BAD MEDICINE

Conventional medicine has a sad and dysfunctional relationship with nutrition. Growing evidence on connections between diet and disease means doctors are asked questions they have evaded for decades. Many of my clients experiencing the benefits of a healthy plant-based diet ask “Why didn’t my doctor know about this?”

I fully respect the good work that most doctors do. Modern medicine can do many wonderful things. But the profession is rarely criticised or assessed rigorously from the outside. We seem much more interested in who pays the bill rather than the quality of the service. There are mythologies surrounding medicine that are deeply embedded in our culture, and that profoundly affect our attitudes to health.

Since the 1950’s medical shows on television have been a standard entertainment; at last count there have been 93 successful shows (32 in the UK) with a medical format. From ‘Dr Kildare’ and ‘Ben Casey’ in the 60’s to ‘ER’ and ‘House’ in the 21st century, television doctors have portrayed the power of medicine over suffering and death. But it is a mistake to believe that this power indicates that doctors understand health. They are sickness experts – not health experts.

An analogy of the comparison is this: imagine a highway with hundreds of cars speeding along. Suddenly a bridge collapses. Standing by the road, you see cars hurtling off it, into the canyon below. What do you do? Do you go down into the canyon and help those injured? Or do you stop the traffic?

Medicine has chosen to go into the canyon and help the injured. And maybe they put up ambiguous warning signs such as ‘Speed Kills’, ‘Watch Out!’ or ‘Use Caution’.

Someone has to stop the traffic. The medical establishment has not taken on that role in the past, and there is no sign that they will in the future, although a few brave souls venture out to stem the traffic flow.

It’s hard to get out of that canyon once you are down there. Things are not going so well at the crash site. As the traffic increases the services and personnel become more overworked, and resources are constantly under stress. There is an endless demand for more money and new technologies – but extra resources don’t seem to help.

In America just under 18% of the GNP is spent on health care; in the UK the figure is 9.6%[1].  Yet in an exhaustive survey done by the United Nations, published in 2000, America only ranked 37th  out of 190 countries and the UK ranked 18th.[2] Something is seriously wrong and money isn’t fixing it. One problem is that the growing demands and increased complexity of treatment creates an environment where mistakes are unavoidable. A 2013 report from the Institute of Medicine reported that there are 440,00 preventable deaths from medical errors annually in America.[3]  That makes medical error the third leading cause of death following heart disease and cancer.

The focus at the crash site is the prescription of pills.  We live in a culture where every complaint, real or imagined, requires medication. Driven by the pharmaceutical mentality, the abuse of prescriptive drugs grows yearly. An estimated 48 million Americans have abused prescription drugs – nearly 20% of the U.S. population. Deaths by prescription drugs are more common than deaths by car accidents in America, and far outstrip deaths by illegal drugs. Disturbingly, the non-medical use of prescription drugs has been rising steadily for adolescents, particularly prescription pain relievers, anti-anxiety medications, stimulants and steroids.[4]

What about antibiotics? Sometimes a doctor prescribes antibiotics under pressure from a misguided patient who demands medication. Common colds, flu (influenza), bronchitis, most cough’s, most sore throats, some ear infections, many sinus infections and stomach flu (viral gastroenteritis) do not respond to antibiotics.  Yet antibiotics are regularly prescribed for these cases. Doctors may even write the prescription before receiving test results that identify the infection.

The long-term and combined effects of our romance with drugs is making us sicker. Antibiotics are specifically designed to kill microorganisms – but it is almost impossible to target a single species. Antibiotics are literally ‘anti-life’.  In using them, we may kill the bacteria we want to kill. We also kill or damage our beneficial bacteria, and mutate harmful ones.

As antibiotic use increases, bacteria adapt to them and become resistant. A 2013 report by the Centers for Disease Control and Prevention states that at least 2 million people annually “acquire serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections.” [5] At least 23,000 people die annually in America from antibiotic-resistant infections.

