Читать книгу What Doctors Don’t Tell You - Lynne McTaggart, Lynne McTaggart - Страница 9

It’s comforting in life to have certainties. One of the cosiest of certainties we’ve grown up with is that modern medicine works miracles and doctors cure diseases. In the stories we tell ourselves, Dr Kildare, Marcus Welby, Dr Finlay, clad in symbolically pure white, engage in the business, all day, every day, of saving lives. And even though more people die in our modern-day equivalents like ER and Casualty, those doctors in the emergency room still have gadgets capable of raising the dead.

Our greatest certainty about medicine is that it is a lofty and reputable science, arrived at by scientists in laboratories by exhaustive testing and review. We proudly point to the fact that science has progressed and triumphed over chaos and darkness, over the time when doctors didn’t even know that they had to wash their hands.

Since the Second World War, and the discovery of the two great miracle drugs of this century – penicillin and cortisone – medicine has indeed worked miracles. People who would have died from hormone-related deficiencies such as Addison’s disease, and life-threatening infections such as pneumonia or meningitis, can now recover easily and return to normal lives. Most of the great medical discoveries – painless surgery, antiseptic hospital environments, x-rays – only discovered in the last century, have given us in the West the best emergency medicine in the world. If you have an unforeseen heart attack, an operable brain tumour, a near fatal car accident, an emergency in childbirth, then Western medicine, with its array of space-age gadgetry, is without parallel for sorting you out. If a building ever falls on me, I’d like all the very latest in Western gee-whizz technology to put me back together. Indeed, if it hadn’t been for 20th-century drugs, my mother would have died in her early twenties and I never would have been born.

It was also these discoveries during the Second World War, ending abruptly with the ultimate scientific discovery, the atomic bomb, which left us with a great expectancy about science. The aftermath of victory was also the dawning of the scientific age of medicine. Science had helped us to conquer our human enemies. Now it would do battle with our microscopic ones. We were beginning to conquer space; it wouldn’t be very long, as Life magazine promised my generation in America, before we conquered disease.

Doctors and medical authorities contribute to this view of infallible medical science. Whenever discussing its own track record, especially against that of alternative treatments, medicine stakes out the moral high ground, flying the territorial flag of established scientific fact. In mounting an attack on alternative medicine, a British Medical Journal editorial self-congratulatingly trumpeted medicine’s ‘record of objective evaluation of claims.’¹

By the same token, orthodox medicine denounces alternative medicine as not following suit. The Royal College of Physicians and the Royal College of Pathologists once denounced alternative treatments for allergies as unscientific, warning that ‘until the methods have been evaluated by reputable, randomized, double-blind, placebo-controlled trials they cannot be accepted into routine clinical practice.’²

Our faith in medical science is so ingrained that it has become woven into the warp and woof of our daily routine. In any average day in Britain, a family may place its entire future in the hands of medical advance. For a pregnant mother, the result of prenatal tests may determine whether she carries her pregnancy to term. Her child may be given his vaccine and her husband his blood-pressure lowering drugs on the premise that this medicine will prevent them from getting future disease. Medical tests determine whether we can have children, continue working, have operations, are eligible for insurance, require caesareans, or, as with an HIV test that comes back positive, are shunned as pariahs. It is doctors with their miracle treatments, we believe, who will deliver us from evil, which, these days, is not temptation so much as the frightening randomness of disease.

But much as we cling to the notion of science as a force of redemption, our faith is misplaced. The truth of it is that medical science actually isn’t working too well. The United States and Britain are losing the ‘War on Cancer’.³ Despite state-of-the-art mammogram screening equipment and surgical techniques, breast cancer mortality rates stubbornly refuse to fall. Despite millions of people following low-fat diets, heart disease is still the biggest killer in the West. With all the fancy chemicals and computerized testing equipment we have to hand, asthma, arthritis, diabetes, cancer – virtually all the chronic degenerative diseases known to mankind – are thriving, and medicine hasn’t affected their incidence one tiny bit.

