FEATURE

Medicine is too much with us.

Prof. B. M. Hegde,

hegdebm@gmail.com

I get a weekly dose of happiness from the British Medical Journal these days. This week, the last of February 2013, is something that gives me lots of joy as I have been saying this for now well over 45 years. The first article that I published-How to avoid modern medicine and survive-almost cost me my job in the medical school. I survived by the skin of my teeth. This week’s BMJ says just what I said then-Too much medicine. 

I was reminded of this little poem by that Romantic British poet, William Wordsworth, who in the year 1802 criticised the world for the First Industrial Revolution where he thought that we had lost ourselves in materialism to the exclusion of nature! How true it could be said today about modern medicine and its ravages?

“The world is too much with us; late and soon,

Getting and spending, we lay waste our powers;

Little we see in Nature that is ours;

We have given our hearts away, a sordid boon”.

Every word that he wrote there could aptly be said about modern medicine and our obsession with the philosophy of a pill for every ill.

Medicine is too much with us; late and soon,

Diagnosing and drugging, we lay waste our powers;

Little we see in nature that is curative medicine,

We have given our hearts away to the drug barons, a sordid boon.”

Call me a therapeutic nihilist, if you will-I couldn’t care less. I shall give you an idea as to what we are doing at the moment. Just as the industrial revolution did a lot of damage and is still doing, drugs and irrational modern medicine will do the same if left unchecked. For most of us it is safer and profitable to go with the flow but if you have the good of the common man at heart it pains to know the truth in modern medicine-a Golem, indeed!

The first five years of the Iraq War cost USA a total of 4200 soldiers dead. In the first three months of 2008 alone 4800 patients died because of prescription medicines. Every year 700,000 people in the USA need emergency out-patient hospital care following an adverse reaction to a prescription drug. Of these, 16 per cent are admitted to hospital for surveillance. (JAMA 2006; 296: 1858-1866) That's according to a new analysis by the Institute for Safe Medication Practices, a watchdog group that compiled reports from FDA’s own statistics.

More than a quarter of a million Adverse Drug Reactions a year, costing the NHS Sterling pounds 466 million (BMJ 2004; 329: 15-19.) come from common drugs like aspirin, diuretics, warfarin, pain killers and many such drugs which could have easily been avoided. The indirect deaths due to antibiotics, various blockers and statins are not recorded.  From these data the researchers extrapolated the data for the whole of UK to be 250,000 per year deaths due to prescription drugs alone. One could imagine the death load for a vast country like India of 1.2 billion population, which could be mind boggling. I dare say the greatest weapons of mass destruction are the prescription drugs! May be we in India also get another benefit. They are a useful tool for population control, in addition!

A Dutch study published in the European Heart Journal a few years ago gave the statistics of all deaths between 1995 and 2003 in a population of half a million people from 150 general practices with perfect record keeping systems. Those who had sudden cardiac deaths were compared to matched controls.  The analysis showed that people using a range of drugs known to affect the heart were nearly three times more likely to die suddenly. All those drugs were known to prolong the QT interval in the ECG. One example was Cisapride, commonly given for heart burn. There are many others. In short, there is nothing called the fully safe drug!, Antibiotics, antipsychotic drugs and those used to treat nausea and vomiting may all be involved because they have the ability to interfere with the electrical activity that controls the heartbeat.

Barbara Starfield of Johns Hopkins alerted the USA about this sordid boon in the year 2000 in her article in the  (JAMA 2000; 284: 483) She showed from the IOM data that the medical establishment was one of the leading causes of death in that country. She also quoted the 14  industrialized countries’ study which showed that with minimum medical effort Japan stood on top and USA with top heavy medical system came last but one with Germany at the bottom! 

Gary Null and his colleagues, using the same data five years later, showed that the medical profession topped the list of cause of death followed by cancer and heart attack in that order of preference! Doctors going on strike in different countries at different times in the last twenty five years consistently showed death and disability rates falling down sharply only to level again when they come back! (BMJ 2000; 320: 1561.1) All this and more show that all in not well and needs immediate change for the better. Wake up, arise, and sleep not until we set our house in order for the good of the common man.

Author is the former Vice Chancellor of Manipal University & a recipient of Padma Bhushan.