A little while back I had a discussion on an online forum about sickness and the sickening medical profession with a supporter of the medical industry…

 

Me (with a little help from Ivan Illich): Doctors systematically avoid the cause of illness. When, for example, was the last time you heard a doctor say ‘you are doing a meaningless task for forty hours a week in an unnatural and stressful environment. Cease this and your overall health will improve’? Many other causes are ignored too. Doctors ignore the context — they even largely ignore you. Once upon a time, when you visited your doctor he would look into your eyes, check your tongue, ask you about your lifestyle, diet, all kinds of things (or he would know about your life through being part of your community) — now they look at a computer. Worse then this, as a profession they are systematically committed to preventing or limiting self-treatment or allowing technical procedures necessary for well-being to pass into the hands of ordinary people and, as psychologists (far greater frauds than GPs) to suppressing anti-authoritarian attitudes by labelling them as pathological (ADHD, ODD, CFS, etc) and by medicalising social, ethical and even aesthetic problems.

Patient: Every GP I know does a physical, and if they don’t they are committing professional negligence.

Also, what’s this myopic nonsense about stopping work altogether as a means for improving health?

Every doctor will advise you if you job is hurting you (workers compensation? professional standards? OH/S ? Full disclosure principles?) but none will tell you to stop working because:

  • You need a job to live, the outcome is worse if you starve
  • Everyone has to work or be stressed, it is excessive stress that is the issue
  • There’s nothing inherently wrong with unnatural environs

The problem with ADHD and ADD is diagnosis — it is a serious problem for some people, but not all the people. The cause of illness is literally unknown in many cases, and trying to trace a casual link is a tenuous venture for your GP who spends an hour with you if you’re lucky.

As for self treatment (?) — What the fuck? Most GPs will say: hey, to lose weight go exercise and eat less.

I don’t know where you are coming from to be honest, I have not had this experience, and I have read much material describing how GPs and professionals deal with issues like this and am familiar with procedure…

Me: The cause of a great deal of unhappiness, ill-health and outright madness is living in a society which curtails genuine freedom, autonomy and generous spontaneity, and which forces you to work 40 – 50 hours a week in a joyless, sexless, deathless, etiolated and unnatural environment doing a few highly specialised and ultimately purposeless tasks over and over again so that perhaps you might one day be able to give more orders than you receive. Hard to see this if you’re one of the winners of course.

You need a job to live, the outcome is worse if you starve.

No. You need money to survive in the system. Quite different.

Everyone has to work or be stressed

No, everyone has to do something; we are active creatures, but activity does not equal ‘having a job in the work-economy’. And stress, along with unhappiness, boredom and lack of delight are avoidable impositions.

The problem with ADHD and ADD is diagnosis

No, the problem is growing up in a mediated, virtual world awash with stress and poison and then being forced to go to school for eight hours a day to perform a limited number of meaningless tasks, dictated to you by other people.

Self treatment

Yes, observing your body, researching the problem, experimenting with solutions and, if that does not work, or it is urgent, consulting someone who has made it their business to know more than you (provided that they understand the role that work, school and deep family horror, etc — the environment and your life — have on your health).

Patient: Right, well good luck treating your type 1 diabetes through personal experimentation…

Me: Urinalysis followed by fasting blood sugar analysis. As far as I understand this gives almost 100% certainty of diagnosis. If type one, then insulin treatment titrated to individual needs. Don’t need a doctor for any of this, just a little intelligence and care. A veterinary nurse could do it.

Patient: And where are you going to get the training/equipment to check a urine glucose and understand insulin titration? Or check your A1C? Or check for ketones?

People aren’t capable of managing their diabetes even with intensive MD/Nurse assistance, I shudder to think what they’d manage on their own…

Me: Testing bloody sugar is easy, but I’m not saying that anyone can do all these things. There’s obviously a place in society for someone to specialise in blood tests just as there is for someone to specialise in pottery, but diagnostic techniques and technology could be available to local communities. Neighbours and friends with basic training could be in charge of the local X-ray machine, or could freely make illness their study or could take bloods to send off to the local lab, etc. There is absolutely no need for professionals to control health or access to treatments and tests.

