Diagnosis
On Minting Fear and New Business
I don't advise anyone who has no symptoms to go to the doctor for a physical examination. For people with symptoms, it's not such a good idea, either.
My favorite study is one in which 197 out of 200 people were "cured" of their abnormalities simply by repeating their lab tests!
Most doctors are unable to recognize wellness, simply because they're not trained in wellness but in disease.
Sometimes a doctor will have you placed on a cart to be wheeled into the x-ray room. This is a typical ploy to deliberately humiliate, depersonalize and demean perfectly capable men and women and transform them to docile, cooperative, accepting, manageable patients.
Doctors in general should be treated with about the same degree of trust as used car salesmen. [Unbekoming: Unfortunately Robert here slanders used car salesmen.]
– Dr Robert Mendelsohn
Stay out of hospitals.
Actually, stay out of Cartel Medicine’s system altogether, if you can help it.
The system weaponizes our “need to know.” It does that through Diagnosis.
If what is required at the bottom of the river is totalitarian monopolistic profit, then what is at the top of the river must be in service of that.
Everything needs to flow in that direction.
"When illness is blamed on bacteria, so-called "viruses" and genes, not only are enormous profits generated for the pharmaceutical industry selling their antibiotics, antivirals, vaccines and the myriad of other related drugs, but it also protects the other hand of the same industry that sells herbicides, pesticides, chemical fertilizers, preservatives, etc... as it obscures one of the fundamental causes of illness...our nutrient-deficient and poison laden foods." - T.C. Fry , Founder of Life Science Institute
Diagnosis is new business.
It’s a form of minting.
It creates something out of nothing.
Diagnosis is near the very top of the river.
The problem is, it’s just a machine. And it has no off-switch. - CJ Hopkins
Confessions of a Medical Heretic (1979)
By Dr Robert Mendelsohn
Chapter 1 Dangerous Diagnosis
I don't advise anyone who has no symptoms to go to the doctor for a physical examination. For people with symptoms, it's not such a good idea, either. The entire diagnostic procedure -- from the moment you enter the office to the moment you leave clutching a prescription or a referral appointment -- is a seldom useful ritual.
The mere act of delivering yourself to the priestly doctor and submitting to his wishes presumably bestows the benefit. The feeling is that the more exams you have, and the more thorough the exams, the better off you'll be.
All of which is nonsense. You should approach the diagnostic procedure with suspicion rather than confidence. You should be aware of the dangers, and that even the simplest, seemingly innocuous elements can be a threat to your health or well-being.
The diagnostic tools themselves are dangerous. The stethoscope, or example, is nothing but the priestly doctor's religious badge. As a tool, it does more harm than good. There's no question that there's a high degree of contagion from the use of stethoscopes from patient to patient. And there's almost no form of serious disease that cannot be suspected or diagnosed without the stethoscope. In congenital heart disease where the baby is blue, it's obvious because the baby is blue. In other forms of heart disease, the diagnosis can be made by feeling the various pulses around the body. In coarctation of the aorta, for example, there's a deficiency of the pulse rate in the femoral arteries in the groin, You don't need a stethoscope to make that diagnosis.
The only value of the stethoscope over the naked ear applied to the chest is in the convenience and modesty of the physician. There's nothing that he can hear with the stethoscope that he cannot hear with his ear against the person's chest. As a matter of fact, I know some doctors who now put the stethoscope around their neck and don't put the ear pieces in their ears as they apply the bell to the patient's chest! At one time I used to think that was really terrible. Not any more.
The doctor probably realizes, consciously or otherwise that the patient needs the stethoscopic examination because it's part of the sacred ritual rather than because it makes any sense or does any good.
And it can do harm, especially in the case of children. Suppose a mother brings her daughter in for her annual exam. The child has no symptoms of illness whatsoever. But the doctor uses the stethoscope and discovers a functional heart murmur -- a harmless heart sound found in at least one third of all children at one time or another. At that point the doctor has to make a decision whether or not to tell the mother. Now at one time doctors used to keep this information to themselves. They might put it in the chart in symbolic form so that nobody but a doctor could read it. Recently doctors have been taught to share this information with the parents either because of their belief in the patient's right to know or -- more likely -- because they're afraid another doctor will find it and tell them first.
So the doctor tells the mother. And whether or not he reassures the family that the murmur is innocent, both mother and daughter may suspect -- perhaps for the rest of their lives -- that something really is wrong! Mother may then begin a trek to pediatric cardiologists who will take repeated EKGs, chest x-rays, or even perform cardiac catheterizations to help the mother "get to the bottom of all this." Studies have shown that families of children with heart murmurs tend to do two things: they restrict their child's activity and do not allow them to play in sports, and they encourage them to eat more. Naturally these are the worst things they can do! They literally make cardiac cripples out of their children.
