Cheating by Modern Medicine? Thought provoking articles by a senior allopath
Collection of articles by Dr.Prof. B. M. Hegde Published in Hindu daily
MBBS, MD, MRCP(UK), FRCP(London), FACC(Bethesda Md USA), FRCPG(Glasgow USA), FRCPE(Edn), FRCPI(Dublin), FAMS
- Former Vice Chancellor, Manipal Academy of Higher Education, Deemed University
- Former Pro Vice Chancellor, Manipal Academy of Higher Education, Deemed University
- Former Dean, Kasturba Medical College, Mangalore
- Former Principal, Kasturba Medical College, Mangalore
- Former Director of PG studies, Professor & Head of the Dept. of Medicine, Kasturba Medical College, Mangalore
- Former professor of cardiology, the Middlesex Hospital Medical School, University of London
Where the prescription looks like the laundry list!
“All good is hard. All evil is easy. Dying, losing, cheating, and mediocrity is easy. Stay away from easy.” — Scott Alexander
The foundation of modern medical science is shaky. The gold standard of medical science is only statistical, randomised controlled trials (RCTs) used to test drugs and instruments. In short, if there is a science (I have shown elsewhere that there is no science of man), it is just statistical science and does not meet the strict standards of either science or technology as defined by the National Aeronautics and Space Administration’s Technology Readiness Levels (NASA-TRL) or modern systems engineering (MSE). I have extensively written about the unscientific base of the RCTs in both my books and articles over the past four decades.
Even the President of NICE, which is the highest body to oversee drug research in the U.K., Sir Michael Rawlins, in his Harveian Oration at the Royal College, had this to say about RCTs: “That randomised controlled trials (RCTs), long regarded as the ‘gold standard’ of evidence, have been put on an undeserved pedestal.” Sir Michael outlines their limitations in several key areas, arguing that a diversity of approaches should be used to analyse the whole evidence base. (Rawlins M. The Harveian Oration of 2008, De Testimonio. On the evidence for decisions about the use of therapeutic interventions. Royal College of Physicians, 2008). This is bad news for the conventional thinkers, coming as it does from the highest level in their own backyard.
Using this kind of science, industry tries to exploit the public to make money with all kinds of chemicals passed off as effective drugs! History tells us that Nujol, the useless byproduct of petroleum extraction, was the first anti-cancer drug; and chlorpromazine, (Largactil), used extensively in psychiatry, is a byproduct of rocket fuel extraction! Many of the present expensive anticancer chemicals have not even gone through the inadequate RCT test! Now my friends who hate me for writing that a routine check of healthy individuals is dangerous will understand why I wrote what I wrote. Check-up means labelling, which is followed by drugging or intervening by other means. Most modalities of treatment, using both drugs and surgery, have no scientific base, although many of them seem to work through a very powerful placebo effect. Corrective surgery is an exception.
Most body parameters do change as there is need for them to do so for reasons unknown to us at the moment. Sugar, cholesterol and blood pressures belong to that category. The surest way to get them back to what we think should be the normal is to change our unhealthy lifestyle. Interventions with drugs have a dubious reputation in this field. Lifestyle change is something that is universally useful. Instead of going for a check-up when one is healthy, it is safer to change one’s lifestyle and try to live as close to nature as is possible, keeping one’s mind filled with universal love, devoid of hatred, greed, jealously and anger.
Heavy smokers and alcoholics need check-ups as their body warning signals of diseases fail anyway. The rest of us could make do with seeing doctors only at the first symptom of any change in our body. Symptoms denote the failure of our inbuilt repair mechanism, the immune guard. This also is due to the wrong lifestyle these days.
The pharma industry could go to any extent to fool even the governments to sell its wares. A recent revelation in the Guardian, London, exposed one such heinous act that could have endangered and/or extinguished many lives already. (http://www.guardian.co.uk/society/2010/nov/17/drugs-companies-exorbitant-profits- nhs). The European Union has defined some diseases as ‘orphan diseases,’ where the drug companies are not interested in finding a cure since the financial return might not be attractive. Companies finding out newer treatments for ‘orphan diseases’ would get special incentives from the governments. Please note that the industry is keen only on imaginary diseases (the so-called silent killers) that need lifelong drug therapy; the latter are their cash cows. Blood pressure, sugar and cholesterol are the three biggest milch cows.
