Confessions of a Medical Heretic

by

Robert Mendelsohn

Miraculous Mayhem

I can still remember how, early in my medical career, I gave intravenous penicillin every few hours to children who were suffering the agonizing symptoms of bacterial meningitis, and then watched miraculous changes occur hour by hour. Children who had been on the verge of death recovered consciousness and began to respond to stimuli within a few hours. A few days later those same children were back on their feet, almost ready to go home.

Patients with lobar pneumonia also would endure terrible agonies. They would enter a crisis of high fever, severe cough, gasping for breath, shaking, chills, and extreme chest pains. Some recovered, but many died. When penicillin came along, people with lobar pneumonia no longer went through a crisis period. Instead, the fever, cough, and other symptoms resolved within days. People who would never have left the hospital alive packed their bags and walked out.

I -- and other doctors -- truly felt that we were witnessing and working miracles.

Things are different today. Meningitis and lobar pneumonia are uncommon. Even when a doctor does come up against such a life-threatening condition, the treatment is so routine that it is mainly carried out by a nurse or a medical technician. While the fascination with the miracle remains, these drugs that were once extremely valuable are now extremely dangerous.

Many doctors prescribe penicillin for conditions as harmless as the common cold. Since penicillin works almost exclusively against bacterial infections, it’s useless against viral conditions such as colds and flu. Penicillin and other antibiotics do not shorten the course of the disease, do not prevent complications, and do not reduce the number of pathogenic organisms in the nose and throat. They do no good at all.

What they can do is cause reactions ranging from skin rish, vomiting, and diarrhea to fever and anaphylactic shock. If you’re lucky, you’ll only be one of the seven to eight percent of people who suffer a rash -- although a much higher percentage of people suffering from mononucleosis have gotten a rash when given ampicillin. For the unlucky five percent who get serious reactions to penicillin, the picture of a patient in anaphylactic shock is not pretty: cardiovascular collapse with clammy skin, sweating, unconsciousness, fallen blood pressure, disturbance in heart rate and rhythm. It eerily evokes images of the very diseases which penicillin was designed to cure.

By no means is penicillin the only villain. Chloromycetin is a drug which is effective in a certain type of meningitis caused by the H. influenza bacillus, as well as in diseases caused by typhoid and similar germs. In such situations, chloromycetin is often the only antibiotic that will work. But chloromycetin also has the not uncommon fatal side effect of interfering with the bone marrow’s production of blood.

When a person’s life is at stake anyway, this is an acceptable risk to take. But if a child suffers nothing more than a viral sore throat, is the non-relief chloromycetin will bring worth risking depression of the child’s bone marrow which will require multiple transfusions and other therapies, none of which will guarantee complete recovery? Of course it’s not; yet doctors do prescribe chloromycetin for sore throats.

Tetracycline became so popular in outpatient clinics and office practices that it became known as the housecall antibiotic. It has been widely prescribed for children as well as other age groups because it is effective against a wide variety of organisms and because it’s side effects are not considered dangerous. But there is a fair list of adverse reactions which the informed person might not choose over the drug’s non-use in situations it wasn’t designed for anyway. A more formidable side effect is that the drug is deposited in the bones and teeth. While no one knows exactly what tetracycline does to the bones, hundreds of thousands -- perhaps, millions -- of parents and children know that it permanently stains the teeth yellow or yellow-green.

Though you might feel that’s too high a price to pay for the dubious effectiveness of the drug in relieving the symtoms of a common cold, many doctors do not. The current rationalization for the drug’s use in such situations is the suspicion that a child who appears to be suffering from a cold might actually have a mycoplasma infection. The vast majority of children with a common cold have no trace of this sort of infection.

The U.S. Food and Drug Administration finally woke up to the widespread overuse of tetracyclines in 1970, when it required a warning on all packages of the drug: “The use of drugs of the tetracycline class during tooth development (last half of pregnancy, infancy and childhood to the age of eight years) may cause permanent discoloration of the teeth yellow-gray-brown. This adverse reaction is more common during long term use of the drugs, but has been observed following repeated short term courses. Malformation of tooth enamel has also been reported. Tetracycline, therefore, should not be used in this age group unless other drugs are not likely to be effective or are contraindicated.”

Whether this warning has done much good is hard to tell, since doctors very seldom read package inserts on drugs. Even if they do, warnings do not usually stop them from using the drugs when they feel like it. Particularly when the warning on the insert, like the one for tetracycline, doesn’t really make it clear enough that these drugs carry side effects which merit their use only in critical situations.

One of those risks is even more grim than that of the side effects: superinfections. When an antibiotic fights one infection, it may encourage an even worse infection by a strain of bacteria that is resistant to the drug. Bacteria are remarkably adaptable organisms. Subsequent generations can develop resistance to a drug as their ancestors are exposed more and more. Penicillin in moderate doses once easily cured gonorrhea. Now it takes two large shots of the antibiotic to treat it, and it’s sometimes necessary to use additional drugs! Two new strains of gonorrhea recently were discovered in the Philippines and in West Africa -- strains which totally destroy penicillin’s effectiveness.

Of course, Modern Medicine has a stronger drug ready for the stronger gonorrhea bacteria -- spectinomycin. Spectinomycin costs six times as much and has even more side effects. Mean while, the gonorrhea bacteria have developed a strain which is resistant to spectinomycin, too! As the battle escalates, the germs grow stronger while the patients and their pocketbooks grow weaker.

All of which would not happen if doctors recognized that antibiotics have a place in the practice of medicine -- a severely limited place -- and if they enforced that restriction. A person may need penicillin or some other antibiotic three or four times during his or her entire life, at times when the stakes are worth the risks.

