FEATURE
Performativity
Prof. B. M. Hegde,
hegdebm@gmail.com
“For what shall it profit a man, if he shall gain the whole world, and lose his own soul?”
Mark 8:36,
Modern medicine, people believe, is very scientific; evidence based, and has a very robust research backing. That idea gets dinned into our heads, thanks to the medical claptrap. I would also like to believe that but, my fecund experiences inside the arena for five decades do not permit me intellectually accept it in Toto. The science of modern medicine is only statistical, evidence base is evidence burdened, and the research is repetitive and, many a time, is fraudulent. We are lost in labeling patients with a diagnosis; which seems to be central to all our actions there after, unmindful of the complex individuality of the owner of that diagnosis. The latter, our patient, should be our focus of attention and not so much his/her disease. “Do it-fix it” seems to be the goal, hereinafter called, performativity. Fixing with quick fixes, chemical drugging, surgical interventions, industry funded research grant getting, conventional conference meetings, and occasional teaching seems to be the accepted routine of the star performers in the field. In reality what we need urgently is thinking. Thinking brings in wisdom which helps us to refute false myths and dogmas in the field.
Our logic seems to be mundane, not in keeping with the complexities of the human body’s performance both in health and disease. Modern medicine, especially of the American variety, which we follow in India faithfully, concentrates on chemical suppression of symptoms without going into the root cause of the illness. We do not even consider the enormous power of self healing ability that humans have in them. This has resulted in medical curricula, textbooks, medical education and the whole gamut of illness management running after the mirage of fixing it with the help of chemicals and interventions, performativity, many of which have serious repercussions on human health.
Toxicology teaches the student the definition of target organ damage when a person gets poisoned. The same happens with every single chemical therapeutic drug that we prescribe. The first thing that happens is what we call the “first pass effect.” Liver is the largest chemical factory in the body that tries its best to eliminate unwanted chemicals entering the system through food contamination or as drugs, both therapeutic and recreational. Changes do occur in every other organ of the body when we consume any chemical, may be, to a lesser extent. Many of the modern newer presentations of diseases or increased incidence of older diseases has been traced to this kind of chemical slow poisoning. Adverse drug reactions that kill millions every year are the overt face of target organ damage described above. The present tendency for polypharmacy compounds the problems with chemical drug interactions!
Two glaring examples of the above would make the point clear. Every single chemical prescribed for mental illness eventually slowly destroys the brain cells leading to dementia. Similarly, chemotherapy and radiation for cancer treatment are now known to produce a new second cancer in some patients. A whole new industry has grown around this second cancer. Oncologists are keen to discover a new cancer even in a dying patient as if the original cancer was not enough to kill the patient. They feel happy when they have discovered a new cancer and a new label. It is known to generate lot more funds for corporate hospitals-more MRIs, scans and scopes! “…The goal is no longer truth (in medicine), but performativity-that is, the best possible input-output equation….scientists, technicians, and instruments are purchased not to find the truth, but to augment power….” write Famularo and his colleagues in their paper in the journal AIDS (1997; 11: 185-190)
I happened to read an eye opener in Grace Jackson’s new book-Dementia, a drug induced disease and a perfect crime, which has confirmed many of my long held opinions and clarified some of my doubts. She writes passionately, having even sacrificed her lucrative post in the US Navy as also a University position to write this book, which can easily be classed as one of the best that I have read in a long, long time. She writes “Within the conduct of medical practice, medical education, and medical research, it is performativity that has constricted the quest for knowledge and the authentic pursuit of healing.” How very true? Indeed, this was what I wrote in simpler English in 1968 or so in my article “How to avoid Modern Medicine?”
Our drug trials, the so called randomized controlled trials (RCTs), the bench mark of drug research, are the biggest pseudo science performativity. This is confirmed by the best authority in the UK, the NICE, recently. My editorial in our journal, The Journal of the Science of Healing Outcomes, had extensive details on RCTs a couple of years ago. In addition, many of the RCTs are stage managed. Industry funded RCTs had 90% positive results while the same RCTs seen through independent researchers have less the 30% positive results! “Only 15% of what doctors do is based on some scientific backing; 85% per cent has no science at all,” wrote David Eddy, the former professor of cardiac surgery at Stanford University. He was a thinker and so could not do what he had to do-daily bypass surgeries (for money and power) and the like. He found no scientific basis for all those quick fixes. He resigned to study mathematics to reform medical science. (www.archimedesmodel.com)
Many of the recent diseases are a part of this performativity quagmire-pre-diabetes, pre-hypertension, mild cognitive impairment (MCI), and very early cancers are some of them. Most, if not all of these, are known to be harmless by observational research. At best they need life style modifications. One has only to read this wonderful book by Professor Joerg Blech to go to the root of these tricks of the trade. “Disease Inventors” is that book in German, translated by Herbert Nehrlich into English for me to understand. (“Die Krankheitserfinder”, translated “The Disease Inventors”, Joerg Blech, ISBN 3-10-004410-X, www.s-fischer.de)
In addition, we do not have any definition of “normals” in medicine. What should be the normal blood pressure for Mr. X? I do not know. What is early cancer? If we have the means to detect (we might have in future) each of us has many new cancers daily sprouting in our system. Cancer begins as a rogue cell, a cell that does not die by apoptosis on the appointed day to be replaced by a new cell. This rogue cell usually dies shortly after that, but if the environment is conducive, it might grow into a clinical cancer after many years. What is early cancer diagnosis or precancerous state? Your sugar would naturally go up when you are frightened for your own good. If you are tested at that stage you are labeled a diabetic for the rest of your life and intervened. Even if someone touches you unexpectedly your blood pressure could jump up quite a bit-alarm reaction. What is this new disease called cholesterol? What, then, is the definition of “normal” in medicine? I am reminded of what Desiderius Erasmus wrote in the 15th Century: “Every definition is dangerous.”