It is now discovered that some companies have repackaged some of the old drugs in a new format and called them new cure for ‘orphan diseases’ and have milked the National Health Service of millions of pounds! The Guardian article gives graphic descriptions of the fraud going on. These so-called new drugs could easily pass the RCT test to qualify them as having evidence base. The tall talk of evidence-based medicine is as hollow as are many of our claims to superiority to all other modalities of treatment such as Ayurveda and homoeopathy. In fact, most of them have a better scientific base than our modern medicine. While U.S. medical schools teach for six months, out of their four-year MD course, the basis of other complementary systems, in India, the cradle of the best medical wisdom, Ayurveda, we seem to be averse to teaching anything other than the unscientific modern medicine.
The result is that most of our graduates become good technicians mastering a couple of interventions to make money. The rest of them become researchers, doing RCTs for western drug companies, making tonnes of money in the bargain through the new CROs. One has only to see one of the prescriptions which reads like a laundry list with one beta blocker, one ACE inhibitor, one blood thinner, one sugar lowering drug, of course, one cholesterol lowering drug and many others for every patient.
There is NO science base for this kind of poly-pharmacy, not even the imperfect RCT to back such practices. Recent studies show that patient compliance with such poly-pharmacy is less than 23 per cent. Seventy seven per cent of the recipients are, therefore, safe as they forget to take those tablets! God alone can save mankind from human greed, which has invaded every sphere of human activity ranging from 2G spectrum to patient care. “Do not make money in the sick room,” wrote Hippocrates. We take our oath in his name when we graduate only to become hypocrites in later life! “It is double pleasure to deceive the deceiver.” — Niccolo Machiavelli
The truth: there’s no pill for every illness
Dr.Prof. B. M. Hegde
This morphologically young woman in her early 50s, let us call her Gita, called me the other day in great hurry and she was palpably agitated, to say the least. She was not even coherent. “I am truly down and feeling so low that I feel I have a serious problem. I feel very low after my evening walk.” I asked her “what happened?” She shot back, “My doctor told me my pressure is way high at 160/100. She immediately asked me to take a tablet, which I took.”
“You must be feeling fine now,” I interrupted her. “No, No, No. I am feeling worse now. My doctor told me a couple of days later that my pressure is still way above normal at 130/80. She gave me a new tablet and asked me to swallow it right there as she wanted the pressure down to 110/70 as fast as possible.” In addition, my doctor asked me to urgently see a cardiologist to have a complete work up.”
“What happened then? I asked. “My doctor’s last advice put me off and I thought I better talk to you.” I could see her almost in tears. To cut the long story short, I had to talk to her at length to counsel and convince her that the blood pressure reading that she was worried about was all in her mind! The reader might think it is very easy. It is easier said than done. I can assure you that it would have been easier to give birth to a baby had I been pregnant than to successfully counsel an agitated 50-year-old postmenopausal, morphologically young lady to cool her down on the phone.
Let us look at Gita in toto to know her better. “Know your patient better than his disease,” wrote Hippocrates. He was dead right. Gita was educated in the U.S. Her husband, a brilliant and capable scientist was the one who put together one of the most successful business groups in India. She had two beautiful and intelligent kids. She also had a cushy job on hand. Theirs was a happy & perfect family. But fate willed otherwise. Her handsome, intelligent husband died one sad morning due to what doctors called heart attack. Gita was devastated and shattered. One could understand. She came out of that reactive depression slowly but steadily and still does her job very successfully. She brought up the children like a true Indian mother and now both are successfully placed in society. Her families on either side were a great help and so were her colleagues and her husband’s former colleagues.
Turning 50, Gita felt lousy. An informed woman, she was worried about her menopause. That needed counselling again. Right then both her children went abroad in search of greener pastures and higher education. Gita was outwardly ecstatic but subconsciously she was feeling lonely and forlorn. That mind of Gita was somatising as “her feeling very low” which took her to her a “good” doctor in the first place, more due to family pressure. The rest is history.
