Cartel Medicine

On Predation, Creative Diagnosis, and Male Practice by Robert Mendelsohn M.D.

Modern Medicine is predatory.

Modern Medicine is Cartel Medicine.

Cartel Medicine is predatory.

It needs to feast. Regularly.

When it is full, it wants more.

It will not send back anything, but it does have a preference.

It prefers Women.

As clearly demonstrated in The Hysterectomy Series.

Robert Mendelson published a whole book on the subject in 1981.

I just got my hands on an old hardback copy.

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Male Practice: How Doctors Manipulate Women

by Robert S. Mendelsohn

Chapter 2

"It's a Good Thing You Came to See Me When You Did.''

Women are the victims of so much dangerous and unnecessary medical and surgical intervention that watching what happens to them at the hands of their doctors makes me sick. Much of the time it also makes them sick.

Don't misunderstand me. I don't believe that very much of this medical abuse occurs because doctors are consciously greedy, or even inept. It happens because doctors haven't been taught to keep you healthy. They've been taught to believe that almost everyone is sick. Since your doctor is the sole arbiter of your physical condition, and because he expects you to be unhealthy, it is easy for him to find symptoms that will convince him, and help him convince you, that you really are sick. Keep that in mind when your doctor tells you that it's a good thing you came to see him when you did. Is it a good thing for you or a good thing for him?

Those who face death sometimes view life with a clarity not given to those of us who have not lived out our years. In 1980, as he lay dying of cancer, an eminent seventy-one-year-old internist, Dr. Frederick Stenn, made his final assessment of Modern Medicine in a letter to the New England Medical Journal.

It was published under the title, "Thoughts of a Dying Physician." This is what he said:

Most physicians have lost the pearl that was once an intimate part of medicine-humanism. Machinery, efficiency, precision have driven from the heart warmth, compassion, sympathy and concern for the individual. Medicine is now an icy science. Its charm belongs to another age. The dying man can get little comfort from the mechanical doctor.

Dr. Stenn, whom I knew as a faculty member at the Northwestern University Medical School, had practiced in Chicago for forty-six years. He was recalling the era during which our grandparents and great-grandparents were growing up and the doctor's job was to make you well, not to make you sick. Medical practice was a labor-intensive profession, and most doctors didn't know a driver from a divot because they were on call twenty-four hours a day, seven days a week. The only time they saw a golf course was when one of their patients had a heart attack on the green.

Half a century ago doctors expected to make house calls when their patients were sick. They didn't tell mothers to bring their feverish babies to the office in order to save themselves a trip. They waited in the parlor for hours in order to be on hand for the blessed event, with no thought of inducing labor so that they could get home on time for dinner. They weren't there to intervene in the natural process of birth and to deliver the baby, but to help the mother deliver it in those rare instances when something went wrong.

In those days doctors knew their patients as human beings, not as scribbles on a chart. They knew whole families and even family trees. They didn't walk into the examining room on your sixth or eighth or tenth visit, pick up your file, and muse absentmindedly, "Let's see; I believe you've been here before."

Many doctors didn't even have an examining room. Their patients were greeted in a comfortable, reassuring office, not herded into cubicles to await their fate like so many defenseless sheep.

The family physician was willing to spend time with those who sought his help, listening to their woes, getting to know them, and providing comfort as well as advice. He cured a lot of ailments with doses of sympathy, kindness, reassurance, and plain old-fashioned common sense.

Doctors were trained-or taught themselves-to use their senses, their judgment, and even their intuition to diagnose their patients' ills. Using these priceless skills, most of them could make a clinical diagnosis that was more accurate than those arrived at today through batteries of often questionable computerized laboratory tests. Natural remedies weren't the butt of medical humor; they still had credibility, and many of them really worked! I guess the only survivor can be found in the Jewish branch of Modern Medicine-chicken soup!

Doctors were not yet the captives of the drug company detail men, so the toxic chemicals now sold by the ton were rarely used. Tests had not been substituted for wisdom, knowledge, and judgment, and they were seldom administered. Surgery, recognized as a dangerous treatment alternative, was something to be feared and avoided-the physician's last resort. X-rays weren't spreading cancer throughout the universe, and if you were sent to a hospital, you were probably on the verge of death.