Though it's a lot more impressive than the stethoscope, the electrocardiogram (EKG) is little more than an expensive electronic toy for the physician. More than twenty years ago a survey revealed that the reports of expert EKG interpreters varied by twenty percent among individuals and by another twenty percent when the same individuals re-read the same tracing at another time. Time of day, recent activity, and many other factors besides the condition of one's heart can affect the readings. In one test the EKG delivered a positive finding in only twenty-five percent of cases of proven myocardial infarction, an equivocal finding in half, and a totally negative finding in the rest. And in another test, more than half of the readings taken of healthy people were grossly abnormal.
Yet physicians and other medical personnel continue to increase rather than decrease their reliance on the EKG as a detector of cardiac problems. I have a recurring fantasy of a person lying in an intensive coronary care unit after suffering a heart attack. He is perfectly comfortable -- until he's approached by a nurse with a hypodermic syringe. She explains that his EKG monitor has shown an irregularity that demands immediate treatment. Of course, she is not aware of the studies that show the high degree of error in electronic monitoring equipment, or the studies that show the not infrequent leakage of electricity from one monitor to another in the same ward. My fantasy patient protests and pleads with the nurse: "Please, nurse, feel my pulse. It's absolutely regular!" The nurse's answer is that there's no point in feeling his pulse. You can't argue with the machine. So she immediately plunges the needle in his arm. You can guess at the outcome.
My fantasy is not so fantastic as you might think. There are electronic monitors in "advanced" coronary units that are equipped to electrically "correct" the heartbeat of patients who, the machine decides, need a jolt. I have heard of cases where the machine decided the person needed a jolt when, in fact, he didn't.
While the electroencephalogam (EEG) is an excellent instrument for the diagnosis of certain kinds of convulsive disorders and the diagnosis and localization of brain tumors, not many people are aware of its limitations. About twenty percent of people with clinically established convulsive disorders never have an abnormal EEG. Yet fifteen to twenty percent of perfectly normal people have abnormal EEGs! To demonstrate the questionable reliability of the EEG as a measure of brain activity, one researcher connected one in the standard manner to a mannequin's head filled with lime jello and got a reading indicating "life."
Despite the obvious possibilities for error the EEG is used as the primary diagnostic tool in determining whether or not a child truly has organic learning difficulties, minimal brain damage, hyperactivity, or any of the twenty or thirty other names assigned to this ill-defined syndrome. Despite the fact that every pediatric neurologist in need of publishing a paper has reported some significance of this spike or that dip, there has been a total lack of agreement on a valid correlation between an EEG reading and a child's behavior.
Nevertheless, this lack of scientific validation has in no way interfered with the proliferation of EEG machines and the skyrocketing numbers of EEGs performed. I often recommend to students in search of a career the entire field of electroencephalography since it, like everything else connected with learning disabilities, is a growth industry. Today educators, physicians, and parents have consciously or otherwise joined in a conspiracy to medicalize almost all behavior problems.
What happens is that a child gets sent home with a note asking for a conference. At the conference, the parents are told the child might have an organic brain problem, might be hyperactive, might be minimally brain damaged. Parents and child are hustled off to the doctor for an EEG. Then, on the basis of the EEG -- which may or may not be accurate -- the child is drugged into fitting the behavior mold that best suits the teacher.
By far, the most pervasive and dangerous diagnostic tool in the doctor's office is the x-ray machine. Unfortunately, because of its religious significance, the x-ray machine will be the hardest for doctors to give up. They know that people are awed by the doctor's power to see right through their flesh, to gaze firsthand at what is afflicting them, to see where they cannot. Doctors literally got drunk on this power and started using x-rays on everything from acne to settling the mysteries of the developing fetus. Many obstetricians still insist on x-rays if they don't quite trust their skill in determining fetal position by palpation -- despite the fact that childhood lukemia has a well-documented link with prenatal radiation exposure.
Thyroid lesions, many of them cancerous, are now turning up by the thousands in people who were exposed to head, neck and upper chest radiation twenty to thirty years ago. Thyroid cancer can develop after an amount of radiation that is less than that produced bv ten bite-wing dental x- rays. Scientist testifying before Congess have emphasized the hazards of low level radiation to both the present generaton and to future generations in the form of genetic damage. They have implicated x-rays in the development of diabetes, cardiovascular disease, stroke, high blood pressure, and cataracts -- all associated with aging. Other studies have matched radiation to cancer, blood disorders, and tumors of the central nervous system. Conservative estimates peg the number of deaths each year directly attributable to medical and dental radiation at 4000.