Unfortunately, doctors have seeded the entire population with these powerful drugs. Every year, from 8 to 10 million Americans go to the doctor when they have a cold. About ninety-five percent of them come away with a prescription -- half of which are for antibiotics. Not only are these people duped into paying for something which has no effectiveness against their problem, but they’re set up for the hazards of side effects and the risks of deadlier infections.

The doctor, once the agent of cure, has become the agent of disease. By going too far and diffusing the power of the extreme on the mean, Modern Medicine has weakened and corrupted even the management of extreme cases. The miracle I and other doctors were once proud to take part in has become a miracle of mayhem.

In 1890, Dr. Robert Koch derived a substance from tuberculosis bacteria which he claimed would cure the disease. When he injected it into patients, however, they got worse or died. In 1928, a drug called thorotrast was first used to aid in obtaining x-ray outlines of the liver, spleen, lymph nodes, and other organs. It took nineteen years to discover that even small doses of the drug caused cancer. In 1937, children who received a new antibacterial drug died because the drug was contaminated with a toxic chemical. In 1955, more than 100 fatal and near fatal cases of polio developed among unsuspecting people receiving certain lots of the Salk vaccine which contained presumably inacivated polio viruses. In 1959, about 500 children in Germany and 1,000 elsewhere were born severely deformed because their mothers had taken thalidomide, a sleeping pill and tranquilizer during the early weeks of pregnancy. In 1962, a cholesterol-lowering drug, triparanol, was removed from the market when it was acknowledged that the drug caused numerous side effects, cataracts among them.

Most of these pharmaceutical backfires were corrected either when the drug was removed from the market or when the manufacturing error was discovered and tighter controls were established. The controls haven’t been tight enough though, because drug disasters like these are going on every day. Actually, the only apparatus that has grown stronger seems to be the machinery of keeping dangerous drugs moving from the factories through the hands of doctors into the mouths and bodies of unwary patients. Reserpine, a drug used, against high blood pressure, is still prescribed, even though it was discovered in studies five years ago to triple the risk of breast cancer. Although insulin is turning up in scientific studies as one of the causes of diabetic blindness, its use is still heralded as a medical miracle.

Of course, if drugs were merely products of medical science, dealing with them would be a matter of science, rationality, and common sense. But drugs aren’t merely scientific -- they’re sacred. Like the communion wafer which Catholics receive on the tongue, drugs are the communion wafers of Modern Medicine. When you take a drug you’re communing with one of the mysteries of the Church: the fact that the doctor can alter your inward and outward state if you have the faith to take the drug. And just as an undeniable factor in the healing or the spiritual boost the communicant gets at the altar rail is psychologically determined, the placebo effect -- the power of suggestion -- plays a tremendous role in whatever good a drug may do. As a matter of fact there are some drugs and other procedures in which we know the placebo effect is the primary therapeutic agent!

The sacraments of the Catholic Church -- or any other real church -- seldom harm anyone. Doctor-prescribed sacramental drugs of Modern Medicine kill more people than illegal street drugs. A nationwide survey of medical examiners reported that street drugs cause twenty-six percent of drug abuse deaths. Valuim and barbiturates -- prescription drugs -- made up another twenty-three percent of drug abuse deaths. This study did not take into account the 20,000 to 30,000 yearly deaths attributed to adverse reactions to drugs prescribed by doctors. The reason for the wide girth between the estimates is that doctors often fudge in stating whether or not drugs are the actual cause of death. If a patient has a terminal illness and dies during the drug therapy, the death will be attributed to the disease, even if the patient wouldn’t normally have died for some time yet. The Boston Collaborative Drug Surveillance Program monitored patients admitted to acute disease medical wards and found the risk of being killed by drug therapy was better than one in 1,000 in American hospitals. An earlier survey by the same group found that the risk among hospitalized pitients with serious chronic diseases such as cancer, heart disease and alcoholic cirrhosis was four in 1,000. Of course, many of these people were in the hospital in the first place because of the effects of drugs prescribed by their doctors. Conservative estimates say that five percent of the people in American and British hospitals are there because of adverse reactions to drugs. Another conservative estimate puts the price tag on this preventable suffering at more than $3 billion.

Another, even more powerful, group of drugs whose use for the treatment of extreme conditions has shifted to common conditions is the steroid drugs. Steroids mimic the action of the adrenal glands, the most powerful regulators of body metabolism. Practically every organ is directly or indirectly affected by the secretions of the adrenal glands -- as well as by the synthetic chemicals prescribed by the doctor. Once upon a time, steroid drugs were prescribed for severe adrenal insufficiency, for disturbances of the pituitary gland and for certain life- threatening conditions such as lupus erythematosus, ulcerative colitis, leprosy, leukemia, Hodgkin’s Disease, and lymphoma. Today steroids are prescribed for conditions as common as sunburn, mononucleosis, acne, and a large variety of skin rashes which are often incorrectly diagnosed.

The entire list of precautions and adverse reactions to Prednisone fills two columns of small print in the Physicians Desk Reference, the enclyclopedia or “bible” of licensed drugs in the United States. Among the adverse reactions are: hypertension, loss of muscle tone, peptic ulcer with possible perforation and hemorrhage, impaired wound healing, increased sweating, convulsions, vertigo, menstrual irregularities, suppression of growth in children, manifesiation of latent diabetes, psychic disturbances, and glaucoma. Is getting rid of some minor skin rash worth risking one of these disasters? Apparently some doctors think it is.

For example, a woman from Atlanta wrote me about her twenty-year-old daughter who had never had a menstrual period. At the age of eleven, the girl had developed a rash on her feet. The dermatologist prescribed Prednisone, and the youngster took it for three years. “Can anything be done for our daughter?” the woman asked me. “If only that dermatologist had told us that drug might do this to our daughter’s reproductive system, we would have let her keep the rash!”