This sad story is all but lost on our modern medical business that tries to attack the palpable abnormal body parameter, which is mistaken for a disease to be drugged ruthlessly. Twenty-four hours after her traumatic experience, Gita was back to her usual confident self, with an on-top-of-the-world feeling, back on her job. The drugs are in the waste basket as she had to survive. “Thank you, Dr. Hegde, I feel fine. All in the mind — yes, yes, I now believe you.”
Let us examine the science behind this misadventure. A thinking American professor, a rarity in that country these days, Mary Tinnetti, had this to say about our obsession with a firm diagnosis and our disease concept. “The time has come to abandon disease as the focus of medical care. The changed spectrum of health, the complex interplay of biological and non-biological factors, the aging population, and the inter-individual variability in health priorities render medical care that is centred on the diagnosis and treatment of individual diseases at best out of date and at worst harmful. A primary focus on disease may inadvertently lead to undertreatment, overtreatment, or mistreatment.”
The drugs are being pushed irrationally and the gullible doctors who depend on drug companies for their continued education believe their advice a hundred per cent. The pharma lobby even gets research data manipulated. (JAMA 2010; 303(20): 2058-64.) “Speaking of Big Pharma’s big, bad influence, here’s more proof they’re not interested in playing on a level field. It turns out a controversial and dangerous hormone therapy that was all the rage a few years back was pushed in medical journals by writers who were paid by Big Pharma,” according to court papers found in August 2009 by The New York Times.
The paper also found that “in one case that seemed typical, the drug company paid around $25,000 to a third-party medical writing firm to generate one of these reports. That might sound like a lot of money to you or me, but it’s money well-spent for Big Pharma. In fact, these shady reports helped hormone treatments generate $2 billion in sales in 2001, just before that money train was derailed.”
The whole thing looks like a stage-managed effort to keep the best treatment method, change of mode of living, for chronic diseases like raised sugar, blood pressure and cholesterol from practising doctors as the pharma company profits from life-long drug treatments could be mind-boggling.
This reminds me of the infamous Tuskegee experiment where 400 African-Americans suffering from syphilis were observed from 1932 through 1972 withholding penicillin treatment just to record the natural history, symptoms and complications of the disease without their consent. Sir George Pickering, a doyen in hypertension research, had this to say: “More people make a living off hypertension than dying of it.” This was written in the 1950s when there were hardly a couple of crude drugs for hypertension. What would he have said about our situation today? God only knows!
Right-thinking people in the medical profession have a tough job on hand to try and get at the truth, which in itself is a daunting task, and then cross a greater hurdle to deschool society of its firm belief that modern medicine is a true science and there is a pill or surgery for every illness!
The truth is that while there is certainly no pill for every illness, every pill is followed by a definite illness. Pills might thrill but could even kill. Change of mode of living — diet, exercise, mental tranquillity in the midst of this maddening world running after the mirage called money, universal compassion and simple nature-given immune boosters in vegetables and fruits should set right most transitory parameters. It is too late in the day to start deschooling society to reverse the trend and help hapless patients like Gita.
Modern medicine has given illness care a miss
Dr.Prof. B. M. Hegde
The quote below is one of the many brilliant sayings of that great brain, Sir William Osler. “One of the first duties of the physician is to educate the masses not to take medicines.” In the 21 century, I could only echo that great sentiment as a truism, despite all the tall talk about the “so-called” evidence-based medicine. Napoleon Bonaparte went one step further, but one could argue that he was not a physician. He was at the receiving end of such a medical practice when he died. “Medicine is a collection of uncertain prescriptions the results of which, taken collectively, are more fatal than useful to mankind.” Napoleon, though, was more accurate scientifically today. The latest science says uncertainty is the only certainty in the world. This is truer in medical science. A proverb is a short sentence based on a long experience. If that were so, this one from Voltaire would take the cake: “The art of medicine consists in amusing the patient while nature cures the disease.”
Time and again, I have written in my articles elsewhere that our evidence base has been built on loose sand. (www.plosmedicine.org/annotation/listThread.action-ww.bmj.com/content/338/bmj.b1272.extract/reply) Of course, no one seems to take it seriously. They would have, if it had any financial interest behind it. The present Randomised Controlled Trials and linear relations help generate billions of dollars in chemical therapeutics even if that results in thousands dying of our efforts directly or indirectly. (search.barnesandnoble.com/Death-by- Medicine /Gary-Null/…/9781607 660026 )> A study by researchers in a respectable U.S. university of the placebo-based RCTs did show that the contents of the placebo capsule, which need not legally be made known to the regulating agencies like the FDA, were very potent substances that would show the company drug as very effective in comparison. To cite an example, anti-diabetic drugs are usually compared with sugar filled placebo capsules! Many such glaring criminal activities have come to light now in the field of “Evidence-based medicine” of today!)
