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 euipped 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

ad%anced 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 rateso) b$inding simp$' because the' cou$d a))ord the %er' best nurser' euipment: 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$$owgreen 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 $ater around the time we )ound out that the abso$ute$' harm$ess 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$ace-

But # 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 nondiseases.

# be$ie%e that more than ninet' percent o) &odern &edicine cou$d disappear )rom the )ace o) the

earth doctors, hospita$s, drugs, !17" and euipment and the e))ect on our hea$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, $e%e$and(s &ar%e$ous &edica$ actor', boasted o) the

$e%e$and $inic(s accomp$ishments $ast 'ear: ,98 openheart operations, 1.5 mi$$ion $aborator'

tests, 5,5 e$ectrocardiograms, , )u$$bod' xra' scans, 7,5;8 surgica$ procedures.

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 $e%e$and $inic(s maga" #) 'ou make the mistake o) going to the doctor with a co$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 manmade )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 sa%ed 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$$ make sure 'our ?>ada' deathbed has a$$ 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


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uncorrupted. ear 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


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insurance )orms )i$$ed out. # mean 'ou ha%e to get in and out a$i%e and accomp$ish 'our mission.

or 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 hurch o) &odern !19" &edicine ne%er ca$$s itse$) achurch. 6ou($$ 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 hurch 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. or 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. or

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


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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 thestethoscope 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


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&' )antas' is not so )antastic as 'ou might think. 3here are e$ectronic monitors in ad%anced

coronar' units that are euipped to e$ectrica$$' correct 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 kindso) con%u$si%e disorders and the diagnosis and $oca$i


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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 xra'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 rereading 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 xra's are sti$$ sacred in most doctors( and dentists( o))ices. Iundreds o) thousands o) women

are sti$$ $ining up e%er' 'ear )or breast xra's, despite the we$$ 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 preemp$o'ment xra', the schoo$ entrance xra', and the hea$th )air xra' continue. # hear

about and get $etters )rom peop$e whose doctors pronounce them in per)ect hea$th, but sti$$ insist on

a chest xra'. 4ne man to$d me about going to the hospita$ !9" )or a hernia operation, where he

was gi%en six chest xra's. rom 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' xra's at a $oca$

denta$ schoo$ where he went to get a crown rep$aced.

&an' doctors de)end their use o) xra's on the grounds that the patients demand or expect xra's.

3o that excuse, # rep$' that i) peop$e are addicted to xra's, the greatest ser%ice doctors might

per)orm wou$d be to rig up machines that $ook and sound $ike rea$ xra' machines. 0 tremendousamount o) disease cou$d be a%oided.

ab tests are another part o) the diagnostic procedure that do more harm than good. &edica$ testing

$aboratories are scanda$ous$' inaccurate. #n 19>, the enter )or *isease ontro$ G*H 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 high

standard $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) $abs tested b' the * cou$d not identi)' sick$e ce$$ anemia.

0nother test group incorrect$' identi)ied in)ectious mononuc$eosis at $east one third o) the time.

rom 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

cured o) their abnorma$ities simp$' b' repeating their $ab tests=#) 'ou think these tests are shocking keep in mind that the enter )or *isease ontro$ monitors and


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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 2ust in case medicine 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 $ook atthem is as sacred orac$es or )ortune te$$ing ritua$s: the' depend on the whims o) the deities and the

ski$$ o) the magicianpriest. 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 xra'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=

ab 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 xra' machines, EF@s, EE@s, and $ab tests, peop$e and doctors are

da. 4n the other hand, there are $i)ethreatening diseases, such as

tubercu$ous meningitis and others, that carr' no )e%er at a$$ or e%en a subnorma$ temperature. 3hedoctor shou$d be asking )or ua$itati%e in)ormation, such as how the chi$d is )ee$ing and what the


