Time was when diseases and dying progressively came down in all the developed countries. Ireland, for example, had the following statistics. Decade after decade the Census had recorded a steady improvement in the health of the Nation since the great Famine. In 1851 there were 104,000 people recorded sick (15 people per 1000 living); ten years later it came down to 12 per 1000, and at the turn of the century it was 8 per 1000 living which had dipped down to 7 per 1000 ten years later. Impressed by these figures, John Moore, in his inaugural address of the Meath Hospital session of 1895, feared for the medical students sitting in the audience: “The triumph of Hygiene means the passing away of medicine………..already there are signs which seem to indicate that at least in certain directions the doctors’ occupation will be gone.” Whole of Europe had better health for their inhabitants, mainly because of better nutrition, sanitation, housing, better quality water, economic prosperity and improved personal hygienic standards. Average incomes had quadrupled since 1845 in Europe.



George Bernard Shaw in the preface to his The Doctor’s Dilemma wrote IN 1911 that ”Ireland is certainly a transfigured country since my youth” he wrote, “as far as clean faces and pinafores can transform it.” Even at that time medical profession did not claim that they were responsible for the better health status of the population. In fact, they were not! John Moore would indeed be grieving in his grave today, looking at what is happening to the developed west, not to speak of the other developing countries. Diseases and death are going up steadily even when the general living standards and economic status of the people is much better than what it was in the nineteenth century. Let us take United Sates of America as an example. The recent Institute of Medicine report gives any reader a shock, indeed. The US ranks last but one in the fourteen developed countries surveyed with Germany at the bottom and Japan at the top with other countries in between. Doctors and hospitals have been the third most important cause of death with adverse drug reactions following closely at the fourth place.



Americans have the healthiest habits both in eating, drinking alcohol and smoking among those fourteen countries. The sanitation is probably the best that could be there in any nation. Despite all that the health status of the populace is anything to write home about. In the midst of all these noises the signals must be there for all of us to recognize and learn from. Earlier we did that the better for mankind. We claim, and the pharmaceutical companies and technology manufacturers reaffirm, that modern medicine today is at its best. We even claim that we have the power to keep the population healthy for a long time if all of them came to us regularly for their check ups. The advertisements in these areas, as in any other area, are so powerful that the literate gullible public is made to believe all these in the fond hope of living long and healthy. We never realize the gravity of the health scare that we produce by these advertisements. Increasing the anxiety level in itself is a good provocation for ill health in the public. Screening the healthy population and predicting their futures by studying a few parameters of the body would never ever be correct and we have been predicting the unpredictable future of a dynamic human system. Audits have shown every health screening activity as counter-productive at the end. 180,000 deaths in the hospital in patients and an additional 140,000 deaths in out patients due to adverse drug reactions alone in one year in the US should alert the medical profession that not letting the well alone is dangerous.



On the contrary, when a patient has symptoms it is our sacred duty to do all that we could, despite knowledge in the area being equivocal, as doctors are there to cure rarely, comfort mostly, but to console always. We should use all the drugs in our armamentarium and the gadgets in full to try and do our best to the suffering humanity. If one senses the signals coming from the recent audits, referred to earlier, one quickly realizes the one activity that we should abandon is to intervene in the apparently healthy in the midst of all the noises produced by the drug companies and the technology lobby. Marcia Angell, the former Editor in Chief of the New England Medical Journal and a teacher of pathology, did a great service to the medical profession by publishing her recent book (Random House) How Do Drug Companies Deceive Us: What to Do About It, which bares all the tricks of the most powerful pharmaceutical drug lobby.



Robert Hutchinson had a prayer: “Lord give me deliverance from: treating suffering human beings as cases; making my intervention worse than his disease; and Oh Lord, from not letting the well alone.” This prayer is useful for all doctors even today. In the developed countries today the most important risk factor for killer diseases seems to be negative thoughts in the minds of people. Recent studies have revealed hatred as the most powerful risk factor for heart attacks while frustration and depression provoking cancer growth with anger precipitating hemorrhagic stroke as realities! Monetary economy where man eats man, has brought mankind to the brink of self destruction. While it is true that the developed nations take their health tips of eating, exercising, and sanitation to greater heights of excellence they have to learn a lot to calm their minds to live and let others live in peace. It is what eats one that kills and not what one eats.



Healthy body resides in a healthy mind; mind resides inside every human body cell at its sub-atomic level. Just as every sub-atomic particle gets affected by the consciousness of the observer, the consciousness of the patient and the healer play a vital role in the final outcome even in the disease scenario. Let the medical profession become tranquil and thus make the patient tranquil as well. William Osler had this to say to doctors on his final retirement speech at the Johns Hopkins. Doctors must have two qualities of head and heart to make them good doctors. They must be imperturbable and aequinamitus. Those are the dire needs of the present time. John Moore will rest in his grave peacefully if we could again turn the trend of disease and death to decline to make the world happier, even at the cost of breaking our rice bowl!