Doctors must reject Big Pharma’s soulless treatment model.
Isit at the bedside grieving over medicine as it expires into a soulless technocracy. I watch its extremities cyanose as it struggles for air, its body reeking with the stench of commingled corruption and cowardice. Yet I hope for its resuscitation.
Exhibit A. Medical students report rates of depression up to 30% higher than the general population. About 400 U.S. physicians commit suicide annually, with the rate for female physicians four times higher than among other female professionals. A 2015 survey reported that 13% of male physicians and 22% of female physicians suffered from alcohol abuse or dependence. A 2021 study found that 63% of U.S. physicians experienced burnout, with one in five intending to leave their practice within two years. These statistics attest to medicine’s core problem that affects the welfare of patients and the health, sanity, and professional longevity of physicians. It is this: we physicians have traded in our former gods for ersatz idols.
At my initial medical evaluation at a Kaiser hospital in Los Angeles, billed as a “Meet and Greet,” a fortyish man in a white coat entered my exam room and marched directly to a computer screen. There he sat without once looking at me, introducing himself, or shaking hands. He lobbed a litany of rote questions at me without a glance away from the screen. He seemed to be conversing with it, not with me. Was I watching a sci-fi depiction of intergalactic medical care on Alpha-Zebulon? I toyed with the notion of answering him in the beeps and whistles of R2-D2. Instead, after a few minutes I rose, said, “We’re done here,” and walked out. I don’t think he noticed.
The above scenario recurs daily in thousands of medical offices. Sir William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease.” Most modern doctors are not Osler’s healers of people but normalizers of data. Physicians comb computer printouts of molecular titers for hieratic meaning. Internists may order such tests before they even see a patient. However, only whole human beings reveal ultimate clinical truths. In atomizing patients into their tiniest components, MDs disconnect from patients and themselves. If docs spent more than five minutes per appointment and peppered their interviews with interest and caring, those pesky lumps of flesh on the exam table could sprout into actual people. What patients can reveal if given a chance would surprise clinicians and obviate hundreds of tests. Unless doctors start treating whole people, AI will displace them, and no one will know the difference.
To estrange themselves further from their calling, doctors bow as never before to the state and the corporation. They grovel before the altar of the “electronic health record,” or EHR, a corporate creation that widgetizes and dehumanizes doctor and patient. In 2016, MDs spent almost 40% of their patient care time (now surely higher) pecking on computers. No wonder they retire or leap from ledges.
With the advent of EHRs, weekly meetings of the clinical staff where I once worked no longer included discussions of actual patients. Instead we war-gamed how to enter EHR data so as to satisfy insurers, the government, and our corporate overseers. Such trends are as congenial to good medicine as spike proteins are to coronary arteries. To restate a Zen aphorism, a physician who conflates a computer screen with truth is like a man pointing a finger at the moon: only a fool mistakes the finger for the moon.
Political ideology increasingly corrupts medicine. Quotes from three versions of the Hippocratic Oath illustrate the trend. The first of these is from the classic Hippocratic Oath, formulated in ancient Greece. “I swear by Apollo the physician…and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath…. With regard to healing the sick…I will take care that they suffer no hurt or damage…. Nor shall any man’s entreaty prevail upon me to administer poison to anyone [italics mine].”
Next the revised Hippocratic Oath, composed in 1964 by Louis Lasagna. In this version, God and gods have disappeared except for “I must not play at God.” There is no longer a do-no-harm clause. It refers only to “avoiding those twin traps of overtreatment and therapeutic nihilism.” This admonition is a tautology, for it is axiomatic that in any endeavor it is desirable, by definition, to avoid doing too much of it or too little. Gone is any appeal to transcendent beings or values.
Finally, excerpts from the oath chanted by my alma mater Columbia University School of Medicine Class of 2025 during their White Coat Ceremony. “We also recognize the acts and systems of oppression effected in the name of medicine. We take this oath of service to begin building a future grounded in truth, restoration, and equity to fulfill medicine’s capacity to liberate…. I acknowledge the past and present failures of medicine to abide by its obligation to do no harm and affirm the need to address systemic issues in the institutions I uphold…. I promise to…engender an inclusive, equitable field of medicine….”
Eschewing the original Hippocratic injunctions, these initiates don’t accept responsibility for “doing no harm” themselves. Instead, they decry others’ failures in that regard, befitting a woke ideology that divides us into the aggrieved, whose victimhood immunizes them from responsibility for anything, and the oppressors.
But why fret? With our scientific and technological advances, aren’t we much healthier? On the contrary. Copious U.S. government statistics document the relentless increase in the prevalence of every chronic disease, physical and mental, in our society, even before Covid. In that respect, modern medicine’s idols fail us.
Events of the past three years highlighted an even more ominous problem. Physicians jettisoned their souls and became felons as they shilled for their new gods. They hacked off body parts of confused minors. They foisted dangerous drugs—remdesivir and gene shots—upon us without informed consent, that is, the transmission of truthful information about risks, benefits, and alternatives. Some practitioners even refused treatment to those unwilling to acquiesce.
The profession to which I have devoted five decades is sinking fast. I hesitate these days to seek a medical appointment for myself, so dissolute has medicine become. Doctors, in order to save yourselves, you must decentralize your work away from large groups with their soul-sucking cultures and toward small, intimate groups and solo practices. True, you will earn less—perhaps a lot less—and in the process you will need to decide your purpose in life, why you are here. Stop being Big Pharma’s bitches, and learn about natural treatments. Be healers, not ideologues. Develop parallel systems of medical training and care that emphasize prevention and the treatment of the whole person. Not only do we need to save lives. We need to save our profession and our souls.
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