The human body is home to billions of microbes. They inhabit every part of the body from the eyelash to the gut. They perform essential tasks in protecting us from potential pathogens. Microorganisms are crucial to our digestive system. The colonies of microbes that form the microbiome in our gut are the key to good digestion – and more. When we eat, it is these tiny creatures that increase the efficiency of metabolism, fine-tune immune response and even synthesize some vitamins.

It seems clear that the overuse of antibiotics is having a negative impact on many indigenous organisms in the gut. These microbes have established a commensal (mutually beneficial) relationship with their human hosts. Their disappearance, under the onslaught of antibiotics and the modern diet, seems to promote conditions such as obesity and asthma.[6] The use of antibiotics dramatically alters digestive function. Think of the common side-effects of nausea and diarrhea. This is part of a vicious cycle: our diet makes us more prone to disease, and then we take drugs that hamper digestion and compromise immune function.

A recent study in the British National Health Service found that nine out of ten General Practitioners in the UK feel pressurized by their patients to prescribe antibiotics. Ninety-seven percent of these patients are prescribed antibiotics regardless of their illness.  When the National Institute for Health and Care Excellence (NICE) suggested that doctors who over-prescribe be censured,[7] doctors were upset.

Antibiotics first arrived on the medical scene in 1932. They were the first medicines labeled ‘wonder drugs’. The introduction of the sulfa drugs meant the U.S. mortality rate from pneumonia dropped from 0.2% each year to 0.05% by 1939. This was indeed a wonderful treatment and saved many lives. Penicillin, introduced a few years later, provided a broader spectrum of activity, and had fewer side effects. Streptomycin, discovered in 1942, was the first effective drug against tuberculosis, and came to be the best known of a long series of important antibiotics. The root causes of the diseases treated were lost in the celebrations.

Tuberculosis can be directly traced to individual and social behavior. This was also the case with whooping cough, pneumonia and other diseases of poverty. They originate in crowded and unhygienic environments where malnutrition is common. Now that we were able to cure the illnesses with antibiotics, we stopped focusing on cleaning up the slums and the provision of healthy food.

Taking medication is a huge act of faith. We believe that the healer knows about invisible forces – and knows how to control them. It doesn’t matter if the healer is a shaman on the Mongolian tundra, a Wise-Woman herbalist in the forests of ancient Europe, or a doctor in modern America. The healer’s naming of the evil spirit indicates special wisdom. If the name is in a foreign language all the better (Latin is a good start). Doctors unwittingly support and encourage this fantasy. We may mock other cultures for their superstitions, but are our own illusions really that different?

The relationship between the healer/doctor and the patient is based largely on the faith of the patient, rather than knowledge.  It is an infantile bond, disempowering to the one seeking help. We are uneducated about health, and the doctor is unlikely to have the time (or perhaps the inclination) to educate us. That is not their job, they just want to treat us. So we continue thinking that we must hand over the care of our health to our doctor – and that they know what they are doing.

Disease is generally described as an enemy. Invisible and mysterious adversaries surround us.  We are ‘fighting’ heart disease; we are ‘battling’ cancer we will ‘conquer’ diabetes. Who or what are we fighting? As long as the enemy is concealed behind a cloak of mystery we can leave the battle up to the wizards and hope for the best. In order to discover the culprit all that we need is a mirror. Our major antagonist is hiding in clear sight. We like to think that responsibility for our illnesses lies outside us. If my illness is caused by a virus, bacteria or genetics, then I am blameless. But change my daily habits? Surely not! It can’t be that simple, can it?

[1] Organization for Economic Co-operation and Development, Health Data 2013

[2] World Health Organization, World Health Report 2000

[3] As reported in Forbes Magazine, September 23, 2013

[4] National Council on Alcoholism, and Drug Dependence

[5] Centers For Disease Control and Prevention, Antibiotic Resistance in the United States, 2013, cdc.gov

[6] Nature Reviews Microbiology 7, 887-894 (December 2009) What are the consequences of the disappearing human microbiota?

[7] National Institute for Health and Care Excellence Report, Aug, 2015