As far as I'm concerned, these deaths are unnecessary, as is the host of other afflictions attributed to radiation. A quarter century ago I was taught in medical school that x-rays of [28] the breast were practically worthless. A recent survey showed that things haven't changed very much.
Physicians supposedly trained to interpret mammograms were no more accurate than untrained physicians in spotting breast cancer on mammograms. A survey more than thirty years ago showed that as many as twenty-four percent of radiologists differed with each other interpreting the same chest film, even in cases of extensive disease. Thirty-one percent of them even disagreed with themselves when re-reading the same films! Another study in l955 showed that thirty-two percent of chest x-rays showing definite abnormalities in the lungs were misdiagnosed as negative. In 1959, thirty percent of the experts disageed with other experts on radiographic readings, and twenty percent disagreed with themselves when rereading the same films! A 1970 Harvard study showed that the going rate of disagreement among radiologists was still at least twenty percent.
Yet x-rays are still sacred in most doctors' and dentists' offices. Hundreds of thousands of women are still lining up every year for breast x-rays, despite the well published scientific evidence that the mammography itself will cause more breast cancer than it will detect! The ritual of the annual x-ray, the pre-employment x-ray, the school entrance x-ray, and the health fair x-ray continue. I hear about and get letters from people whose doctors pronounce them in perfect health, but still insist on a chest x-ray. One man told me about going to the hospital for a hernia operation, where he was given six chest x-rays. From the radiologists conversations, he got the distinct impression they were experimenting with the exposure levels. This same man was given thirty x- rays at a local dental school where he went to get a crown replaced.
Many doctors defend their use of x-rays on the grounds that the patients demand or expect x-rays. To that excuse, I reply that if people are addicted to x-rays, the greatest service doctors might perform would be to rig up machines that look and sound like real x-ray machines. A tremendous amount of disease could be avoided.
Lab tests are another part of the diagnostic procedure that do more harm than good. Medical testing laboratories are scandalously inaccurate. In 1975, the Center for Disease Control (CDC) reported that its surveys of labs across the country demonstrated that ten to forty percent of their work in bacteriology testing was unsatisfactory, thirty to fifty percent failed various simple clinical chemistry tests, twelve to eighteen percent flubbed blood grouping and typing and twenty to thirty percent botched hemoglobin and serum electrolyte tests. Over all, erroneous results were obtained in more than a quarter of all the tests. In another nationwide survey fifty percent of the "high standard" labs licensed for Medicare work failed to pass. A large scale retesting of 25,000 analyses made by 225 New Jersey labs revealed that only twenty percent of them produced acceptable results more than ninety percent of the time. Only half passed the test seventy-five percent of the time.
To get some idea of what people are really getting for $12 billion worth of lab tests each year, thirty-one percent of a group of labs tested by the CDC could not identify sickle cell anemia. Another test group incorrectly identified infectious mononucleosis at least one third of the time. From ten to twenty percent of the tested groups incorrectly identified specimens as indicating leukemia. And from five to twelve percent could be counted on to find something wrong with specimens which were healthy! My favorite study is one in which 197 out of 200 people were "cured" of their abnormalities simply by repeating their lab tests!
If you think these tests are shocking keep in mind that the Center for Disease Control monitors and regulates fewer than ten percent of the country's labs. So these tests indicate the best work of the best labs. With the rest, you pay your money and you take your chances. And you will pay more and more, because doctors practicing "just in case medicine" are ordering more and more laboratory tests.
As long as these tests have such an immense possibility for inaccuracy, the only way to look at them is as sacred oracles or fortune telling rituals: they depend on the whims of the deities and the skill of the magician-priest. Even if the deities are keeping up their end of the bargain and your tests results are miraculously correct, there is still the danger that the doctor [31] will misinterpret them. One woman wrote me that at her last routine examination, a test revealed blood in her stool. Her doctor subjected her to every possible test, including barium x-rays, all of which proved negative. The doctor did not give up. Though the woman was in real pain because of the tests, he recommended further testing. Six months later, his diagnosis was announced to a much weakened woman: she had too much acid in her stomach!
Lab tests and diagnostic machines wouldn't be so dangerous if doctors weren't addicted to the quantitative information these tools provide. Since numbers and statistics are Modern Medicine's language of prayer, quantitative information is considered sacred, the word of God, indeed, the last word in a diagnosis. Whether the tools are simple, like thermometers, scales, or calibrated infant bottles, or complicated like x-ray machines, EKGs, EEGs, and lab tests, people and doctors are dazzled into crowding out of the process their own common sense and the qualitative judgment of doctors who are real diagnostic artists.
