The Damage That Doctors Do

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The Damage That Doctors Do

Post by MediumTex »

I was reading a story in the NYT about the girls in the small town in New York who all got various tics, spasms and similar ailments at more or less the same time and the different theories, diagnoses and treatments that had been offered.

The consensus seems to be that the girls have "conversion disorder", which is basically some kind of pathological group mental process of mimicking certain behaviors and responses.  It tends to correct itself on its own as the stressors that triggered the response in the first place are either eased or redirected.  There were, however, several doctors involved, a few of whom seemed to have very different theories about what was causing the symptoms.

This situation got me thinking about how there are ailments and illnesses people have that likely become self-reinforcing and self-perpetuating through the actions of doctors.  I see this happening in several different types of situations:

1. Strength of doctor's personality.  Many doctors are strong-willed and/or charismatic personalities and their overall presentation conveys legitimacy, authority and persuasion.  I think that it is easy for some people to follow a narrative offered by a doctor explaining their health issues, even if the narrative doesn't quite fit with all of what the person is actually experiencing.  This sort of thing seems to be problematic where a doctor offers an explanation for a cluster of symptoms when the better response might be to tell the patient: "We don't know what this is and we may never know."  This kind of thing is why I have a strong preference for doctors who strike me as more humble people, because it allows me to let my guard down since I don't have to be concerned that I am dealing with a person who is too insecure to admit he/she doesn't know the answer or has difficulty letting go of an early theory in favor of a later one that comes to light based on new information.

I think that with some doctors there is a bit of the same kind of thinking that you see with investment advisors who are able to persuade their clients that they know where the markets are going to go next.  Perhaps what I am suggesting in the medical field is the same kind of humility that Harry Browne suggested could be the basis for effective strategies in the investment field.

2. Medications that create the illness they are seeking to cure.  The best example of this has to be antidepressant medications, which often appear to take a case of transitory depression and turn it into a chronic condition.  I am sure that antidepressant medications work well for some people, but the fact that we are prescribing far more antidepressants today than ever before at the same time that we have far more people who describe themselves as depressed than ever before suggests that the antidepressants may not be achieving their goal of actually reducing depression.

3. The "Label Fallacy". Many patients seem relieved if they can find a doctor who will give a name to the cluster of symptoms they are experiencing.  People seem to think that labelling something somehow makes it easier to treat, when the opposite is often the case--by labelling a cluster of symptoms that may not actually all be connected with a legitimate underlying disorder, the stage is set for a guesswork approach to treatment that can leave patients worse off than when they started.

4. Failure to acknowledge self-healing.  One thing I can't ever remember hearing from any doctor is something along the lines of: "I think what you have is ____.  The treatment for ____ is typically ____, but for thousands of years before that treatment existed people got ____ and just took it easy for a while and watched their stress levels, diet and fluid intake and it cleared up on its own most of the time."  I think that people sometimes forget that many ailments will heal on their own whether or not you go to the doctor (though some obviously will not).

***

I think there are a couple of medical professionals here, and I am anxious to hear what your thoughts are on the ideas above. 
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Re: The Damage That Doctors Do

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Some ailments are curable and do kill you if there is not timely intervention (eg some kinds of cancer). I guess the ideal situation would be if doctors were appropriately vigilant about diagnosing such cases but left well enough alone for the cases where things were a lot more iffy. I also guess that sometimes "non-medical" interventions might work better eg with depression, encouraging plenty of exercise in the fresh air etc etc.

I know athletes foot is the ultimate trivial ailment but people do take medication for it. I'm sure a much better treatment is to put rolled up tissue paper between your toes so as to keep them separate and dry :) .

I do think the charisma of medical professionals can be a good thing in certain circumstances. As a personal experience when a psychiatric patient I did feel an incredible sense of relief when it was impressed upon me that I was suffering psychosis and everything could be dealt with on that basis. I think it was the charisma of that psychiatric nurse that turned me around. It felt like an exorcism at the time.

