”The delivery of good medical care is to do as much nothing as possible”
~ Samuel Shem, The House of God
Medicine is undergoing an existential crisis today. Its core value proposition – to help and not hurt — is failing to manifest. Patients are suffering. Doctors are suffering. The only exuberant party on the battlefield against disease is the pharmaceutical industry. An industry whose annual causalities far exceed the death total from our two decade long involvement in the Vietnam war.
The entire system is on the precipice of a collapse, if not for economic reasons alone, then certainly for ethical and intellectual ones. The irony is that the system has become so ineffective and dangerous that avoiding medical treatment (excluding perhaps emergency care) has become one of if not the best healthcare strategy you can implement to protect your health and well-being.
Nowhere is this clearer than in the realm of cancer. Over the past few decades, billions have been spent on screening asymptomatic populations to “prevent cancer,” with the result that millions have been assigned with questionable diagnoses (e.g.,”early stage-” or “stage zero-cancers”) and then shepherded into chemo, radiation and surgery treatments as if watchful waiting, or better yet, making significant nutritional and lifestyle modifications, would be a suicidal approach vis-à-vis the inexorability and presumed lethality of genetically-determined cancer.
We needn’t detail the misery this approach has produced, but suffice it to say that despite the industry’s claims of thousands of “lives saved” from the detection of “early cancers,” breast and prostate cancer specific mortality has at best stayed the same, and may have actually increased in some cases. In light of the fact that the financial costs of misapplied treatment in some cases is so high that the uninsured, their families, and society as a whole, face bankruptcy, the situation is dire indeed.
Even after the cat was let out of the bag in 2013, and a National Cancer Institute commissioned expert panel concluded that labeling screening detected lesions known as ductal carcinoma in situ (DCIS) and high-grade intraepithelial neoplastic hyperplasia(HG-PIN) (colloquially labeled as “breast cancer” and “prostate cancer,” respectively) as carcinomas (“cancer”) is no longer justified. Instead they opted for redefining what were previously considered potentially lethal cancers as “benign or indolent lesions of epithelial origin.” Yet, you hear virtually no mention of this change anywhere. Tens of thousands are still being diagnosed with the same “cancers” and being cut, poisoned and burned, without informed consent.
The lack of acknowledgment and discussion about these tremendous diagnostic “errors” is less surprising when you consider that about 1.3 million U.S. women were wrongly treated for breast cancer in the past 30 years, with prostate and lung cancer representing two additional icebergs upon which the Titanic cancer industry is presently running itself aground upon, regardless of whether the medical establishment will accept responsibility. Ignoring the truth that millions suffered needlessly, it would seem, is less painful than admitting wrong, and dealing with the psychological and financial fallout that inevitably follows. But is it possible to stem the tide much longer against the inevitable transformations brewing?
If you check the pubmed.gov statistics, interest in “overtreatment” and “overdiagnosis” has grown exponentially from only a few decades ago, when the terms were rarely mentioned. A new editorial, titled, “It Is Overtreatment, Not Overdiagnosis,” points out the real issue behind the epidemic of cancer overdiagnoses:
The most widely accepted definition of ”overdiagnosis” is ”diagnosing a person without symptoms with a disease that will (ultimately) never cause symptoms or death during the person’s lifetime” (2). It should not be confused with misdiagnosis or false-positive findings, which are completely different entities and outside the scope of this commentary. As the generally accepted definition encapsulates downstream effects (ie, ”would otherwise not go on to cause symptoms or death”, the real issue lies with ”overtreatment” of these accurate diagnoses rather than overdiagnosis itself.
Overtreament does not happen in a vacuum. The very industries that produce the treatments also create and supports the “awareness campaigns” that not only use fear to corral the population into screening, but also “pinkwash” away their true causes, i.e. breast cancer awareness month talks about needing a cure but not the causes right under our noses (i.e. carcinogens). Therefore, the more diagnoses that are generated, the more treatments will be “recommended,” resulting in greater revenue and profit – an economic growth model that itself can only be described as a malignant process at least as violent, if not more, than the disease it is claiming to treat and manage.
The editorial concluded:
“The effects of treating inconsequential lesions, rather than their diagnosis per se, result in increased morbidity and cost without added benefit. Society as a whole should strive to treat individuals who should be treated and not those who would not benefit. The 13th law of Shem, true in 1978, remains true today.”
Essentially, modern medicine has become our most Orwellian institution, with “detecting cancer early” the biomedical equivalent of the Thought Police detecting crime before it happens. The prognosticating itself, is a highly toxic process (nocebo: e.g., “You have cancer and 6 months to live.”) that can contribute to evoking cancer-promoting physiological reactions, as well as inflicting real psychospiritual wounds that have been determined to dramatically increase the risk of heart-related deaths and suicides. Medicine has also adopted the metaphorics of another powerful global force: the military industrial complex, with the cancer “prevention” being equated to “striking first,” eerily similar to the Bush doctrine of preemptive war to secure peace. Here, the precautionary principle is co-opted and inverted from its true meaning. Instead of “doing no harm,” unnecessary medical intervention is considered the only non-violent solution even when the collateral damage is so great that the patient often dies from the violence of “treatment” with weapons-of-mass-destruction grade radioisotopes and chemicals and not the condition.
We need to completely rethink medicine’s role in healing. What happens when we return to the fundamentals of an entity – the human, soul and body together — whose self-healing capabilities are so powerful that even the suggestion through sugar pill or kind word of a health practitioner that a disease can attenuate or disappear actually causes significant improvement? What if given the right conditions – clean air, water, food and a healthy environment, physically and emotionally – the conditions for disease were suddenly removed, and replaced with an opposite environs promoting health? If medicine makes it through the birth process of its own existential crises, these principles will invoke an entirely new medical model where the placebo effect is not to be “controlled for,” but liberated and expanded by educating the patient to the fact that they can and do heal themselves, mainly by avoiding medical treatment and doing the right amount of nothing.