A Frugal Physician Prescribes
Common Sense and Enthusiasm
Good Medicine, Bad Medicine
Despite obvious and common
shortcomings, modern medicine has indeed done some amazing things
during its development over the last hundreds of years. Those advances
are just a beginning. It is hard to imagine what the state of medicine
will be hundreds of years from now. But, it will be built on some of
the accomplishments of recent history.
Even now, medical care
excels in some areas while others lag far behind those in which
technology and common sense come to the rescue. We don’t want to “throw
out the baby with the bath water.” Let’s first look at positive points
in medicine - where medicine excels and where consumers can expect real
First Aid. This tops them all. In case of true emergency, access to a
Trauma Center puts patients in the best possible position for
immediate, aggressive and effective treatment. “If doctors reduced
their involvement with people by ninety percent and attended only
emergencies, there’s no doubt in my mind that we’d be better off.”
Medicine, like most disciplines, does its best work
in situations where problems are clear and well-defined. That is
usually the case in true emergencies. If you have one, you want to be
near a tried and trusty big city ER.
In incidents like motor
vehicle injury, construction mishaps, explosions, and the like, life
threatening problems can be quickly identified and substantive care
provided. Operating theaters and intensive care units can be mobilized
to sustain life for extended periods. This is television ER at work
doing its finest. If medicine ever “saves lives,” it is in such
• Man-made injuries. From another angle, medicine is
best in dealing with problems which human advancement and technology
have helped to create. Like wounds from bullets, moving vehicles, and
falling objects. If human beings created the implement of injury, they
have likely prepared - to some degree - for the sinister effects of
such products and structures.
Many, many modern medical
innovations have come out of the effects of warfare. Every new weapon
has spawned new medical advances to deal with man’s aggression.
Military medics and surgeons have literally been at the front lines to
deal with new kinds of injuries as well as their long term effects.
Warfare has obviously damaging effects. It also has the effect of
creating products and procedures which help civilians in peace time.
Prosthetic limbs, skin grafting, cosmetic repair, joint replacement,
etc. have evolved out of War Medicine.
There are numerous
drawbacks to such advances: The tools and weapons of war have rolled
over into civilian life. Wounds from AK47s don’t just occur on
battlefields. Cosmetic surgery becomes a fetish with some. Joint
replacement had become commonplace.
• Prosthesis. Centuries
removed from barbaric amputations and equally crude prostheses (wooden
legs), surgeons have become proficient at removing and replacing limbs.
The former aided by anesthesia and latter with computers. Those two
aspects, however, are only half the battle, so to speak. The body must
adapt and adapt and adapt. Healing from such major trauma is generally
a very long process.
From prosthetic advances have come joint
replacements which are more and more and more common. Orthopedic
surgery is a booming business. Surgeons have the aura and patients have
the belief that joints are as replaceable as teeth. (Teeth are not all
that replaceable.) They forget that even if joint replacement is a
“success,” they are trading one problem for another.
problem for several. Every bodily intervention has wide ranging
effects. Some take months or years to show, as in the taking of
medication. Some of the effects are undoubtedly in other body systems.
Despite what physicians and scientists suggest, there is no metal or
substance which can be implanted in the body which is totally inocuous.
“Bone on bone” (pretty simplistic) is the common refrain -
along with patient complaints - which gets people into the operating
theater to have their living joints sawn out and titanium ones hammered
in. Watching such surgery is like viewing a carpenter in action. Only
one who is in a hurry, makes a bloody mess, and expects miracles out of
his quick work. Only one attempt, usually. Not much of an opportunity
for fitting, etc.
Physicians and patients forget that people are
not machines with interchangeable parts. Every human “part” is invested
and connected with numerous layers and lines, tissues and vessels,
networks and systems - visible and invisible. All much more complicated
than any man-made device ever will be.
There is no surgical
invasion of the body or chemical intervention (medication) which is
without acute AND long term effects. Nonetheless, medics and cutters
persist in spreading their trades thinking that they KNOW. How little
do they know How little do we know
(Confessions) retold a thought-provoking story which any potential
orthopedic surgery patient might wish to ponder: “My favorite example
of how doctors can be less intelligent than the situation calls for is
a matter of public record. As part of the hearings before the Senate
Health Subcommittee, Senator Edward Kennedy recalled a skiiing injury
to his shoulder, suffered when he was a young man. His father called in
four specialists to examine the boy and recommend treatment. Three
recommended surgery. The advice of the fourth doctor, who did not
recommend surgery, was followed, however. He had just as many degrees
as the others. The injury healed. Senator Kennedy’s colleagues then
proceeded to question Dr. Lawrence Weed, Professor of Medicine at the
University of Vermont and originator of a highly popular patient record
system for hospitals. Dr. Weed’s reply was the ‘senator’s shoulder
probably would have healed as satisfactorily if the operation had been
I will leave the reader to make his/her own observations on this story. It was and still is quite a shocker to the writer.
Poisonings. Humans have probably made more poisons in last hundred
years than nature has in eons. Certainly, infinitely more people go to
the hospital for artificial poisoning than ones they consume in nature,
like mushrooms. Still, if chemists can make a poison, they can also
make antidotes. And, usually do.
So in case of poisoning, deliberate or incidental, “Hie thee to the hospital.”
considering incidental poisoning, it should be correct to point out how
common downright deliberate poisoning occurs in the medical setting.
Practically all of cancer chemotherapy is medical poisoning. If the
disease won’t kill you, the chemical cure has a good chance.
is meant to poison and destroy the “bad cells” more quickly than the
good cells. A neat trick. It may be no more than a trick. But, it
certainly is poison, toxic and very traumatic to the human system.
can’t help remembering when my mother used to come home from her
chemotherapy infusions for breast cancer. The poison was by then
coursing through her bloodstream into her whole system. It was scary. I
described it inadequately saying, “She was buzzing.”
Restorative surgery. The author has been impressed by the benefits of
some surgeries. The list is not long and most have obvious and outward
effect. Cataract surgery, in which the lens of the eye is removed and
replaced, is generally very successful and dramatically improves the
quality of a person’s life.
Cosmetic repair of face and skin
after injuries can have profoundly beneficial effects. Some orthopedic
repairs for congenital deformities can be impressive.
other hand, surgical procedures in general are way out of hand.
Caesarean sections are sometimes as frequent as one in four deliveries.
Something is not quite kosher there.
Tonsillectomies are not
as common as they used to be, but still much over done. Appendectomies
should be passe in this age. Hysterectomies are far too readily
recommended than needed. “Oh, you don’t need it anymore.” Bosh!
surgical procedures are downright hokum. Modern versions of snake oil.
Tennis elbow surgery for one. The operation severs the tendon to
supposedly relieve pain. Scientific rationale behind the procedure is
non-existent. There is practically no rationale behind it, “But it
works.” Eventually. And, so does time.
Like the cortisone shots
which often precede it, the tenotomy is a very common, wasteful, inane
procedure. Many rotator cuff operations fit pretty much in the same
ballpark. Cutting into healthy functioning tissue to cure a temporary
problem often causes more of them in the future.
We have taken
a quick look at Good Medicine, with more than a few forays into Bad
Medicine. Sadly, there is still much of the latter because of our
medical ignorance and continued blind belief in medicine as we know it.
We must become willing to explore other layers and dimensions of human
life. When we do, Frugal Physicians will be part of that change and
help bring in a new era of real knowledge and true health.
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