Why do we indulge in this kind of medical practice? Writes Grace Jackson thus: “They include conformity with clinical practice guidelines (CPGs), treatment algorhythms, consensus statements, pay-for-performance mandates (P4P), and other manifestations of commercially biased Group Think, in order to obtain or maintain academic tenures, political appointments, research funding, and the maximization of corporate profits and investment returns.” Can there be something more dangerous for mankind than this performativity obsession? God only can save mankind. Doctors would do well to read this phenomenal book by David Wootton, Bad Medicine: Doctors doing harm since Hippocrates (Oxford University Press, £16.99, pp 320 ISBN-10: 0 19 280355 7 ISBN-13: 978 0 19 280355 9)
The reader might wonder as to why I write what I write. Instead of explaining the reasons at length, let me quote Dr. Iain Mc Clare, when he reviewed Wootton’s book for the BMJ: “Having been thoroughly impressed by this book’s arguments, I began to wonder—what are we, as doctors, doing to ensure that our profession remains the vehicle of progress and not its obstacle? One concern must be that medical history is not routinely taught in medical schools. It is a well understood maxim, that to discover where you want to go, you need to know where you are. To truly know where you are, I would argue, you need to understand how you got there. Wootton’s book should be standard issue for every first year medic.” That has been my concern also for the last half a century.
Health maintenance, on the contrary, is very simple. Good food, clean water, roof on top and sanitary facilities for all with literacy and economic empowerment of the masses in the poorer nations will do the job. The richer nations will have to control their food, drug and chemical industries to keep people healthy. Human greed is also a killer. While there is enough in this world for man’s need there isn’t enough for man’s greed.
“Experience is not what happens to a man: it is what a man does with what happens to him.”
Aldous Huxley.
Prof. B. M. Hegde,
hegdebm@gmail.com
“For what shall it profit a man, if he shall gain the whole world, and lose his own soul?”
Mark 8:36,
Modern medicine, people believe, is very scientific; evidence based, and has a very robust research backing. That idea gets dinned into our heads, thanks to the medical claptrap. I would also like to believe that but, my fecund experiences inside the arena for five decades do not permit me intellectually accept it in Toto. The science of modern medicine is only statistical, evidence base is evidence burdened, and the research is repetitive and, many a time, is fraudulent. We are lost in labeling patients with a diagnosis; which seems to be central to all our actions there after, unmindful of the complex individuality of the owner of that diagnosis. The latter, our patient, should be our focus of attention and not so much his/her disease. “Do it-fix it” seems to be the goal, hereinafter called, performativity. Fixing with quick fixes, chemical drugging, surgical interventions, industry funded research grant getting, conventional conference meetings, and occasional teaching seems to be the accepted routine of the star performers in the field. In reality what we need urgently is thinking. Thinking brings in wisdom which helps us to refute false myths and dogmas in the field.
Our logic seems to be mundane, not in keeping with the complexities of the human body’s performance both in health and disease. Modern medicine, especially of the American variety, which we follow in India faithfully, concentrates on chemical suppression of symptoms without going into the root cause of the illness. We do not even consider the enormous power of self healing ability that humans have in them. This has resulted in medical curricula, textbooks, medical education and the whole gamut of illness management running after the mirage of fixing it with the help of chemicals and interventions, performativity, many of which have serious repercussions on human health.
Toxicology teaches the student the definition of target organ damage when a person gets poisoned. The same happens with every single chemical therapeutic drug that we prescribe. The first thing that happens is what we call the “first pass effect.” Liver is the largest chemical factory in the body that tries its best to eliminate unwanted chemicals entering the system through food contamination or as drugs, both therapeutic and recreational. Changes do occur in every other organ of the body when we consume any chemical, may be, to a lesser extent. Many of the modern newer presentations of diseases or increased incidence of older diseases has been traced to this kind of chemical slow poisoning. Adverse drug reactions that kill millions every year are the overt face of target organ damage described above. The present tendency for polypharmacy compounds the problems with chemical drug interactions!
