It's getting scary.

Medical research is largely or more and more being funded by drug companies - DCs.
The universities and their professors are becoming largely dependent upon DCs.
So are medical journals.
DCs are not primarily interested in the potential for harm.
They have been known to with hold information.
DCs have no interest in unprofitable treatments.
They have a duty to their shareholders not to patients.
They do what's expected of them.
Their influence is everywhere.
They need new drugs which can be patented.
Lifestyle drugs is the name of the game.
It's in their interest to have as many people as possible taking pills.
They have done great things for us but they should not control research to the extent that they do.


Guidelines are becoming a standard to judge performance and determine pay.
More and more of our top medical scientist are being helped financially by the DCs.
Too many sit on guideline committees while being paid by DCs whose products are under consideration.
Too many of our guideline producers have career conflicts of interest too.
Too many do not see these conflicts of interest as a problem.
Their mistakes and prejudices are becoming enforced on the workforce under the guise of evidence based medicine.
Tops scientists for instance should not be the ones to decide on the validity of research in their field of interest. Do the research have others crunch the numbers.
We need independent critical appraisers arguing the pros and cons of research.
Anyone being paid by a drug company should be excluded from having any a seat on anyy guidelines committee.

Evidence based medicine is a great boon and a potential trap
What is true today may not be tomorrow.
Findings may be plain wrong.
Things can be fudged.
DOEMs become more important than POEMs (disease as opposed to patient orientated evidence)
(what matters is not your cholesterol level for instance but where you have an MI stroke etc or not)
Statistical tricks can be played.
Very few doctors have the ability to sort wheat from chaff.
Critical appraisers with no conflicts of interest are a rare breed.
Once something becomes a truth it's very hard to change

Doctors are losing power to the politicians and managers.
Their livelihoods more and more dependent upon, not patients, but those that pay them and control their right to practice.
Controllers love guidelines - so would I if I was one - they simplify.
It's not their job to determine whether guideline are the truth or not.
Doing so would complicate their lives.
They tell us guidelines are only guidelines yet demand explanation if one steps out of line.
The professional and government bodies are part of this system too. They too use guidelines.
Doctors are controlled beings. If not they will be.
They are becoming less and less able to act out of their own knowledge or even the knowledge of experts that disagree with guidelines.
They are destined to become obedient souls - soldiers - unless things change.

Doctoring is becoming more and more a business rather than a profession. The yard stick - when your doctor is with you are they putting your interest before their own? Are they interested in you or more interested in their computer's requests - thats' where the money is? Ask them what's the evidence? Whats the countering evidence? What's the number needed to treat and harm? Who funded the research? Does he or she know the interaction of all those drugs she or he is offering? If you ask me, you'd get a lot of don't knows! Are you prepared for the discomfort of there being no certainty - only possibilities and probabilities

It's getting scary out there. Not too bad just yet maybe but the future looks grim to me.

Here's some of my stuff on these issues

Tight control of sugar levels in type 2 diabetes. Take a look at this for an example of differences in interpretation of evidence. As good as no benefit over less tight control

Things are not black and white. The more one knows the more Grey they become. Managers and controllers can not handle grey. Individual doctors and patients can but that's too anarchistic for the piper payers. The two people that matter in the moment are being taken bit by bit out of the game. But even for the doctors and their patients the whole business is too time consuming - better just to rely on those guidelines. Mostly they are pretty good but ......

Paranoid - yup.

A letter to a dear friend

Here is a bit of a rave in response to your feeling at fault - being the cause of your troubles. It's a bit philosophical - not meant to be personal - kind of working things out for myself I suppose.

We give ourselves too much credit - we all do - for our successes and failures. The issue is how much are we creators of our experience or more importantly to what extent is the ego in control?

So here goes - the ego or 'I' is powerless and yet thinks it isn't. The 'I' that thinks it creates reality is an illusion. It's just thought - a product of thought. Thought produces the 'I". The 'I' is a servant of thought. Thought being all the learned, conditioned stuff that makes up what we call mind. There is a sense or feeling of 'I' but there is no actual thing which exists. It's never been found or located. There is no place for it except in the imagination. As kids dream up imaginary friends so we dream up the 'I'.

For those that claim there is an 'I' and it is in control, I ask where is it and how does it control anything? A thought arises - I want a lolly. That thought then stimulates should I or shouldn't 'I'. A yes or know arises. The action then follows. The 'I' thinks it is in controls. Simple observation tells me this isn't so even though I feel it is.

Does this make you and I as mind body things powerless - hell no. But when the 'I' tries to run the show then we end up experiencing powerlessness or the fake power of one aspect of thought pretending its running the show when it isn't - conditioned thought is. An aspect of thought that calls itself 'I' tries to control its source - the power base out of which it arises. Thought continues to do it's thing. The 'I' attempts to resist. It's a bit like having a foot on the accelerator and brake at the same time. It's nuts.

When things are going well there isn't an issue. When fear runs the show - not feeling so good - then control becomes an issue for us all. This is the "I"'s fuel.

I am feeling low angry depressed. Firstly where are these things low, angry, depressed etc - what are they? Secondly assuming the 'I' exist what does it use to control them - what does it have to act on them with? Does it have mental hands or what? In what space and time can it act?

When it is truly known that the 'I' has zero power to do anything beyond maybe resist, the problem is solved - that is when thought stops trying to control thought something else arises. It's not solved - it simply goes. When there is the slightest glimmer of a feeling that 'I' can do something, which is how it is for all of us, nothing much changes until the issue sinks out of awareness - until of course it gets triggered again.