More than this we are in a society that creates or exacerbates the problems it then creates monolithic institutions to solve. Diabetes, in this sense, is no different from cancer — both were rare or unknown before modernity (see here, also A.David and R.Zimmerman, 2010). In a healthy society the need for treatment would be rare or non-existent.

It comes down, in the end, to how much you trust people. I have faith in humanity. Underneath their friendly, happy, cheerful, sane masks is a hollow, irresponsible, anxious, authority-worshipping and lonely child. Underneath that is a decent, loving, discerning and dignified human being which, through insane upbringing, schooling and work and through professions usurping his ability to heal, educate, entertain and feed himself, has been suppressed and denied. Give humans real freedom, in the right way, and they eventually become real humans.

As I say, this isn’t to say that there are not decent doctors out there, or that we would be better off without people who can perform a coronary artery bypass graft, but that the professional dominance of society creates more sickness than it cures.

Patient: And who would read the X-rays and the lab results? It takes a lot more than ‘basic training’ to make sense out of fuzzy black and white images and complicated lab results.

Me: Where reading X-rays becomes too difficult for a lightly trained local — and, as I say, I am not saying that literally all medical tests and procedures can be done with basic training, sometimes it is too complicated — then yes, send away to a specialist.

Patient: The ‘professional dominance of society’ has resulted in improved life expectancy for type 1 diabetics, those infected with HIV, cancer sufferers, and countless others. Those advances are part of the system you don’t like.  I’d like to see a loose organization of neighbors pull that off.

Me: Cancer, heart disease and diabetes hardly existed two hundred years ago. Those diseases that did exist (TB, smallpox, etc) were not merely reduced but totally eradicated and not by professional technique or specialised understanding of aetiology but by environmental improvements. The environment also causes cancer, heart disease, diabetes and all other modern illnesses; Improve the world we live in and they will vanish. Until then doctors can tinker and ‘improve’ all they like, but nothing, essentially, will ever change.

I’d like to see a loose organization of neighbors pull that off.

You’d be surprised what a loose organisation of neighbours can pull off. Living in total subservience to professional bestowers of heath, education, entertainment, law and so forth for so long it’s very difficult to imagine the extraordinary powers of ordinary people and for many (particularly, of course, the knowledge-guarding middle class) actually terrifying. This is the main reason for the vehement, sometimes hysterical ire with which the idea is received.

Patient: So smallpox was eradicated by environmental improvements, not an intensive world-wide vaccination program?

Then I’m also assuming massive detection, vaccination, and treatment programs for TB had nothing to do with the fact there are not sanitoriums on every corner as well.

Interesting.

Me: Smallpox vaccination became effective when it became part of wider culture and was applied independently of professional delivery. The doctors involved in developing and promoting these vaccines based their understanding on physical measurements and were considered quacks by the established professional hegemony of the time.

TB was already on the decline when the vaccine was developed and had almost vanished by the time the first sanatorium opened (many figures, e.g. New York 1812 700 deaths per 10,000, by the time Koch isolated the vaccine 370 per 10,000, by the opening of first sanatorium 180 per 10,000). Cholera, dysentery and others also peaked and declined completely independently of clinician’s control.

In addition improvements in antiseptic hygiene which helped eradicate the ailments of industrial modernity were actively resisted by the medical profession of the time. The two men behind it, Joseph Lister and Ignaz Semmelweis were actively persecuted; the latter even giving his name to the widespread tendency of medical institutions to reject new paradigms in health.

Generally you should be very careful in basing your opinion of history on sources written by professionals, for the same reason that your should think twice before accepting histories written by victors. Knowledge professionals routinely distort and caricature history in order to justify their power.

Patient: Just like you shouldn’t trust someone who says they have total faith in humanity, then goes on a long rant about the medical profession. If you want to go back to the days of hedge witches and alchemists, high infant mortality, and life expectancy in the 50s, go for it. I’ll stick with medical textbooks, peer-reviewed research, and reproducible results.

Me: Now you’re being silly. Only a nutcase equates humanity with special interest groups. I said I had faith in the essence of man and woman, not in their compulsive subservience to insane institutions; the distorting domesticated filter that institutional life layers over their better selves.