I think a lot of the problem comes when medical interventions are seen as a product to be sold rather than a cost to be avoided unless it provides a greater benefit.
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Re: The Damage That Doctors Do

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Re Failure to acknowledge self-healing

Big pharma has brainwashed the medical profession into prescribing expensive drugs or medical procedures for every known ailment.  While some doctors are more holistic in their approach, in many cases doctor's can be defined as "drug prescribers" or "surgury peddlers" rather than "healers".

Examples from my own experience: 

For a 2-3 year period, I suffered repeated cases of gout.  My doctors therfore had me taking alpurinol (sp) daily and colchicine for acute attacks.  They also told me to avoid any organ meats and alcohol.  This is accordance with general accepted practice.  I started researching the medical journals and based on my research decided to thow away all those pills and change my diet to a very low carb diet with zero high fructose corn syrup.  I often eat liver and have a daily glass of wine with my meal.  I haven't had a gout recurrance in the 4 years since then.  This outcome shocked my internal med doctors till I showed him the studies that proved high fructose corn syrup consumption induces gout attacks.  No drugs are needed to combat this affliction.

For years my cholesterol levels were considered poor.  I had high LDL cholesterol and low HDL cholesterol.  Therefore I was prescribed a statin drug that are pushed so aggressively by drug companies.  Later after some research I was convinced a person's LDL level has no relation to heart attack risk.  HDL levels apparently are important.  So I tossed my statin drugs and began taking immediate release niacin I bought from from my local grocery store, drank a glass of wine daily, and went low carb.  My HDL is now 40% higher while my LDL is about the same as it was before.  No drugs needed for a better outcome

Pharma has also convinced doctors to prescribe drugs like Actos, Avandia, Januvia, metformin to diabetics.  Virtually all diabetics take one or more of these drugs.  However, research clearly shows that only a small percentage of diabetics (maybe 10%) show any glucose lowering after taking these drugs.  Even for the people who show improvement, the improvement is so slight it can be considered irrelevant.  Of course these drugs can have serious side effects that kill many users.   Rather than relying on potentially dangerous drugs, why not simply go to a very low carb diet.  Doing so guarantees low blood glucose levels.  No drugs needed for a better outcome.   

Recently the American diabetes association has recomended bariatric surgury for diabetics who are overwight.  Doing so helps keep blood glucose levels low.  However, research shows 5-8% of people who undergo this procedure die within 5 years due to complications.  Why would any sane person recommend this radical procedure as opposed to simply changing one's diet?

BTW the is a book called Hypocrates' Shadow - What Doctors Don't Know, Don't Tell You, and How Truth Can Repair the Patient - Doctor Breach by David Newman, M.D. and it is an interesting read.  There is no alternative medicine discussed but does include some interesting chapters including We Don't know, It Doesn't Work, We Prefer Tests, We Don't Agree, and We Won't Unlearn. 
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Re: The Damage That Doctors Do

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MediumTex wrote:4. Failure to acknowledge self-healing.  One thing I can't ever remember hearing from any doctor is something along the lines of: "I think what you have is ____.  The treatment for ____ is typically ____, but for thousands of years before that treatment existed people got ____ and just took it easy for a while and watched their stress levels, diet and fluid intake and it cleared up on its own most of the time."  I think that people sometimes forget that many ailments will heal on their own whether or not you go to the doctor (though some obviously will not).
I have three close family members that are doctors.  When they talk shop, there's a handful of issues they frequently mention as really bugging them.  Apart from how awful Obamacare is, the single thing that bugs them most about medicine is how few patients understand the concept that you just described.

Basically, as physicians, they feel that the role of medicine is first to diagnose and then to assist or augment the body's natural healing abilities.  I think that this makes sense.  Our ability to heal is something that evolved over millions of years.  Medicine is a discipline that has jumped in forward and backward fits and starts for only a few centuries.