A young woman from Ohio wrote me that she had gotten a prescription for Prednisone accompanied by shots of another steriod, Kenalog, for poison ivy. “I suffered severe headaches, muscle cramps, swelling of my breasts, and bleeding for twenty-five days.” Her gynecologist told her the bleeding was caused by the medications she took for the poison ivy, so she must now undergo a D&C (scraping of the walls of the uterus).

A couple of years ago, the University of Chicago was slapped with a $77-million class-action suit filed on behalf of more than 1,000 women who unwittingly took part in a University experiment, some twenty-five years ago, with the synthetic hormone DES. This suit has special significance to me since I was then a student at the university’s school of medicine and spent part of my time at Chicago Lying-In Hospital. I knew of the experiment, which tested the use of diethylstilbesterol in preventing threatened miscarriages. Being a conscientious medical student who trusted his school and believed his professors knew what they were doing I didn’t even question the experiment.

Of course neither I nor the 1,000 or so women should have trusted the school, because the professors didn’t know what they were doing. In 1971, Dr. Arthur L. Herbst, then of Harvard Medical School, first announced that an alarmingly high rate of daughters of women who had taken DES were developing vaginal cancer. Later on we learned that male offspring of these women had an alarmingly high rate of genital malformations. And a statistically significant number of the women themselves were dying of cancer.

Of course, by then the bloom was off the rose as far as my unquestioning acceptance of medical science was concerned. I was not surprised when I heard the news. The damaging effects of hormones used in the Pill and in sex hormones used for menopause had already surfaced. If it hadn’t been obvious twenty-five years ago that DES would have a damaging effect on the developing, vulnerable fetus, it was now.

Today my surprise quotient is so low that I scarcely raise an eyebrow when I see that the same Dr. Herbst who unveiled the dangers in the first place has since come out with a paper that plays down the DES cancer risk! Since the damage has already been done and doctors have been exposed as ignorant of the possible dangers of the drugs they use, all that can be done now is retreat into the sacred language and make it look like the mistake wasn’t a mistake at all, the danger not a danger at all. Try to convince the mothers who found out they were guinea pigs in the DES experiment. Try to convince their children. For every one of those diseased or deformed children, the risk has been l00 percent.

Dr. Herbst’s own records show 300 cases of vaginal or cervical cancer in babies whose mothers were treated with DES. Imagine what a commotion Modern Medicine would have made a couple of years ago if “only 300 case” of swlne flu had been discovered. Would doctors then talk about how really miniscule the risk was? How about when a doctor wants to use antibiotics on an infant when the chances the child really needs them are less than one in 100,000?

DES is just one of the sex hormones prescribed for women at all stages of their lives. Tens of millions of women take such hormones daily in the form of contraceptive pills or menopausal estrogens. DES is still being given as the "morning after" contraceptive pill and to dry up breast milk. In 1975, the FDA sent a warning bulletin to doctors recommending that they switch women over age forty to a contraceptive other than the Pill. In 1977, the FDA required a warning brochure emphasizing the astronomical risk of cardiovascular disease among women over forty taking the Pill. Whether these warnings will do much good remains to be seen.

Women over forty are still taking the Pill, either because they are not properly informed or because they choose to accept the risks. The overwhelming majority of women on the Pill are under forty. The risks are great for these women, too, and they include not only cardiovascular disease, but liver tumors, headaches, depression and cancer. While taking the Pill over age forty multiplies the risk of dying from a heart attack by a factor of five, from age thirty to forty the PilI multiplies it by a factor of three. All women taking the Pill run a risk of high blood pressure six times greater than women not taking it. Their risk of stroke is four times greater, and their risk of thromboembolism is more than five times greater.

Doctors maintain the enormous market for the Pill by telling women it’s safer to take the Pill than to get pregnant. Of course, that argument defies logic as well as science. First of all, the dangers of the Pill are just beginning to surface. They are the dangers of an unnatural substance interfering with body processes. Pregnancy, however, is a natural process, which the body is prepared to deal with -- unless it is unhealthy in some way. To take the Pill is to introduce disease into the body. Comparing the risk of pregnancy to the risk of taking the Pill illogically jumbles together rich women, poor women, healthy women, sick women, women on the Pill, women off the Pill, women using other contraceptives, women using no contraceptives, married women, single women teenagers, adults, promiscuous women, and non-promiscuous women. When these women get pregnant, they already bring to the statistics risk factors which have nothing to do with pregnancy.

Of course, it’s bad science to compare the Pill’s dangers with pregnancy anyway. The real question is: Is the Pill safer than other forms of contraception?

Added to the 10 million women who still take the Pill are more than 5 million who take menopausal estrogens. Again, these drugs have been implicated so strongly in the causation of gall bladder disease and cancer of the utenus (they multiply the risk by a factor of five to twelve) that the FDA has been forced to issue warnings to doctors and patients. Warnings which have gone largely unheeded, as far as doctors are concerned. For instead of limiting the use of these drugs to infrequent, short term relief of severe symptoms, most doctors use them routinely supposedly to prevent the mildest of menopausal discomforts. Estrogen therapy is used to preserve youth, for cosmetic purposes, to relieve depression, and for the prevention of cardiovascular disease -- all for which its effectiveness has been disproved. Estrogens also are used to prevent bone demineralization in older women. Exercise and diet can prevent demineralization and they don’t cause cancer. Many women obtain estrogens from their doctor at the first sign of depression during middle age. Seldom does the doctor take the time to find out if perhaps the depression isn’t caused by some other factor, something that can be treated without estrogen or -- perish the thought -- without any drug.

