Disclaimer : I am not a medical expert. The following are based on my personal experience and knowledge. This article is NOT medical advise.
One of the things I strongly believe is in the superiority of "natural processes". It is only common sense that things that have evolved over millions of years (or designed by god, depending on your point of view) is always superior than the things that we have created in last 100 years or so. But a large percentage of people believe that medical intervention is always good and is better than our natural immune system. People rarely think whether a medical intervention or treatment is necessary. They just go along with doctor’s advice without even bothering to get a second opinion or think about possible options.
Following is a list of common myths about medical intervention I hear from people all the time. These myths are used by fraudulent doctors and hospitals to take advantage of the patients. Poor people loose money, time, health and sometimes even their lives following them blindly. Just like in US, a dangerous nexus of pharmaceutical companies, doctors, clinics, hospitals and insurance companies are taking shape in India.
Common myths on medical intervention
Medicines are always good – I have seen people who take a Paracetamol tablet once in every three days because they think it can prevent disease! When my 2 year daughter had severe cold&cough, I took her to a doctor and she prescribed over 8 medicines to be given continuously for 2 weeks! (of which I gave only 2 after cross checking with another doctor). All over the world, rich pharmaceutical companies are doing everything they can to increase the consumption of medicines and we patients blindly follow them. They have even invented "female erectile dysfunction"!
People tend to think that medicines are always good. But the reality is very different. Prolonged use of any medicine can have serious side effects which are probably worse than the conditions for which you are taking the medicines. Our body tries hard to get rid of the antibiotics and the most affected organ usually is kidney. I don’t think there are any medicines which are completely free of any side effects.
A bigger danger of overuse of medicines (especially antibiotics) is that over time viruses and bacteria mutate to become resistant to the drug. Antibiotics save lives when used where it is very essential. For example, after any surgery biggest risk to the patient is a severe bacterial infection which can lead to death. So antibiotics are usually prescribed after surgery for a few days. But in my country (India) antibiotics are being prescribed for everything and over time this means that they have no effect in cases where its action is urgently needed (like in post operative infections).
A number of bacteria types have been identified recently which are very resistant to antibiotics. See the recent controversy regarding NDM1 bacteria (superbug) in India. Politicians and media are saying that it is a conspiracy, but what is funny is that in March 2010, Journal of Association of Physicians of India has published an article titled – "An obituary- On the Death of antibiotics!" which states,
Indian medical community has to be ashamed of the NDM-1 (“New Delhi Metallo-1”) gene. Even though we have not contributed to carbopenem development, we have contributed a resistance gene with a glamorous name. The overuse of antibiotics is embedded in our Indian gene. It is an Indian tradition.
I live in Kerala (southern state of India) which is unique for its near 100% literacy. It is estimated that 20% of the total drug sales in India is in Kerala which has less than 5% of total population!
All medical conditions require urgent action – There are a lot of diseases and health issues for which it is better NOT to do an immediate medical intervention. Common cold is an example. Our body is capable of fighting most of these diseases and anyway antibiotics are of limited use against viral infections. In this case, using drugs affects individual’s health which in turn may reduce the immune system’s ability to fight the viral infection.
Recently my wife (who was pregnant) was detected with a kidney stone. The doctor we went to said that he needs to immediately implant permanent DJ stents (temporary tube between kidney and bladder) during the entire pregnancy. When I asked him whether there are any other options including waiting for the stone to pass naturally he responded – "Your wife may have serious complications soon and can die" and he said this when my wife was also present. When I asked about the possible side effects of DJ stents he responded – "Side effects? Hey dude, I am driving back to home and I may die in accident. How about that?".
Obviously this doctor lacked any medical ethics and hence I discharged my wife from this hospital and went to another urology specialist. This specialist gave me the complete picture. If the stone is small, it is usually better to wait than to do any medical intervention. After 2 days the stone was removed without any permanent stenting. I have serious doubt whether even that was necessary.
In US it is considered bad manners even to cough in a public place. You are supposed to use symptom suppressor drugs. It also appears they take regular vaccination even against flu! I think "human progress" is like climbing a hill. Countries like US are now climbing down on the other side! But even then I prefer US setup since patient has rights and can demand more information and can take decisions. In India, patients are like guinea pigs – they are rarely given any information by doctors. In my experience a lot doctors in India are very intolerant to the questions posed by patients or relatives. You can’t even ask what medicine is given to a patient.
Take for example, the heart bypass surgery which is a major surgery with a lot of possible complications. I have seen patients undergoing the surgery without knowing either the surgical procedure or the possible complications and possible impact to quality of life after the surgery. In many cases, there may not be an urgent need for bypass surgery.
Medical intervention is better than natural cure – Many of my friends and relative believe that cesarean is better and safer than natural birth. Many doctors also propagate this myth since cesarean delivery brings in a lot of money for the hospital. In fact, there are clinics in Kerala which offers early child birth to avoid the discomfort of 9 months of pregnancy. They do cesarean even at 7 or 8 months of pregnancy saying that it is the safest option! In reality an early birth means compromised immune system and reduced survival chance for the infant.
Caesarian is a surgical procedure and hence inherently contains a lot of risks. It is the last resort if there is something seriously wrong with the child or mother during a pregnancy(Also see relation between cesarean and food allergy). I think (again using common sense) the pregnancy cases requiring caesarian should be less than 5%. In many hospitals it is as high as 80%!
These days children are brought up in sterilized environments and their natural immunity is severely compromised. They also develop nasty allergies early in their life (allergy to flowers, allergy to peanuts, allergy to dust etc.). The more we get away from natural environment, the more medical intervention we need to have. I think soon we will reach a stage where our entire life will need to be supported by regular drugs and supportive devices.