Speaking of this "forward and backward" evolution of medicine, it's interesting to point out that stone age humans performed successful brain surgeries and the Romans were performing cataract surgery before the birth of Christ.  As a species, we really have been thinking about these problems for a while.  Given this, I think that it's reasonable to expect us to take a while to catch up with mother nature!

A few months back I read an interesting article (written by a doctor) that pulled no punches expressing similar ideas to yours (although he places most blame on the patient.)

Here's the article: http://www.epmonthly.com/columns/in-my- ... ous-wimps/.  A quote to give you the flavor of it:
The bottom line is that most conditions are self-limited. This doesn’t mesh well with our immediate-gratification, instant-action society.  But usually that bronchitis or back ache or poison ivy or stomach flu just needs time to get better. Take two aspirin and call me in the morning wasn’t your doctor being lazy in the middle of the night; it was sound medical practice. As a wise pediatrician colleague of mine once told me, “Our best medicines are Tincture of Time and Elixir of Neglect.”?  Taking drugs for things that go away on their own is rarely helpful and often harmful.
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Re: The Damage That Doctors Do

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I'm still thinking that paying for drug development by awarding prizes rather than patents would stop drugs being dished out inappropriately. With a "prize" system, once a drug was developed, there would be no financial incentive to use it. So use would only be according to medical need rather than due to marketing by the drug company.

The UK has the moronic system where homeopathic drugs are available for free but cancer diagnosis is delayed so as to "save costs".
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Re: The Damage That Doctors Do

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I fall into the "blame the victim" camp.

I have a family member on anti-depressants and has a whole host of digestive and other health related problems.  But I look at her lifestyle and it's completely obvious that this is the root cause of the problem.  A diet mainly composed of energy drinks, chips and pizza, staying up until 2am, then being unable to sleep, constantly on the computer or iPhone, never exercises, lots of stress, etc.  It's the most frustrating thing in the world to see someone you love destroying their life.

IMO depression is a self-defence mechanism created by the body to tell the person that it is fucking pissed off.  You cannot tell me it is simply a chemical imbalance in the brain that a pill will correct...what caused the chemical imbalance in the first place...unless you were born that way then I'd say it's the shitty lifestyle.  Mother Nature is a bitch, and if you don't follow her rules, then she will kill your body...it's as simple as that.

It saddens me to see how unwilling people are at taking control of their own health and bodies.  They assume a doctor and pills will make everything better.  IMO a doctor should be used as a means of last resort, except obviously for major injuries, cancers, etc.
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Re: The Damage That Doctors Do

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Lone Wolf wrote: Here's the article: http://www.epmonthly.com/columns/in-my- ... ous-wimps/.  A quote to give you the flavor of it:
The bottom line is that most conditions are self-limited. This doesn’t mesh well with our immediate-gratification, instant-action society.  But usually that bronchitis or back ache or poison ivy or stomach flu just needs time to get better. Take two aspirin and call me in the morning wasn’t your doctor being lazy in the middle of the night; it was sound medical practice. As a wise pediatrician colleague of mine once told me, “Our best medicines are Tincture of Time and Elixir of Neglect.”?  Taking drugs for things that go away on their own is rarely helpful and often harmful.
By the way that was a great article...I laughed (and then cried) when I read this paragraph:
In a single night I had patients come in for the following complaints (all brought by ambulance):  “Smoked marijuana and got dizzy”?, “stung by a bee and it hurts”?, “got drunk and have a hangover”?, “sat out in the sun and got sunburn”?, “ate Mexican food and threw up”?, “picked my nose and it bled, but now it stopped”?, “just had sex and want to know if I’m pregnant.”?
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Re: The Damage That Doctors Do

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One really good piece of advice that you don't hear very often from doctors is this:

Do everything you can to stay out of the hospital.  Hospitals are full of sick people, and many people go into the hospital a litlte sick and come out very sick if they come out at all.

