatus that has grown stronger seems to be the machiner' o) keeping dangerous drugs mo%ing )rom the )actories through the hands o) doctors into the mouths and bodies o) unwar' patients. Eeserpine, a drug used, against high b$ood pressure, is sti$$ prescribed, e%en though it was disco%ered in studies )i%e 'ears ago to trip$e the risk o) breast cancer. 0$though
insu$in is turning up in scienti)ic studies as one o) the causes o) diabetic b$indness, its use is sti$$ hera$ded as a medica$ mirac$e. !>8" 4) course, i) drugs were mere$' products o) medica$ science, dea$ing with them wou$d be a matter o) science, rationa$it', and common sense. But drugs aren(t mere$' scienti)ic ,, the'(re sacred. Bike the communion wa)er which 8atho$ics recei%e on the tongue, drugs are the communion wa)ers o) &odern &edicine. When 'ou take a drug 'ou(re communing with one o) the m'steries o) the 8hurch: the )act that the doctor can a$ter 'our inward and outward state i) 'ou ha%e the )aith to take the drug. 0nd 2ust as an undeniab$e )actor in the hea$ing or the spiritua$ boost the communicant gets at the a$tar rai$ is ps'cho$ogica$$' determined, the p$acebo e))ect ,, the power o) suggestion ,, p$a's a tremendous ro$e in whate%er good a drug ma' do. 0s a matter o) )act there are some drugs and other procedures in which we know the p$acebo e))ect is the primar' therapeutic agent= 3he sacraments o) the 8atho$ic 8hurch ,, or an' other rea$ church ,, se$dom harm an'one. *octor, prescribed sacramenta$ drugs o) &odern &edicine ki$$ more peop$e than i$$ega$ street drugs. 0 nationwide sur%e' o) medica$ examiners reported that street drugs cause twent',six percent o) drug abuse deaths. Ka$uim and barbiturates ,,prescription drugs ,, made up another twent',three percent o) drug abuse deaths. 3his stud' did not take into account the / , to 5 , 'ear$' deaths attributed to ad%erse reactions to drugs prescribed b' doctors. 3he reason )or the wide girth between the estimates is that doctors o)ten )udge !>9" in stating whether or not drugs are the actua$ cause o) death. #) a patient has a termina$ i$$ness and dies during the drug therap', the death wi$$ be attributed to the disease, e%en i) the patient wou$dn(t norma$$' ha%e died )or some time 'et. 3he Boston 8o$$aborati%e *rug +ur%ei$$ance Jrogram monitored patients admitted to acute disease medica$ wards and )ound the risk o) being ki$$ed b' drug therap' was better than one in 1, in 0merican hospita$s. 0n ear$ier sur%e' b' the same group )ound that the risk among hospita$i<ed pitients with serious chronic diseases such as cancer, heart disease and a$coho$ic cirrhosis was )our in 1, . 4) course, man' o) these peop$e were in the hospita$ in the )irst p$ace because o) the e))ects o) drugs prescribed b' their doctors. 8onser%ati%e estimates sa' that )i%e percent o) the peop$e in 0merican and British hospita$s are there because o) ad%erse reactions to drugs. 0nother conser%ati%e estimate puts the price tag on this pre%entab$e su))ering at more than ?5 bi$$ion. 0nother, e%en more power)u$, group o) drugs whose use )or the treatment o) extreme conditions has shi)ted to common conditions is the steroid drugs. +teroids mimic the action o) the adrena$ g$ands, the most power)u$ regu$ators o) bod' metabo$ism. Jractica$$' e%er' organ is direct$' or indirect$' a))ected b' the secretions o) the adrena$ g$ands ,, as we$$ as b' the s'nthetic chemica$s prescribed b' the doctor. 4nce upon a time, steroid drugs were prescribed )or se%ere adrena$ insu))icienc', )or disturbances o) the !; " pituitar' g$and and )or certain $i)e,threatening conditions such as $upus er'thematosus, u$cerati%e co$itis, $epros', $eukemia, Iodgkin(s *isease, and $'mphoma. 3oda' steroids are prescribed )or conditions as common as sunburn, mononuc$eosis, acne, and a $arge %ariet' o) skin rashes which are o)ten incorrect$' diagnosed. 3he entire $ist o) precautions and ad%erse reactions to Jrednisone )i$$s two co$umns o) sma$$ print in the Jh'sicians *esk Ee)erence, the enc$'c$opedia or 1bib$e1 o) $icensed drugs in the Cnited +tates. 0mong the ad%erse reactions are: h'pertension, $oss o) musc$e tone, peptic u$cer with possib$e per)oration and hemorrhage, impaired wound hea$ing, increased sweating, con%u$sions, %ertigo, menstrua$ irregu$arities, suppression o) growth in chi$dren, mani)esiation o) $atent diabetes, ps'chic disturbances, and g$aucoma. #s getting rid o) some minor skin rash worth risking one o) these
disasters- 0pparent$' some doctors think it is. 9or examp$e, a woman )rom 0t$anta wrote me about her twent','ear,o$d daughter who had ne%er had a menstrua$ period. 0t the age o) e$e%en, the gir$ had de%e$oped a rash on her )eet. 3he dermato$ogist prescribed Jrednisone, and the 'oungster took it )or three 'ears. 18an an'thing be done )or our daughter-1 the woman asked me. 1#) on$' that dermato$ogist had to$d us that drug might do this to our daughter(s reproducti%e s'stem, we wou$d ha%e $et her keep the rash=1 0 'oung woman )rom 4hio wrote me that !;1" she had gotten a prescription )or Jrednisone accompanied b' shots o) another steriod, Fena$og, )or poison i%'. 1# su))ered se%ere headaches, musc$e cramps, swe$$ing o) m' breasts, and b$eeding )or twent',)i%e da's.1 Ier g'neco$ogist to$d her the b$eeding was caused b' the medications she took )or the poison i%', so she must now undergo a *M8 Gscraping o) the wa$$s o) the uterusH. 0 coup$e o) 'ears ago, the Cni%ersit' o) 8hicago was s$apped with a ?::,mi$$ion c$ass,action suit )i$ed on beha$) o) more than 1, women who unwitting$' took part in a Cni%ersit' experiment, some twent',)i%e 'ears ago, with the s'nthetic hormone *E+. 3his suit has specia$ signi)icance to me since # was then a student at the uni%ersit'(s schoo$ o) medicine and spent part o) m' time at 8hicago B'ing,#n Iospita$. # knew o) the experiment, which tested the use o) dieth'$sti$bestero$ in pre%enting threatened miscarriages. Being a conscientious medica$ student who trusted his schoo$ and be$ie%ed his pro)essors knew what the' were doing # didn(t e%en .uestion the experiment. 4) course neither # nor the 1, or so women shou$d ha%e trusted the schoo$, because the pro)essors didn(t know what the' were doing. #n 19:1, *r. 0rthur B. Ierbst, then o) Iar%ard &edica$ +choo$, )irst announced that an a$arming$' high rate o) daughters o) women who had taken *E+ were de%e$oping %agina$ cancer. Bater on we $earned that ma$e o))spring o) these women had an a$arming$' high rate o) !;/" genita$ ma$)ormations. 0nd a statistica$$' signi)icant number o) the women themse$%es were d'ing o) cancer. 4) course, b' then the b$oom was o)) the rose as )ar as m' un.uestioning acceptance o) medica$ science was concerned. # was not surprised when # heard the news. 3he damaging e))ects o) hormones used in the Ji$$ and in sex hormones used )or menopause had a$read' sur)aced. #) it hadn(t been ob%ious twent',)i%e 'ears ago that *E+ wou$d ha%e a damaging e))ect on the de%e$oping, %u$nerab$e )etus, it was now. 3oda' m' surprise .uotient is so $ow that # scarce$' raise an e'ebrow when # see that the same *r. Ierbst who un%ei$ed the dangers in the )irst p$ace has since come out with a paper that p$a's down the *E+ cancer risk= +ince the damage has a$read' been done and doctors ha%e been exposed as ignorant o) the possib$e dangers o) the drugs the' use, a$$ that can be done now is retreat into the sacred $anguage and make it $ook $ike the mistake wasn(t a mistake at a$$, the danger not a danger at a$$. 3r' to con%ince the mothers who )ound out the' were guinea pigs in the *E+ experiment. 3r' to con%ince their chi$dren. 9or e%er' one o) those diseased or de)ormed chi$dren, the risk has been $ 4 percent. *r. Ierbst(s own records show 5 cases o) %agina$ or cer%ica$ cancer in babies whose mothers were treated with *E+. #magine what a commotion &odern &edicine wou$d ha%e made a coup$e o) 'ears ago i) 1on$' 5 cases1 !;5" o) sw$ne )$u had been disco%ered. Wou$d doctors then ta$k about how rea$$' miniscu$e the risk was- Iow about when a doctor wants to use antibiotics on an in)ant when the chances the chi$d rea$$' needs them are $ess than one in 1 , *E+ is 2ust one o) the sex hormones prescribed )or women at a$$ stages o) their $i%es. 3ens o) mi$$ions o) women take such hormones dai$' in the )orm o) contracepti%e pi$$s or menopausa$
estrogens. *E+ is sti$$ being gi%en as the 1morning a)ter1 contracepti%e pi$$ and to dr' up breast mi$k. #n 19:>, the 9*0 sent a warning bu$$etin to doctors recommending that the' switch women o%er age )ort' to a contracepti%e other than the Ji$$. #n 19::, the 9*0 re.uired a warning brochure emphasi<ing the astronomica$ risk o) cardio%ascu$ar disease among women o%er )ort' taking the Ji$$. Whether these warnings wi$$ do much good remains to be seen. Women o%er )ort' are sti$$ taking the Ji$$, either because the' are not proper$' in)ormed or because the' choose to accept the risks. 3he o%erwhe$ming ma2orit' o) women on the Ji$$ are under )ort'. 3he risks are great )or these women, too, and the' inc$ude not on$' cardio%ascu$ar disease, but $i%er tumors, headaches, depression and cancer. Whi$e taking the Ji$$ o%er age )ort' mu$tip$ies the risk o) d'ing )rom a heart attack b' a )actor o) )i%e, )rom age thirt' to )ort' the Ji$# mu$tip$ies it b' a )actor o) three. 0$$ women taking the Ji$$ run a risk o) high b$ood pressure six times greater than women not taking it. !;7" 3heir risk o) stroke is )our times greater, and their risk o) thromboembo$ism is more than )i%e times greater. *octors maintain the enormous market )or the Ji$$ b' te$$ing women it(s sa)er to take the Ji$$ than to get pregnant. 4) course, that argument de)ies $ogic as we$$ as science. 9irst o) a$$, the dangers o) the Ji$$ are 2ust beginning to sur)ace. 3he' are the dangers o) an unnatura$ substance inter)ering with bod' processes. Jregnanc', howe%er, is a natura$ process, which the bod' is prepared to dea$ with ,, un$ess it is unhea$th' in some wa'. 3o take the Ji$$ is to introduce disease into the bod'. 8omparing the risk o) pregnanc' to the risk o) taking the Ji$$ i$$ogica$$' 2umb$es together rich women, poor women, hea$th' women, sick women, women on the Ji$$, women o)) the Ji$$, women using other contracepti%es, women using no contracepti%es, married women, sing$e women teenagers, adu$ts, promiscuous women, and non,promiscuous women. When these women get pregnant, the' a$read' bring to the statistics risk )actors which ha%e nothing to do with pregnanc'. 4) course, it(s bad science to compare the Ji$$(s dangers with pregnanc' an'wa'. 3he rea$ .uestion is: #s the Ji$$ sa)er than other )orms o) contraception0dded to the 1 mi$$ion women who sti$$ take the Ji$$ are more than > mi$$ion who take menopausa$ estrogens. 0gain, these drugs ha%e been imp$icated so strong$' in the causation o) ga$$ b$adder disease and cancer o) the utenus !;>" Gthe' mu$tip$' the risk b' a )actor o) )i%e to twe$%eH that the 9*0 has been )orced to issue warnings to doctors and patients. Warnings which ha%e gone $arge$' unheeded, as )ar as doctors are concerned. 9or instead o) $imiting the use o) these drugs to in)re.uent, short term re$ie) o) se%ere s'mptoms, most doctors use them routine$' supposed$' to pre%ent the mi$dest o) menopausa$ discom)orts. Estrogen therap' is used to preser%e 'outh, )or cosmetic purposes, to re$ie%e depression, and )or the pre%ention o) cardio%ascu$ar disease ,, a$$ )or which its e))ecti%eness has been dispro%ed. Estrogens a$so are used to pre%ent bone deminera$i<ation in o$der women. Exercise and diet can pre%ent deminera$i<ation and the' don(t cause cancer. &an' women obtain estrogens )rom their doctor at the )irst sign o) depression during midd$e age. +e$dom does the doctor take the time to )ind out i) perhaps the depression isn(t caused b' some other )actor, something that can be treated without estrogen or ,, perish the thought ,, without an' drug. 0ctua$$', .uite a )ew drugs are in%ented and prescribed )or conditions which can be treated per)ect$' we$$ with $ess dangerous methods. 0ntih'pertension drugs ha%e )i$$ed such a market %oid )or an eas' wa' to $ower b$ood pressure that their popu$arit' has soared in the )ew 'ears the'(%e been a%ai$ab$e. Now a doctor no $onger has to te$$ a person with high b$ood pressure that his $i)est'$e is ki$$ing him. Ie can 2ust write a prescription )or a drug and use his powers o) persuasion
to get the patient to take !;;" the drug. We e%en ha%e te$e%ision, radio, and maga<ine commercia$s urging peop$e to take their high b$ood pressure medication= +omehow, somewhere, someone has con%inced enough peop$e that taking these drugs is the on$' wa' to $ower b$ood pressure. 0nd someone has, o) course, a$so )ai$ed to a$ert a $ot o) peop$e to the side e))ects o) these drugs. +omeone is aware o) those side e))ects, though, because man' o) the high b$ood pressure drug ads in the medica$ 2ourna$s are )or drugs designed to dea$ with the side e))ects o) the antih'pertension drugs= +ome o) those side e))ects inc$ude: rash, hi%es, sensiti%it' to $ight, di<<iness, weakness, musc$e cramps, in)$ammation o) the b$ood %esse$s, ting$ing sensation in the skin, 2oint aches, con)usion, di))icu$t' concentrating, musc$e spasms, nausea, and $oss o) sex dri%e and potenc'. 3hat $ast side e))ect, b' the wa', a))ects both men and, women on antih'pertensi%es. +ometimes # wonder 2ust how much o) the midd$e,aged popu$ation su))ers )rom impotenc' ,, not )rom an' ps'cho$ogica$ cause but simp$' )rom their b$ood pressure medication. 0$$ the sex therap' in the wor$d won(t correct drug,induced impotence and $oss o) $ibido. #) doctors aren(t aware o) the side e))ects )rom these drugs, the' aren(t doing their 2ob, because the manu)acturers $ist them in the Jh'sicians *esk Ee)erence GJ*EH. #) the' do know about them and prescribe these drugs an'wa', 'ou ha%e to stop and wonder: wou$d a doctor who was !;:" )ound to ha%e high b$ood pressure take these drugs himse$)Jerhaps an' doctor )oo$ish enough to prescribe these drugs is a$so )oo$ish enough to take them himse$), since most doctors are aware o) the contro%ers' o%er whether these drugs do an' good at a$$. E%en i) 'ou assume that high b$ood pressure is dangerous, doctors are sti$$ gui$t' o) being a bit .uick with the prescription. &an' peop$e who recei%e high b$ood pressure medication are rea$$' border$ine cases: their b$ood pressure isn(t high enough to warrant a drug with the side e))ects o) antih'pertensi%es. &ost o) these peop$e cou$d more e))ecti%e$' $ower their b$ood pressure through re$axation therap', dietar' or $i)est'$e changes. #n one stud', re$axation therap' reduced b$ood pressure )aster and )arther than drug therap'. +imi$ar studies ha%e shown that weight $oss, reduction o) sa$t intake, %egetarian diet, and exerc$se can a$so $ower b$ood pressure at $east as e))ecti%e$' and certain$' more sa)e$' than drug therap'. 3here(s $itt$e doubt that man' patients don(t need to $ower their b$ood pressure at a$$, since as soon as the' $ea%e the danger <one o) the doctor(s o)ice, their b$ood pressure returns to norma$. 4ne o) the unwritten ru$es in &odern &edicine is a$wa's to write a prescription )or a new drug .uick', be)ore a$$ its side e))ects ha%e come to the sur)ace. Nowhere is this s'ndrome more e%ident than in the un$eashing o) the herd o) new antiarthritic drugs on the unsuspecting !;8" patients. Nowhere is it more e%ident that the 1cures1 are worse than the disease. Within the $ast )ew 'ears, a torrent o) ad%ertisements in medica$ 2ourna$s has hera$ded the coming o) such anti,arthritis drugs as Buta<o$idin a$ka, &otrin, #ndocin, Napros'n, Na$)on, 3o$etin, and others, 3he drug companies ha%e spared neither time nor mone' in rushing their arthritis 1cures1 to the marketp$ace. &i$$ions upon mi$$ions o) prescriptions ha%e been written. 0nd in 2ust these )ew 'ears, this new c$ass o) drugs has a record o) side e))ects that promises to ri%a$ antibiotics and hormones as genuine pub$ic hea$th menaces. Aust reading the in)ormation supp$ied b' the manu)acturer o) Buta<o$idin a$ka, and thinking that 'our doctor actua$$' is prescribing the stu)) to 'ou is enough to make 'ou i$$: 13his is a potent drugD its misuse can $ead to serious resu$ts. 8ases o) $eukemia ha%e been reported in patients with a histor' o) short and $ong term therap'. 3he ma2orit' o) the patients were o%er )ort'.1 #) 'ou read
)urther 'ou )ind that 'our doctor is setting 'ou up )or a possib$e 9/ ad%erse reactions, inc$uding headaches, %ertigo, coma, h'pertension, retina$ hemorrhage, and hepatitis. 3he compan' goes on to admit: 18are)u$$' instruct and obser%e the indi%idua$ patient, especia$$' the aging G)ort' and o%erH who ha%e increased susceptibi$it' to the drug. Cse $owest e))ecti%e dosage. Weigh initia$$' unpredictab$e bene)its against risk o) se%ere, e%en )ata$ reactions. 3he disease condition itse$) is una$tered b' the drug.1 !;9" 0)ter reading that, 'ou ha%e to wonder wh' the drug compan' wou$d bother marketing the stu)). What doctor wou$d gi%e such poison to his patient- What person wou$d wi$$ing$' take this drug- 6ou can stop wondering, because Butaso$idin a$ka makes mi$$ions o) do$$ars )or its manu)acturer. *octors ma' or ma' not be aware o) the drug(s disastrous side e))eets. 3he' ma' not be o))ended b' the admission b' the compan' that the doctor has to weigh unpredictab$e bene)its against the possibi$it' o) death. 3he' 2ust ma' not care. 4r the' ma' be guided b' a )orce that goes be'ond $ogic and consideration ,, the rh'thm o) a re$igious sacri)ice. #n the case o) at $east one antiarthritis drug, Napros'n, the sacri)ice has graduated into a )arce. 3hough the 9*0 has disco%ered that +'ntex, the drug(s manu)acturer, )a$si)ied records o) tumors and anima$ deaths during the sa)et' tests )or its drug, the go%ernment is unab$e to remo%e the drug )rom the market without $ong and tedious proceedings. No modern medica$ procedure better disp$a's the in.uisitoria$ nature o) &odern &edicine than the drugging o) so ca$$ed 1h'peracti%e1 chi$dren. 4rigina$$', beha%ior contro$$ing drugs were used to treat on$' the most se%ere cases o) menta$ i$$ness. But toda', drugs such as *exedrine, 8'$ert, Eita$in, and 3o)rani$ are being used on more than a mi$$ion chi$dren throughout the Cnited +tates ,, on the basis o) o)ten )$ims' diagnostic criteria o) h'peracti%it' and minima$ brain damage. +ome medica$ !: " tests, when per)ormed correct$', are conc$usi%e. But there is no sing$e diagnostic test that wi$$ identi)' a chi$d as h'peracti%e or an' o) the twent',one other names assigned to this s'ndrome. 3he $ist o) inconc$usi%e tests is at $east as $ong as the $ist o) names. 0$$ a doctor has to go on is a $ist o) inconc$usi%e tests and the 1educated1 guess o) an 1expert.1 4ne schoo$ in 3exas took ad%antage o) this ambiguit' and diagnosed )ort' percent o) its students as minima$$' brain damaged in a 'ear when go%ernment mone' was a%ai$ab$e to treat that s'ndrome. 3wo 'ears $ater, this mone' was no $onger a%ai$ab$e, but )unds )or treating chi$dren with $anguage $earning disabi$ities were )$oating around. +udden$', the minima$$' brain damaged students disappeared and thirt',)i%e percent o) the chi$dren were diagnosed as ha%ing $anguage $earning disabi$ities= #) that schoo$ district and others took the go%ernment mone' and used it on teachers( sa$aries, books, p$a'ground e.uipment, and supp$ies, their $arcen' cou$d be )orgi%en. But what happens is that the chi$d who can(t sit sti$$ in c$ass ,, instead o) being gi%en tasks that wi$$ interest and occup' him ,, is diagnosed as h'peracti%e and 1managed1 b' drugs. 3hese drugs are not without serious side e))ects. Not on$' do the' suppress growth and cause high b$ood pressure, ner%ousness, and insomnia, but the' trans)orm chi$dren into 1bra%e new wor$d1 t'pe <ombies. +ure, the kids s$ow down ,, dramatica$$'. 3he'(re a$so $ess responsi%e and enthusiastic, and more humor$ess and apathetic. !:1" 0nd the' don(t per)orm an' better when measured ob2ecti%e$' o%er $ong periods o) time. 3he origina$ authors o) scienti)ic studies on these beha%ior modi)'ing drugs ha%e tried to disassociate themse$%es )rom their present use b' c$aiming that the prob$em isn(t the drugs(
existence but the wa' doctors o%er,diagnose, mis,diagnose, and o%ermedicate. Whi$e such arguments ma' sa$%age a )ew indi%idua$ reputations, keep in mind that the origina$ in%estigators and authors ha%e made $itt$e or no attempt to proper$' $imit the use o) their disco%eries. 4n the contrar', we sti$$ ha%e three,page ads in the medica$ 2ourna$s which picture a schoo$ teacher proud$' proc$aiming, 1Iow wonder)u$= 0nd'(s handwriting no $onger $ooks $ike hen scratchings.1 3his is the )irst time in histor' that power)u$ drugs ha%e been so$d to cure poor penmanship= 0nd so$d .uite success)u$$', # might add. &ore then a mi$$ion chi$dren are being gi%en these drugs, a 'ear$' habit that stu))s tens o) mi$$ions o) do$$ars into the pockets o) the drug companies. Nowhere does the 8hurch(s #n.uisition emerge as c$ear$' as it does through the drugging o) chi$dren as a means o) contro$. 3he medie%a$ #n.uisition went be'ond de)ining unorthodox be$ie)s and beha%ior as a 1sin1 and started ca$$ing them a crime. 8rimina$s were punished, )irst b' the 8hurch and then b' the secu$ar authorities. &odern &edicine sets up its #n.uisition to de)ine beha%ior which doesn(t con)orm as sick. 3hen it proceeds to 1punish1 the gui$t' b' 1managing1 them with drugs. !:/" +ince the primar' purpose o) schoo$s is not to $iberate the inte$$igence through $earning but to create proper$' socia$i<ed and manageab$e citi<ens, the &edica$ 8hurch and the +tate 2oin )orces to maintain pub$ic order. 3he 8hurch en)orces the beha%ior standards that suit the +tate and the +tate en)orces the exc$usi%e %iew o) rea$it' that a$$ows the 8hurch to )$ourish. 0$$ in the name o) Iea$th ,, which, in rea$it', is not e%en a minor consideration o) either part'. Witness the %igor with which the +tate prose$'ti<es &odern &edicine(s $ine o) Io$' Waters. Now, Io$' Waters are specia$ cases s$ight$' remo%ed )rom drugs in that the thin %ei$ o) diagnostic necessit' has been remo%ed. E%er'bod' needs ,, and gets ,, the Io$' Waters: routine si$%er nitrate in the e'es o) the newborn, routine intra%enous )$uids to $aboring mothers and other hospita$ patients, routine immuni<ations, and )$uoridation o) water supp$ies. 0$$ )our o) these procedures are automatica$$', thought$ess$' imposed on peop$e whether the' wish them or not, whether the' need them or not. 0$$ )our o) them are at best unnecessar' ninet',nine percent o) the time. 0$$ )our o) them are o) .uestionab$e sa)et'. 6et a$$ o) them ,, except the intra%enous )$uids so )ar ,, are not on$' 8hurch Baw, but +tate Baw as we$$. #($$ ne%er )orget the o%erwhe$ming compu$sion o) the priest making his wa' to the premature nurser' to get some ho$' water on the in)ants and bapti<e them be)ore the' died. 3hat same )ierce compu$sion moti%ates the !:5" priests o) &odern &edicine in s$apping their Io$' Waters on their patients. 4ne o) the mottoes medica$ students are taught to memori<e but ne%er practice ,, such as 1)irst do no harm1 ,, is 1when 'ou hear the sound o) hoo)beats, think o) horses be)ore <ebras.1 #n other words when s'mptoms present themse$%es, )irst consider the most ob%ious, common sense cause. 0s 'ou can see, this motto doesn(t sur%i%e %er' $ong in most doctors( practices. 6ou can(t use power)u$ and expensi%e drugs and procedures on horses. +o what the doctor does is hear a herd o) <ebras e%er' time, and treat according$'. #) a chi$d is bored or can(t sit sti$$, he(s h'peracti%e and needs a drug. #) 'our 2oints are sti)) because 'ou don(t exercise them the wa' 'ou shou$d, 'ou need a drug. #) 'our b$ood pressure is a $itt$e high, 'ou need a drug. #) 'ou(%e got the sni))$es, 'ou need a drug. #) 'our $i)e isn(t going the wa' it shou$d, 'our need a drug. 4n and on ... the <ebras keep coming. 4ne o) the )actors that keeps those <ebras coming is the co<' and pro)itab$e re$ationship that exists between the drug companies and doctors. 3he drug companies spend an a%erage o) ?;, per 'ear on each and e%er' doctor in the Cnited +tates )or the purpose o) getting them to use their drugs.
8ompan' detai$ men, actua$$' sa$esmen, bui$d )riend$', pro)itab$e re$ationships with the doctors on their route, wining and dining, doing )a%ors, handing out samp$es o) drugs. 3he sad )act is that !:7" most o) the in)ormation reaching doctors about the uses and abuses o) drugs comes )rom the drug companies, through the detai$ men and ad%ertising in medica$ 2ourna$s. +ince most o) the c$inica$ test reports are )inanced b' the drug companies, in)ormation )rom these, too, is high$' suspect. 0 commission o) distinguished scientists, inc$uding )our Nobe$ Baureates, studied the drug prob$em and )ound that the cu$prits are the doctors and the scientists who test the drugs. 3he' )ound c$inica$ tria$s o) new drugs were 1a shamb$es.1 3he 9*0 spot checked the work o) some doctors doing such c$inica$ tria$s and )ound twent' percent gui$t' o) a wide range o) unethica$ practices, inc$uding gi%ing incorrect dosages and )a$si)' records. #n a third o) the reports checked b' the 9*0, the tria$ had not been carried out at a$$. #n another third, the experimenta$ protoco$ was not )o$$owed. #n on$' a third o) the tests cou$d the resu$ts be considered scienti)ica$$' worthwhi$e= !Aourna$ o) the 0merican &edica$ 0ssociation, No%ember 5, 19:>" *espite the ob%ious corruption o) the drug compan',doctor marketing connection, # don(t b$ame the drug companies, the detai$ men, the go%ernment agencies which are supposed to po$ice these acti%ities, or the patients who badger their doctors )or drugs. *octors ha%e enough )acts in their possession to know what(s going on. E%en where the drug is )u$$' tested and the side e))ects and $imitations o) the drug are we$$ known, most o) the harm is done b' !:>" doctors indiscriminate$' prescribing the drug. *octors, a)ter a$$, are the ones who c$aim the sacred power and the ethica$ superiorit' that goes with it. 3he drug companies are in business to make mone', and the' do that b' se$$ing as much o) their product as the' can at as high a price as the' can. 0nd a$though the drug companies sub%ert the scienti)ic process through which drugs are tested, certi)ied, and made a%ai$ab$e to doctors, once the drugs are a%ai$ab$e the' do $et doctors know ,, a$beit subt$' ,, 2ust what these drugs can and cannot do. 3he drug companies don(t ha%e to )ight against package inserts that wou$d exp$ain the side e))ects and ha<ards o) medications to the peop$e who take them: the 0merican &edica$ 0ssociation does it )or them. *octors either p$a' down the side e))ects or concea$ them a$together on the grounds that the doctor,patient re$ationship wou$d be endangered. 1#) # had to exp$ain things to patients, # cou$d ne%er get through m' o))ice hours.1 4r, 1#) patients knew e%er'thing these drugs cou$d do, the' ne%er wou$d take them.1 Eather than protecting the patient, the doctor protects the sacred re$ationship ,, which re$ies on ignorance to sur%i%e. B$ind )aith. #) doctors sti$$ obe'ed the )irst ru$e o) medicine ,, Jrimum, non nocere, )irst do no harm ,, there wou$d be no need )or them to en)orce the b$ind )aith o) their patients. When it came down to weighing risks against bene)its, the patient(s we$)are wou$d be the )irst consideration. !:;" But that ru$e has been rationa$i<ed into a grotes.ue mutation that a$$ows the doctor to weigh the risks and bene)its in a tota$$' di))erent ethica$ )rame. Now the ru$e is 9irst *o something. Now, 'ou hurt the patients most b' not gi%ing them something, whether it(s a drug or some other procedure. Whether the 1something1 does an' good or not is irre$e%ant. G3o .uestion it is irre%erent=H Whether it does an' harm matters e%en $ess. #) the treatment does happen to hurt enough to make the patient comp$ain, the doctor mere$' sa's 1Bearn to $i%e with it.1 4) course, a doctor wou$d ne%er consider sa'ing that to a patient unti$ he had tried at $east one drug. *octors ha%e comp$ete$' bought the ad%ertising s$ogan 1Better Bi%ing 3hrough 8hemistr'.1 6ou might think the reason )or this is pure$' economic. 3he doctor can write a prescription in a )ew seconds, whereas discussing with the patient the state o) his nutrition, exercise patterns, career, and
ps'che wou$d certain$' take up more time and a$$ow him to see )ewer patients. #n a )ee,)or,ser%ice s'stem, the .uick chemica$ )ix has its ob%ious )inancia$ reward )or the doctor as we$$ as )or the pharmacist and the drug manu)acturer. # think the reasons go deeper than mone'. 4ne wa' to $ook at it ,, though an admitted$' c'nica$ wa' ,, is to recogni<e that doctors ha%e throughout the ages embraced the wrong ideas. 8onsidering the drug prob$em in our time, the adamant disregard o) steri$it' in the nineteenth centur', $eeches, b$eeding, purgati%es, 'ou !::" cou$d make a case that medicine has a$wa's been ha<ardous to the ma2orit' o) patients. 3hat ,, and most doctors( high regard )or )inancia$ reward ,, he$ps exp$ain what the patient is up against. #) 'ou go deeper sti$$, 'ou come up against phi$osophica$ reasons that # can on$' describe as the 3heo$og' o) &odern &edicine. #ronica$$', this theo$og' is a corruption o) certain aspects o) 8hristian theo$og'. #) 'ou $ook at a$most an' other s'stem o) medicine besides the Western, 'ou($$ )ind a hea%' re$iance on )ood. 3he )ood o) &odern &edicine, howe%er, is the drug. 3he 0merican doctor, aside )rom a %er' )ragmentar' and usua$$' incorrect approach to certain 1therapeutic diets1 Ggout, diabetic, $ow sa$t, ga$$badder, weight reduction, $ow cho$estero$H, comp$ete$' disregards nutrition. 3hose who are concerned with nutrition are $abe$ed )addists, )reaks, extremists, radica$s, and .uacks. 4ccasiona$$', the'(re Gmore correct$'H re)erred to as heretics. 4rienta$ medicine, on the other hand, recogni<es and uti$i<es the importance o) nutrition in hea$th. #) 'ou $ook at 4rienta$ re$igion, 'ou($$ )ind that it, too, regards )ood as important to a person(s spiritua$ we$)are. But Western re$igion, name$' 8hristianit', did exact$' what &odern &edicine did: substituted as an obiect o) re%erence a sacramenta$, s'mbo$ic )ood in p$ace o) rea$ )ood. 1What goes into the mouth does not make a man unc$eanD it is what comes out o) the mouth that makes him unc$ean.1G&atthew 1>:11H !:8" Jerhaps in their <ea$ to re2ect the 4$d 3estament dietar' $aws, some o) the ear$' 8hristian $eaders mo%ed too )ar in the opposite direction and b'passed nutrition a$together. 3here(s no doubt that &odern &edicine took the hint and carried it to extremes. 4b%ious$', as )ar as a person(s hea$th is concerned, what goes into the mouth is at $east as important as what comes out. #n )act, what goes in ma' determine what comes out. 6et, i) an'one dares to c$aim that a person is what he or she eats, &odern &edicine regards them as a heretic or an inte$$ectua$ weak$ing. #nstead, the 1)ood1 with the sacred 1power1 is the drug, the man,made chemica$ coursing through 'our %eins, )or better or )or worse. 3o protect 'ourse$) )rom the pusher,priest 'ou again ha%e to make the heretic(s radica$ $eap o) un)aith. *on(t trust 'our doctor. 0ssume that i) he prescribes a drug, it(s dangerous. 3here is no sa)e drug. E$i Bi$$' himse$) once said that a drug without toxic e))ects is no drug at a$$. E%er' drug has to be approached with suspicion. 3hat goes doub$e i) 'ou(re pregnant. #n )act, i) 'ou(re pregnant 'ou and 'our bab' are better o)) i) 'ou sta' awa' )rom a$$ drugs comp$ete$'. 0 drug that has minor side e))ects or e%en no side e))ects on 'ou ma' do irreparab$e harm to a de%e$oping )etus. Iundreds o) drugs are marketed $ong be)ore their e))ects on the )etus are known. Cn$ess 'ou want to donate 'our bab'(s we$)are to science and be one o) !:9" the )irst to )ind out a drug(s e))ects, don(t take an' drug un$ess 'our $i)e is at stake. 3hat inc$udes aspirin. 3hough it(s been around )or eight' o) more 'ears doctors sti$$ don(t know how aspirin works. Because it(s been a 1)riend o) the )ami$'1 )or so $ong, peop$e don(t rea$i<e that aspirin is not without side e))ects and dangers o) its own. Besides the most common side e))ect,
stomach b$eeding, aspirin can cause a hemorrhage under the sca$p o) a newborn i) a mother takes it within se%ent',two hours o) de$i%er'. #(%e o)ten wondered wh' doctors a$wa's sa' to take 1two tab$ets1 o) )i%e grains each despite the a%ai$abi$it' o) a sing$e, ten,grain aspirin tab$et. 8ou$d there be some sort o) re$igious signi)icance in recei%ing ten o) something in two tab$etsBe)ore 'ou take the )irst dose o) an' medication 'our doctor prescribes, 'ou shou$d make it 'our business to )ind out more about the drug than the doctor himse$) knows. 0gain, $earning more about 'our situation than the doctor won(t be a$$ that di))icu$t. *octors get most o) their in)ormation about drugs )rom ad%ertisements and )rom detai$ men and their pamph$et handouts. 0$$ 'ou ha%e to do is spend some time with a good book or two in order to get the in)ormation 'ou need be)ore deciding whether to take a drug or not. 3he best book to start with is the Jh'sicians( *esk Ee)erence, the J*E. 3he J*E is the beginning o) know$edge about drugs. 0$though it(s easi$' a%ai$ab$e now, up unti$ about two !8 " 'ears ago the pub$isher re)used to distribute it to other than members o) the medica$ pro)ession. # wasn(t aware o) this when # ga%e the J*E man' p$ugs in m' co$umn and news$etter. 9ina$$', # got a $etter )rom the pub$isher te$$ing me to p$ease stop re)erring peop$e to their book since the' distributed it on$' to pro)essiona$s. 3he' )e$t that the pub$ic wou$dn(t understand the J*E and wou$d be con)used b' it. We$$, # pub$ished that $etter in m' co$umn and # commented that it was the )irst time in histor' a pub$isher didn(t want to se$$ his books. +hort$' therea)ter, without an' kind o) )an)are, the J*E not on$' started showing up in bookstores, but it was promoted in bookstores= Now, i) 'ou go into the bookstores, 'ou($$ see pi$es o) J*E(s. # guess the pub$isher )ina$$' got the idea. 4) course, 'ou don(t ha%e to bu' the book. 0$most e%er' pub$ic $ibrar' now has it. 6ou shou$dn(t worr' about understanding it. 0n'bod' with an eighth grade education and a dictionar' can read an' medica$ book. E%en doctors wi$$ testi)' that patients a$wa's seem to be ab$e to pick out and understand the parts that the' must know. 3he J*E is good because a$$ the in)ormation is pro%ided b' the drug companies in an e))ort to protect themse$%es. Not on$' does the 9*0 re.uire them to put in a$$ the in)ormation the' ha%e, but the' a$so want to ward o)) an' $iabi$it' c$aims against them. #n e))ect, the' are sa'ing to the doctor: we are te$$ing 'ou e%er'thing we know about this drug. What it ma' be !81" use)u$ )or. What it ma' do to the person who takes it. 3he wonder)u$ thing that seems to be happening is that the J*E is becoming more and more discreet. 9or examp$e, the $atest issues di%ide drug side e))ects into ma2or categories according to how )re.uent$' the' can occur. Now at $east 'ou(%e got horse race odds when 'ou take 'our medicine. 3he J*E can be considered the 1bib$e1 o) the 8hurch o) &odern &edicine, especia$$' since )or a $ong time it was )orbidden $iterature except to the priesthood. But there are other sources )or the kind o) drug in)ormation 'ou need. 3he 0merican &edica$ 0ssociation pub$ishes a *rug E%a$uations book which in some cases gi%es e%en more in)ormation than the J*E. 9or one thing, the 0&0 book has a $ist o) cross,re)erenced s'mptoms in the back. 6ou $ook up 'our s'mptom or 'our side e))ect and it wi$$ te$$ 'ou which drugs are indicated or suspected. Because we(re $i%ing in an era o) po$',pharmac' ,, e%er'bod' is taking more than one drug at a time ,, 'ou(%e got to become aware o) the dangers o) combinations o) drugs. 4ne drug ma' ha%e side e))ects harm)u$ to one organ three or )our percent o) the time, two percent to another organ, six percent to another. 0 second drug ma' ha%e dangers )or one organ that occur three percent, dangers )or another organ ten percent. #) 'ou(re taking enough drugs, the danger can easi$' add up to more than 1 percent. 6ou(re %irtua$$' assured o) su))ering some toxic e))ect= E%en more dangerous are
the !8/" potentiating e))ects o) drug combinations. 4ne drug might ha%e on$' a )i%e percent chance o) hurting 'ou. But in combination with another drug, the danger can be mu$tip$ied b' a )actor o) two, three, )our, )i%e ... who knows- Not on$' can the risk be mu$tip$ied, but so can the strength o) the toxic e))ect= 3here are books which gi%e $ists o) drugs which interact with a gi%en drug. G0n exce$$ent one which # use is Eric &artin(s Ia<ards o) &edications.H 4) course, 'ou a$so shou$d $et 'our doctor know what drugs 'ou are taking. But don(t re$' on his know$edge o) an' dangerous cross,reactions that might occur. 6ou shou$d be aware o) a$$ the drugs )or which the side e))ects are the same as the indications. 3his isn(t as rare as 'ou might think. 9or examp$e, i) 'ou read the $ist o) indications )or Ka$ium, and then read the $ist o) side e))ects, 'ou($$ )ind that the $ists are more or $ess interchangeab$e= Cnder the indications 'ou($$ )ind: anxiet', )atigue, depression, acute agitation, tremors, ha$$ucinosis, ske$eta$ musc$e spasms. 0nd under the side e))ects: anxiet' )atigue, depression, acute h'perexcited states, tremors, ha$$ucinations, increased musc$e spasticit'= # admit # don(t know how to use a drug $ike this: what am # supposed to do i) # prescribe it and the s'mptoms continue- +top the drug or doub$e the dose- What strateg' $ies behind using drugs $ike this is a m'ster' to me. Jerhaps doctors are p$a'ing the p$acebo e))ect )or a$$ it(s worth- 4r ma'be the' are mere$' tr'ing to sancti)' a patient(s origina$ s'mptoms !85" b' gi%ing a drug that causes them- &a'be the' )igure the s'mptoms wi$$ go awa' when the drug is withdrawn, in the )ashion o) primiti%e rites o) puri)ication and purging#n an' case, Ka$ium is the $argest se$$ing drug in histor', with prescriptions approaching ; mi$$ion a 'ear. &a'be it deser%es to be the $argest se$$ing drug in histor', since, b' ha%ing identica$ indications and side e))ects, it achie%es what a$$ s'stems o) science, art, and )aith stri%e )or: Cnit'= 6ou shou$d not $et 'our doctor prescribe a drug without asking him $ots o) .uestions. 0sk him what wi$$ happen i) 'ou don(t take the drug. 0sk him what the drug is supposed to do )or 'ou and how it(s going to do it. 6ou can a$so ask him the same .uestions 'ou wi$$ bring to the J*E, .uestions about side e))ects and situations when the drug is not ad%ised. *on(t expect too exp$icit an answer. &ost drugs( mechanisms remain m'steries e%en to the peop$e who de%e$op them. 4nce 'ou(%e exposed 'ourse$) to a$$ this in)ormation 'ou ha%e to sit down and decide whether or not 'ou want to take the drug. 0gain, don(t trust 'our doctor(s decision. E%en i) 'ou can get him to admit to the side e))ects, he($$ most $ike$' discount them b' sa'ing the' occur on$' in a sma$$ percentage o) cases. 6ou a$so might get that impression )rom the J*E or an' other book 'ou consu$t. *on(t be mis$ed b' risks that are expressed in sma$$ percentages. #) 'ou 2udge the danger o) an iceberg b' the si<e o) the part that(s abo%e the water, 'ou(re not !87" going to sta' a)$oat %er' $ong. Bike a game o) Eussian Eou$ette, )or the person who gets the $oaded chamber, the risk is 1 percent. But un$ike that game, )or the person taking a drug no chamber is entire$' empt'. E%er' drug stresses and hurts 'our bod' in some wa'. 3he doctor doesn(t consider this because his phi$osoph' o) decision is corrupted. 9irst *o +omething. 3he doctor is going to )ind himse$) sa'ing ridicu$ous things such as, 13he Ji$$ is sa)er than pregnanc'.1 Because the doctor be$ie%es it, he(s dangerous. 6ou ha%e to determine 'our risk indi%idua$$'. 4n$' 'ou, as 'ou read up on the drug wi$$ be ab$e to recogni<e certain conditions 'ou ha%e or ha%e had which might make the drug e%en more dangerous. 0nd on$' 'ou wi$$ be ab$e to decide whether or not 'ou want to risk going through one or more o) whate%er side e))ects 'ou )ind there in exchange )or the possib$e bene)it the drug ma' de$i%er. &ost o) a$$, 'ou shou$d keep in mind that 'ou can re)use to take the drug. #t(s 'our hea$th that(s at stake. #) 'ou read things that make 'ou not want to take the drug, )irst o) a$$ con)ront the doctor
with the in)ormation. 3hrough ca2o$er', badgering, or some process o) persuasion, 'ou shou$d con%ince the doctor that 'ou rea$$' want to a%oid the drug. 0s in a$$ con)rontations with doctors, his reaction ma' te$$ 'ou more than 'ou bargained )or. 6ou ma' once and )or a$$ recogni<e that his opinion is no more %a$id than 'ours. 4n the other hand i) 'ou don(t )ind an'thing !8>" in 'our research to dissuade 'ou )rom taking the drug, i) the possib$e bene)its appear to outweigh the risks, 'ou(re sti$$ not home )ree. 6ou sti$$ ha%e to protect 'ourse$). 9irst o) a$$, make sure 'ou carr' out the instructions gi%en b' 'our doctor. #) 'ou )ind his instructions are di))erent )rom the prescribing in)ormation in the J*E 'ou shou$d ask him wh'. Ie ma' ha%e a per)ect$' good reason: his experience ma' suggest that the drug works best when taken according to his instructions. 4r he ma' be making a mistake that cou$d decide whether or not the drug wi$$ he$p 'ou or hurt 'ou. 0nother reason wh' 'ou shou$d )o$$ow the instructions is that o)ten these wi$$ inc$ude %arious tests that shou$d be carried out whi$e 'ou(re taking the drug, tests that are designed to re%ea$ an' serious ad%erse e))ects be)ore the' go too )ar. 3hese tests are usua$$' )ound with the prescribing in)ormation. E%er' doctor knows about or has access to this in)ormation. 6et )ew doctors bother to )u$)i$$ this responsibi$it'. +o it(s up to 'ou to make sure 'our bod'(s reaction to the drug is tested. 6ou shou$d a$so monitor the drugs e))ect sub2ecti%e$'. Iow does the drug make 'ou )ee$- #) 'ou experience an' side e))ects ,, no matter how unimportant the' ma' seem at )irst ,, 'ou shou$d ca$$ 'our doctor and $et him know. Iere is where 'our homework can rea$$' pa' o)), because 'our doctor ma' not be aware o) certain side e))ects that are a signa$ to stop taking the drug. 4n the other hand, some side e))ects are temporar', and i) 'ou(%e a$read' !8;" made up 'our mind to take the drug, 'ou ma' not want to stop as $ong as the discom)ort is temporar'. #) 'ou(re hit b' a serious side e))ect 'ou shou$d immediate$' seek medica$ attention. *on(t wait too $ong )or 'our doctor to get in touch with 'ou. @o to the hospita$ emergenc' room. 6ou(re not on$' protecting 'our hea$th, but 'ou(re co%ering a$$ the bases in the e%ent an' $ega$ action e%er resu$ts )rom the therap'. #) on the basis o) 'our comp$aints o) side e))ects, or because 'ou re)use to take a certain drug at a$$, 'our doctor prescribes another drug make sure it(s not the same substance with a di))erent brand name. 3he doctor ma' himse$) be ignorant ,, or he ma' be tr'ing to put one o%er on 'ou. #) 'ou )ind 'ourse$) ha%ing to protect 'our chi$d )rom the recommendations o) schoo$ o))icia$s and doctors that he or she be 1treated1 )or h'peracti%it', 'our )irst mo%e shou$d be to prepare 'ourse$) to start with simp$e measures but be wi$$ing and ab$e to go on to more drastic maneu%ers. 3he simp$est procedure in%o$%es a $itt$e dip$omac', a $itt$e ski$$)u$ deception o) pro)essiona$s, and perhaps a )ew changes in how 'ou manage 'our chi$d. Ia%e a con)erence with the c$assroom teacher. Bet him or her know that 'ou don(t want 'our chi$d recei%ing drugs and that 'ou want to exp$ore a$ternati%e wa's o) dea$ing with the prob$em. #t he$ps to tr' to )ind out exact$' what aspects o) 'our chi$d(s beha%ior $ed the teacher to $abe$ him or her 1h'peracti%e.1 6ou can ask )or suggestions !8:" on how to change 'our management o) the chi$d at home in order to better prepare )or the c$assroom. Iere is where 'ou(%e got to be read' to $ie a $itt$e. 6ou shou$d gi%e the teacher(s suggestions honest consideration. #) the' sound reasonab$e, 'ou shou$d consider changes. But i) the' don(t seem $ike things 'ou cou$d do without sacri)icing )ami$' habits and practices that 'ou consider important, 'ou shou$d discard them. 6ou don(t ha%e to te$$ the teacher that. 6ou can $ie and ra%e about how 'our chi$d has changed so positi%e$' since 'ou tried his or her suggestions. 8hances are that wi$$ end the prob$em, since the teacher(s expectations o) the chi$d(s beha%ior determine the teacher(s perception o) it, and ma' e%en determine the chi$d(s actua$ beha%ior in accord with the
se$),)u$)i$$ing prophec'. 3he next step is to ha%e a con)erence with the teacher to exp$ore possib$e wa's in which the c$assroom management cou$d be modi)ied. 6ou(re going to meet resistance here, because the phi$osoph' o) most schoo$s ,, despite a$$ the $ip ser%ice to indi%idua$ attention and consideration is that the student has to )it the mo$d cast b' the schoo$. 0t this point, i) 'ou(re not getting an'where, 'ou might want to consu$t with peop$e who ha%e wisdom and whom 'ou trust. 3hese can be specia$ education experts or grandmothers. 8onsider a change in 'our chi$d(s c$assroom. Be)ore 'ou a$$ow a doctor to tamper with 'our chi$d(s chemistr', 'ou shou$d rea$i<e that perhaps it(s the 1chemistr'1 between chi$d and !88" teacher, or chi$d and c$assmates, that is rea$$' at )au$t. 0 mo%e to another schoo$ cou$d be the answer )or the same reasons. 3he most drastic so$ution is to remo%e 'our chi$d )rom schoo$ a$together and ha%e him or her tutored at home, i) state $aw permits. #) 'our chi$d rea$$' does seem to ha%e a beha%ior prob$em that goes be'ond the norma$ range o) chi$dhood intractabi$it', 'ou might want to consider a so$ution man' )ami$ies ha%e success)u$$' tried: the 9eingo$d diet. *r. Ben 9eingo$d is the chie) o) the Faiser 9oundation(s a$$erg' c$inics. Iis diet e$iminates )ood co$oring and other arti)icia$ additi%es, and certain natura$ )oods ,, on the assumption that certain substances in these )oods stimu$ate a chi$d who is especia$$' susceptib$e. 3he concept is sound ,, a$though %igorous$' attacked b' ad%ocates o) drug therap'. 6ou can(t re$' on 'our doctor to aid 'ou in 'our strugg$e to keep a chi$d diagnosed as h'peracti%e o)) drugs. the doctor ma' p$a' a$ong with 'ou and sa', 1we$$, $et(s ta$k to the teacher and tr' to change the en%ironment=1 but in ninet',nine out o) one hundred cases the doctor wi$$ return to the drugs. 3he same is $ike$' to happen i) 'ou tr' to get 'our doctor to treat 'ou without drugs in an' other situation. *octors simp$' don(t be$ie%e in non,drug therapies. 9or one thing, %er' )ew o) them know how to treat without drugs. +o the' don(t be$ie%e in it. #) 'ou ha%e high b$ood pressure and 'our doctor wants to put 'ou on drugs but 'ou don(t want to take them, he might tr' b' ha%ing 'ou !89" $ose weight and b' exercising. But he($$ make on$' a ha$),hearted attempt because in the )irst p$ace he doesn(t be$ie%e in it and in the second p$ace doctors don(t know enough about nutrition and $i)est'$e to rea$$' show a patient how to make a use)u$ change. &a'be one doctor in )i)t' knows. 9rom the standpoint o) the patient, o) course, it makes per)ect$' good sense to want to be treated without drugs. But )rom the standpoint o) the doctor, it(s tota$$' outrageous. 0gain, the ethics o) the doctor and the ethics o) the patient con)$ict. 3hat shou$dn(t come as too big a surprise. &edica$ ethics are usua$$' the opposite o) traditiona$ ethics. 9or instance, i) 'ou(re in the operating room and somebod' )inds a sponge in the be$$' $e)t )rom a pre%ious operation, traditiona$ ethics wou$d make sure that somebod' in the )ami$' )ound out about it. &edica$ ethics te$$s 'ou to keep 'our mouth shut about it. 3he surgeon wi$$ sa', 1# don(t want an'bod' to know about this,1 and i) the nurse te$$s the )ami$', she($$ be out o) a 2ob. &edica$ ethics a$so wa))$es on the point o) stopping at the scene o) an accident. #) a doctor passes the scene o) an accident traditiona$ ethics te$$s him to stop and tr' to sa%e a $i)e. &edica$ ethics te$$s him )irst to )ind out i) the state has a @ood +amaritan $aw. 3he ethics o) &odern &edicine are di))erent )rom traditiona$ re$igious ethics as we$$ as )rom traditiona$ socia$ ethics. Ee$igious s'stems that are in con)$ict genera$$' tr' to dissubstantiate the ethics and be$ie)s o) the s'stems the' are at !9 " odds with. #n the 8hurch o) &odern &edicine, the doctor who treats without drugs is regarded as a heretic because he or she appears to ha%e re2ected the sacrament o) medication. Nondrug hea$ers are regarded as be$onging to a di))erent re$igious
s'stem and are thought o) as .uacks, nuts, or )adists. 3he re$igious restrictions are so stringent that doctors are discouraged )rom e%en associating with the in)ide$s. 3he 0&0 code o) ethics sa's that &.*.s are not supposed to associate with cu$tists. 3he'(re not to ta$k to them, not to ha%e them in their homes= #) 'ou keep in mind that this is the t'pe o) person that(s ad%ising 'ou to take this or that dangerous substance into 'our bod', 'ou shou$d ha%e no prob$em mustering the moti%ation to protect 'ourse$).
Chapter " Ritual Mutilations

