Literally and metaphorically, medicine is killing us. In hospital you have a one in ten chance of being the subject of medical error and a one in three hundred chance of dying as a result. But that is the tip of the iceberg.
The current focus of medicine — a pill for this and a cure for that – is a philosophical dead end; it can go literally nowhere. It is the result of a coup, largely in the US, where political shenanigans led to medical education being restricted to allopathic medical practice and to the outlawing of all the local and informal sources of intervention. People used the latter because they were cheap: doctoring used to be a very low paid profession. Now of course there are 600,000 bankruptcies a year in the US from the expenses of medical interventions, and a significant proportion of crowd-funding campaigns aim to avoid excessive medical debt.
The philosophy of this medicine is that germs invade our bodies and things go wrong with our bodily processes. The job is to kill the germs and correct the processes. We rely on statistical data across whole groups of people to say what “works”, with quite a low bar for success: anything where treating ten people gets one good result is regarded as highly efficacious. Unfortunately there are fortunes to be made from this narrative. Exclusion and sterility as a route to wholeness? You have to be kidding. Can we convince entire populations that we have the answers, the only answers worth having? Well for a while, yes, just watch us.
Of course, the narrative must be that officially approved medical interventions are proven. And this is the metaphorical killer. Because that largely false narrative must prevail we cannot do science: any real science would push us towards a change in the paradigm. Any real breakthroughs would invalidate the dominant narrative altogether. That is the threat that social media bring to the profession: social media allow people with conditions to find other people to share their experience with and to discover non-medical interventions that work. They don’t need to make grandiose claims to knowledge, they just find routes to health.
You can judge the level of the threat from people turning away from medical authority by the volume of the howls of protest from the establishment and from the increasingly authoritarian responses. You WILL do what we tell you, for your own good. If necessary, we will apply force and sanctions. Meanwhile the general health, including and especially mental health, of the entire population is degrading.
The Cochrane affair
One way of judging the veracity of the narrative about healthcare interventions is by looking at Cochrane reviews. Cochrane is a charity that establishes a strict set of guidelines and standards for looking at the actual data in medical research, both the positive and the negative data. Cochrane opens up a chasm of many, many licensed medicines and procedures that do not do what it says on the tin.
That of course is a threat to the profits of big pharma and to the reputation of a whole tribe of health professions. Peter Gotzsche in Denmark has made a career out of carrying the fight to the establishment. In the latest twist, he was ousted from the board of the Scandinavian chapter of Cochrane and has written a book based on recordings of the proceedings: Death of a whistleblower and Cochrane’s moral collapse. It doesn’t really matter what you make of the contradictory stories and conniving: the narrative that health is for the benefit of you and me is simply not viable.
Peter Gotzsche’s book about mental health is Deadly Psychiatry and Organised Denial. The stories that come out of the world of mental health I find the most distressing. There is clear over-prescription of anti-depressants and anti-anxiety drugs. And there are lots of stories about people being unable to come off the drugs when they try, and of brain damage and long term serious side effects. And there is certainly a closing of ranks of professionals to deny the harms that are done, as in the book title.
We discussed last week how the chemicals used within the nervous system and the brain to signal are created by bacteria in the gut, bacteria we casually disrespect quite routinely. And that the ultimate source of the organisation of these microbiomes is the mirroring microbiome in the soils that we destroy. The notion that we can destroy the body’s mechanisms for health and then treat the victims with chemicals that fry their brains is to me the central tragedy of this entirely erroneous narrative.
We made our choices a century and a half ago about the sort of medicine that we wanted to give official sanction to. Those choices became self-reinforcing as professional associations, global corporates, government departments, and major medical institutions consolidated behind them. As ever, there was no end game, no way to recover lost direction: we just assumed that things would continue to get better. There was no diversity left in the system for better approaches to be tried and tested. All the available resources were swallowed up by the Frankenstein monster we created.