One glance at the statistics shows that, except in the case of getting run over or needing an emergency caesarean, orthodox Western medicine not only won’t cure you but may leave you worse off than you were before. In fact, these days, scientific medicine itself is responsible for a good percentage of disease. If you’re in hospital, there’s a one in six chance that you landed there because of some modern medical treatment gone wrong.⁴ Once you get there, your chances are one in six of dying in hospital or suffering some injury while you’re there. Since half this risk is caused by a doctor’s or hospital’s error, you’ve got an 8 per cent chance of being killed or injured by the staff.⁵ At last count, about 1.17 million Britons end up in hospital each year because of doctor error or a bad reaction to a drug. In the United States, if we extrapolate the results of a 1984 study, over one million Americans are being injured in hospital every year, and 180,000 die as a result.⁶ Recently, the Journal of the American Medical Association, the official organ of the primary organization representing physicians in America, recently admitted that doctor-induced disease is the third leading cause of death in America, responsible for a quarter of a million deaths per year.⁷ Dr Allen Roses, the only worldwide vice-president of genetics at GlaxoSmithKline (GSK), shocked the world by recently admitting that 90 per cent of his company’s – or any other drug company’s products – don’t work on the majority of patients.⁸ In Britain, the latest statistics are that 10,000 Britons die every year from a reaction to a drug, and one in every 16 patients is put in hospital because of an adverse reaction to everyday drugs – even aspirin. To put the magnitude of the problem in perspective, the entire population of a city the size of Birmingham is put in a hospital bed every year by medical error. If you live in the US, where about 40,000 people are shot dead every year, you are nevertheless three times more likely to be killed by a doctor than by a gun.⁹

This appalling track record has nothing to do with incompetence or lack of dedication. Most doctors are extremely well-intended, and probably a majority are highly competent in what they’ve been taught.

The problem isn’t the carpenter, but his tools. The fact is that medicine is not a science, or even an art. Many of your doctor’s arsenal of treatments don’t work – indeed, have never been proven to work, let alone to be safe. It is a false science, built upon conjuring tricks, supposition and blind preconception, whose so-called scientific method is a vast amount of stumbling in the dark.

Many of the treatments we take for granted – for breast cancer or heart surgery, even treatments for chronic conditions such as arthritis or asthma – have been adopted and widely used without one single valid study demonstrating that they are effective or safe.The so-called ‘gold standard’ respected by medical scientists as the only scientific proof of the true worth of a drug or treatment is the randomized, double-blind, placebo-controlled trial – that is, a study in which patients are randomly assigned to receive either a drug or a sugar pill, with neither researchers nor participants aware of who is getting what. Nevertheless, despite the fact that thousands of studies are conducted every year, very few of the treatments considered to be at the very cornerstone of modern medicine have been put to this most basic of tests – or, indeed, to any test at all.

For all the science-speak in medicine about risk-factors and painstakingly controlled data, the stringent government regulation, the meticulous peer review in professional literature – for all the attempts to cloak medicine in the weighty mantle of science – a good deal of what we regard as standard medical practice today amounts to little more than 21st-century voodoo.

In their own literature, medical authorities openly acknowledge this fact. New Scientist once announced on the cover of one issue that 80 per cent of medical procedures used today have never been properly tested.¹⁰

Medicine as it is practised today is largely a conspiracy of faith. Probably because of the miracle of drugs such as antibiotics, doctors have come to believe that their little black bag ought to be filled, in effect, with magic. The late medical critic Dr Robert Mendelsohn was one of the first to liken modern medicine to a church, with doctors its high priests following the teachings with blind faith: ‘Modern Medicine is neither an art nor a science. It’s a religion,’ he wrote in his book, Confessions of a Medical Heretic (Contemporary Books), ‘just ask why? enough times and sooner or later you’ll reach the Chasm of Faith. Your doctor will retreat into the fact that you have no way of knowing or understanding all the wonders he has at his command. Just trust me.’¹¹

Doctors believe so fervently in the power of their tools that they are willing to suspend all reasonable scepticism about current and new medical treatments – so long as these treatments fit in with orthodox medical practice. Most doctors and researchers operate on the assumption of a priori benefit, whether or not a given remedy has actually been proven: we know what we’re doing is right. Enthusiasm for statins, the current favourite for high cholesterol, is so great, for instance, that doctors are willing to ignore the grossest of scientific lapses in safety testing in order to promote what is looked upon prima facie as a good thing. We know what we’re doing is right.

