LET’S LEAVE THE WELL ALONE
Posted by bmhegde on 1
“God give me deliverance from….
* not letting the well alone
* making my treatment worse than his disease, and
* treating hapless humans as cases.”
Hutchinson’s Prayer.
“Time has come”, the Walrus said “to talk of many things-cabbages and kings….” Time really has come to take stock of the position of modern medicine vis-à-vis human health. While the hi-tech modern medicine seems to have done a lot in the area of medical care of the sick, its role in preserving health of the public, its prime duty, does not seem to have been addressed at all. In fact, studies have shown that in places where there more doctors there is less health and vice versa. Death and disabilities seem to go down when doctors go on strike and interventions come down! These should not surprise anyone if one pauses to think of the way the medical world has gone beyond its calling to intervene in the apparently healthy population who has no need to seek medical help.
Thinkers have, time and again, warned us against this kind of interference. Lord Hutchinson’s prayers to God to grant him deliverance from “not letting the well alone”, Sir William Osler’s plea “patient doing well do not interfere”, Lord Platt’s plea to avoid modern medicine when one is healthy, Sir George Pickering’s warning on his pet theme high blood pressure when he wrote: “more people make a living off hypertension than die if it”, which was later ratified by the Medical Research Council’s famous study of mild hypertension treatment in 1985 that showed that to prevent one stroke in society we will have to treat 850 normal people unnecessarily with anti-hypertensive drugs for well over five years, and Richard Asher’s tongue-in-cheek reference to the blood pressure apparatus in his own inimitable style: “Riva Roci would grieve indeed in his grave about the misuse and abuse to make people miserable of the instrument that he had invented,” have all pointed to the same truth.
“Cure rarely, comfort mostly, but console always” has been the greatest truth of modern medicine as enunciated by the father of modern medicine, Hippocrates. Recent happenings show that things have, if anything, got worse in the last fifty odd years that modern medicine has been riding piggyback on technology. To compound the problem the manufacturers of technology and pharmaceutical companies have been spending billions of dollars to sell these ideas to doctors from day one in the medical school till they die. The present medical profession does not see the writing on the wall that “truth could only influence half a score of men in a century while false hood and mystery would drag millions by the nose.” This is Aristotelian dogma but, the present day world of drugs and technology advertisements take the cake and cloud all such thinking. In his inimitable style, Richard Smith, writing his editorial in a recent issue of the BMJ, says it all when he quotes many others in the field to show how the advertisements are many times more influential than the real stuff that they are trying to highlight.
It is shocking to know that these drug barons direct medical education in the west, not to speak of lavish hospitality they provide for all continuing medical education activities trying to brainwash the medical profession. They even invent new diseases using the medical fraternity, to sell their drugs. Female impotence is the recent glaring example of this phainomenon. Many of the so called “thought leaders” in the medical profession who go round the globe lecturing need to disclose the source of their funding and come clean. The divine interventionalists will have all kinds of advantages in the present set up. They get money, perks, media glare, and, above all, they are looked up to by the lay public, taken in by the medical claptrap, as the saviours of mankind while the truth is otherwise.
Epidemiologists are roped in to frighten the public that they would be swallowed by killer diseases in the near future if they did not take shelter under the hi-tech interventions. Most of these predictions do not come true as time evolves. Many studies have shown the futility of intervening in asymptomatic people. Long term audits of interventions in healthy people with raised blood pressure, sugar, cholesterol, coronary arterial blocks etcetera have all shown that more people did suffer in the bargain.
Modern medicine seems to have forgotten the golden rule that human physiology is capable of correcting most deviations as time evolves without assistance from outside. It is only in the unlikely event of the body’s repair mechanisms failing in symptomatic patients that we need to intervene to “cure rarely, comfort mostly but console always.” Modern medical technology has done wonderfully well in comforting people in distress and we have come a long way from our ancestors in this area.
In the present modern medical scenario the well man is the one who has not seen a doctor. The new total body scanner would declare everyone unwell because of its inherent false-negativity. While this is good for the industry it will be a curse on society. All these screening methods increase the anxiety levels in society while the golden rule in medicine is to allay anxiety to make society healthier.
Will the profession take notice of the writing on the wall before the common man takes shelter under the many unscrupulous charlatans trying to sell their wares outside the scientific medical community? Already the alternative medical community is doing brisk business even in the industrialized west. Let me stress again that we have no way in our present knowledge in medicine that permits us to intervene in healthy people. May be a day will come when we may be better equipped to help people to live longer and healthier. Life style change is the only thing that the human physiology needs help from to accomplish its task of setting systems right when something goes wrong. Indian Ayurveda and yoga systems do just that. Let us leave the well alone.