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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, # don(t knowD # ha%en(t taken it. 4r, # don(t ha%e a

thermometer in the house. 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 tocommand the doctors attention, pick out a high number, 17 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', 4h, it was so much higher be)ore= #) 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, # might ha%e misread the thermometer= 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 #s 'our chi$d toi$et trained- 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'earo$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'.

irst 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 minimumnumber !5>" 1>, , >, whate%er it is o) catheteri


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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(resick. #) 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


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0s a patient, once 'ou submit to a ph'sica$ examination, 'our doctor might interpret minor

abnonma$ities rea$ or bogus as preconditions o) some serious i$$ness, reuiring, o) course,

serious preinter%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 precoronar' condition. 3hen 'ou($$ !59" go home with a precoronar' drug or two, which whi$e

)ighting 'our precondition 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


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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. ather 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$e seem tobe$ie%e that. 6ou must rea$i


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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 xra'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. ina$$', 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. rom 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 xra's. 4) course, the best protection is no

radiation at a$$. Breast xra'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 xra's. 0n'

woman can a%oid xra's mere$' b' te$$ing the doctor she thinks she might be pregnant whethershe is or not. +ometimes, as happened to the wi)e o) one o) m' co$$eagues, c$aiming 'ou(re

pregnant wi$$ pro%oke them into reuiring a pregnanc' test, too= &' )riend(s wi)e a%oided that b'

te$$ing the nurseinuisitor 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 xra'. 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 xra' 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;" 3echniues )or a%oiding xra'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$ed into the xra' room. 3his is a t'pica$ p$o' to de$iberate$' humi$iate, depersona$i


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that 'ou wi$$ )ind it using the xra's- an '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 xra'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)ormedchoice. #) 'ou decide that 'ou must ha%e the xra'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 as $ong as

'ou(re on the tab$e.

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 sixpack 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. heck out whate%er he sa's. 0gain, read a$$ thesources 'ou can )ind. 6ou ha%e to know more about it than he does.


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*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. or

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$d go back andcon)ront the )irst doctor with what the second doctor said. Jeop$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$'. ind 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 Mahe!

!>1" # can sti$$ remember how, ear$' in m' medica$ career, # ga%e intra%enous penici$$in e%er' )ew

hours to chi$dren who were su))ering the agoni" the )e%er, cough, and other s'mptoms reso$%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 $i)ethreatening condition, the treatment is so routine that it is main$'

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


16/106


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$$in. or the un$uck' )i%e percent who get serious reactions topenici$$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. h$orom'cetin is a drug which is e))ecti%e in a certain

t'pe o) meningitis caused b' the I. in)$uen7" )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 knowsexact$' what tetrac'c$ine does to the bones, hundreds o) thousands perhaps, mi$$ions o) parents

and chi$dren know that it permanent$' stains the teeth 'e$$ow or 'e$$owgreen. 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


17/106


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. +ubseuent 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 $arge shots o) the antibiotic to treat it, and it(ssometimes necessar' to use additiona$ 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" 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

tranui$i


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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. ike the communion wa)er which atho$ics recei%e on the tongue, drugs are thecommunion wa)ers o) &odern &edicine. When 'ou take a drug 'ou(re communing with one o) the

m'steries o) the hurch: 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 atho$ic hurch or an' other rea$ 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 o$$aborati%e *rug +ur%ei$$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


19/106


disasters- 0pparent$' some doctors think it is.

or examp$e, a woman )rom 0t$anta wrote me about her twent''earo$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. an an'thing be

done )or our daughter- the woman asked me. #) on$' that dermato$ogist had to$d us that drugmight do this to our daughter(s reproducti%e s'stem, we wou$d ha%e $et her keep the rash=

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%'. # su))ered se%ere headaches,

musc$e cramps, swe$$ing o) m' breasts, and b$eeding )or twent')i%e da's. Ier g'neco$ogist to$d

her the b$eeding was caused b' the medications she took )or the poison i%', so she must now

undergo a *M Gscraping o) the wa$$s o) the uterusH.