Actually, quite a few drugs are invented and prescribed for conditions which can be treated perfectly well with less dangerous methods. Antihypertension drugs have filled such a market void for an easy way to lower blood pressure that their popularity has soared in the few years they’ve been available. Now a doctor no longer has to tell a person with high blood pressure that his lifestyle is killing him. He can just write a prescription for a drug and use his powers of persuasion to get the patient to take the drug. We even have television, radio, and magazine commercials urging people to take their high blood pressure medication! Somehow, somewhere, someone has convinced enough people that taking these drugs is the only way to lower blood pressure. And someone has, of course, also failed to alert a lot of people to the side effects of these drugs. Someone is aware of those side effects, though, because many of the high blood pressure drug ads in the medical journals are for drugs designed to deal with the side effects of the antihypertension drugs!

Some of those side effects include: rash, hives, sensitivity to light, dizziness, weakness, muscle cramps, inflammation of the blood vessels, tingling sensation in the skin, joint aches, confusion, difficulty concentrating, muscle spasms, nausea, and loss of sex drive and potency. That last side effect, by the way, affects both men and, women on antihypertensives. Sometimes I wonder just how much of the middle-aged population suffers from impotency -- not from any psychological cause but simply from their blood pressure medication. All the sex therapy in the world won’t correct drug-induced impotence and loss of libido. If doctors aren’t aware of the side effects from these drugs, they aren’t doing their job, because the manufacturers list them in the Physicians Desk Reference (PDR). If they do know about them and prescribe these drugs anyway, you have to stop and wonder: would a doctor who was found to have high blood pressure take these drugs himself?

Perhaps any doctor foolish enough to prescribe these drugs is also foolish enough to take them himself, since most doctors are aware of the controversy over whether these drugs do any good at all. Even if you assume that high blood pressure is dangerous, doctors are still guilty of being a bit quick with the prescription. Many people who receive high blood pressure medication are really borderline cases: their blood pressure isn’t high enough to warrant a drug with the side effects of antihypertensives. Most of these people could more effectively lower their blood pressure through relaxation therapy, dietary or lifestyle changes. In one study, relaxation therapy reduced blood pressure faster and farther than drug therapy. Similar studies have shown that weight loss, reduction of salt intake, vegetarian diet, and exerclse can also lower blood pressure at least as effectively and certainly more safely than drug therapy. There’s little doubt that many patients don’t need to lower their blood pressure at all, since as soon as they leave the danger zone of the doctor’s ofice, their blood pressure returns to normal.

One of the unwritten rules in Modern Medicine is always to write a prescription for a new drug quicky, before all its side effects have come to the surface. Nowhere is this syndrome more evident than in the unleashing of the herd of new antiarthritic drugs on the unsuspecting patients. Nowhere is it more evident that the “cures” are worse than the disease. Within the last few years, a torrent of advertisements in medical journals has heralded the coming of such anti-arthritis drugs as Butazolidin alka, Motrin, Indocin, Naprosyn, Nalfon, Toletin, and others, The drug companies have spared neither time nor money in rushing their arthritis “cures” to the marketplace. Millions upon millions of prescriptions have been written. And in just these few years, this new class of drugs has a record of side effects that promises to rival antibiotics and hormones as genuine public health menaces.

Just reading the information supplied by the manufacturer of Butazolidin alka, and thinking that your doctor actually is prescribing the stuff to you is enough to make you ill: “This is a potent drug; its misuse can lead to serious results. Cases of leukemia have been reported in patients with a history of short and long term therapy. The majority of the patients were over forty.” If you read further you find that your doctor is setting you up for a possible 92 adverse reactions, including headaches, vertigo, coma, hypertension, retinal hemorrhage, and hepatitis. The company goes on to admit: “Carefully instruct and observe the individual patient, especially the aging (forty and over) who have increased susceptibility to the drug. Use lowest effective dosage. Weigh initially unpredictable benefits against risk of severe, even fatal reactions. The disease condition itself is unaltered by the drug.”

After reading that, you have to wonder why the drug company would bother marketing the stuff. What doctor would give such poison to his patient? What person would willingly take this drug? You can stop wondering, because Butasolidin alka makes millions of dollars for its manufacturer. Doctors may or may not be aware of the drug’s disastrous side effeets. They may not be offended by the admission by the company that the doctor has to weigh unpredictable benefits against the possibility of death. They just may not care.

Or they may be guided by a force that goes beyond logic and consideration -- the rhythm of a religious sacrifice.

In the case of at least one antiarthritis drug, Naprosyn, the sacrifice has graduated into a farce. Though the FDA has discovered that Syntex, the drug’s manufacturer, falsified records of tumors and animal deaths during the safety tests for its drug, the government is unable to remove the drug from the market without long and tedious proceedings.

No modern medical procedure better displays the inquisitorial nature of Modern Medicine than the drugging of so called “hyperactive” children. Originally, behavior controlling drugs were used to treat only the most severe cases of mental illness. But today, drugs such as Dexedrine, Cylert, Ritalin, and Tofranil are being used on more than a million children throughout the United States -- on the basis of often flimsy diagnostic criteria of hyperactivity and minimal brain damage. Some medical tests, when performed correctly, are conclusive. But there is no single diagnostic test that will identify a child as hyperactive or any of the twenty-one other names assigned to this syndrome. The list of inconclusive tests is at least as long as the list of names. All a doctor has to go on is a list of inconclusive tests and the “educated” guess of an “expert.”

One school in Texas took advantage of this ambiguity and diagnosed forty percent of its students as minimally brain damaged in a year when government money was available to treat that syndrome. Two years later, this money was no longer available, but funds for treating children with language learning disabilities were floating around. Suddenly, the minimally brain damaged students disappeared and thirty-five percent of the children were diagnosed as having language learning disabilities!