Here is a story that runs entirely parallel. We have a sense that allows us to understand and pursue which foods are nutritious for us. How could it be otherwise? And how could this sense not intimately involve the taste and smell of our food? Because we are often short of key micronutrients, this sense of what we should eat and how much of it we should eat is intimately tied up with our health and our bodies’ ability to self-regulate. Food that tastes and smells nutritious is compelling for us. You can check out the details in Mark Schatzker’s book The Dorito Effect. I find the title caries the message very well: you want to eat more Doritos? Really?
So, as we destroy soils and create factory farming systems, our food signals to us that it is of poor quality: tasteless, boring, nutritionally deficient. So far, so good. But the corporates that want to sell us vast quantities of cheap and nasty food need to up their game, so they develop the additives that are effective at signalling to us that this is what we want to eat. My brother informs me from an insider standpoint that most ham and cheese pizzas don’t contain either ham or cheese.
So now we get food that is nutritionally deficient — yes almost all of it, even “wholefoods” — that makes us want to eat more of it to address that deficit. Which it never can, by definition, but the marketing guys have done their bit. This is a major reason why people can be both starving and obese at the same time and why bodily regulation mechanisms break down, even in toddlers.
Autopoiesis describes a sort of auto-catalytic self-creation. It applies to all life. What we see as a living organism is in fact continually re-creating itself. The apparent stability of form is an illusion of the patterns of self-creation and self-regulation. The simplest observation of this is the way we regulate our body temperature and how changes in body temperature signal challenges the body is facing. Autopoiesis takes place in an environment: any organism that loses effective contact with its environment is dead. And our autopoiesis is exquisitely sensitive to our environment, changing our bodies to subtly adapt to our circumstances.
The environment that we place our bodies in is degraded. Polluted air, polluted water, ubiquitous radiation, crap food. But most of all, the decimation of the creatures in our microbiological environment that we depend on so intimately and so invisibly. And our bodies adapt to that environment when they re-create themselves: they can do no other. This is a better philosophical starting point for the care of our health: the first thing to be said is that if our health is defective then what we are trying to adapt to does not support human health. Because this is a continuous process, many times if we find the right conditions for health our health returns.
The last thing we need is to find (medicinal) ways of correcting the symptoms without addressing the environmental stresses on our bodies as they regenerate themselves. The chances of simply complexifying the challenges our bodies face by introducing a “cure” are close to 100%. These are all shortcuts that end further away from recovered self-regulation than where we started. Even the working definition of a “cure” is misleading.
Health can only be a properly self-regulating condition, where the body knows how to adjust and how to repair itself. Helping that condition along is just fine, but since we don’t know how most of self-regulation works we cannot understand how we might be hobbling ourselves. One way to see how far we are adrift is to look at “polypharmacy”: the uninhibited prescription of many drugs simultaneously. We don’t know much about how individual drugs “work”. We know next to nothing about how drugs interact. The best estimate is that more than five drugs at the same time is a lottery and there are people who have been prescribed fifteen. Think about the implications of fifteen simultaneous shortcuts.
Because we are far too cognitive in our approach to life, we think our environment consists only of the stuff we can consciously pay attention to. Our bodies contain more microbiota than human cells. Our microbiota have more genetic diversity than we do, and we depend on that genetic diversity. (So much for the human genome project). If we try to live in a degraded microbiotic environment, we cannot function in the way our bodies evolved to function. If our houses are too clean, if we are never in contact with living plants and healthy soil, if all our insects are dying off, if we are not in close contact with animals, if we take antibiotics, if we are exposed to glyphosate in the rain, etc., then we cannot be properly self-regulating. Our autopoiesis starts to break down.
Lets just be clear about germs. If we get an acute infection of some sort it is a signal. It is a signal that the microbiota that would normally regulate the bacterium or virus in the infection cannot do so, that things are out of balance. Medicine is not remotely interested in restoring the balance so that infections don’t happen. It wants to blatt the germs, no matter who suffers from friendly fire. We throw away the opportunity to regain effective self-regulation, every time.