0 coup$e o) 'ears ago, the Cni%ersit' o) hicago was s$apped with a ?mi$$ion c$assaction 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

hicago '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 191, *r. 0rthur . 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. ater 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' unuestioning 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$dren. or e%er' one o) those diseased or de)ormed chi$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) on$' 5 cases !;5" o) sw$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$


20/106


estrogens. *E+ is sti$$ being gi%en as the morning a)ter contracepti%e pi$$ and to dr' up breast

mi$k. #n 19>, the *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 *0 reuired a warning brochure

emphasi 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 *0 has been )orced to issue warnings to doctors and patients. Warnings which ha%e gone

$arge$' unheeded, as )ar as doctors are concerned. or instead o) $imiting the use o) these drugs to

in)reuent, 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


21/106


to get the patient to take !;;" the drug. We e%en ha%e te$e%ision, radio, and maga


22/106


)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: are)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$) isuna$tered b' the drug.

!;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 *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$a's the inuisitoria$ nature o) &odern &edicine than the

drugging o) so ca$$ed h'peracti%e chi$dren. 4rigina$$', 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, '$ert,

ita$in, and 3o)rani$ 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 testthat 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 educated guess o) an expert.

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$a'ground euipment, and supp$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 managed 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$dren into bra%e new wor$d t'pe


23/106


existence but the wa' doctors o%erdiagnose, misdiagnose, 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 threepage ads in the medica$ 2ourna$s which picture a schoo$ teacher

proud$' proc$aiming, Iow wonder)u$= 0nd'(s handwriting no $onger $ooks $ike hen scratchings.3his is the )irst time in histor' that power)u$ 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 hurch(s #nuisition emerge as c$ear$' as it does through the drugging o)

chi$dren as a means o) contro$. 3he medie%a$ #nuisition went be'ond de)ining unorthodox be$ie)s

and beha%ior as a sin and started ca$$ing them a crime. rimina$s were punished, )irst b' the

hurch and then b' the secu$ar authorities. &odern &edicine sets up its #nuisition to de)ine

beha%ior which doesn(t con)orm as sick. 3hen it proceeds to punish the gui$t' b' managing

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


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ompan' 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$ aureates, 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$s o) new drugs were a shamb$es. 3he *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$si)' records. #n a third o) the reports checked b' the *0, the tria$

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


25/106


ps'che wou$d certain$' take up more time and a$$ow him to see )ewer patients. #n a )ee)orser%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:11H!8" Jerhaps in their


26/106


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 two

tab$ets o) )i%e grains each despite the a%ai$abi$it' o) a sing$e, tengrain aspirin tab$et. ou$d there

be some sort o) re$igious signi)icance in recei%ing ten o) something in two tab$ets-

Be)ore 'ou take the )irst dose o) an' medication 'our doctor prescribes, 'ou shou$d make it 'ourbusiness to )ind out more about the drug than the doctor himse$) 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 e)erence, the J*. 3he J* 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* man' p$ugs in m' co$umn and news$etter. ina$$', # 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* 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* not

on$' started showing up in bookstores, but it was promoted in bookstores= Now, i) 'ou go into the

bookstores, 'ou($$ see pi$es o) J*(s. # guess the pub$isher )ina$$' 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* 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 *0 reuire 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* is

becoming more and more discreet. or examp$e, the $atest issues di%ide drug side e))ects into ma2or

categories according to how )reuent$' the' can occur. Now at $east 'ou(%e got horse race odds

when 'ou take 'our medicine.