And remember, a hospital is the place where you have the highest chance of getting another disease. You may be going for a small treatment, but in that process you end with serious diseases. All the equipments if not properly sterilized (which you can expect anywhere) can transmit diseases. Blood transfusions etc. are inherently very risky. Personally I know a lot of people who has contracted Hepatitis B through some kind of medical procedure (Root canal therapy of the tooth or Endoscopy).
Modern medicine can handle everything – Most of the diseases we get in our lifetime cure naturally and our body has a very good immune system which keeps us alive for a long time. We usually think that the medicine is so advanced that once you are in a hospital you are safe. But the reality is quite different. Modern medicine has a lot of limitations and the survivability of a person depends a lot on the person itself. It even depends on a person’s will to survive.
Here are some typical cases where modern medicine is quite effective,
- You have a fungal infection on the skin. There are quick acting medicines which can cure this.
- Severe bacterial infections can be quickly treated with a wide range of antibiotics. However blind antibiotic treatment without knowing the cause is disastrous in the long run.
- Vaccination against deadly diseases such as Diphtheria, Tetanus etc. However it is not practical nor wise to vaccinate against every disease. Also note that people with good immune systems survive even the deadly diseases. You need to take the decision by balancing the risk of contracting the disease with the possible side effects of the vaccination. Take for example, the case of HPV vaccine against cervical cancer. In India, this vaccine’s clinical trials were done on poor tribals who had no clues about the possible side effects. So it turns out that there were side effects and possibly some children also died due to it (see Hindu reports – uninformed consent | death of six children not due to HPV ). Finally after a lot of protest, these experiments were put on hold by Indian government – but what about those who died or who had no clue what was injected to them? What is more infuriating is the government response that the Right to Information Act (RTI) is not applicable for these clinical trials. With the level of corruption in India and with the well known greed of pharmaceutical companies, there is a lot to worry in future.
However when it comes to diseases such as Cancer, solutions offered by modern medicine is nothing better than torture. There are a lot of diseases for (Herpes for example) which there is no cure. Most of these are not life threatening but reduces the quality of life of a person drastically. Alternative medicines such as Ayurveda or Homeopathy may provide better disease management/palliative care than modern medicine in many of these cases due to less side effects.
Prolong life by any means necessary – Modern medicine tries to prolong life at any costs. It is assumed that a treatment which prolongs life is better even if side effects have horrible effects on the quality of life of the patient. This is quite evident in secondary stage cancer treatment. In advanced forms of cancer, the treatment may prolong life by one or two years, but it causes unimaginable suffering for the patient.
Over a period of time doctors and medical field in general, started viewing humans as some kind of machines. When there is a problem with a machine, we replace the part which caused the problem. We don’t evaluate whether machine feels pain or how the part change affects the machine’s life. So when everything in hospitals have become like a factory floor, it is the patients who suffer a lot. They are just a set of machines which needs to be corrected.
I think for terminal illnesses such as cancer, the patient and the relatives should be educated on the treatment. They should know the possible problems due to treatment and also due to NON treatment. In some cases it is probably better to die without treatment than die a horrible death with treatment.
Doctors know everything/can handle everything - A large number of people don’t apply critical reasoning when it comes to doctor’s advice. I am not saying that we should always challenge a doctor. What I am saying is that you should have complete knowledge of the procedure recommended and the possible side effects. And yes, unfortunately not everyone can handle the information.
Also just like any other field, there are good, bad and worse. If you need a surgery, you need to find a doctor who is an expert surgeon. Not all surgeons have the same skill. Some are born surgeons who has an inherent skill in doing surgery. Find them.
Whenever I ask a doctor/nurse about a medicine or its side effects they tend to be uncomfortable. They feel that I am challenging them. These days I cross check the prescribed medicine on Internet to see its need and side effects.
Of course you can’t blame doctors alone. It is the ill informed patients who should be blamed more. When someone visits a doctor, they expect the doctor to give them a couple of medicines. If not, they claim – "this doctor doesn’t know anything".
Incidents of doctors being assaulted by patients & relatives are increasing in my state (Kerala). So government has now decided to bring in a law (hospital protection act) which makes it a serious criminal offense (without a possibility of bail!) to attack or abuse doctors. It also proposes the rights of the patients to receive complete information about the treatment received.
Responsibility of healthcare service institutions to give complete information of medical treatment. — It shall be the responsibility of each healthcare service institution to furnish, in writing, the complete information about medical treatment provided by such healthcare service institutions, to the patients who seek treatment in the said institutions or to their relatives.
But I still feel that more provisions are required in the law to protect the patient and penalties for doctors must also be added in the law. One thing is sure – currently patients are also at the receiving end and when they ask for any information, most of the time they are arrogantly dismissed or scolded by doctors.
True story – When a woman was admitted in a hospital with abdominal pains, her brother asked the doctor what medicine was given. Immediately the doctor started hurling abuses at the poor man who just wanted to know what was being given to his sister since his sister was pregnant. He knew his sisters life was in this man’s hands and he stood there with his hands folded suffering public humiliation.
It is important to realize that medical intervention is not always the only answer. Sometimes you can wait & avoid the potential disadvantages of treatment. Sometimes waiting can be fatal. You need to be smart to make that decision or at least smart enough to find a doctor who can take the smart decision. For important medical decisions always get a second opinion.
August 15, 2010 | Posted in Opinion 4 Comments » | By Jayson