!91" # be$ie%e that m' generation o) doctors wi$$ be remembered )or two things: the mirac$es that turned to ma'hem, such as penici$$in and cortisone, and )or the mi$$ions o) muti$ations which are ceremonious$' carried out e%er' 'ear in operating rooms. 8onser%ati%e estimates ,, such as that made b' a congressiona$ subcommittee ,, sa' that about /.7 mi$$ion operations per)ormed e%er' 'ear are unnecessar', and that these operations cost ?7 bi$$ion and 1/, $i%es, or )i%e percent o) the .uarter mi$$ion deaths )o$$owing or during surger' each 'ear. 3he #ndependant Iea$th Eesearch @roup sa's the number o) unnecessar' operations is more than 5 mi$$ion. 0nd %arious studies ha%e put the number o) use$ess operations between e$e%en and thirt' percent. !9/" &' )ee$ing is that somewhere around ninet' percent o) surger' is a waste o) time, energ', mone', and $i)e. 4ne stud', )or examp$e, c$ose$' re%iewed peop$e who were recommended )or surger'. Not on$' did the' )ind that most o) them needed no surgur', but )u$$' ha$) o) them needed no medica$ treatment at a$$. 3he )ormation o) committees to re%iew tissue remo%ed in operations has resu$ted in some te$$ing statistics. #n one case /;/ appendectomies were per)ormed the 'ear be)ore a tissue committee began o%erseeing surger'. *uring the )irst 'ear o) the committee(s re%iew, the number dropped to 1:8. Within a )ew 'ears, the number dropped to ;/. 3he percentage o) norma$ appendices remo%ed )e$$ )i)t',)i%e percent. #n another hospita$ the number o) appendectomies was s$ashed b' two,thirds a)ter a tissue committee went to work. 3hese committees and stud' teams are composed o) doctors who are sti$$ working within the be$ie) s'stem o) &odern &edicine. 3here are do<ens o) common operations the' wou$d no doubt see as use)u$ most o) the time, such as cancer surger', coronar' b'pass surger', and h'sterectomies. 6et as )ar as #(m concerned ninet' percent o) the most common operations, inc$uding these, are at best o) $itt$e %a$ue and at worst .uite harm)u$. 3he %ictims o) a $ot o) need$ess surger' are chi$dren. 3onsi$$ectom' is one o) the most conmmon surgica$ procedures in the Cnited +tates. Ia$) o) a$$ pediatric surger' is )or the remo%a$ !95" o) tonsi$s. 0bout a mi$$ion are done e%er' 'ear. 6et the operation has ne%er been demonstrated to do %er' much good. Back around the same time # got into troub$e )or cutting uro$ogica$ workups on chi$dren at an outpatient c$inic, # got into troub$e again )or not discussing the si<e o) tonsi$s. 3here are %er' rare cases ,, $ess than one in 1, ,, where someone ma' need a tonsi$$ectom'. #(m not ta$king about when the chi$d snores or breathes noisi$'. But when it rea$$' impedes the chi$d(s breathing, i) he or she is rea$$' choking, the tonsi$s ma' ha%e to come out. 6ou don(t ha%e to ask a chi$d or a parent about it. #t(s ob%ious= +o # cut out that .uestion on the examination. 4) course, the number o) tonsi$$ectomies went wa' down. 0s 'ou might expect, # soon got a ca$$ )rom the chairman o) the
ear, nose, and throat department: # was threatening his teaching program. 3onsi$$ectomies ha%e been per)ormed )or more than /, 'ears, and their use)u$ness in most cases ne%er has been pro%ed. *octors sti$$ can(t agree on when the operation shou$d or shou$dn(t be per)ormed. 3he best reason doctors and parents can gi%e )or the attack on the tonsi$s is, as i) the' were some mountain range that had to be con.uered, 1because the'(re there.1 Jarents are $u$$ed into be$ie%ing that the operation 1can(t do an' harm.1 3hough ph'sica$ comp$ications are rare, the'(re not a$together non,existent. &orta$it' ranges in di))erent sur%e's )rom one in 5, to one in 1 , . Emotiona$ !97" comp$ications abound. @etting to eat a$$ the ice cream 'ou want doesn(t make up )or the 2usti)ied )ear a chi$d experiences that his parents and the doctor are ganging up on him. 0 $ot o) chi$dren show marked changes )or the worse in their beha%ior a)ter the operation. 3he'(re more depressed, pessimistic, a)raid, and genera$$' awkward in the )ami$'. Who can b$ame them- 3he' can sense, and un)ortunatet' be serious$' a))ected b', a patent$' absurd ,, though dangerous ,, situation. Women a$so seem to be the %ictims o) a $ot o) unnecessar' surger'. 0nother operation steadi$' c$imbing towards the mi$$ion,a,'ear mark is the h'sterectom'. 3he Nationa$ 8enter )or Iea$th +tatistics estimated that ;9 , women had their uteruses remo%ed in 19:5, which resu$ts in a rate o) ;7:.: per 1 , )ema$es. Besides the )act that this is a higher rate than )or an' other operation, i) the rate continued, it wou$d mean ha$) o) a$$ women wou$d $ose their uterus b' age ;>= 3hat(s i) the rate ho$ds stead'. 0ctua$$', its growing. #n 19:>, 8 8, h'sterectomies were per)ormed. Ker' )ew o) them were necessar'. #n six New 6ork hospita$s, )ort',three percent o) the h'sterectomies re%iewed were )ound to be un2usti)ied. Women with abnorma$ b$eeding )rom the uterus and abnorma$$' hea%' menstrua$ b$ood )$ow were gi%en h'sterectomies e%en though other treatments ,, or no treatment at a$$ ,, wou$d ha%e most $ike$' worked 2ust as we$$. #n their $usting a)ter the status and power o) surgeons, obstetricians are rapid$' turning the !9>" natura$ process o) chi$dbirth into a surgica$ procedure. Ba'er upon $a'er o) 1treatment1 buries the experience under the mant$e o) sickness, as each $a'er re.uires another $a'er to compensate )or its ad%erse e))ects. +trange$' enough, 'ou can a$wa's count on doctors to take credit )or the compensations, but not )or the medica$ disasters that make the compensations necessar' in the )irst p$ace= 3he )irst ma2or intrusion into chi$dbirth was the introduction o) )orceps. 3wo sinister sixteenth, centur' barber,surgeons, the 8hamber$en brothers, a$wa's carried a huge wooden box into the de$i%er' room. 3he' sent e%er'one e$se out o) the room and b$ind)o$ded the mother in $abor be)ore opening the box. #t wasn(t unti$ the nineteenth centur% that the contents o) the box became wide$' known: obstetrica$ )orceps. Csing )orceps to extract the bab' whether or not the birth proceeds norma$$' was the )irst step towards turning $abor and de$i%er' into surger'. 3he next step came as scientists became interested in the birthing process. *octors began to compete with midwi%es, and as the' won, the process came to be super%ised b' the ma$e doctor rather than the )ema$e midwi)e. #t wasn(t $ong be)ore chi$dbirth mo%ed )rom the home into the hospita$, where a$$ the trappings and stage settings )or treating it as a disease cou$d be easi$' arranged. 4) course, when the ma$e doctors took o%er chi$dbirth, it did become a disease. 3he doctors did something the midwi%es ne%er did: the' went right )rom the !9;" autops' $abs where the' were hand$ing corpses to the maternit' wards to attend births. &aterna$ and in)ant death rates sk'rocketed )ar be'ond where the' had been when midwi%es de$i%ered babies. 4ne courageous doctor, #gna< Jhi$ipp +emme$weis, pointed out the dead$' connection and was hounded out o)
medicine, and into an insane as'$um )or suggesting that doctors were the agents o) disease. 4nce +emme$weis( suggestion that doctors wash their hands be)ore attending a birth was adopted, materna$ and in)ant morta$it' rates dropped ,, an e%ent )or which the pro)ession predictab$' took credit. 4nce it became possib$e to drug the mother into a state o) he$p$ess ob$i%ion, the obstetrician cou$d become e%en more power)u$. +ince the mother cou$dn(t assist in the de$i%er' whi$e unconscious, the )orceps p$ace in the de$i%er' room was assured. +edated, )eet in stirups, sha%en, attached to an intra%enous )$uid bag and a batter' o) monitors the woman in $abor is set up so we$$ )or surger', an operation had to be in%ented so the scene wou$dn(t go to waste. Enter the episiotom'. +o routine is this surgca$ s$icing o) the perineum to widen the opening o) the %agina that )ew women and e%en )ewer doctors think twice about it. *octors c$aim that the surgica$ incision is straighter and simp$er to repair than the tear that is $ike$' to occur when the bab'(s head and shou$ders are born. 3he' )ai$ to acknow$edge that i) the woman is not drugged si$$', and i) she(s proper$' coached b' someone !9:" who knows what(s going on, and i) she(s prepared, then she wi$$ know how and when to push and not push to ease the bab' out. When the birth is a conscious de$iberate experience, the perinea$ tear can usua$$' be a%oided. 0)ter a$$, the %agina was made to stretch and a$$ow a bab' to pass through. E%en i) tearing does occur, there(s no e%idence that the surgica$ incision hea$s better than a tear. Luite the contrar', m' experience demonstrates that tears hea$ better, and with $ess discom)ort, than episiotomies. 3here is some )ee$ing that the episiotom' ma' $ead to a $ater $essening o) sexua$ p$easure. 4bstetricians were not $ong satis)ied b' the minor surger' o) the episiotom'. 3he' had to ha%e something more awesome and dangerous. 0)ter a$$, the de$i%er' room setting on$' adds to the )ee$ing that something terrib$' abnorma$ must be happening here. 0nd such an abnorma$ process sure$' demands medica$ inter%ention. 3he more extreme the better. 0nd since the de$i%er' room is rea$$' an operating room disguised b' the simp$e addition o) an incubator, what rea$$' shou$d be going on here is a )u$$ b$own operation. Ience the obstetrica$ sacri)ice graduates be'ond the simp$e muti$ation o) the episiotom' to the most sinister de%e$opment o) modern obstetrics, the epidemic o) 8aesarean de$i%eries. 9eta$ monitoring ,, $istening to the )eta$ heart either through the mother(s abdomen or, most recent$', through e$ectrodes screwed into the in)ant(s sca$p during $abor ,, is the diagnostic !98" sowing procedure that is reaping the har%est o) 8aesarean section de$i%eries. Whether or not the )etus is rea$$' in troub$e, i) the monitor sa's something is wrong, there(s a rush to s$ice the mother open and remo%e the bab'. 3hen the obstetrician can bask in a$$ the $ime$ight that comes with per)orming a mirac$e. 0)ter a$$, he(s snatched a $i)e )rom the 2aws o) certain death or disab$ement. +tudies o) comparab$e de$i%eries show that 8aesarean de$i%eries occur three to )our times more o)ten in births attended b' e$ectronic )eta$ monitoring than in those monitored with a stethoscope. 3hat(s not so hard to understand. #) the mother doesn(t want the operation, a$$ the obstetrician has to do is point to the distressed b$ips on the monitor screen. 3hat(s rea$it', what appears on the cathode ra' tube, not what the woman )ee$s and wants. 0 woman has p$ent' o) other reasons not to want her de$i%er' e$ectronica$$' monitored. #n order to attach the e$ectrodes to the )etus( sca$p, the bag o) waters must be arti)icia$$' broken. 3his resu$ts in an instant depression o) the )eta$ heart rate. #n one stud', chi$dren whose birth was e$ectronica$$' monitored were sixt',)i%e percent more $ike$' to su))er beha%iora$ or de%e$opmenta$ prob$ems $ater
in $i)e. 4) course, what the woman )ee$s and wants is secondar' to what the obstetrician sa's must be. 0nd that inc$udes schedu$ing the de$i%er' according to the doctor(s con%enience. #n man' hospita$s the induced, 1nine,to,)i%e1 de$i%er' has become the ru$e. Working on$' )rom his !99" ca$cu$ations o) when the bab' is due ,, which can be o)) b' as much as six weeks= ,, the doctor induces $abor when he )ee$s $ike it, not when the bab' is natura$$' read' to pass through the birth cana$. 0 $abor induced b' the doctor can end up a 8aesarean de$i%er' because a bab' that(s not read' to be born wi$$ natura$$' show more distress on )eta$ monitors, distress at being summoned premature$'. 9eta$ $ung disease, )ai$ure o) norma$ growth and de%e$opment, and other menta$ and ph'sica$ disabi$ities associated with premature birth are dangers o) induced de$i%er'. 0s man' as )our percent o) the babies admitted to new,born,intensi%e care nurseries come in a)ter medica$$' induced de$i%eries. &others, too, are more $ike$' to end up in the intensi%e care ward a)ter an induced de$i%er'. Jost operati%e comp$ications occur in ha$) o) a$$ women who de$i%er b' 8aesarean section. 0nd the materna$ death rate is /; times higher than in women who de$i%er %agina$$'. # propose that we drop the term )eta$ monitoring and start ca$$ing it )ata$ monitoring= 9u$$,term, regu$ar si<e babies de$i%ered b' 8aesarean section are a$so in danger o) a serious $ung condition known as h'a$ine membrane disease or respirator' distress s'ndrome. 3his poor$' understood, sometimes )ata$, and usua$$' unresponsi%e to treatment condition was once )ound a$most exc$usi%e$' in premature in)ants. #) a bab' de$i%ers norma$$', the compressing action o) the uterus s.uee<es the chest and $ungs as the bab' emerges. 3he )$uids !1 " and secretions that accumu$ate in the $ungs are then prope$$ed through the bronchia$ tubes and expe$$ed through the mouth. 3his does not take p$ace in 8aesarean babies. 4ne stud' conc$uded that the incidence o) this disease cou$d be reduced at $east )i)teen percent i) obstetricians were more care)u$ about 8aesarean de$i%eries. 3he same report stated that at $east ;, o) the estimated 7 , cases o) h'a$ine membrane disease cou$d be pre%ented i) doctors didn(t induce de$i%er' unti$ the )etus was mature enough to $ea%e the womb. 6et the rates o) induced de$i%eries and 8aesarean sections are going up, not down. # can remember when i) a hospita$(s incidence o) 8aesarean de$i%eries went abo%e )our or )i%e percent, there was a )u$$ sca$e in%estigation. 3he present $e%e$ is around twent',)i%e percent. 3here are no in%estigations at a$$. 0nd in some hospita$s the rate is pushing )i)t' percent. We tend to get the idea that medicine is a$wa's progressing and that surgica$ procedures are de%e$oped, pro%ed use)u$, and incorporated into e%er'da' practice at $east unti$ the' are supp$anted b' the next mirac$e. But that(s not the wa' it happens at a$$. +urger' goes through three phases, but none o) them has the $east to do with progress. 3he )irst phase a new surgica$ procedure goes through is enthusiastic acceptance. 4) course, the natura$ order o) things sa's that a new de%e$opment shou$d be treated with skepticism be)ore enthusiasm. But that(s not the wa' things work in !1 1" &odern &edicine. 4nce an operation is pro%ed possib$e, its enthusiastic acceptance is guaranteed. 4n$' a)ter an operation has been around )or some time and the rea$ use)u$ness and ob,use)u$ness ha%e had p$ent' o) chances to emerge )rom the )og o) ear$' enthusiasm, does skepticism begin to seep in )rom around the edges. 8oronar' b'pass surger' en2o'ed unbounded acceptance )or the )irst )i%e or six 'ears. E%er'one acted $ike the operation, in which a b$ood %esse$ c$ogged b' )at deposits is surgica$$' 1b'passed,1 was the answer to the catastrophic rate o) death b' heart attack in the Cnited +tates. But the $i$' hasn(t been ab$e to stand up to the gi$ding process. 3hough tens o) thousands o) men and women
sti$$ $ine up )or this operation e%er' 'ear, more and more peop$e are getting skeptica$. 0pparent$', the operation doesn(t work as we$$ as surgeons wou$d $ike to think. 0 se%en,'ear stud' b' the Keterans 0dministration o) more than 1, peop$e )ound that except )or high,risk patients with rare $e)t,main arter' disease, the coronar' b'pass pro%ided no bene)it. &orta$it' rates )or surger' patients were not signi)icant$' di))erent )rom those medica$$' treated. #n )act, among the $ow,risk patients, the morta$it' rates a)ter )our 'ears were s$ight$' higher among those recei%ing the operation. 4ther studies ha%e shown that peop$e who ha%e coronar' b'pass surger' sti$$ show abnorma$ities on exercise EF@ tests and that the' ha%e no $ess risk o) su))ering a heart attack than those who are treated nonsurgica$$'. !1 /" 3hough the operation seems to pro%ide re$ie) )rom angina pain, some doctors be$ie%e this ma' be either a p$acebo a))ect or the resu$t o) surgica$ destruction o) ner%e pathwa's. 9urthermore, the b'pass itse$) can become c$ogged and $ea%e the patient right back where he or she started be)ore the operation. 3he most e))ecti%e treatment )or heart disease appears to be a radica$ change in diet )rom the t'pica$ high )at to one in which )at makes up ten percent or $ess o) tota$ ca$ories, combined with a progressi%e exercise regimen. 3his treatment has demonstrated e%idence o) hea$ing as we$$ as re$ie) )rom s'mptoms. 0$$ o) which wi$$ e%entua$$' push the coronar' b'pass into the third phase: abandonment. But operations die hard, especia$$' enormous$' pro)itab$e ones $ike the b'pass. 0$though it(s )air$' ob%ious that rep$acing a two or three inch section o) a c$ogged $arge %esse$ isn(t going to do an'thing )or 99.9 percent o) c$ogged arteries that are $e)t, the b'pass operation sti$$ packs (em in. 9ortunes, careers, and $i%es sti$$ depend on it. Jerhaps what it wi$$ take to put the b'pass under )or good is the kind o) courage it took one surgeon to pound the $ast nai$ into the co))in o) 1poudrage,1 a heart operation that was popu$ar a )ew decades ago. #n this operation, the' wou$d open up the chest and simp$' sprink$e ta$cum powder on the outside o) the heart. Jresumab$', this wou$d irritate the $inings and the %esse$s so the' wou$d de%e$op !1 5" new b$ood %esse$s and increase circu$ation. Joudrage was a$$ the rage unti$ a surgeon took a series o) patients )or the operation, opened a$$ their chests, but sprink$ed the powder on on$' ha$) o) them. 3he resu$ts were exact$' the same. 3he' a$$ )e$t the same a)ter surger'= 4nce a surgica$ procedure is abandoned b' a$$ rationa$ pretense, it isn(t necessari$' abandoned b' &odern &edicine. #) 'ou take the ma2or categories o) surger', most reached this point 'ears ago. 3heir rea$ use)u$ness is hard to )ind, but the' o%er)$ow with sacramenta$ bene)its. 0s ritua$s o) the 8hurch, the' ne%er die. 0$though tonsi$$ectomies shou$d ha%e been )or a$$ practico$ purposes abandoned )or /, 'ears, the'(re sti$$ .uite popu$ar as a medica$ ceremon'. 4phtha$mo$ogists scare the he$$ out o) parents b' te$$ing them their chi$d wi$$ de%e$op b$indness in one e'e i) his or her mi$d crossed e'e s'ndrome isn(t surgica$$' corrected. #) that were true, we wou$d ha%e mi$$ions o) peop$e wa$king around b$ind in one e'e, since that(s how man' cases ne%er reach the ophtha$mo$ogists. 0nd though the b$oom is o)) the rose as )ar as the coronr' b'pass is concerned, doctors in &odern &edicine(s sacrament mi$$ are de%e$oping the same basic ,, and use$ess ,, techni.ue )or use on other )orms o) cardio%ascu$ar disease= &odern cancer surger' someda' wi$$ be regarded with the same kind o) horror that we now regard the use o) $eeches in @eorge Washington(s !1 7" time. #t was shown to be irrationa$ thirt',)i%e 'ears ago when Warren 8o$e at the Cni%ersit' o) #$$inois showed that i) 'ou examine the periphera$ b$ood a)ter 'ou open the skin, 'ou )ind that as a resu$t o) surger' the tumor ce$$s ha%e a$read' spread.
*octors answered that b' sa'ing o) course the tumor spreads, but the rest o) the bod' can take care o) it. 3hat(s a si$$' answer. #) the person(s bod' cou$d 1take care o) it,1 the person wou$dn(t ha%e cancer in the )irst p$ace= +ome sa' that cancer surger' is threatened because o) a$$ the new techni.ues )or )ighting cancer. #t(s the other wa' around: the new techni.ues are capturing peop$e(s imagination and hope because cancer surger' is pro%ing a disappointment. 6our surgeon, nonethe$ess, wi$$ be the $ast to admit this. Jeop$e ask me wh' there(s so much unnecessar' surger', and # te$$ them there are more reasons wh' there shou$d be than there are that there shou$dn(t be. 3he on$' reason wh' there shou$dn(t be so much unnecessar' surger% is that it causes su))ering and $oss o) $i)e, hea$th, and expenses that do not ha%e to be. 3hat consideration a$one has ne%er had much e))ect on the workings o) the 8hurch o) &odern &edicine. 4n the other hand, the reasons wh' there shou$d be unnecessar' surger' are $egion, and .uite compe$$ing within the ethica$ )ramework o) the 8hurch. 3he simp$est reason is that surger' can be put to man' uses besides the stated purpose o) !1 >" correcting or remo%ing a disease process. +urger' is a geat teaching too$ as we$$ as a )erti$e experimenta$ )ie$d ,, a$though the on$' thing that(s e%er 1$earned1 or 1disco%ered1 is how to per)orm the surger'. When # was +enior Jediatric 8onsu$tant to the *epartment o) &enta$ Iea$th in #$$inois, # cut out a certain kind o) operation that was being per)ormed on mongo$oid chi$dren with heart de)ects. 3he stated purpose o) the operation was to impro%e ox'gen supp$' to the brain. 3he rea$ purpose, o) course, was to impro%e the state(s residenc' programs in cardio%ascu$ar surger', because nothing bene)icia$ happened to the brains o) mongo$oid chi$ren ,, and the surgeons knew that. 3he who$e idea was absurd. 0nd dead$', since the operation had a )air$' high morta$it' rate. Natura$$', the uni%ersit' peop$e were %er' upset when # cut out the operation. 3he' cou$dn(t )igure out a better use )or the mongo$oid chi$dren, and, besides, it was important to train peop$e. @reed p$a's a ro$e in causing unnecessar' surger' a$though # don(t think the economic moti%e a$one is enough to exp$ain it. 3here(s no doubt that i) 'ou e$iminated a$$ unnecessar' surger', most surgeons wou$d go out o) business. 3he'(d ha%e to $ook )or honest work, because the surgeon gets paid when he per)orms surger' on 'ou, not when 'ou(re treated some other wa'. #n prepaid group practices where surgeons are paid a stead' sa$ar' not tied to how man' operations the' per)orm, h'sterectomies !1 ;" and tonsi$$ectomies occur on$' about one,third as o)ten as in )ee,)or,ser%ice situations. #) we had about one,tenth as man' surgeons as we ha%e now, there wou$d be %er' $itt$e unnecessar' surger'. E%en the 0merican 8o$$ege o) +urgeons has said we need on$' > , to ; , board certi)ied surgeons, p$us about 1 , interns and residents, to pro%ide amp$' )or the countr'(s surgica$ needs )or the next ha$) centur'. 0ccording to their pro2ections ,, which we wou$d expect to be considerate o) the )inancia$ p$ight o) surgeons i) their suggestions were taken serious$' ,, a$most ha$) o) the 1 , or so surgeons we actua$$' do ha%e right now are super)$uous. 3hose > , or so extra unsheathed sca$pe$s do a $ot o) damage. #gnorance p$a's a part in a $ot o) unnecessar' surger', too. # don(t mean ignorance on the part o) patients. #), )or examp$e, 'ou e$iminated a$$ g'neco$ogica$ surger' that resu$ted )rom improper, outdated, and outright stupid obstetrica$,g'neco$ogica$ practice, there wou$dn(t be much g'neco$ogica$ surger' $e)t. *octors know )u$$ we$$, )or instance, that women who experience menstrua$ irregu$arities are more prone to de%e$ap %agina$ or cer%ica$ cancer i) the' take ora$ contracepti%es. #n )act, the risk )or some o) these women, depending on what caused their menstrua$ irregu$arities, is more than ten times the a$read' increased risk. 6et )ew doctors bother to
)ind out who these women are be)ore the' put them on the pi$$. # know o) one woman who was taking the Ji$$ )or !1 :" 'ears ,, unad%ised o) the danger she was in. +he had se%ere b$eeding during her )irst period, an incident that marked her as someone who shou$d not take the Ji$$. E%en when her checkup re%ea$ed ,, %ia a Jap smear ,, that something irregu$ar was going on, her g'neco$ogist to$d her not to worr' since she cou$d a$wa's get a h'sterectom'. 0pparent$', his moti%es were a mixture o) greed and ignorance, because the next doctor she went to to$d her that i) she didn(t ha%e a re$ati%e$' minor surgica$ procedure right awa', she wou$d de)inite$' need a h'sterectom' within a )ew 'ears. But e%en that minor operation cou$d ha%e been a%oided had her doctor in)ormed her o) the danger she was in the moment she started taking the Ji$$. @reed and ignorance aren(t the most important reasons wh' there is so much unnecessar' surger', howe%er. #t(s basica$$' a prob$em o) be$ie): doctors be$ie%e in surger'. 3here(s a certain )ascination in 1going under the kni)e,1 and doctors take e%er' ad%antege o) it to get peop$e there. 0)ter a$$, surger' is an e$ement o) Jrogress, and Jrogess separates us )rom those who came be)ore us and )rom those we are surpassing. #n 0merica, what can be done wi$$ be done. Whether something shou$d be done is beside the point. 0s $ong as we can bui$d the too$s and do it, it must be the right thing to do. +o not on$' do we ha%e coronar' b'passes, tonsi$$ectomies, and radica$ mastectomies ,, but transsexua$ surger' as we$$. 3he )irst surger' was re$igious, and ninet' !1 8" percent o) the surger' per)ormed toda' is a$so re$igious. 3he Aewish ritua$ circumcision, or bris, has a p$ace in Aewish $aw and cu$ture. 3he bris is per)ormed on the eighth da' o) $i)e b' a trained mohe$ who uses the same techni.ue that has withstood more than 7, 'ears o) use. 3en men stand b' to make sure he does it, too. &odern &edicine(s routine circumcision, howe%er, takes p$ace on the )irst or second da' o) $i)e, when b$ood $oss can be especia$$' dangerous. #t(s per)ormed b' a surgeon, or an intern, or a medica$ student using the 1$atest1 techni.ue. Where the bris ceremon' inc$udes pouring some wine in the in)ant(s mouth, no anesthetic at a$$ is used in &odern &edicine(s ritua$. Eoutine circumcision o) a$$ ma$es makes no sense outside o) a re$igious )ramework. 0 circumcision is an operation, and its dangers are not inconsiderab$e. #t(s not a$together rare )or a surgeon to get smart and use cauter' instead o) a kni)e ,, and to s$ip and burn o)) most o) the penis. #n some primiti%e re$igions submitting to ritua$ muti$ation e$e%ates the %ictim to a higher consciousness. 3hrough either the intense pain o) the muti$ation or the e))ects o) drugs ,, or both ,, the %ictim ha$$ucinates communion with the deities. +ometimes this 1pri%i$ege1 is reser%ed )or the priesthood or )or ceriain communicants o) specia$ status. #n 8hristianit', on$' Aesus and the mart'rs were graced with muti$ation ,, except )or a dubious m'stic e%er' !1 9" now and then who miracu$ous$' bears the 1stigmata,1 or the wounds o) 8hrist. #n the 8hurch o) &odern &edicine, no one is exc$uded )rom the sacri)ice. Cnti$ the in%ention o) anesthesia, %ictims gritted their teeth and saw their gods with the c$arit' agon' brings ,, unti$ the' passed out. Now the %ictim is 1put under1 in a )orm o) mock death, so the surgeon not on$' has the opportunit' to hea$ him, but bring him back )rom the dead as we$$. 4) course, e%en that opportunit' has been superceded b' the re)inement o) $oca$ anesthesia, Now the %ictim can sta' awake and obser%e the surgeon )idd$ing with his morta$it'. 0)ter the operation, o) course, e%en chi$dren en2o' showing o)) their scars. #) the'(re the chi$dren o) doctors, chances are better that the'($$ ha%e scars to show o)), because doctors )ami$ies tend to ha%e more surger' than an'bod' e$se. Which demonstrates that doctors be$ie%e in the sacrament(s power at $east as )aith)u$$' as the' expect e%er'bod' e$se to.
4ne o) the true tests o) a )anatic is whether or not he takes his own medicine ,, or be$ie%es his own press re$eases. 3he )act that doctors do get in $ine )or the sacri)ice on$' strengthens its grounding in ceremon'. 3he most sinister aspect o) &odern &edicine(s be$ie) in surger' is the presumption that $ies behind that be$ie), that the priest can o%ercome an'thing because he can operate on 'ou. 6ou don(t ha%e to take care o) 'ourse$), we can )ix 'ou i) 'ou go wrong. 0$$ 'ou ha%e to do is !11 " be$ie%e enough to show up )or the sacrament, which in this case is a ritua$ muti$ation. &odern &edicine has succeeded in usurping the power o) traditiona$ re$igions so a$$ o) us, inc$uding the priests, rabbis, ministers, and monks, see ourse$%es as u$timate$' repairab$e to and b' the power that resides in the tabernac$e o) the operating room. 3o protect 'ourse$) )rom 'our doctor(s be$ie) in surger' and a%oid the kni)e(s sacramenta$ use on 'our own )$esh, 'our )irst step is to educate 'ourse$). 4nce again, make it 'our business to $earn more about 'our case than 'our doctor does. Books, 2ourna$s, and maga<ines a%ai$ab$e at the pub$ic $ibrar' shou$d pro%ide 'ou with enough in)ormation. 6ou shou$d be especia$$' war' i) 'our doctor recommends one o) the common operations, such as tonsi$$ectom', h'sterectom', umbi$ica$ hernia repair, etc. Eemember that the doctor doesn(t %iew surger' as a potentia$$' harm)u$ in%asion o) 'our bod', but as a bene)icent ceremon' that can(t he$p but bestow some good. E%en a trusted )ami$' doctor cannot be trusted to prescribe surger' on$' when it(s rea$$' necessar'. 6ou shou$d start asking .uestions the moment the doctor mentions surger'. What is this operation supposed to accomp$ish- Iow does it do it- What wi$$ happen i) # don(t ha%e surger'- 0re there an' a$ternati%es to surger'- What are the chances the operation wi$$ not succeed in what it(s supposed to do- 0)ter !111" 'ou(%e obtained 'our doctor(s answers, 'ou shou$d check out e%er'thing he sa's on 'our own. 8hances are good that 'ou wi$$ )ind con)$icting in)ormation i) 'ou dig deep enough. 3hat(s the idea. @et a second opinion. *on(t go to a doctor in the same group practice, or e%en to one on the same hospita$ sta)). 6ou ma' ha%e to go out o) town to reach a rea$$' independent doctor. 6ou shou$d ask the second doctor the %er' same .uestions that 'ou asked the )irst. #) 'ou get two wide$' di))erent opinions, 'ou shou$d )irst go back to the origina$ doctor and con)ront him with the in)ormation. 3hat sti$$ ma' not reso$%e the di))erences to 'our satis)action. #n that case, ask 'our genera$ practitioner to ho$d an o$d )ashioned consu$tation at which a$$ the doctors are present with 'ou. 3his ma' sound $ike a $ot o) troub$e to go to. But 'ou shou$d keep in mind that the u$timate goa$ is to keep 'ou in one piece un$ess abso$ute$' necessar'. *on(t be a)raid to get a third or e%en a )ourth opinion. 8onsidering the enormous .uantit' o) unnecessar' surger', the chances are .uite good that what 'our doctor(s recommending is a$so unnecessar'. 6ou shou$d a$wa's keep this in mind, especia$$' when the doctor tries to make 'ou )ee$ $ike surger' is the on$' answer to 'our prob$em. Not on$' might it not be the on$' answer, but it might be no answer at a$$. 6ou might not e%en ha%e a prob$em= *on(t hesitate to con)ront 'our doctor with !11/" whate%er in)ormation, opinions, and )ee$ings 'ou gather )rom 'our 1homework.1 6ou(re bound to $earn something )rom his reaction. *on(t be a)raid to re$' 1on the opinions o) )riends, neighbors, )ami$' members, the peop$e whom 'ou be$ie%e ha%e wisdom. #) 'ou decide that surger' isn(t the answer, do whate%er 'ou ha%e to do to detach 'ourse$) )rom the situation. *on(t be a)raid o) o))ending the doctor. 0$though it(s best to simp$' dec$are the )act that
'ou don(t want the operation and 'ou(re not going to ha%e it, 'ou ma' )ee$ better p$a'ing the 1#($$ think about it1 game. 4nce 'our doctor has tried to persuade 'ou to ha%e surger', he ma' not be ab$e to retreat )rom that position and continue as 'our doctor. 0)ter a$$, i) he has to$d 'ou that surger' is the on$' a%enue, he can(t %er' we$$ treat 'ou some other wa' can he- 4ne wa' or the other, i) 'our decision to sta' in one piece means 'ou $ose a doctor, 'ou(re better o)). #), on the other hand, 'ou decide to ha%e the operation, 'ou sti$$ shou$dn(t $ie back and $et the ceremon' proceed .uite 'et. 8ontrar' to what most doctors wou$d ha%e 'ou be$ie%e it does make a $ot o) di))erence who per)orms the surger'. Wh' shou$dn(t it- #t makes a di))erence who paints 'our house or )ixes 'our car doesn(t it- #sn(t it reasonab$e that ta$ent shou$d a$so make a di))erence in who remo%es 'our ga$$ b$adderJeop$e o)ten ask me how to go about picking a surgeon i) the' 1must1 ha%e surger'. # a$wa's !115" sa' that i) 'ou rea$$' 1must1 ha%e surger', 'ou(re most $ike$' in no position to make a choice because the on$' 1must ha%e1 situation # recogni<e is the emergenc'. 0nd in an emergenc' 'ou don(t ha%e a choice. #) 'our in an accident and 'ou need surger', 'ou take an' surgeon 'ou can get. #n an' situation short o) an emergenc', 'ou(%e got p$ent' o) time not on$' to decide whether or not 'ou need the surger' but a$so who shou$d per)orm the operation. 0gain, 'ou start to pick a surgeon b' asking .uestions. 6ou shou$d ta$k to se%era$ surgeons, and ask each and e%er' one: Iow man' times ha%e 'ou done this operation- What(s 'our batting a%erageIow man' o) the operations ha%e been success)u$- Iow man' ha%en(t- What(s 'our rate o) comp$ications- What is the death rate )rom this operation- Iow man' o) 'our patients ha%e died during or short$' a)ter this operation- 8an 'ou re)er me to some o) 'our patients who(%e had this operation- Wou$d the' be wi$$ing to ta$k to me&' )a%orite .uestion to ask a surgeon is, 1#) 'ou were out o) town when the operation was per)ormed, who wou$d 'ou recommend )or the operation-1 0 %ariation o) that is, 1#) 'ou need the operation, doctor, who wou$d 'ou go to-1 6ou shou$d a$so be asking the surgeons what kind o) surger' is necessar'. 6ou might be ab$e to get awa' with $ess radica$ surger' than origina$$' recommended. 0nd don(t neg$ect to ask each surgeon, once again, i) the operation is !117" necessar'. 3his ma' sound $ike a waste o) time once 'ou(%e a$read' decided to ha%e the operation. But 'ou ma' come across new in)ormation, or a doctor who does ha%e an a$ternati%e treatment. #n an' case, i) 'ou are exposed to new in)ormation, hit the books again and check it out. #) the surgica$ procedure is extreme$' comp$ex, it might be a good idea to ca$$ whate%er surgeon has a reputation )or the operation. #) he is in another cit' and 'ou don(t want to tra%e$ ,, or he doesn(t want to take on another case ,, ask him to re)er 'ou to someone c$oser or someone who wi$$ take 'ou on. 6ou shou$d a$so ask )riends and )ami$' members to he$p out in )inding the right surgeon. # a$so ha%e a hea$th' respect )or the abi$it' o) the a%erage c$erg'man to pick out a good doctor. No matter who re)ers 'ou, or what the reputation o) the surgeon, 'ou shou$d ne%er $et down 'our guard and $et things go b' that 'ou don(t understand to 'our satis)action. 0nd that goes doub$e a)ter the operation. #) the operation doesn(t work out as p$anned, or i) 'ou su))er side e))ects that don(t seem ca$$ed )or, waste no time in ha%ing them checked out. 0s with the side e))ects o) a drug, the discom)ort ma' be temporar' and harm$ess. 4r it ma' be dead$'. When 'ou approach a di))erent doctor with post,operati%e prob$ems, 'ou shou$d cha$$enge him with the )o$$owing .uestions: 8an 'ou gi%e me an honest opinion with regard to the other doctor(s per)ormance on this operation- Wou$d 'ou gi%e me an honest opinion !11>" e%en though it were to
resu$t in a ma$practice suit against the other doctor- 4r against 'our hospita$*epending on how he answers these .uestions, 'ou can decide whether or not to trust him. #n this and an' other medica$ situation, 'our re$uctance to gi%e awa' 'our trust is 'our )irst de)ense. &ake e%er' doctor earn it, especia$$' i) he wants to muti$ate 'ou.
Chapter # $he $e!ples of Doo!