Scales cause all kinds of trouble in pediatrics and obstetrics. The pediatrician weighs the baby and gets all upset if the baby doesn't gain a certain amount of weight. Again, he's substituting a quantitative evaluation for a qualitative one. The important questions are: what does the baby look like? What's his behavior? How does he look at you? What are his movements like? How's his nervous system functioning? Rather than relying on these observations, the doctor goes by the numbers. Sometimes a breastfed baby won't gain as fast as the doctor mistakenly thinks it should. So he puts the baby on formula -- to the detriment of both mother and baby.
Pregnant women also should pay no attention to the scale. There is no correct amount of weight for any mother to gain. Again, the important evaluations are qualitative rather than quantitative. She should be eating the right food, not merely "correct quantities" of any food. If she's careful about what she eats, how much she eats will take care of itself. She'll rightly be able to ignore the scale.
Calibrated infant formula bottles are another menace. The pediatrician tells the mother to make sure the baby gets "x" amount at every feeding, and, by golly, she's determined to stick to that goal. So at every feeding she cajoles, threatens, and in some way gets that exact amount out of the bottle and into the baby. Most of the time the baby will throw most of it back up, anyway. The net result is a lot of bad feelings between mother and baby -- a lot of anxiety and tension where there should be love and enjoyment. Not to mention a good chance of obesity in later life.
Temperature taking is virtually useless, too. The first question a doctor asks a mother over the telephone when she calls to complain about an illness is what is the child's temperature. This question has no meaning because there are innocuous diseases that carry very high fevers.
Roseola, for example, is a common disease of infancy, absolutely harmless; yet it frequently carries a temperature of 104 or 105. On the other hand, there are life-threatening diseases, such as tuberculous meningitis and others, that carry no fever at all or even a subnormal temperature. The doctor should be asking for qualitative information, such as how the child is feeling and what the mother has noticed in his behavior. The reliance on numbers is simply to validate the whole process for religious purposes. Because it is merely a useless ritual, mothers should answer the physician's question about temperature by saying, "I don't know; I haven't taken it." Or, "I don't have a thermometer in the house." Of course, the doctor then thinks they're kooks or health nuts or mentally deficient, so I tell mothers instead just to pick out a fictitious number. If you really want to command the doctors attention, pick out a high number, 104 or anything within the realm of credibility. Then if the doctor comes over and finds the temperature is normal, right on the button 98.6, you can say, "Oh, it was so much higher before!" If the doctor doesn't believe you, the only thing he can accuse you of is misreading the thermometer. You can even volunteer that remark by saying, "I might have misread the thermometer!" Then, once you get by the sacred quantitative barrier of the thermometer, you and the doctor can move on to more important things.
One of the common dangers of going in for an exam is that you'll be used for purposes other than your own. Years ago, after becoming [34] director of an outpatient clinic I found out that one of the routine questions asked of mothers was "Is your child toilet trained?" Every boy who was not toilet trained by the age of four was separated out and referred for a urological workup, which included, among other things, a cystoscopy. All these four-year-old kids were being cystoscoped! I immediately eliminated the question about toilet training. It didn't take long before I got a call from the chairman of the urology department, who happened to be a friend of mine. He was very angry. First he told me I had done the wrong thing eliminating the question and, thereby, the urological workup. He said it was important to do this kind of examination in order to find the rare cases in which there might be something organically wrong. Well, of course that was nonsense, because all the rare cases can be identified by measures that are far less dangerous than a cystoscopy.
Then he told me more about what was going on. The real problem was that I was destroying his residency program because in order for a residency to be approved by the accrediting authorities, the residents have to perform a certain number of cystoscopies every year. In this case it was around 150. I was taking away his source of cystoscopies, and I got into trouble over it.
This is true for other specialties, too. In order to have a cardiology residency approved, the resident must perform a minimum-number -- 150, 200, 500, whatever it is – of catheterizations every year. There is a great tendency to take people off the street and identify them as needing a cardiac catheterization!
Because of the increased danger of being used for the doctor's own purposes, it's best to regard any doctor who does research or teaching as potentially harmful. As far as I'm concerned, a doctor treating a person should be a treating doctor. Leave the research and teaching to someone who is identified as a researcher or a teacher. When a doctor mixes roles he has to be extremely careful. And so does his patient.
Naturally, the most sinister and dangerous ulterior purpose you expose yourself to is the doctor's need to recruit patients. Without the ritual of the checkup, internists would have trouble paying the office rent. How else can the doctor ensure a steady supply of sacrificial victims for the Church's other sacraments without the examination? The Gospel said many were called and few were chosen, but the Church of Modern Medicine has gone that one better: All are called and most are chosen.