Even if studies have been done demonstrating that a treatment is ineffective or even downright dangerous, so powerful is this faith that these results often get ignored. Virtually every good study of foetal monitoring – devices employing ultrasound testing supposedly to measure the condition of the foetus during labour and birth – all show that this procedure produces a worse outcome for mother and child.¹² This information appears well known to many senior obstetricians – the former head of the Oxford Perinatal Unit repeatedly has written widely about this fact – yet foetal monitors continue to be employed in every delivery room in the land. We know what we’re doing is right.

This is probably why doctors make such rotten logicians. Many in medicine get tied into logical knots, attempting to justify apparent contradictions with the most arcane Alice-in-Wonderland reasoning. Robert Mendelsohn used to say that his favourite line spouted by doctors was: ‘Breastfeeding is best, but bottlefeeding is just as good.’

‘High serum cholesterol levels are an important risk factor for coronary disease,’ once wrote noted heart researcher Dr Meir J. Stampfer of the Harvard School of Public Health, repeating the prevailing view. In the next breath, however, he added, parenthetically: ‘but most patients with [heart attacks] have normal cholesterol levels’ (my italics).¹³

The faith in the infallibility of their tools allows doctors to adopt as the ‘gold standard’ what are usually little more than experimental treatments, and employ these on millions before their effects are fully understood or the procedure has stood the test of time. The favourite line of doctors, when steam-rolling ahead without proof, is that if they had always waited until they had proper evidence, goodness knows how many advances in medicine would have been held up (and how many millions of people would have died). That argument does not, of course, take into account the vast number of people who have died taking unproven treatments later found to be dangerous. The new Cox 2 arthritis drug Vioxx, one of the biggest money spinners of all drugs, was withdrawn by its manufacturers Merck after it was discovered that it doubled the risk of heart attacks. Still others, such as amalgam in dental silver fillings and the radical mastectomy, are treatments devised a century ago and never properly tested or reviewed to determine whether they are as safe or effective as has always been presumed.

Medicine as it is now practised relies entirely on numbers. When judging the worth of any treatment, researchers must weigh the risks of the drugs or treatments (and all treatments in orthodox medicine carry some risks) against their likely benefits and against the risk of the illness being treated. A drug known to be effective but with serious side-effects might be worth taking if you have a life-threatening illness, but not if your medical problem is a hangnail.

Medical science is, in the main, a triumph of statistics over common sense. When bumping up against unpalatable truths in the study, medical scientists, who again always assume a medical treatment to be beneficial, are inclined to put the best face on the whole exercise, or cut and paste, refine and edit, to fit the premise or explain away an undesirable result.

Some years ago, a large study from the Netherlands Cancer Institute showed that all women taking the Pill, no matter what their age, had an increased risk of breast cancer. Most worryingly, 97 per cent of women under aged 36 who contracted breast cancer had taken the Pill, for any length of time.¹⁴ For more than 30 years, doctors have been touting the Pill as the safest drug ever developed. The Dutch study, now the fifth and possibly most damning to show a link between the Pill and cancer, was a colossal embarrassment to an entire industry devoted to contraception at all costs.

However, once they trumpeted the negative findings in the beginning of their article, the Dutch researchers began back-pedalling, by qualifying the overall implications of their findings. They emphasized that the increased risk mainly occurred among certain subgroups. Because the numbers supposedly showed no increased risk of breast cancer after long-term use among women in their latter thirties, their study was, in effect, good news: ‘Our findings accord with the mass of evidence that [oral contraceptive use] by women in the middle of their fertile years [25–39 years] has no adverse effect on breast cancer risk’ (my italics).

Doctors can often minimize the risks of drugs by magnifying the risk of not using them. Most studies have been able to justify that the Pill is safe by turning pregnancy into a dangerous disease. This risk-benefit equation only works if you believe it is better to risk breast cancer, cervical cancer, a stroke or thrombosis – all known risks associated with the Pill – than to have an unwanted baby or to use a condom instead.