!11:" 0 hospita$ is $ike a war. 6ou shou$d tr' 'our best to sta' out o) it. 0nd i) 'ou get into it 'ou shou$d take a$ong as man' a$$ies as possib$e and get out as soon as 'ou can. 9or the amount o) mone' the a%erage hospita$ sta' costs, 'ou cou$d spend an e.ua$ $ength o) time at 2ust about an' resort in the wor$d, transportation inc$uded. 0nd un$ess 'our condition re.uired emergenc' treatment, 'our hea$th might be better o)) i) 'ou spent the time and mone' at the resort, too. 9or the hospita$ is the 3emp$e o) the 8hurch o) &odern &edicine, and thus one o) the most dangerous p$aces on earth. When a cu$ture de%e$ops to the point where its citi<ens $i%e in houses, the gods o) the peop$e ha%e to reside somewhere, too. 0 temp$e is !118" bui$t to house the spirit o) the re$igion. Whate%er %ision in)orms the re$igion is present in the temp$e, and the bui$ding becomes the center o) prophec', the p$ace where the gods speak to the peop$e. When # hear someone ,, usua$$' an o$der person who wasn(t born in this countr' ,, sa' that the hospita$ is 1where 'ou go to die,1 # sa' to m'se$) that he or she has been hearing what the gods are sa'ing. 8hi$dren, again, pro%ide us with a message )rom their unc$ouded perception: kids are unabashed$' a)raid o) go$ng to the hospita$. Aust as their )ear o) doctors is something we cou$d a$$ cu$ti%ate to our ad%antage, so is their )ear o) hospita$s. 4) course, a chi$d wou$d be hard pressed to articu$ate his or her )ear, E%en most adu$ts wou$d ha%e a hard time iso$ating and describing exact$' what speci)ic things he or she is a)raid o) in the hosiita$. Besides, adu$ts are a)raid to admit )ear. Jriests o) the 3emp$e take ad%antage o) ignorance and reticence b' assuring us, 13here is nothing to be a)raid o).1 3here(s p$ent' to be a)ra$d o). 3he @od that resides in the temp$e o) &odern &edicine is *eath. 3here are germs in hospita$s that 'ou can(t get an'where e$se in town, not on$' because hospita$s are such dirt' p$aces, but because o) &odern &edicine(s )etish )or ritua$ puri)ication. Now, that appears to be a contradictor' statement, but it(s not. Iospita$s aren(t kept an'where near as c$ean as the' shou$d be. Iousekeeping sta))s are genera$$' sma$$er than necessar'. Whene%er 'ou ha%e an o%erworked !119" sta)), the tendenc' is )or on$' the ob%ious 2obs to get done, and not that care)u$$', either. +o what 'ou(re $iab$e to )ind i) 'ou $ook c$ose$' is dust and dirt in corners and other out o) the wa' p$aces. Iospita$ dust and dirt isn(t the kind o) dust and dirt 'ou )ind an'where. Where e$se can 'ou )ind a$$ in one bui$ding: anima$ and %egetab$e waste )rom )ood preparation, rubbish and trash, bio$ogica$ wastes )rom diagnostic, medica$, surgica$, autops', and wound dressing acti%ities, bandages, discarded tissues )rom surger' and autops', sputum, p$acentas, organs, amputated $imbs, sacri)iced research anima$s, disposab$e diapers and underpads, catheters, soap, bodi$' secretions, cups, masks, swabs, sanitar' napkins, p$aster casts, s'ringes, and )eca$ materia$- 0$$ o) this goes down the same chute, co$$ected and thrown b' the same peop$e ,, peop$e who ha%e access to patients( bedrooms and operating rooms as we$$ as the kitchen, $aboratories, and morgue.
#n one hospita$, it was disco%ered that stretchers used to transport patients a$so were used to carr' cada%ers. 3hat(s bad enough, but these stretchers sti$$ bore the residue )rom their prior grim 2ourne's. #n this same hospita$, which b' wa' is a $arge pub$ic hospita$ in Washington, *.8., 1organic residue and )eca$ materia$1 were a$so )ound in emergenc' rooms, )$oors, and working areas in the morgue. #n patients( rooms, soi$ed dressings, dirt' shower sta$$s, h'podermic need$es, and hea%' accumu$ations o) dust were )ound. +uch disco%eries don(t shock me an'more, !1/ " since #(%e rea$i<ed that these conditions are the ru$e rather than the exception. 0nd what makes these situations e%en more dangerous are the hospita$ heating and air condit$oning s'stems which b$ow the dust and germs a$$ o%er the hospita$. Not to mention the p$umbing s'stem. Iospita$s ha%e more p$umbing than an' ordinar' bui$ding. Besides the usua$ hot and co$d water, hospita$s ha%e chi$$ed water, disti$$ed water, %acuum s'stems, )$uid suction s'stems, ox'gen, sprink$ing s'stems )or )ire Gmost o) which are inade.uateH, re)rigerant, recircu$ated coo$ing water, drainage s'stems, sewage s'stems, and irrigation s'stems ,, a$$ going through their wa$$s and )$oors. Not on$' are the chances )or accidenta$ cross connection enormous, but so are the chances that i$$ega$ connections wi$$ increase the dangers o) cross, contamination. &odern &edicine(s )anatica$ de%otion to puri)ication ironica$$' mu$tip$ies the dangers o) creating a c$ass o) germs which are resistant to antibiotics. #n 8hapter 3wo # ta$ked about how the o%eruse o) antibiotics gi%es rise to bacteria which are resistant to the drugs. What better breeding ground )or these supergerms cou$d there be than a modern hospita$, where antibiotics )$ow $ike soup- +ome bacteria e%en adapt to the point where the' )eed on the antibiotics. 3hen what happens, o) course, is that the hospita$ sta)) becomes a wa$king cu$ture dish )or these germs. +ince the'(re exposed to them e%er' da', howe%er, the' aren(t harmed b' !1/1" them. But that doesn(t do 'ou an' good when the housekeeper or the nurse hand$es 'our bedding 'our )ood, 'our c$othes, and 'ou. 3he priests o) the 3emp$e, the doctors, are e%en worse spreaders o) disease. *octors neg$ect to wash their hands, un$ess it(s be)ore the sacrament o) surger', where it(s part o) the ritua$. Csua$$' the' casua$$' go )rom sick patient to sick patient, hand$ing tongue depressors, s'ringes, and %arious parts o) the patients. 6et the' seem to )ee$ that there(s something uni.ue$' c$ean about themse$%es, and the' don(t wash their hands in between. *octors a$so ha%e great con)idence in caps, masks, and rubber g$o%es ,, none o) which deser%es an' con)idence at a$$. &asks become so contaminated a)ter 2ust ten minutes that the' ser%e as bacteria$ cu$tures rather than shie$ds. Eubber g$o%es o)ten are contaminated, too. When # wa$k into a newborn nurser' wearing a c$ean suit that # 2ust put on that morning the nurses a$wa's make a )uss and make me put on a robe. # make )un o) it b' asking them i) the'(re insu$ting m' new suit. 3heir beha%ior shows that the' ha%e p$aced their trust in the sacred %estments rather than their own perception o) rea$it'. 3here(s no guarantee that the white robe the' make me put on is an' c$eaner than m' suit. #n )act, there(s e%idence to the contrar'. 3hat white robe ma' ha%e been sitting on the she$) )or months. Iow do the' know it was proper$' $aundered- Especia$$' since it was no doubt thrown into the same tub as soi$ed sheets, pi$$ow cases, and operating !1//" room $inens. Aust because it(s white doesn(t mean it(s c$ean. 3he same goes )or the bedding. 3he $inens ma' be washed, but the mattresses and pi$$ows are not. 4%era$$ 'our chances o) getting an in)ection in the hospita$ are about one in twent'. 3hat(s a conser%ati%e estimate. Ia$) o) the in)ections in hospita$s are caused b' contaminated medica$
de%ices such as catheters and intra%enous e.uipment. Be)ore the exp$osion in the use o) these de%ices around 19;>, de%ice,re$ated in)ections were %irtua$$' nonexistent. 0bout 1>, peop$e die )rom hospita$,ac.uired in)ections e%er' 'ear. 0s in the case o) drug deaths, hospita$ sta)) wi$$ )udge statistics when a serious$' i$$ patient succumbs to a hospita$,ac.uired in)ection. 6our chances a$so depend on what 'ou(re in the hospita$ )or. #) 'ou go )or an operation, 'ou(re not on$' going to be exposed to the operating room dangers, but 'our bod' wi$$ be serious$' weakened b' the surger' and won(t be ab$e to )ight o)) in)ections as we$$. #) 'ou(%e been burned or wounded, 'ou($$ a$so be weakened and there)ore more $ike$' to get an in)ection. #n m' experience, a one in twent' risk wou$d ha%e to be the base $ine risk representing the minimum danger o) in)ection. #(%e seen epidemics spread through hospita$s so )ast that e%er'bod' had to be sent home. Jediatric wards and newborn nurseries are the most %u$nerab$e to spreading in)ections. #t(s a we$$,kept secret in hospita$s that the most dangerous p$ace in the hospita$ ,, as )ar as the patients are!1/5" concerned ,, is the newborn nurser', where none o) the patients ha%e Gparticu$ar$' those who are denied the immunit',trans)erence o) breast)eedingH de%e$oped their immunit' to germs. 0s bacterio$ogica$$' o%errun as hospita$s are, #(%e rare$' seen an epidemic that was b$amed on the hospita$ or the sta)). 3he' a$wa's pin it on the %isitors= 3he ine%itab$e a)termath o) the epidemic is restriction o) %isiting hours. 0ctua$$', keeping %isitors awa' is on$' ha$) o) what shou$d done. Jatients wou$d be better o)) i) the' were kept out o) the hospita$s, too. Iospita$s are contaminated with more than germs. Eemember, since hospita$s are the temp$es o) &odern &edicine, a$$ the dangerous chemica$s that doctors $o%e to use are in p$enti)u$ supp$'. With a$$ those drugs at their disposa$ doctors are bound to use them. 0nd the' do. Jatients in the hospita$ recei%e an a%erage o) twe$%e di))erent drugs. But e%en i) 'ou(re not drugged to death or disabi$it', there are other chemica$s )$oating around that can make 'our sta' $ess than hea$th'. #n the )irst p$ace, 'our doctor ma' not be using drugs, but e%er'one e$se(s doctor is. Joisonous so$%ents used in $aboratories and c$eaning )aci$ities, )$ammab$e chemica$s, and radioacti%e wastes a$$ threaten 'ou with contamination. #) hospita$s were the sharp$' e))icient p$aces the' pretend to be, we cou$d rest $ess uneasi$' about those dangers. Cn)ortunate$', hospita$s are %irtua$ mode$s o) ineptitude. 3here are so man' simp$e mistakes ,, mistakes in which !1/7" someone has two or three choices and chooses wrong ,, that 'ou must )ee$ extreme$' apprehensi%e when 'ou start to contemp$ate a$$ the opportunities )or comp$ex errors= E%er'thing gets mixed up in hospita$s ,, inc$uding patients. &' brother went to the hospita$ )or a hernia operation man' 'ears ago. Ie was schedu$ed )or surger' at 11 a.m. # went up to his room at 9:5 , but he wasn(t there. # knew right awa' what had happened. # ran down to the operating room, and sure enough, there he was. 3he'(d taken him instead o) another patient. 3he on$' reason he escaped was that the other patient was supposed to get a h'sterectom'. &ixups occur in hospita$s a$$ the time. +urgeons operate on the wrong $eg. &edicines are gi%en to the wrong patients. 3he wrong )ood is ser%ed to peop$e on specia$ diets. E%en babies are mixed up. Iard$' a 'ear goes b' without some stor' appearing in the newspapers about a co$ossa$ mixup o) babies and mothers at a $oca$ hospita$. No doctor who has had an' experience in maternit' wards has not seen the wrong bab' brought to the mother b' the nurse and the nurse corrected b' the mother. 3here are twent' to thirt' babies in the a%erage nurser'. E%er' doctor knows )ootprints are not re$iab$e, and those arm bands are a$wa's )a$$ing o)). +o who knows one )rom the other-
Not on$' are peop$e mixed up in hospita$s, the'(re $ost, too. Newspaper stories ha%e to$d o) patients )ound dead in hospita$ e$e%ators and !1/>" $itt$e,used bathrooms. 3wo 'ears ago a bab' was sto$en )rom the Cni%ersit' o) 8hicago Iospita$. E%er' time # go b' the newborn nuser' at &ichae$ Eeese Iospita$, # stir up the nurses b' asking i) an'one there has heard )rom the 9ron<ack bab'. &ore than a decade ago, the 9ron<ack bab' simp$' disappeared )rom their nurser' and was ne%er )ound. 0bout a 'ear ago, there was a case in #srae$ in which two mothers were gi%en the wrong babies. #t wasn(t )ound unti$ the babies were two months o$d. 0t )irst, neither mother wou$d exchange 1her1bab'. What do 'ou ca$$ someone who(s been 'our mother )or two months0s )ar as #(m concerned, one o) the best arguments )or ha%ing 'our bab' at home is the distinct possibi$it' that 'ou($$ go home )rom the hospita$ with the wrong bab'. 0nother ha<ard that threatens 'ou in the hospita$ is the $ike$ihood o) an accident. #n a suburban hospita$ in Jenns'$%ania, it was disco%ered that ox'gen and nitrous oxide $abe$s were accidenta$$' switched when a construction crew insta$$ed gas $ines in the emergenc' room. Cnti$ the mixup was disco%ered, peop$e who shou$d ha%e been getting nitrous oxide were getting ox'gen and peop$e who were supposed to get ox'gen were getting nitrous oxide. #t took six months )or the hospita$ to disco%er the error. 3he hospita$ admitted to )i%e deaths )rom the accident, but said that a$$ thirt', )i%e deaths in the emergenc' room during that period were not caused b' the switch because some o) those were dead on arri%a$ and some !1/;" were too )ar gone to bene)it )rom ox'gen e%en i) the' had recei%ed it. #) that sounds $ike the kind o) )udging doctors use to co%er up a treatment,re$ated death, 'ou(re getting m' message. 0s doctors re$' more and more on techno$og', hospita$s become more and more $ittered with e$ectronic gear and wiring, and the chances o) being e$ectrocuted rise right a$ong with the e$ectric bi$$. #n the same Washington, *.8., hospita$ cited ear$ier )or )i$th, three patients and se%era$ doctors and nurses were se%ere$' shocked and burned b' )au$t' e$ectrica$ e.uipment in the coronar' care unit. 3his t'pe o) accident is not uncommon, and it wi$$ grow more common as hospita$ maintenance sta))s shrink and become $ess ab$e to cope with comp$ex wiring. +o $oose$' organi<ed and run are most hospita$s that murder is e%en a c$ear and present danger. Witness the de$iberate in2ection o) para$'<ing drugs to patients at a &ichigan Keterans 0dministration hospita$. *ead$' drugs are so wide$' a%ai$ab$e and so $oose$' contro$$ed that the hospita$ cou$dn(t e%en begin to $ook )or the cu$prit. 3he 9B# had to be ca$$ed in. #) 'ou want to commit the per)ect crime, do it in a hospita$. 4) course, 'ou cou$d make a case that hospita$s are a$read' getting awa' with murder. #) the drugs, the germs, the surger', the chemica$s, or the accidents don(t get 'ou, 'ou sti$$ stand, a good chance o) star%ing to death. 4ne o) the )irst ma2or studies o) the scanda$ous state o) hospita$ nutrition examined e%er' surger' !1/:" patient in a $arge Boston municipa$ hospita$. 3he' were tested )or protein,ca$orie ma$nutrition, a minima$ standard which te$$s on$' whether the person is getting enough protein and ca$ories e%er' da' o%er a period o) time. Whether the patients were getting enough %itamins and minera$s was not tested. Nonthe$ess, ha$) o) the surger' patients were not getting enough protein and ca$ories. Ia$) o) these were se%ere$' ma$nourished: the' were ma$nourished enough to threaten their reco%er' and $engthen their sta' in the hospita$. +ince the' weren(t gi%en enough )ood b' the hospita$, 'ou can be sure the' weren(t getting enough %itamins and minera$s. 3he resu$ts o) this stud' are b' no means uncommon. &an' studies since ha%e disco%ered ma$nutrition in an'where )rom twent',)i%e to )i)t' percent o) patients in 0merican and British
hospita$s. 3he doctor who carried out the Boston stud', @eorge B. B$ackburn, has since stated that ma$nutrition is one o) the most common causes o) death among o$d peop$e in hospita$s. 3hat(s not rea$$' such a start$ing statement, in $ight o) )acts *r. B$ackburn unco%ered. &a$nutrition ob%ious$' puts a person in the worse possib$e state to )ight o)) whate%er disease brought him to the hospita$ in the )irst p$ace. 0dd to that the dangers and stresses o) the hospita$, and 'ou ha%e a recipe )or disaster. 4) course, we can on$' guess about the true magnitude o) that disaster. 0s with drugs, accidents, and other treatment,re$ated deaths, doctors )udge. We don(t know exact$' how man' !1/8" peop$e die direct$' or indirect$' )rom ma$nutrition in hospita$s. What we do know, howe%er, is that a $ot o) peop$e are ma$nourished in hospita$s, that ma$nourishment is dead$', and that a $ot o) peop$e die in hospita$s. Wh' are peop$e ma$nourished in hospita$s- 0s bad as most hospita$ )ood is, i) it were eaten it most $ike$' wou$d pre%ent most o) the protein,ca$orie ma$nutrition these studies turn up. 3he prob$em is that it(s not eaten. Nobod' sees to it that the patient eats. 0t best, the tra' is brought in and set beside the bed on a tab$e. 0nd there it sits. 0t worst, the hospita$ schedu$e and sta)) gang up on the patient to keep him or her )rom touch$ng the )ood: time )or $ab tests, time )or therap', time )or an enema, time )or drugs, time )or this and time )or that. J$ent' goes on in the 3emp$e o) &odern &edicine simp$' to make 'ou $ose 'our appetite. 3he ps'cho$ogica$ dangers o) the hospita$ are e%er' bit as dead$' as the ph'sica$ dangers. 6our hospita$ sta' )rom the moment 'ou wa$k in the )ront door unti$ the moment 'ou wa$k ,, or are carried ,, out has a ps'cho$ogica$ e))ect on 'ou simi$ar to a hex or a %oodoo curse. Whether 'ou conscious$' acknow$edge it or not hospita$ procedures and en%ironment encourage despair and debi$itation rather than hope and support. Nobod'(s optimistic. 6ou see the $ong )aces o) the peop$e su))ering and d'ing, and 'ou see the )aces o) the peop$e who must watch them su))er and die. 6ou see the hospita$ sta)) denature their responses and become !1/9" machines. 0nd then 'ou are denatured at the admissions desk as 'ou are reduced to a co$$ection o) numbers and s'mptoms be$onging not to 'ou but to the doctor. 6ou $ea%e 'our )ormer wor$d and identit' behind. 6ou(re $itera$$' stripped o) 'our )ormer $i)e as 'ou take o)) 'our c$othes and hide them and 'our persona$ be$ongings in a c$oset ,, arti)acts o) 'our rea$ $i)e. 3hat past $i)e is kept )rom reasserting its ties with 'ou ,, 'our re$ati%es are restricted )rom spending more than token amounts o) time with %ou. 3he e))ect o) a$$ these ps'cho$ogica$ pins is that 'ou re$in.uish an' notion 'ou ma' ha%e had about ha%ing contro$ o%er 'our hea$th. 6our captors iso$ate 'ou, a$ienate 'ou, scare 'ou, depress 'ou, and genera$$' make 'ou )ee$ so anxious that 'ou submit to their e%er' wish. 6our spirit broken, 'ou are read' to be a @ood Jatient. 8hi$dren and o$der peop$e seem to be especia$$' susceptib$e to the damaging e))ects o) hospita$ %oodoo. 8hi$dren react %er' rapid$' with strong )ee$ings o) abandonment and separation anxiet'. 0dd to this the )ear the chi$d has o) the operation or whate%er the'(re going to do to him or her. #t(s no m'ster' wh' chi$dren who ha%e had as $itt$e as one or two nights in the hospita$ without their parents regress in their beha%ior to where the' $ose their toi$et training or their abi$it' to speak. E%er' doctor shou$d know that the ages between three and six are 'ears o) great con)usion. Fids hard$' know what(s going on at that age. 3o !15 " sub2ect them to the hospita$ en%ironment without the bene)it o) a parent c$ose b' is patent crue$t'. &ore than twent' 'ears ago, # wrote a paper about chi$dren(s )antasies be)ore a hernia operation. # inter%iewed kids and asked them what the' thought was going to happen to them. 0$most e%er' chi$d thought something was going to happen to his genita$s. When # asked them where on their
bod' the operation was going to take p$ace, some o) them actua$$' grabbed their genita$s de)ensi%e$'. 3hat was an e'e,opener )or me. 4ur conc$usion at the time was that chi$dren shou$d be counse$ed be)ore surger' and ha%e the operation exp$ained to them. Now, # know that doesn(t do an' good. What the' rea$$' need is to be assured that their parents wi$$ be with them throughout the hospita$i<ation. 3hat(s what we shou$d ha%e ad%ised. # sti$$ don(t $ike to make rounds through hospita$s at night: too man' cr'ing babies. # a$wa's ha%e a $ot o) troub$e with cr'ing babies ,, # can(t ignore them. When # used to make night rounds regu$ar$' # wou$d pick up the cr'ing babies or the $itt$e kids and carr' them out to the nurses( station. #) the' cou$d sit on the nurses( $aps or on the edge o) the desk the' wou$dn(t cr'. 0du$ts and the e$der$' a$so su))er )rom a hospita$ sta'. *r. *a%id @reen has ca$$ed hospita$s 1the worst p$ace in the wor$d )or aged peop$e.1 # don(t disagree with him, except that # wou$d sa' that hospita$s are the worst p$ace !151" in the wor$d )or e%er'bod'. # don(t know how we can expect chi$dren not to be harmed b' the super stresses o) a hospita$ sta' when those stresses are so hard on adu$ts. #ronica$$', we expect the kids to act $ike super adu$ts in the hospita$ and ad2ust to the separation and the )ear ,, whi$e we expect the adu$ts to ad2ust to being treated $ike he$p$ess chi$dren. Iospita$ procedures ha%e abso$ute$' no respect )or a person(s dignit'. 6ou ha%e to take o)) 'our own c$othes and wear a hospita$ gown that $ea%es 'ou immodest$' %u$nerab$e to inspection and attack b' innumerab$e doctors, nurses, and technicians. 6ou ha%e to $ie down most o) the time. 6ou can(t come and go as 'ou p$ease. 0nd 'ou ha%e to eat what the' ser%e 'ou ,, i) there(s time. 3hen, to top it o)), 'ou ha%e to s$eep in a room with strangers ,, sick strangers at that= Iospita$i<ation degrades 'ou. #n m' twent',)i%e 'ears o) practicing and witnessing the practice o) medicine, #(%e ne%er seen a degrading experience that did an'bod'(s hea$th an' good. But remember, hospita$s are the temp$es o) &odern &edicine. When 'ou enter the temp$e o) another re$igion, 'ou enter the presence o) that re$igion(s deities. No gods wi$$ a$$ow 'ou to take ri%a$ gods into their house, so 'ou $ea%e behind 'our o$d gods and a$$ that the' taught 'ou be)ore 'ou enter. +ince the 8hurch %iews a$$ aspects o) $i)e that contribute to hea$th as ri%a$ gods, 'ou must $ea%e 'our identit', 'our )ami$', 'our con)idence, and 'our dignit' at the temp$e door. 4n$' when 'ou(%e been puri)ied o) 'our rea$ $i)e can 'ou be e$igib$e !15/" )or the sinister rewards o) the 8hurch o) *eath(s sacraments. #(m a$wa's )ascinated when one kind o) epidemic or another spreads through a hospita$ so )ast that e%er'bod' has to be sent home or trans)erred to another hospita$. Csua$$', %er' )ew peop$e ha%e to be trans)erred to other hospita$s. We a$wa's manage to send nine out o) ten patients home with no prob$ems. 0bout twent',)i%e 'ears ago, # decided to conduct a $itt$e experiment to )ind out 2ust how necessar' hospita$i<ation rea$$' is. # was in charge o) a hospita$ ward that had about twent%,eight beds. # decided that none o) the twent',)our patients a$read' there wou$d sta' un$ess the' abso$ute$' re.uired hospita$i<ation. # a$so had contro$ o) admissions. +o when someone came to be admitted, we decided whether or not the' rea$$' had to be. We had specia$ procedures a%ai$ab$e to a$$ow peop$e to be treated at home. We cou$d, )or examp$e, pa' their taxi )are )or outpatient %isits, and we had a truck we cou$d use to go out to adiust patients( de%ices i) the' were in traction. # kept this up unti$ we got down to three or )our patients. # )igured # had prett' we$$ pro%ed that hospita$s weren(t necessar'. # )ound out a)terwards that # was the one who wasn(t necessar'. 3he nursing o))ice started to comp$ain because the nurses in m' ward had nothing to do and were in danger o) being trans)erred. 3he interns and residents comp$ained that the' did not ha%e enough
teaching !155" materia$. 3hat was the end o) m' experiment on hospita$ uti$i<ation. Iospita$s exist in such aggressi%e abundance )or the con%enience o) the medica$ pro)ession, not )or the good o) the peop$e the'(re supposed to ser%e. Iospita$s started out as 1poor houses1 where doctors cou$d send patients who did(t ha%e the mone' to pa' )or their ser%ices. 0)ter awhi$e, doctors rea$i<ed that it was much easier )or them to ha%e a$$ their patients in one p$ace, with a$$ the machiner' right there. Natura$$', as medicine becomes $ess persona$ and more mechanica$, it becomes increasing$' con%enient )or the doctor to manage patients in the hospita$. #t(s a we$$, known )act that a doctor has to be sharper and more ski$$)u$ i) he treats peop$e on an outpatient basis. 0s ta$ent and consideration ha%e become rare commodities among doctors, hospita$s ha%e burgeoned. #nsurance companies dri%e peop$e into hospita$s b' re)using to pa' )or outpatient treatments. #) we didn(t recogni<e that hospita$ and medica$ insurance pa'ments were rea$$' indu$gences to keep a corrupt 8hurch so$%ent, we wou$d brid$e at the absurdit' o) an insurance compan' pre)erring to pa' thousands o) do$$ars )or treatment in the hospita$ that cou$d be per)ormed out o) hospita$ )or hundreds. &odern &edicine doesn(t ha%e to account )or absurdities or )or the dangers o) hospita$s. Iospita$s are, )or practica$ purposes, se$),accredited. 3he boards and committees that decide whether or not a hospita$ shou$d be a$$owed !157" to carr' on are made up o) the same 1good o$( bo's1 that run the hospita$. E%en when a )edera$ agenc' enters the picture, the massi%e institutiona$ inertia o) the s'stem keeps bad hospita$s operating and discourages ade.uate re)orm o) bad practices in a$$ hospita$s. 0 )ew 'ears ago the *epartment o) Iea$th, Education, and We$)are GIEWH spot,checked 1 > hospita$s )or dangers that were speci)ica$$' mentioned in the &edicare $aw. 3he' )ound sixt', nine hospita$s )ai$ed to meet the speci)ications regarding )ire sa)et', drug records, si<e o) nursing sta)), number o) doctors, dietar' super%ision, medica$ records, and medica$ $ibraries. 0$$ o) the hospita$s had recent$' been passed b' the Aoint 8ommission on 0ccreditation o) Iospita$s, and a)ter the IEW test resu$ts were made known, the A80I re)used to withdraw accreditation o) the o))ending hospita$s. Jub$ic outcr' o%er hospita$ conditions ha%e spawned what # ca$$ a 1haunted house )u$$ o) ghost re)orms.1 &ost o) these re)orms take p$ace either on paper or in secret meetings o) the peop$e who run the hospita$. 3he 8hurch is not about to gi%e up an' power, especia$$' where its own temp$e is concerned. Wou$d 8atho$ics a$$ow Aews to te$$ them how to run their churches and schoo$sEe)orms such as hospita$ ombudsmen and patient ad%ocates to re%iew and act on patients( comp$aints are set up mere$' to run inter)erence on ma$practice suits. 3he' $u$$ the patients into thinking that their rights are being $ooked a)ter. &ore than two 'ears a)ter the 0merican Iospita$ 0ssociation !15>" 1)orma$$' adopted1 the 1Jatient(s Bi$$ o) Eights1 and distributed it to a$$ member hospita$s, on$' a )raction o) the hospita$s had made the 1rights1 a%ai$ab$e to patients. We can(t rea$$' expect the temp$es o) &odern &edicine to enact these re)orms. since the %er' idea that a patient has an' rights is tota$$' contrar' to the operating concept o) the institution. 9urthermore, i) the patients( rights were rea$$' $ooked a)ter, the hospita$s wou$d be c$osed= #t(s been known )or some time that we rea$$' ha%e too man' hospita$s and that peop$e do not need to spend an'where near the amount o) time in the hospita$ that is present$' routine. Numerous studies ha%e shown o%er the 'ears that most $ength' hospita$ sta's are unnecessar'. 9i%e da's, three da's, or e%en ha$) a da' in the hospita$ )or chi$dbirth is at best unnecessar'. Csua$$', it(s downright harm)u$ to both mother and bab'. 3he $ength o) time in the hospita$ that heart patients can pro)it )rom is rapid$' diminishing, according to the scienti)ic $iterature. Whereas doctors once cou$d point to
studies that showed that a month was the minimum, we(re )inding out now that a three,week sta' is no better than a two,week sta', that a one,week sta' might be sti$$ better, and that patients treated at home, on their )eet do e%en better= E%en the 0merican Iospita$ 0ssociation admits that we(%e got more hospita$ beds than we need, so 'ou can 2ust imagine how gross$' ob%ious the super)$uous hospita$s rea$$' are to those who can see what(s going on. !15;" 4) course, the 0I0 and other 8hurch agencies do their best to keep the pub$ic )rom )inding out what is going on. 3he pri%ate$' )unded Gwith the mone' 'ou pa' the hospita$sH 8ommission on Jro)essiona$ and Iospita$ 0cti%ities maintains a computer bank o) in)ormation on what goes on in 0merican hospita$s, inc$uding comparati%e death rates )or procedures, accidents, in)ections, errors ,, e%er'thing 'ou(%e got to be a)raid o) in hospita$s. Aust tr' to take a peek at this in)ormation. 3he 8ommission guards it with a %engeance the go%ernment wou$d en%'. 9or good reason. When exp$aining wh' the in)ormation is 1c$assi)ied,1 8ommission and 0I0 spokespeop$e wi$$ te$$ 'ou that the 1in)ormation cou$d be misinterpreted and cou$d discourage the kind o) ana$'sis that $eads to impro%ement.1 What the' mean is that the pub$ic wou$d 1misinterpret1 hospita$ shortcomings as so dangerous that the' wou$dn(t be caught dead in them. 0nd, o) course, that wou$d 1discourage impro%ement1 because there wou$dn(t be an'thing to impro%e: the hospita$s wou$d c$ose= # suggest that this computer bank contains the potentia$ )or a 1Jentagon Japers1 and 1Watergate1 combined. #t(s we$$,known that &odern &edicine doesn(t act on scienti)ic know$edge unti$ pub$ic awareness grows strong enough to demand it. Eesearch is the pra'er o) the re$igion o) &odern &edicine. Eesearch is 4F as $ong as 'ou don(t act on it. 0 doctor doing research can ruin his career in the e'es o) &odern &edicine !15:" mere$' b' o%erstepping that $ine and ad%ocating that his research resu$ts be imp$emented= Whether the 3emp$e or an' o) what goes on inside does good or harm is irre$e%ant. What(s important is that the )aith)u$ are )aith)u$ and that the' show their be$ie) b' showing up )or the sacraments, which are so$d not on the basis o) what the' do but what the'(re supposed to do. 0$$ their intentions ma' be good, but e%er'bod' knows what the road to he$$ is pa%ed with. Besides, &odern &edicine(s intentions can be counted on to be corrupt, too. When hospita$s started re$axing %isiting hours, the' didn(t do it because the' rea$i<ed that peop$e shou$d be a$$owed to be with their )ami$'. 3he' did it because pediatrics was d'ing and the beds in the pediatric wards were empt'. 3he' wou$d ha%e done an'thing to get chi$dren in there ,, $et mothers, )athers, sib$ings, cats, or dogs in )or a %isit= 4bstetrics is d'ing, too. Jeop$e want to ha%e their babies at home, not in the hospita$. +o toda' the'($$ $et an'bod' in the de$i%er' room, husband, sister, mother, bo')riend ... an'bod'= 0s $ong as the' get the re%enue. What the'(re counting on is that peop$e wi$$ be $u$$ed into )ee$ing that the hospita$ rea$$' is the p$ace )or them, that the 3emp$e rea$$' can sa%e them. 4) course, it can(t. 3he 3emp$e has nothing to do with hea$th. 3here are no )aci$ities in hospita$s )or hea$th or )or an' o) the things common$' recogni<ed as contributing to hea$th. 3he )ood is as bad as 'ou(d )ind in the !158" worst )ast )ood dri%e,in. 3here are no )aci$ities )or exercise. 0$$ the persona$ )actors that can make 'ou we$$ or keep 'ou hea$th' are remo%ed ,, )ami$', )riends, and sense o) se$). #n no uncertain terms, when 'ou wa$k into a hospita$, 'ou are surrendering ,, 1Iere # am, tota$$' unab$e to he$p m'se$). 6ou must sa%e me. # am without power. 0$$ power is 'ours.1 Iospita$ costs are the biggest sing$e e$ement in the countr'(s tota$ bi$$ )or medica$ 1care.1 3hat bi$$ is rapid$' o%ertaking de)ense, the Number 4ne item on the countr'(s tota$ bi$$ )or e%er'thing. When medicine exceeds de)ense, the #n.uisition wi$$ rea$$' be unstoppab$e. No one serious$' cha$$enges
whate%er institution is the )irst item on the budget. Whate%er costs more than an'thing e$se gathers bureaucratic inertia o) such immense proportions that it contro$s the destin' o) the countr'. 3hen the dream o) &odern &edicine wi$$ be )u$)i$$ed: the who$e countr' wi$$ become a hospita$. We($$ a$$ be patients in the 3emp$e o) *oom. 3he )irst thing 'ou shou$d do to protect 'ourse$) against the dangers o) the modern hospita$ is to reso$%e to a%oid unnecessar' hospita$i<ation. +ince most peop$e are in the hospita$ because their doctor put them there, 'ou simp$' shou$d not $et 'our doctor put 'ou there. 3hat means not taking drugs un$ess abso$ute$' necessar' and not ha%ing surger' un$ess abso$ute$' necessar'. G+ee the pre%ious two chapters.H 3here are man' common procedures that doctors won(t do on an outpatient basis ,, un$ess 'ou insist. Iere is where, once again, 'ou ha%e !159" to do some homework that wi$$ put 'ou one up on the doctor as )ar as knowing what can and can(t be done. &ore than ninet',)i%e percent o) births to hea$th' women, )or examp$e, can and shou$d be done outside the hospita$. 6et doctors sti$$ scare 'oung mothers and )athers into the de$i%er',operating room with horror stories o) 1comp$ications1 which are, in truth, statistica$ )antasies or comp$ications which resu$t )rom obstetrica$ inter%ention. Now that the scare tactics ha%en(t diminished the home birth mo%ement, we see more and more 1birthing rooms1 appearing in hospita$s. *on(t kid 'ourse$) into thinking that birthing rooms made up to $ook 2ust $ike a rea$ Gmote$H bedroom are going to make an' di))erence. 4nce 'ou a$$ow 'ourse$) to be $ured onto &odern &edicine(s tur), the'(%e got 'ou. # ha%e the recurring dream o) a nice 'oung coup$e going into the birthing room, $ike the one at #$$inois &asonic Iospita$ ,, comp$ete with brass bed and co$or 3K set. 3he doctor smi$es and acts 2ust $ike a )riend$' unc$e. But once the mother is strapped into the brass bed, the doctor pushes a button on a secret pane$ and the papered wa$$s s$ide awa', the )urniture disappears, and the'(re sudden$' in an operating room under the g$are o) the operating $ight with the surgeon standing there sca$pe$ in hand read' to s$ice her be$$' )rom one end to the other. 3hat )antas' isn(t so unrea$. Birthing rooms are not so iso$ated )rom the operating rooms that the brass bed can(t be ro$$ed into action be)ore the 'oung mother and )ather know !17 " what(s going on. #) 'ou(re on the doctor(s tur), 'ou p$a' b' the doctor(s ru$es. Whereas i) 'ou ha%e 'our bab' at home, the doctor has to do his homework. #) 'ou need the hospita$ )aci$ities, 'ou shou$d use them. But i) 'ou can ha%e 'our bab' in a birthing room, 'ou can ha%e it in 'our own bedroom. #n protecting 'ourse$) )rom 'our doctor(s tendenc' to send 'ou to the hospita$ unnecessari$', 'ou shou$d use the same tactics discussed in a%oiding drugs and surger'. Educate 'ourse$) to the possibi$ities, a$ternati%es, and conse.uences. #) that means going to other doctors, do it. #) it means going to hea$ers that aren(t medica$ doctors, do it. *on(t be a)raid to con)ront 'our doctor with the in)ormation 'ou gather. 4) course, what 'ou(re rea$$' doing is searching )or the right doctor. 0nd that, actua$$', is exact$' how 'ou shou$d go about )inding the right hospita$ ,, i) 'ou decide that 'ou need one. 8on%entiona$ wisdom preaches that the best hospita$ is the one which is hea%i$' in%o$%ed in teaching, one that has $ots o) students, $ots o) house o))icers, $ots o) research. 3hat wisdom ma' ha%e been %a$id thirt' or )ort' 'ears ago when there were some prett' pecu$iar things going on in communit' hospita$s. But it(s nonsense toda' ,, un$ess 'ou want to )ee$ $ike the )rogs, cra')ish, and )eta$ pigs in a bio$og' c$ass. #) 'ou want to )ind the hospita$s that ha%e the highest rates o) nosocomia$ Gdoctors( 2argon )or hospita$,ac.uiredH in)ection, that make the most mistakes regarding $ab !171" tests and dispensing drugs, that mix up more patients, and that do more ps'cho$ogica$
damage ,, then go to teaching or research hospita$s. #) 'ou want to be used )or someone e$se(s purpose ,, whether it(s to demonstrate the right Gwrong-H wa' to per)orm a procedure or to )ind out i) this or that drug rea$$' works ,, 'ou cou$dn(t go to a better p$ace than a teaching hospita$. 3here used to be another piece o) con%entiona$ wisdom which stated that i) 'ou had a %er' rare or serious condition 'ou were better o)) in a teaching hospita$. 3hat(s no $onger true, either. 3he teaching hospita$s are there, don(t )orget, to teach the orthodox treatments. What 'ou(re going to get is the orthodox treatment, whether it works or not. #) 'ou want to get the $atest, unorthodox treatment, 'ou ha%e to go to a sma$$er hospita$ or e%en one outside the reach o) the 8hurch ,, out o) the countr'. *on(t choose a hospita$ at a$$, because hospita$s don(t treat patients, doctors do. 8hoose a doctor. #) 'ou(%e chosen the right doctor, chances are he wi$$ ha%e chosen the right workshop )or his ski$$s. &ost o) the doctors # know who )a$$ into that categor' o) good doctors spend %er' $itt$e o) their time in big teaching or research hospita$s. 3he m'thica$ three,$egged stoo$ o) medicine ,, research, teaching, and patient care ,, is not a stoo$ at a$$ because the $egs aren(t e.ua$. Jatient care a$most a$wa's gets the short $eg when doctors and hospita$s tr' to make a stoo$ out o) it. +o i) !17/" someone te$$s me the' ha%e chosen a teaching hospita$, # te$$ them to be on their guard because the'(re in serious danger. No matter who 'our doctor is and what hospita$ he or she has put 'ou in, 'ou(re a$wa's in morta$ danger, so 'ou a$wa's shou$d be on 'our guard. Not passi%e$', either. 6our 2ob is to make troub$e. 3roub$e )or the nurses, troub$e )or the doctors, troub$e )or e%er'one. +ub%ert the s'stem that wi$$ stea$ 'our dignit' and ma'be 'our $i)e i) 'ou $et it. 3hat(s not a$wa's eas' to do. #) 'ou ho$d a high rank in societ', 'ou can do it )air$' easi$'. When the wi)e o) the chairman o) the board goes in, he o)ten gets a suite right next to hers. #) 'ou(re not %er' high$' p$aced, 'ou(%e got to use whate%er musc$e 'ou ha%e. 6ou(%e got to be prepared, cunning and ski$$)u$. # $ike mothers and )athers to sta' with their chi$dren whi$e the'(re in the hospita$. #n one o) the hospita$s # worked in, parents cou$d sta' with the chi$d on$' i) he or she was on the critica$ $ist. +o # wou$d put a$$ o) the kids on the critica$ $ist= 3he' $e)t me a$one on that )or a $ong time ,, unti$ the showdown. 3he %isiting hours were supposed to end at ::5 e%er' e%ening. 4ne mother ca$$ed me and said her chi$d was cr'ing but that he wou$d stop cr'ing and go to s$eep b' 8:5 i) on$' she cou$d sta' with him unti$ 8:5 . # to$d her to go up to his room and sta'. 3hen the nurse ca$$ed me and said that this woman has to $ea%e because the chi$d wasn(t critica$ and %isiting hours were o%er. # asked her what she wou$d !175" do i) the mother decided to sta'. +he said she(d ca$$ the super%isor. # ca$$ed the super%isor and asked her the same .uestion. +he said she(d ca$$ the hospita$ administrator. 3he administrator ca$$ed me and # asked him what he p$anned to do. Ie said he(d ha%e a po$ice guard come and escort the woman out o) the hospita$. # asked him to do me a )a%or and ho$d o)) )or )i)teen minutes so # cou$d see what # cou$d do. Ie )igured # was a nice gu' and wou$d take care o) it )or him, so he agreed. # ca$$ed up a $oca$ 3K newsman ,, an acti%ist ,, and to$d him # had a mother who was about to be thrown out o) the hospita$ because she wanted to sta' with her cr'ing chi$d )or an extra hour unti$ he went to s$eep= Ie asked me to ho$d them o)) )or twent' minutes so he cou$d rush cameras to the scene. # said #(d see what # cou$d do and #(d get back to him. 3hen # ca$$ed up the administrator and asked him to ho$d o)) )or 2ust twent' minutes more because the 3K camera crew was on the wa' to
)i$m the po$iceman escorting the woman out o) the hospita$. 3he administrator said, 1a$$ right, Bob, 'ou win. 6ou ca$$ o)) 'our dogs, and #($$ ca$$ o)) mine. But tomorrow # want to see 'ou in m' o))ice.1 Next morning # went to his o))ice and he to$d me he cou$d throw me o)) the sta)) )or doing what # did. # to$d him # knew that, but that # a$so knew that he wasn(t going to do it. Because i) he did # wou$d go right to the newspaper and make the biggest )uss he(d e%er seen. Ie said that was right. 0nd he made a !177" dea$ with me: 16our patients( %isitors can sta' as $ong as the' want, but nobod' e$se(s. # don(t want 'ou to bring this up with the rest o) the sta)).1 3hat(s the wa' it was. +ome o) the nurses used to be )rightened o) me, or 2ust p$ain mad at me, because # a$wa's demanded that m' patients recei%e whate%er # thought the' shou$d ha%e ahead o) e%er'bod' e$se. 3he nurse wou$d sa' 1But *r. &ende$sohn, there are twent',se%en other patients on the )$oor. Wh' shou$d 'ours come )irst-1 0nd # wou$d te$$ her that m' patients did come )irst, because i) the' didn(t # was going to raise the biggest ho$$er in the wor$d. &' patients did get taken care o) )irst most o) the time. # used to %io$ate the ru$es a$$ the time. Which is exact$' what 'ou ha%e to do to protect 'ourse$) when 'ou are in the hospita$. 6ou can(t do it a$one. 6ou need someone with 'ou a$$ the time who(s c$ose to 'ou. Not a pri%ate nurse. +omeone )rom 'our )ami$' or a good )riend has to sta' with 'ou. # $earned that poor )ami$ies were usua$$' strong and rich )ami$ies )re.uent$' weak, because # cou$d a$most a$wa's get a )ami$' member to sta' with a poor patient. When # had a we$$,to,do or upper midd$e c$ass patient, # had to get a pri%ate nurse because e%er'bod' in the )ami$' was working and no one was a%ai$ab$e or wi$$ing. 3hat taught me a great $esson about the re$ati%e strength o) poor and rich )ami$ies. 4) course, it most $ike$' wi$$ not be eas' to keep a )riend or )ami$' member with 'ou at a$$ !17>" times. 6ou ha%e to use some musc$e. When the person is to$d to $ea%e, he or she must not $ea%e. *rop the word $aw'er .uite a bit because doctors are a)raid o) $aw'ers. +a', 1we$$, m' brother,in, $aw is a $aw'er and he said # cou$d sta'.1 3hat sometimes works. 0nother techni.ue is to bring in a bunch o) tough,$ooking re$ati%es. # used to take care o) g'psies on the +outh +ide o) 8hicago. 4ne da' the prince o) the g'psies )e$$ out o) a window and hurt his head. Ie sur%i%ed, o) course, and did %er' we$$. But he was brought to the hospita$ b' his )ather, the king o) the g'psies, and about two hundred other g'psies. 3he' came in a cara%an o) cars, a$$ with the $itt$e )$ags on the aeria$s. #t was .uite a dramatic sight. 0$$ the cars pu$$ed up, and the g'psies got out on the )ront $awn. 0bout twent' o) them went up with this kid to his room. Kisiting hours were $ong o%er, but there wasn(t one nurse or doctor who was going to go in there and te$$ those g'psies to $ea%e. 3he )irst responsibi$t' o) the )riend or re$ati%e is to make sure that 'ou are we$$,)ed. #) 'ou expect to sur%i%e 'our hospita$ sta' with out star%ing, 'ou ha%e to take responsibi$it' )or 'our own nutrition. #) the hospita$ )ood is not up to 'our standards, 'ou shou$d ha%e )ood brought in )rom home. G#) the hospita$ )ood is up to 'our standards, either 'ou(re in an exceptiona$ hospita$ or 'ou shou$d serious$' reexamine 'our dietar' habits.H 6our re$ati%e has to be prepared to run inter)erence )or 'ou when the nurse or technician tries to interrupt or cance$ 'our mea$ )or a test or some other procedure. !17;" #n the e%ent that 'ou(re too weak or uninterested to )eed 'ourse$), 'our )riend is there to )eed 'ou. Ie or she a$so can monitor 'our mea$s and te$$ the doctor what 'ou(%e been eating and not eating. #) 'ou are on a specia$ diet, he or she can make sure the )ood is part o) the recommended diet. 6our )riend or re$ati%e has to know what pi$$s 'ou(re supposed to get, so that 'ou don(t get pi$$s that the patient in the next bed shou$d ha%e gotten. 6our partner a$so can make sure 'ou(re not mistaken
)or the next patient when the' come to co$$ect him )or his surger'. 6our partner can make sure 'ou don(t disappear. Ie or she can go with 'ou )or $aborator' tests and examinations. #) 'ou(re taken )or x,ra's, he or she can go with 'ou to make sure 'ou are brought to the right p$ace, to see to it that 'ou don(t sit in a dra)t' ha$$wa' most o) the da', to make sure 'ou get the right x,ra's. 6our partner is there to ask .uestions and, in genera$, to make troub$e. 6our partner shou$d ask the nurse how )ast the intra%enous drip shou$d be dropping, so that 'ou don(t get it too )ast. Ie or she a$so shou$d make sure the' don(t put a patient with a contagious disease in the same room. 6our partner shou$d ask the doctor to wash his hands be)ore he touches 'ou. 4ne o) the side e))ects o) doctors not making house ca$$s is that the' don(t wash their hands an'more. # remember when # made house ca$$s, peop$e wou$d po$ite$' sa' when # wa$ked in the door, 1*octor, the bathroom is right this wa'.1 3he' !17:" wou$d show me to the washroom where there was a towe$ and a bar o) soap. #t was expected that # wou$d wash m' hands be)ore # went in to see the patient. # didn(t rea$$' $earn to wash m' hands unti$ # started making house ca$$s. Now, i) 'ou watch a doctor going )rom room to room and patient to patient, sometimes he washes his hands and sometimes he doesn(t. +ometimes he passes his hands through the water ceremonious$' but not in a wa' that does an' good. 6our partner shou$d make sure the doctor washes his hands thorough$' be)ore touching 'ou. Who knows what he(s had his hands in be)ore getting to 'ou= #) )or nothing e$se, it(s a good idea to ha%e a partner in the hospita$ to protect 'ou )rom the ps'cho$ogica$ dangers, the 1%oodoo curse1 o) the hospita$ sta'. 0 )riend or a re$ati%e pro%ides an in%a$uab$e $ink to 'our rea$ $i)e, to 'our identit', and to 'our dignit' that can keep 'ou a$i%e and strong when the hospita$ sta)) and procedures gang up on 'ou. E%en the best hospita$s are )rightening and dangerous. #t(s rea$$' common sense to ha%e a good )riend or a re$ati%e there to de)end 'ou and support 'ou when 'ou most need it. #) 'ou are )ortunate enough to ha%e someone who wi$$ team up with 'ou to cause the nurses and sta)) to comp$ain that the two o) 'ou are uncooperati%e and troub$e makers, then # know that 'ou are we$$,protected ,, and $o%ed.
Chapter % Hol &ar on the 'a!il