…life expectancy in the 50s…

By life expectancy you probably mean average life expectancy (not how long people actually lived — pre-civ people were and are long lived) which was low because of higher infant mortality in the past. Ivan Illich: ‘It would be entirely incorrect to attribute more than one of those [infant] lives ‘saved’ to a curative intervention that presupposes anything like a doctor’s training, and it would be a delusion to attribute the infant mortality rate of poor countries, which in some cases is ten times that of the United States, to a lack of doctors. Food, antisepsis, civil engineering and, above all, a new widespread value placed on the death of a child no matter how weak or malformed, are much more significant facotrs and represent changes that are only remotely related to medical intervention.’

If you want to go back to the days of hedge witches and alchemists, go for it. I’ll stick with medical textbooks, peer-reviewed research, and reproducible results.

This is the usual false dichotomy thrown up against criticism of modern life: a comparison with the worst period of medieval history. Before civilisation there was no sickness — no modern illnesses or any of the absolutely colossal number of diseases that animal domestication generated (diphtheria, influenza, measles, mumps, smallpox, tuberculosis, etc — see, e.g., N.Wolfe et al, 2007)

I am not suggesting we all run out into the woods and gather nuts and berries, but there is abundant evidence that a sickness free — or radically healthy — life is possible for mankind. Just as soon as we free ourselves from sickening institutions, systems and environments.

Here is an introduction to this subversive theme by Arnold DeVries:

The common view that primitive man is generally short lived and subject to many diseases is often held by physician as well as layman, and the general lack of sanitation, modern treatment, surgery and drugs in the primitive world is thought to prevent maintenance of health at a high physical level. For the average nutritionist it is quite natural to feel that any race not having access to the wide variety of foods which modern agriculture and transportation now permit could not be in good health. These assumptions have helped to determine existing therapeutic methods, and they have largely prevented serious consideration that might be based upon factual data. But the facts are known, and these comprise a very interesting and important story. They indicate that, when living under near-isolated conditions, apart from civilization and without access to the foods of civilization, primitive man lives in much better physical condition than does the usual member of civilized society. When his own nutrition is adequate and complete, as it often is, he maintains complete immunity to dental caries. His teeth are white and sparkling, with neither brushing nor cleansing agents used, and the dental arch is broad, with the teeth formed in perfect alignment. The facial and body development is also good. The face is finely formed, well-set and broad. The body is free from deformity and proportioned as beauty and symmetry would indicate desirable. The respective members of the racial group reproduce in homogeneity from one generation to the next. There are few deviations from the standard anthropological prototype. One individual resembles the other in facial form, looking much like sisters or brothers, with the chief differences in appearance being in size. Reproductive efficiency is such as to permit parturition with no difficulty and little or no pain. There are no prenatal deformities. Resistance to infectious disease is high, few individuals being sick, and these usually rapidly recovering. The degenerative diseases are rare, even in advanced life, some of them being completely unknown and unheard of by the primitive. Mental complaints are equally rare, and the state of happiness and contentment is one scarcely known by civilized man. The duration of life is long, the people being yet strong and21 vigorous as they pass the proverbial three score and ten mark, and living in many cases beyond a century. These are the characteristics of the finest and most healthful primitive races, who live under the most ideal climatic and nutritional conditions. Primitive races less favored by environment are less successful in meeting weakness and disease, but even the poorest of these have better teeth and skeletal development than civilized man, and they usually present other physical advantages as well…

Patient: Right… Does Mr. DeVries actually have sources for his utopic information, or did he just read Clan of the Cave Bear a couple of times?

Me: These are the sources he lists. Checked a few out. They stand up. The anthropological literature on the extreme good mental and physical health of primitive people (pre agrarian, pre desertification) is as extensive as the hostility it provokes in people who, despite their complaints, love living a sick life.