A spokeswoman from the British Family Planning Association, which has probably handed out its fair share of Pills to teenagers, dismissed any breast cancer risk out of hand, arguing that this theoretical risk had to be weighed against the ‘evidence that the Pill protects against endometrial and ovarian cancer’.¹⁵ This is a typical example of medical reasoning. This drug is beneficial because it may ‘protect’ you against one kind of fatal cancer (a highly questionable conclusion, in any event), even though it may give you another potentially fatal cancer.

And because they live and breathe medicine by numbers, and believe in the infallibility of their tools, doctors are willing to hand out dangerous medication on the confident assumption that new tests will pick up any side-effects that they cause, and yet other drugs will be able to treat these new problems. Hence the reason why family planning enthusiasts will usually patiently explain that, even though the Pill may cause cervical cancer, cervical smears should pick up early changes, at which stage things are mainly treatable. Like many in medicine, they make the fatal error of requiring medicine to be infallible. This reasoning works if a test that can be wrong more than half the time picks up the cancer early, and if medicine can always cure cancer, which thus far it has singularly failed to do.

This kind of tortuous logic was once used to minimize evidence showing a link between vasectomy and the development of prostate cancer. The two studies, which examined over 74,000 men who had had vasectomies, showed that vasectomy increases the prostate cancer risk by 56 to 66 per cent.¹⁶ Those patients who’d had their operation done 20 years ago faced a whopping increase in risk of between 85 and 89 per cent. In other words, having a vasectomy 20 years ago nearly doubles your risk of getting cancer.

Pretty damning evidence, one would have thought. Nevertheless, after it was published, some professional magazines encouraged doctors to tell their patients that the risk of prostate cancer following a vasectomy was minimal. The article attempted to claim that, compared to other methods of birth control (the condom? natural family planning?), vasectomy is ‘still one of the safest’. A Family Planning Association spokesperson concurred: ‘These studies do not tell us that vasectomy causes prostate cancer’ (again, my italics).

A similar situation has occurred with HRT. Although two major studies were stopped when it was found that women on HRT are more likely to have heart attacks, cancer and stroke, the British medical establishment refused to recant or admit that this might not be the treatment of choice for women going through the menopause.

Doctors and medical researchers have been known to hype up the risks of a disease compared with the risks of the drug used to treat it. Dangerous drugs look good if you turn an ordinarily benign problem into a killer disease. In 1992, the UK Department of Health (DoH) announced the hasty withdrawal of two of the three brands of the combined measles, mumps and rubella (MMR) vaccines. The official line circulated to the press about why these drugs were withdrawn, after having been jabbed into millions of 15-month-olds, were allegedly the results of a study showing that the two withdrawn brands had a ‘negligible’ (1 in 11,000) risk of causing a ‘transient’ and ‘mild’ (all DoH words, these) case of meningitis. The third brand, made from a different strain of the mumps virus, supposedly did not pose this risk.

In 1989, when I first interviewed Dr Norman Begg of the UK’s Public Health Laboratory Service, which recommended the vaccine in Britain, he assured me that mumps on its own was a very mild illness in children. Mumps, he said, ‘very rarely’ leads to long-term permanent complications such as orchitis (where the disease hits the testicles of adult males, very occasionally causing sterility). The mumps component had only been added, he said, to give ‘extra value’ to the jab.¹⁷

By 1992, however, when the two versions of the MMR were withdrawn, the British government painted a very different picture, announcing that mumps leads to meningitis in 1 in 400 cases. Hence, even though the old vaccine was dangerous (and it must have been pretty dangerous to get hauled off the market virtually overnight), it was not as dangerous as catching mumps.

But of course, two-thirds of medical practices don’t have any proof at all. There is no such regulatory agency like the Food and Drug Administration or the Committee on Safety in Medicines to monitor surgery, screening or diagnostic tests – nothing but peer review through national medical associations. Run by doctors for doctors, these organizations tend to rule by consensus, and by a peculiarly circular logic: if a practice is universally employed, it must be safe, even when many studies point otherwise.