!179" #) 'ou were set on destro'ing the )ami$' 'ou cou$dn(t do a better 2ob than &odern &edicine. 3hat the )ami$' is disintegrating has been common khow$edge )or 'ears. 4ne chi$d out o) e%er' six is now raised b' sing$e adu$t. E%er' other marriage is doomed. We(%e e%en debased the word ()ami$'1 itse$). When # sa' )ami$', # mean the entire co$$ection o) b$ood re$ati%es: chi$dren, mothers, )athers, grandparents, aunts, unc$es, and cousins. B' re)erring to this as the 1extended1 )ami$', we attempt to ignore the harm done b' ha%ing on$' one )ami$' in twent' $i%ing with more than two adu$ts under the same roo). 4n the other hand, the experts ga%e us the term 1nuc$ear )ami$'1 to e%oke a$$ the positi%e images once associated with nuc$ear energ'. 3hat image !1> " ne%er was an' good. What(s supposed to be at the core o) the atomic )ami$'- 3he parents- 3he chi$dren- Nothing- 8a$$ing the )ami$' 1nuc$ear1 prepares us )or the exp$osi%eness and instabi$it' that characteri<es atoms in nature. When the nuc$ear )ami$' starts spinning o)) its indi%idua$ members we can )ee$ that it(s actua$$' )u$)i$$ing its destin' rather than )rustrating it. +choo$s and teachers are sometimes b$amed )or the destruction o) the )ami$', but a$though teachers and educators are sure$' part o) the arm' o) pro)essiona$s attacking and cripp$ing our )ami$ies, the genera$s are the doctors. 3he doctors are the rea$ $eaders because without their sanction, without the
b$essings o) &odern &edicine, none o) the )ami$' destro'ing agencies cou$d exist, $et a$one succeed. 9urthermore, &odern &edicine(s own Io$' War on the )ami$' is more de%astating and %icious than the schoo$s( e%er cou$d be. 9ami$' medicine, )or examp$e, shou$d mean the hea$th' in)$uence o) the )ami$'. 3o the doctor, howe%er, )ami$' medicine is the necessar' inter%ention in the )ami$' b' the doctor )or sacramenta$ purposes. 0n' in)$uence the )ami$' might ha%e is $ess than secondar': it(s use$ess and to be a%oided. &ost peop$e think doctors stopped making houseca$$s because the' cou$d see more patients in the o))ice. 3he rea$ reason is that doc$ors don(t want to meet the )ami$' on on it(s own tur). Not on$' can 'ou cram more patients into an o))ice, but 'ou can iso$ate a person )rom the )ami$'(s in)$uence. #t(s that much !1>1" harder )or a doctor to contro$ the situation and disso$%e )ami$' ties when he(s a guest in 'our house. 9or his 1medicine1 to succeed, the doctor must impose his ethics and be$ie)s in p$ace o) the )ami$'(s. Ie has to take o%er ro$es traditiona$$' p$a'ed b' )ami$' members. Not on$' don(t doctors share )ee$ings, cu$tura$ traditions, and $o'a$ties o) )ami$' members, the' a$so don(t care what happens. #) the patient dies, it(s not a traged', because he or she is a patient ,, not a son or daughter or mother or )ather or unc$e or aunt or cousin. *octors are care)u$$' taught to distance themse$%es )rom their patients. 3his distancing comes in hand' when the doctor has to step in at times o) crisis or stress and 1take o%er.1 0$$ re$igions institute sacraments or ritua$s at certain stress)u$ moments in $i)e that o%erwhe$m us with m'ster' and tease us with hints o) what $i)e(s a$$ about, moments such as birth, coming o) age, marriage, and death. Where other re$igions design these ritua$s to support the )ami$', the 8hurch o) &odern &edicine aims on$' to disrupt. #(%e a$read' ta$ked about what a dangerous p$ace the hospita$ is. &odern &edicine has such arrogance that the hospita$ p$atoon is ca$$ed the hospita$ 1)ami$'=1 No other modern re$igion gets awa' with what the 8hurch o) &edicine does routine$'. No modern re$igion re.uires b$ood sacri)ices, 'et to get married with the doctor(s sanction 'ou ha%e to gi%e b$ood. B$ood tests be)ore marriage ha%e $itt$e !1>/" more than ceremonia$ %a$ue. 0s soon as an' process becomes routine, nobod' pa's an' attenton to it. Babs make so man' mistakes most doctors don(t e%en bother to check the resu$ts. #n one stud', a $ab intentiona$$' sent back positi%e reports )or %enerea$ disease. Ker' )ew doctors repeated the test. 3hat b$ood sacri)ice be)ore a )ami$' is e%en a$$owed to begin is on$' a re$ati%e$' innocuous s'mbo$ o) the sinister ritua$s to come. When the third member o) the )ami$' enters the picture the campaign intensi))es. Now, where other re$igions are satis)ied with reasonab$' unobtrusi%e ceremonies, &odern &edicine mounts a )u$$ sca$e attack b' in%enting a crisis out o) a norma$ situation. B' treating chi$dbirth as a disease, the obstetrician makes his inter%ention indispensib$e. #) obstetricians acknow$edged the )act that more than ninet',)i%e percent o) births proceed entire$' without comp$ications, more than ninet',)i%e percent o) their ser%ices wou$d be recogni<ed as unnecessar'. 3hat wou$d mean a $ot )ewer obstetricians ,, as we$$ as heathier )ami$ies. #nstead, what we ha%e is chi$dbirth taking p$ace in an operat$ng room. 4) course, it ma' not be a bad idea to ha%e a$$ hospita$ births occur in an operating room, since hospita$ births are a $ot more dangerous. Babies born in the hospita$ are six times more $ike$' to su))er distress during $abor and de$i%er', eight times more $ike$' to get caught in the birth cana$, )our times more $ike$' to need resuscitation, )our times more $ike$' to become in)ected, and !1>5" thirt' times more $ike$' to be premanent$' in2ured. 3heir mothers are three times more $ike$' to hemorrhage.
Whereas primiti%e cu$tures make birth an e%ent )or the who$e )ami$' to share in some use)u$ wa' ,, e%en to the point o) a$$owing the husband or the mother to assist at the de$i%er' ,, modern medicine a$$ows on$' the doctor and his assistants to attend. 1Ee)orms1 such as birthing rooms, husbands in the de$i%er' rooms, and prenata$ discussions o) what the mother,to,be wants and doesn(t want are $itt$e more than marketing come,ons. 4nce the obstetrician has 'ou on his tur), he(s in contro$. Ie demonstrates ,, or )$aunts ,, his contro$ b' putting the woman through a series o) debasing maneu%ers. 9irst she must ha%e her %agina$ area sha%ed, though it(s been known since the 195 s that doing so prior to de$i%er' in no wa' decreases and ma' we$$ increase the number o) bacteria present. 3hen the woman must put her )eet in stirrups and assume a supine position again on$' to satis)' the doctor(s wi$$. 3he intra%enous )$uid connection to the woman(s bod' ensures that the doctor can rapid$' administer anesthetics when he decides the'(re necessar'. 0$read' separated )rom her )ami$' and her contro$ o%er her bod' Gthe doctor ma' e%en ha%e decided when the e%ent is to occurH, the mother,to,be ma' be denied the experience o) the e%ent b' being drugged sense$ess and memor'$ess. 4) course the doctor ma' be )orced to put her to s$eep in order to per)orm his coup de grace: the 8aesarean de$i%er'. !1>7" 4ne o) the side e))ects o) a 8aesarean de$i%er' sometimes doesn(t show up )or weeks or months a)ter the birth: babies de$i%ered this wa' seem to be more $ike$' to become %ictims o) chi$d abuse. &others who gi%e birth this wa' usua$$' are unab$e to be with their babies during the ear$iest hours and da's o) $i)e because it sometimes takes that $ong )or the e))ects o) the anesthesia to wear o)). 3he'(re a$so uncom)ortab$e )rom the surger' itse$). Not on$' are the )irst important periods o) materna$,in)ant bonding mang$ed b' the procedure, but whate%er )ee$ings the mother does come awa' with are su$$ied b' her disappointment and pain. 4) course, mothers who gi%e birth norma$$' or to premature babies a$so are entit$ed to ha%e their )irst )ew %ita$ hours and da's with their new babies unsu$$ied. Cn$ess a new mother puts up a he$$ o) a )ight ,, something not too eas' to do a)ter $abor, de$i%er', episiotom', and anesthesia ,, her bab' is immediate$' swept awa' to that concentration camp known as the newborn nurser'. Iospita$ regu$ations )urther iso$ate the )ami$' )rom the birth experience. Kisiting restrictions break up the )ami$' b' a$$owing the new mother on$' one or two %isitors at a time. # don(t know o) a more di%isi%e situation than ha%ing to choose among husband, mother, mother,in,$aw, )ather, )ather,in, $aw, aunts, unc$es, and cousins. #n addition, the hospita$ a$most ne%er permits sib$ing %isitors, and when it !1>>" does, it(s )rom the other side o) a g$ass partition. +o much )or togetherness= Jediatricians are as determined as obstetricians to weaken tho )ami$'. 3he' start b' making the new mother )ee$ abso$ute$' une.ua$ to the task o) $ooking a)ter the we$)are o) her bab'. Be)ore the doctor e%en appears on the scene, the stage )or submission is set b' a p$atoon o) pediatric nurses who incessant$' badger the mother with dos and don(ts regarding e%er' aspect o) the bab'(s care. 4) course, the'(re on$' )o$$owing orders. 3he )irst broadside the pediatrician de$i%ers to the new mother,chi$d re$ationship is his 1ad%ice1 regarding the )eeding o) the in)ant. 0s i) @od made a mistake in not )i$$ing her breasts with +imi$ac, the new mother is to$d that man,made )ormu$a is e%er' bit as good )or the bab' as her own breast mi$k. Ear$' in m' own pediatric training # was taught that i) a mother .uestioned whether she shou$d breast)eed or bott$e)eed, the proper answer is: 13he decision is strict$' up to 'ouD # wi$$ assist 'ou in whate%er method 'ou decide to use.1 4) course, that answer is an outright $ie. Bott$e)eeding ,, the grandadd' o) a$$ 2unk )ood ,, wasn(t then, isn(t now, and ne%er wi$$ be 1as good as1 breast)eeding. Iuman mi$k is designed )or human
babies, cow(s mi$k )or ca$%es. 3he structure and composition o) each is suited to the particu$ar need o) the intended recipient. 0mong anima$s switching mi$k sources ,, sa', )or examp$e, gi%ing a ca$) sow(s mi$k ,, !1>;" resu$ts in sickness and, o)ten, death )or the newborn. 3he bott$e)ed human bab' is substantia$$' more $ike$' to su))er a who$e nightmare o) i$$nesses: diarrhea, co$ic, gastrointestina$ and respirator' in)ections, meningtis, asthma, hi%es, other a$$ergies, pneumonia, ec<ema, obesit', h'pertension, atherosc$erosis, dermatitis, growth retardation, h'poca$cemie tetan', neonata$ h'poth'roidism, necroti<ing enteroco$itis, and sudden in)ant death s'ndrome. 9rom a scienti)ic, bio$ogica$ standpoint, )ormu$a )eeding cannot be considered an acceptab$e a$ternati%e to breast)eeding ,, especia$$' since more than ninet',nine percent o) new mothers are per)ect$' capab$e o) doing it. E%en premature in)ants shou$d get breastmi$k. When # had m' pediatric training more than twent', )i%e 'ears ago, # was strong$' Gand thank)u$$'H in)$uenced b' one o) the great nurses in the )ie$d o) premature babies, E%e$'n Bundeen. &iss Bundeen not on$' encouraged but insisted, that mothers supp$' breastmi$k to their premies, e%en to those who weighed on$' two pounds. # can remember watching husbands de$i%er the bott$es o) mi$k their wi%es had pumped. 3here(s no doubt in m' mind that the premature in)ant )ed breastmi$k does much better than the premature in)ant )ed )ormu$a. #n m' own practice # ha%e discharged )rom the hospita$ man' babies who weighed $ess than )i%e pounds, a$$ breast)ed, o) course, since now # won(t accept a chi$d as a patient un$ess the mother is determined to breast)eed. !1>:" 3e$$ing mothers that breast)eeding is superior to )ormu$a )eeding is m' recipe )or e$iminating a pediatric practice. #) a pediatrician te$$s a mother the truth that breast)eeding is good and bott$e)eeding is dangerous, it wi$$ $ead to )ee$ings o) gui$t on the part o) the mother who chooses not to breast)eed. 3he gui$t' mother then wi$$ scurr' o)) to a pediatrician who(s wi$$ing to re$ie%e that gui$t b' te$$ing her that it makes no di))erence whether or not she breast)eeds. 4n the other hand those women who do breast)eed wi$$ ha%e babies that ne%er get sick. 3here goes the pediatrict practice= 6ou won(t )ind man' pediatricians who insist that a woman breast)eed her bab'. #nstead, 'ou($$ )ind what # ca$$ Jediatric *oub$ethink, the statement that breast)eeding is best, but )ormu$a is 2ust as good. 6ou($$ )ind pediatricians who hand out )ree samp$e six,packs o) in)ant )ormu$a to new mother(sD 'ou($$ )ind pediatricians who insist that newborns waste their sucking re)$ex and energ' on sugar,water bott$esD 'ou($$ )ind pediatricians who push )ree 1supp$ementar' )ormu$a1 kits on mothers who are breast)eedingD and 'ou($$ )ind pediatricians who discourage a mother )rom breast)eeding i) her bab' doesn(t gain as much weight as the manua$ pro%ided b' the )ormu$a compan' sa's it shou$d. 6ou($$ )ind pediatricians neg$ecting to in)orm mothers that in)ant )ormu$a can contain )rom ten to 1 times as much $ead as breastmi$kD neg$ectihg to te$$ a mother that breast)eeding protects her in)ant )rom a$$ in)ectious !1>8" diseases she has had or )ought o)) through her immune s'stemD neg$ecting to te$$ mothers that breast)eeding promotes better bone maturation and inte$$ectua$ de%e$opmentD and neg$ecting to te$$ them that breast)eeding wi$$ he$p protect the mothers themse$%es )rom cancer o) the breast. Breast)eeding is better )or the )ami$', too. 3he bond between a mother and her chi$d is secure and hea$th' when the mother breast)eeds. Not on$' does the sucking o) the in)ant stimu$ate hormones that reduce postnata$ b$eeding and discom)ort and cause the uterus to shrink back sooner, but it a$so gi%es the mother sensua$ p$easure as we$$. Bott$e)eeding, howe%er, gi%es the mother no such p$easure. #t does make possib$e ,, indeed necessar' ,, the sacred )our hour )eeding schedu$e, which
does unto$d damage to a$$ in%o$%ed, in the name o) 1regu$arit'.1 Bea%ing the hospiia$ and going home with her new bab' doesn(t protect the mother and )ami$' )rom the di%isi%e ons$aught o) doctors. 3he parting ad%ice o) the pediatrician and nurser' sta)) is $ike$' to be something $ike, 1Eemember, i) the bab' cries, $et him or her cr' it out because cr'ing wi$$ strengthen its $ungs, and besides 'ou want it to $earn not to cr' when it wants something.1 Now this piece o) ad%ice ,, besides )$'ing in the )ace o) common sense ,, ignores the instincts not on$' o) the bab' but o) e%er' mother #(%e e%er ta$ked to. @od apparent$' made another mistake in ha%ing babies cr' when the' want something= !1>9" 0$$ the wa' down the $ine the doctor uses his authorit' to put the )ami$' at odds with its own instincts and traditions. #nstead o) trusting in the wisdom o) accumu$ated experience, the )ami$' $oses con)idence in its own )ee$ings and submits be)ore the doctor(s 1education,1 his 1certi)ied wisdom1 signi)ied b' his dip$oma and specia$t' papers. #) 'ou ask the doctor where it(s written that a ma$e pediatrician who ma' ne%er ha%e )athered a chi$d and certain$' ne%er mothered one is a better source o) in)ormation about the needs o) a cr'ing bab' than the bab'(s own mother or grandmother, he($$ most $ike$' point to the )ramed dip$omas on the wa$$. E%en though the 'oung mother ma' spend on$' a )ew minutes a month with the pediatrician, a gang o) experts endorsed b' the doctor ,, such as *octors +pock, +a$k, @inott, and Bette$heim ,, are prepared to con)use her thorought' through the %ar'ing opinions in their books and artic$es. 3he 'oung mother is tota$$' without a de)ense against this barrage o) ad%ice since she has no con)idence in her own thoughts and )ee$ing and since she has been taught b' the doctorGsH to re2ect her mother(s and grandmother(s ad%ice as 1o$d wi%es ta$es.1 #nstead, she turns to the o$d doctors( ta$es and is $e)t with her head spinning= +ince )ew 0merican )ami$ies $i%e with or c$ose to other re$ati%es, the mother is ph'sica$$' remo%ed )rom the so$ace and support her mother or grandmother cou$d pro%ide. &' recipe )or making a mother at $east neurotic and at worst cra<' is to put her in the house a$one !1; " e'eba$$ to e'eba$$ with a new bab' with on$' a gagg$e o) disagreeing experts to guide her through the crises o) her )irst )ew months as a mother. 3his situation ,, which is the most common one in this countr' ,, can make a woman neurotic be)ore the bab'(s a 'ear o$d. G0 )ather in the same situation wou$dn(t $ast a month.H +ince there(s no one to he$p her in the home, the woman tries to sa%e herse$) b' escaping )rom the home. #n man' cases, the strain on the husband and the wi)e is so great when the' ha%e on$' each other to $ook to as both the cause and the so$ution o) their prob$ems, that the marriage ends in di%orce. 4r, $ess drastia$$', the woman wastes no time )inding a 1)u$)i$$ing1 2ob outside the home. Either wa', the chi$d is shunted o)) to a da',care center. 0 woman(s %ision o) )u$)i$$ment in a 2ob outside the home is more o)ten than not an i$$usion. &ost 2obs ,, inc$uding those per)ormed b' men ,, are not )u$)i$$ing in the $east, but rather are du$$, routine, mechani<ed tasks that mean on$' one thing: a pa'check. 9ew 2obs are as )u$)i$$ing as homemaking and chi$drearing. Women do need and shou$d cu$ti%ate acti%ities inside and outside the home that wi$$ he$p them )u$)i$$ their persona$ identit'. But precious )ew pa'ing 2obs do that. E%en with the best o) 2obs, a working woman o)ten )inds herse$) 2ugg$ing her man' ro$es and )inds that she has $itt$e or no time $e)t )or the things she cares about most. Not on$' must she work, but she a$so must adopt the goa$,oriented attitude o) men who compete )or success, an attitude !1;1" which in itse$) is unhea$th' ,, )or men or women. 3he goa$s o) working outside the home ma' be i$$usor', but the e))ects on the )ami$' are rea$. Whereas chi$dren used to $ea%e the home at age six, with da',care centers sprouting and mothers
)i$$ing them as soon as the'(re a$$owed, we now ha%e chi$dren 1starting schoo$1 as ear$' as age one= B' da',care center # don(t mean the o$d )ashioned nurser' schoo$ in which a chi$d spent on$' a )ew hours. &ea$s were not ser%ed in nurser' schoo$s, and the chi$d spent most o) the da' at home. Not so in toda'(s da',care center. #n Europe da',care centers o)ten are $ocated in the same )actories, shops, or o))ices as the mothers( 2obs, or at $east c$ose enough so the mother can $essen the impact o) separation b' %isiting the chi$d and sharing mea$s. #n this countr', howe%er, da',care centers are $ocated too )ar awa' )or mother and chi$d to share an' more than a .uick goodb'e be)ore mother hust$es o)) to get to work across town and returns tired and grouch' eight, nine, or ma'be e%en ten 1)u$$)i$$ing1 hours $ater. 0t the da',care centers, the chi$d is )ed b' strangers, not b' its mother. What is meant b' nature to be a subt$e mechanism in which a chi$d is nurtured b' his or her )ami$' becomes instead a situation where the chi$d is in)$uenced at a crucia$ period in its de%e$opment b' strangers. 4) course, to app$' the %eneer o) education to the chi$d s separation )rom the )ami$', we now ha%e academic departments !1;/" dedicated to certi)'ing experts in 1ear$' chi$dhood education.1 &an' da',care centers pro%ide break)ast, $unch, and dinner. # can remember most e$ementar' schoo$s twent' 'ears ago had no )aci$ities )or )eeding their students, but toda' schoo$ $unches are now a matter o) course in e%er' schoo$ district. +ince $unches are now ser%ed on the premises, $unch periods ha%e been shortened to pre%ent e%en the chi$dren who want to go home )or $unch )rom doing so, e%en i) mom is home. What we end up with is a situation in which the chi$d spends more and more o) his or her time with peop$e who most $ike$' don(t share the same %a$ues, traditions, or ethics as the )ami$'. +ince the chi$dren spend $ess and $ess o) their most important de%e$opmenta$ time with their )ami$', the' grow up tru$' 1independent1 o) a$$, )or better or worse, that their )ami$' ho$ds dear ,, and o) the )ami$' itse$). 0$$ o) this wou$dn(t be possib$e i) doctors didn(t sanction and encourage unhea$th' notions o) 1independence.1 #(m reminded o) the stor' o) a 'oung New 6ork )ami$'. 3he husband to$d me that his wi)e had gone back to work when he had $ost his 2ob, but that be had 2ust gotten another 2ob. Iis wi)e was going to continue to work, but in a new 2ob as director o) a se%en,stor' da',care center. 3heir three,'ear,o$d son was attending the same center. # to$d the )ather that # thought this was a good arrangement, since the chi$d wou$d ha%e his mother reassuring$' c$ose to him a$$ da'. 14h !1;5" no,1 gasped the )ather, 1# don(t want him to be reassured. # want him to be independent.1 3he )ather and mother had ensured their son(s independence to the point o) mapping out separate bus routes )or mother and chi$d on the wa' to the center. # can(t he$p wondering whether that )ather ma' not someda' regret making his son so independent. 0)ter a$$, isn(t dependence the proper business o) a three,'ear,o$d- Behind that )oo$ish 'oung man # see a pediatrician somewhere, urging him to encourage independence among )ami$' members ,, starting with the 1$et him cr' it out1 admonition ,, whi$e discouraging his independence )rom the doctor(s intrusion in the )ami$'(s responsibi$ities. 3he dependence between a mother and her chi$d is the core and the mode$ )or a )ami$'(s hea$th,producing interdependence. 9ami$' members are supposed to depend on one another= We shou$d ce$ebrate a 9ami$' *ec$aration o) *ependence e%er' da'. When a chi$d goes o)) to schoo$, &odern &edicine en$ists the he$p o) teaching pro)essiona$s to keep the )ami$' at ba'. Not on$' is the parent(s ro$e as teacher usurped, but the parents are shunted o)) into meaning$ess acti%ities such as J30 bake sa$es and carni%a$s. Jarents are remo%ed )rom the arena where the rea$ batt$e )or their chi$dren(s minds is taking p$ace. 8$e%er tactics such as changing
st'$es o) teaching ,, new math )or one generation, o$d math )or the next ,, keep parents )rom p$a'ing a signi)icant ro$e in their chi$dren(s education. 3he' !1;7" can(t e%en he$p with the homework= +ex education the chi$dien recei%e in schoo$ more $ike$' than not con)$icts with the )ami$'(s %a$ues. J30 meetings take the parents awa' )rom the )ami$' in the e%enings. 3he kids start sta'ing awa' more and more to attend extracurricu$ar acti%ities. Bitt$e b' $itt$e, the gap between parents and chi$dren is widened. When it comes time to dea$ with prob$ems, parents are too con)used and distant )rom their chi$dren to be e))ecti%e. 3he'(%e been robbed o) an' con)idence the' might ha%e had at the beginning. 4)) to the ps'chiatrist= 3he'(%e been success)u$$' recruited )or ps'chotherap' or the ministrations o) some other chamber o) the 8hurch o) &odern &edicine. 3his new team o) experts gi%es the )ami$' 2ust what it needs to so$%e its prob$ems: a %ocabu$ar'. Jarents are gi%en a bag o) words with which to describe their chi$dren: irresponsib$e, immature, hosti$e, resent)u$. 8hi$dren are gi%e a bag o) words to describe their parents: inhibited, repressed, o%er,protecti%e, re2ecting. Need$ess to sa', these words are tossed about between )ami$' members $ike brickbats. Eather than gi%ing the )ami$' too$s )or repairing re$ationships, stock de)initions )ree<e the thinking processes in which peop$e can come to understand each other. B' nature, ps'chiatr' is )ami$',di%isi%e. Js'chiatrists encourage peop$e to sa' bad things about their re$ati%es. #) conducted proper$', such therap' can re$ease tensions between and within peop$e and a$$ow greater emotiona$ mobi$it' !1;>" and hea$th. But %er' $itt$e o) it that(s going on is %er' we$$ conducted, because # see a $ot o) peop$e going in )or therap' and %er' )ew peop$e coming out an' better. Iow can 'ou come out an' better when the ps'chiatrist has 'ou pegged e%en be)ore 'ou open 'our mouth- #) 'ou arri%e )or 'our appointment $ate, he($$ sa' 'ou(re hosti$e. #) 'ou are ear$' 'ou must be anxious. 0nd i) 'ou(re right on time, 'ou(re compu$si%e= 6ou can(t win= When # see a married coup$e go to a ps'chiatrist )or )ami$' counse$ing, # can predict with prett' good horse racing odds that the' wi$$ end up getting a di%orce. 3he p$atoons o) 1he$ping pro)essiona$s1 that gang up on the )ami$' are disab$ing. 3he' o))er )ew too$s to he$p a )ami$' sta' together. Because the' rob the )ami$' o) its own too$s, the )ami$' is $e)t with no e))ecti%e resources. #t(s no wonder that b' the time the chi$dren reach co$$ege age the' can(t wait to get awa' )rom the house. Who wou$d want to $i%e in a house where the peop$e were %irtua$$' une.uipped to re$ate to one another in an' wa' other than the mechani<ed, sub2ect,to,the, whims,o),ps'chiatr' )ashion ad%ised b' maga<ine expertsNowada's, a co$$ege education is somehow $ess than it shou$d be i) the student doesn(t attend a co$$ege at $east a da'(s tra%e$ )rom home. E%er'bod', idea$$', goes to schoo$ on the opposite coast. &idwesterners ha%e two coasts to choose )rom. 3his wide separation between )ami$' members remo%es an' %estiges o) in)$uence and $ea%es the chi$d tota$$' 1)ree1 !1;;" to be in)$uenced b' peers and pro)essors. #) someone cou$d show me how this does an' good )or either parents or chi$dren, #(d $et the sub2ect drop. #n m' experience, # see a higher rate o) i$$ness among )irst,'ear co$$ege students than a$most an' other socia$ subgroup. 3he' are more prone to depression, h'poth'roidism, tubercu$osis, rheumatic )e%er, in)ectious, mononuc$eosis, and menstra$ disturbances. 0nd, sma$$ wonder, their suicide rate is second on$' to that o) 0merican #ndian chi$dren sent awa' )rom the reser%ation )or high schoo$. None o) this wou$d be possib$e without the sanction o) &odern &edicine. 9rom one end o) $i)e to the other, the 8hurch inter)eres and substitutes its empt' ceremonies )or the bonds and traditions o) the )ami$'. Bi)e is debased. 0s soon as 'ou a$$ow a sing$e,natura$ process to be corrupted or
1impro%ed( b' treating it as i) it were a disease, the who$e organism o) $i%ing processes can begin to rot. 8hi$dren once per)ormed use)u$ )unctions within the home. Nowada's their use)u$ness is re$ated entire$' to outside acti%ities. 3he same )ate awaits peop$e when the' reach o$d age. 4$der peop$e are treated with contempt and swept out o) the home into retirement 1resorts1 or rest homes. Wh' shou$d the' sta' around the house- 3heir ad%ice isn(t respected, nor are their specia$ ta$ents and ski$$s de%e$oped o%er a $i)etime. &odern &edicine wou$d much rather ha%e o$d peop$e separated )rom their )ami$ies, their ta$ents, and their respect. 3hat wa' the' pro%ide a much better potentia$ patient popu$ation. !1;:" 3he' get sick more o)ten under the %oodoo curse propagated b' the 8hurch,1 the curse o) una%oidab$e debi$it' in o$d age, the curse o) the $ong stead' dec$ine to death. Not on$' is the person iso$ated )rom the )ami$' at the $ast moments o) $i)e, strapped and wired into the #ntensi%e 8are Cnit, but sedati%es and tran.ui$i<ers handed out b' the )ami$' doctor at the )unera$ rob mourners o) an' emotiona$ re$ease the' ma' get )rom cr'ing. E%en there, &odern &edicine, e%er on guard against disrupti%e beha%ior, du$$s the senses to rob participants o) precious moments in their $i%es. 0s &odern &edicine gets stronger, more )orce)u$ methods are used to attack the )ami$'. 6ou ha%e to submit to the 8hurch in order to go to schoo$. 3he' won(t $et 'ou in the door un$ess 'ou can pro%e that 'ou(%e recei%ed a$$ the sacramenta$ immuni<ations. +ooner or $ater doctors and some schoo$ districts are going to get rea$$' rough and go a)ter peop$e who re)use to ha%e their chi$dren immuni<ed. 3he'($$ simp$' dec$are the chi$dren %ictims o) chi$d abuse and remo%e them )rom the home. 3his sort o) %io$ence a$read' is going on. Bate$', #(%e been in%o$%ed in more and more cases in which m' )unction as a ph'sician has been to spring chi$dren )rom hospita$s. 3he usua$ stor' is this: the chi$d has a temperature o) 1 5 or 1 7 and ma' ha%e a throat or ear in)ection. Ie(s taken to the hospita$ where the doctor sees that he(s got a coup$e o) bruises on his bod'. 3he socia$ worker is ca$$ed in, and a)ter a )ew .uestions the )inger is aimed at the !1;8" parents. 3he chi$d is hospita$i<ed, presumab$' )or his own protection. 3hen the parents ha%e to )ind somebod' who wi$$ testi)' that there is no possibi$it' o) chi$d abuse and that the bruises are )rom some other cause. 0t one time, chi$d abuse was ob%ious to doctors. #t consisted o) chi$dren who came in with mu$tip$e broken bones. 3oda', that de)inition has been extended so that i) 'ou take a chi$d into the emergenc' room and he or she has a )ew bruises 'ou(re immediate$' .uestioned b' a socia$ worker. With the thousands o) empt' beds in hospita$ pediatric units, it(s to e%er'bod'(s ad%antage ,, except the )ami$'(s ,, to tr' to estab$ish a charge o) possib$e chi$d abuse. 0 mother # know had a bab' and decided to $ea%e the hospita$ right awa' because she didn(t $ike the hospita$ and she wanted to breast)eed her bab'. +he went home and about a month $ater came back )or a checkup at the hospita$ outpatient c$inic. Ier bab' hadn(t gained enough weight. 3he doctor said this was because o) the breast)eeding and to$d her to stop breast)eeding immediate$' and put her bab' on )ormu$a. +he decided she didn(t want to do that, so she continued to breast)eed. 0t the next month(s checkup ,, # don(t know wh' she went back ,, the bab' had gained more weight but not as much as the doctor thought the bab' shou$d. Ie said it was a possib$e case o) chi$d neg$ect and ordered the bab' hospita$i<ed. 3he mother ca$$ed her )riends in the Ba Beche Beague who had been ad%ising her with !1;9" her breast )eeding. 3he' got in touch with me, since # am a medica$ ad%isor to the Beague. # $ooked into the case and )ound that tbe woman had been doing a %er' good 2ob o) breast)eeding. What she was most concerned about now was that the' wou$dnt $et her sta' with the chi$d. B' the time # was
contacted, the chi$d had been awa' )rom the mother )or )i%e or six hours. Ier breasts were )i$$ing up. +he was getting uncom)ortab$e, but the hospita$ didn(t care. 3he' were )eeding the in)ant )ormu$a. 3hings were reaching an urgent point, so # got in touch with the +tate(s 0ttorne' and within an hour the mother was a$$owed to go upstairs and nurse the bab'. Next morning an emergenc' hearing was he$d and the chi$d was re$eased. 3his sort o) thing is not a rare incident. 0s $ong as &odern &edicine aids the +tate b' sanctioning the +tate(s attack on the )ami$', the +tate $ets &odern &edicine ha%e a$$ the power it needs to en)orce its $aws. # now warn parents to be extreme$' care)u$ when the' bring their chi$dren to a hospita$ emergenc' room because 'ou ne%er know what can happen once a doctor starts to examine a chi$d. # wonder whether certain e$ements o) 0merican societ' ha%en(t a$wa's been out to ki$$ the )ami$'. 3he %er' existence o) 0merica sp$it mi$$ions o) )ami$ies around the wor$d as the great wa%es o) immigration )i$$ed our cities. &an' o) these immigrants, howe%er, depended on re$ati%es a$read' here to he$p them o%er the di))icu$t )irst months in the New Wor$d. 3he pioneer !1: " )ami$ies certain$' had to stick together, too ,, a$though, once again, the initia$ $eap into the wi$derness genera$$' sp$it 'oung parents and chi$dren )rom their o$der re$ati%es who sta'ed behind. +ince o$der re$ati%es ,, bearers, as we$$ as s'mbo$s, o) traditions carried o%er )rom 1the o$d countr'1,,weren(t around to maintain the traditions, subse.uent generations $ost touch with the 1o$d wa's1 o) doing things. 3he me$ting pot wasn(t a me$ting pot at a$$: it was a steri$i<ing cau$dron in which )ami$' ties and traditions were boi$ed awa'. When immigration was cut o)) a)ter Wor$d War #, the stage was set )or the war against the )ami$' to begin in earnest. Without )resh supp$ies o) immigrants to maintain ties with )ami$ies and their traditions, peop$e cou$d at $ast start not on$' to escape those traditions but to )orget that the' e%er existed. &odern &edicine took ad%antage o) this situation to boost the de%e$opment o) pediatrics, m' own specia$t'. *uring the )irst )our decades o) this centur' pediatrics had no more than a )ew thousand practitioners. But when Wor$d War ## started, the countr' need women in the )actories to take the p$ace o) men who had to go and )ight. 3here was no wa' these women were going to be ab$e to do that and take care o) their chi$dren the wa' the' had be)ore the war. 4h, nurseries cou$d ha%e been set up in the )actories to a$$ow the mothers to do their patriotic dut' and their bio$ogica$ dut' as we$$. But instead, doctors simp$' denied the bio$ogica$ dut'. 3he words bab',sitter,1 1nuc$ear !1:1" )ami$',1 and 1mother surogate1 came into )ashion during the war. #nstead o) sa'ing that e%er' chi$d needed a mother, doctors said that e%er' chi$d needed a mother or a mother surrogate. 3hat wa', mi$$ions o) Eosie the Ei%eters cou$d 2oin the war e))ort without a twinge o) gui$t o%er $ea%ing their chi$dren in the care o) strangers. +ince these mothers cou$dn(t be with their babies )or more than a coup$e o) hours at the end o) each da', breast)eeding became impractica$. #t didn(t become an' $ess bio$ogica$$' necessar' or superior as )ar as the bab'(s hea$th was concerned. But since it was impractica$, doctors pronounced )ormu$a )eeding to be not on$' the answer to a di$emma, the better o) two e%i$s Gthe a$ternati%e e%i$ being not )eeding the bab' at a$$H, but the e.ua$ o) the on$' scienti)ica$$' sound a$ternati%e. Bike the priest who b$essed the hot dogs to sa%e parishioners )rom the mora$ bane o) eating meat at a 9rida' night church carni%a$, doctors ga%e their b$essing to bott$e )eeding. Iad the' to$d the truth the' wou$d ha%e ad%ised women that a$$ studies showed a higher morta$it' rate among bott$e)ed babies. 3he' wou$d ha%e to$d women the bene)its o) breast)eeding o%er bott$e )eeding. 3he' might ha%e, patriotica$$', thrown up their hands and admitted the di$emma whi$e gi%ing women the
opportunit' to make an in)ormed choice, But the' chose instead to sub%ert bio$og' in )a%or o) po$itics and powerD 3he', in e))ect to$d women the' didn(t ha%e to be responsib$e to bio$og', to nature(s !1:/" $aws. Whi$e pediatrics grew in popu$arit' and power, manu)acturers o) in)ant )ormu$as ,, some o) whom a$so make drugs ,,grew into mu$tinationa$ super,corporations. &odern &edicine has teamed up with these corporations to export the techno$og' o) in)ant nutrition a$$ o%er the wor$d. 0ctua$$', what the'(re doing is carr'ing on human in)ant sacri)ices among %ast numbers o) peop$e who ha%e no wa' o) de)ending themse$%es. #n 19>/, ninet',)i%e percent o) 8hi$ean mothers breast)ed their chi$dren be'ond the )irst 'ear. B' 19;9, on$' six percent did, and on$' twent' percent o) the babies were being nursed as $ong as two months. 3his dec$ine in breas))eeding ,, and simi$ar dec$ines across the wor$d ,, has been brought about b' doctors a$$owing sa$esmen )rom the )ormu$a manu)acturers to go into the maternit' wards and se$$ mothers on the 1modern1 wa' to )eed 'our bab'. 4) course, )ree samp$es are distributed. *octors care)u#$' ad%ise mothers that )ormu$a is as good or better than their own mi$k. No mother wants to be accused o) being o$d,)ashioned when her bab'(s hea$th is at stake, and especia$$' when the )ormu$a sa$esperson wears the same white coat that the doctor wears. &an' o) these new mothers ,, in )act most o) them ,, can(t a))ord the extra cash to pa' )or in)ant )ormu$as. 3he' a$so ma' not ha%e )aci$ities )or preparing the )ormu$a correct$'. Nest$e(s bab' book sa's, 1Wash 'our hands thorough$' with soap each time 'ou ha%e to prepare a mea$ )or bab'.1 9ormu$a a$so has to !1:5" be mixed with c$ean water. Now in the Cnited +tates or Europe, where e%er' househo$d has three or )our sinks connected to a reasonab$' c$ean water supp$', these directions present no prob$em. But in the underde%e$oped countries where )ormu$as are most aggressi%e$' marketed, it(s a di))erent stor'. #n one in%estigation in 8hi$e, eight' percent o) the bott$es examined bad high bacteria$ contamination. #n &a$awi(s capita$ cit', sixt',six percent o) the househo$ds ha%e no washing )aci$ities at a$$. 9urthermore, b' the time the )ree samp$e runs out, the mother(s breasts are dr' and her pocketbook empt'. +he can(t bu' more )ormu$a so she ma' end up )eeding her in)ant worse )ood. When we brag that our in)ant morta$it' rate is among the best in the wor$d Gwhich, )or a$$ our bragging, it isn(tH, we shou$d stop and think about the ro$e &odern &edicine p$a's in keeping in)ant morta$it' rates in underde%e$oped countries arti)icia$$' high. &odern &edicine attacks the )ami$' )or the simp$e reason that i) 'ou want to con%ert someone to a di))erent re$igion, 'ou )irst go a)ter his )ami$' ties. *on(t $isten to 'our mother or 'our grandmother. 3hose are o$d wi%es ta$es. Bisten to us. We are taught not to depend on an'one but the pro)essiona$s ,, the doctors. With the )ami$' in)$uence gone, what # ca$$ the %ertica$ transmission o) %a$ues )rom one generation to the next is gone, too. 0$$ 'ou(re $e)t with is hori<onta$ transmission o) %a$ues through the in)$uence o) peers and other contemporar' sources o) in)ormation such as !1:7" research studies, news media, and the entertainment,ad%ertising industr'. 0nd doctors. Iea$th maintenance organi<ations GI&4sH are a good examp$e o) the kind o) medica$ institution that thri%es on the breakdown o) the )ami$'. #n an I&4, peop$e pa' a set )ee e%er' month and ha%e %irtua$$' un$imited use o) the 8hurch(s 1hea$th maintaining1 )aci$ities. Besides the )act that those )aci$ities( abi$it' to maintain hea$th is most doubt)u$, the )act is that the )ami$' itse$) is the best hea$th maintenance organi<ation there is= Where do I&4s )$ourish- Where )ami$ies ha%e $itt$e in)$uence. 0sk Ienr' Faiser, who set up his Faiser,Jermanente I&4 in 8a$i)ornia, where there are no )ami$ies because e%er'bod'(s mo%ed there )rom somewhere e$se. #) 'ou want to set up an I&4 e$sewhere in the countr', 'ou(%e got to go to a uni%ersit' where, again, peop$e ha%e no )ami$ies because the students and, the )acu$t', are a$$ )rom e$sewhere. 4r 'ou set one up in a s$um
neighborhood, where )ami$' stabi$it' and troub$e setting up an I&4 in an area where )ami$' ties are strong. Not on$' do )ami$' members )ind the best doctors and stick to them, but )ami$ies tend to keep their members hea$thier without the bene)it o) a gagg$e o) pro)essiona$s, thank 'ou. 4) course, &odern &edicine is out to destro' the )ami$' )or precise$' that reason. +trong )ami$ies ob%iate the need )or doctors and other 1he$ping1 pro)essiona$s. #t(s no accident !1:>" that prostitution is ca$$ed the o$dest pro)ession rather than the o$dest business. Cn$ike business transactions, which are characteri<ed b' an exchange o) commodities, pro)essiona$s gi%e themse$%es in the per)ormance o) a ser%ice in return )or a )ee. &ore o)ten than not, that ser%ice is one which idea$$' wou$d be per)ormed b' a )ami$' member, )riend, or b' the person himse$). 3he prostitute rep$aces the wi)e, as, the doctor rep$aces the entire conste$$ation o) the )ami$'. 3he weaker the )ami$' the greater the opportunit' )or pro)essiona$s. 0 hea$th' societ' is characteri<ed b' strong, positi%e )ami$' re$ationships and subse.uent minima$ need )or doctors. &odern &edicine(s Io$' War on the )ami$' is a batt$e )or sur%i%a$ against a competing s'stem o) hea$th and hea$ing. 0s $ong as the enem' is an'thing that can bui$d, maintain, or restore hea$th, the casua$t' wi$$ be the indi%idua$ we$)are o) e%er' de)ense$ess person who goes to a doctor. 3o protect 'our )ami$' against the attacks o) doctors and other 1he$ping1 pro)essiona$s, 'ou )irst shou$d recogni<e that experts se$dom ha%e a better idea o) what(s 1right1 than 'ou do. 3his becomes .uite p$ain when 'ou $ook at what the experts were c$aiming was gospe$ truth in the past. 9or examp$e, the standard pediatrics texts during the ear$' 19/ s ad%ised: 13he practice o) p$a'ing with in)ants and exciting them b' sights, sounds, and motions unti$ the' shriek with apparent de$ight is o)ten harm)u$ and shou$d be condemned. Ne%er hug and kiss them. Ne%er $et them sit on 'our $ap. !1:;" #) 'ou must, kiss them once on the )orehead when the' sa' goodnight. Babies under six months o$d shou$d ne%er be p$a'ed with. 0nd o) kissing, the $ess the better. Eocking is )orbidden. +o are paci)iers. +hou$d the chi$d attempt to paci)' himse$) b' sucking his thumb, pasteboard sp$ints must be app$ied to his e$bows to pre%ent him )rom bending his arms. 0t night, his arms must be tied to his sides.1 4) course, we 1know1 now that this ad%ice was ridicu$ous. But # wonder how man' mothers went against their natura$ inc$inations to entertain and stimu$ate their babies and as a resu$t raised )ami$ies o) du$$ards. #) 'ou are thinking about starting a )ami$', 'ou can begin b' deciding )or 'ourse$) how man' chi$dren 'ou want to ha%e. *on(t accept the ad%ice o) <ero popu$ation growth ad%ocates, or an' other se$) proc$aimed expert on the idea$ si<e o) a )amii'. # know o) no e%idence that suggests that chi$dren )rom $arge )ami$ies are an' $ess success)u$ than chi$dren )rom sma$$ )ami$ies. 6ou shou$dn(t a$$ow po$itica$ considerations to determine the si<e o) 'our )ami$'. When 'ou do start 'our )ami$', )ind a doctor who is .ua$i)ied to de$i%er 'our bab' at home. Iome birth e$iminates a$$ the risks o) a hospita$ sta' and a$$ows 'ou to spend the time immediate$' )o$$owing 'our )ami$'(s addition en2o'ing 'ourse$) rather than de)ending 'ouse$) against the intrusions o) the hosptta$ sta)). #) 'ou )ind 'our obstetrician tr'ing to ta$k 'ou out o) home birth b' $isting dangers be)ore he(s examined !1::" 'ou, he(s ob%ious$' not .ua$i)ied. 0 .ua$i)ied home birth doctor or midwi)e wi$$ support 'our desire to ha%e 'our bab' at home and wi$$ care)u$$' examine 'ou to determine whether 'ou are sub2ect to an' specia$ risks that make home birth especia$$' dangerous. 9or the %ast ma2orit' o) )ami$ies, there is )ar $ess risk in a home birth, than in a hospita$ birth. #) 'ou are unab$e to )ind a doctor who wi$$ per)orm a home de$i%er' Gat the end o) the book # $ist
resources )or this searchH, 'ou shou$d go )or the next best thing, which is a hospita$ de$i%er' )o$$owed b' .uick exit )or home. Barring an' serious comp$ications, there is no reason wh' 'ou and 'our bab' can(t $ea%e the hospita$ as soon as 'ou )ee$ ab$e ,, which can be an' where )rom twent' minutes to a )ew hours. &' )a%orite stor' regarding a )ami$'(s reaction to a doctor hosti$e to home birth in%o$%es a )ormer student o) mine. When his wi)e to$d the obstetrician she wanted her husband present during the de$i%er', the doctor said he )e$t the de$i%er' o) a bab' was )ar too persona$ an e%ent )or a husband to be there. +he shot back that i) it was that persona$ she wasn(t so sure she wanted the doctor to be there either= 3he' did go ahead and ha%e their )irst bab' in the hospita$, but the' $e)t twent' minutes a)ter the bab' was born. 3heir subse.uent babies ha%e been de$i%ered at home, and the husband has become a specia$ist and a $eading authorit' on home birth. +ince &odern &edicine begins its assau$t on the )ami$' b' separating husband )rom wi)e !1:8" during the birth o) the bab', 'ou shou$d insist on a de$i%er' in which the husband is present. 4) course, he shou$d not mere$' suit up and stand around. Ie(s there to assist, support, and protect his wi)e and chi$d. 0t a$$ points a$ong the wa' 'ou shou$d $earn to identi)' and .uestion ru$es that separate )ami$ies. 0)ter the bab' is born, )or examp$e, the nurse wi$$ take him or her awa' un$ess 'ou make known be)ore, during, and a)ter the birth that 'ou want the bab' in 'our arms or 'our husband(s immediate$'. 6our bab' is 'ours, not the hospita$(s. Feep him or her c$ose to 'ou )or those important minutes a)ter birth. E%en i) the hospita$ promises rooming,in, 'ou shou$d be aware that hospita$s sometimes re%oke the pri%i$ege without warning. 0t one hospita$, rooming,in disappears e%er' 'ear when the hospita$(s regu$ar pediatric nurses $ea%e )or the summer= Next 'ou must protect 'ourse$) and 'our bab' against 'our doctor(s( pre2udice against breast)eeding. Iere, again, 'ou are going to ha%e to $earn to $ie to the doctor. When he sa's bott$e )eeding is 2ust as good as breast)eeding 'ou won(t get an'where b' arguing with him, and 'ou might make him especia$$' %indicti%e against 'our particu$ar e))ort. 3he best thing to do is to 2ust nod ambiguous$' and ignore him. 0n ac.uaintance o) mine was to$d b' her doctor that her bab' wasn(t gaining weight )ast enough. Ie ga%e her a )ree six pack o) )ormu$a and to$d her to supp$ement her breast)eeding with it. +he didn(t argue with him, but on her !1:9" wa' home the )ormu$a ended up in the )irst trash can she came across. &ore than twent' 'ears ago, when a 8hicago area woman named &arian 3ompson had her )irst bab', she cou$d )ind no one to go to )or ad%ice about breast)eeding. Ier doctor didn(t know the )irst thing about breast)eeding. +o she and six other women started a group ca$$ed Ba Beche Beague whose purpose is to teach mothers how to breast)eed their chi$dren. +ince its )ounding, Ba Beche Beague #nternationa$ has he$ped hundreds o) thousands o) women throughout the wor$d, not to mention the chi$dren o) these mothers. 9or support and encouragement in breast)eeding, 2oin Ba Beche Beague. 3here are a number o) 1$itt$e1 things that doctors te$$ women the' shou$d do with their babies which # be$ie%e are detrimenta$ to the )ami$'. 9irst the' te$$ them breast)eeding is 4F but that so$id )ood shou$d be gi%en a)ter six weeks. 3his is nonsense. 3here is no need to gi%e a bab' so$id )ood be)ore six months. 3he six,week ru$e resu$ts in a dai$' s$apstick routine, in which the mother tries to 2am, ram, or cram something, an'thing, that )aint$' resemb$es 1so$id1 )ood into the bab'. 3here is no better )ood )or the bab' than mother(s mi$k. *on(t be a)raid to pick up 'our bab' when it cries. #) he or she didn(t need 'ou, he wou$dn(t be
cr'ing. 3he idea that a bab' shou$d be 1trained1 not to cr' )or its parents b' ignoring it is patent$' absurd, and it ignores instinct. #) the bab' wakes up during the night perhaps it !18 " needs the extra securit' that s$eeping in the same room ,, or e%en the same bed ,, as mom and dad wou$d gi%e. 3he ru$e that chi$dren and parents must s$eep in separate rooms is one o) those ru$es that separate )ami$ies )or a$$ the wrong reasons. # don(t know man' adu$ts who are rea$$' com)ortab$e s$eeping a$one. Iow can 'ou expect an in)ant who has known the warmth and intimac' o) its mother(s bod' to ad2ust to the co$d, empt' dark o) 1its own room.1 When 'ou do start to )eed 'our bab' so$id )ood, ignore the propaganda o) the bab' )ood manu)acturers ,, who ne%er seem to run out o) uni%ersit' research centers that wi$$ run a stud' pro%ing that home,prepared )ood is $ess hea$th' than the processed stu)) the' put in 2ars. #) the )ood 'ou eat at home is tru$' $ess hea$th' than bab' )ood in 2ars, 'our who$e )ami$' is in troub$e. 9eed 'our bab' what 'ou eat. 8hop it, grind it, puree it, or b$end it. Be care)u$ to introduce on$' one new )ood at a time, howe%er, so as to catch an' de%e$oping a$$ergic reactions as soon as the' begin. 3r' to make mea$times a shared experience. 3his means getting the who$e )ami$' at the tab$e at once. When )ami$' members are together )or a nice mea$, the' are automatica$$' encouraged to ta$k and share themse$%es with one another. +ta' as c$ose to re$ati%es as 'ou can. 3r' especia$$' to keep e$der$' re$ati%es c$ose b', because the' need 'ou and 'ou need them. #n%ite re$ati%es to bab'sit. 3he more re$ati%es a !181" chi$d is c$ose to and com)ortab$e with, the better. 0%oid separation whene%er possib$e. &others and )athers shou$d insist on sta'ing with their chi$dren in the hospita$. 0$so, consider a$ternati%es to da',care. 0 2ob at home, when a$$ )actors are considered, ma' be more )u$$)i$$ing than work outside the home. #) a )u$$,time or part,time 2ob outside the home is necessar' tr' to set up an arrangement with re$ati%es or with neighbors. 6ou might be ab$e to start up a cooperati%e nurser' schoo$ among 'our neighbors. 0 home,t'pe en%ironment is superior to the institutiona$ setting o) the da',care center. #) 'our 2ob or schoo$ keeps 'ou and 'our chi$dren separated during the da', don(t participate in organi<ations that meet in the e%ening when 'ou shou$d be spending time with 'our )ami$'. +pend ho$ida's with re$ati%es, )riends, and neighbors. Js'chiatrists a$most ne%er take %acations around 8hristmas, because the season is marked b' great depression and a heightened suicide rate among their patients. Io$ida's were made )or peop$e to get together and ce$ebrate and renew the bonds that ha%e supported them throughout their $i%es. Jeop$e who ha%e a$$owed the war against the )ami$' to keep them apart )rom their )ami$' are natura$ %ictims o) )rustrated $egitimate needs. Kisit 'our co$$ege,age chi$dren who are awa' )rom home. Encourage them to come home when their schedu$e permits and sometimes when it doesn(t. &ake sure the' know !18/" that 'ou(re there when the' need 'ou, because the' wi$$ need 'ou. 8o$$eges are becoming increasing$' competiti%e, $one$' p$aces. 0$$ a$ong the wa' 'ou ha%e to $earn to dea$ with pro)essiona$s. +ometimes this means. 'ou ha%e to be practica$ rather than pure. 9or examp$e, assume that 'our doctor wi$$ bu$$' 'ou i) 'ou $et him, especia$$' i) 'ou are a woman. Now this is certain$' not the wa' things shou$d be. But as $ong as things are that wa', # ad%ise peop$e, especia$$' women, to go to the doctor in pairs. Wi%es shou$d go with their husbands, since a doctor wi$$ pa' more attention to a woman(s prob$em i) the husband is a$ong. +ure, doctors shou$dn(t treat women as second,c$ass humansD but the' do and 'ou shou$dn(t sacri)ice 'our hea$th )or an abstract princip$e. We need success)u$ heretics, not mart'rs. 0 more humorous ,, and $ess po$itica$$' charged ,, situation where 'ou ha%e to be more practica$
than pure is when 'our chi$d goes o)) to nurser' schoo$. # remember a mother phoning me at 11: one night to te$$ me she had an emergenc'. When # asked her the nature o) the emergenc', she said her three,'ear,o$d bo' wasn(t toi$et trained 'et and cou$dn(t enter nurser' schoo$ unti$ he was. When # asked her wh' this was an emergenc', she to$d me she $i%ed on the eighteenth )$oor o) a high,rise apartment and was going to 2ump out the window i) # cou$dn(t gi%e her an' ad%ice. # ageed it was an emergenc'. # ha%e $ong ad%ised mothers to send their !185" non,toi$et trained chi$dren to nurser' schoo$ a)ter $'ing to the schoo$ and sa'ing the chi$d is trained. &an' chi$dren do, .uite m'sterious$', become toi$et trained on the )irst da' o) schoo$. #n the case o) the others, the teacher usua$$' ca$$s the mother a)ter a week o) )rustration and sa's, 1# thought 'ou to$d me the chi$d was toi$et trained=1 3he mother(s rep$' shou$d be: 1What ha%e 'ou done to m' chiid-1 +ometimes in dea$ing with doctors, nurses, and other pro)essiona$s, 'ou ha%e to be down, right indomitab$e. 4r immo%ab$e, as the case ma' be when a nurse tries to remo%e 'ou )rom the bedside o) a hospita$i<ed re$ati%e. 9irst o) a$$, termina$$' i$$ re$ati%es shou$d be a$$owed to die at home. Iospita$s don(t own peop$e at either end o) $i)e. #) a re$ati%e is in the intensi%e care unit 'ou ha%e to buck the ten minute ru$e to remain with him or her. 6our )irst mo%e shou$d be simp$' to stand sti$$. *on(t en)orce the hospita$(s ru$es )or them. When the nurse asks 'ou to $ea%e, ask wh'. #) she sa's 'our presence is too much o) a strain on the patient, te$$ her that 'ou are a better 2udge o) whether 'our re$ati%e is strained b' 'our presence. 3hen cha$$enge the nurse to produce e%idence. +he ma' then retreat to a new position: the ru$es sa' 'ou ha%e to $ea%e. 0sk )or a cop' o) the ru$es in writing. Ier next mo%e wi$$ be to summon the doctor. 0sk him the same .uestions. Iow do 'ou know m' presence here causes a strain on m' re$ati%e- Iow do 'ou !187" know that the presence o) hospita$ sta)) is automatica$$' good and the presence o) )ami$' members automatica$$' bad )or the patientWhi$e 'ou(re protecting 'our )ami$' against &odern &edicine(s Io$' War, recogni<e that besides being protected, the )ami$' shou$d be used as a hea$th resource. 0t times o) crisis, seek out the ad%ice and support o) )ami$' and )riends. When other members o) the )ami$' need he$p and support, be there. Because i) not, 'ou can be sure that the doctor wi$$, soon enough.
Chapter ( Doctor Death