In addition to the problem of hospitals being full of sick people, they are also environments that tend to increase patients' stress levels through lack of sleep, poor food and a generally foreign environment.
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What I find curious though is that the US Veterans' medical care system seems to be conducted in a way perfected to avoid all of this nonsense and to have great outcomes to match. BUT everyone on here seemed to really not want such a no-nonsense medical care system for themselves. It is as though people can see that the standard system is ridiculous but they are wedded to it nonetheless ???
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Re: The Damage That Doctors Do

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stone wrote: What I find curious though is that the US Veterans' medical care system seems to be conducted in a way perfected to avoid all of this nonsense and to have great outcomes to match. BUT everyone on here seemed to really not want such a no-nonsense medical care system for themselves. It is as though people can see that the standard system is ridiculous but they are wedded to it nonetheless ???
It's funny how you keep bringing up the VA system as a model health care system.  If you walked through a few of these facilities and talked to people who have to rely on them for their care I am pretty sure you would revise your views.

It's entirely possible that this system does look good when viewed from a statistical perspective, but in my limited experience with these facilities, I have never smelled a stronger scent of human urine as I have smelled in VA facilities, and I have never seen a more unhealthy looking group of people than I have seen at VA facilities.
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Re: The Damage That Doctors Do

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MediumTex wrote: It's funny how you keep bringing up the VA system as a model health care system.  If you walked through a few of these facilities and talked to people who have to rely on them for their care I am pretty sure you would revise your views.
It's entirely possible that this system does look good when viewed from a statistical perspective, but in my limited experience with these facilities, I have never smelled a stronger scent of human urine as I have smelled in VA facilities, and I have never seen a more unhealthy looking group of people than I have seen at VA facilities.
Mystery solved  :)

I wonder how much it would cost to clean up the smell of urine? I guess the same system but without the piss smell would be nirvana. The patients looking unhealthy could be because they are genuinely ill or because they are less well off. Either way it is hardly an adverse indication of the system is it? Medical care is something to get because you're sick isn't it rather than something to partake in so as to mingle with the beautiful people ???
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Re: The Damage That Doctors Do

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stone wrote:
MediumTex wrote: It's funny how you keep bringing up the VA system as a model health care system.  If you walked through a few of these facilities and talked to people who have to rely on them for their care I am pretty sure you would revise your views.
It's entirely possible that this system does look good when viewed from a statistical perspective, but in my limited experience with these facilities, I have never smelled a stronger scent of human urine as I have smelled in VA facilities, and I have never seen a more unhealthy looking group of people than I have seen at VA facilities.
Mystery solved  :)

I wonder how much it would cost to clean up the smell of urine? I guess the same system but without the piss smell would be nirvana. The patients looking unhealthy could be because they are genuinely ill or because they are less well off. Either way it is hardly an adverse indication of the system is it? Medical care is something to get because you're sick isn't it rather than something to partake in so as to mingle with the beautiful people ???
You would probably have to talk to a few people who rely on the VA system for all of their medical care to really get a sense for whether the treatment outcomes are telling the whole story.

One possibility for the statistically good treatment outcomes is there are many veterans who can get near-free treatment at VA facilities and thus they use them for routine care (even though they aren't all that impressed with the quality of care).  When, however, they have a serious health condition they may seek care outside the VA system using health coverage they have through an employer or spouse's employer.

Here is an interesting VA-related article I ran across from 2009:
"How many patients can you see in a day and still give proper care?" asked Jim Strickland, a veterans' advocate and former health care technician who contributes to VAWatchdog.org. "There aren't enough physicians to handle the crisis that the VA faces."

Richard Dodd, a litigator who has represented veterans in lawsuits against the government, said that poor funding has lowered the quality of care and interest from some physicians.

"They're generally under-funded ... and I think the interest of the doctors suffers to some degree," he told FOXNews.com. "Generally speaking, the physicians that work at the VA work there because they have no interest in private health care, and in some situations are unable to find jobs in private industry."

Strickland said care and oversight would not improve until funding is increased and the leadership makes sweeping changes.