Annual physicals were once recommended for such high-risk groups as industrial workers and prostitutes. However, today many doctors recommend that everybody have at least one a year. In the last fifty years of regular checkups, however, not a shred of evidence has emerged to show that those who faithfully submit live any longer or are any healthier than those who [36] avoid doctors. Because of the definite risks involved, I'd say those that stay away are better off.
In no uncertain terms, you're at the doctor's mercy. The fact that you're there in the first place means you don't know how you are or what is going on with you and that you want the doctor to tell you. So you're ready to give up a precious liberty, that of self identification. If he says you're sick, you're sick. If he says you're well, you're well. The doctor sets the limits of what's normal and abnormal, what's good and what's bad.
If you could rely on the doctor's conception of normal and abnormal, sick and well, submitting to him would be scary enough. But you can't rely on it. Most doctors are unable to recognize wellness, simply because they're not trained in wellness but in disease. Because they have sharper eyes for signs of disease than for signs of health, and because they have no conception of the relative importance of signs of both in the same person, they're more apt to pronounce you sick than well.
As long as the doctor is in control, he can define or manipulate the limits of health and disease any way he chooses, narrowly or broadly -- depending on his intentions and interests. In this way he can manipulate the amount of disease. For example, he can define high blood pressure as anything above or within the high range of normal. And he can treat it accordingly -- often with very powerful drugs. Disease can thus be defined to encompass small or large [37] numbers of the population. If he measures 100 children's height, he can state that any child standing at either extreme -- in the lowest and highest one, two, or five percent -- is "abnormal" and requires further testing. He can set his outer limits of normal blood or urine values or electrocardiogram readings so that a certain percentage of each population is labeled possibly abnormal, requires further investigation.
If he were selling laxatives, he would tend to define constipation in such a way as to include the great majority of Americans, by saying that if a person doesn't have a good bowel movement once a day, he or she is constipated. On the other hand, if he's interested in the truth, he would say that if a person has normally formed bowel movements, it doesn't make a difference if they have them once or twice a week. That puts almost nobody in the "sick" category.
The doctor can define sickness even where no sickness exists. After all, among those 100 children measured for height, among those blood, urine, and electrocardiogram measurements, someone has to be at the extreme high and low ends of the scales. And there are very few people in whom a battery of thirty or forty tests will not reveal at least one "statistical abnormality" which can then lead to an entire series of potentially damaging and disabling medical events.
You have to consider -- and beware of -- the doctor's self interest. Doctors almost always get more reward and recognition for intervening than for not intervening. They're trained to intervene and do something rather than observe, wait, and take the chance the patient will get better all by himself or go to another doctor. As a matter of fact, one of my key pieces of subversive advice to medical students is this: To pass an exam, get through medical school, and retain your sanity, always choose the most interventionist answer on a multiple choice test and you're more likely to be right. For example, suppose somebody says to you that the patient has a pimple on his nose, and asks what should you do? If the first answer is watchful expectancy, wait and see what happens for a few days, that's wrong, reject that. But if one of the answers is cut off his head and hook him up to a heart lung machine, then resew all the arteries and give him twenty different antibiotics and steroids, that answer is right. This piece of advice has carried more of my students through various crucial examinations, including national boards and speciality exams, than any other lesson.
As a patient, once you submit to a physical examination, your doctor might interpret minor abnonmalities -- real or bogus -- as pre-conditions of some serious illness, requiring, of course, serious pre-intervention. A minor fluctuation on a blood sugar test might be interpreted as pre- diabetes, and you'll get some medicine to take home. Or the doctor may find something -- maybe a stray tracing on the EKG caused by a passing jet plane -- that leads him to believe you have a pre- coronary condition. Then you'll [39] go home with a pre-coronary drug or two, which while fighting your pre-condition will mess up your life through striking alterations in behavior and mental status, including blurred vision, confusion, agitation, delirium, hallucinations, numbness, seizures, and psychosis.
Maybe you'll get a prescription for Atromid S, a cholesterol-lowering drug, which, besides possibly lowering your cholesterol, could also give you one or more of these side effects: fatigue, weakness, headache, dizziness, muscle ache, loss of hair, drowsiness, blurred vision, tremors, perspiration, impotence, decreased sex drive, anemia, peptic ulcer, rheumatoid arthritis, and lupus erythematosis. Of course your doctor is not likely to read you this list from the prescribing information that comes with the drug. And he's even less likely to tell you the contents of the paragraph that's set in a black border: "It has not been established whether drug-induced lowering of cholesterol is detrimental, beneficial, or has no effect on the morbidity or mortality due to atherosclerotic coronary heart disease. Several years will be required before scientific investigations will yield the answer to this question."
What kind of person will take that drug after reading that information?
