“A vast amount of contemporary clinical care is incidental to the curing of disease, but the damage done by medicine to the health of individuals and populations is very significant.”
― Ivan Illich, Medical Nemesis: The Expropriation of Health,1976
Here’s a medical anecdote predating pandemic-era mRNA snake oil.
Years ago, my uncle went to his GP complaining of a stomach ailment. He returned home with a prescription for a quinolone antibiotic known as ciprofloxacin. After taking it he experienced a rash, which began to spread.
He advised his GP about the rash, but was told not to worry about it. It was the last trip to a doctor’s office he’d ever make.
His skin’s surface became a reddened, autoimmune battlefield. Spurred by the antibiotic, his body had declared war on itself. With each visit to the hospital I found my dear uncle less and less recognizable, swollen and scarred under a cat's cradle of tubes and wires. A man in his seventies in good health with a full head of hair, he now resembled Marlon Brando’s bulky and bald Colonel Kurtz character in Apocalypse Now. My father and I would visit and talk, but my uncle’s eyes were fixed straight ahead, unmoving.
The good-humoured, thoughtful man I had watched Warner Brothers cartoons and PBS documentaries with…reduced to a wraith, thanks to medical malpractice.
According to clinical literature on ciprofloxacin I dug up after his death, a total of sixteen percent of 2600 patients tested had “adverse events” that “were considered likely to be drug related.” The document went on to say that “serious and occasionally fatal hypersensitivity reactions, some following the first dose, have been reported in patients receiving quinolone therapy.” Another paper on contraindications exclaimed that “some hypersensitivity reaction have been fatal at the first dose of the drug!” No figures for fatalities were supplied in either case.
The more time, toil, and sacrifice spent by a population in producing medicine as a commodity, the larger will be the by-product, namely, the fallacy that society has a supply of health locked away which can be mined and marketed.”
― Ivan Illich, Medical Nemesis: The Expropriation of Health
In his 1998 book Bitter Pills, journalist Stephen Fried tells a similar tale of another quinolone antibiotic. “My wife's gynecologist gave her samples of a new antibiotic to treat a urinary tract infection so minor, she didn't even know she had it.” On his way to work one morning, Fried waved goodbye to his wife -- in a deeper sense than he knew at the time -- after she swallowed her first pill at breakfast. Six hours later, after hearing her near-unintelligible phone call for help, he brought his wife into Emergency.
After several hours of neurological exams, the word came back -- from a place called the Poison Control Center -- that all of Diane's symptoms had been previously reported as reactions to the antibiotic she took. The drug is called Floxin. She had, as we now say, been “Floxed.”
The journalist’s wife was suffering all the signs of toxic psychosis, including hallucinations and depersonalization.
But her symptoms did not disappear as promised. Some waned, but new ones developed. ...She had really aggressive, buzzy insomnia, visual distortions that made the world seem six-dimensional, and aphasia: She would get halfway through a sentence and just couldn't get the rest of the words out.
Fried wondered if his wife was a “victim of a pharmacological foul-up or just a statistically acceptable casualty of ‘friendly fire’ in the war on disease.” He tells how she was incapable of spelling ‘world’ backwards in the emergency ward. “World backwards. Tell me about it.”
Medical Betrayal
“Time to Say Goodbye” was a hit rotating on the radio at the time of my uncle’s death. My father, who had spent a lifetime bottling up his feelings, couldn’t keep from crying whenever it came on, reminded of the unfortunate farewell to his brother.
And he was next in line in the family for medical betrayal.
After my dad had a back injury resulting in chronic pain, his GP prescribed him the anti-inflammatory drug Celebrex (celecoxib). He experienced severe chronic stomach pains soon after. I researched the literature on the medication and discovered Celebrex was the likely culprit, with up to half of users reporting gastrointestinal discomfort, pain or bleeding.
NSAIDs such as celecoxib may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. - Medline
Not only did my father get little relief from a conga line of doctors and specialists for his back pain, one of them added another health complication to the mix. He ended up being on multiple medications to the very end - the standard medical profile of an aged health care “user” in the industrialized west.
At the time, I cautioned my parents about prescription drugs, and to do their own research, or at least let me do it on their behalf - to no avail. The last ten years of my dad’s life was a story of chronic pain.
(A side story: I was with my father when he died in the hospital. Or rather, almost. While I slipped out of the room for a few minutes, he slipped away. I returned to see flat-lined monitors. I called attention to this, and with hospital workers ran about with great fanfare, compressing his chest and producing paddles to shock him back to life. When I shared this some years later with a doctor acquaintance and former BC health minister, he gave his expert opinion that this practice is largely theatre, performed to mollify any family members present rather than recover patients past hope. I don’t know if this is true or not, but the violent scene was more horrifying than mollifying.)
You may be saying, ‘this is all very sad, but the plural of anecdote is data. Where’s the data?’ We’ll get to that.
The proposal that doctors not be licensed by an in-group does not mean that their services shall not be evaluated, but rather that this evaluation can be done more effectively by informed clients than by their own peers.”