In the meantime, he said, "we are doing such a disservice to our veterans."
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Re: The Damage That Doctors Do

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MediumTex wrote:
stone wrote: What I find curious though is that the US Veterans' medical care system seems to be conducted in a way perfected to avoid all of this nonsense and to have great outcomes to match. BUT everyone on here seemed to really not want such a no-nonsense medical care system for themselves. It is as though people can see that the standard system is ridiculous but they are wedded to it nonetheless ???
It's funny how you keep bringing up the VA system as a model health care system.  If you walked through a few of these facilities and talked to people who have to rely on them for their care I am pretty sure you would revise your views.

It's entirely possible that this system does look good when viewed from a statistical perspective, but in my limited experience with these facilities, I have never smelled a stronger scent of human urine as I have smelled in VA facilities, and I have never seen a more unhealthy looking group of people than I have seen at VA facilities.
Yes.  Every doctor I've talked to that's done a VA rotation has told me that it's a terribly dispiriting experience.

One described it to me as watching the country's warmest, most grateful, and most conscientious patients receive some of the country's worst, most uncaring treatment.
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Re: The Damage That Doctors Do

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Medium Tex, thanks for the link. What really stunned me previously though was to read that doctors do their job much better from an outcome perspective if they are rushed off their feet. To get the best outcomes, doctors need to have seen it all before recently. Having a doctor who has a lengthly pleasant chat with you means that that doctor isn't seeing the ten other patients who might be giving her the experience she needs to instinctively spot when their is something seriously wrong. I really think that there is a big conflict between what actually works and what is nice.
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Re: The Damage That Doctors Do

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Lone Wolf wrote:
MediumTex wrote:
stone wrote: What I find curious though is that the US Veterans' medical care system seems to be conducted in a way perfected to avoid all of this nonsense and to have great outcomes to match. BUT everyone on here seemed to really not want such a no-nonsense medical care system for themselves. It is as though people can see that the standard system is ridiculous but they are wedded to it nonetheless ???
It's funny how you keep bringing up the VA system as a model health care system.  If you walked through a few of these facilities and talked to people who have to rely on them for their care I am pretty sure you would revise your views.

It's entirely possible that this system does look good when viewed from a statistical perspective, but in my limited experience with these facilities, I have never smelled a stronger scent of human urine as I have smelled in VA facilities, and I have never seen a more unhealthy looking group of people than I have seen at VA facilities.
Yes.  Every doctor I've talked to that's done a VA rotation has told me that it's a terribly dispiriting experience.

One described it to me as watching the country's warmest, most grateful, and most conscientious patients receive some of the country's worst, most uncaring treatment.
Lone Wolf, when they say it was poor treatment, from an outcome perspective that isn't borne out is it? Presumably the doctors who told you about this did themselves care. Was it simply that they were rushed? I genuinely want to understand how a system can have such great outcomes, be such great value for money and yet be so reviled.
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stone wrote: Lone Wolf, when they say it was poor treatment, from an outcome perspective that isn't borne out is it? Presumably the doctors who told you about this did themselves care. Was it simply that they were rushed? I genuinely want to understand how a system can have such great outcomes, be such great value for money and yet be so reviled.
Here is a short article that provides a partial answer to your questions.

As I suggested in a prior post, apparently almost all VA system patients receive a significant part of their health care from other sources, which means that even if the VA system is creating good outcomes, those good outcomes relate to only a portion of the average VA patient's overall health needs.

Maybe the story on the VA is more along the lines of: "For the patients we are able to see and for the health conditions they trust us to treat, we tend to have cost effective outcomes."
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Re: The Damage That Doctors Do

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Gosso wrote: I have a family member on anti-depressants and has a whole host of digestive and other health related problems.  But I look at her lifestyle and it's completely obvious that this is the root cause of the problem.  A diet mainly composed of energy drinks, chips and pizza, staying up until 2am, then being unable to sleep, constantly on the computer or iPhone, never exercises, lots of stress, etc.  It's the most frustrating thing in the world to see someone you love destroying their life.