What must be the most common pre-treatment for pre-disease is what happens when you go in and the doctor finds your blood pressure a little high. Ignoring the fact that your hypertension might be temporarily caused by your very presence in the office, you'll most likely [40] leave with some sort of anti-hypertensive drug. Though you'll receive little in the way of relief from it, you might get something else: side effects ranging from headaches, drowsiness, lethargy, and nausea to impotence. In 1970, the Coronary Drug Project Research Group found that these drugs produced an excess number of adverse effects such as non-fatal infarction and pulmonary embolism -- and that these effects were not outweighed by any trend towards reduced mortality.
Doctors started hawking the importance of the physical examination during the Depression of the 1930s -- for all the obvious reasons. For the same obvious reasons, dentists are beginning to hustle people into their offices for routine checkups. I got an announcement the other day from an establishment dental organization that every child should be examined on his third birthday by a dentist and on his seventh birthday by an orthodontist. These exams certainly will not do very many children any good, and they will definitely do most of them harm. Not only from the mercury pollution characteristic of dental offices, the sacramental x-rays, and the Holy Water fluoride applications -- but from the treatments themselves. The sharp dental explorer that dentists use to examine teeth has been shown to actually inoculate various bacteria from infected teeth to healthy teeth. Orthodontia is still a mysterious and unproven art. We know that a lot of people get into gum problems later in life because of orthodontia early in life. We also know that a lot of people who are recommended for orthodontia and don't get it find that their teeth straighten out all by themselves. Although the recommended exams most probably won't do you or your child any good, they certainly will be good for the dentist or orthodontist.
From my experience, doctors -- and dentists, especially -- got very defensive about the regular checkup. I've known dentists to refuse to see patients in emergencies because the person hadn't been in for a regular checkup within the past six months. Of course, this attitude gives doctors and dentists the right to play the big game in medicine, Blame the Victim. Rather than admit that their sacraments are useless, the magic nonexistent, they can always tell you that you came to them too late.
You can never go to the doctor too soon, most doctors would claim. And most people seem to believe that. You must realize, however, that the mere act of submitting to the diagnostic procedure implies that you're asking for treatment, at least as far as the doctor is concerned. In no uncertain terms, if you show up, you're asking for it. You're asking to be exposed to the whole range of sacramental treatments, from aspirin to ritual mutilation. Of course, the doctor is going to tend towards the more intense forms of sacrifice, since these increase his sacred stature. Some lean so heavily in that direction that they miss completely the lower extreme of possibilities. A young friend of mine took up the challenge of a 1OO-mile bicycle race, something he'd never done
[42] before. About a third of the way into the race he'd already made up his mind that he wasn't trained for this sort of punishment -- but some passing cyclists jeered at him for his slow pace. That made him angry and he vowed to finish the race, which he did. The next day he woke up and could hardly move. His knees had taken the brunt of the punishment. He was in such discomfort that he went to a doctor. After examining him and taking x-rays, the doctor let him know that he had either gonorrhea or some kind of cancer of the knee. My friend, who had told the doctor about the 100-mile ride, asked whether that didn't have something to do with his condition. The doctor said, "Not at all," and wanted to refer him to a specialist. Of course, my friend didn't even bother to take the referral home with him. In a matter of day, his legs were as good as new.
Some doctors blame the patients for demanding treatment for conditions that will take care of themselves, they use the excuse that people show up wanting antibiotics to knock out colds, or powerful and dangerous anti-arthritics for mild joint stiffness, or hormone pills for teenagers to fight acne or stifle growth. I don't accept this excuse. Patients demand a lot of things such as more considerate care, more natural healing techniques, and discussion of alternatives -- and doctors rarely give in on these issues.
If you want to defend yourself, you've got to understand that the doctor's standards are different from yours and that his are no better. Doctors aren't considerate of the fact that their very questions imply the need for treatment. I counsel doctors not to tell patients about harmless heart murmurs, large tonsils, umbilical hernias -- almost all of which will disappear by the sixth birthday. I tell doctors not to ask mothers of three-year old boys whether or not the child is toilet trained because that automatically makes the mother think there's something wrong with her child if he's not toilet trained.
There are lots of other attitudes and strategies you need to learn if you want to defend yourself against the dangers of the diagnostic procedure. Of course, if it's an emergency such as an accident, injury, or acute appendicitis, you have no choice. But these situations account for only five percent of medical situations. If you have no symptoms at all, you've got no business going to the doctor in the first place. If you do have symptoms, if you are sick, then your first defense is to become more informed about your problem than the doctor. You've got to learn about your disease, and that's not very hard. You can get the same books the doctor studied from, and chances are he's forgotten most of it. You can find books written for laymen on just about every disease you're likely to have. The idea is to find out as much about it as possible so you can discuss your problem on an equal -- or better -- informational footing with the doctor.