One has to wonder why Modern Medicine is so proud that subtly, over half a century or so, highly structured medical education, technology, and specialty practice have changed all that. To the joy of doctors, who are now paid more for working less, and the sorrow of everyone else, medical practice has deliberately been dehumanized. It is no longer labor­ intensive but expensively capital-intensive. The patient has become an object on the assembly line-or disassembly line-of a huge, overstaffed, well-oiled, impersonal machine.

More often than not, it is women who get caught in its cogs.

Unfortunately for its victims, the machine needs raw mate­ rial to keep running. Modern Medicine is as concerned about that as General Motors, because when the assembly line isn't running it isn't paying for itself. The need to keep beds full and machines busy is at the top of the priority list of hospital administrators, well ahead of sanitation, safety, and medical care. At a retreat for the directors of a suburban hospital an executive conducted a seminar last year on "creative hospital marketing." He called it "a must in the highly competitive_ environment of health care institutions." It may not square with your perception of hospitals as caring nonprofit institutions, but he was simply pointing up the fact that the nation has too many hospitals and too many beds. It takes a lot of "creative marketing" to keep bodies in the beds.

That wouldn't be threatening if it were simply a matter of marketing strategies that kept one hospital filled at the expense of the others. Unfortunately, in most urban areas, there are also too many doctors. A piece of that creative marketing is an abundance of creative diagnosis by staff physicians to make sure that there are enough hospital patients to go around.

Creative diagnosis is a euphemism I coined to describe the indefensible behavior of doctors who keep themselves busy by finding disease where none exists. They do it by redefining the norms of health and sickness and employing other deceptions to create an artificial need for their services and those of their wondrous machines. Their eager allies in the medical-industrial complex are the drug companies, the equipment manufacturers, the testing laboratories, and even those friendly folks who manufacture infant formula and canned baby food.

I remember being amused years ago by pharmaceutical ads that defined constipation so broadly that unless you ate and slept in the bathroom you fell into the "irregular" class. The ads usually portrayed a middle-aged woman in a gingham housedress with a pained expression on her face. One hand was pressed against her hunched-over back, while the other pushed a vacuum cleaner or stirred a pot on the stove. Over the picture was a blazing caption, "CONSTIPATED?" that left no doubt about what the poor woman's problem was supposed to be.

I guess I was still too close to my own medical school brainwashing to be offended by the ad, but in retrospect I'm ashamed that I found it amusing. God knows how many millions of unconstipated women believed the ad's message about regularity and became instant candidates for the drug company's pills. Although the medicine itself was not particularly toxic, it was also worthless, and the means used to peddle it was a classic example of drug industry avarice and cynicism that has become commonplace today.

Almost no one seems to know it, because they've been educated by the ads but there is no arbitrary standard for regularity. Unless you have physical symptoms of constipation, and you'll know if you do, it makes no difference whether you have a bowel movement three times a day or once a week. The damage is done when you are told you should have one daily, believe it, and take medications because you don't. You weren't constipated before you took the medicine, but once you're hooked on it you can be almost certain that it will so upset your normal rhythm that real constipation will result. That, of course, is precisely what the drug manufacturer wanted to achieve.

That's one example of creative diagnosis. Observe that the unsuspecting victims are persuaded that there's something wrong with them so they’ll swallow a "cure" that will make them sick!

This is not an isolated example. Let me describe another variation of the same technique. One of the indications for the prescription of Valium-the most frequently used and abused drug in the country-is anxiety. Millions of normally anxious women are hooked on it by their doctors every year. It can be sold only by prescription, so while its sale enriches Roche Laboratories, it also enriches tens of thousands of doctors and pharmacists as well.