IMO depression is a self-defence mechanism created by the body to tell the person that it is fucking pissed off.  You cannot tell me it is simply a chemical imbalance in the brain that a pill will correct...what caused the chemical imbalance in the first place...unless you were born that way then I'd say it's the shitty lifestyle.  Mother Nature is a bitch, and if you don't follow her rules, then she will kill your body...it's as simple as that.
That's a terrible thing to witness.  Happily, though, these bad lifestyle choices can often be turned around before it's too late.  It's possible to wait too long but while there's life, there's hope.

It's like you said -- when your lifestyle puts you so thoroughly at odds with your evolutionary history, it stands to reason that you'll suffer some negative consequences (not all of which you can easily predict.)  But humans evolved to:
  • Move.  We evolved to roam great distances in search of resources.  You have to spend some time "being an animal" or your body doesn't function as it should.
  • Be exposed to sunlight during the day.  Getting out in the open air (and possibly taking some Vitamin D) are so good for you.
  • Drink water.  Sodas and energy drinks can hydrate you but who wants to be part of an ongoing chemistry experiment in their own body?
  • Eat whole foods.  Everyone's got their own idea of what this means but I think we can agree that there's little sense in overdoing the processed crapola.
  • Eat in amounts commensurate with your activity level.  For most of the time humans have roamed the Earth, it was damn hard work seeking out calories.  Eating an excessive number of calories was actually really difficult to do.
  • Pick up something heavy every once in a while.  It's "unusual" for a human to not expend physical effort while trying to survive.  Most of us are capable of being much stronger and more robust than we think.
  • Seek companionship.  If you don't like people, dogs work too.
  • Not stare at screens all day long.  (I'm a huge violator of this one but it's the truth.)
Barring some kind of disability, until a person has hit this whole checklist, antidepressants seem premature.
stone wrote: Lone Wolf, when they say it was poor treatment, from an outcome perspective that isn't borne out is it? Presumably the doctors who told you about this did themselves care. Was it simply that they were rushed? I genuinely want to understand how a system can have such great outcomes, be such great value for money and yet be so reviled.
These doctors did rotations as medical students.  I don't recall specific criticisms of the doctors so much as the staff.

I found it interesting that they came away with very positive impressions of the patients but still wanted to get the hell out of there when their rotation was done.  They all described the patients as being really wonderful people.  Whatever the cause, it makes me happy to hear that the outcomes tend to be good for them.
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Re: The Damage That Doctors Do

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Medium Tex, thanks for the balancing background. That link mentioned Kaiser Permanente http://en.wikipedia.org/wiki/Kaiser_Permanente .
Is that system well regarded? Is it possible to have an outcome orientated (rather than drug selling, anxiety exploiting) system that nevertheless treats patients with dignity and gives adequate coverage ???
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Re: The Damage That Doctors Do

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Lone Wolf wrote: That's a terrible thing to witness.  Happily, though, these bad lifestyle choices can often be turned around before it's too late.  It's possible to wait too long but while there's life, there's hope.
It is a sad thing to see, but I'll admit the antidepressants are helping (whether it is placebo or not).  But the underlying lifestyle problems still exist which will just lead to other diseases down the road.

