পার্থ বন্দ্যোপাধ্যায় স্মরণে

Violence in Modern Medicine

MANU L. KOTHARI & LOPA A. MEHTA

(Its a 29 page article. The first three pages of this illuminating article is published here for our readers to get a perspective of this aspect. The remaining part may be read from Prof Kothari's archive: http://www.cancerfundamentaltruth.com/archives.htm )

I. A paradox?

The popular image of a doctor is of an angel in a white coat. Few are able or willing to perceive the reality behind the image and the violence which today is inseparable from modern medical science. This violence is not limited to human beings; it extends to the environment, to animals, to the fiscal fortunes of a person or a society.

Violence as a Term

The root of the words 'violence' and 'violate' is the Latin vim, which is related to the Sanskrit vyas (he goes). The term implies interference that smacks of righteousness, thoughtlessness or willed ignorance. But violence is also transgression of what Einstein called self-evident truth. The perception of such truth does not seem to be a function of 'development', as the tragic experience of the last 200 years shows. Learnedness, industrialization and modern media - indeed, the more we have of these 'achievements', the less we perceive the self-evident truth that 'progress' and violence go hand in hand. With 'progress', more and more leaves are suffocated with grime, deforestation spreads, more fish die and more whales get harpooned, and the balance, the regenerative capacity of nature, is irreparably damaged.

Psychodynamics of Medical Violence

Medical violence is a curious product of the physician's arrogance, trappings of technique, and the laity's love of the fanciful coupled with an undying hope that, given enough money, there is no physical or mental problem that some Cooley or Barnard cannot solve. The ethos has been piquantly summed up by Burnet:

One might justly summarize American medicine (and all those who reverently follow the American lead) as being based on the maxim that what can cure a disease condition (assumed, simulated or natural) in a mouse or a dog can with the right expenditure of money, effort and intelligence, be applied to human medicine.

The quote exposes the man-centred temper of modern medical science. It strives to achieve something for man, against man's disease and man's death. The outcome is that the USA, the UK and India increase their spending to the point of bankruptcy and get less and less of health. The Rockefeller Foundation summarized the current predicament in a book titled Doing Better and Feeling Worse - Health in USA. In the midst of the ever-widening gulf between medicine's promise and performance, most people - including doctors and patients - have lost sight of a  self-evident fact, namely that the way to iatrogenic (doctor-made) hell is paved with professedly good therapeutic intentions. The only way out of this mess is, as Ivan Illich suggests, for the laity, the patient, to wake up to the realities effectively kept away from them by the medical profession.

L. Dossey, himself a physician, has bemoaned 'the philosophic backwardness in contemporary medicine', even though any allusion to the word 'philosophy' in the context of modern medicine is a red rag to the medical bull. Medical men dismiss philosophy as incompatible with scientific medicine. Thus, thirteen years ago, a book on cancer, scientifically documented and annotated, was condemned as mere philosophy. During these thirteen years, the only comment the book has elicited from the cancerology establishment, both local and global, is that the book is 'philosophical'. The data in the book have not been questioned; the reasoning has not been found faulty. For establishment cancerologists, the book is philosophy and therefore not worth serious consideration. 'Philosophy', evidently, is not used in the lexicographical sense; it is a pejorative term tagged on to anything the establishment disapproves of - even dissent within the community itself.

Cancerology's obsessive resistance to philosophy has made the discipline, in the words of biologist J. B. Watson, 'scientifically bankrupt, therapeutically ineffective and wasteful'. A panel appointed by the national Cancer Advisory Board, USA, has found that highly reputed scientists could deviate from accepted standards of integrity when tempted to bolster their theorems and prejudices with huge sums of the public's money, and an American scientist has advised other scientists: 'Stay out of cancer research because it's full of money and just about out of science.'

The heartlessness of modern medicine can be directly traced to its calculated myopia. 'I am absolutely convinced', says Victor Frankl, 'that the gas chambers of Auschwitz, Treblinka, and Maidanek were ultimately prepared not in some Ministry or other in Berlin, but rather in the lecture halls of nihilistic scientists.' Hence the mythology reflected in movies like Coma; hence, the recurrent reality in India where surgeons merrily transplant kidneys from the desperately poor into paying patients. It is not uncommon in such transplants for the donor to get Rs 30,000 while the agent makes Rs 50,000 When we questioned the anaesthetist of a kidney transplant team about this, his reply was scientific: 'We are happy if the donor has been clinically and psychiatrically investigated, and rendered ready by the agent.' A recent review of kidney transplants in the The New England Journal of Medicine concluded that the ease with which a kidney transplant was done lacked any scientific basis, and medicine did not have answers to the problems the transplant created for its new host. We must thank providence that Christian Barnard failed in his much publicized brain transplant and that a heart transplant is not yet available commercially.