3he J* can be considered the bib$e o) the hurch 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*. or one thing,

the 0&0 book has a $ist o) crossre)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 morethan 1 percent. 6ou(re %irtua$$' assured o) su))ering some toxic e))ect= E%en more dangerous are


27/106


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


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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


29/106


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.

onsider 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


30/106


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 toprotect '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.

onser%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 esearch @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 numberdropped to 18. 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' twothirds 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


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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 conuered, because the'(re there.Jarents are $u$$ed into be$ie%ing that the operation can(t do an' harm. 3hough ph'sica$

comp$ications are rare, the'(re not a$together nonexistent. &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$$iona'ear mark is the h'sterectom'. 3he Nationa$ enter )or Iea$th

+tatistics estimated that ;9, women had their uteruses remo%ed in 195, 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>, 88, 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. a'er upon $a'er o) treatment buries the

experience under the mant$e o) sickness, as each $a'er reuires 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' barbersurgeons, the hamber$en brothers, a$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$i%ered babies. 4ne courageousdoctor, #gna< Jhi$ipp +emme$weis, pointed out the dead$' connection and was hounded out o)


32/106


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$dbecome e%en more power)u$. +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 isrea$$' an operating room disguised b' the simp$e addition o) an incubator, what rea$$' 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)

aesarean de$i%eries.

eta$ 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) aesarean 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 aesarean 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


33/106


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, nineto)i%e 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 $abor whenhe )ee$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 aesarean 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$'.

eta$ $ung disease, )ai$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 newbornintensi%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'

aesarean 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=

u$$term, regu$ar si


34/106


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 highrisk patients with

rare $e)tmain arter' disease, the coronar' b'pass pro%ided no bene)it. &orta$it' rates )or surger'

patients were not signi)icant$' di))erent )rom those medica$$' treated. #n )act, among the $owriskpatients, the morta$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. urthermore, 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.

ortunes, 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) poudrage, 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 onthe outside o) the heart. Jresumab$', this wou$d irritate the $inings and the %esse$s so the' wou$d

de%e$op !15" new b$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

hurch, 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 techniue )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) $eeches in @eorge Washington(s !17" time. #t was shown to be irrationa$ thirt')i%e 'ears

ago when Warren o$e at the Cni%ersit' o) #$$inois showed that i) 'ou examine the periphera$ b$ooda)ter 'ou open the skin, 'ou )ind that as a resu$t o) surger' the tumor ce$$s ha%e a$read' spread.


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*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$d take care o) it, the person wou$dn(t ha%e

cancer in the )irst p$ace= +ome sa' that cancer surger' is threatened because o) a$$ the new

techniues )or )ighting cancer. #t(s the other wa' around: the new techniues 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 hurch

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 hurch.

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 $earned or disco%ered is how to per)orm

the surger'. When # was +enior Jediatric onsu$tant to the *epartment o) &enta$ 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$though # don(t think the economic moti%e a$oneis 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 onethird as o)ten as in )ee)orser%ice

situations.

#) we had about onetenth as man' surgeons as we ha%e now, there wou$d be %er' $itt$e unnecessar'

surger'. E%en the 0merican o$$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 theirmenstrua$ irregu$arities, is more than ten times the a$read' increased risk. 6et )ew doctors bother to


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)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$', hismoti%es were a mixture o) greed and ignorance, because the next doctor she went to to$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 going under the kni)e, 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$igious, and ninet' !18" percent o) the surger' per)ormed toda' is a$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 techniue 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 $atest techniue. Where the bris ceremon' inc$udes pouring some wine in the in)ant(smouth, no anesthetic at a$$ is used in &odern &edicine(s ritua$.

outine 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 pri%i$ege is reser%ed )or the

priesthood or )or ceriain communicants o) specia$ status. #n hristianit', on$' Aesus and the mart'rs

were graced with muti$ation except )or a dubious m'stic e%er' !19" now and then who

miracu$ous$' bears the stigmata, or the wounds o) hrist.

#n the hurch 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 put under 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' expecte%er'bod' e$se to.


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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$ie), that the priest can o%ercome an'thing because he can operate on 'ou. 6ou don(t ha%e totake care o) 'ourse$), 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


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

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