Yiati grafo afto pou grafo?

(Why I write what I write?)

—B. M. Hegde

It is more than a year ago that Mr. Ron Paul, Congressman from Texas, predicted in his historic speech in the Congress that the US economy would soon collapse. He was laughed at and ridiculed for those statements. Today he is being remembered by ordinary Americans who are on the verge of losing everything. Similarly, I have been writing to warn our fraternity that our system is doomed to fail and collapse sooner than later, thanks to its obsession with making money at any cost for which we have joined hands with the pharma and technology manufacturers (and recently with “health” insurance companies, another of those American flops), almost from the late 1960s when I wrote a paper How to avoid modern medicine? “Never make money in the sick room” was the warning given by Hippocrates himself.

People ridiculed me and laughed behind my back. There was even an attempt to get me out of my department! A recent IOM audit in the US has shown that the US medicine and the medical establishment are the worst in the world and are the leading causes of death and disability there!

My colleagues think that I am coming in their way of making money. That is very far from the truth. I would be the happiest person if they make any amount of money by the right royal way. I was only trying to tell the people in medical profession that the drug companies and the instrument manufacturers are taking us for a ride using our goodwill with patients to bleed the latter of their hard earned money. In the name of regular screening the ignorant people are made to believe that if they went for a regular checkup they will live happily ever after. This is another ruse to net more people to take drugs. Recently it was recognized that in the US healthy young people, by the time they reach the age of thirty, are already on at least one tablet daily for some fault or the other in their checkup reports. Mind you, this is in addition to multivitamins, baby aspirins and what have you! The propaganda against the innocent cholesterol, a life-saving chemical in our system, mostly manufactured by our own body for its survival, has reached its pinnacle in that most Americans look, at least a decade older than their chronological age, and are looking famished with their skin coming off their moorings. Cholesterol lowering drugs are a big business hit. Most Americans today hardly eat anything and look sickly! Poor cholesterol, it is having a tough time trying to keep man alive with billions of new cells being formed daily to replace the dead ones. Every cell wall is made up of hydrophobic cholesterol. Lowering cholesterol unnecessarily could result in faulty cell wall which is an invitation for cancer growth!

My daughter always asks me why I write what I write. She is very critical of my quoting US statistics to prove my point in any article. She is an internist in practice in the US. US is one country where there is total freedom of speech and expression. That should never be misconstrued as freedom to write anything one wants to write and criticize anyone or any country. As long as one knows that one is upholding the truth as is known at that point in time, one need not be worried about anything else.

I have a very simple principle in life. Any human activity should be for the common good of people and society. There are so many myths in the field of modern medicine that need to be demolished for the common good. This could never be done with authenticity by someone outside the field of modern medicine, although there have been attempts by great writers to look inside the medical field from outside and point out the mistakes. Unfortunately, most, if not all of them, blame the malady on doctors and not the system.

George Bernard Shaw is a noted name here. His play The Doctor's Dilemma was the one that changed the practice of medicine in England forever. Until that play was enacted in London many of the illustrated doctors there, like many of our illustrated doctors here, were doing whatever they thought was good for the patients, irrespective of the consequences of their action. Unfortunately, no one from inside the system tried to undo the damage.

Bernard Shaw took upon himself to correct the system having observed the stupidity of many medical interventions of his time. One example will suffice. Sir Arbuthnot Lane was a great surgeon in London at that time. No one dared to talk to him about his methods. He had a hypothesis that all people with vague symptoms, which today are being labeled as chronic fatigue syndrome, had bad toxins emanating from their large gut as the cause of the disease!

His remedy was simple—total colectomy for such patients. Though this was resented by many patients, they subjected themselves to the procedure as they had implicit faith on Sir Arbuthnot. The result was that almost half of the population of London was walking with an open drainage in their abdomen making the city really stink. The book by Shaw put an end to the procedure and Sir Arbuthnot’s practice as well. My efforts are to see that a similar fate does not befall us today.

Let us try and put our heads together to see how we could get back our position of authority and respect in society as in the distant past where doctors were looked up to as next only to God. After all, patients can certainly live without doctors, as they had done for ages in the past, but doctors cannot hope to live without patients. Unlike in the 19th century London, information gets round pretty fast these days, thanks to the internet. Before patients leave us let us put our house in order. Ivan Illich also did make an attempt to set things right in the medical field in the US in the 1930s, without much success.

While there could be a few greedy doctors in every society at any time, as there are greedy people in every other walk of life, majority of doctors in the US, India and elsewhere work with a mission of doing good to others. Despite all that US statistics do show that the medical profession has become a bane to society in the present milieu. This is a very serious matter to be brushed under the carpet. We should never have an ostrich like approach to difficult problems thinking that the problem does not exist or would go away. We should face the challenge and start a debate to get into the core of the matter to set things right, if we could. If we do not do then it will soon fall into the hands of outsiders like Sir George Bernard Shaw, Illich and others who do not know of the trials and tribulations that the majority of doctors have to, per force, go through to survive in this hostile atmosphere.

I think I am qualified to look into the system from within as I have been in this business of understanding medicine for more than half a century, if I were to start from the day I entered the Stanley Medical College in the then Madras city in India where the East India Company had started one of the first three medical colleges in India. Interestingly, all those three cities have since changed their names but the content and the curriculum brought by the British has changed very little in medical education even to this day. Ever since that time I have been a curious student of the working of this enigma, the human body, both in times of illness and wellness. I must admit that I am as curious now as I was fifty years ago.

About the Author
Dr Belle Monappa Hegde was the visiting professor at various universities. He has been the chairman of Bharathiya Vidya Bhavan in Mangalore for the last 36 years. He has authored 35 books in English and Kannada, besides presenting 289 research papers in the country and abroad.

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