If that school district and others took the government money and used it on teachers’ salaries, books, playground equipment, and supplies, their larceny could be forgiven. But what happens is that the child who can’t sit still in class -- instead of being given tasks that will interest and occupy him -- is diagnosed as hyperactive and “managed” by drugs. These drugs are not without serious side effects. Not only do they suppress growth and cause high blood pressure, nervousness, and insomnia, but they transform children into “brave new world” type zombies. Sure, the kids slow down -- dramatically. They’re also less responsive and enthusiastic, and more humorless and apathetic. And they don’t perform any better when measured objectively over long periods of time.

The original authors of scientific studies on these behavior modifying drugs have tried to disassociate themselves from their present use by claiming that the problem isn’t the drugs’ existence but the way doctors over-diagnose, mis-diagnose, and overmedicate. While such arguments may salvage a few individual reputations, keep in mind that the original investigators and authors have made little or no attempt to properly limit the use of their discoveries. On the contrary, we still have three-page ads in the medical journals which picture a school teacher proudly proclaiming, “How wonderful! Andy’s handwriting no longer looks like hen scratchings.” This is the first time in history that powerful drugs have been sold to cure poor penmanship! And sold quite successfully, I might add. More then a million children are being given these drugs, a yearly habit that stuffs tens of millions of dollars into the pockets of the drug companies.

Nowhere does the Church’s Inquisition emerge as clearly as it does through the drugging of children as a means of control. The medieval Inquisition went beyond defining unorthodox beliefs and behavior as a “sin” and started calling them a crime. Criminals were punished, first by the Church and then by the secular authorities. Modern Medicine sets up its Inquisition to define behavior which doesn’t conform as sick. Then it proceeds to “punish” the guilty by "managing" them with drugs. Since the primary purpose of schools is not to liberate the intelligence through learning but to create properly socialized and manageable citizens, the Medical Church and the State join forces to maintain public order. The Church enforces the behavior standards that suit the State and the State enforces the exclusive view of reality that allows the Church to flourish. All in the name of Health -- which, in reality, is not even a minor consideration of either party.

Witness the vigor with which the State proselytizes Modern Medicine’s line of Holy Waters. Now, Holy Waters are special cases slightly removed from drugs in that the thin veil of diagnostic necessity has been removed. Everybody needs -- and gets -- the Holy Waters: routine silver nitrate in the eyes of the newborn, routine intravenous fluids to laboring mothers and other hospital patients, routine immunizations, and fluoridation of water supplies. All four of these procedures are automatically, thoughtlessly imposed on people whether they wish them or not, whether they need them or not. All four of them are at best unnecessary ninety-nine percent of the time. All four of them are of questionable safety. Yet all of them -- except the intravenous fluids so far -- are not only Church Law, but State Law as well.

I’ll never forget the overwhelming compulsion of the priest making his way to the premature nursery to get some holy water on the infants and baptize them before they died. That same fierce compulsion motivates the priests of Modern Medicine in slapping their Holy Waters on their patients.

One of the mottoes medical students are taught to memorize but never practice -- such as “first do no harm” -- is “when you hear the sound of hoofbeats, think of horses before zebras.” In other words when symptoms present themselves, first consider the most obvious, common sense cause. As you can see, this motto doesn’t survive very long in most doctors’ practices. You can’t use powerful and expensive drugs and procedures on horses. So what the doctor does is hear a herd of zebras every time, and treat accordingly. If a child is bored or can’t sit still, he’s hyperactive and needs a drug. If your joints are stiff because you don’t exercise them the way you should, you need a drug. If your blood pressure is a little high, you need a drug. If you’ve got the sniffles, you need a drug. If your life isn’t going the way it should, your need a drug. On and on ... the zebras keep coming.

One of the factors that keeps those zebras coming is the cozy and profitable relationship that exists between the drug companies and doctors. The drug companies spend an average of $6,000 per year on each and every doctor in the United States for the purpose of getting them to use their drugs. Company detail men, actually salesmen, build friendly, profitable relationships with the doctors on their route, wining and dining, doing favors, handing out samples of drugs. The sad fact is that most of the information reaching doctors about the uses and abuses of drugs comes from the drug companies, through the detail men and advertising in medical journals. Since most of the clinical test reports are financed by the drug companies, information from these, too, is highly suspect.

A commission of distinguished scientists, including four Nobel Laureates, studied the drug problem and found that the culprits are the doctors and the scientists who test the drugs. They found clinical trials of new drugs were “a shambles.” The FDA spot checked the work of some doctors doing such clinical trials and found twenty percent guilty of a wide range of unethical practices, including giving incorrect dosages and falsify records. In a third of the reports checked by the FDA, the trial had not been carried out at all. In another third, the experimental protocol was not followed. In only a third of the tests could the results be considered scientifically worthwhile! [Journal of the American Medical Association, November 3, 1975]

Despite the obvious corruption of the drug company-doctor marketing connection, I don’t blame the drug companies, the detail men, the government agencies which are supposed to police these activities, or the patients who badger their doctors for drugs. Doctors have enough facts in their possession to know what’s going on. Even where the drug is fully tested and the side effects and limitations of the drug are well known, most of the harm is done by doctors indiscriminately prescribing the drug. Doctors, after all, are the ones who claim the sacred power and the ethical superiority that goes with it. The drug companies are in business to make money, and they do that by selling as much of their product as they can at as high a price as they can. And although the drug companies subvert the scientific process through which drugs are tested, certified, and made available to doctors, once the drugs are available they do let doctors know -- albeit subtly -- just what these drugs can and cannot do.

The drug companies don’t have to fight against package inserts that would explain the side effects and hazards of medications to the people who take them: the American Medical Association does it for them. Doctors either play down the side effects or conceal them altogether on the grounds that the doctor-patient relationship would be endangered. “If I had to explain things to patients, I could never get through my office hours.” Or, “If patients knew everything these drugs could do, they never would take them.” Rather than protecting the patient, the doctor protects the sacred relationship -- which relies on ignorance to survive. Blind faith.