Whenever a lab test is prescribed, look up the test and find out what it's supposed to show. Ask the doctor what the test is supposed [44] to demonstrate. Your doctor won't tell you this, but if you do your own detective work, you'll find out that the simple tests such as the blood counts, urine analysts, tuberculin tests, and chest x-rays are so controversial and difficult to interpret that their usefulness is extremely limited.
You should also try to find a lab which maintains a high degree of accuracy. If a lab won't talk about its rate of errors, scratch it off your list. If a lab boasts perfect or near perfect accuracy be suspicious. But keep asking questions. How do they know they're so accurate? Is the accuracy certified? By whom? You might never find a lab that satisfactorily answers all your questions. If you do, insist that your doctor use that lab. You might have tough going here because a lot of doctors have a financial interest in certain testing laboratories. Insist. If your doctor does all his own testing, ask the same questions that you would ask a lab. Finally, if a serious course of treatment hinges on the results of lab tests, have them done again at another lab. Even if you have to have them done again at the same lab, have them repeated.
The most important way to subvert the diagnostic procedure for your own protection is to ask the doctor questions. In some cases, he'll answer the questions. That's the rare exception. In most cases, the doctor will get upset. Ask the questions anyway -- short of getting yourself thrown out of his office. From his attitude [45] and his responses, you can judge him as a human being and get an idea of his expertise.
Questioning can come in handy to protect yourself from x-rays. Of course, the best protection is no radiation at all. Breast x-rays for women under fifty, women with no symptoms, and women with no history of breast cancer in their family are unjustifiable for the detection of breast cancer. And they're of dubious value to all other women, since the breasts are especially sensitive to x- rays. Any woman can avoid x-rays merely by telling the doctor she thinks she might be pregnant -- whether she is or not. Sometimes, as happened to the wife of one of my colleagues, claiming you're pregnant will provoke them into requiring a pregnancy test, too! My friend's wife avoided that by telling the nurse-inquisitor that she wanted her husband to perform the test since this was her first baby and they wanted to keep as much of the event to themselves as possible. She never had to get the x-ray. You can get away with a similar ploy by merely saying you want your own doctor to perform the pregnancy test. Then, rely on bureaucratic inertia to keep the question from ever coming up again. A woman who is pregnant, or who truthfully thinks she may be, should make her condition clear by speaking up loudly to anyone who tries to aim an x-ray machine in her direction. Any doctor or dentist who insists on needlessly radiating a pregnant woman should have his license pulled.
Techniques for avoiding x-rays can range from playing dumb -- Do I really need all those x- rays, doc? -- to persuasion and cajolery. Sometimes these will work but you should be prepared to resort to direct challenge and confrontation. Sometimes a doctor will have you placed on a cart to be wheeled into the x-ray room. This is a typical ploy to deliberately humiliate, depersonalize and demean perfectly capable men and women and transform them to docile, cooperative, accepting, manageable patients. If this ever happens to you, jump off the cart and stand on your own two feet. Exercise responsibility for your own health. Any disability you suffer from jumping off the cart will doubtlessly prove less than the effects of the x-rays.
Once you've made known your preference for avoiding x-rays, if your doctor still wants you under the gun, here are the questions you should ask: What are you looking for? What is the likelihood that you will find it using the x-rays? Can you find what you are looking for by a safer method? Are you using the most modern and well-maintained machines with the lowest possible dose of radiation? Will you properly shield the rest of my body? In what way will the x-rays change my course of treatment? When was the last time your machine was checked for safety? Keep asking questions until the doctor explains the situation in such a way that allows you to make an informed choice. If you decide that you must have the x-rays, submit to only the specific photos necessary at the time. Don't let either your doctor or the radiologist shoot extra photos "as long as you're on the table."
To fully protect yourself from your doctor, you must learn how to lie to him. This is not such a strange maneuver, really, since anyone who has learned to survive professional bureaucracies has learned to deceive professionals. You learn to lie to school teachers quite early in life, since the purpose of going to school isn't to learn but to end up with a credential at the end. Then you do all your real learning outside of school. I advise medical students to learn the arts of hypocrisy and duplicity, just as Southern blacks once learned the art of shuffling. Shuffling was the fine art of appearing to be active and obedient when in reality you were nothing of the sort. That's what you have to do with your doctor.
If you are a mother who wants to breastfeed, for example, your doctor will almost always be against it, even if he says he doesn't care one way or the other, because doctors know nothing about breastfeeding. What do you do when your doctor weighs the baby and finds it hasn't gained as much weight as his chart says it should? What do you do when he tells you to start hot dogs at two weeks of age? My favorite image is that of the obstetrician waiting, and as the baby emerges from the womb he sticks a hot dog in its mouth to get it started on solid foods and to create an early dependence. Well, when a doctor tells you to start solid food such as cereal or fruit or anything else at one month of age, you can try arguing with him since you know what's best for your baby better than he does. You can simply refuse to do it, in which case he'll get huffy and probably fire you as a patient. You can try to persuade or cajole the doctor, on the assumption that he's a rational, caring human being. If you try that, good luck.