In the case of surgery, most treatments get the nod without any kind of clinical trial (partly because it is very difficult to have either a randomized or double-blind trial or to reverse an operation with an unfavourable result). Consequently, some new techniques get adopted with very little in the way of proof to show they are doing any good or at least not doing drastic harm.

Medicine as it is currently practised is a private conversation by doctors, for doctors. There’s no doubt that medicine maintains a double standard. Doctors often privately voice their doubts, disappointments and fears about particular treatments in their own literature, yet fail to disclose this in any discussion with patients or the press. For instance, some years ago an especially alarming piece of information came to light about vaccines. The US Centers for Disease Control and Prevention in Atlanta, Georgia, discovered that children receiving the triple jabs for diphtheria/tetanus/whooping cough or for measles/mumps/rubella were three times more likely to suffer seizures. Nevertheless, this information was only announced to nine scientists and was never otherwise publicized.

Another prime example of this double standard surrounded the issue of treatment for breast cancer. An editorial in The Lancet published a scathing attack on the failure of mammography as a technology to halt the rising breast cancer death rates, and organized a conference to talk over new solutions¹⁸ – at the same time that various government bodies were calling for increasing the frequency of mammograms.

The greatest reason that medical research is tainted is that the majority of it is funded by the very companies who stand to gain by certain results. These drug companies not only pay the salaries of researchers, but they can often decide where – indeed, whether – they get published. It’s wise to keep in mind that this industry, in a sense, has a vested interest in ill health: if drug companies found cures, rather than lifelong ‘maintenance’ therapies, they’d soon be out of business.

The constant exposure of medicine to the pharmaceutical industry, and the reliance of future medical research on these companies, has bred a climate in which much of mainstream medicine refuses to consider any other treatment options besides drugs and surgery, even when copious scientific evidence exists to support those options. Many conventional doctors are especially vituperative in their dismissal of important work by innovators, while uncritically embracing many surgical or drug-based solutions that are little more than modern-day snake oil. This has bred a climate into which healers are polarized into ‘alternative’ and ‘orthodox’ camps, rather than into one common group approving of anything that has a solid basis in science or clinical practice. Dr Peter Duesberg, a leading University of California professor in molecular biology, was one of many publicly vilified for suggesting, with a well-reasoned argument backed up by a 75-page published paper, that HIV is not the cause of AIDS.

To give you some idea how medicine handles heretics, witness how it still reacts to scientific evidence supporting alternative medicine. A study conducted scientifically, with all the usual gold-standard double-blind, placebo-controlled checks and balances that medicine prides itself on, showed that homoeopathy for asthma actually works. Scientists now had some proof: homoeopathy works. In fact it was the third study carried out by the same man since 1985 to show exactly the same result.

Nevertheless, in his published report the leader of the trial distanced himself from his results, pointing out in his conclusion that tests such as these just might end up producing false-positive, or wrong, results.¹⁹ Despite the scientific design of the trial, an editorial in The Lancet flatly refused to accept the results: ‘What could be more absurd than the notion that a substance is therapeutically active in dilutions so great that the patient is unlikely to receive a single molecule of it?…Yes, the dilution principle of homeopathy is absurd; so the reason for any therapeutic effect presumably lies elsewhere.’²⁰ In other words, the scientific method works only when it applies to things we have faith in, but not, it seems, with anything we don’t understand or agree with.

The problem with this dogmatic adherence to preconception and dismissal of dissension or doubt, as far as you and I are concerned, is that it covers up the fact that much of standard medical practice may not work very well. It makes dangerous drugs look safe and effective. It makes it seem like people who don’t need drugs should take them. It justifies a lot of useless surgery that may very well kill you, and certainly isn’t going to make you better. It explains away many promising treatments that don’t require dangerous drugs or surgery. Despite the very best of intentions, it sometimes causes untold pain and suffering, rather than contributing to your health. In fact, you are in grave danger from the moment you walk into your doctor’s surgery, particularly at the point when he tells you he’d like to take a few tests.