!18>" &odern &edicine is an ido$atrous re$igion, )or what it ho$ds sacred are not $i%ing things, but mechanica$ processes. #t doesn(t boast o) sa%ing sou$s or $i%es but o) how man' times this or that new machine was used and how much mone' was taken in b' the process. What resides at the core o) e%er' re$igion, the core )rom which hope radiates when a$$ human attempts to dea$ with earth$' conditions )ai$, is the *eit', the 4ne Who 3ranscends it a$$. 3o get to the core o) &odern &edicine 'ou ha%e to wade through an ocean o) man,made drugs and )ight 'our wa' through end$ess tons o) machiner'. #) 'ou then don(t understand wh' the 8hurch is sa%age$' ido$atrous and must be destro'ed, 'ou wi$$ when 'ou stare its *eit' in the )ace. !18;" 3he @od o) &odern &edicine is *eath. #n )act, a new word was recent$' coined b' *r. Luentin 6oung to describe one acti%it' o) &odern &edicine: iatrogenocide. #atrogenocide Giatros is the greek )or doctorH is the s'stematic destruction o) a $arge group o) peop$e b' doctors, 0n examp$e o) iatrogenocide is the in)ant sacri)ices in de%e$oping countries, which # described in the preceeding chapter. 3his widespead marketing o)
in)ant )ormu$a among peop$e who can(t a))ord it or imp$ement it sa)e$' amounts to a doctors( crusade against unsuspecting, de)ense$ess in)ide$s. Iow tru$' dead$' the 8hurch is comes into stark re$ie) whene%er there(s a doctors( strike. #n 19: in Bogota, 8o$ombia, there was a )i)t',two da' period in which doctors disappeared a$together except )or emergenc' care. 3he 1Nationa$ 8atho$ic Eeporter1 described a 1string o) unusua$ side e))ects1 )rom the strike. 3he death rate went down thirt',)i%e percent. 0 spokesman )or the Nationa$ &orticians( 0ssociation said 1#t might be a coincidence but it is a )act.1 0n eighteen percent drop in the death rate occurred in Bos 0nge$es count' in 19:; when doctors there went on strike to protest soaring ma$practice insurance premiums. *r. &i$ton Eoemer, Jro)essor o) Iea$th 8are 0dministration at C8B0, sur%e'ed se%enteen ma2or hospita$s and )ound that sixt' percent )ewer operations were per)ormed. When the strike ended and the medica$ machines started grinding again, the death rate went right back up to where it had been be)ore the strike. !18:" 3he same thing happened in #srae$ in 19:5 when the doctors reduced their dai$' patient contact )rom ;>, to :, . 3he strike $asted a month. 0ccording to the Aerusa$em Buria$ +ociet', the #srae$i death rate dropped )i)t' percent during that month. 3here had not been such a pro)ound decrease in morta$it' since the $ast doctors( strike twent' 'ears be)ore= When the doctors were asked to exp$ain this phenomenon, the' said that since the' on$' attended emergenc' cases, the' cou$d in%est their best energies into the care o) the tru$' i$$ peop$e. When the' didn(t ha%e to $isten to the da',to,da', presumab$' unimportant comp$aints o) the a%erage patients, the' cou$d de%ote themse$%es to a greater sa%ing o) $i)e. 3hat(s not such a bad answer. #(%e been sa'ing right a$ong that what we need is a perpetua$ doctors( strike. #) doctors reduced their in%o$%ement with peop$e b' ninet' percent and attended on$' emergencies, there(s no doubt in m' mind that we(d be better o)). We 2ust can(t get awa' )rom the )act that a disturbing amount o) doctors( energies are de%oted to death,oriented acti%ities. # te$$ m' students that to succeed in &odern &edicine a$$ 'ou ha%e to do is $ook )or some )ie$d that encourages death or thinking about death and 'ou(%e got a bri$$iant )uture ahead o) 'ou. 0s )ar as &odern &edicine is concerned, death is a growth industr'. 6ou can(t pick up a medica$ 2ourna$ without reading the $atest on: con, traception, abortion, steri$i<ation, genetic counse$ing and screening, amniocentesis, <ero !188" popu$ation growth, 1death with dignit',1 1.ua$it' o) $i)e,1 and euthanasia. 0$$ o) these acti%ities ha%e as their purpose the pre%ention o) termination o) $i)e. 3hings such as mass genetic screening and compu$sor' amniocentesis with the option o) abortion are now mere$' at the ta$king stage, but ta$k is a pre$ude to action. #n our rush to embrace these acti%ities ,, with enthusiasm # can describe on$' as re$igious )er%or ,, we are duped into both ignoring their dehumani<ing e))ects and their $ack o) scienti)ic 2usti)ication. 3he' are sacraments, a)ter a$$. +acraments o) death. 9or examp$e, thanks to &odern &edicine(s sanction, what were once ca$$ed sins are no $onger sins at a$$. 3hus, homosexua$it' is now ca$$ed an 1a$ternati%e $i)est'$e.1 3his and other )orms o) non, procreati%e sexua$ acti%it' are encouraged, promoted, indeed g$ori)ied. #n m' $i)etime #(%e seen societ'(s attitudes towards masturbation, )or examp$e, go through three distinct phases. When # was 'oung masturbation was sin)u$ and dangerous. #t either made 'ou b$ind or grew hair on 'our pa$ms. 4) course, scientists didn(t e%en tr' to determine whether or not this was true. Bater, when # was in co$$ege, masturbation was neutra$, it was neither harm)u$ nor good. Now, howe%er, we(re in the third phase o) masturbation. Not on$' is masturbation 4F, but it(s norma$, hea$th', and good. #) 'ou don(t do it, there(s something wrong with 'ou. 0nd i) 'ou don(t know how to do it, there are peop$e
who wi$$ teach 'ou ,, especia$$' i) 'ou(re a woman. !189" # exp$ain this radica$ shi)t in attitude within the space o) a generation b' re$ating it to societ'(s attitude towards popu$ation. When ha%ing chi$dren was good, masturbation was $ess than good. When the tide turned and ha%ing chi$dren became bad, masturbation, homosexua$it' ,, and an'thing e$se that he$ped us not to ha%e more chi$dren became good= We are programmed )or $i)e %er' deep$' in our natures. 4ur strongest urges are procreati%e and $i)e, supporting, but these are the instincts and acti%ities that &odern &edicine attacks. 3hus, dangerous )orms o) birth contro$ ,, abortion on demand, masturbation, and homosexua$it', a$$ non,procreating )orms o) sexua$ acti%it' ,, resu$t in diminution o) popu$ation growth. 3hese 1a$ternati%e $i)est'$es1 which do not promote $i)e are acceptab$e, but things peop$e ha%e been doing )or thousands o) 'ears to promote $i)e are not. 3he on$' 1a$ternati%e $i)est'$e1 that is not acceptab$e is an' one which prec$udes participation in the 8hurch. #t(s a sin i) 'ou ha%e 'our bab' at home, but not a sin i) 'ou ha%e an abortion. #t(s a sin i) 'ou honor a )oreign god b' going to a chiropractor, but it(s not a sin i) 'ou go to one o) the shrines o) &odern &edicine )or a sex change. 0n' bio$ogica$ stress these acti%ities ma' ha%e on the bod' and sou$ are ignored. What is wrong here is that the 8hurch exaggerates its encouragement o) non,$i)e acti%ities whi$e it exaggerates its contempt )or $i)e. 3he common sense, more human appoach is !19 " tramp$ed. &odern &edicine, )or examp$e, sa's that an' woman shou$d ha%e the right to an abortion. Whether or not this is po$itica$$' bene)icia$, it(s important to recogni<e that bio$ogica$$' there ma' be more to it than simp$e )reedom o) choice. +ome traditiona$ ethica$ s'stems, such as Aewish $aw, mandate abortions when the $i)e o) the mother is at stake. 0 2udgment is made that the $i)e o) the mother is more important than the $i)e o) the in)ant. But in the wa' &odern &edicine encourages abortion, it doesn(t consider $i)e at a$$, either the mother(s or the in)ant(s ,, its main interest is its own techno$og'. 4ne o) the sacred catastrophes o) the past twent' 'ears is the 8hurch(s promotion o) birth contro$ at a$$ costs. Iere the di))erence between a mora$ sin and a bio$ogica$ 1sin1 is most c$ear. Birth contro$, per se, is not mora$$' wrong. 8ertain methods o) birth contro$, howe%er, are bio$ogica$$' wrong in that their e))ects on the $i)e o) the user are negati%e. +hort o) re)using to dea$ with harm)u$ methods such as the Ji$$ and the #C*, i) doctors acknow$edged to e%er' woman the rea$ dangers in%o$%ed and a$$owed e%er' woman to make an in)ormed choice, there wou$d be $itt$e prob$em. But doctors ne%er a$$ow a patient to choose or not choose a procedure based on a ba$ancing o) the bio$ogica$ risk with how much a woman wishes to endanger her $i)e. 3he' simp$' ignore bio$og'D the' ignore the )act that a part$cu$ar procedure ma' do more harm than good. +o pro)ound is their de%otion to this ignorance, the !191" on$' exp$anation is that the deep purpose o) &odern &edicine is being $o'a$$' ser%ed through it. When # was a medica$ student in the $ate 197 s and ear$' 19> s, # thought medicine was concerned a$most exc$usi%e$' with sa%ing and pro$onging $i)e. # hard$' remember an' serious discussion about what is now re)erred to as 1the .ua$it' o) d'ing.1 # $earned to treat death b' den'ing it, b' maintaining hope. *enia$ is supposed to be a bad word nowada's, despite the )act that a number o) research studies show that patients with cancer and other serious diseases seem to $i%e $onger when the' den' and )ight their disease than when the' 1accept1 it. #n the British &edica$ Aourna$ GNo%emder //, 19:>H there appeared this tidbit: 1E%idence )rom research certain$' supports the %iew that ps'cho$ogica$ )actors can p$a' a part in determining the $ength o) sur%i%a$. Weisman and
Wordan recent$' compared patients with cancer who sur%i%ed )or $onger than sur%i%a$ statistics wou$d suggest with others whose death occured sooner than predicted. 3he' )ound that moti%ation to sur%i%e, as expressed in (rising resentment( as the i$$ness progressed and a positi%e attitude to treatment, was associated with $onger sur%i%a$. 8on%erse$', patients who expressed a wish to die or a read' acceptance o) death died sooner than expected. +imi$ar$', se%era$ studies suggest that patients with coronar' thrombosis who are prone to depression or become depressed a)ter an in)arction are $ess $ike$' to sur%i%e than those who are not me$ancho$ic. !19/" 0$$ in a$$ it seems that attitudes o) determination and hope pro$ong $i)e, whereas acceptance o) death or attitudes o) g$oom and despondenc' shorten it.1 # was recent$' at a medica$ meeting at which a doctor who treats cancer patients with chemotherapeutic agents admitted that as interested as he was in sa%ing $i%es and in disco%ering new methods o) treatment, he was e%en more interested in making sure his patients( deaths occurred with a certain degree o) 1acceptance and peace.1 Ie and his sta)) spend a ma2or part o) their time and resources counse$ing d'ing patients, pre)erab$' in the absence o) their )ami$ies. #t(s no m'ster' to me wh' these +a$esmen o) *eath insist on 1counse$ing1 patients in the absence o) the patient(s )ami$', the )ami$'(s who$e purpose, and there)ore its in)$uence, is )or $i)e, not death. 3his doctor ,, and man' $ike him who make a stud' o) death ,, operate under the assumption that a person shou$d accept death. #n e))ect, the' 1treat1 the patient to death, since the' can(t treat him or her to $i)e. 3he' assert that den'ing death is in some wa' menta$$' unhea$th'. 3hanato$ogists c$aim that i) 'ou don(t ta$k about death, )ace it, and resign 'ourse$) to it, 'ou($$ make 'ourse$) sick= 0s )ar as #(m concerned, thanato$ogists and e%er'one e$se who counse$ resignation to death ha%e it backwards. 0 doctor who te$$s a patient that there(s no hope )or his or her $i)e is not doing that patient an' good at a$$. 9irst o) a$$, the doctor is making an enormous assumption !195" in presuming his power is the on$' one that can restore the patient(s hea$th. 3e$$ing a patient he or she is going to die is tantamount to a curse. 3he patient be$ie%es it so it comes true. We are 2ust beginning to )ind out how the mind can a))ect the bod'(s own hea$ing powers. 4) course, doctors wi$$ be the $ast to acknow$edge that the bod' has signi)icant power to hea$ itse$). But 'ou can see how deser%ing optimism shou$d be the )irst priorit'. Eather than pronouncing the patient(s doom, the doctor shou$d he$p the patient p$an his or her )uture. #t(s one thing to in)orm a patient that he or she su))ers )rom a dead$' disease and that the magic o) the doctor doesn(t go )ar enough to do an' good. But it(s another thing entire$' to te$$ a patient that the end is ine%itab$e. 4) course i) the doctor were to admit that he had no power o%er the patient(s a))iction but that other powers ,, such as those o) other hea$ers o) the patient(s own ,, ma', he wou$d $ose his contro$ o%er the patient. 9urthermore, since &odern &edicine(s rites are not on$' growing $ess and $ess success)u$ but a$so more and more dead$', it makes good business sense to prepare the patient )or the ine%itab$e resu$ts o) the doctor(s work. 4nce death is accepted as 12ust another part o) $i)e,1 it can be gi%en its proper p$ace on the hospita$ menu. &odern &edicine is now better geared )or ki$$ing peop$e than it is )or hea$ing them. 6ou see this best at both ends o) $i)e, where $i)e is more de$icate and death is c$oser and easier to ascribe to 1natura$ causes.1 #t(s becoming increasing$' !197" dangerous, )or instanceD )or a &ongo$oid newborn with an intestina$ obstruction to reside in a nurser'. 3hough the obstruction is surgica$$' correctab$e, there is an increasing $ike$ihood that he wi$$ be depri%ed o) care and a$$owed to die. 3he same goes )or retarded chi$dren in state hospita$s who are un)ortunate enough to )a$$ serious$' i$$.
0t the other end o) $i)e, 1undesirab$es1 are a$$owed or e%en encouraged to die. 4$d peop$e in nursing homes, despite the )$ower' ad%ertisements accompan'ing these p$aces, are put there to keep them out o) 1rea$1 peop$e(s wa'. 3he'(re put there to die, and the' genera$$' take the hint. #t doesn(t take much to recogni<e a curse when it(s directed at 'ou. *octors actua$$' encourage o$d peop$e to get out o) the wa' and die. 3heir attitudes towards o$d peop$e and their prob$ems amount to a sentence o) $ong, s$ow death. +uch phrases as 16ou($$ 2ust ha%e to $earn to $i%e with it,1 and 1What do 'ou expect at 'our age-1 te$$ the o$d person that his or her prob$ems are to be expected. 8onse.uent$', o$d peop$e expect them. 0nd get them. Because the doctor doesn(t admit that the prob$ems usua$$' associated with o$d age are not ine%itab$e at a$$ and that the' can be pre%ented or dea$t with natura$$', the patient is wide open )or the who$e arra' o) pa$$iati%e ,, and dead$' ,, drugs. #n cu$tures not 'et under the death swoon o) &odern &edicine, peop$e $i%e to ad%anced age in )u$$ possession o) their capacities. But &odern &edicine !19>" renders o$d peop$e incapab$e, and rather than pro$onging their $i%es, it 2ust makes d'ing $onger and harder. #(%e a$wa's be$ie%ed that i) 'ou want to )ind out what a societ'(s rea$$' a$$ about, $ook at its mottoes and what it c$aims to prohibit. Book on a coin and 'ou($$ see 1#n @od We 3rust.1 Now i) there(s a societ' that trusts $ess in @od than the Cnited +tates, # ha%en(t heard o) it. 3he motto o) the medica$ pro)ession has a$wa's been 19irst *o No Iarm.1 0s we(%e a$read' seen, that motto is respected more in the breach than an'where e$se, but it ser%es a %er' use)u$ purpose. 3he medica$ pro)ession can hide a $ot o) atrocities under the guise o) doing no harm. 3he )irst thing to change when one cu$tura$ )orce o%ercomes another and takes o%er a societ' is $anguage. When 'ou contro$ a peop$e(s wa' o) describing things, 'ou contro$ their wa' o) dea$ing with them. We ha%e a popu$ation 1exp$osion,1 which makes a $ot o) babies sound ominous and harm)u$. We ha%e pregnanc' 1p$anning1 or pregnanc' 1termination1 to make abortion sound c$inica$$' detached )rom $i)e and death. We sa' 1euthanasia1 instead o) 1merc' ki$$ing,1 which somehow was too accurate a description e%en with the nice ad2ecti%e. 3he most outrageous attempt to hide rea$it' b' changing %ocabu$ar' is the term 1death with dignit'.1 Now, death is a$$ right under an' circumstances as $ong as it(s with 1dignit'.1 3he )unn' thing is that in the !19;" situations in which this term is most o)ten emp$o'ed, the act o) 1pu$$ing the p$ug1 remo%es a$$ possibi$it' o) dignit' )rom the e%ent. 3o me, a$$ these death,oriented acti%ities are )rightening$' reminiscent o) the Na<is. 3he medica$ pro)ession in @erman' dri)ted into these same acti%ities prior to Wor$d War ##. @erman doctors wi$$ing$' got rid o) 1use$ess peop$e1 such as se%ere$' retarded and de)ormed chi$dren. Bibera$i<ed abortion and euthanasia were )o$$owed b' the 1death with dignit'1 o) o$d peop$e ,, meaning the' were a$$owed and encouraged to die. Bater came the murder o) g'psiesD then the rounding up o) anti,Na<is and Aews. 3he Na<is were )ighting a Io$' War, too. 0s &odern &edicine(s War on Bi)e intensi)ies, hospita$s are rapid$' becoming unab$e to hand$e the o%er$oad. +o we ha%e to bui$d 1death centers1 ca$$ed ,, again, using a %er' com)ortab$e sounding word to hide the rea$it' hospices. *eath counse$ors are a$so mo%ing into hospita$s, which #(%e a$read' identi)ied as 3emp$es o) *oom, to prepare patients )or the institution(s ma2or product. 4) course, this is nothing i) not good marketing strateg'. What 'ou ha%e to do to se$$ an'thing is create a desire and an acceptance o) 'our product. +ince the product o) &odern &edicine is death, we are 1so)tened1 to the idea o) non,$i)e )irst. 4nce we are a$ienated )rom our own instincts )or $i)e,
accepting dehumani<ing, dangerous procedures is easier. 9ina$$', with on$' a purgator' !19:" o) drug,induced semi,$i)e to $ook )orward to, we we$come the sa$esman o) death when the' come to counse$ us out o) this wor$d. When that moment comes, the )u$$ attention o) the 8hurch is directed at 'our participation in the 8entra$ &'ster'. Bike the 8atho$ic &ass, which ce$ebrates the Eesurrection, 'our death in the intensi%e care unit is the supreme sacrament. +o sacred are the pre$iminar' ceremonies that 'ou are separated )rom 'our )ami$', 2ust as #(m sure sacri)icia$ %ictims o) ear$ier re$igions were kept apart )rom re$ati%es who might inter)ere with the machinations o) the priests. #nstead o) ho$ding the hand o) a )ami$' member, 'ou(re connected to the )inest and most ad%anced e$ectronic gadgetr'. 0t $ast, deep within the 3emp$e(s Io$' o) Io$ies, 'ou )u$)i$$ the Jromise and commune with the @od o) &odern &edicine. When a new re$igion wants to discredit an o$d re$igion, it does so b' b$aming the prob$ems o) the peop$e on the o$d gods. &odern &edicine sa's 'our disease is caused b' a %irus. Who created the %irus- 3he o$d @od. 0nd so on. #t(s not 'ou or we who are causing 'our disease, it(s natura$ things such as %iruses and bacteria and the tendenc' o) ce$$s to di%ide irregu$ar$' and heredit' and .... 3he o$d @od is responsib$e ,, the @od o) Bi)e. &odern &edicine can )ree 'ou )rom the bonds o) the o$d @od. &odern &edicine can gi%e 'ou a new @od that can counterract a$$ the pesk' )orms o) $i)e that get in the wa', such !198" as bacteria, %iruses, ce$$s di%iding out o) contro$, incon%enient )etuses, de)ormed or retarded chi$dren, and o$d peop$e. 9ortunate$', the same natura$ processes that &odern &edicine attacks appear to ha%e the weight o) histor' on their side. #) 'ou examine the ma2or re$igious groups that ha%e sur%i%ed the $ongest ,, the Aewish, 8hristian, &os$em and 4rienta$ re$igions ,, a$$ ha%e ethica$ s'stems which are not too di))erent. 3he' )a%or $arge )ami$ies and respect o) o$der generations b' 'ounger ,, within $imits, o) course. 0$$ 2udge a societ' b' its treatment o) margina$ groups such as premature babies, retarded chi$dren, and o$d peop$e. 3he' discourage non,procreati%e )orms o) sexua$ acti%it'. 4) course, there are di))erences among them, but not as )ormidab$e as their di))erences )rom re$igions that are death, oriented and which ha%en(t sur%i%ed. 0ncient @reek and Eoman re$igions )a%ored popu$ation contro$, abortion, in)anticide, ki$$ing o) o$d peop$e, homosexua$it' ard other non,procreati%e )orms o) sex ,, a$$ in the name o) .ua$it' o) $i)e. 6et .ua$it' o) $i)e is %er' simp$' a )unction o) .uantit' o) $i)e. 3he reason #(m interested in $ong $i)e is that # hope to ha%e man' grandchi$dren. 3he .ua$it' o) m' $i)e depends on how man' grandchi$dren # get to see grow up. # want to $i%e as $ong as # can. #) #(m tru$' a$i%e as $ong as #(m $i%ing, then the .ua$it' o) m' $i)e wi$$ take care o) itse$). # won(t need a gang o) pro)essiona$s around to counse$ me on the .ua$it' o) m' $i)e. !199" 4) course, the pro)essiona$s ,, $ed b' the doctors ,, are aggressi%e in their intrusion into the .ua$it' and .uantit' o) our $i%es. What we need to do is )ind doctors who are $i)e,oriented, doctors who share our regard )or $i)e and who use their inte$$igence and ski$$s to protect it. 3hat, un)ortunate$', ma' be the hardest 2ob o) a$$.
Chapter 7 $he De)il*s +riests