Solzhenitsyn has shown in Cancer Ward that the best way of dehumanizing a doctor is to look up to him as scientific. In the west, the popular and the professional media persist in portraying all diseases in paranoic terms - 'This disease is killer number one', 'that disease is killer number n' - while claiming in the same breath tremendous advances made by medical science in its battle against all medical problems. The result is that the doctor sees neither the disease nor the patient. All he sees is some enemy that must be destroyed at all costs. And since no killer disease - cancer, heart attack, hypertension, diabetes - has yet yielded to their ministrations, all that happens is that the frustrated physician wrecks his vengeance on disease and death, with the patient as the battlefield.

Some surveys of the medical scene in the 1980s give a fair idea of what modern medicine is, and will be, all about. To quote D. Horrobin,

Lay organizations, whether charities or governments, do not fund medical research for the sake of culture. They believe that practical benefits will follow. It is gradually dawning on the donors that for the past 20 years practical benefits have not followed. During that time there have been no substantial improvements in morbidity or mortality from major diseases that can be attributed to public funding of medical research.

A. Relman, editor of The New England Journal of Medicine, comments: 'We have learned how to keep alive very old, sick, and feeble - even brain-dead - people as well as infants born terribly deformed.'¹⁰And a journalist has recently echoed Relman. 'I do know', he says, 'that the miracles of modern medicine can prolong life far beyond the point at which it has meaning.'

Science in this respect has let down modern medicine. Apparently their continuing partnership is a marriage that has soured. Yet the purveyors of modern medicine have a vested interest in the partnership, for it endows them with an invincible halo of propriety and philanthropy. It has allowed the modern medical student, teacher, practitioner, and researcher to completely ignore the fact that most human diseases and death are not only beyond science but also beyond technique - extant, evolving or envisaged.

The mindless craze for gadgets and chemicals leads medical men to create a modern medical police state where symptoms are suppressed and signs are erased. When a child has upper respiratory infection, the body enters into a dialogue with the microbes under an optimal thermal state. But this is deemed as 'fever' by the doctor. Drugs are given to bring down the fever, and antibiotics are administered to knock the microbes out. A peace talk is thus aborted, the child acquires lifelong immuno-deficiency and his natural growing-up is thwarted. Commenting on this common scenario, the English microbiologist J. A. Raeburn has prophesied, 'In years to come, the story of antibiotics may rank as Nature's most malicious trick.'

A healthy adult is sent for a 'regular medical check-up', considered a business venture in medical circles, and walks out a depressed, harried patient. The reason may be that the doctor has detected a sign as yet nowhere defined but called high blood pressure. What had not bothered the patient ever must now be annihilated to ease the scientific conscience of the doctor. There is no field of medicine in which this police-state approach does not pose a physical, mental, and fiscal hazard for the patient.

The patchwork nature of such doctoring, and the hazards it poses, can be guessed from a recent medical tragedy. In an editorial in The Lancet of 29 January 1983, the story of the benoxaprofen (Opren) was reviewed in the wake of allegations in the media that approximately 60 avoidable deaths had occurred in Britain as a result of an 'unscrupulous pharmaceutical firm, feeble watchdogs and gullible doctors'. The firm had promoted benoxaprofen with the willing collaboration of the media that later turned critical of the drug. The verdict was updated by The Lancet in 1984 under the heading 'The Seven Pillars of Foolishness', describing how the practice of medicine had caused the death of patients worldwide, thanks to seven suppressive 'cousins' called anti-arthritic drugs, promoted through collusion between doctors, media, government bodies, bribery and corruption. Such tragedies will continue to occur till mankind wakes up to the realization that modern medicine has not and cannot live up to its claims.

AAP Government’s One Month

Stink Sting and Shrill

Somen Chakraborty

Two major developments have marked AAP government’s one-month journey from mid February to mid March, 2015. One is, of course, making water free and reduction of electricity tariff with effect from March 1, 2015. The other one is mud-slinging among the comrades followed by ousting of two founder leaders from the Political Affairs Committee, the highest decision making body of Aam Aadmi Party.

Consolidating the traditional vote bank or reciprocating the most valued voters by doling out facilities free or at subsidised rates is not new for the governments in India. Draining off public exchequer to gain cheap populism is common for the parties in power. From rice to computer and even gold has been distributed free in the name of welfare and poverty eradication. Subsidy has become somewhat an eternal feature of India’s party politics. At the same time, the very principle of a welfare state is to enable people access to the basic needs, if need be at free of cost. Therefore, channelising revenue towards the benefit of the weaker sections is a necessity to bring about just and equal social order.

In the case of free water and electricity, the AAP Government has submitted two benign logic. During the election campaign, when AAP’s chances to win were looking bleak, Kejriwal unambiguously argued for free water. AAP believes that every human being has a right over the natural resources. The state regulates the redistribution to ensure that the water stock meets the present need without inflicting crisis to the future generation. AAP has upheld commitment to an ancient human right by enabling people to consume what is scientifically accepted as the minimum need for a decent living. The ‘free life line water’ scheme for domestic use up to 20,000 litre a family a month introduced by the AAP Government earlier in 2014 has now been resurrected. This facility is to stay as long as AAP is in power.