If doctors still obeyed the first rule of medicine -- Primum, non nocere, first do no harm -- there would be no need for them to enforce the blind faith of their patients. When it came down to weighing risks against benefits, the patient’s welfare would be the first consideration. But that rule has been rationalized into a grotesque mutation that allows the doctor to weigh the risks and benefits in a totally different ethical frame. Now the rule is First Do something. Now, you hurt the patients most by not giving them something, whether it’s a drug or some other procedure. Whether the “something” does any good or not is irrelevant. (To question it is irreverent!) Whether it does any harm matters even less. If the treatment does happen to hurt enough to make the patient complain, the doctor merely says “Learn to live with it.”

Of course, a doctor would never consider saying that to a patient until he had tried at least one drug. Doctors have completely bought the advertising slogan “Better Living Through Chemistry.” You might think the reason for this is purely economic. The doctor can write a prescription in a few seconds, whereas discussing with the patient the state of his nutrition, exercise patterns, career, and psyche would certainly take up more time and allow him to see fewer patients. In a fee-for-service system, the quick chemical fix has its obvious financial reward for the doctor as well as for the pharmacist and the drug manufacturer.

I think the reasons go deeper than money. One way to look at it -- though an admittedly cynical way -- is to recognize that doctors have throughout the ages embraced the wrong ideas. Considering the drug problem in our time, the adamant disregard of sterility in the nineteenth century, leeches, bleeding, purgatives, you could make a case that medicine has always been hazardous to the majority of patients.

That -- and most doctors’ high regard for financial reward -- helps explain what the patient is up against. If you go deeper still, you come up against philosophical reasons that I can only describe as the Theology of Modern Medicine. Ironically, this theology is a corruption of certain aspects of Christian theology.

If you look at almost any other system of medicine besides the Western, you’ll find a heavy reliance on food. The food of Modern Medicine, however, is the drug. The American doctor, aside from a very fragmentary and usually incorrect approach to certain “therapeutic diets” (gout, diabetic, low salt, gallbadder, weight reduction, low cholesterol), completely disregards nutrition. Those who are concerned with nutrition are labeled faddists, freaks, extremists, radicals, and quacks. Occasionally, they’re (more correctly) referred to as heretics.

Oriental medicine, on the other hand, recognizes and utilizes the importance of nutrition in health. If you look at Oriental religion, you’ll find that it, too, regards food as important to a person’s spiritual welfare. But Western religion, namely Christianity, did exactly what Modern Medicine did: substituted as an obiect of reverence a sacramental, symbolic food in place of real food. “What goes into the mouth does not make a man unclean; it is what comes out of the mouth that makes him unclean.” (Matthew 15:11)

Perhaps in their zeal to reject the Old Testament dietary laws, some of the early Christian leaders moved too far in the opposite direction and bypassed nutrition altogether. There’s no doubt that Modern Medicine took the hint and carried it to extremes. Obviously, as far as a person’s health is concerned, what goes into the mouth is at least as important as what comes out. In fact, what goes in may determine what comes out. Yet, if anyone dares to claim that a person is what he or she eats, Modern Medicine regards them as a heretic or an intellectual weakling. Instead, the “food” with the sacred “power” is the drug, the man-made chemical coursing through your veins, for better or for worse.

To protect yourself from the pusher-priest you again have to make the heretic’s radical leap of unfaith. Don’t trust your doctor. Assume that if he prescribes a drug, it’s dangerous. There is no safe drug. Eli Lilly himself once said that a drug without toxic effects is no drug at all. Every drug has to be approached with suspicion.

That goes double if you’re pregnant. In fact, if you’re pregnant you and your baby are better off if you stay away from all drugs completely. A drug that has minor side effects or even no side effects on you may do irreparable harm to a developing fetus. Hundreds of drugs are marketed long before their effects on the fetus are known. Unless you want to donate your baby’s welfare to science and be one of the first to find out a drug’s effects, don’t take any drug unless your life is at stake.

That includes aspirin. Though it’s been around for eighty of more years doctors still don’t know how aspirin works. Because it’s been a “friend of the family” for so long, people don’t realize that aspirin is not without side effects and dangers of its own. Besides the most common side effect, stomach bleeding, aspirin can cause a hemorrhage under the scalp of a newborn if a mother takes it within seventy-two hours of delivery. I’ve often wondered why doctors always say to take “two tablets” of five grains each despite the availability of a single, ten-grain aspirin tablet. Could there be some sort of religious significance in receiving ten of something in two tablets?

Before you take the first dose of any medication your doctor prescribes, you should make it your business to find out more about the drug than the doctor himself knows. Again, learning more about your situation than the doctor won’t be all that difficult. Doctors get most of their information about drugs from advertisements and from detail men and their pamphlet handouts. All you have to do is spend some time with a good book or two in order to get the information you need before deciding whether to take a drug or not.

The best book to start with is the Physicians’ Desk Reference, the PDR. The PDR is the beginning of knowledge about drugs. Although it’s easily available now, up until about two years ago the publisher refused to distribute it to other than members of the medical profession. I wasn’t aware of this when I gave the PDR many plugs in my column and newsletter. Finally, I got a letter from the publisher telling me to please stop referring people to their book since they distributed it only to professionals. They felt that the public wouldn’t understand the PDR and would be confused by it. Well, I published that letter in my column and I commented that it was the first time in history a publisher didn’t want to sell his books. Shortly thereafter, without any kind of fanfare, the PDR not only started showing up in bookstores, but it was promoted in bookstores! Now, if you go into the bookstores, you’ll see piles of PDR’s. I guess the publisher finally got the idea.