# a$wa's $augh when someone )rom the 0merican &edica$ 0ssociation or some other doctors(
organi<ation c$aims that doctors ha%e no specia$ powers o%er peop$e. 0)ter # )inish $aughing, # a$wa's ask how man' peop$e can te$$ 'ou to take o)) 'our c$othes and 'ou($$ do it. Because doctors are rea$$' the priests o) the 8hurch o) &odern &edicine, most peop$e don(t den' them their extra in)$uence o%er our $i%es. 0)ter a$$, most doctors are honest dedicated, inte$$igent, committed, hea$th', educated, and capab$e, aren(t the'- 3he doctor is the rock upon which &odern &edicine(s 8hurch is bui$t, isn(t heNot b' a $ong shot. *octors are on$' human ,, in the worst wa's. 6ou can(t assume 'our !/ /" doctor is an' o) the nice things $isted abo%e, because doctors turn out to be dishonest, corrupt, unethica$, sick, poor$' educated, and downright stupid more o)ten than the rest o) societ'. &' )a%orite examp$e o) how doctors can be $ess inte$$igent than the situation ca$$s )or is a matter o) pub$ic record. 0s part o) the hearings be)ore the +enate Iea$th +ubcommittee, +enator Edward Fenned' reca$$ed a skiing in2ur' to his shou$der, su))ered when he was a 'oung man. Iis )ather ca$$ed in )our specia$ists to examine the bo' and recommend treatment. 3hree recommended surger'. 3he ad%ice o) the )ourth doctor, who did not recommend surger', was )o$$owed, howe%er. Ie had 2ust as man' degrees as the others. 3he in2ur' hea$ed. +enator Fenned'(s co$$eagues then proceeded to .uestion *r. Bawrence Weed, Jro)essor o) &edicine at the Cni%ersit' o) Kermont and originator o) a high$' popu$ar patient record s'stem )or hospita$s. *r. Weed(s rep$' was that the 1senator(s shou$der probab$' wou$d ha%e hea$ed as satis)actori$' i) the (operation had been per)ormed.1 When doctors are )orma$$' tested, the resu$ts are $ess than encouraging. #n a recent test in%o$%ing the prescribing o) antibiotics, ha$) o) the doctors who %o$untari$' took the test scored sixt',eight percent or $ower. We(%e a$read' seen in the pre%ious chapters how dangerous it is to ha%e a doctor work on 'ou. 0$$ o) that danger doesn(t necessari$' deri%e )rom the inherent risks o) the treatment itse$). *octors !/ 5" simp$' botch some o) those procedures. When # meet a doctor, # genera$$' )igure #(m meeting a person who is narrow,minded, pre2udiced, and )air$' incapab$e o) reasoning and de$iberation. 9ew o) the doctors # meet pro%e m' prediction wrong. *octors can(t be counted on to be entire$' ethica$, either. 3he dean o) Iar%ard &edica$ +choo$, *r. Eobert I. Ebert, and the dean o) the 6a$e &edica$ +choo$, *r. Bewis 3homas, acted as paid consu$tants to the +.uibb 8orporation at the same time the' were tr'ing to persuade the 9ood and *rug 0dministration to $i)t the ban on &'stec$in, one o) +.uibb(s biggest mone'makers. *r. Ebert said that he 1ga%e the best ad%ice # cou$d. 3hese were honest opinions.1 But he a$so dec$ined to speci)' the amount o) the 1modest retainer1 +.uibb Kice,Jresident Norman E. Eitter admitted pa'ing both him and *r. 3homas. *r. Ebert $ater became a paid director o) the drug compan' and admitted to owning stock %a$ued at ?1>, . #n 19:/, *r. +arirue$ +. Epstein, then o) 8ase,Western Eeser%e Cni%ersit', one o) the wor$d(s authorities on chemica$ causes o) cancer and birth de)ects, to$d the +enate +e$ect 8ommittee on Nutrition and Iuman Needs that 1the Nationa$ 0cadem' o) +ciences is ridd$ed with con)ict o) interest.1 Ie reported that pane$s that decide on crucia$ issues such as sa)et' o) )ood additi%es )re.uent$' are dominated b' )riends or direct associates o) the interests that are supposed to be regu$ated. 1#n this countr' 'ou !/ 7" can bu' the data 'ou re.uire to support 'our case,(he said. 9raud in scienti))c research is commonp$ace enough to keep it o)) the )ront pages. 3he 9ood and *rug 0dministration has unco%ered such niceties as o%erdosing and underdosing o) patients, )abrication o) records, and drug dumping when the' in%estigate experimenta$ drug tria$s. 4) course, in these instances, doctors working )or drug companies ha%e as their goa$ producing resu$ts that
wi$$ con%ince the 9*0 to appro%e the dnrg. +ometimes, with competition )or grant mone' getting more and more )ierce, doctors simp$' want to produce resu$ts that wi$$ keep the )unding $ines open. +ince a$$ the 1good o$( bo'1 researchers are in the same boat, there seems to be a geat to$erance )or s$opp' experiments, uncon)irmab$e resu$ts, and care$essness in interpreting resu$ts. *r. Ernest Borek, a Cni%ersit' o) 8o$orado microbio$ogist, said that 1increasing amounts o) )aked data or, $ess )$agrant$', data with bod' Eng$ish put on them, make their wa' into scienti)ic 2ourna$s.1 Nobe$ Jri<e winner +a$%adore E. Buria, a bio$ogist at the &assachussetts #nstitute o) 3echno$og', said 1# know o) at $east two cases in which high$' respected scientists had to retract )indings reported )rom their $aboratories, because the' disco%ered that these )indings had been manu)actured b' one o) their co$$aborators.1 0nother now c$assic examp$e o) )raud occurred in the +$oane,Fettering #nsitute where in%estigator *r. Wi$$iam +ummer$in admitted !/ >" painting mice to make them $ook as though success)u$ skin gra)ts had been done. 0 predecessor to *r. +ummer$in was Jau$ Fammerer, the 0ustrian geneticist, who ear$' in the twentieth centur' was accused o) in2ecting india ink into the )oot o) a toad in order to pro%e the Bamarchian theor' o) transmission o) ac.uired traits. Fammerer shot himse$), but the who$e stor' imp$icating others appears in 0uthur Foest$er(s book, 3he 8ase o) the &idwi)e 3oad. *r. Eichard W. Eoberts, director o) the Nationa$ Bureau o) +tandards, said that 1ha$) or more o) the numerica$ data pub$ished b' scientists in their 2ourna$ artic$es is unusab$e because there is no e%idence that the researcher accurate$' measured what he thought he was measuring or no e%idence that possib$e sources o) error were e$iminated or accounted )or.1 +ince it is a$most impossib$e )or the a%erage reader o) scienti)ic 2ourna$s to determine which ha$) o) the artic$e is usab$e and which is not, 'ou ha%e to wonder whether the medica$ 2ourna$s ser%e as a%enues o) communication or con)usion. 4ne method o) 2udging the %a$idit' o) a scienti)ic artic$e is to examine the )ootnote )or the source o) )unding. *rug companies( records regarding integrit' o) research are not spark$ing enough to warrant much trust. *octors ha%e been shown not to be abo%e )udging and e%en )abricating. research resu$ts when the stakes were high enough. *r. Bero' Wo$ins, a ps'cho$ogist at #owa +tate Cni%ersit', had a student write to thirt',se%en authors o) scienti)ic !/ ;" reports asking )or the raw data on which the' based their conc$usions. 4) the thirt',two who rep$ied, twent',one said their data either had been $ost or accidenta$$' destro'ed. *r. Wo$ins ana$'<ed se%en sets o) data that did come in and )ound errors in three signi)icant enough to in%a$idate what had been passed o)) as scienti)ic )act. 4) course, research )raud is nothing new. 8'ri$ Burt, the $ate British ps'cho$ogist who became )amous )or his c$aims that most human inte$$igence is determined b' heredit', was exposed as a )raud b' Beon Famin, a Jrinceton ps'cho$ogist. #t seems that the 1coworkers1 responsib$e )or Burt(s research )indings cou$d not be )ound to ha%e actua$$' existed= 3here is e%en e%idence that @regor &ende$, )ather o) the gene theor' o) heredit', ma' ha%e doctored the resu$ts o) his pea, breeding experiments to make them con)orm more per)ect$' to his theor'. &ende$(s conc$usions were correct but a statistica$ ana$'sis o) his pub$ished data shows that the odds were 1 , to one against their ha%ing been obtained through experiments such as &ende$ per)ormed. *octors( unethica$ beha%ior is not $imited to the medica$ business. 0 doctor whose name is practica$$' s'non'mous with the de%e$opment o) a ma2or surgica$ procedure was con%icted o) )i%e counts o) income tax e%asion )or omitting more than ?/> , )rom his tax returns )or 19;7 through 19;8. 0 )ew 'ears ago the chairman o) the Board o) the 0merican &edica$ 0ssociation was
indicted, con%icted, and sentenced !/ :" to eighteen months in 2ai$ a)ter p$eading gui$t' to participating in a conspirac' to misuse ?1.8 mi$$ion in bank )unds. 0ccording to the 9B#, he and his code)endants had conspired to obtain unsound indirect $oans )or their own interest ... pa'ing bank )unds on checks which had insu))icient )unds to back them ... and de)rauding the go%ernment ....1 Feep in mind that these shenanigans are going on at the highest $e%e$s o) the medica$ pro)ession. #) this kind o) dishonest', )raud, and thie%er' is going on among the bishops and cardina$s o) &odern &edicine at 6a$e and Iar%ard and the Nationa$ 0cadem' o) +ciences and the 0&0, imagine what is going on among the parish priests at the other medica$ schoo$s and medica$ societies= Jerhaps the most te$$ing characteristic o) the pro)ession that is supposed to de$i%er hea$th care is that doctors, as a group, appear to be sicker than the rest o) societ'. 8onser%ati%e counts peg the number o) ps'chiatrica$$' disturbed ph'sicians in the C.+. at 1:, or one in twent', the number o) a$coho$ics at more than 5 , , and the number o) narcotics addicts at 5,> or one percent. 0 thirt','ear stud' comparing doctors with pro)essiona$s o) simi$ar socio,economic and inte$$ectua$ status )ound that b' the end o) the stud' near$' ha$) the doctors were di%orced or unhappi$' married, more than a third used drugs such as amphetamines, barbiturates, or other narcotics, and a third had su))ered emotiona$ prob$ems se%ere enough to re.uire at $east ten trips to a !/ 8" ps'chiatrist. 3he contro$ group o) non,doctors didn(t )are near$' as bad$'. *octors are )rom thirt' to one hundred times more $ike$' than $a' peop$e to abuse narcotics, depending on the particu$ar drug. 0t a semiannua$ meeting o) the 0merican &edica$ 0ssociation in 19:/, sur%e's cited showed that near$' two percent o) the doctors practicing in 4regon and 0ri<ona had been discip$ined b' state $icensing authorities )or drug abuse. 0n e%en $arger percentage got into troub$e )or excessi%e drinking. E%en the 0&0 admits that one and one,ha$) percent o) the doctors in the Cnited +tates abuse drugs. Karious re)orm and rehabi$itation measures o%er the 'ears ha%e not changed these percentages. Feep in mind that these )igures represent on$' the identi)ied cases. #n $$$inois, )or examp$e, *r. Aames West, chairman o) the #$$inois &edica$ +ociet'(s Jane$ )or the #mpaired Jh'sician, reported that )our percent rather than two percent o) #$$inois doctors are narcotics addicts= Ie )urther estimated that e$e%en,and,one,ha$) percent were a$coho$ics ,, one in nine. +uicide accounts )or more deaths among doctors than car and p$ane crashes, drownings, and homicides combined. *octors( suicide rate is twice the a%erage )or a$$ white 0mericans. E%er' 'ear, about 1 doctors commit suicide, a number e.ua$ to the graduating c$ass o) the a%erage medica$ schoo$. 9urthermore, the suicide rate among )ema$e ph'sicians is near$' )our times higher than that )or other women o%er age twent',)i%e. !/ 9" 0po$ogists )or the medica$ pro)ession cite se%era$ reasons )or doctors( high rate o) sickness.3he drugs are easi$' a%ai$ab$e to themD the' must work $ong hours under se%ere stressD their background and ps'cho$ogica$ makeup predisposes them to stretech their powers to the $imitsD and their patients and the communit' make excessi%e demands on them. 4) course, whether or not 'ou accept these reasons, the' don(t exp$ain awa' the )act that doctors are a %er' sick group o) peop$e. Nonethe$ess, # pre)er to $ook )or more reasons. 9raud and corruption in the research process comes as no surprise to an'one who witnesses the $engths to which drug and )ormu$a companies go to $ure doctors to their wa' o) thinking. 9ree dinners, cocktai$s, con%entions, and subsidi<ed research )e$$owships sti$$ are on$' super)icia$ exp$anations. When 'ou examine the ps'cho$ogica$ and mora$ c$imate o) &odern &edicine, 'ou begin to get c$oser to understand wh' doctors are so unhea$th'.
&edica$ po$itics, )or examp$e, is a cutthroatpower game o) the most primiti%e sort. # much pre)er po$itica$ po$itics, because there 'ou ha%e the art o) the possib$e, which means 'ou ha%e to compromise. &edica$ po$itics is the art o) sheer power. 3here is no compromise: 'ou go right )or the 2ugu$ar %ein be)ore 'our own is torn out. 3here is no room )or compromise because churches ne%er compromise on canon $aw. #nstead o) a re$ati%e$' open process in which peop$e with di))erent interests get together to tr' to get the most out o) the situation !/1 " that the' can, in medica$ po$itics there is a rigid authoritarian power structure which can be mo%ed on$' through winner, take,a$$ power p$a's. Iistorica$$', doctors who ha%e dared to change things signi)icant$' ha%e been ostraci<ed and ha%e had to sacri)ice their careers in order to ho$d to their ideas. 9ew doctors are wi$$ing to do either. 0nother reason wh' doctors are $ess prone to compromise is because doctors tend to restrict their )riendships to other doctors. 8$ose )riendships between doctors and non,doctors are nowhere near as )re.uent as among other pro)essions. 8onse.uent$', doctors rari$' ha%e to de)end their opinions among peop$e who don(t share their background and who might o))er a di))erent point o) %iew. *octors can de%e$op their phi$osop$' in re$ati%e pri%ac', )ora' at inter%a$s into the pub$ic scene to promote these ideas, and then rapid$' retreat to the securit' o) other doctors who support the %iews o) the in,group. 3his $uxur' is not a%ai$ab$e to others in in)$uentia$ positions in pub$ic $i)e. 4) course, doctors do see their patients. But the' don(t see them as peop$e. 3he doctor,patient re$ationship is more $ike that between the master and the s$a%e, since the doctor depends on the comp$ete submission o) the patient. #n this kind o) c$imate, ideas can hard$' be interchanged with an' hope o) the doctor(s being a))ected. Jro)essiona$ detachment boi$s down to the doctor rendering the entire re$ationship de%oid o) human in)$uences or %a$ues. *octors !/11" rare$' rub e$bows with non,doctors in an' other posture but the pro)essiona$. 9urthermore, since the doctor(s ambitions pro2ect him into the upper c$asses, that(s where his s'mpathies $ie. *octors identi)' with the upper c$ass and be'ond, e%en. 3he' %iew themse$%es as the true e$ite c$ass in societ'. 3he doctor(s $i)est'$e and pro)essiona$ beha%ior encourage autocratic thinking, so his conser%ati%e po$itics and economics are predictab$e. &ost doctors are white, ma$e, and rich ,, hard$' in a position to re$ate e))ecti%e$' with the poor, the non,white, and )ema$es. E%en doctors who come )rom these groups rare$' return to ser%e and 1be with1 them. 3he', too, become white, ma$e, and rich )or a$$ practica$ purposes and treat their )e$$ows with a$$ the paterna$istic contempt other doctors do. When asked where doctors $earn these bad habits, # used to rep$' that doctors $earned them in medica$ schoo$. Now # rea$i<e the' $earn them much ear$ier than that. B' the time the' get to pre, medica$ training, the'(%e picked up the cheating, the competition, the %'ing )or position ,, a$$ the tricks the' know the' need i) the' want to get into medica$ schoo$. 0)ter a$$, our uni%ersit' s'stem is mode$ed a)ter the medica$ schoo$s, and our high schoo$s are mode$ed a)ter our uni%ersities. 3he admissions tests and po$icies o) medica$ schoo$s %irtua$$' guarantee that the students who get in wi$$ make poor doctors. 3he .uantitati%e tests, the &edica$ 8o$$ege 0dmission !/1/" 3est, and the re$iance on grade point a%erages )unne$ through a certain t'pe o) persona$it' who is unab$e and unwi$$ing to communicate with peop$e. 3hose who are chosen are the ones most sub2ect to the authoritarian in)$uences o) the priests o) &odern &edicine. 3he' ha%e the compu$sion to succeed, but not the wi$$ or the integrit' to rebe$. 3he hierarch' in contro$ wants students who wi$$ go through schoo$ passi%e$' and ask on$' those .uestions the pro)essors can answer com)ortab$'. 3hat usua$$' means the' want on$' one .uestion at a time. 4ne o) the things # ad%ise m' students to do
in order to sur%i%e medica$ schoo$ is to ask one .uestion but ne%er ask two. &edica$ schoo$ does its best to turn smart students stupid, honest students corrupt and hea$th' students sick. #t isn(t %er' hard to turn a smart student into a stupid one. 9irst o) a$$, the admissions peop$e make sure the pro)essors wi$$ get weak,wi$$ed, authorit',abiding students to work on. 3hen the' gi%e them a curricu$um that is abso$ute$' meaning$ess as )ar as hea$ing or hea$th are concerned. 3he best medica$ educators themse$%es sa' that the ha$),$i)e o) medica$ education is )our 'ears. #n )our 'ears ha$) o) what a medica$ student has $earned is wrong. Within )our 'ears o) that, ha$) again is wrong, and so on. 3he on$' prob$em is that the students aren(t to$d which ha$) is wrong. 3he'(re )orced to $earn it a$$. +uper%ision can be %er' c$ose. 3here is no schoo$ in the countr' where the student,teacher ratio is as $ow as it is in medica$ schoo$. *uring the $ast !/15" coup$e o) 'ears o) medica$ schoo$, 'ou )re.uent$' )ind c$asses o) on$' two or three students to one doctor. 3hat doctor has tremendous in)$uence o%er those students, through both his proximit' and his $i)e,and,death power o%er their careers. &edica$ students are )urther so)tened up b' being ma$icious$' )atigued. 3he wa' to weaken a person(s wi$$ in order to mo$d him to suit 'our purposes is to make him work hard, especia$$' at night, and ne%er gi%e him a chance to reco%er. 6ou teach the rat to race. 3he resu$t is a person too weak to resist the most debi$itating instrument medica$ schoo$ uses on its students: )ear. #) # had to characteri<e doctors, # wou$d sa' their ma2or ps'cho$ogica$ attribute is )ear. 3he' ha%e a dri%e to achie%e securit',p$us that(s ne%er satis)ied because o) a$$ the )ear that(s drummed into them in medica$ schoo$: )ear o) )ai$ure, )ear o) missing a diagnosis, )ear o) ma$practice, )ear o) remarks b' their peers, )ear that the'($$ ha%e to )ind honest work. 3here was a mo%ie some time ago that opened with a marathon dance contest. 0)ter a certain $ength o) time a$$ the contestants were e$iminated except one. E%er'bod' had to )ai$ except the winner. 3hat(s what medica$ schoo$ has become. +ince e%er'bod' can(t win, e%er'bod' su))ers )rom a $oss o) se$) esteem. E%er'bod' comes out o) medica$ schoo$ )ee$ing bad. *octors are gi%en one reward )or swa$$owing the )ear pi$$ so wi$$ing$' and )or sacri)icing the hea$ing instincts and human emotions that !/17" might he$p their practice: arrogance. 3o hide their )ear, the'(re taught to adopt the authoritarian attitude and demeanor o) their pro)essors. With a$$ this pushing at one end and pu$$ing at the other, it(s no wonder that doctors are the ma2or sources o) i$$ness in our societ'. 3he process that begins with cheating on a bio$og' exam b' mo%ing the microscope s$ide so that the next student %iews the wrong specimen, that continues with dropping sugar into a urine samp$e to change the resu$ts )or those who )o$$ow, with hiring others to write papers and take exams, and with 1dr' $abbing1 experiments b' )abricating resu$ts, ends with )a$si)'ing research reports in order to get a drug appro%ed. What begins with )ear and )atigue o%er exams and grades ends with a drug or a$coho$ prob$em. 0nd what begins with arrogance towards others ends up as a doctor prescribing dead$' procedures with $itt$e regard )or the $i)e and hea$th o) the patient. &' ad%ice to medica$ students is a$wa's to get out as soon as possib$e and as easi$' as possib$e. 3he )irst two 'ears o) medica$ schoo$ are sur%i%ab$e because the students are re$ati%e$' anon'mous. 3he student shou$d tr' his or her best to remain so, since i) the pro)essors don(t know him the' can(t get to him. 3he $ast two 'ears are more persona$, but the student has more time o)) to reco%er )rom the assau$ts. #) a student simp$' does enough work to pass and doesn(t get a$$ wrapped up in the ro$$er derb' menta$it', he or she can make it to the )inish $ine re$ati%e$' unscathed. 3hen, as soon !/1>" as the student is e$igib$e )or a state $icense # ad%ise him to .uit. 9orget residenc' and specia$t'
training because there the pro)essiona$s ha%e the student da' and night, and he can rea$$' be brainwashed. 3hat(s when the rea$ making o) the *e%i$(s priests occurs. *octors are on$' human. But so are the rest o) us, and sometimes we need the ser%ices o) a$$,too, human doctors. Because the doctor,priest acts as a mediator or a conduit between the indi%idua$ and the power)u$ )orces the indi%idua$ )ee$s he cannot )ace a$one, a )au$t' conduit can resu$t in some %er' power)u$ energ' )$owing into the wrong p$aces. 9or examp$e, when doctors are compared with other peop$e in e%a$uating retarded and other handicapped persons, those who a$wa's gi%e the most disma$ predictions and the $owest e%a$uations are the doctors. Nurses are next $owest, )o$$owed b' ps'cho$ogists. 3he group that a$wa's gi%es the most optimistic e%a$uation is the parents. When #(m )aced with a doctor who te$$s me a chi$d can(t do certain things and parents who te$$ me that the can do them, # a$wa's $isten to the parents. # rea$$' don(t care which group is right or wrong. #t(s the attitude that counts. Whate%er attitude is rein)orced and encouraged wi$$ pro%e true. # know doctors are pre2udiced against cripp$es and retarded peop$e because o) their education ,, which teaches that an'one who is handicapped is a )ai$ure and is better o)) dead ,, so # can protect m' patients and m'se$) against the doctors( se$),)u$)i$$ing prophecies o) doom. !/1;" 6et doctors continue to get awa' with their attitude and their se$),ser%ing practices. E%en though doctors deri%e a great dea$ o) their economic status and power )rom insurance companies, the doctors are in contro$. +o much in contro$, in )act, that insurance companies genera$$' act against their own interests when the choice is that or weaken the power o) doctors. B$ue 8ross and B$ue +hie$d and other insurers $ogica$$' shou$d be searching )or methods o) decreasing unnecessar' uti$i<ation o) medica$ ser%ices. 4ccasiona$$', we see ha$), hearted attempts in this direction, such as the )$urr' o) ru$es re.uiring second opinions be)ore e$ecti%e surger' or the e%er',so,o)ten po$ic' o) discontinuing reimbursement )or procedures $ong )a$$en into ob$i%ion. 3hese e))orts are more window dressing than an'thing e$se. 3he' are introduced with considerab$e )an)are, rapid$' generate a groundswe$$ o) contro%ers', and then .uiet$' s$ip awa'. Eegard$ess o) how we$$, intentioned the' are, the' sti$$ address themse$%es on$' to the periphera$ aspects o) medica$ care and not to the areas where rea$ mone' is to be sa%ed. #) insurance companies rea$$' wanted to cut costs, the' wou$d promote reimbursement )or a wide range o) simp$er, more e))ecti%e, cheaper procedures such as home birth. 0nd the' wou$d a$$ow reimbursement )or measures that restore and maintain hea$th without drugs or surger' ,, such as diet therap' and exercise. 4ne o) the most )ascinating statistics #(%e e%er run across is one that was reported b' the !/1:" &edica$ Economics 8ompan', the pub$ishers o) the Jh'sician(s *esk Ee)erence. 0mong other .uestions, the' asked a representati%e samp$ing o) more than 1,: peop$e, 1#) 'ou $earned that 'our doctor had $ost a ma$practice suit, wou$d it a$ter 'our opinion o) him-1 What ama<es me is that se%ent',se%en percent o) the peop$e said No= Now # don(t rea$$' know i) that means that peop$e expect their doctors to commit ma$practice or i) the' don(t care whether he does or not= # do know that the insurance companies are bamboo<$ed b' the doctors into spending more mone' than the' ha%e to. # a$so know that on$' about se%ent' doctors $ose their $icenses e%er' 'ear dispite a$$ the ob%ious corruption, sickness, and dangerous ma$practice. Iere we come to one o) the tru$' wondrous m'steries o) &odern &edicine. *espite Gor because o)-H a$$ that )ear and competition among medica$ students, doctors are extreme$' re$uctant to report incompetent work or beha%ior on the part o) their co$$eagues. #) a hospita$, )or examp$e, disco%ers ma$practice b' one o) its doctors, the most that wi$$ habpen is the doctor wi$$ be asked to resign. Ie won(t be reported to state medica$
authorities. When he seeks emp$o'ment e$sewhere, the hospita$ wi$$ most $ike$' gi%e him a shining recommendation. When the )amous &arcus twin,brother team o) g'neco$ogists were )ound dead o) narcotics withdrawa$ during the summer o) 19:>, then news that the doctors were addicts came as a !/18" surprise to e%er'one but their co$$eagues. When the brothers( 1prob$ems1 were noticed the 'ear be)ore b' the hospita$ sta)), the twins were asked to take a $ea%e o) absence to seek medica$ care. When the' returned to New 6ork Iospita$,8orne$$ &edica$ 8enter, the' were watched )or signs that the' had impro%ed. 3he' had not. Were the' then whisked o)) the sta)) and kept out o) touch with patients be)ore an'one was serious$' harmed- Were the' reported to state $icensing authorities- No. 3he' were to$d in &a' that as o) Au$' $, the' wou$d not be a$$owed to work in the hospita$. 3he' were )ound to ha%e died within da's a)ter the' $ost the pri%i$ege to admit patients to the hospita$. 0nother )a%orite examp$e o) doctors a$$owing their co$$eagues to commit ma'hem on unsuspecting patients occurred in New &exico. 0 surgeon tied o)) the wrong duct in a ga$$ b$adder operation and the patient dies. 0$though the error was disco%ered at autops', the doctor was not discip$ined. 0pparent$'. he wasn(t taught the right wa' to do the operation, because a )ew months $ater he per)ormed it again, wrong ,, and another patient died. 0gain, no punishment and no surger' $esson. 4n$' a)ter the doctor per)ormed the operation a third time and ki$$ed another person was there an in%estigation resu$ting in the $oss o) his $icense. #) # had to answer the .uestion o) wh' doctors are so re$uctant to report neg$igence in the practice o) their co$$eagues 'et so cutthroat !/19" when it comes to medica$ po$itics and medica$ schoo$ competition, # go back to the basic emotions engendered in medica$ schoo$: )ear and arrogance. 3he resentment doctors are taught to )ee$ )or each other as students is trans)erred to the patients when the doctor )ina$$' gets into his own practice. 4ther doctors are no $onger the enem' as $ong as the' don(t threaten to rock the status .uo through po$itics or research which doesn(t )o$$ow the part' $ine. 9urthermore, the o$d )ear o) )ai$ure ne%er goes awa', and since the patient is the primar' threat to securit' ,, b' presenting a prob$em which must be so$%ed, much $ike a medica$ schoo$ test ,, an' mistake b' a sing$e doctor threatens the securit' o) a$$ doctors b' cha$king one up )or the other side. 0rrogance on the part o) an' pro)essiona$ group is a$wa's directed at the outsiders that the group )ears most ,, ne%er at the members o) the same pro)ession. 4b%ious$', doctors get awa' with more arrogance than an' other pro)essiona$ group. #) &odern &edicine weren(t a re$igion, and i) doctors weren(t the priests o) that re$igion, the' wou$dn(t get awa' with an'where near so much. *octors get awa' with substantia$$' more than priests o) other re$igions, because o) the pecu$iar$' corrupt nature o) &odern &edicine. 0$$ re$igions promote and re$ie%e gui$t. 3o the extent that a re$igion is ab$e to encourage use)u$ beha%ior b% promoting gui$t and re$ie%ing it, that re$igion is 1good.1 0 re$igion which !// " promotes too much gui$t and re$ie%es too $itt$e, or which encourages the wrong kind o) beha%ior ,, beha%ior which wi$$ not resu$t in the impro%ement o) the we$)are o) the )aith)u$ ,, is a 1bad1 re$igion. 0n examp$e o) how a re$igion promotes and re$ie%es gui$t is the a$most uni%ersa$ proscription against adu$ter'. 4b%ious$', i) re$igions didn(t tr' to make peop$e )ee$ that adu$ter' was 1wrong1 and encourage them to )ee$ gui$t' about it, more and more peop$e wou$d do it and necessar' socia$ structures wou$d weaken. Jeop$e wou$dn(t know who their parents were, propert' cou$d not be order$' trans)erred )rom generation to generation, and %enerea$ disease cou$d threaten the existence o) an especia$$' energetic cu$ture.
*octors are so power)u$ precise$' because the' ha%e, as priests o) the 8hurch o) &odern &edicine, remo%ed a$$ the o$d gui$ts. &odern &edicine in%a$idates the o$d gui$ts which strange$' enough he$d peop$e to their o$d re$igions. Nothing is a 1sin1 an'more, because i) there is a ph'sica$ conse.uence, the doctor has the power to )ix 'ou up. #) 'ou get pregnant, the doctor can per)orm an abortion. #) 'ou get %enerea$ disease, the doctor can gi%e 'ou penici$$in. #) 'ou are g$uttonous and damage 'our heart, the doctor can gi%e 'ou a coronar' b'pass. #) 'ou su))er )rom emotiona$ prob$ems, the doctor has Ka$ium, Bibrium, and other narcotics to he$p 'ou get b' without caring, or )ee$ing. #) those don(t work, there are p$ent' o) ps'chiatrists. 3here is one 1sin1 that &odern &edicine !//1" wi$$ make 'ou )ee$ gui$t' about: not going to the doctor. 3hat(s 4F, because the doctor is the priest, who takes awa' e%er' other gui$t. Iow much harm can there be in gui$t that dri%es 'ou to the doctor e%er' time 'ou )ee$ sick3he doctor,priest gets awa' with a $ot because he can c$aim to be up against the %er' 9orces o) E%i$. When a priest is in a touch' situation and the probabi$it' )or success is disma$, he escapes b$ame b' sa'ing that he(s up against the *e%i$. 3he doctor,priest does the same thing. When the prognosis is not good, he retreats into his morta$it' and admits that he(s on$' a man up against the *e%i$. 3hen, i) he wins, he(s a hero. #) he $oses, he(s a de)eated hero ,, but sti$$ a hero. Ne%er is he seen in his true $ight ,, as the agent o) the *e%i$. 3he doctor ne%er $oses, though he p$a's both sides against the midd$e and takes bigger risks than necessar'. 3hat(s because he has succeeded in identi)'ing his ritua$s as sacred and potent regard$ess o) their rea$ e))icac'. Ie uses his ho$iest imp$ements to raise the ante and make the game more ominous than it rea$$' needs to be. #) a mother comes into the hospita$ with her bab' in the breech position and the )eta$ monitor sa's the bab' is in distress, the doctor $oses no time in dec$aring it a $i)e and death situation ,, which, indeed, it becomes once he starts to per)orm a 8aesarean,section de$i%er'. Bio$ogica$$', the doctor knows the 8,section is dangerous. But the game is no $onger being p$a'ed b' bio$ogica$ ru$es. #t(s a !///" re$igious game, a ceremon', and the priest ca$$s the shots. #) mother and chi$d sur%i%e, the priest is a hero. #) the' die, we$$.. it was a $i)e,and,death situation an'wa'. 3he doctor ne%er $oses: on$' the patients $ose. 3he adage that a doctor buries his mistakes sti$$ app$ies. We used to re)er mistaken$' to doctors as airp$ane pi$ots. #) the p$ane goes down, the pi$ot goes down with it. But the doctor ne%er goes down with the patient. *octors a$so escape b$ame b' c$aiming that their )ai$ures are caused b' their successes. #) 'ou point out, )or examp$e, that a disproportionate number o) premature babies seem to be turning up b$ind in premie nurseries, the doctor wi$$ sa' that it(s the price 'ou ha%e to pa'. 1@ee, we managed to sa%e these $itt$e 1, and /,pound babies. 4) course the' a$$ end up b$ind and de)ormed. 3he'(d be dead i) we didn(t sa%e them.1 *octors use the same excuse with the prob$em o) diabetic b$indness. 3he reason we ha%e so much diabetic b$indness, the' sa', is because we ha%e succeeded in keeping so man' diabetics a$i%e $onger. *octors wii$ use this 1we managed to keep them a$i%e $onger1 excuse )or e%er' disease the' ha%e troub$e treating success)u$$' ,, which inc$udes a$$ the ma2or causes o) nonaccidenta$ death. 3he' abso$ute$' ignore the bio$ogica$ death. 3he' abso$ute$' ignore the bio$ogica$ )acts that creep in and point the )inger at &odern &edicine(s mismanagement o) both hea$th and disease. *octors e%en manage to get awa' with b$aming their own disease on their successes. When 'ou point to the $arge numbers o) !//5" dishonest, unhapp', and 2ust p$ain sick doctors, the excuse usua$$' runs something $ike this: 13he reason )or the ps'cho$ogica$ disabi$it' is our tendenc' to be compu$si%e, per)ectionistic, easi$' gi%en to a sense o) gui$t i) our c$inica$ e))orts
)ai$.1 0 president o) the 0merican &edica$ 0ssociaton o))ered that one. *octors protect themse$%es )urther through the sacred $anguage o) the priest. 0 re$igion must ha%e a sacred $anguage to separate the discourse o) the priesthood )rom the $ow$' banter o) the masses. 0)ter a$$, the priests are on speaking terms with the powers that keep the uni%erse on course. We can(t ha%e 2ust an'one $istening in. +acred $anguage o) doctors is no di))erent )rom 2argon de%e$oped b' an' e$itist group. #ts main )unction is to keep outsiders ignorant. #) 'ou cou$d understand e%er'thing 'our doctor was sa'ing to 'ou and to other doctors, his power o%er 'ou wou$d be diminished. +o when 'ou get sick because o) the genera$$' )i$th' conditions in the hospita$, he($$ ca$$ 'our $n)ection nosocomia$. 3hat wa', 'ou($$ not on$' not get angr' at the hospita$, but 'ou($$ )ee$ pri%i$eged to ha%e such a distinguished sounding disease. 0nd too scared to get mad. *octors use their semantic pri%i$eges to make 'ou )ee$ stupid and con%ince 'ou that the' are genuine$' pri%' to powers that 'ou(d better not mess with. 0s $ong as their ritua$s are m'sterious, as $ong as the' don(t ha%e to 2usti)' them bio$ogica$$', the' can get awa' with an'thing. 3he'(re not e%en sub2ect to the !//7" $aws o) $ogic. *octors wi$$, )or examp$e, 2usti)' coronar' b'passes b' sa'ing that e%er'one who has one )ee$s better. But i) 'ou ask to be treated )or cancer with $aetri$e because e%er'one 'ou know who has been treated with it )ee$s better, 'our doctor wi$$ te$$ 'ou that it hasn(t been scienti)ica$$' pro%ed e))ecti%e. +emantic iso$ation a$so ser%es to disen)ranchise the indi%idua$ )rom the hea$ing process. +ince the patient has no hope o) knowing what(s going on, $et a$one assisting, wh' a$$ow him or her an' part in the process at a$$- 3he patient gets in the wa' o) the ritua$, so get the patient out o) the wa'. 3hat(s one reason wh' doctors aren(t interested in he$ping patients maintain their hea$th. 3o do that, the'(d ha%e to in)orm them rather than work on them. *octors aren(t going to share in)ormation, because that means sharing power. 3o back them up, doctors ha%e an enormous tonnage o) techno$ogica$ gadgets which pro$i)erates a$arming$'. 9irst o) a$$, the patient must stand in awe o) the arra' o) machiner' the doctor assemb$es to attack his prob$em. Iow cou$d an' sing$e person ,, other than the doctor, who has the power ,, hope to contro$ such )orces- 0$so, the e$ectronic wi<ardr' adds weight to the doctor(s c$aim that he 1did e%er'thing he cou$d.1 #) it(s 2ust a doctor standing there with a b$ack bag, 1a$$ that he cou$d1 doesn(t mean %er' much. But i) the doctor throws the switches on ?7 mi$$ion worth o) machiner' that )i$$s three rooms, that means he did 1a$$ that he cou$d1 and then some= !//>" 3'pica$ o) an' de%e$oped re$igion, the ceremonia$ ob2ects in which the most power is concentrated reside in the 3emp$e. 3he higher the status o) the temp$e, the more machiner' within the wa$$s. When 'ou get to the cathedra$s and the $itt$e 1Katicans1 o) &odern &edicine, 'ou are up against priests who ha%e the weight o) in)a$$ibi$it' behind them. 3he' can do no wrong, so the' are the most dangerous. 3he re)orms that ha%e been introduced in an e))ort to so$%e some o) the prob$ems #(%e ta$ked about in this chapter don(t impress me as doing %er' much good. Eehabi$itation programs, )or examp$e don(t rea$$' attack the roots o) the sicknesses doctors seem to )a$$ pre' to. 3hat ma' be a resu$t o) their sh'ing awa' )rom exposing the prob$em as a disease o) the core o) &odern &edicine. 4) course, doctors are not trained to attack the core o) an' prob$em, mere$' to suppress the s'mptoms. 0ttempts to keep doctors( know$edge up,to,date a$so do $itt$e good, since what doctors don(t need is more o) the same kind o) in)ormation the' recei%ed in medica$ schoo$. 3hat(s precise$' what the' get in most continuing medica$ education programs. 3he'(re taught b' the same peop$e who taught them in medica$ schoo$. Who(s responsib$e )or keeping them proper$' in)ormed-
0s #(%e a$read' said, 'ou ha%e to protect 'ourse$). 3o do that, 'ou need to remember the two ma2or attributes o) doctors: )ear and arrogance. What 'ou ha%e to do is $earn how to work on his )ears without cha$$enging his arrogance !//;" unti$ 'ou ha%e the winning hand. +ince doctors are scared o) 'ou and what 'ou can do to them, 'ou shou$dn(t hesitate to use that )ear. *octors are scared o) $aw'ers, not because $aw'ers are so power)u$ but because $aw'ers can a$$' themse$%es with 'ou, whom the doctor rea$$' )ears. #) a doctor does 'ou dirt', sue him. #t is in courts and 2uries that 'ou(re most $ike$' to )ind common sense. 9ind a good $aw'er who knows a $ot about medicine and who is not a)raid to put a doctor through the wringer. #) there(s one thing a doctor doesn(t $ike it(s to be in court on the wrong end o) a $aw'er ,, because that(s one p$ace where the patient has a$$ies, that can e))ecti%e$' cha$$enge the doctor(s priest$' immunit'. 3he increase in ma$practice suits is encouraging, since it means more and more peop$e are being radica$i<ed to the point where the' cha$$enge the doctor(s power to determine the ru$es. #) 'our doctor gi%es 'ou troub$e but not enough to take him to court, 'ou need to be care)u$ about how much 'ou cha$$enge him ,, not because o) what he can or cannot do to 'ou, but because how )ar 'ou go wi$$ determine 'our e))ecti%eness. #) a doctor threatens 'ou and becomes angr', 'ou shou$d stand up to him. *on(t back down. 3hreaten him back. When a person rea$$' threatens a doctor, the doctor a$most a$wa's backs down i) the person shows that he means it. *octors back down a$$ the time because the' )igure, 1What do # need this one kook )or-1 #t(s important, though, not to threaten a doctor !//:" un$ess 'ou are prepared to carr' through. #n other words, don(t re%ea$ 'our rebe$$ion unti$ 'ou ha%e to, unti$ 'ou ha%e the emotiona$ commitment and the ph'sica$ capabi$it' to carr' on a success)u$ campaign. *on(t get into an argument with a doctor with the hope o) changing his mind on an'thing. Ne%er sa' to the doctor who(s treating 'ou )or cancer with traditiona$ chemotherap', ,1*oc, what do 'ou think about $aetri$e- 6ou won(t get an'where and 'ou won(t get an' $aetri$, either. *on(t sa' to the doctor who recommends a securit' bott$e )or 'our bab', 1But #(m breast)eeding and # don(t want to do that.1 *on(t bring 'our doctor co$umns )rom the newspaper expecting him to change his mind or tr' something new. *on(t cha$$enge him unti$ 'ou(re read' with an a$ternati%e action. *o 'our own homework. What does a 8atho$ic do when he decides that his priests are no good- +ometimes he direct$' cha$$enges them, but %er' se$dom. Ie 2ust $ea%es the 8hurch. 0nd that(s m' answer. Bea%e the 8burch o) &odern &edicine. # see a $ot o) peop$e doing that toda'. # see a $ot o) peop$e going to chiropractors, )or examp$e, who wou$dn(t ha%e been caught dead in a chiropractor(s o))ice a )ew 'ears ago. # see more and more peop$e patroni<ing the heretics o) &odern &edicine.
Chapter , -f $his is +re)enti)e Medicine, -*ll $a.e M Chances /ith Disease