It's like you said -- when your lifestyle puts you so thoroughly at odds with your evolutionary history, it stands to reason that you'll suffer some negative consequences (not all of which you can easily predict.)  But humans evolved to:
  • Move.  We evolved to roam great distances in search of resources.  You have to spend some time "being an animal" or your body doesn't function as it should.
  • Be exposed to sunlight during the day.  Getting out in the open air (and possibly taking some Vitamin D) are so good for you.
  • Drink water.  Sodas and energy drinks can hydrate you but who wants to be part of an ongoing chemistry experiment in their own body?
  • Eat whole foods.  Everyone's got their own idea of what this means but I think we can agree that there's little sense in overdoing the processed crapola.
  • Eat in amounts commensurate with your activity level.  For most of the time humans have roamed the Earth, it was damn hard work seeking out calories.  Eating an excessive number of calories was actually really difficult to do.
  • Pick up something heavy every once in a while.  It's "unusual" for a human to not expend physical effort while trying to survive.  Most of us are capable of being much stronger and more robust than we think.
  • Seek companionship.  If you don't like people, dogs work too.
  • Not stare at screens all day long.  (I'm a huge violator of this one but it's the truth.)
Barring some kind of disability, until a person has hit this whole checklist, antidepressants seem premature.
I see you have been swayed by the Paleo side of the force, me too, although I am nowhere near as hardcore as I used to be.  I completely agree with your list, but I would like to add a few more points:
  • Sleep. I do what I can to follow the sun, and try to reduce bright lights after 9:00pm.  Tip: If you must use your computer at night use F.lux to automatically dim your computer monitor when the sun sets.
  • Stress.  I have recently started doing yoga, which has been surprisingly helpful.  Also whenever I feel the stress build up I'll turn everything off, light a candle, relax as much as possible, and watch my mind wander for an hour or so.
  • Caffeine.  I have cut back from 4-5 cups of coffee a day to a single cup of tea in the morning.  It takes awhile for the body to rebalance, but it has done wonders for my heart burn, anxiety, sleep, and general wakefulness.
  • There are NO magical vitamins, herbs, or special diets that will fix you.  It took me a long time to figure this out (I have a cupboard full of vitamins to prove it).  Just eat real food, take a multivitamin, and a little extra vit D in the winter, and then stop stressing about it.
I am not perfect and still have plenty of vices. I don't even follow my own rules half the time, but I am miles ahead of where I used to be.
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Lone Wolf
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Re: The Damage That Doctors Do

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Gosso wrote: I see you have been swayed by the Paleo side of the force, me too, although I am nowhere near as hardcore as I used to be.
I think that the Paleo crowd makes a heck of a lot of good points.  I eat a lot of milk protein, though, and I don't shun whole grains.  That puts me well outside of the paleo orthodoxy.  I think that the diet they prescribe is excellent -- I just constrain myself a bit less.

I like your list.  I am ashamed to note that while I think that I have a good handle on stress, I am quite lousy about my sleep habits.  When it comes time to fit everything into the day, sleep is what tends to get the short end of the stick.

After going through a hurricane we went for 8 days without power.  No TV, lots of time spent outside cleaning up, and spent most of the day working, talking, reading, or taking walks.  With no lights in the house we felt sleepy by 9 pm and got tons of shut-eye.  It was fantastic.
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Gosso
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Re: The Damage That Doctors Do

Post by Gosso »

Lone Wolf wrote:
Gosso wrote: I see you have been swayed by the Paleo side of the force, me too, although I am nowhere near as hardcore as I used to be.
I think that the Paleo crowd makes a heck of a lot of good points.  I eat a lot of milk protein, though, and I don't shun whole grains.  That puts me well outside of the paleo orthodoxy.  I think that the diet they prescribe is excellent -- I just constrain myself a bit less.

I like your list.  I am ashamed to note that while I think that I have a good handle on stress, I am quite lousy about my sleep habits.  When it comes time to fit everything into the day, sleep is what tends to get the short end of the stick.

After going through a hurricane we went for 8 days without power.  No TV, lots of time spent outside cleaning up, and spent most of the day working, talking, reading, or taking walks.  With no lights in the house we felt sleepy by 9 pm and got tons of shut-eye.  It was fantastic.
It sounds like we have a very similar diet.  I also eat whole grains and even white bread  :o, but they are no longer a staple of my diet.  Dairy is also just too fantastic to give up, plus it doesn't bother me (even though I thought I was lactose-intolerant back in my hypochondriac days).  I seem to run better on a decent amount of carbs from rice and potatoes.