What does Valium do for the women who take it to relieve their anxiety? Well, the first of Valium's side effects is-guess what?-anxiety!  The drug your doctor gives you to relieve anxiety also produces it, along with a generous helping of new symptoms as well. Take Valium to relieve anxiety and you may be rewarded with more anxiety, plus the potential side effects of confusion, constipation, depression, dizziness, drowsiness, fatigue, headache, incoordination, insomnia, jaundice, joint pain, libido changes, nausea, rage, rash, slurred speech, tremor, double vision, vision blurring, urinary incontinence, urine retention, and others.

The one that surprises me least is rage. Every woman who is. put on Valium to relieve the normal stresses of everyday life should feel rage when she experiences some of the devastating side effects-or the addiction-that her doctor has wished on her.

Bendectin is another case in point. This toxic drug is pre­ scribed for the relief of nausea and vomiting during pregnancy, although there is no solid scientific basis to believe that it works. Since nausea and vomiting are two of its side effects, it would be a miracle if it did work. But even more alarming is the fact that any doctor would ask a pregnant woman to risk diarrhea, dizziness, headache, irritability, rash, stomach pain, painful urination, vision blurring, and other more devastating side effects that I'll discuss later, in order to find out whether or not Bendectin works.

This sort of pharmaceutical creativity couldn't succeed and prosper, of course, if Modern Medicine decided to stamp it out. Prescription drug manufacturers couldn't sell their witches' brews if there weren't willing doctors to ladle them out. But don't expect the drug companies to go broke, because compared to doctors, the crime syndicate's pushers are pikers where drug abuse is concerned. Given the drug manufacturers' propensity to use the total populace as human guinea pigs, turning millions of circulatory systems into miniature Love Canals¹, doctors should be their leading adversaries. Obviously, they're not. Instead, Modern Medicine and the pharmaceutical industry are co-conspirators in advocating and dispensing the $19 billion worth of drugs-many of them dangerous, untested, and worthless-that are sold every year.

Meanwhile, in order to keep an oversupply of doctors busy, Modern Medicine has concocted no end of business development strategies of its own. Doctors have displayed incredible ingenuity in the use of creative diagnosis to manufacture non­existent disorders simply by altering the previous norms. This strategy enables them to determine that normal physical characteristics are abnormal, minor ailments are major ones, inconsequential variations from questionable tests are indications of disaster, and small departures from standardized measurements are symptoms of life-threatening disease.

If you are like most Americans, you probably like to eat. It's a propensity we've developed because, unlike much of the world, there's a lot of rich food on our tables and most of it tastes pretty good. If you enjoy too much food too often, you inevitably become a little fat, and there's nothing really wrong with that. You may not even feel guilty about your weight if your husband diagnoses your condition as "pleasingly plump," hoping that you'll consider him "muscular," since he's no string bean, himself.

So you're both comfortable, well fed, and happy, right? Your life isn't upset by the agonies of rigorous self-denial, and the excess of adipose tissue is really nothing to worry about. Now, present your ample, healthy body to your doctor for a routine physical examination and see what happens: you're in trouble the minute you step on his scale! He peeks over your shoulder, compares your 150 pounds with the averages on his worthless chart, assumes a mournful expression, and shakes his head in dismay.

You walked into his office healthy, happy, and pleasingly plump. You leave it miserable, dejected, and disgustingly obese. You can consider yourself lucky if you don't also have a worthless and possibly dangerous prescription in your hand.

Without unduly laboring the point, let me suggest that almost endless opportunities for creative diagnosis are at your physician's disposal. Hypertension didn't attract much attention from doctors until the drug companies began making pills that gave Modern Medicine a profitable opportunity to intervene.

Hypertension is now interpreted by some screeners to include hordes of people who would have been considered healthy a few years ago. This justifies the administration of powerful, toxic medications with so many horrendous side effects that they make many of the dubiously hypertensive patients really sick. Many of them produce loss of libido and impotence and are, I suspect, responsible for more sexual dysfunction in the United States than psychological hang-ups.

If the blood pressure cuff doesn't give your doctor a reading. high enough to declare that you're mildly hypertensive, he needn't despair. There's a good chance that your blood pressure will be low enough so that he can find you a victim of hypotension, a non-disease that was discredited nearly thirty years ago-long enough so that it can now be credibly revived.

