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Sunday, February 3, 2019

Can Medicine Be Cured? PaleoJay's Smoothie Cafe Podcast

Can Medicine Be Cured?  
Subtitle:  The Corruption Of A Profession.

This is the title of a new book by Seamus O'Mahony, a physician at Cork hospital in Ireland.  This is an impressive book, since he goes out on a limb and says what most physicians are actually thinking:

He challenges the usefulness and credibility of medical research; the illusion of progress; our stubborn belief that we can be perfected; over-prescribing; poly-prescribing; the efficacy of many drugs that are routinely administered; the corruption of academic medical research; our collective failure to accept that medicine cannot cure everything, and indeed can cause trouble of its own; over-reliance on metrics; the pharmaceutical industry and its vast reach and influence, and far more.

There was, he points out, a 'Golden Age' of medicine, from the 1930s to the 1980s, during which a number of huge advances were made. TB, smallpox, polio, all huge killers, were effectively eradicated in the developed world. This Golden Age ended "just as I came into it, I caught the end of it. There have been very big advances since then, but nothing like that accelerated level of discovery and innovation that occurred in those 50 years." Since then, medicine has increasingly lost its way.

Starting with 'research' - that great hope that will save us all - he is fairly scathing. I suspect that many of us believe (as I did) that medical research is being conducted in a coherent, structured, completely credible way, such that it will gradually solve all ills. That all one has to do is wait, and research will do the rest, finding cures for sicknesses long before we succumb to them. Maybe not, it seems. 

"Contemporary bio-medical research is itself very sick as an endeavour," O'Mahony says. "There is even an acknowledgement and a consensus within bio-medical science that it has lost its way. It's been estimated that anything up to 85 percent of all bio-medical research is a waste of time. 

And that's at a cost of $170bn annually."  

There is a fairly negative trickle-down effect to this; "frontline workers, GPs, hospital doctors, who may not be carrying out any of the research, who just do what they're told in a way. I've drawn a parallel between modern medicine and medieval church: the higher level lay out dogma, the lower level work on the front line and implement it. They are not supposed to question any of it".
At a more practical level, there's the routine over-prescribing that goes on. "Pushing people into patient-hood," as O'Mahony describes it, "for marginally elevated cholesterol levels, for example. The statin story is a great example of how the medical-industrial complex works. The overwhelming majority of people prescribed statins for high cholesterol levels are never going to benefit from taking this medication, and may experience harm."
Connected with that, is poly-pharmacy, in which patients are prescribed further medication to deal with the side effects resulting from the primary medication, to the point where many elderly patients in particular are now taking five or more medications daily, all with their own side effects and possible complications.

What would he like readers to take away from this book? "I write about the bogus contract between doctor and patient that has existed for several decades. The basis of this contract is that we can diagnose everything, fix most things, we never make mistakes and medicine is not dangerous. All of these things are untrue. We have limited powers. Medicine is very often ineffective and sometimes dangerous. We can't fix everything, particularly social and existential problems. I think society needs to lower its expectations around what medicine can deliver. That's one message I'd like people to take away with them.
"Then, there's this cultural thing where a consultation with a doctor must conclude with a prescription.
 I'd like people to think, 'Is this medication really going to help me?' I'd think about that in particular when it comes to drugs like statins, drugs for high blood pressure, high cholesterol, osteoporosis - these drugs that you're going to take for the rest of your life, maybe 40 years, with an overwhelming likelihood that it will not give you any benefit whatsoever."

There is also a strong current of social conscience that runs through the book:
 "Medicine and healthcare has relatively little effect, now, on overall population health," he points out. "Your health is far more likely to be determined by your education, your income, your job and where you live. Take the USA where they spend around 20pc of the GDP on healthcare and yet they have some of the worst outcomes, healthwise, in the world in terms of infant mortality, longevity and so on. We're spending an ever-increasing amount of money on healthcare, but the benefit to us as a society is getting less and less as time goes on." 
That healthcare budget should be put into housing, education, the eradication of deprivation, a boost in opportunity, the arts - "that's a more effective way to treat the health of the population."
Equally, he has simple, obvious solutions to the growing gap in global health inequality: "If we simply applied evenly and fairly across the world what we know currently works, medicine and society would be transformed. If we never did another new research project, and just took what we know now, and gave everybody access to it, global health would be transformed."
I certainly agree with this last!  If everyone would live in a rural or small town area, with pure water and air, low congestion and stress, that is half the battle right there.
If you also added in daily natural, perfectly paleo types of exercise, eliminated wheat and most sugar, and slept a good 8 hours per night in a blacked out room with no TV or screens present- why, that alone would solve most health problems right there!
And if we gardened organically, eliminated herbicides and pesticides from our areas, if we also ate organic fruits and veggies, pastured eggs and meat and dairy, and consuming a daily green smoothie…
We would rarely need a doctor or hospital at all!  Most diseases and conditions would simply evaporate, healed (as they are meant to be) by the healthy body itself!