Even though I'm not orthodox Paleo anymore, I still learned a lot about how the human body is meant to function.
TripleB
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Re: The Damage That Doctors Do

Post by TripleB »

I'll throw out some rough numbers that I pulled out of my butt:

70% of medical problems will get better on their own (i.e. a sore throat)
25% of medical problems have cures that are worse than the disease (i.e. chemotherapy)
5% of medical problems have cures that are worth taking (i.e. antibiotics to mitigate septic shock)

I'm nearly to the point of recommending most people skip medical insurance because of this. Either something is going to cost you a few thousand dollars max, or it's something you'd wish you just let yourself die and file a DNR.

When you pay for it all out of pocket, then you self-ration and don't go to the doctor every time you have a sore throat. The other upside is that when you aren't spending $5k to $10k per year on health insurance (which is the average cost in the US), you can afford to work "$10k less" per year, have less stress, eat better, get exercise, and avoid lots of health issues. Unfortunately our system is designed against doing this, and most people can't simply refuse health insurance and scale their hours back by 10 per week to compensate for their reduced expenses.

Barring congenital health issues, most health problems can be avoided by simply:

a) stop eating shit food and being fat
b) get off your ass and exercise
c) quit smoking
d) don't ride a motorcycle
Last edited by TripleB on Thu Mar 08, 2012 5:29 pm, edited 1 time in total.
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6 Iron
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Re: The Damage That Doctors Do

Post by 6 Iron »

This is a loaded topic, because almost everyone knows someone that has been made worse by care that they have received. I work in these trenches, and can say that I have seen anecdotal evidence for most comments that have been made. That said, I have a couple of comments: the saddest cases that I see involve patients that did not seek care because of suspicion, or finance, or alternative beliefs, turning a fixable problem into one that is not. Be wary of giving up on us. Despite our flaws we can be pretty handy allies.

Take care of yourself, as mentioned above; the 16 to one benefit ratio ascribed to prevention and cure is probably off by a factor of 10.
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Re: The Damage That Doctors Do

Post by AdamA »

MediumTex wrote:
This situation got me thinking about how there are ailments and illnesses people have that likely become self-reinforcing and self-perpetuating through the actions of doctors.  
You said a mouthful.

There's an Upton Sinclair quote that surfaces on this website every so often, "It is difficult to get a man to understand something when his salary depends upon his not understanding it," and I think this is as true in medicine as it is anywhere else.  You could probably put a slash next to "salary" and add the word "ego"  to the above quote when applying it to medicine, though.  

Don't get me wrong, if I have appendicitis I want a surgeon, if I had type I diabetes, I'd want insulin, and I'm very happy to have been vaccinated against Polio.  

The thing is, we've taken our successes against these very objective illnesses and tried to apply the same thinking to more ill-defined "medical" problems.  The end result is a glut of strange drugs and procedures being used on people with illness that are often lifestyle related or psychological.  

The docs are only half of the problem, though.  I'm a physician, and many many many of the patients I see in my practice are looking to the medical system to validate psychosomatic complaints.  These people are so unhappy in their lives that they, maybe only subconsciously, seem to be in search of a medical condition to blame for their suffering.  If you combine these patients with a physician who may be looking to finance a vacation home, the end result is a lot of over diagnosis and over treatment, i.e. harm.    And...even if a physician wants to avoid over doing it with these people, it can be very difficult because they tend to return time and again and basically demand further evaluation.  

 
"All men's miseries derive from not being able to sit in a quiet room alone."

Pascal
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AdamA
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Re: The Damage That Doctors Do

Post by AdamA »

MediumTex wrote: Do everything you can to stay out of the hospital.  Hospitals are full of sick people, and many people go into the hospital a litlte sick and come out very sick if they come out at all.
I'll say it!!!

There are few things in my practice that give me more pleasure than convincing someone who doesn't need to be hospitalized that they don't need to be hospitalized.
"All men's miseries derive from not being able to sit in a quiet room alone."

Pascal
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