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Nature, 136, 302, 1935. DURAND, A., The Making of a Frontier. 1894. EDEN, W., The History of New Holland. London, John Stockdale, 1787. EHRMANN, W. W., The Timuca Indians of Sixteenth Century Florida. The Florida Historical Quarterly, Jan., 1940. FANNING, E., Voyages and Discoveries in the South Seas. Salem, Mass., Marine Research Society, 1824. FERGUSON, R. A., A Dental Survey of the School Children of American Samoa. J. Am. Dent. A., 21, 534, 1934. FORSTER, F., A Voyage Round the World. London, B. White, 1777. FURNAS, C. C., and FURNAS, S. M., Man, Bread and Destiny. Reynal and Hitchcock, 1937. GOODRICH-FREER, A., Outer Isles. Westminster, England, Archibald Constable, 1902. GRAHAM, S., Science of Human Life. New York, Fowler and Wells, 1852. GRILLET, J., and BECHAMEL, F., A Journal of the Travels of John Grillet and Father Francis Bechamel into Guiana in 1674. London, Samuel Buckley, 1698. HALLIBURTON, R., Seven League Boots. New York, Bobbs-Merril, 1935. HOYGAARD, A., Some Investigations into the Physiology and Nasology of Eskimos from Angmagsslik in Greenland. Oslo, Dybward, 1937. HRDLICKA, A., Disease, Medicine and Surgery Among the American Aborigines. J. A. M. A., 20, 1661,1932. HRDLICKA, A., The Anthropology of Florida. Deland, Fl., Florida State Historical Soc., 1922. JACKSON, W., The Australian Captive. Cincinnati, Henry W. Derby, 1853. JAMES, G. W., The Indian’s Secrets of Health. Pasadena, Radiant Life Press, 1917. KRUSENSTERN, A. J., Voyage Round the World. London, John Murray, 1813. KERR, R., A General History and Collection of Voyages and Travels, 12 vol. London, T. Cadell, 1824. LA FORGE, O., The Changing Indian. Norman, University of Oklahoma Press, 1942. LANE, A.., Preface to Maori Symbolism. London, Paul Trench, 1926. LANGSDORFF, G. H., Voyages and Travels in Various Parts of the World. London, Henry Colburn, 1813. LA PEROUSE, The Voyage Round the World. London, John Stockdale, 1798. LAUDONNIERE, R., History of the First Attempt of the French to Colonize the Newly Discovered Country of Florida. New York, J. Savin & Sons, 1869. LEIGH, R. W., Dental Pathology of Aboriginal California. Am. Arch. and Ethol., 23, 399, 1928. LEIGH, R. W., Dental Pathology of Indian Tribes of Varied Environmental Food Conditions. Am. J. Physiol. Anthropol., 8, 179, 1925. LORIMER, E. O., Language Hunting in the Karakoram. London, Allen and Unwin, 1939. LOUGHRAN, J. X., Live or Die. New York, Rudor Pub. Co., 1932. MACKENZIE, G. S., Travels in the Island of Iceland. London, John Murray, 1811. MCCARRISON, R., Studies in Deficiency Disease. London, Oxford University Press, 1921. MCCARRISON, R., Problems of Nutrition in India. Nutr. Abs. and Rev. 2, 1, 1932. MCCARRISON, R., Nutrition and National Health. London, Faber and Faber, 1944. MCCAY, D., Protein Element in Nutrition. London, Longmans, Green and Co., 1912. 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Patient: Alrighty, I have to admit that your POV is interesting, and a page of legit references is impressive.

I’m just a fan of modern medicine.

Me: If by modern medicine you mean [some] technology and expertise, then only a fool would be against it. Likewise only a madman would support the dismantling of free public health care and the handing over of medical resources to private interests. This technology and expertise, however, whether it is publicly or privately owned, sits within an elitist, professional context-denying health-system that is extremely harmful to health and that, more often than not, does nothing more than correct problems that the system it is an integral part of creates in the first place. The distinction between medicine and health is actually enormous (as large as that between schooling and education), it only seems subtle because of the warped dependence of modern people on institutions (through the scarcity such institutions create).

I recommend Ivan Illich’s Medical Nemesis (and his Deschooling Society / Tools for Conviviality) for a more thorough treatment. In fact I’ll leave him with the last word:

The destructive power of medical overexpansion does not, of course, mean that sanitation, inoculation, and vector control, well-distributed health education, healthy architecture, and safe machinery, general competence in first aid, equally distributed access to dental and primary medical care, as well as judiciously selected complex services, could not all fit into a truly modern culture that fostered self-care and autonomy.

The best of health to you.