The rise of electricity rate, as they argue, is an artificial construct by the distribution companies (Discom). In AAP’s view, hike of electricity rate at a spiraling speed has no justification but profit motive. An unholy alliance of politicians, the distribution companies and public servants has made this to happen over the years. There is no denying that every person essentially needs some amount of electricity for existence and survival. Its price, therefore, has to be within a reachable and reasonable scale so that even the poor people can consume it up to a limit.

Reconsideration of the electricity charges will depend on the outcome of the audit of the production and distribution cost of electricity. The electricity distribution companies in Delhi seemed to have eluded the audit on one or other pretext and the succeeding state governments have avoided pursuing it. AAP fulfills two objectives by cutting down the electricity charges. The difficulty that the economically weaker sections of Delhi were facing earlier to bear the electricity cost will feel happy for the tariff has been reduced by 50% only for domestic use up to 400 units. And secondly, it will create pressure to complete the audit at the earliest. The Government knows that given the per capita income ratio and consumption behaviour of the middle and upper class Delhites, combined with the compulsion during summer and winter, a large number of the city dwellers will not be able to take advantage of this subsidy. The benefits will be reaped exclusively by the poor and the weaker sections.

Water and electricity aside, the Government of Delhi has important steps on education, health, safety and security of women. The government has served notice to 200 schools for charging exorbitant fees. CCTV installation process in and around the educational institutions has started. The private hospitals are instructed to allow poor people to have access to health services. A cap has been put on the swine flu testing charges. Special e-rickshaw licensing camps have been organised. The police have become cautious in their actions. Prices of the essentials have been stable.

The government is handicapped to go fast because the budget is not yet prepared and approved. Kejriwal’s absence due to ill health has also reduced speed of decision making. Meanwhile, the entire contingent of AAP leadership has diverted energy and time into coterie politics. What has transpired in this self-tarnishing exercise by the party leadership is that a few months before some ambitious individuals challenged Arvind Kejriwal’s command over the decision making process. These leaders could push certain action plans in spite of opposition by the members of the ‘Kejriwal group’. Now in retaliation they have ghettoised those frontline leaders and manufactured dirty tricks to weed them out. As it has appeared, the strategic steps for this had been framed up well-in-advance by the ‘party supremo’ Mr Arvind Kejriwal before his departure for the Jindal Ayurvedic Institute in Bangalore.

Aam Aadmi Party could make a spectacular victory in the Delhi assembly election also because many persons shifted their position against bhagore and whimsical AAP at a later stage. These remotely located volunteers and sympathisers voted for AAP and also mobilised support of the family members, friends and associates for the AAP candidates. If the same principle of revenge is now applied in the case of volunteers then majority of them has no place in the Party. For a larger part of the election campaign these people, in fact, opposed AAP and wanted Kejriwal to be defeated.

Aam Aadmi Party emerged as a party of alternative politics. At the very outset the Party consciously discarded the classical leadership image wrapped in white kurta-pajama. It crafted a political behaviour that aam aadmi could trust, depend on, feel aligned and most importantly, that could diffuse the gap between the leaders and the workers. The Party scrupulously nurtured volunteerism and reached deep into the hamlets and hutments of the poor where development mattered most. So entrenched became its credibility that the downtrodden and deprived people not only mobilised support for the Party but also helped it grow and expand as a powerful alternative.

Later, when within less than two weeks of forming the government, hatred, anger, extreme dislike and sheer antagonism came out pronouncedly in tweets, blogs, stings, press comments, letters, public statements, body language, facial expressions and eye movements of the leaders, it deeply shocked the volunteers, sympathisers and supporters. The appearance of ‘Kejriwal camp’, ‘Maharashtra camp’, ‘Punjab camp’ and ‘Dissident group’ has created doubt if the Party will remain faithful anymore to ‘Lokpal’ and ‘Swaraj’. They are afraid if this leadership will ever encourage the competent, committed, assertive and outspoken people to become leaders in different forums or to be the insiders of the Party. Apprehension is looming large that for different committees and forums the leadership may pick only those who are ready to compromise or show absolute allegiance to the specific camp, leader, coterie or faction.

But then, it is neither Kejriwal nor its leadership alone, but thousands of volunteers, sympathisers and voters have collectively enabled AAP to come to the power. If these faceless volunteers can decide about whom to vote and support, in need they can exhibit their power to bring down the Government too. ‘Panch Saal - Kejriwal’, the key election slogan of Aam Aadmi Party bears a different meaning for the people. The people perceive in it a Delhi where corruption will dwindle to insignificance, every child will attend school and child labour will disappear forever. They expect Delhi will become a clean city soon. The Government will not only recognise people’s reasonable rights and entitlements but also respect it in real life situation. The leadership need to accept that AAP is now much more than a political party. It is a process of change belongs to none but the people. It is a hope for equality and justice. People will expect its leadership to contribute energy more towards development and empowerment of the people than competing with each other to hijack the internal lokpal or to become a political celebrity.

c_somen@yahoo.com