Or, you can shuffle. Don't tell the doctor anything but Yessir. If he has given you a six-pack of formula to take home and start the baby on, throw it in the trash at your earliest convenience. Simply continue to breastfeed your baby. When the next checkup comes around and the doctor puts the baby on the scale, just tell the doctor how the child's enjoying his cereal and fruit. Then the doctor will look at the scale and tell you the baby's doing just fine.
Unfortunately, in some medical situations you reach the point where you can't lie to the doctor. In obstetrics, the doctor gets a chance to see what you're doing. He can check on you with the scale and enforce his dangerous ideas of limiting the amount of weight you gain during pregnancy. My women will bring a list of what they want and don't want to the obstetrician on the first visit, They'll tell him they don't want to be shaved, no episiotomy, analgesia, induction of labor, and so on. The doctor will nod his head. Then, in the final moments of labor, she'll find out that she's getting them anyway. You can't really expect a woman in labor to say no to whatever her doctor says she needs.
That's why it's crucial to subvert the process and get the jump on the doctor as much as possible before the situation gets critical. After you've asked your questions, don't take it for granted that you can trust the doctor's answers. Check out whatever he says. Again, read all the sources you can find. You have to know more about it than he does.
Doctors in general should be treated with about the same degree of trust as used car salesmen. Whatever your doctor says or recommends, you have to first consider how it will benefit him. For example, if a neonatologist tells you that high risk nurseries improve the survival rates of babies, find out if he works for a high risk nursery.
Whenever you get a second opinion that is different from the first opinion, you should go back and confront the first doctor with what the second doctor said. People don't often do this because they're afraid of the anger and hostility of the first doctor. It's very valuable to test the doctor this way. It's a good idea to elicit that anger and hostility because that might change your attitude towards the doctor, And towards doctors in general.
Whenever you have to make a decision regarding a medical procedure, you should seek out and talk to people you regard as having wisdom. At one time, if you go back far enough, doctors were wise, cultured people. They knew literature and culture and were marked by sagacity and consideration. That is not the case anymore. People who may be a [50] source of information and counsel are people who have had the same experience as you, people with the same symptoms or disease. Talk over your problem, whatever your doctor tells you it is and whatever you think it is, with friends, neighbors, and family. Find out what their doctors say. Doctors tell you not to do this, not to listen to opinions you hear in the butcher shop or the grocery store or the hairdresser's.
They tell you not to listen to relatives and friends. But they are wrong. They're protecting their sacred authority. As a matter of fact, you should talk to friends and relatives, people who live around you, whom you know and trust, at the outset of your symptoms.
You may find you can do without the doctor.
For more from Dr Robert Mendelsohn:
Why pediatricians are dangerous
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Covid really did me in. The greatest example of malfeasance ever seen. Cold symptoms? you're kidding me, right? They called it a corona virus. I looked it up. Never has been a cure for corona and for good reason. Right out there for all to see. Testing? PCR? Kary Mullis out there for all to see what PCR was capable of. And people lined up for all of it. Behooved me then and after 4 years they're still doing it. You just can't cure dumbed-down-stupid.
Recently my sister came thru the door squawking like a wet hen, in a fury. Her front center tooth implant fell out and she needed to find a dentist to literally screw the tooth back in. This jackass demanded 16 x-rays before and after insertion of the tooth. End of story. She said no and left.
I have so many stories, I could be here all day but suffice to say, Mendelsohn did it better. The biggest scam of all, the one that drives me to drink, is the Wellness Checks for babies. Great thinking, calling them wellness check-ups. A dastardly ploy to get dumbed-down-stupid mothers to bring their children into a mass-murderers office to jab literal poison into your child. And you go along with this.
Speaking of mass murderers, there has been a halt of hostilities, so they say, in Palestine because Tedros of UN fame, decided all Palestinian children need "humanitarian aid", not in the form of food and water, but the newly minted NOPV2 Polio vaccine, a highly infectious re-introduced viral polio solution, not jabbed (no need for medical personnel) , but in capsule form squeezed right into the mouths of all children. And they are all lining up. Explain that to me like I'm a 4 year old.
I agree, I never go to the doctor, I figure things out myself. Haven’t been to the dentist either in like 20 years. Still have all my teeth and only one filling and I’m almost 60. I don’t trust them much except for if I break a bone