What is the science base of our reductionism, organ- based specialisation and our reliance on Mendelian inheritance? Instead of trying to rehash the existing evidence base, it is better to think of a new evidence base for health and illness. Health is a state where each human body cell is in sync with other cells. Illness is when this communication breaks down. (en.wikipedia.org/wiki/Biophoton) We need a new non-linear, holistic, dynamic, scientific base for future medical research. Nature has provided a robust repair mechanism inside the human system which has been weakened by our modern lifestyle. Even though both Claude Bernard and Louis Pasteur did note that the “terrain is more important than the seed,” we have gone the whole hog on the seed, risk factors, and what have you. Modern medicine has forgotten the essence of illness care which is basically to strengthen the terrain. Ayurveda and many other complementary systems stress just that fact to strengthen one’s immune system. Ayurveda has many immune boosting modalities in its armamentarium. Many simple methods which have stood the test of time are being forgotten now, thanks to the brainwashing of the masses, through mass media advertisements, with the wrong approaches to keep one healthy. The leading one among them is goading people to have a regular “health” check-up. Nothing could be more dangerous than that to apparently healthy people. When one is healthy one should NEVER ever go for a check-up! The common man will have the doubt as to how he or she could know about health. One is healthy when one has (a) enthusiasm to work and (b) enthusiasm to be compassionate. One of the ancient exercises could be the most potent modern medicine — a daily walk if one is not a physical labourer.
After 25 years follow-up of one of the largest-ever studies of risk factors (which are being sold to the gullible public day in, day out as silent killers), the MRFIT study (Multiple Risk Factor Interventional Trial) observed that: “In conclusion, we have shown that it is possible to apply an intensive long-term intervention program against three coronary risk factors, high blood pressure, cholesterol and smoking with considerable success in terms of risk factor changes. The overall results do not show a beneficial effect on CHD or total mortality from this multiple risk factors intervention trial. (Zukel, Paul and Schnaper, 1981).”
In other words, they found that changing the “risk factors” does not apparently change the risks. This necessarily means that the “risk factors” are not as important as was thought. Indeed, it should be concluded that the “risk factors” were no such thing, at least as far as this trial is concerned.
At the University Of Maryland School of Medicine, Roger Sherwin was Principal Investigator of the Baltimore Center of the Multiple Risk Factor Intervention Trial (MRFIT). He served on several national MRFIT committees and was the first chairman of the Intervention Committee responsible for the implementation of the complex intervention programme. He was disappointed that the MRFIT turned out to be only a boondoggle.
An audit by Uffe Ravnskov of the 17 leading hypertension intervention trials in the world literature showed hardly any significant difference in the outcomes in mortality between the groups whose blood pressure was tightly controlled with drugs and the groups that changed their mode of living to a healthier one.
A recent CADD study did show that very tight control of blood sugar with powerful drugs in diabetics only increased the micro-vascular complications. Most of our studies, based on which we model our treatment plans, show only a decrease in the surrogate end points like blood sugar report improvement in diabetics; they have never shown in the long run any fall in mortality. Surrogate end point research could, at times, be dangerous especially in medicine where the NNT (a statistical term denoting the number needed to treat) is prohibitively high.
One example will suffice. The large MRC study on mild to moderate hypertension treatment showed that to save possibly one stroke death in the next five years in society we will have to unnecessarily treat 850 healthy human beings with powerful anti-hypertensive drugs whose side-effects could seriously damage the health of at least 75 healthy people with some of them meeting their maker prematurely! The NNT in heart ailment drugs and cancer treatment could be much more than in hypertension.