Forget that studies have shown that people with low blood pressure usually live longer. If your doctor says hypotension is a disease, it is a disease, and he'll probably treat it with shots of vitamin B-12. Even if hypotension were a disease, the shots wouldn't do any good.

You can also expect your doctor to cast a covetous eye on your kids. Educators who don't like unruly pupils have, with the willing help of doctors and psychologists, broadened the definition of hyperactivity to include a substantial percentage of those in the country who are under age twenty-one. As a consequence, for the comfort and convenience of teachers and parents, millions of normally lively kids have been drugged with Ritalin and turned into virtual zombies by its effects.

The time of life when doctors consider it safe to have children has been narrowed to the point where having babies is called unsafe at almost any age. Get pregnant when your doctor thinks you are too old or too young and he’ll expose you to his whole bag of obstetrical tricks. Among them will be amniocentesis, a dangerous procedure that should be used sparingly, if at all, to determine abnormality of the fetus. Its staunchest advocates now recommend amniocentesis for all women over thirty. The indications for delivery by Caesarean section have been expanded so creatively that the section rate in some hospitals is now over 50 percent. Most of the indications are the result of analgesia, anesthesia, induced labor, and other intervention by the obstetrician in the natural process of birth.

All of this creative diagnosis is lucrative, of course. It keeps the drug factories humming and the hospital beds filled. It even makes the morticians break out in smiles. And it also makes doctors look good. The most striking example of this is the fact that a single pimple today is called acne, greatly enhancing the stature of dermatologists, who can now claim an 80 percent cure. That's almost as good as the concerned teenager could have obtained by staying away from the doctor and washing his or her face.

My friend John McKnight, a professor of urban studies at Northwestern University, looks at all of this with a probing and critical eye. He teaches that in the name of curing, caring, helping, and loving, increasing numbers of healthy people are being defined as sick. But behind this mask of service, he notes, lies the reality of servicers who need income-doctors, nurses, hospitals, drug manufacturers, pharmacists, and many others. Thus, "the client is less a person in need than a person who is needed," says John.

But what a price Americans pay to satisfy Modern Medicine's need!

A final warning: if your doctor is an expert at creative diagnosis, don't, for heaven's sake, ever tell him that you have a headache. Unless you have other symptoms that concern you, remind yourself that seven out of ten Americans take an analgesic to relieve a headache at least once a month. Keep your headache to yourself, because if you don't, you'll open a Pandora's Box of possible indications of serious disease. They'll be enough to keep your doctor, the laboratories, and maybe even the hospital, busy for weeks or months, subjecting you to a lengthy roster of expensive tests.

Your doctor knows that unless your headache is accompanied by a combination of additional symptoms it is probably psychogenic-a tension headache-and the best advice he can give you is to relax, take an aspirin, and go to bed. But if he's truly creative, and d mite unconscionable, your headache is the only excuse he needs to begin a search for an endless array of exciting diseases. They range from the innocuous common cold to cancer of the brain, but a host of others fall in between. Unless you crave attention, take a small gamble and assume that your headache isn't the result of chicken pox, diphtheria, scarlet fever, mumps, mononucleosis, influenza, pneumonia, hepatitis, sinusitis, tonsillitis, encephalitis, typhoid fever, brucellosis, dengue, Rocky Mountain spotted fever, leptospirosis, smallpox, yellow fever, tularemia, anthrax, malaria, meningitis, allergic rhinitis, gastroenteritis, polyps, hypoglycemia, hyperthyroidism, or cervical syndrome.

Headache is a symptom of all of these ailments, but chances are that you don't have any of them unless other symptoms are present-not even the one I forgot to mention, the plague!

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1. "Love Canal" is being used metaphorically to refer to a site of toxic waste and pollution. Love Canal was a neighborhood in Niagara Falls, New York, that became infamous in the late 1970s due to the discovery of 21,000 tons of toxic waste buried beneath it. This led to severe environmental problems and health issues for its residents.