Of course, you don’t have to buy the book. Almost every public library now has it. You shouldn’t worry about understanding it. Anybody with an eighth grade education and a dictionary can read any medical book. Even doctors will testify that patients always seem to be able to pick out and understand the parts that they must know.

The PDR is good because all the information is provided by the drug companies in an effort to protect themselves. Not only does the FDA require them to put in all the information they have, but they also want to ward off any liability claims against them. In effect, they are saying to the doctor: we are telling you everything we know about this drug. What it may be useful for. What it may do to the person who takes it. The wonderful thing that seems to be happening is that the PDR is becoming more and more discreet. For example, the latest issues divide drug side effects into major categories according to how frequently they can occur. Now at least you’ve got horse race odds when you take your medicine.

The PDR can be considered the “bible” of the Church of Modern Medicine, especially since for a long time it was forbidden literature except to the priesthood. But there are other sources for the kind of drug information you need. The American Medical Association publishes a Drug Evaluations book which in some cases gives even more information than the PDR. For one thing, the AMA book has a list of cross-referenced symptoms in the back. You look up your symptom or your side effect and it will tell you which drugs are indicated or suspected.

Because we’re living in an era of poly-pharmacy -- everybody is taking more than one drug at a time -- you’ve got to become aware of the dangers of combinations of drugs. One drug may have side effects harmful to one organ three or four percent of the time, two percent to another organ, six percent to another. A second drug may have dangers for one organ that occur three percent, dangers for another organ ten percent. If you’re taking enough drugs, the danger can easily add up to more than 100 percent. You’re virtually assured of suffering some toxic effect!

Even more dangerous are the potentiating effects of drug combinations. One drug might have only a five percent chance of hurting you. But in combination with another drug, the danger can be multiplied by a factor of two, three, four, five ... who knows? Not only can the risk be multiplied, but so can the strength of the toxic effect! There are books which give lists of drugs which interact with a given drug. (An excellent one which I use is Eric Martin’s Hazards of Medications.) Of course, you also should let your doctor know what drugs you are taking. But don’t rely on his knowledge of any dangerous cross-reactions that might occur.

You should be aware of all the drugs for which the side effects are the same as the indications. This isn’t as rare as you might think. For example, if you read the list of indications for Valium, and then read the list of side effects, you’ll find that the lists are more or less interchangeable!

Under the indications you’ll find: anxiety, fatigue, depression, acute agitation, tremors, hallucinosis, skeletal muscle spasms. And under the side effects: anxiety fatigue, depression, acute hyperexcited states, tremors, hallucinations, increased muscle spasticity! I admit I don’t know how to use a drug like this: what am I supposed to do if I prescribe it and the symptoms continue? Stop the drug or double the dose? What strategy lies behind using drugs like this is a mystery to me. Perhaps doctors are playing the placebo effect for all it’s worth? Or maybe they are merely trying to sanctify a patient’s original symptoms by giving a drug that causes them?

Maybe they figure the symptoms will go away when the drug is withdrawn, in the fashion of primitive rites of purification and purging? In any case, Valium is the largest selling drug in history, with prescriptions approaching 60 million a year. Maybe it deserves to be the largest selling drug in history, since, by having identical indications and side effects, it achieves what all systems of science, art, and faith strive for: Unity!

You should not let your doctor prescribe a drug without asking him lots of questions. Ask him what will happen if you don’t take the drug. Ask him what the drug is supposed to do for you and how it’s going to do it. You can also ask him the same questions you will bring to the PDR, questions about side effects and situations when the drug is not advised. Don’t expect too explicit an answer. Most drugs’ mechanisms remain mysteries even to the people who develop them.

Once you’ve exposed yourself to all this information you have to sit down and decide whether or not you want to take the drug. Again, don’t trust your doctor’s decision. Even if you can get him to admit to the side effects, he’ll most likely discount them by saying they occur only in a small percentage of cases. You also might get that impression from the PDR or any other book you consult. Don’t be misled by risks that are expressed in small percentages. If you judge the danger of an iceberg by the size of the part that’s above the water, you’re not going to stay afloat very long. Like a game of Russian Roulette, for the person who gets the loaded chamber, the risk is 100 percent. But unlike that game, for the person taking a drug no chamber is entirely empty. Every drug stresses and hurts your body in some way.

The doctor doesn’t consider this because his philosophy of decision is corrupted. First Do Something. The doctor is going to find himself saying ridiculous things such as, “The Pill is safer than pregnancy.” Because the doctor believes it, he’s dangerous. You have to determine your risk individually. Only you, as you read up on the drug will be able to recognize certain conditions you have or have had which might make the drug even more dangerous. And only you will be able to decide whether or not you want to risk going through one or more of whatever side effects you find there in exchange for the possible benefit the drug may deliver.

Most of all, you should keep in mind that you can refuse to take the drug. It’s your health that’s at stake. If you read things that make you not want to take the drug, first of all confront the doctor with the information. Through cajolery, badgering, or some process of persuasion, you should convince the doctor that you really want to avoid the drug. As in all confrontations with doctors, his reaction may tell you more than you bargained for. You may once and for all recognize that his opinion is no more valid than yours.

On the other hand if you don’t find anything in your research to dissuade you from taking the drug, if the possible benefits appear to outweigh the risks, you’re still not home free. You still have to protect yourself. First of all, make sure you carry out the instructions given by your doctor. If you find his instructions are different from the prescribing information in the PDR you should ask him why. He may have a perfectly good reason: his experience may suggest that the drug works best when taken according to his instructions. Or he may be making a mistake that could decide whether or not the drug will help you or hurt you.

Another reason why you should follow the instructions is that often these will include various tests that should be carried out while you’re taking the drug, tests that are designed to reveal any serious adverse effects before they go too far. These tests are usually found with the prescribing information. Every doctor knows about or has access to this information. Yet few doctors bother to fulfill this responsibility. So it’s up to you to make sure your body’s reaction to the drug is tested.