There can be no subtler or more complete instrument for understanding our environment and our interdependence with it than our whole selves. Everything we do and every response we make to our environment tells us something about how it all works. That is so whether we are conscious of the interactions or not. The fact that many literally vital interactions and interdependencies are outside our awareness and consciousness is simply a measure of how partial our awareness and consciousness are. There are things we need to know in order to stay alive that we don’t even suspect exist. The hubris of medical man in thinking we know how things work is the only judgement on medicine that we need to know.
The problem with complexity and particularity and specificity is only that it makes it difficult to market things, difficult to make a general statement that “this will make you better”. For all the vaunted statistical sophistication of the National Institute for Clinical Excellence, it is a parading of ignorance albeit with a brave face. The majority of people in the UK, even more so in the US, suffer from a compromised metabolic status: their (our) bodies don’t work properly in a really fundamental way. The knock-on consequences of this metabolic dysfunction are what is being treated by allopathic medicine, while almost no-one is asking about the source of the underlying problem. Still less is anyone doing serious research into what our bodies are adapting to that produces the dysfunction in the first place.
 That’s conventional medicine, for those of you playing along at home. Often it tries to balance the symptoms by administering a drug that has the opposite effect. In Batesonian terms, that’s a dangerous shortcut.
 For junior doctors in the UK, it still is. The gruelling process of being inducted into the club only strengthens the need to make a positive return (on time, cash, work-life balance, etc) later on.
 I saw the crowdfunding figures earlier this week, but can’t seem to locate them.
 Not restricted to medicine of course, this unhelpful obsession with certainty and the appearance of evidence, but for our immediate topic the ‘killer’ phrase is all too literal.
 In the same way that people find routes to functioning in their own homes, even as their bodies begin to fail them, and why successful social programmes extract old people from hospitals promptly, in order to save them from the system. (Says the man currently nursing a swollen knee, using a cane, and operating with all the awkward physicality of a much older person.) Someone said that aging is the process of biography becoming biology. I’m in the middle of that experience now…
 I’m currently en route to the US, where I expect to encounter a lot of this attitude, hopefully outside the bounds of the medical profession. Just boarding the airplane at Heathrow was a muddle of conflicting directives. One official asked me twice in the space of a minute whether I’d been given anything to carry in my baggage. Is it on the checklist twice, I wonder?
 Taste and smell, not just appearance and robustness as prized by supermarkets. In Oliver Sacks’ Island of the Colour-Blind, he relates a story of islanders selecting ripe bananas that the visiting westerners were overlooking because they were still solidly green. Only our commercially impoverished monoculture varieties turn yellow as they ripen…
 At university I learned of an experiment in which babies and toddlers were allowed to choose (with assistance) their own foods. One day it’d be all mango, the next it’d be carrots, or beef, or whatever. Wild excess from the officially sanctioned perspective, but over the course of days the proportions of this automagically diet became clear. The same experiments with rats have the same result — self-managed good health — except when sugar is introduced, whereupon they all get gloriously fat and keel over for having ignored what was good for them!
 I remember a pizza company that advertised “made with real cheese”, which is enough to give you pause. Sometimes it’s a case of advertising a common step (“it’s toasted”), sometimes a differentiator. In which case, what the heck do the other companies use instead?
 After removing her mercury ‘silver’ fillings, my girlfriend’s health improved dramatically, in stages that roughly matched the timescales of the cells of various bodily organs having completely changed over, all the old cells having died off and replaced by new ones.
 Decimation in the modern sense of near-genocide, rather than the original punitive one-tenth.
 That’s worth reading again: in the right conditions, the right things happen. You can apply that to physical fitness, productivity at work, romantic relationships, etc. Context matters.
 Back to me and my cane. I don’t yet know how long my poor knee will take to recover itself, but putting it under less stress seems likely to be a key part of that equation, whereas walking on it unaided for a week in the meantime is likely to have lengthened the process significantly. Whoops.
 Seth Godin (iirc) once noted that any mass-advertised product is necessarily mediocre. Partly because of the tyranny of scale when it comes to maintaining any semblance of quality, and partly because the drive to be widely appealing means that it can’t possibly suit you as well as something more specific. A product designed by a committee, if you will.