Two glaring examples of the above would make the point clear. Every single chemical prescribed for mental illness eventually slowly destroys the brain cells leading to dementia. Similarly, chemotherapy and radiation for cancer treatment are now known to produce a new second cancer in some patients. A whole new industry has grown around this second cancer. Oncologists are keen to discover a new cancer even in a dying patient as if the original cancer was not enough to kill the patient. They feel happy when they have discovered a new cancer and a new label. It is known to generate lot more funds for corporate hospitals-more MRIs, scans and scopes! “…The goal is no longer truth (in medicine), but performativity-that is, the best possible input-output equation….scientists, technicians, and instruments are purchased not to find the truth, but to augment power….” write Famularo and his colleagues in their paper in the journal AIDS (1997; 11: 185-190)
I happened to read an eye opener in Grace Jackson’s new book-Dementia, a drug induced disease and a perfect crime, which has confirmed many of my long held opinions and clarified some of my doubts. She writes passionately, having even sacrificed her lucrative post in the US Navy as also a University position to write this book, which can easily be classed as one of the best that I have read in a long, long time. She writes “Within the conduct of medical practice, medical education, and medical research, it is performativity that has constricted the quest for knowledge and the authentic pursuit of healing.” How very true? Indeed, this was what I wrote in simpler English in 1968 or so in my article “How to avoid Modern Medicine?”
Our drug trials, the so called randomized controlled trials (RCTs), the bench mark of drug research, are the biggest pseudo science performativity. This is confirmed by the best authority in the UK, the NICE, recently. My editorial in our journal, The Journal of the Science of Healing Outcomes, had extensive details on RCTs a couple of years ago. In addition, many of the RCTs are stage managed. Industry funded RCTs had 90% positive results while the same RCTs seen through independent researchers have less the 30% positive results! “Only 15% of what doctors do is based on some scientific backing; 85% per cent has no science at all,” wrote David Eddy, the former professor of cardiac surgery at Stanford University. He was a thinker and so could not do what he had to do-daily bypass surgeries (for money and power) and the like. He found no scientific basis for all those quick fixes. He resigned to study mathematics to reform medical science. (www.archimedesmodel.com)
Many of the recent diseases are a part of this performativity quagmire-pre-diabetes, pre-hypertension, mild cognitive impairment (MCI), and very early cancers are some of them. Most, if not all of these, are known to be harmless by observational research. At best they need life style modifications. One has only to read this wonderful book by Professor Joerg Blech to go to the root of these tricks of the trade. “Disease Inventors” is that book in German, translated by Herbert Nehrlich into English for me to understand. (“Die Krankheitserfinder”, translated “The Disease Inventors”, Joerg Blech, ISBN 3-10-004410-X, www.s-fischer.de)
In addition, we do not have any definition of “normals” in medicine. What should be the normal blood pressure for Mr. X? I do not know. What is early cancer? If we have the means to detect (we might have in future) each of us has many new cancers daily sprouting in our system. Cancer begins as a rogue cell, a cell that does not die by apoptosis on the appointed day to be replaced by a new cell. This rogue cell usually dies shortly after that, but if the environment is conducive, it might grow into a clinical cancer after many years. What is early cancer diagnosis or precancerous state? Your sugar would naturally go up when you are frightened for your own good. If you are tested at that stage you are labeled a diabetic for the rest of your life and intervened. Even if someone touches you unexpectedly your blood pressure could jump up quite a bit-alarm reaction. What is this new disease called cholesterol? What, then, is the definition of “normal” in medicine? I am reminded of what Desiderius Erasmus wrote in the 15th Century: “Every definition is dangerous.”
Why do we indulge in this kind of medical practice? Writes Grace Jackson thus: “They include conformity with clinical practice guidelines (CPGs), treatment algorhythms, consensus statements, pay-for-performance mandates (P4P), and other manifestations of commercially biased Group Think, in order to obtain or maintain academic tenures, political appointments, research funding, and the maximization of corporate profits and investment returns.” Can there be something more dangerous for mankind than this performativity obsession? God only can save mankind. Doctors would do well to read this phenomenal book by David Wootton, Bad Medicine: Doctors doing harm since Hippocrates (Oxford University Press, £16.99, pp 320 ISBN-10: 0 19 280355 7 ISBN-13: 978 0 19 280355 9)
The reader might wonder as to why I write what I write. Instead of explaining the reasons at length, let me quote Dr. Iain Mc Clare, when he reviewed Wootton’s book for the BMJ: “Having been thoroughly impressed by this book’s arguments, I began to wonder—what are we, as doctors, doing to ensure that our profession remains the vehicle of progress and not its obstacle? One concern must be that medical history is not routinely taught in medical schools. It is a well understood maxim, that to discover where you want to go, you need to know where you are. To truly know where you are, I would argue, you need to understand how you got there. Wootton’s book should be standard issue for every first year medic.” That has been my concern also for the last half a century.
Health maintenance, on the contrary, is very simple. Good food, clean water, roof on top and sanitary facilities for all with literacy and economic empowerment of the masses in the poorer nations will do the job. The richer nations will have to control their food, drug and chemical industries to keep people healthy. Human greed is also a killer. While there is enough in this world for man’s need there isn’t enough for man’s greed.
“Experience is not what happens to a man: it is what a man does with what happens to him.”
Aldous Huxley.
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