― Ivan Illich, Medical Nemesis: The Expropriation of Health
If you haven’t experienced it yourself, you likely have someone close with a maddening story of inaccurate diagnosis, questionable medication, or some other form of high-tech quackery with serious adverse effects, up to and including death. (Let’s remember iatrogenic illness literally means physician-caused. )
We hold the people inspecting our bodies - doctors - to a higher standard than the mechanic at the garage working on our car. Or at least, we should. The trouble is, physicians are the priest-class of The Science™. We enter their sacred spaces of healing in postures of suppliance, our critical faculties strangely numb. Yet if any place calls for skepticism, it’s a GP's office, where tunnel vision training combined with overbooking can turn medical consultation into a zero-sum game of pat answers and educated guesswork.
There are certainly GPs responsible with their time and expertise, who bring some critical thinking and curiosity to their patients. And there’s there’s those on autopilot, with many of the older ones cruising along on outdated information they learned decades ago in university. Yet no matter how well intentioned they are, general practitioners aren’t scientists. They’re technicians. And their profession is embedded in a pharmaceutical-industrial complex that traffics in poorly tested, heavily lobbied, and highly profitable pharmaceutical drugs.
Some of the more dangerous quack remedies are recalled after the fallout severely injures the brand. Yet some drugs continue to survive legal challenges, along with any bad press they receive from a legacy press chronically addicted to pharmaceutical ad revenue.
I’ve only experienced minor medical betrayal myself - my stories are comical rather than catastrophic - because I’ve long had the same approach to doctors as I do with lawyers: they’re part of a professional class I have no desire to interact with unless absolutely necessary (that said, I do think yearly checkups after a certain age are worthwhile).
And yes, it’s necessary to remember that many prescribed drugs have proven long-term safety and efficacy (although mRNA vaccines are anecdotally and factually not among them).
Sure, we can blame Big Pharma for continuing to push medications with contraindications as long as your arm, but front-line doctors bear responsibility as the public interface with the medical system. And they certainly know directly from their patients of the damage done to them by prescribed medicine. (Celebrex and Ciprofloxine continue to be prescribed to this day.)
During the last century doctors have affected epidemics no more profoundly than did priests during earlier times. Epidemics came and went, imprecated by both but touched by neither. They are not modified any more decisively by the rituals performed in medical clinics than by those customary at religious shrines.
― Ivan Illich, Medical Nemesis: The Expropriation of Health
Acceptable risk
Pharmaceutical PR reps and their media mouthpiece like to go on about “acceptable risk,” whether it’s antibiotics, anti-inflammatory drugs, vaccines, or any other Big Pharma magic bullet. But what constituted “acceptable risk” in my uncle’s case? He had an intestinal bug, likely viral. It didn’t leave him bedridden or severely compromise his health. Yet his doctor prescribed a hydrogen bomb to swat a housefly - and blew away the house in the process. (I wanted to pursue legal action, but my father resisted and I respected his decision. In any case, such legal challenges against doctors rarely get traction. The College of Physicians protects its own.)
The irony is sickening. For years, medical researchers counseled against the over-prescription of antibiotics, after drug-resistant "super-bugs” appeared largely as the result of the practice of physicians, who until recently acted as agents of natural selection by dispensing antibiotics like candy - even for viral infections - mostly as placebos.
Combine pharmaceutical sales reps with incurious, overbooking doctors, and you have a combination that can be lethal -- quite literally. A 2014 journal article in the NIH Library of Medicine asserted that prescription drugs are the third leading cause of death in the industrialized world:
Our prescription drugs are the third leading cause of death after heart disease and cancer in the United States and Europe. Around half of those who die have taken their drugs correctly; the other half die because of errors, such as too high a dose or use of a drug despite contraindications.
The risk to life and limb from medical malfeasance is hardly a recent phenomenon. Even entry into a hospital can kill you in all sorts of sideways directions, according to a 2000 report from the US Institute of Medicine Committee on Quality of Health Care in America:
Preventable adverse events are a leading cause of death in the United States. When extrapolated to the over 33.6 million admissions to U.S. hospitals in 1997, the results of these two studies imply that at least 44,000 and perhaps as many as 98,000 Americans die in hospitals each year as a result of medical errors. 3 Even when using the lower estimate, deaths in hospitals due to preventable adverse events exceed the number attributable to the 8th-leading cause of death. Deaths due to preventable adverse events exceed the deaths attributable to motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516).
A 2013 study estimated a fatality rate four time higher, with “200,000 to 400,000 deaths per year from preventable harm in hospitals.” And this isn’t even estimating the long-term injuries resulting from medical malpractice in hospitals.
An earlier journal report estimated that adverse effects from appropriately administered, government-approved drugs, physician-prescribed medicine was killing more people annually than illegal drugs (and this was before the stretch when US doctors were dispensing oxycontin like candy.) Deaths equivalent to four packed jumbo jets slamming into the ground every day.
Useful information for the next time you hear big media cant about the "risks" from herbal remedies (a doctor friend of mine literally talks about the dangers of what she calls “Big Herba’).
On my uncle’s tombstone are the words, “I'll be right back.” What could have been more darkly comic as an epitaph - and damning of allopathic medicine - are his last words to my sister: “When all this is over, I'm going to get another GP.”
World backwards.
If you have a story of medical betrayal, feel free to share it in the comments below.
Brilliant article btw.
I read this recently and had a laugh
New Year’s resolutions
Give up my three main vices
-alcohol
-smoking
-doctors