0 )e$$ow doctor once wrote and asked me how the medica$ pro)ession 1might p$a' an inspirationa$ and practica$ ro$e in the .uest )or wor$d peace.1 &' answer was: 1@o out o) business.1 We(%e a$read' seen what a disaster curati%e medicine has become, but so,ca$$ed pre%enti%e
medicine is 2ust as dangerous. #n )act, the 2uggernaut o) &odern &edicine(s dri%e )or power o%er our $i%es is pre%enti%e medicine. #t(s no secret what ma'hem power,hungr' institutions ,, inc$uding go%ernments ,, can get awa' with hiding behind the intention o) 1pre%enting1 troub$e. &odern &edicine gets awa' with e%en more. 9or examp$e, the *e)ense *epartment exp$ains the bi$$ions it spends b' )orwarding the o$d 1we(re protecting 'ou )rom came$s1 !/5 " routine. 3hough a great portion o) those bi$$ions is no doubt wasted mone', at $east the *e)ense *epartment can point to the %irtua$ absence o) came$s as e%idence that some o) the mone' is spent on worthwhi$e acti%ities. &odern &edicine can(t e%en make that c$aim. 3here(s no wa' an'bod' can 2usti)' the bi$$ions o) do$$ars we spend e%er' 'ear on 1hea$th care.1 We(re not getting hea$thier as the bi$$ gets higher, were getting sicker. Whether or not we ha%e nationa$ hea$th insurance is, at best, irre$e%ant and, at worst, one o) the most dangerous decisions )acing us in the 'ears ahead. Because e%en i) a$$ doctors( ser%ices were )ree, disease and disabi$it' wou$d not decrease. # wonder i) we can rea$$' expect an'one to ask whether more o) what we a$read' ha%e too much o) wi$$ do us an' good. &odern &edicine has succeeded in teaching us to e.uate medica$ care with hea$th. #t is that e.uation which has the potentia$ to destro' our bod's, our )ami$ies, our communities, and our wor$d. We(%e a$read' seen how much o) what &odern &edicine describes as 1pre%enti%e1 medicine is not on$' ine))ecti%e but dangerous. 3he sacrament o) the regu$ar ph'sica$ exam exposes 'ou to the who$e range o) dangerous and ine))ecti%e procedures. 9rom this 1act o) )aith1 'ou recei%e the abso$ution o) the priest ,, i) 'ou(re $uck'. 9irst 'ou ha%e to gi%e him a )u$$ con)ession, a comp$ete and honest histor', inc$uding things 'our wi)e and best )riends don(t e%en know. 3hen he($$ pass the ceremonia$ !/51" stethoscope o%er 'our %ita$ parts ,, a stethoscope that has a good chance o) not working proper$'. 3he doctor wi$$ check 'our ori)ices, )urther the humi$iation b' ha%ing 'ou gi%e a bott$e o) urine to the nurse, hit 'ou ceremonious$' on the knee with a rubber hammer, and pronounce 'ou sa%ed= 4r write out 'our penance in Batin. 4r ,, i) 'our sins ha%e been $egion ,, send 'ou to a specia$ist )or rea$$' sophisticated punishments. +creening progams cou$d be ca$$ed a 8omed' o) Errors i) the resu$ts weren(t so o)ten $ess than )unn'. 3he tubercu$in test, )or examp$e was origina$$' %er' %a$uab$e as a method o) identi)'ing peop$e who re.uired )urther in%estigation )or tubercu$osis. But the current %er' $ow incidence o) tubercu$osis means that the test has instead become used as a method o) 1pre%enti%e management.1 3his means that in order to pre%ent the possib$e one case out o) 1 , or more, potent and dangerous drugs such as #NI are gi%en )or months and months to peop$e who are so,ca$$ed 1primar' reactors.1 3here is a$so considerab$e ps'cho$ogica$ damage that can resu$t when a person becomes a socia$ pariah because )riends and neighbors )ind out that he or she is a positi%e reactor. *octors now ha%e to caution mothers against $etting neighbors and e%en re$ati%es know that a chi$d has had a positi%e tubercu$in test, since the test doesn(t usua$$' indicate communicabi$it' in a chi$d. #) 'ou )o$$ow the sounds o) medica$,go%ernmenta$ !/5/" drum,beating in )a%or o) a 1pre%enti%e1 procedure, 'ou($$ more o)ten than not )ind 'ourse$) in the midst o) one o) the 8hurch(s $east sa)e and e))ecti%e sacraments. 9or instance, with some immuni<ations the danger in taking the shot ma' outweigh that o) not taking it= *iphtheria, once an important cause o) disease and death, has a$$ but disappeared. 6et immuni<ations continue. E%en when a rare outbreak o) diphtheria does occur, the immuni<ation can be o) .uestionab$e %a$ue. *uring a 19;9 outbreak o) diphtheria in 8hicago, )our o) the sixteen %ictims had been 1)u$$' immuni<ed against the disease,1 according to the 8hicago Board o) Iea$th.
9i%e others had recei%ed one or more doses o) the %accine, and two o) these peop$e had tested at )u$$ immunit'. #n another report o) diphtheria cases, three o) which were )ata$, one person who died and )ourteen out o) twent',three carriers had been )u$$' immuni<ed. 3he e))ecti%eness o) the whooping cough %accine is hot$' debated a$$ o%er the wor$d. 4n$' about ha$) o) its recipients bene)it, and the possibi$it' o) high )e%ers, con%u$sions, and brain damage is too high to ignore. +o great are the dangers that man' pub$ic hea$th authorities now prohibit the use o) the %accine a)ter age six. &eanwhi$e, whooping cough itse$) has a$most comp$ete$' disappeared. Whether or not the mumps %accine is ad%isab$e is a$so in doubt. Whi$e the %accine de)inite$' $owers the incidence o) mumps in those !/55" who recei%e it, it does so at the risk o) exposing them to the dangers o) mumps $ater on a)ter the immunit' has worn o)). 9urthemore, diseases such as mumps, meas$es, and @erman meas$es ,, )or which %accines ha%e been de%e$oped o%er the past )ew 'ears ,, dont(t ha%e the dread imp$ications o) sma$$pox, tetanus, and diphtheria. 8ontrar' to popu$ar be$ie), meas$es cannot cause b$indness. Jhotophobia, which is mere$' a sensiti%it' to $ight, can be treated as parents 'ears ago did: b' pu$$ing down the windowshades. &eas$es %accine is supposed to pre%ent meas$es encepha$itis, which is said to occur in one out o) 1, cases. 0n' doctor who has had decades o) experience with meas$es knows that whi$e the incidence ma' be that high among chi$dren who $i%e under po%ert' and ma$nutrition, among we$$ nourished midd$e and upper c$ass chi$dren the incidence is one in 1 , or e%en one in 1 , . &eanwhi$e, the %accine itse$) is associated with encepha$opath' in one case per mi$$ion and more )re.uent$' with other neuro$ogic and sometimes )ata$ conditions such as ataxia GdiscoordinationH, retardation, h'peracti%i', aseptic meningitis, sei<ures, and hemiparesis Gpara$'sis o) one side o) the bod'H. @erman meas$es or rube$$a %accine remains contro%ersia$ in that there is $itt$e consensus regarding the age at which peop$e shou$d be immuni<ed. Kaccine )or rube$$a ma' a$so do more harm than good, since there is a risk o) arthritis arising )rom the drug which, a$though temporar', ma' $ast )or months. #n the Cnited !/57" +tates, rube$$a %accine is gi%en to chi$dren rather than to women contemp$ating pregnanc'. #t(s debatab$e whether this does an' good in protecting unborn )etuses since the rate o) de)ormed babies born to mothers with ob%ious, diagnosed rube$$a %aries )rom one 'ear to the next, )rom one epidemic to the next, and )rom one stud' to the next. #mmuni<ation isn(t the on$' )actor determining whether or not a person contracts a disease. Numerous other )actors such as nutrition, housing, and sanitation a$$ )igure strong$'. *oubts persist as to whether the whooping cough GpettussisH %accine has rea$$' had much to do with the dec$ine in that disease ,, as we$$ as to whether the %accine wou$d pass 9ood and *rug 0dministration standards i) introduced toda'. +ometimes the %accine itse$) can trigger the disease. #n +eptember, 19::, Aonas +a$k testi)ied a$ong with some other scientists that o) a hand)u$ o) po$io cases which had occurred in the Cnited +tates since the ear$' 19: s most were $ike$' the b'product o) the $i%e po$io %accine which is in standard use here. #n 9in$and and +weden, where the ki$$ed %irus is used a$most exc$usi%e$', there ha%e been no cases o) po$io in ten 'ears. No one who $i%ed through the 1974s and saw chi$dren in iron $ungs, saw a president con)ined to his whee$chair, or who was )orbidden )rom using pub$ic beaches )or )ear o) catching po$io, can )orget the )rightening spectre raised in our minds. 3oda', when the man credited with stamping out po$io !/5>" points to the %accine as the source o) the hand)u$ o) cases which do exist, it(s high time to .uestion what we are gaining b' using the %accine on an entire popu$ation. 3he mad %ehemence o) &odern &edicine is nowhere more e%ident than in the 'ear$' in)uen<a
%accine )arce. # can ne%er think about )$u shots without remembering a wedding # once attended. +trange$' enough, no grandparents were among the participants and no one seemed to be o%er age ; . When # )ina$$' asked where a$$ the o$d )o$ks were, # was to$d the' had a$$ recei%ed their )$u shots a )ew da's be)ore. 3he' were a$$ at home reco%ering )rom the shots( i$$ e))ects= 3he entire )$u shot e))ort resemb$es some massi%e rou$ette game, since )rom one 'ear to the next it(s an'bod'(s guess whether the strains immuni<ed against wi$$ be the strains that are epidemic. We were a$$ a))orded a peek at the rea$ dangers o) )$u %accines when in 19:;, the @reat +wine 9$u 9iasco re%ea$ed, under c$ose go%ernment and media sur%ei$$ance, >;> cases o) @ui$$ain,Barre para$'sis resu$ting )rom the %accine and thirt' 1unexp$ained deaths o) o$der persons within hours a)ter recei%ing the shot. # wonder what wou$d be the har%est o) disaster i) we kept as c$ose a watch on the e))ects o) a$$ the other )$u shot campaigns. *r. Aohn +ea$, o) the Nationa$ #nstitute o) 0$$erg' and #n)ectious *isease, sa's, 1We ha%e to go on the basis that an' and a$$ )$u %accines are capab$e o) causing @ui$$ain,Barre s'ndrome.1 !/5;" 0gain, besides chi$dren and o$d peop$e, women are more %u$nerab$e and, there)ore, more o)ten abused b' the medica$ pro)ession. No good e%idence exists that screening )or breast cancer does an'bod' an' good. 6et doctors ha%e whipped the popu$ace into such a )ren<' o%er breast cancer 1pre%ention1 that what # can on$' ca$$ 10$ice,in,Wonder$andish1 e%ents start to occur. 8onsider the suggestion that the danger o) breast cancer and other )ema$e,associated cancers is so great in some )ami$ies that surgica$ remo%a$ o) breasts and o%aries shou$d be per)ormed as a pre%enti%e measure= 0nother examp$e o) this sort o) 1pre%enti%e surger'1 is the current practice o) %aginectom' Gremo%a$ o) the %aginaH in adu$t women who ha%e no s'mptoms but whose mothers recei%ed *E+ during their pregnancies. Women shou$d be %er' care)u$ what the' te$$ their doctors about themse$%es or their )ami$'. 6ou ne%er know what he might want to remo%e )rom 'our bod' in order to 1protect1 'ou. &en, on the other hand, probab$' don(t ha%e to be so care)u$, since doctors wi$$ ne%er start surgica$$' remo%ing penises to protect men )rom an'thing. 4) course, besides the )act that these 1pre%enti%e measures1 are ine))ecti%e and harm)u$, doctors do )urther harm b' withho$ding in)ormation that might rea$$' pre%ent disease. #(m thinking o) the )our causes o) breast cancer which a$$ women shou$d know about. #(d be wi$$ing to wager that %er' )ew o) the women who do know these )our causes )ound out !/5:" about them )rom their doctor. 3he )our ingredients in the recipe )or breast cancer are: sma$$ number o) chi$dren or no chi$dren at a$$, bott$e,)eeding rather than breast)eeding, use o) the Ji$$, and use o) post,menopausa$ hormones such as Jremarin. 0nother campaign carried on against women in the name o) 1pre%ention1 is the wide$' promu$gated notion that women o%er thirt' shou$dn(t ha%e chi$dren. When # was in medica$ schoo$, # was taught that women shou$d not ha%e babies i) the'(re o$der than )ort',)i%e. B' the time # was an intern, it was down to )ort'. When # was a resident, thirt',eight. 3en 'ears ago it was down to thirt',)i%e. 0nd now it(s ho%ering between thirt' and thirt',two. 3he reason usua$$' gi%en b' doctors )or restrictions on the age o) a mother is that something happens to the eggs o) a woman as she gets o$der, the' get worn out and tired. +o we ha%e 1tired egg s'ndrome causing de)ormities in babies. 6ou ne%er hear an'thing about 1tired sperms.1 0ctua$$', age has nothing to do with whether a mother gi%es birth to a de)ormed bab'. 0 stud' at Aohns Iopkins re%ea$ed that the incidence o) denta$ and medica$ x,ra's in mothers who ha%e gi%en birth to &ongo$oid chi$dren is se%en times as high as in mothers o) comparab$e age who ha%e gi%en birth to norma$ chi$dren. 3his stud' has been backed up b' other studies, too, so the rea$ cause o)
de)ormed babies is associated with age on$' in that o$der women ,, i) the' ha%en(t been care)u$ ,, ha%e exposed !/58" themse$%es to more medica$, denta$, therapeutic, and $arge$' use$ess x,ra's. 0t the other end o) $i)e, women are to$d not to ha%e babies i) the'(re too 'oung= 3eenage pregnancies ha%e a bad reputation, but again, the rea$ threat has nothing to do with the age o) the mother. 3eenage pregnancies get their bad reputation )rom the )act that most o) them occur in poor women. #) a midd$e or upper c$ass, we$$,nourished and cared )or teenager gets pregnant, she has as good a chance ,, ma'be better ,, as an'one o) ha%ing a hea$th' bab'. &odern &edicine(s brand o) pre%enti%e medicine is so dangerous that we rea$$' shou$d abandon the term. 3here(s nothing wrong with the idea that peop$e shou$d take care o) themse$%es so that the' won(t get sick, but &odern &edicine(s concept o) pre%ention is as )ar )rom that as 'ou can get. Jre%enti%e medicine per)ormed b' the 8hurch is as oppressi%e and dangerous as 1curati%e1 medicine ,, ma'be more so, since doctors use the shie$d o) pre%enti%e medicine to hide an' number o) tru$' aggressi%e procedures. #n the )irst p$ace, &odern &edicine does not address itse$) to hea$th. &ost doctors don(t know how to describe a hea$th' person. 3he most the' can come up with is, 1this is norma$.1 9urthermore, since the doctor can run the patient through an incredib$e arsena$ o) tests, the $imits o) what is 1norma$1 are practica$$' a$$,exc$usi%e. 3here(s a$wa's going to be !/59" something wrong with 'ou, because the doctor doesn(t get an'thing out o) the situation i) 'ou(re 1norma$,1 or hea$th'. Jub$ic hea$th doctors were once he$d b' their co$$eagues in %er' $ow esteem. 3he' dea$t with sanitation and other basic items that tended to keep peop$e awa' )rom doctors. Iowe%er, since pub$ic hea$th doctors ha%e adopted screening as their primar' acti%it', the'(re now he$d in %er' high esteem because the' are the procurers o) &odern &edicine. 3he' de$i%er patients instead o) keep them awa'. &odern &edicine doesn(t be$ie%e that a person can do an'thing about sta'ing hea$th', since doctors be$ie%e that disease is 2ust a curse in)$icted anon'mous$' and warded o)) not b' concrete actions but b' s'mbo$ic sacraments that bear no re$ation to the rea$ wor$d. 0nd because &odern &edicine recogni<es no s$ns but those against its $aws, e%er'one comes into the wor$d with the origina$ sin o) potentia$ disease. *octors assume 'ou(re sick unti$ 'ou pro%e otherwise. 6ou cannot be c$eansed mere$' b' 1c$aiming1 to be hea$th' and s'mptom,)ree. 6ou ha%e to go through the exam, the proo) o) 'our immuni<ations, and the 1con)ession1 o) 'our and 'our )ami$'(s histor'. *octors make 2udgments 2ust $ike other priests. When 'ou are .uestioned during the 1con)ession,1 and asked whether 'ou(%e e%er had %enerea$ disease, do 'ou know what the doctor writes down i) 'ou sa' ne%er had K*- Ie !/7 " writes: 1Jatient denies K*.1 3here are no other diseases that doctors are taught to write 1patient denies.1 #) a doctor practices rea$ pre%enti%e medicine his patients are going to be hea$thier and wi$$ there)ore re.uire )ewer %isits to his o))ice. 6ou can see right awa' that this is as contrar' as 'ou can get to &odern &edicine(s idea. 3he 8hurch is primari$' interested in its authorit', so an'thing that $essens it ,, such as )ewer %isits to the doctor ,, is taboo. &odern &edicine thri%es on disease, not hea$th. 3he more )rightened peop$e become o) a$$ the disease 1out there1 waiting to strike them down random$', the more susceptib$e the' are to the come,ons and put,downs o) &odern &edicine. 4ne o) the mechanisms doctors use to enhance the genera$ )ren<' is the B$ame 3he Kictim game. #t(s 'our )ou$t i) 'ou(re sick, not because o) disease,producing habits 'ou de%e$oped and re)used to exchange )or hea$th,producing ones, but because 'ou didn(t recei%e the sacraments o) &odern &edicine soon enough or at a$$. 3hough a doctor wi$$ ne%er gi%e up and dec$are a patient 1in @od s
hands1 unti$ he has exhausted his supp$' o) potions, muti$ations, and sacri)tces, a patient sometimes goes a$$ the wa' to @od sooner than expected. E%en when the worst occurs, doctors ne%er admit that it was the sacrament that ki$$ed. Csing their semantic pri%i$ege the' turn it around and make it the %ictim(s )au$t. Ie was too )ar gone. !/71" #) 'ou be$ie%e in &odern &edicine, 'ou be$ie%e that 'ou ne%er rea$$' can expect hea$th. 6ou ne%er rea$$' know what to expect, since disease is a random process. 6ou $i%e in a neurotic state o) tension, )ear, and gui$t, anestheti<ed against 'our responsibi$ities and powers. 6ou are primed to be passi%e$' taken o%er b' the nearest wi$$ stronger than 'our own. 3he )act that patients o)ten don(t take their medicine dri%es doctors up the wa$$. Jatient comp$iance is a %er' big research )ie$d, because &odern &edicine wants to impro%e its methods o) getting patients to do what it te$$s them. 3he idea$ wou$d be a constant e$ectronic monitoring s'stem that wou$d a$$ow the doctor to keep tabs on the 1comp$iance1 o) e%er' patient, with perhaps an optiona$ e$ectronic bu<<er or 1catt$e1 prod to remind the patient to take his medicine. Cnti$ this kind o) en)orcement o) doctor(s orders becomes socia$$' acceptab$e, &odern &edicine has to satis)' itse$) with keeping the )$ock in $ine through more con%entiona$, indeed medie%a$, methods. When enough peop$e are radica$i<ed b' too good a $ook at a re$igion, that re$igion goes on the de)ensi%e and institutes a theo$og'. 3o pre%ent heretics )rom unsett$ing a com)ortab$e status .uo, church )athers )ree<e the re$igion(s be$ie)s and practices and in%ent or exaggerate the importance o) a$read' existing m'tho$gg'. B' harking back to pre%ious successes, the doctor,priest g$ori)ies contemporar' practices b' gi%ing them the aura o) di%ine re%e$ation. !/7/" 3hen, to protect the priest(s interpretation o) the di%ine, &odern &edicine dec$ares itse$) in)a$$ib$e. 0rgue with that and 'ou(re a heretic. 0n'thing outside the narrow sight o) 8hurch Baw, an' treatment not part o) standard procedure, is termed unorthodox, thereb' banishing it to a netherwor$d o) suspicion !see )ootnote be$ow". #(%e a$read' discussed how &odern &edicine neutra$i<es e))ecti%e pre%enti%e action b' ignoring true causes o) disease. 3he same mechanism b' which we are taught that heart disease is a matter o) chance rather than diet and $i)est'$e is a$so used to di%ert our ga<e )rom other causes o) disease, name$', po$itica$ causes. &ost o) the diseases which are ki$$ing us nowada's are the resu$t o) 1po$$ution1 o) our ph'sica$, po$itica$, economic, communit', )ami$', and indi%idua$ ps'cho$ogca$ en%ironments. 3rue pre%enti%e medicine cannot ignore these issues when addressing a prob$em o) hea$th, 'et doctors dec$are the prob$ems strict$' medica$, thus so$%ab$e through the sacraments o) the 8hurch o) &odern &edicine. !/75" 4ne o) m' )a%orite examp$es o) this process is $ead poisoning. *octors are taught in medica$ schoo$ that the cause o) $ead poisoning is pica. Jica is de)ined as an' abnorma$ appetite )or non, )ood substances. #n this case, the o))ending substance is $ead. Where do the chi$dren get the $ead9rom windowsi$$s and %arious parts o) a bui$ding where paint is pee$ing. 0s $ong as we be$ie%e that, we don(t recogni<e the root cause o) $ead poisoning, which is that the chi$d is eating paint o)) the windowsi$$s because there(s no )ood in the re)rigerator. E%en in the da's o) interior $ead,based paint, midd$e and upper c$ass chi$dren ne%er got $ead poisoning. Wh' shou$d the' eat paint- 3he' can go to the re)rigerator when the'(re hungr'= #) we are a$$owed to see the rea$ cause a) $ead poisoning as hungar, we either must write o)) the chi$dren in danger or decide to address the prob$em at its roots, since the medica$ treatment o) $ead poisoning is most$' ine))ecti%e and o)ten dangerous. 4nce 'ou decide to get at the roots o) the prob$em o) $ead poisoning, 'ou open a c$oset )u$$ o) medica$,po$itica$ !/77" ske$etons. 0)ter 'ou
$ook at hunger, 'ou ha%e to $ook at $ead in the air )rom )ue$,burning, $ead in toothpaste, and $ead in bab' )ormu$a. #t(s so much simp$er to b$ame the mother )or $etting the chi$d suck on paint. 4) course, it a$so makes the po$itica$ c$imate much more amenab$e to the growth o) &odern &edicine. &edica$ sanction and promotion o) birth contro$ at a$$ costs and sma$$ )ami$ies doesn(t ser%e an' pro%en medica$ purpose, but it sure ser%es the interests o) the industr',go%ernment comp$ex. 4nce again, women and chi$dren are on the wrong end o) the process. &an' women must work in an outside 2ob mere$' to make ends meet in the househo$d. 3hat strikes me as a po$itica$,economic prob$em more than an'thing e$se, since the head o) a househo$d ,, man or woman ,, shou$d be ab$e to support the )ami$' without the other adu$t ha%ing to go to work. 9acing that prob$em re.uires taking on some o) the basic ine.uities o) our societ'. +o we ca$$ in the doctors to medica$i<e the situation. +ince $arge )ami$ies re.uire a mother Gor )atherH to sta' around the house $onger be)ore going to seek emp$o'ment, doctors dec$are !/7>" sma$$ )ami$ies better than $arge ones. 3hen, doctors supp$' the apparatus needed to keep )ami$ies sma$$ and put $ess strain on the institutions that $ike to maintain economic and po$itica$ contro$, institutions that wou$d ha%e to 'ie$d some power i) it sudden$' became an issue that one wage,earner per )ami$' was simp$' not enough an'more. Barge )ami$ies re.uire more time and mone', but the' a$so pro%ide a support )or their members, which u$timate$' makes them more independent o) the go%ernment and the industria$ emp$o'er. #) a man has brothers, sisters, aunts, unc$es, and parents c$ose,b', he can count on their support i) conditions on the 2ob make working more unhea$th' than not working. But when the )ami$' is sma$$ and iso$ated )rom re$ati%es, there is no such cushion at home. 3he nuc$ear )ami$' best ser%es the interests o) the emp$o'er, since the worker has enough responsibi$it' to re.uire emp$o'ment, but not enough to moti%ate him to exceed the $imits acceptab$e to industr', When the home is strong, howe%er, 2ob, hospita$, and go%ernment ha%e $ess chance o) appropriating the wi$$ o) the peop$e. *octors !/7;" promise a woman 1$iberation1 )rom her bio$og', but de$i%er her into the hands o) )ar $ess considerate s$a%ers. *octors don(t rea$$' address the prob$em o) what causes cancer. 3he' dec$are a 1War on 8ancer1 which is a )uti$e assau$t on s'mptoms. #denti)'ing the po$$ution o) our air, water, )ood, and $i)est'$e wou$d re.uire the same kind o) po$itica$ action &odern &edicine mustered to e$e%ate immuni<ations, )$uoridation, and si$%er nitrate to the $e%e$ o) Io$' Waters en)orced b' $aw. Because &odern &edicine is the 8hurch o) *eath, the stronger its in)$uence on societ', the worse o)) a$$ human e$ements wi$$ be. 0 pub$ic order brought about through the too$s o) &odern &edicine wi$$ resemb$e the peace o) the cemeter'. Where%er &odern &edicine gains signi)icant in)$uence in the $i)e o) a communit', that communit' is more o)ten than not harmed rather than he$ped. @o%ernment )ood programs dictated b' nutritiona$ experts, )or examp$e, assau$t minorit' communities b' )orcing them to eat 1standardi<ed1 0merican )ood, which ma' be into$erab$e to their habits as we$$ as their bio$og'. #n schoo$ $unch programs and !/7:" nutrition programs )or o$der peop$e, $itt$e attention is paid to cu$tura$, )ami$ia$, or re$igious )ood traditions. &odern &edicine simp$' sa's that e%er'bod' needs the Big 9our: %egetab$es and )ruits, grains, meats, and dair' products. We know, o) course, that man' cu$tures cannot to$erate cows mi$k because o) en<'matic de)iciencies. We a$so know that traditiona$ cu$tura$ diets are .uite nutritious, since the' ha%e de%e$oped o%er hundreds o) 'ears o) adaptation. 0merican nutritiona$ habits, howe%er, are dictated b' a %ariet' o) considerations, some o) which are hea$th', but most o) which are not. 8ommunities a$so are damaged b' mass screening programs designed to iso$ate carriers o) certain
racia$$',associated diseases. +creening )or 3a',+achs disease has been contro%ersia$ within the Aewish communit' because o) its e))ects on the mora$e and beha%ior o) an'one who is identi)ied as a carrier. 3he same is true within the b$ack communit', which must endure the in%asion o) communit' hea$th o))icers screening )or sick$e ce$$ anemia. 3he )irst ingredient in m' recipe )or turning a hea$th' communit' into a s$um is to bui$d a !/78" hospita$ right in the midd$e o) it. 4nce the hospita$ has estab$ished a beachhead, &odern &edicine can $aunch its )irst attack, which is against the )ami$'. #) # were out to destro' )ami$' ties among the poor, the )irst thing # wou$d do is hospita$i<e them )or chi$dbirth and make sure the' ga%e their chi$dren )ormu$a instead o) breastmi$k. 0t the Cni%ersit' o) #$$inois Iospita$ about thirt' 'ears ago, ninet',nine percent o) the new mothers were breast)eeding. 3oda' it(s down to one percent. Next # wou$d institute )ami$' p$anning in poor neighborhoods. #(d hire a who$e bunch o) poor peop$e to teach contraception to other poor peop$e. 3he )edera$ go%enment started to do a$$ this twent',)i%e 'ears ago with the intentions o) pre%enting i$$egitimac' and %enerea$ disease. What has been the resu$t a)ter twent',)i%e 'ears- 3he poor peop$e ha%e more i$$egitimac' and %enerea$ disease than e%er be)ore, and )ami$' ties are weaker. 3he next thing # want to do, once #(%e so)tened them up with )ora's o) in)ant )ormu$a and )ami$' p$anning, is to make the inhabitants o) poor neighborhoods ,, b$ack peop$e ,, )ee$ in)erior. !/79" +o # institute a sick$e ce$$ anemia screening program which identi)ies one out o) se%en b$acks as carriers. 3hen # reassure the carriers 2ust as # reassure peop$e with )unctiona$ heart murmurs, that it doesn(t mean an'thing to be a carrier. 4) course, the' don(t be$ie%e it )or a minute. 3he' are con%inced the'(%e got 1bad b$ood,1 so the' ha%e to be care)u$ about whom the' marr', and the' $et it weigh them down )or the rest o) their $i%es. +o much )or the poor neighborhoods. *octors make sure other segments o) societ' remain poor, too. *iscrimination against o$d peop$e begins with the 1curse1 on them, which sa's the' wi$$ necessari$' dec$ine in a$$ ta$ents and abi$ities which make peop$e worthwhi$e members o) societ'. 3hus medica$$' cursed, the o$d person is )orced to retire and become a ward o) the state, or ,, better sti$$ ,, a ward o) the 8hurch as an inmate o) a rest home. 4) course, the u$timate goa$ is that we wou$d a$$ become wards o) &odern &edicine. *octors exhibit a dangerous tendenc' to take ad%antage o) e%er' opportunit' to )orce indi%idua$s to do things 2ust )or the sake o) doing them, #) doctors !/> " didn(t want more and more power o%er the indi%idua$, wh' wou$d more and more medica$ procedures be showing up as $aws- Wh' shou$d 'ou ha%e to )ight with a doctor in order to ha%e 'our bab' at home, breast)eed it, send it to schoo$ or treat its i$$nesses in an' manner 'ou be$ie%e e))ecti%e#(m not too surprised that norma$$' a$ert and power)u$ organi<ations $ike the $abor unions and the 0merican 8i%i$ Biberties Cnion ha%en(t responded to this threat against our )reedom. 3he' )ai$ to acknow$edge the prob$em because the' subscribe to the re$igion o) &odern &edicine. #nstead o) sa'ing that e%er' person is entit$ed to not ha%e an x,ra' or an abortion, the' sa' the opposite. 3he' won(t notice when the 8hurch re.uires )irst o$der mothers, then a$$ mothers, to submit to amniocentesis to ru$e out birth de)ects. 3he' won(t notice when the 8hurch )orces these mothers to ha%e abortions, either. 0nd when 'our turn be)ore the &edica$ 0uthorities comes up ,, who knows what )or- &a'be 'ou($$ need pre%enti%e surger' ,, 'ou($$ stand a$one. Whene%er a re%o$utionar' group adopts a !/>1" word, the reactionar' group adopts it. 3his is precise$' what &odern &edicine has done with the term 1pre%enti%e medicine.1 B' making a
distinction between pre%enti%e medicine and other )orms o) medicine, the 8hurch contro$s the concept and $egitimi<es its own obsession with crisis medicine. #) the' want to ca$$ what the'(re doing pre%enti%e medicine, $et them. But $et(s not ca$$ an'thing we do pre%enti%e medicine. 4n the other hand, i) the' want to $abe$ re%o$utionar' procedures according to their own interests, that(s 4F, too. 6ou can be re)erred to as chi$d abuser )or encouraging mothers to ha%e their babies at home. #) necessar', instead o) )ighting o%er the words, 'ou shou$d be per)ect$' wi$$ing to be identi)ied as a chi$d abuser. #) somebod' sa's that breast)eeding ties down mothers and increases the chi$d(s dependenc', sa' 'ou(re in )a%or o) mothers being tied down and o) chi$dren being dependent on their mothers. #) an'bod' sa's that peop$e who want their )ood to be pure and natura$ are nuts, )addists, and extremists, re)er to 'ourse$) and 'our )riends as nuts, )adists, and extremists. &odern !/>/" &edicine ma' $abe$ unorthodox doctors as .uacksD ma'be what we need is more 1.uacks.1 Words aren(t important. 0ction is. 0nd the kind o) action that(s re.uired is nothing $ess than the destruction o) the 8hurch o) &odern &edicine. 0cross the countr' there are hundreds o) bri$$iant peop$e per)orming research on wa's to )ight and pre%ent ki$$er diseases such as cancer and heart disease, but because their wa's aren(t orthodox, the' must tread on %er' $ight )eet i) the' don(t want to be hounded out o) town b' the 8hurch. Witness the denia$ o) )unds to Nobe$ Baureate Binus Jau$ing, who simp$' wanted the Nationa$ 8ancer #nstitute to grant a modicum o) )unds to )ind out i) ascorbic acid rea$$' pro%ided some bene)it )or cancer patients ,, which his ear$ier research indicated. Witness the )act that more than one doctor # ha%e spoken to has admitted that he wou$d use out$awed cancer therapies on himse$) or his )ami$'. #s this the kind o) s'stem 'ou can work withinJeop$e shou$d work to $iberate themse$%es comp$ete$' )rom &odern &edicine. #t wi$$ take an arm' o) heretics with )irm reso$%e to be )ree !/>5" o) &odern &edicine and with the courage, cunning, and resources to reconstruct societ'(s attitudes towards hea$th and disease. What(s needed is a New &edicine, a new %ision o) medica$ care.
Chapter 9 $he Ne/ Medicine

3he New &edicine is m' recipe )or winning, m' b$ueprint )or the de)eat o) the 8hurch o) &odern &edicine. Cp to now #(%e been te$$ing 'ou wh' and how 'ou shou$d protect 'ourse$) )rom &odern &edicine. #(%e to$d 'ou how to decei%e the doctor, how to )ind out i) his ad%ice is good, how to check up on him, how to scare him, how to con)ront him, and how to maintain 'our hea$th despite his dangerous practices. &a'be 'ou(%e tried some o) these recommendations, or ma'be 'ou(re 2ust reading this book )or entertainment. #) 'ou ha%e tried an' o) them, 'ou(re probab$' aware that 'ou(%e been doing somewhat more than protecting 'ourse$). 6ou(%e been sub%erting &odern &edicine. #(%e to$d 'ou to $ie to 'our doctor, to !/>;" shu))$e and smi$e ,, and to organi<e behind his back with peop$e who think the wa' 'ou do about hea$th. #(%e to$d 'ou to $ea%e the 8hurch o) &odern &edicine and not to cha$$enge it and become a mart'r. #(%e been setting 'ou up. 4ne o) m' )a%orite mottoes is that there comes a time to rise abo%e princip$e and to do what has to
be done. 4nce 'ou put an' part o) m' recipe into practice, 'ou($$ )ind out prett' .uick$' that deciding to protect 'ourse$) )rom 'our doctor ine%itab$' $eads to a much more pro)ound commitment. 0 sing$e )irst step towards the New &edicine wi$$ render 'ou unab$e to stand sti$$. 6ou($$ either ha%e to retreat and $et the doctors run 'our $i)e again, or 'ou($$ ha%e to keep going )orward. &a'be 'ou($$ start b' deciding 'ou want to ha%e 'our bab' at home, or that 'ou want to breast)eed 'our bab', or that 'ou want to enro$$ 'our chi$dren in schoo$ without immuni<ing them, or that 'ou want to skip this 'ear(s annua$ 2ob ph'sica$, or that 'ou want to pin down 'our doctor on wh' he recommends surger', or that 'ou want the doctor to do something )or 'ou or 'our chi$d without using drugs. 8ommit 'ourse$) to an' one o) these things and m' guess is that 'our experience wi$$ be the )irst chink in the g$ass, the radica$i<ing experience that wi$$ $ead to 'our becoming a medica$ guerri$$a. #(m gi%ing 'ou )air warning. 4n the other hand, 'ou don(t ha%e to take a $o'a$t' oath to 2oin this re%o$utioin. We don(t need s'mbo$ic protestations o) de%otion with !/>:" more s'mbo$ic than actua$ worth. 3he practice o) the New &edicine immediate$' estab$ishes 'ou as $o'a$. 3aking on the responsibi$it' )or 'our own hea$th and the hea$th o) 'our )ami$' constitutes a po$itica$ act as $ong as &odern &edicine uses po$itica$ power to execute its attack on the indi%idua$(s and the )ami$'(s right to se$),determine hea$th. 4ur %er' act o) commitment to the )ami$' as a unit o) hea$th and to the communit' as a co$$ection o) )ami$ies is po$itica$ because it resists the notion that the indi%idua$ is the unit o) hea$th as we$$ as o) societ'. 4ur New &edicine cuts across a$$ po$itica$ and ideo$ogica$ $ines and touches the core o) e%er' person(s re$ationship with $i)e: Iow $ong and how we$$ wi$$ # $i%e- 3he New &edicine, too, takes on some o) the trappings o) a re$igion. 3he 4$d &edicine became a church because it ine%itab$' dea$t with the same prob$ems o) $i)e and death and meaning that re$igions do. #t has done a bad 2ob o) dea$ing with them, particu$ar$' because it de%e$oped a theo$og' based on non,$i%ing things. #t became a corrupt, ido$atrous church. #t discredited the o$d re$igions, which ,, )or better or )or worse ,, had he$ped peop$e dea$ with $i)e and death and e%er'thing in between. 3hat is a mistake the New &edicine won(t make. #n this book, # ha%e tried m' best to discredit the 8hurch o) &odern &edicine. Now # can(t do that without suggesting an a$ternati%e !/>8" to &odern &edicine. # want to e%ict the %i$$ains )rom the structure and )i$$ the structure with new peop$e, per)orming new tasks. 9aith is the )irst re.uirement )or a re$igion, and 'ou sti$$ need )aith to practice the New &edicine. But 'ou won(t need )aith in techno$og' or doctors, or drugs, or pro)essiona$s. 6ou need )aith in $i)e. B' )aith)u$$', re$igious$' i) 'ou wi$$, regarding $i)e ,, and $o%ing it ,, the New &edicine immediate$' wi$$ discredit &odern &edicine. 3he New &edicine need not come between a person and whate%er traditiona$ re$igion he or she chooses, because the re$igions that ha%e sur%i%ed a$$ support $i)e. E%er' person needs a s'stem o) %a$ue, an ethica$ sturcture to assist in )undamenta$ decisions. 0 person who c$aims to get a$ong without making %a$ue 2udgments is sti$$ abiding b' a s'stem ,, o) making no %a$ue 2udgments. 3here(s no wa' to escape it, and that(s what re$igion is a$$ about. Ee$igion de)ines a hierarch' o) %a$ues and gi%es a perscription )or action so that peop$e can determine which wa' to go when a$ternati%es are set be)ore them. &odern &edicine came a$ong and took o%er the show b' sa'ing, 16ou no $onger ha%e to worr' about the %a$ues o) these other ethica$ s'stems, because we can )ix an'thing that happens to 'ou.
We re$ease 'ou )rom the ethics o) considering %a$ue and, in return, demand on$' )aith in a s'mbo$ic ethic, a sacramenta$ ethic o) our own distorted $ogic.1 !/>9" No s'stem o) $ogic, distorted or otherwise, e%er got around bio$og'. 0nd in bio$og', the New &edicine )inds its ethic, its %a$ue s'stem. +ince $i)e is the centra$ m'ster' o) our New &edicine, our 1sacraments1 acknow$edge and ce$ebrate the $i)e o) the uni%erse. 3he 1sins1 o) the New &edicine, in man' cases, turn out to be the %irtues o) the 8hurch o) &odern &edicine: an' practice that promotes or condones %io$ence against $i)e. 3he New &edicine sa's it(s a 1sin1 to restrict weight gain during pregnanc', to use the Ji$$ )ree$' on the theor' that it(s sa)er than pregnanc', to submit to routine annua$ ph'sica$s, to put si$%er nitrate in babies( e'es, to immuni<e chi$dren routine$', to be ignorant o) nutrition, and a host o) other acti%ities that &odern &edicine promotes as 1hea$th'.1 3hese acti%ities are sins not because the' o))end an'bod'(s idea o) correct or po$ite beha%ior, but because the' present a c$ear and present danger to $i)e. 3he' are o))enses against bio$og'. +ince the $i)e in our bodies seems to ha%e an incredib$e capacit' to hea$ itse$), i) gi%en the proper conditions the correcti%e acti%ities o) the New &edicine ,, gui$t and penance ,, wi$$ aim at producing those proper conditions. #mba$ance is o)ten as di))icu$t to a%oid in human $i)e as ba$ance is desirab$e. +ince this is a human medicine, not one bound to the death$' )orma$it' o) machines, hope is one thing that is ne%er taken awa' )rom e%en the worst 1sinner.1 3he New &edicine doesn(t ha%e an' empt' !/; " ritua$s. 6ou )u$)i$$ the 1commandments1 and ce$ebrate the sacraments b' doing rea$ things. Natura$$', we ha%e priests in this re$igion, too. But the New *octor is not the prime mediator between the )aith)u$ and the ob2ect o) )aith. 3he authorit' o) the doctor is se%ere$' $imited b' the indi%idua$ taking the responsibi$it' upon himse$). +ti$$, a s'stem o) ethics needs a mediator, a supporter o) the )aith)u$ in their .uest, a $i)eguard when the .uest runs into troub$e. Ne%er )orget that the New *octor(s goa$ is to work himse$) or herse$) right out o) business, so 'our dependence on the pro)essiona$ shou$d diminish e%er' da'. 6ou ha%e to $earn to get a$ong without doctors, because doctors aren(t the 4rac$es o) )aith: 3he 4rac$es o) )aith, the the ce$ebrants o) the re$igion o) $i)e are the se$), the )ami$', and the communit'. 9rom these %esse$s )$ow the determinants o) hea$th: $i)e, $o%e, and courage. 6our )irst responsibi$it' is to take care o) 'our bod' and mind. 9ood is %er' important, but not )ood mere$' in the sense o) bread, water, protein, )iber, and %itamins. 6ou must tr' to eat pure )ood and drink pure water. 6ou must )ind out a$$ 'ou can about which )oods are best )or 'ou, since what goes into 'our mouth does make a di))erence in what comes out. We ha%e other appetites that must be nourished, too. #n a sense, e%er'thing that comes into 'our $i)e and bod' is )ood. Whether it(s nourishing or whether it(s 2unk )ood is the indi%idua$(s responsibi$it', and wi$$ determine the se$)(s success !/;1" in reaching the goa$ o) hea$th. #) 'ou spend a $ot o) time in )ront o) the te$e%$sion, $ost in a make,be$ie%e wor$d that runs a poor second to rea$ $i)e, 'ou(re wasting the time o) 'our $i)e, time that shou$d be used to nourish 'our se$) and those around 'ou. 8hoose 'our )ood. 3r' to taste and see and hear and )ee$ and touch things that wi$$ add to 'our supp$' o) $i)e. 4ur New &edicine consecrates acti%ities as we$$ as )ood. Luite simp$', there are things peop$e shou$d be doing and shou$dn(t be doing )or themse$%es, )or the sake o) their own bio$ogica$ truths, )or their own $i%es, 3he consecration o) )ood go%erns what comes into the bod'. 3he consecration o) acti%it' go%erns what the indi%idua$ does with the bod' and the mind, the musc$es and the spirit. 0$$ re$igions ha%e some )orm o) %ocation, but the ca$$ing )rom @od is usua$$' reser%ed )or those
who are going to enter the re$igion(s priesthood. 4ur New &edicine sa's that e%er'one shou$d choose his or her career as i) ca$$ed b' @od, because in a %er' rea$ wa' e%er'one does ha%e a %ocation: E%er'one is ca$$ed to $i%e a $ong and happ' $i)e. 4ur New &edicine a$so re.uires peop$e to gather together at signi)icant moments o) $i)e, such as births, marriages, i$$nesses, anni%ersaries, and deaths. +ince industria$ emp$o'ment is o)ten geared )or production, not )or persona$ hea$th, taking enough time to per)orm these ob$igations the wa' the' shou$d be per)ormed !/;/" ma' create a di$emma. 6ou ma' wind up se$),emp$o'ed, or unemp$o'ed. 3he New &edicine ca$$s )or a more ba$anced approach to career. Bui$d a $i)e around persona$ goa$s and human$' satis)'ing acti%ities. Bi)e comes )irst, not the carrot,on,a,stick promises o) the rat race. 4rgani<e 'our time and pursue a career in such a wa' as to a$$ow participation in $i)e e%ents o) signi)icance and beaut'. 3he home is the 3emp$e o) our New &edicine, because the home is the indi%idua$(s )ortress against the unhea$th' institutions such as industr' and the 8hurch o) &odern &edicine. #) an indi%idua$, )or examp$e, has to .uit his or her 2ob because it becomes a threat to hea$th, the )ami$' is there to o))er support unti$ a new source o) income can be set up. 3his ma' sound strange to those o) us who ha%e bought the industria$ societ'(s notion o) the )ami$' as a $iabi$it' rather than an asset. #ndustr'(s purposes are better ser%ed i) the )ami$' is kept sma$$, $imited to two chi$dren and one or two adu$ts, not i) the )ami$' is considered in its true sense, the co$$ection o) re$ated peop$e o) a$$ ages $i%ing in c$ose proximit' and experiencing important $i)e e%ents together. When the )ami$' bands together )or purposes o) de)ense as we$$ as ce$ebration, no institution can disrupt the $i%es o) its members. 4ur New &edicine(s regard )or the )ami$' begins when the )ami$' itse$) begins. 4ur )irst 1commandment1 is 13hou sha$t not pa' an' attention to sca$es during pregnanc'.1 #nstead, !/;5" 'ou pa' attention to the .ua$it' o) the )ood 'ou eat, eat the purest and most nourishing )ood 'ou can get, and stop taking a$$ medications. 6ou don(t take pi$$s 1on$' when necessar',1 because there are )ew doctors who don(t be$ie%e that pi$$s are a$wa's 1necessar'.1 +ame goes )or x,ra's. +ince our New &edicine is a medicine de%oted to $i)e, since birth is the principa$ e%ent o) $i)e, and since the home is the temp$e o) our New &edicine, the birth o) the bab' idea$$' occurs at home, awa' )rom a$$ the dangers o) the hospita$ and c$ose to a$$ the $o%e and support o) the )ami$'. 3he birth o) a new )ami$' member is an e%ent that shou$d not be iso$ated )rom the ma2orit' o) the )ami$'. 0s soon as possib$e a)ter the birth, e%er' )ami$' member shou$d be there to greet the new arri%a$ and to ce$ebrate. 3hat is how the sacrament o) birth is per)ormed, b' ce$ebrating, comp$ete with a )ami$' )east and singing and $aughter. 3o an'one who(s read this book so )ar, it goes without sa'ing that the new mother breast)eeds her bab' exc$usi%e$' at )irst, sa' the )irst six months, and then begins to supp$ement her mi$k with so$id )ood prepared )rom the )ami$'(s tab$e, not the machines o) a )ood manu)acturer. 3he usua$ ad%ice gi%en b' doctors is that in raising chi$dren parents shou$d be consistent. # be$ie%e that the on$' thing parents shou$d do consistent$' is $o%e their chi$dren and each other. 4therwise, there is no particu$ar %irtue in !/;7" consistenc'. Jarents ha%e a hard enough time without tr'ing to keep track o) a$$ that the'(%e done )or and said to their chi$dren. 3he )ami$' is a $i%ing thing and shou$d not be pressed into the con)ormit' o) thought and action characteristic o) a machine. # once stated on the radio that when it comes to caring )or chi$dren, one grandmother is worth two pediatricians. &' department chairman phoned me short$' therea)ter and announced his intent to
rep$ace me with two grandmothers. #n e%er' aspect o) chi$d care, experts shou$d be regarded with utmost suspicion. Each )ami$' must consider the patterns that ha%e pro%ed success)u$ in their )ami$', their cu$ture, their socia$ c$ass, and re$igion. Experts( opinions shou$d be considered worth$ess unti$ pro%ed otherwise b' the strongest possib$e e%idence. Cn)ortunate$', in order to reach back through the disruption o) the )ami$' in modern times, it ma' be necessar' to go back to grandparents or e%en great,grandparents in order to )ind out what these traditiona$ practices were. When the historica$$' %a$idated cu$tura$ patterns ha%e been $ost, it ma' be necessar' to resort to )riends and neighbors who come )rom hea$th' traditiona$ backgrounds. 9rom birth onward, signi)icant e%ents in the $i)e o) the )ami$' are cerebrated en masse b' the )ami$'. We discard the terms 1nuc$ear )ami$'1 and 1extended )ami$',1 because we(re not ta$king about )ami$' i) we(re not ta$king about the entire assemb$age o) b$ood re$ati%es. 0$$ !/;>" generations participate in )ami$' $i)e and re$e%anc' is denied no one because o) age. E%er' )ami$' member knows that when the )ami$' needs him or her, the )ami$' comes )irst. When a )ami$' member has to be hospita$i<ed, there(s a$wa's a crew o) re$ati%es a%ai$ab$e to ride shotgun. *eath is another one o) those una%oidab$e $i)e experiences that brings the )ami$' together. Aust as births, birthda's, marriages, and other )ami$' e%ents take precedence o%er career and other acti%ities, the death o) a )ami$' member re.uires attendance. No )ami$' member dies a$one or with on$' the sta)) o) the intensi%e care ward to note his or her passing. Bi)e shou$d end where it begins, in the home. 4utside o) the home, the 1medica$ gueri$$a1 doesn(t 2ust mind his or her own business either. 3he ethic o) &odern &edicine, and to a great extent the 0merican ethic, sa's that the indi%idua$ shou$d keep to himse$). #(%e a$read' ta$ked about the %arious wa's in which the pro)essiona$ ser%ices o) doctors and others destro' not on$' )ami$' ties but communit' ties as we$$. 4ur New &edicine, howe%er, sa's we need those communit' ties. 6ou are 'our brother(s ,, and sister(s ,, keeper. 4ur New &edicine needs communit' )or a number o) interesting reasons. 9irst o) a$$, though the New &edicine is directed at )reeing the indi%idua$ )rom the disab$ing and dangerous tendencies o) &odern &edicine, we recogni<e that it(s %er' di))icu$t to sustain this !/;;" sort o) rebe$$ion b' 'ourse$). We a$$ need )riends, but e%en more so when we(re carr'ing on a batt$e against the &edica$ #n.uisition. 4ur communit' is a co$$ection o) )ami$ies re$ating to one another as )ami$ies. Now this ma' seem remarkab$' 1o$d,)ashioned1 but remember, the )ami$' is the unit o) hea$th, the indi%idua$(s primar' resource. 3he communit' can a$so be a resource )or hea$th, but communities are more easi$' dispersed, and because o) the nature o) 0merican $i)e, are more o)ten dispersed. 3his is not to sa' that peop$e do not and shou$d not draw upon the resources o) )riends at the )ar corners o) the g$obe. 4n the contrar', the communit' shou$d grow and spread its wings. 3hink o) a communit' as a congregation o) peop$e sharing the same )aith. 4ur communit' or congregation does not con)$ict with a )ami$'(s re$igious congregation, 2ust as our medica$ 1re$igion1 doesn(t compete with an indi%idua$s re$igious be$ie)s. 4) course, 'ou ma' not be ab$e to )ind a congregation. #n that case, 'ou shou$d start 'our own. 6ou ma' be ab$e to start with 'our own )ami$', or 'ou ma' ha%e to start with )riends, or 'ou ma' ha%e to mo%e. # o)ten te$$ women who come to me and sa' the'(d $ike to breast)eed their babies but are not sure the'($$ be ab$e, to mo%e next door to a woman who has suceess)u$$' breast)ed a number o) babies. 3he important thing is to get c$ose to peop$e who share 'our ethics and standards. Each o) us has !/;:" on$' a )inite amount o) time and energ', and since 'our ma2or supports and
encouragements are going to come )rom peop$e who think and )ee$ the wa' 'ou do, 'ou shou$dn(t )ee$ gui$t' about growing apart )rom peop$e who don(t think and )ee$ the same wa'. 0t the same time, our New &edicine doesn(t pro%ide a $icense )or narrowing the scope o) 'our %ision to the point where 'our ph'sica$ and inte$$ectua$ $i)e become a matter o) routine. 6ou shou$d keep in)ormed o) the ethica$ s'stems o) other re$igions and wa's o) hea$th. *on(t 2ust read one or two or three books and pronounce 'ourse$) sa%ed. Eead 1 books= Eead e%er' book 'ou can )ind on the sub2ect o) hea$th, especia$$' those that expose the dangerous inade.uacies o) &odern &odicine, and those that are grounded in traditions that ha%e sur%i%ed )or hundreds o) 'ears. G+ee the Bib$iogaph' )or a good $ist to start with.H @et used to the idea right awa' that no sing$e s'stem can or shou$d c$aim to ha%e an exc$usi%e )ix on the d'namics o) hea$th. +ince our New &edicine is a bio$ogica$ 1re$igion,1 the promised rewards are a$so bio$ogica$. 3he primar' rewards wi$$ be .uantitati%e: $ow in)ant morta$it' and $ong $i)e expectanc'. +pe$$ that out in terms o) .ua$it' o) $i)e and it means that e%er'bod' wi$$ be hea$thier. We wi$$ ha%e a $ow incidence o) bio$ogica$ and socio$ogica$ disease. Bio$ogica$$', there wi$$ be a $ow incidence o) in)ections, a$$ergies, cancer, heart disease, diabetes, and toxic conditions. +ocio$ogica$$', !/;8" there wi$$ be a $ow incidence o) di%orce, suicide, and depression. With $ess disease, there wi$$ be $ess need )or the doctor,priest. 3he number o) %isits to and b' the doctor wi$$ drop, the number o) procedures per)ormed b' doctors wi$$ drop, and the price tag )or medica$ care wi$$ drop. 3he doctor wi$$ be trans)ormed into a )ami$' )riend and wi$$ no $onger be considered the 1outside technician1 whose ski$$s are the ob2ect o) awe. 4ur communit' wi$$ grow, both interna$$' and externa$$', because o) the $iberation o) the )ami$' )rom being considered a $iabi$it' to being considered an asset. #nterna$$', our numbers wi$$ grow as )ami$ies grow $arger. Externa$$', we wi$$ grow b' attracting more and more peop$e who want to be )ree o) &odern &edicine. Jerhaps more important than the measurab$e rewards are the rewards that can(t be expressed in statistics or do$$ars and cents. 4urs is a medicine o) hope, not despairD o) 2o', not sorrowD o) $o%e, not )ear. 0$$ o) our 1sacraments1 are ce$ebrations. We don(t note birthda's, marriages, and other mi$estones b' sucking b$ood or demanding an o))ering. We ask )or a part'= When a woman has a bab' at home, it(s not on$' to a%oid the dangers o) the hospita$. #t(s to make possib$e the 2o'ous sharing o) a$$ )ami$' members in the tru$' b$essed e%ent. When a woman nurses her bab', she(s going to )ee$ 2o' she cou$d ne%er )ee$ i) the bab' were sucking on a p$astic nipp$e attached to a bott$e= !/;9" 4ur New &edicine o))ers the per)ect antidote to the ma2or disease a))$icting 0merican societ' toda': depression. *epression is a s$ice o) death, and our committment to $i)e and 2o' denies us that morse$ o) despair. 3he recipe )or depression is iso$ation, abandonment, )rustration, and a$ienation. 4ur sacraments simp$' don(t $et those situations de%e$op. #t(s %er' di))icu$t to )ee$ a)raid, a$one, and un$o%ed when 'ou(%e got somebod'(s birthda' or bab' or marriage or new 2ob or ... whate%er to ce$ebrate. When we sa' that our New &edicine is a communit' o) ce$ebrants, we mean it. 0nother reward we can promise is that once 'ou ha%e the a$ternati%e o) participating in our New &edicine, 'ou $earn to regard the 1other side1 without the )ear and hatred that are $ike$' when 'ou ha%e no option, when 'ou ha%e to submit to &odern &edicine. 6our origina$ sense o) )rustration and depression is trans)ormed, into amusement, e%en. &an' recent books and mo%ies ha%e %er' c$e%er$' exposed some o) &odern &edicine(s more ob%ious )au$ts. When 'ou(re not aware o) a$ternat$%es to &odern &edicine, these re%e$ations can hit prett' hard. # and some o) m' students
ha%e come c$ose to being thrown out o) mo%ie theaters when our $aughter has rung out o%er an audience(s gasps at the screen(s depiction o) &odern &edicine at its s$apstick best ... or worst. 4nce 'ou get into our New &edicine, once 'ou rea$i<e that 'our hea$th and the hea$th o) !/: " 'our )ami$' is a happ' and hope)u$ pri%i$ege rather than an ominous $iabi$it' to be entrusted to strangers, 'ou wi$$ )ee$ )reer and happier. 0 $ot o) peop$e ha%e come up to me and said that it(s %er' di))icu$t )or someone to embrace this 1re%o$ution1 un$ess the'(%e been radica$i<ed. Cn$ess &odern &edicine has se%ere$' hurt them or someone c$ose to them, peop$e ha%e to$d me, the' won(t begin to see the danger in doctors( procedures we a$$ ha%e come to take )or granted. 3he'(%e to$d me that peop$e need to be scared be)ore the' can )ee$ courage. 0$$ o) that ma' be true. 3his book has, in a wa', been m' answer to m' )riends who ha%e said these things to me. # ha%e written this book precise$' to scare and to radica$i<e peop$e be)ore the' are hurt. Bet this book be 'our radica$i<ing experience. Eemember what #(%e said the next time 'ou go to the doctor. 0nother thing peop$e ask me is how to start. 3he' want to 2oin the re%o$ution but the' don(t know exact$' where to sign up. 6ou don(t ha%e to sign up. 6ou can start the re%o$ution in 'our own home tonight. +tart thinking o) 'our )ami$' as a resource instead o) a $iabi$it'. #) 'ou(re not married, think serious$' about )inding somebod' and getting married. #) 'ou(re married, the most re%o$utionar' act 'ou can per)orm tonight is to concei%e a chi$d. 3hen p$an on ha%ing the bab' at home and breast)eeding him or her. #) 'our parents are a$i%e, ca$$ them up and p$an a %isit o%er the phone )or the next a%ai$ab$e !/:1" weekend. 4r do the same with another re$ati%e. *ecide what 'our priorities are in $i)e. Wou$d 'ou rea$$' rather work on an assemb$' $ine making sure this part )its into that part than making sure the pieces o) a chi$d(s $i)e a$$ )it in p$ace= 0re the rewards o) the rat race rea$$' worth se$$ing so much o) 'our time, energ', and emotiona$ commitment that 'ou don(t ha%e an' $e)t )or 'our )ami$% as we$$ as where rea$ other than c$oser to the coronar' care ward+earch )or a communit'. 0sk the next mother 'ou see i) she is breast)eeding or has breast)ed her bab'. 3he next time somebod' sa's something derogator' about chi$dren or o$d peop$e, sa' something back. When 'ou go to $unch or dinner, start discussing hea$th with peop$e ,, not with the intention o) arguing, but to )ind peop$e who agree with 'ou. 0s soon as 'ou )ind these peop$e, get to know them better. +tart 'our communit'. Jeop$e a$so come up to me and want to know when the re%o$ution wi$$ be o%er, when the' wi$$ be ab$e to stop thinking o) themse$%es as medica$ heretics. # ha%e to admit that # don(t know the answer. # do know that 'ou can te$$ when 'ou(re winning: when 'ou in)$uence those c$osest to 'ou. When 'our )am$' and )riends start to )ee$ and express the 2o' that comes )rom knowing that hea$th is a matter o) choice, not a m'ster' !/:/" o) chance. 3hat can happen when 'ou or a re$ati%e breast)eeds a bab' that(s born at home, or when 'ou or a re$ati%e decides to doub$e,check a doctor(s prescription )or surger' and not on$' a%oids the surger' but )inds a doctor who he$ps so$%e the prob$em without as much as a h'podermic need$e. 0 )ew months ago, # became a grand)ather. 4ur daughter de$i%ered an eight,pound, one,ounce bab' gir$. 8hanna was born, as we p$anned, in our home. #n attendance was m' daughter(s husband, her sister, her mother, &a'er Eisenstein, &.*., and m'se$). Both $abor and de$i%er' )o$$owed an a$most c$assic pattern and $asted about )i%e hours )rom beginning to end. 0)ter 8hanna was born, re$ati%es
and )riends began to %isit. 3he' bare$' paused to greet me at the door be)ore rushing up to greet 8hanna. 9or the )i%e weeks that the new )ami$' sta'ed at our house be)ore mo%ing o)) to their own new home in 8anada, # was ab$e to $ea%e the house e%er' morning whi$e the new mother was as$eep and the new grandmother was rocking the new granddaughter on the porch. 0nd on this wa' home those summer a)ternoons, the new grand)ather didn(t ha%e to stop o)) at the hospita$ to get a peek at his granddaughter behind g$ass. # cou$d go right home and ga<e at her a$$ through dinner. +o # can te$$ we(re winning. # can te$$ we(re winning because the peop$e # see a$read' practicing our New &edicine appear to be the hea$thiest peop$e in our societ'. 3he peop$e o) the Beche Beague and !/:5" N0J+08 and +JCN and simi$ar organi<ations not on$' can turn out thousands and thousands at their meetings, but when the' tra%e$ )rom cit' to cit', the' use each other as points o) re)erence. 3he' ha%e a communit'. # can te$$ we(re winning because in the e'es o) a$$ these )ami$ies and in m' own )ami$' # can see the satis)action, the optimism, and the 2o' when human beings know that the' are the owners o) their own hea$th..
0pilog1 -n Search of the Ne/ Doctor