You should also monitor the drugs effect subjectively. How does the drug make you feel? If you experience any side effects -- no matter how unimportant they may seem at first -- you should call your doctor and let him know. Here is where your homework can really pay off, because your doctor may not be aware of certain side effects that are a signal to stop taking the drug. On the other hand, some side effects are temporary, and if you’ve already made up your mind to take the drug, you may not want to stop as long as the discomfort is temporary. If you’re hit by a serious side effect you should immediately seek medical attention. Don’t wait too long for your doctor to get in touch with you. Go to the hospital emergency room. You’re not only protecting your health, but you’re covering all the bases in the event any legal action ever results from the therapy.

If on the basis of your complaints of side effects, or because you refuse to take a certain drug at all, your doctor prescribes another drug make sure it’s not the same substance with a different brand name. The doctor may himself be ignorant -- or he may be trying to put one over on you.

If you find yourself having to protect your child from the recommendations of school officials and doctors that he or she be “treated” for hyperactivity, your first move should be to prepare yourself to start with simple measures but be willing and able to go on to more drastic maneuvers. The simplest procedure involves a little diplomacy, a little skillful deception of professionals, and perhaps a few changes in how you manage your child. Have a conference with the classroom teacher. Let him or her know that you don’t want your child receiving drugs and that you want to explore alternative ways of dealing with the problem. It helps to try to find out exactly what aspects of your child’s behavior led the teacher to label him or her “hyperactive.” You can ask for suggestions on how to change your management of the child at home in order to better prepare for the classroom. Here is where you’ve got to be ready to lie a little. You should give the teacher’s suggestions honest consideration. If they sound reasonable, you should consider changes. But if they don’t seem like things you could do without sacrificing family habits and practices that you consider important, you should discard them. You don’t have to tell the teacher that. You can lie and rave about how your child has changed so positively since you tried his or her suggestions. Chances are that will end the problem, since the teacher’s expectations of the child’s behavior determine the teacher’s perception of it, and may even determine the child’s actual behavior in accord with the self-fulfilling prophecy.

The next step is to have a conference with the teacher to explore possible ways in which the classroom management could be modified. You’re going to meet resistance here, because the philosophy of most schools -- despite all the lip service to individual attention and consideration is that the student has to fit the mold cast by the school.

At this point, if you’re not getting anywhere, you might want to consult with people who have wisdom and whom you trust. These can be special education experts or grandmothers.

Consider a change in your child’s classroom. Before you allow a doctor to tamper with your child’s chemistry, you should realize that perhaps it’s the “chemistry” between child and teacher, or child and classmates, that is really at fault. A move to another school could be the answer for the same reasons.

The most drastic solution is to remove your child from school altogether and have him or her tutored at home, if state law permits. If your child really does seem to have a behavior problem that goes beyond the normal range of childhood intractability, you might want to consider a solution many families have successfully tried: the Feingold diet. Dr. Ben Feingold is the chief of the Kaiser Foundation’s allergy clinics. His diet eliminates food coloring and other artificial additives, and certain natural foods -- on the assumption that certain substances in these foods stimulate a child who is especially susceptible. The concept is sound -- although vigorously attacked by advocates of drug therapy.

You can’t rely on your doctor to aid you in your struggle to keep a child diagnosed as hyperactive off drugs. the doctor may play along with you and say, “well, let’s talk to the teacher and try to change the environment!” but in ninety-nine out of one hundred cases the doctor will return to the drugs. The same is likely to happen if you try to get your doctor to treat you without drugs in any other situation. Doctors simply don’t believe in non-drug therapies.

For one thing, very few of them know how to treat without drugs. So they don’t believe in it. If you have high blood pressure and your doctor wants to put you on drugs but you don’t want to take them, he might try by having you lose weight and by exercising. But he’ll make only a half-hearted attempt because in the first place he doesn’t believe in it and in the second place doctors don’t know enough about nutrition and lifestyle to really show a patient how to make a useful change. Maybe one doctor in fifty knows.

From the standpoint of the patient, of course, it makes perfectly good sense to want to be treated without drugs. But from the standpoint of the doctor, it’s totally outrageous. Again, the ethics of the doctor and the ethics of the patient conflict. That shouldn’t come as too big a surprise. Medical ethics are usually the opposite of traditional ethics. For instance, if you’re in the operating room and somebody finds a sponge in the belly left from a previous operation, traditional ethics would make sure that somebody in the family found out about it.

Medical ethics tells you to keep your mouth shut about it. The surgeon will say, “I don’t want anybody to know about this,” and if the nurse tells the family, she’ll be out of a job. Medical ethics also waffles on the point of stopping at the scene of an accident. If a doctor passes the scene of an accident traditional ethics tells him to stop and try to save a life. Medical ethics tells him first to find out if the state has a Good Samaritan law.

The ethics of Modern Medicine are different from traditional religious ethics as well as from traditional social ethics. Religious systems that are in conflict generally try to dissubstantiate the ethics and beliefs of the systems they are at odds with. In the Church of Modern Medicine, the doctor who treats without drugs is regarded as a heretic because he or she appears to have rejected the sacrament of medication. Nondrug healers are regarded as belonging to a different religious system and are thought of as quacks, nuts, or fadists. The religious restrictions are so stringent that doctors are discouraged from even associating with the infidels. The AMA code of ethics says that M.D.s are not supposed to associate with cultists. They’re not to talk to them, not to have them in their homes! If you keep in mind that this is the type of person that’s advising you to take this or that dangerous substance into your body, you should have no problem mustering the motivation to protect yourself.

Ritual Mutilations: Chapter 3