I am sure the reader by now would have realised the significance of what William Osler’s prophetic statement of 1905 meant when the great physician did not have any of these powerful drugs that we have today. Cure rarely, comfort mostly but, console always should be our motto when one is ill. Patient care simply is caring for the patient. Let me make a fervent plea for parsimony in using drugs in the healthy segment of the population, by labelling these so-called risk factors as silent killers, in the fond hope of averting major problems in the future. We simply do not have any scientific evidence for their benefit as of now.
Doctors are a step ahead of Yama says Prof Dr BM Hegde
Moneylife Digital Team
While criticising the money minded healthcare and pharma industry, Dr Hegde elaborated the importance of alternative medicines and therapies. He said the key to wellness lies in becoming free from negative thoughts, eating natural food in moderation and having adequate sleep
“These days we don’t have doctors. We have specialists who know more and more about nothing,” says Professor Dr BM Hegde, while speaking at a seminar on holistic approach to healthcare and wellness, organised by Moneylife Foundation.
Prof Dr Hegde, a Padma Bhusan awardee and prolific writer, spoke in detail about various aspects of wellness and the crises in modern medicine. He emphasised that wellness simply is happiness within the human system and health is enthusiasm.
While criticising the money minded healthcare and pharma industry, Dr Hegde elaborated the importance of alternative medicines and therapies like Pranic healing and Reiki. According to him the key to wellness is by being free from negative thoughts, eating natural food in moderation and having adequate sleep.
Prof Dr Hegde, explaining how billions of dollars are spent on AIDS and cancer research across the globe, said that we are living in the era where diseases are sold. “All the crises modern medicine is facing is due to money. The lure for money has resulted in diseases mongering. They are sold.”
He said doctors today are indulging in disease screaming. “If one goes to a high school and screen all the students with an angiogram, it will be found that 76% of them will have pre-vessel block. If you don’t have a block, you will die before the age of 30. When you have a block, it means protection. This is called pre condition. But doctors, after seeing that you have money to spend and a medical insurance, will suggest all kinds of tests and surgeries for the same blockages.”
According to the eminent Professor medical insurance is the biggest curse. Instead people should ensure their health, he said.
Minimum use of medicine and unnecessary treatment
Prof Dr Hegde, often calles as “people’s doctor” believes that way to wellness and healthcare is usage of minimum medicine and avoiding unnecessary treatments or surgeries. He said surgeries should be confined for corrective purposes. “If a child is born is with hole (in heart), then that need to be corrected through surgery,” he said.
He says that people are ensnared to believe that popping a pill gives instant relief. “But one has to remember that behind every ill there is a pill.” He adds, “You have a headache; your blood pressure goes up. Then you go to a doctor for check up, which means you are a patient and you don’t come back. Instead a simple pranayam with five breathing technique can give you faster relief from the headache.”
Prof Dr Hegde also spoke on the tactics used by the doctors and medical institutions in making profits. “Audit in few American hospitals showed that majority of their profits comes from deaths that take place in the Intensive Care Units (ICU).
He raised concern over increasing cases of caesarean births. “Natural tear (caused in normal birth) is quickly healed compared to cuts (due to C-sec births). It is also much safer and helps in the development of mind, which is known as perinatal consciousness. But the doctor and hospital will not earn money through normal delivery, and therefore everyone, especially from metros like Mumbai, opts for the C-Section cut,” he said.
Prof Dr Hegde spoke about the importance of alternative medicines like Ayurveda and Homeopathy. He said, “There are all kinds of tactics are used to suppress Homeopathy as a form of treatment. But it is one of the best medicines. It is much more scientific than modern medicine. Just because one cannot detect the chemical present in the nano particle of the pills, you call it unscientific? This is not fair.”
According to him, modern medicine claims to be based on science but research has found that majority of health problems stem from the mind while modern medicines can offer only a temporary relief. “If one has a happy mind, his body is largely free from diseases.”
Speaking on Ayruveda, Prof Dr Hedge explained that how millions of dollars and many years were spent to find the cause of common cold but nothing was concluded. At the same time Ayurveda, for instance, lists food that has to be consumed during various seasons like eating more spices during winter. “In fact, Lancet (leading medical journal) advised people in Britain to eat to eat curry in Indian restaurants as a cure for common cold during winter.”
Prof Dr BM Hegde also explained the benefits of consuming ginger, garlic and pepper as cure for many diseases and allergies.
Source & Courtesy : Hindu Daily published from India