Iea$th neither begins nor ends with the doctor. 3he doctor(s ro$e is somewhere in the midd$e. 0nd sti$$ crucia$. #) doctors weren(t important, the 8hurch o) &odern &edicine cou$d ne%er ha%e gained the power it has. 3his simu$taneous process o) destro'ing &edicine and rebui$ding &edicine is, b' nature, a po$itica$ process. 0t a$$ $e%e$s, the &edica$ Ee%o$ution in%o$%es the participant in po$itics: #) 'ou keep 'our chi$dren out o) pub$ic schoo$ to a%oid immuni<ing them, that is a po$itica$ act. #) 'ou ha%e 'our bab' at home when state $aws discourage it or hea$th insurance re)uses to pa' )or it, that(s a po$itica$ act. #) 'ou decide to ha%e another bab', that(s a po$itica$ act. Whi$e we turn our backs on the #n.uisition, we turn towards and embrace the !/:;" New &edicine as we need to in order to sur%i%e and prosper. 3hat is going to re.uire action which is exp$icit' po$itica$, too. 0s Aohn &cFnight has said in his essa', 13he &edica$i<ation o) Jo$itics,1 1Jo$itics is the act o) citi<ens poo$ing their inte$$igence to achie%e the maximum human good. &edica$i<ed po$itics is the disa%owa$ o) that common inte$$igence. Jo$itics is the art o) the possib$e ,, a process that recogni<es $imits and grapp$es with the .uestions o) e.uit' imposed b' those $imits. &edica$i<ed po$itics is the art o) the impossib$e ,, the process b' which an un$imited promise is substituted )or 2ustice. Jo$itics is the art o) rea$$ocating power. &edica$i<ed po$itics m'sti)ies contro$ so that power is no $onger an issue. 3he centra$ po$itica$ issue becomes the right to more contro$. Jo$itics is the act o) citi<ens. &edica$i<ed po$itics is the contro$ o) c$ients. 4n$' the hands o) citi<ens can cure medicine. &edicine cannot cure itse$) because its prescriptions came )rom its own s'stem o) %a$ues.1 #) 'our communit' is considering )$uoridating the water ,, or i) it a$read' has )$uoridated water ,, 'ou ma' ha%e to )ight it. 6ou ma' take po$itica$ action and work against the enactment o) nationa$ hea$th insurance, or work )or the inc$usion o) 1re%o$utionar' c$auses1 which wi$$ pre%ent the #n.uisition )rom getting a death grip on our societ'. 6ou ma' work po$itica$$' )or $aws which wi$$ e))ecti%e$' remo%e poisons )rom our air, )ood and water. 4r )or changes in !/::" the +ocia$ +ecurit' and tax $aws that wi$$ )a%or keeping )ami$ies together and strong.
# recent$' was asked b' a group o) Batin,0merican mothers in 8hicago to he$p promote breast)eeding among the members o) their organi<ation )or better chi$d raising. 3he' knew their biggest prob$em was that the communit' hospita$s these women were using sanctioned the use o) )ormu$a. 3he mothers decided to do something with their organi<ation. 3he' %isited the heads o) the hospita$s and tried to persuade them to stop encouraging bott$e)eeding b' handing out )ree sixpacks o) )ormu$a and specia$ 1supp$ementar' )eeding packs1 to mothers who a$read' were breast)eeding. 3he' said that i) the hospita$ heads did not respond to their re.uests, the' were going to picket the hospita$s. #t seems to me that the New *octor has to be in the )ront $ines o) these strugg$es. Ie or she wi$$ ha%e to be in%o$%ed po$itica$$' i) on$' in response to his patients( needs. Ie or she wi$$ be %isib$e through the newspapers and other media when these issues come to the )ore. 0nd i) the' don(t come there, he($$ make sure the' do. 3his is one o) the ma2or di))erences between the ethics o) &odern &edicine and those o) the New &edicine. &odern &edicine te$$s doctors to sta' out o) po$itics. 4) course, this is mere$' to hide the )act that doctors are a$read' into po$itics in an immense$' power)u$ wa'. 3he 8hurch $ikes the status .uo, since it is in contro$, !/:8" so it wants to be ab$e to scare awa' potentia$ troub$emakers and b$acken the reputations o) those who can(t be scared awa', b' $abe$ing them 1po$iticians.1 3he New &edicine sa's that the doctor is not a monastic priest sitting in his monaster', but is a participant in the $i)e o) the communit'. *octors wi$$ be communit' $eaders acti%e in po$itics because concern )or the hea$th o) the communit' demands it. When the water compan' wants to )$uoridate the pub$ic water, the New *octor wi$$ be right there to make sure peop$e know the bio$ogica$ conse.uences. When the power compan' wants to bui$d a nuc$ear power p$ant, the New *octor wi$$ not stand b' and $et the hea$th o) the communit' be threatened. Eather than a$$ow po$itica$ issues to become medica$i<ed and thus de)used ,, the New *octor wi$$ acknow$edge the need )or po$itica$ power to be app$ied to matters o) hea$th and disease. Ie or she wi$$ not shrink )rom identi)'ing 1bad1 po$itics as )actors in disease. 8ommunit' in%o$%ement o) this nature imp$ies a certain t'pe o) doctor with the sensiti%ities, ski$$s, and moti%ation to he$p bui$d the New &edicine. 0n' co$$ection o) ideas,)or,action can be sub%erted b' the peop$e who do the acting. 3he New *octor is com)ortab$e with peop$e )rom a$$ wa$ks o) $i)e ,, not on$' in the doctor,patient re$ationship, but in socia$ re$ationships as we$$. 3he New *octor considers his or her ser%ice as an agent o) socia$ impro%ement, so !/:9" he or she wi$$ need to understand and be aware o) the socia$ and ethica$ )oundations o) medicine. 3he New *octor wi$$ be con%ersant not on$' in the $anguage o) science, but in the $anguage o) peop$e as we$$. Ie or she is going to be constant$' in)orming patients: in)orming them o) the risks and bene)its o) prospecti%e treatments, in)orming them o) the wa's the' can sta' hea$th', in)orming them o) how certain acti%ities and circumstances a))ect hea$th. 3he doctor,patient re$ationship is democratic in the sense that both doctor and patient share in)ormation e.ua$$'. But that 1democrac'1 must necessari$' break down when the doctor has to exercise his or her authorit'. 3he 1per)ect1 examp$e o) this is when the patient is unconscious. 4b%ious$', under those circumstances the doctor must accept responsibi$it' and make choices in the best interests o) the patient ,, without the patient(s consent. When the patient is conscious, howe%er, the doctor must sti$$ recogni<e that there might be a point at which the patient(s know$edge ends and the doctor(s keeps going. 3hat(s wh' the patient is seeing the doctor, a)ter a$$, to depend ,, howe%er much ,, on that know$edge and
training. # don(t care whether the doctor wears b$ue 2eans or a three,piece suit, whether his or her hair is short or $ong, whether he works out o) a brand,new c$inic or a used %an ,, the patient is there )or the bene)it o) the doctor(s know$edge. 3he doctor must in)orm the patient o) how the patient(s choices wi$$ a))ect him, but !/8 " he or she must not shrink )rom making a 2udgment based on his or her know$edge and ta$ents. 3hat(s what the patient is pa'ing )or. When the New *octor is )aced with a patient who has 2ust had a bab', that patient is going to be in)ormed o) what her a$ternati%es are )or )eeding and caring )or that bab'. 3he New *octor is going to te$$ her that bott$e )eeding is not as sa)e or hea$th' as breast)eeding and that the di))erence in bene)it and risk is great enough so that i) she chooses to bott$e )eed, she is going to ha%e to )ind another doctor. 3he New *octor is not a)raid to act on e%idence that(s a%ai$ab$e toda'. Ie or she has enough con)idence in his or her know$edge, training, and instincts to a%oid the cop out: 1We don(t know enough. 0$$ the e%idence isn t in. We need more research.1 Because the New *octor admits up )ront that these choices are necessar', he or she must be aware and responsi%e to the ethics o) the doctor,patient re$ationship. 3o what extent do peop$e ha%e stewardship o%er $i)e, death, and hea$th- Iow )ar can medicine increase our contro$ o%er $i)e and death- What issues are in%o$%ed in the choices to use arti)icia$ organs, transp$anted organs, and arti)icia$ $i)e,extending machiner'- #t(s not enough )or the New *octor to know how to do things, but wh'. Aust because something can be done, does that mean it shou$d be done- 3he ethic that wi$$ permeate the New *octor(s practice and training !/81" is regard )or the rights and dignit' o) human beings. 0s maker o) hea$th, the New *octor is aware that the patient and nature are the ingredients, not mere$' the medium )or the expression o) techni.ue. 0ware o) the $imits o) human competence, the New *octor knows when to inter%ene in natura$ processes, when to encourage natura$ processes, and when to $et natura$ processes run their course. #mp$ied in this know$edge is awareness o) the harm that can be done b' doctors. 13he art o) medicine,1 accord$ng to a co$$eague and good )r$end o) mine, Beo #. Aacobs, &.*., &edica$ *irector o) 9orest Iospita$, *es J$a$nes, #$$inois, 1)$ows )rom the ph'sician(s abi$it' to be introspecti%e and to understand the patient as a human being with certain )ee$ings, thoughts, attitudes, interpersona$ re$ationships, aspirations, and expectations rather than a mere s'mptom carrier. +uch a ph'sician tends to see the patient, and not himse$), as the primar' person responsib$e )or maintaining hea$th, b' $eading a meaning)u$ $i)e in which proper nutrition, exercise, and stress management combine with an appropriate ba$ance o) $o%e, p$a', and work within a harmonious )ami$'. +uch a ph'sician wi$$ resort to drugs or surger' on$' a)ter his understanding o) the patient(s predicament has ru$ed out non,in%asi%e or educationa$, ps'cho$ogica$, or socia$ approaches.1 3he New *octor acknow$edges nature as the !/8/" prime hea$er, and so regards natura$ supports o) hea$th, such as the )ami$', as ha%ing supreme importance in the hea$ing process. 3he )ami$' is the unit o) hea$th and disease, so the New *octor treats the who$e person in the context o) )ami$' as we$$ as re$igion and socia$ s'stem. 3he New *octor makes house ca$$s and meets the )ami$' on its own tur). Ie or she disregards pro)essiona$ $anguage and ad%ice that tends to sp$it )ami$ies into warring )actions. Jroper a%oidance o) hospita$i<ation wi$$ be a ke' goa$, so the New boctor de$i%ers babies at home and scorns the idea that peop$e must come into and $ea%e this wor$d under conditions o) intensi%e care. 3he New *octor is a $i)eguard. Ie or she stands b' read' to inter%ene in $i)e,threatening situations.
0t the beginning o) $i)e he $ets the mother de$i%er the bab' and stands b' )or the tin' percentage o) cases in which he is needed. 0s soon as we assign the ro$e o) $i)eguard to the doctor, we de)ine what he does and does not do throughout his career. Ie or she does not p$a' the centra$ ro$e. 3he centra$ ro$es are p$a'ed b' the indi%idua$, the )ami$', and the communit'. 0nd in 1guarding1 the hea$th o) his patients, the New *octor estab$ishes priorities according to their promise o) sa)et' and e))ecti%eness. 3he Iippocratic order o) treatment p$aced regimen be)ore medicine and surger'. +o wi$$ the New *octor. What a patient does e%er' da' with and to the bod' and sou$ ha%e a greater e))ect on hea$th than what the doctor can do in !/85" a sma$$ )raction o) that time. 3he New *octor must teach the patient what to do during the mass o) time he is $i%ing his $i)e on his own, awa' )rom the doctor, to maintain and maximi<e hea$th. 3he one ru$e # gi%e to a$$ m' medica$ students is that # don(t care what 'ou do to the patient as $ong as he or she )ee$s better when $ea%ing the o))ice than when coming in. 3he New *octor hea$s with himse$). #) the doctor has enthusiasm and hope, and can communicate this to the patien= then the patient is going to )ee$ better. 0 hea$er is a hea$er no matter what techni.ues he uses. 8onscious o) this, the New *octor prescribes 1himse$)1 in generous doses, meaning he or she uses whate%er resources o) persona$it' and human caring possib$e. 3he New *octor sti$$ wi$$ be a priest in the sense that he or she wi$$ o))iciate or mediate at the abso$ution or c$eansing o) the patient(s 1sins.1 6ou($$ sti$$ ha%e to con)ess to the New *octor, in the sense that 'ou wi$$ gi%e 'our 1histor'1 and the doctor w$$$ identi)' what is hea$th,producing and hea$th,destro'ing in 'our $i)e. 3he New *octor doesn(t presume 'ou(re ne%er going to do an'thing unhea$th', but he(s going to make sure 'ou(re aware o) it when 'ou do. We know that the bod' has its own powers o) abso$ution in its incredib$e abi$it' to adapt and make up )or 1mistakes.1 6ou sti$$ ha%e to do penance, but there(s a di))erence. 3he New *octor doesn(t sprink$e 'ou with ho$' water and pronounce 'ou sa%ed i) 'ou take this drug !/87" or $et him muti$ate 'ou. 3he New *octor doesn(t sacri)ice 'ou to an' %enge)u$ gods. 6our penance is bio$ogica$, it(s the price 'ou ha%e to pa' to get back in ba$ance. 6ou ha%e to o%ercompensate )or a whi$e to make up )or going too )ar. Natura$$', the New *octor tries to moti%ate peop$e to a%oid disease, too. # be$ie%e gui$t is one o) the strongest moti%es )or changing one(s beha%ior. 3he New *octor, being concerned with causes o) disease rather than super)icia$ s'mptoms, is going to ascribe gui$t in a more rationa$ and ethica$ )ashion than &odern &edicine. 3he gui$t wi$$ be persona$, but not exc$usi%e$' persona$, and it wi$$ be re$ie%eab$e through action, not s'mbo$ic ritua$s. #n the case o) $ead poisoning, the gui$t wi$$ be ascribed to whoe%er is responsib$e )or the $ack o) )ood in the re)rigerator, whoe%er is responsib$e )or the $ead in the air, in in)ant )ormu$a, and in )ood. #) a woman opts )or ana$gesia and anesthesia during chi$dbirth, she deser%es some gui$t because these things are not good )or the bab'. #) a mother te$$s the New *octor she(s p$anning to bott$e )eed her bab', the New *octor is going to te$$ her she(s threatening the bab'(s hea$th. New *octors wi$$ tr' to make peop$e )ee$ gui$t' about eating re)ined sugar and )$our and o%er,processed )oods, about smoking and about not exercising. 3he New *octor(s use o) gui$t wi$$ moti%ate peop$e to hea$th' habits rather than )rustration and )ear because there won(t be an' doub$e,think in%o$%ed. +omething is either good )or !/8>" 'ou or bad )or 'ou and the New *octor wi$$ make sure 'ou know the di))erence. 3hat di))erence wi$$ be determined bio$ogica$$' rather than po$itica$$' or re$igious$'. #) bott$e )eeding is wrong, it(s wrong because it exposes mother and bab' to a number o) unhea$th' conditions, such as gastroenteritis, a$$ergies, in)ections, and inade.uate bonding between mother and chi$d. 3he New *octor ma'
be$ie%e that a woman(s bod' is her ownD but bio$ogica$$' he or she knows that abortion causes a higher rate o) steri$it' and other comp$ications that a proper$' in)ormed woman wou$d not choose to expose herse$) to. 0 doctor shou$d te$$ a women that an abortion wi$$ increase the chances o) her de$i%ering a premature in)ant in the )uture b' )i)t' percent. Ie shou$d te$$ her about the #srae$i stud' o) more than 11, pregnancies in which women who had pre%ious induced abortions 1were subse.uent$' $ess $ike$' to ha%e a norma$ de$i%er'. #n the births )o$$owing induced abortions, the re$ati%e risk o) ear$' neonata$ death was doub$ed, whi$e $ate neonata$ deaths showed a three, to )our,)o$d increase. 3here was a signi)icant increase in the )re.uenc' o) $ow birthweight, compared to births in which there was no histor' o) pre%ious abortion. 3here were increases in ma2or and minor congenita$ ma$)ormations.1 G0merican Aourna$ o) Epidemio$og', +eptember, 19:>H 3he New *octor(s honest' wi$$ extend to den'ing &odern &edicine(s( m'thica$ c$aim that e%er'thing can be cured, that no matter how 'ou mess 'ourse$) up the ski$$s o) the !/8;" doctor can put 'ou back together. 3he New *octor in)orms his or her patients that rea$ cures are hard to come b' and that e%en mirac$e cures )ade )ast. Jatients are thus cautioned against stra'ing too )ar awa' )rom the ba$ance that wi$$ insure them a $ong and hea$th' $i)e. 3he New *octor wi$$ be skeptica$ o) the promised bene)its o) drugs and surger'. 4ne o) his or her ma2or areas o) responsibi$it' is to protect peop$e against the excesses o) surgeons and drug companies in )oisting o)) their wares. Ne%erthe$ess, the New *octor does not abandon use)u$ techno$og', but rather discriminates between use)u$ machiner' and machiner' )or,the,sake,o), machiner'. Ie(s trained in the use o) scienti)ic e.uipment, but he(s a$so taught the risks and the de)iciencies o) it. &ost o) a$$, the New *octor doesn(t re$' on machiner' un$ess abso$ute$' necessar'. Ie(s aware o) the dangers o) $etting techno$og' ru$e o%er common sense and instinct. +ince he wi$$ re2ect much o) &odern &edicine(s machiner' the New *octor is know$edgeab$e in unorthodox methods o) treating disease, inc$uding nutritiona$ therap', acupuncture, kinesio$og', chiropractic, homeopath', and others. 4ne o) the primar' acti%ities o) the New *octor is to protect patients against the excesses o) specia$ists. New *octors wi$$ be antagonists to the specia$ists: the'($$ make their patients )ee$ gui$t' about going to a specia$ist and endangering themse$%es without 2usti)ication. #nstead o) %iewing the patient as a co$$ection !/8:" o) s'mptoms $oca$i<ed in a sing$e spot, the New *octor wi$$ see the who$e person as the context and possib$e cause )or disease. E%entua$$', in the $ight o) ethics, iatrogenic considerations and exposure, and genera$ist education o) doctors, the specia$ties wi$$ $arge$' disappear. #) the hospita$ addiction can be $icked ear$' in $i)e ,, at birth ,, it wi$$ not become a habit $ater in $i)e. Iome de$i%er' o) babies wi$$ cause the disappearance o) ninet',)i%e percent o) obstetrics and g'neco$og'. 0s the )ai$ure o) ps'chiatric chemotherap', ps'cho,surger', e$ectroshock therap', ana$'sis, and most counse$ing is exposed ,, in )a%or o) strong )ami$ia$, )riendship, se$),esteem support networks ,, most o) ps'chiatr' wi$$ disappear. #nterna$ medicine wi$$ go under with its high$' $ucrati%e recruiting practices: annua$ exams, screening )or h'pertension, and drug therapies )or diseases that can be treated natura$$'. +urger' wi$$ most$' disappear as peop$e $earn to re)use to $et doctors muti$ate them )or no particu$ar$% good reason ,, and. as the' are ab$e to )ind more and more New *octors who wi$$ treat them without surger'. 3he entire )ie$d o) orthodox onco$og' wi$$ disappear as chemotherap', surger', and radiation )or cancer are re%ea$ed as )undamenta$$' irrationa$ and scienti)ica$$' unsupportab$e. Jediatrics. o) course, wi$$ disappear as more and more mothers are encouraged to breast)eed their babies.
3he New *octor is committed not on$' to putting the specia$ists out o) business, but to putting himse$) out o) business as we$$. *octors !/88" used to sa' the' were in business to put themse$%es out o) business, but it was on$' a s$ogan. Now 'ou don t e%en hear them sa'ing it an'more. But the New *octor wi$$ back up his commitment with action. Ie or she wi$$ teach peop$e how to keep themse$%es hea$th' and how to restore hea$th and ba$ance without the aid o) a pro)essiona$. Whi$e the New *octor knows there wi$$ a$wa's be a need )or doctors, the doctor(s ro$e in the person(s hea$th wi$$ diminish to the point where it might not be a bad idea i) doctors had another wa' to earn a $i%ing besides practicing medicine. 4ne thing is certain, i) e%er' doctor were a New *octor, we wou$d need )ar )ewer doctors and medica$ care wou$d not be the outsi<ed behemoth in peop$e(s $i%es that it is toda'. 3he New *octor must be prepared )or courageous beha%ior, which means doing what has to be done e%en though it means gi%ing up the wea$th, power, and status associated with being a con%entiona$ ph'sician. # don(t think we($$ ha%e an' troub$e insti$$ing courage in New *octors. 3he ones #(%e met ,, as both doctors and doctors,to,be ,, seem to come e.uipped with both courage and the cunning to de)end themse$%es. # met a 'oung doctor recent$' who had .uit his )orma$ medica$ education as soon as he was e$igib$e )or a $icense ,, immediate$' a)ter his internship. # asked him where he was $icensed, and he to$d me in )i%e states. Ie said he anticipated ha%ing troub$e with the medica$ estab$ishment, so he(s prepared i) the' start taking his $icense awa'. !/89" +martest )e$$ow #(%e met in a $ong time. 3he New *octor knows what he has to do to sur%i%e $ong enough to work himse$) out o) business. 4b%ious$', the New *octor exists despite his or her medica$ education rather than because o) it. With this in mind, # and a number o) m' co$$eagues ha%e created a b$ueprint )or the New &edica$ +choo$, which is now acti%e$' seeking state appro%a$ and $ooking )orward to taking on its )irst c$ass o) New *octors,to,be. 3he education o) the New *octor wi$$ inc$ude not on$' medica$ and c$inica$ sciences but ethics and $iterature as we$$. 0$$ students in the New &edica$ +choo$ wi$$ be shown how human beha%ior re$ates to hea$th and disease. New *octors wi$$ be trained to comnunicate b' means o) the written as we$$ as the spoken word. 3he' a$so wi$$ $earn the basic techni.ues and socia$ imp$ications o) other media, such as te$e%ision. New *octors must not on$' be ab$e to communicate e))ecti%e$' with the communit', but the' must be aware o) the processes b' which the' and their patients are in)$uenced. +ince $ega$ procedures are important not on$' to the doctor(s protection o) his practice but to the protection o) his patients as we$$, New *octors wi$$ $earn to dea$ with $aw'ers and the $aw. 3he New &edica$ +choo$ wi$$ ha%e a *epartment o) Ethics and Austice. 0 communit'(s concept o) 2ustice determines the hea$th o) its members in terms o) $i)e expectanc', in)ant morta$it', morbidit' statistics, and .ua$it' o) !/9 " medica$ care. 3heoretica$ economic structures are irre$e%ant. 0 )ree enterprise s'stem saturated with 2ustice can pro%ide good medica$ care, whi$e a socia$i<ed medica$ s'stem de%oid o) 2ustice can pro%ide dead$' medica$ care. 0n immora$ societ' that sets arbitrar' $imits on techno$ogica$ achie%ements can be harm)u$, whi$e a mora$ societ' that stri%es )or the best that techno$og' has to o))er can produce hea$th' peop$e. #n our *epartment o) Ethics, the traditiona$ medica$ discip$ines wi$$ be re.uired to expose their materia$ to the )ight o) %arious ethica$ s'stems: Aewish, 8hristian, Iindu, #s$amic, uti$itarian, situationa$, etc. 3he New &edica$ +choo$ wi$$ ha%e a %er' strong *epartment o) #atrogenic *isease. #n this department a$$ medica$ discip$ines and specia$ties wi$$ be re.uired to demonstrate how their
methods can produce disease and disabi$it'. *octors and pro)essors wi$$ be paid to )ind out how medica$ care does more harm than good, and how proposed new treatments might pro%e harm)u$. #nstead o) the New &edica$ +choo$ pro%iding the same specia$ist,encouraging instruction and ro$e mode$s that con%entiona$ schoo$s do, it wi$$ stress genera$ism. 3he New &edica$ +choo$ wi$$ be an open )orm o) ideas on hea$ing. +tudents wi$$ be taught not on$' b' medica$ doctors, but b' osteopaths and chiropractors and naturopaths and nutritionists. We don(t want the New *octors to $earn about these ideas and practices as i) the' were abstract !/91" academic princip$es. We want them to see them practiced )irsthand. 3he New *octor wi$$ be educated in methods and princip$es that do not become obso$ete e%er' )ew 'ears. 4nce the )i)t',to,ninet' percent o) what is now being taught is re2ected as either wrong, outdated or irre$e%ant, we wi$$ ha%e enough time to teach what has to be taught, such as )undamenta$s o) diagnosis and prognosis. 3he New &edica$ +choo$ wi$$ begin producing New *octors b' se$ecting a di))erent kind o) person to be a student. +tudents who score high$' on traditiona$ medica$ schoo$ entrance exams tend to be too compu$si%e$' achi%ement,oriented. 3he' $ose contact with the genuine goa$s o) medicine and become wrapped up in competition and in the app$ication o) techno$og' to subdue rather than restore the ba$ance o) Nature. 3he New &edica$ +choo$ wi$$ downp$a' .uantitati%e tests and $ook )or peop$e who are com)ortab$e being with peop$e rather than doing something )or or to them. We don(t want insecure peop$e with so $itt$e se$),esteem that the' a$wa's need to be pro%ing themse$%es b' cha$$enging their peers and de)ending their status. +uch characters are unhea$th' to those around them as we$$ as to themse$%es. 3o he$p a%oid the socia$ patho$og' that seems to a))ect ph'sicians as a group, the New &edica$ +choo$ wi$$ concern itse$) with supporting and strengthening the )ami$' $i)e o) !/9/" each New *octor. We wi$$ encourage students to marr' and ha%e )ami$ies, because we want them to experience their pro)ession )rom both sides, as rea$ peop$e. 3he New *octor wi$$ a$so ha%e strong roots in the communit', since the $oca$ cu$ture o) a peop$e is a$wa's a )actor in hea$th and disease. # remember some 'ears back # was asked to gi%e the speech to incoming medica$ students at a medica$ schoo$. 3he tit$e o) m' ta$k was 1Iow to +ur%i%e &edica$ +choo$.1 # ga%e them a number o) ru$es, one o) which was to sta' c$ose to 'our )armi$' and to peop$e 'ou knew be)ore medica$ schoo$. +ta' c$ose to peop$e who are not doctors and not stud'ing to be doctors. *on(t work too hard. *ont( tr' )or 0(s. #t(s a$most impossib$e to get kicked out o) medica$ schoo$, so 'ou might as we$$ 2ust s$ide through. &ake a ma2or in%estment in 'our education, but not an exc$usi%e one. Not an in%estment to the exc$usion o) the rest o) 'our $i)e. 0)ter # )inished, the dean o) the schoo$ got up and said he agreed with e%er'thing # said, but that the students shou$d a$wa's remember that when 'ou enter medicine 'ou are entering a new $i)e= +tudents at the New &edica$ schoo$ wi$$ be taught in a di))erent manner, too. 3heir re$ationship to the )acu$t' wi$$ be as graduate students acti%e$' in%o$%ed in the shud' o) a discip$ine rather than as passi%e recipients o) trade schoo$ training. 3he New &edica$ +choo$ wi$$ not be a research institution or a hospita$. #t !/95" wi$$ be a schoo$. +tudents wi$$ be assigned to teachers, not to hospita$s. 3he teaching )ormat wi$$ be b' preceptorship or pro)essiona$ apprenticeship. +tudents wi$$ take responsibi$it' )or their own education. When those 'oung men and women are graduated 'ou won(t ha%e an' troub$e distinguishing them )rom the rest o) the pack. 9or in preparing the state app$ication )orm )or our New &edica$ +choo$, we %isited a number o) other medica$ schoo$s. 4ne o) them was a new schoo$ in a sma$$ communit'
in southern #$$inois. 0)ter the' had )inished showing us a$$ the' had accomp$ished, we asked the directors one .uestion: #) 'ou were to mix 'our graduates with a bunch o) Iar%ard &edica$ +choo$ graduates, wou$d 'ou be ab$e to te$$ them apart- 3he answer was 1No, 'ou wou$dn(t, because our students are indistinguishab$e )rom those at Iar%ard.1 We then decided that we wanted nothing )urther to do with that schoo$. 4ur students are going to be easi$' identi)iab$e: 3heir )irst ru$e is going to be 9irst, *o No Iarm.
'ootnote
9ootnote )rom page !/7/": &odern &edicine has grown so corrupt that not on$' does its Kision )ai$ to inspire )aith and de%otion, but its sacraments and s'mbo$s cannot mo%e peop$e to a better $i)e. +o &odern &edicine has started to become more than de)ensi%e. #t must re$' on )orce to maintain itse$) and grow. 0s its spiritua$ authorit' has diminished &odern &edicine has grown more oppressi%e and %io$ent. What was once the option o) a )ree peop$e is becoming an en)orced ob$igation. We ha%e a &edica$ #n.uisition. 3he )irst, seeming$' innocuous, sign o) an in.uisition is the se$$ing o) indu$gences. B' promoting the se$$ing o) indu$gences, a church admits that it has $ost an' right)u$ c$aim on peop$e(s imaginations and hearts. When 'ou can bu' 'our b$essings, a re$igion moti%ates 'ou not to good works but to whate%er wi$$ a$$ow 'ou to purchase 'our p$ace in 1hea%en.1 3he 8hurch o) &odern &edicine passed that point $ong ago. &edica$ insurance is the doctor(s %ersion o) indu$gences. Whereas most traditiona$ re$igions ne%er demanded more than ten percent, the 8hurch o) &odern &edicine(s price tag on it(s b$essings and sacraments increases )aster than an'thing e$se in the marketp$ace. 6ou bu' )uture b$essings because &odern &edicine tacit$' admits it can(t maintain 'our hea$th, so 'ou(re going to need these b$essings someda'. 3his $ets the doctor o)) the hook and puts 'ou on it. 3he doctor can(t $ose and 'ou can(t win, because 'ou(re tricked into be$ie%ing that 'ou(re going to get sick no matter what 'ou do. What a wa' to go through $i)e= What a spiritua$ inspiration= Besides, medica$ insurance has accomp$ished $itt$e in terms o) protecting the patient. 0)ter a$$, considering the deductib$es, a hospita$i<ed patient toda' is $ike$' to spend 2ust as much mone' a )ew decades ago be)ore insurance. 3he a$most exc$usi%e e))ect o) medica$ insurance has been to enhance the income o) the pro%iders. Bike the medie%a$ #n.usition, the &edica$ #n.uisition assumes 'ou(re gui$t'. Externa$ acts o) hea$th wi$$ not swa' 'our doctor. 3he )act that 'ou can run marathon distances wi$$ on$' make 'our doctor suspicious o) 'ou, and won(t con%ince him that 'ou(re hea$th'. Ie(s more $ike$' to warn 'ou against hurting 'ourse$). 0$so $ike the medie%a$ #n.uisition, a$$ 'our business with the 8hurch is secret ,, e%en )rom 'ou. 3r' getting copies o) 'our medica$ records. 3he medie%a$ #n.uisition was not accountab$e )or its actions. Neither is the &edica$ #n.uisition. #) the medie%a$ #n.uisition executed or tortured a witness to death, no matter. 3here was probab$' something sin)u$ about him an'wa'. #) in the course o) 'our treatment 'our doctor ki$$s 'ou because o) stupidit', neg$igence, or 2ust p$ain ma$e%o$ence, 'our )ami$' wi$$ need the best $aw'er mone' can bu' to ha%e a chance o) getting 2ustice. #) 'our doctor ki$$s 'ou because the recogni<ed sacred treatment he uses on 'ou is bogus though no one wi$$ admit it, then the best $aw'er in the
won(t be ab$e to get 2ustice. 3his happens thousands o) times each da'. &ost peop$e ha%e some idea o) the dictionar' de)inition o) the #n.uisitionD the detection and punishment o) heretics. What isn(t ob%ious in the de)inition is that the #n.uisition was actua$$' a %er' e))ecti%e too$ )or en)orcing 8hurch $aws and maintaining the 8hurch as a cu$tura$ and po$itica$ )orce. 3he e))ect was to keep the 8hurch a potent )orce in peop$e(s $i%es and the $i)e o) the cu$ture. 6ou 2ust cou$dn(t get )rom one end o) $i)e or societ' to the other without pa'ing 'our dues to the 8hurch. 3r' getting )rom one end o) $i)e to the other without pa'ing 'our dues to &odern &edicine. No one passes through without being dipped or sp$ashed with the a$read' mentioned )our ho$' Waters o) &odern &edicine: immuni<ations, )$uoridated water, intra%enous )$uids, and si$%er nitrate. 0$$ )our o) these substances are o) .uestionab$e sa)et' and %a$ue ,, ob2ecti%e$' speaking. Ne%erthe$ess, &odern &edicine has e$e%ated them to the sacred. 3o the )aith)u$, not on$' do these substances carr' great power, but it is 1taboo1 to .uestion or tamper with them. 3he' are to be treated on$' with re%erence, and the' are maintained in their ho$iness b' ci%i$ $aw as we$$ as the 8hurch o) &edicine(s $aw. 0n #n.uisition makes it easier )or a church to discredit and disen)ranchise competing churches, simp$' b' dec$aring the competition(s ritua$s to be heres'. 0n' group o) peop$e, ideas, or practices that can a))ect hea$th is attacked, inc$uding traditiona$ re$igions and the )ami$'. 3he #n.uisition gi%es &odern &edicine the power it needs to prosecute the competition with the )orce o) $aw behind it. #) a doctor 1suspects1 a chi$d had been the %ictim o) chi$d abuse, the state has gi%en the doctor the power to incarcerate the chi$d in the hospita$. What is there to pre%ent the doctor )rom suspecting chi$d abuse in an' number o) situations where the doctor(s power is threatened- 0 $ot o) peop$e are current$' getting around the immuni<ation $aws b' )orging the records or b' taking ad%antage o) s$ack en)orcement b' schoo$ o))icia$s. What wou$d happen i) both sides got tough at the same time. #) the parents pub$ic$' re)used to submit and the schoo$ re)used to admit- What(s to stop the doctors )rom accusing the parents o) chi$d abuse and taking the chi$dren awa' )rom them, or, at $east, )ining them puniti%e$'#n return )or the power granted the #n.uisition b' the state, &odern &edicine does an enormous )a%or )or the state b' medica$i<ing prob$ems that are not medica$ at a$$. 0s Aohn &cFnight, Jro)essor o) 8ommunications +tudies and 0ssociate *irector o) the 8enter )or Crban 0))airs at Northwestern Cni%ersit', has said in his essa' 13he &edica$i<ation o) Jo$itics,1 13he essentia$ )unction o) medicine is the medica$i<ation o) po$itics through the propagation o) therapeutic ideo$og'. 3his ideo$og', stripped o) its m'sti)'ing s'mbo$s, is a simp$e triadic credo: 1. 3he basic prob$em is 'ou. /. 3he reso$ution o) 'our prob$em is m' pro)essiona$ contro$. 5. &' contro$ is 'our he$p. 13he essence o) the ideo$og' is its capacit' to hide contro$ behind the magic c$oak o) therapeutic he$p. 3hus, medicine is the paradigm )or moderni<ed domination. #ndeed, its cu$tura$ hegemon' is so potent that the %er' meaning o) po$itics is being rede)ined. Jo$itics is Gusua$$'H interacti%e ,, the debate o) citi<ens regarding purpose, %a$ue, and power. &edica$i<ed po$itics is uni$atera$ ,, the decision o) the he$pers( in beha$) o) the he$ped.1
2ibliograph
# ha%e purpose$' omitted re)erences )rom the text itse$) or in )ootnotes )or three reasons: 1. 3o a%oid inter)ering with the reader(s concentration on the book itse$). /. #n the be$ie) that the ma2or ideas in the book can stand on common sense, independent$' o) the re)erence sources. 5. *ocumentation o) the )ai$ure o) 0merican medicine is, in 19:9, wide$' pub$ici<ed and we$$, known. Ne%erthe$ess, )or those who are interested in those sources which support m' book, # recommend about 1 hours o) reading: 1. 3here are do<ens o) anti,doctor books easi$' a%ai$ab$e. &' )a%orites, )rom the standpoint !/9;" o) comprehensi%e documentation and $iterar' e$egance are: 13he &edicine &en1 b' Beonard 3ushnet, &.*., +t.&artin(s Jress, 19:1. G0%ai$ab$e through 8a%eat Emptor, ;/ 9reeman +treet, 4range, N.A. : > .H 1&edica$ Nemesis1 b' #%an #$$ich, Jantheon Jress, 19:;. 1&odern &edica$ &istakes1 b' Edward 8. Bambert, &.*., #ndiana Cni%ersit' Jress, 19:8. !9urther re)erences to G/H criti.ues o) modern pre%enti%e medicine G5H criti.ues o) ps'chiatr' and ps'choana$'sis G7H re)erences on ethics and its re$ation to medicine !/9:" G>H his month$' subscription news$etter 13he Jeop$es *octor1 and G;H Jrenata$ 8are, 8hi$dbirth and #n)ant )eeding and mothering organi<ations."
-nde3
0 0nnua$ ph'sica$s, $ack o) necessit' )or, 57,5: 0nti,arthritis drugs, dangers o), ;:,;8 0ntibiotics, unnecessar' administration o), >5,>; 0ntih'pertension drugs, dangers o), ;>,;: 0spirin, dangerous side e))ects o), :9 0tromid +, dangers o), 59 B Birth contro$ pi$$s, dangers o), ;5,;7 Birthing rooms in hospita$s, 159,7 B$ackburn, *r. @eorge B. 1/: !5 " Borek, *r. Ernest, / 7 Breast)eeding, ad%antages o), 1>>,>8 Burt, 8'ri$, / ; Buta<o$idin a$ka, ;8,;9 8 8aesarian de$i%eries and h'a$ine membrane disease, 98,1 8aesarian de$i%eries and postoperati%e comp$ications, 99 8aesarian de$i%eries, epidemic o), 9:,98
8aesarian de$i%er' and its $ink to chi$d abuse, 1>7 8ancer surger', 1 5, 7 18ase o) the &idwi)e 3oad, 3he,1 / > 8h$orom'cetin, dangers o), >/,>5 8h$orom'cetin, unwarranted administration o), >5 8ircumcision, $ack o) need )or outside o) a re$igious )ramework, 1 8 8oronar' b'pass surger', )re.uent ine))ectua$it' o), 1 1,45 8'$ert, ;9 8'stoscop', misuse o), 57 * *eath, modern medicine(s attitude toward, 191,9/ *E+, dangers o), ;$,;5 *E+, e))ects o) administration to pregnant women, 11 *exadrine, ;9 *ieth'$stibestero$, +ee *E+ *octors as spreaders o) disease, 1/ ,// *rug and a$coho$ abuse b' doctors, / :, 9 *rug combinations, dangers o), 81,8/ *rug E%a$uations, 8$ *rugs and pregnanc', :8 *rugs with side e)tects the same as their indications, 8/ !5 1" E Ebert, *r. Eobert I., / 5 EE@s, .uestionab$e re$iabi$it' o), /> EF@s, unnecessar' use o), /5,/; Episiotom', $ack o) necessit' )or, 9; Epstein, *r. +amue$ +., / 5 9 9eingo$d, *r. Ben, 88 9eingo$d *iet )or h'peracti%e chi$dren, 88,89 9eta$ monitoring, dangers o), 9:,98 @ @reen, *r. *a%id, 15 @ui$$ain,Barre s'ndrome, /5> I 1Ia<ards o) &edicaions,1 8/ Ierbst, *r. 0rthur B., ;1,;/ Iomosexua$it', modern medicine(s attitude toward, 188
Iospices, $ack o) a need )or, 19; Iospita$ accidents, 1/7,/; Iospita$ accreditation, 155,57 Iospita$ birthing room, 159,7 Iospita$ ma$nutrition, 1/: Iospita$ mixups, 1/5,/> Iospita$,ac.uired in)ection, high incidence o), 1// Iospita$i<ation, e))ects on ch$$dren, 1/9,5 Iospita$i<ation, e))ects on the e$der$', 151 Iospita$i<ation, ha%ing a re$ati%e or )riend with 'ou, 177,7: Iospita$i<ation, tactics )or a%oiding, 159,71 Iospita$s, $ack o) c$ean$iness in, 118,/5 Iospita$s, ps'cho$ogca$ e))ects o), 1/:,51 I'a$ine membrane disease, high incidence o) in 8aesarian,de$i%ered babies, 99,1 I'peracti%it' drugs, a$ternati%es to, 8:,88 !5 /" I'peracti%it' drugs, dangers o), : ,:1 I'peracti%it' drugs, unnecessar' use o) on chi$dren diagnosed as h'peracti%e, ;9,:1 I'sterectom', unnecessar' numbers o), 97 # #atrogenocide, 18; #mmuni<ations, dangers o), /5/,5> #ndocin, ;5 #nduced de$i%eries, dangers o), 99,1 A Aacobs, *r. Beo #., /81 F Famin, Beon, /4; Fammerer, Jau$, / > B Ba Beche Beague, 1:9 Bab tests, )re.uent inaccuracies in, /9,5 Bundeen, E%e$'n, 1>; Buria, +a$%adore E., /47 & &a$nutrition in hospita$ patients, 1/:,/8 &asturbation, modern medicine(s attitude, 189 &cFnight, Aohn, /:; &ende$, @regor, / >
&enopausa$ estrogens, dangers o), ;7 &otrin, ;8 &'stec$in, / 5 N Na$)on, ;8 Napros'n, ;8,;9 !5 5" Nutrition, importance in hea$th, :;,:8 Nutrition in hospita$s, 1/;,/8 4 4x'gen therap' )or premature in)ants and the risk o) retro$enta )ibrop$asia, 11,1/ J Jau$ing, Binus, />/ Jenici$$in, dangerous side e))ects o), >/ Jenici$$in, unnecessar' use o). >/,>5 Jotentiating e))ects o) drug combinations, 81,8/ 1Jh'sicians *esk Ee)erence,1 :9,81 Joudrage, 1 / E Eegu$ar ph'sica$ examinations, dangers o), /5 Eespirator' conditions in premature babies and their treatment with 3erram'cin, 1/ Eetro$enta )ibrop$asian incidence o) in in)ants, sub2ected to or'gen therap', $$,1/ Eita$in, ;9 Eitter, Norman E., / 5 Eoberts, *r. Eichard W., / > Eoemer, *r. &i$ton, 18; + +a$k, Aonas, /57 +ca$es, misuse o) in pediatrics and obstetrics, 51 +ea$, *r. Aohn, 15> +emme$weis, *r. $gna< Jhi$ipp, 9; +ick$e 8e$$ anemia, /7: +teroid drugs, unnecessar' use o), >9,;; +tethoscope, $ack o) necessit' )or, // +uicide among doctors, high incidence o), / 8 +ummer$in, *r. Wi$$iam, / 7 !5 7" 3 3a',+achs disease, /7:
3emperature taking, )re.uent misuse o), 5/,55 3erram'cin, use o) in treating respirator' conditions in premature babies, 1/ 3etrac'c$ine, undesirab$e side e))ects o), >5 3etrac'c$ine, unnecessar' administration o), >5 3homas, *r. Bewis, / 5 3o)rani$, ;9 3o$ectin, ;5 3ompson, &arian, 1:9 3onsi$$ectom', unpro%ed use)u$$ness o), 95 K Ka$ium, 8/ W Weed, *r. Bawrence, /4/ West, *r. Aames, / 8 Wo$ins, *r. Bero', / >, ; Working mothers and chi$d,rearing, 1;4,;/ N N,ra's, how to a%oid them, 77,7: N,ra's, unnecessar' use o), /:,/9 6 6oung, *r. Luentin, 18;

一个医学叛逆者的自白 CONFESSION OF A MEDICAL HERETIC

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一个医学叛逆者的自白 CONFESSION OF A MEDICAL HERETIC

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Confessions of a Medical Heretic

Chapter 1 Dangerous Diagnosis

Chapter 2 Miraculous Ma he!

Chapter " Ritual Mutilations

Chapter # $he $e!ples of Doo!

Chapter % Hol &ar on the 'a!il

Chapter ( Doctor Death

Chapter 7 $he De)il*s +riests

Chapter , -f $his is +re)enti)e Medicine, -*ll $a.e M Chances /ith Disease

Chapter 9 $he Ne/ Medicine

0pilog1 -n Search of the Ne/ Doctor

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