And yo yo away we go till we die - it's a bugger.

Am I personally free of this shit? No! I have, however, experienced non resistance and allowing reaction in it fullness to be and the 'problem' vanishing into thin air. Now, of course, the 'I", the f...ing ego, knows this experience and so tries to make it happen. Guess what it doesn't work. It may seem to succeed but not really. It may distract us for a while but change anything of substance - of course not. It's the cause.

My answer to you my dear friend is to express yourself in words, painting, music, with others or whatever takes your fancy - let it all hang out and let it be. Let the dam be washed away - stop holding it up. Be curious fascinated interested in the games your 'I' plays. Watch it. Don't try to act on it. If you do it's just the 'I' in another disguise.

Your life is your life. There are no have to's. In your private space or with those you trust give full expression to all thoughts/feelings. Let things be. Allow the process no matter how silly or 'bad' it may seem. Easy to do - probably - well in theory anyway. But not in actuality for most of us except in retrospect. The 'I' has been around a while. It's an habituated automatic phenomenon. It's like a knee jerk. It's just a mental burp. Our brains make it happen. The whole thought process is based in physicality - conditioned reflexes of great complexity and intricacy - way beyond the 'I's ability to understand let alone control.

My personal belief is that when we are able to allow with no resistance the truth of who we are in the moment to be, love, whatever love is, is - operates us: And where love is, the ego isn't and suffering ends until of course the ego gets it act together again. With love - curiosity, interest, intelligence, exploration, discovery and newness are. Power - not power over or any of that shit - is too.

Yes a lot of our reality comes about because of who we are but it,s not under our direct control. When, however, we allow love to be, change happens to us and reality changes too but this has bugger all to do with the ego or our ability to control anything. Love happens, Change happens. It all happens. The only choice it seems to me is to resist or be the ride. And part of the ride will be storms, crap and death.

Just remember I love you no matter what - and so does - think about it - you know who. You don't have to be and do anything to please me. If I get displeased, then I have something to deal with either in my private space or with you. And when you and I are honest emotionally with each other we move into new places together. It may temporarily be difficult but not when we look back.

You and I are very special to each other but in the grand scheme of things we are of no more importance than one leaf is to a tree!! The tree doesn't give a tinker's damn if one leaf is a better leaf than another. In the grand scheme of things, you and I are insignificant specks. Yet in our little neck of the woods you matter to me and I know I matter to you.

So go with it, allow what is to be, allow change to happen and enjoy the ride because after all, what is actual, you and you and your experience, is all there is.

When shit is happening let the emotional impact of it be fully expressed - change will happen. Will you become immortal, enlightened, saved from the actualities of life? No! But you will be more at peace, more able to deal with what is - more able to die to what truly doesn't matter. What is that? Your ego and its suffering which at the moment you think is you.

You are so much more than your petty pathetic winging or crowing ego. You are life being expressed. Let your life be expressed and let it take you way beyond what you ego pretends it can offer.

I love you

your dear dear friend

PS
In some twisted way we seem to prefer the struggle to freedom. I wrote a book once my working title was Fighting To Die The Cost Of Living Is Too High. The cartoon below speaks to this a wee bit.



See you very soon - LOL and LOLs

PPS you know who this started out to. It's turned into a personal rave for me!!

Be nice to your doctors part 2

Your doctor is trained as a doctor in western medicine. He is not a naturopath, osteopath or any other type of alternative practitioner - well not usually. This means he is listening to and dealing with you from this perspective. His opinion about these other ways is probably no more informed than yours. He may think they are all tosh but harmless. He may be strongly against them. He may even dabble. He could have a qualification.

His philosophy on life may not be the same as yours.

When you go to see a doctor you should be expecting a medical opinion. If you are lucky he may be a good listener and have a good bed side manner. Some patients prefer bluntness others prefer a more gentle approach. Find a doctor that suits you.

Medical knowledge as you may know if you have read some of this blog isn't necessarily straightforward and black and white. In fact the more one delves into things the more grey they often become. Now and again things are easy and straight forward but often they are not.

When seeking a medical opinion accept that you may not know what's wrong. Some patients come in and tell me they have got this or that. They've been on the net. They want their serum selenium measured. By all means tell your doctor what you think but then let them do their job. Your doctor is trained to make diagnoses - that's what he does, to start with. When telling your story talk about your experiences - don't talk in labels, categories and diagnoses. Let him give you his medical opinion. There's a good chance he might be wrong. It's only an opinion. It's a starting place.

Headache is a diagnosis. I have a recurring knife like pain in the centre of my forehead, isn't. Indigestion is a diagnosis. I have a burning sensation here - point, isn't. Stress is a label, so is pressure and tension. It's not easy to describe sensations but do the best you can.

If you give labels and diagnoses, your doctor will have to undo these. You may feel irritated thinking he doesn't believe you. He isn't deconstructing your labels because he doesn't believe you. It's because he can not do his job if he accepts your labels. What you call vertigo or whatever maybe different to how others use this word. Things go grey, black and I feel I am falling is very different to the walls are moving or spinning.

Unless you are heading for hospital, there is time. Time to reflect and maybe get another opinion. Time to do some research. So you have a raised cholesterol - there is no rush.

Remember and remind yourself, it's your body, it's your health issue and it's your choice as to what happens. You are the one in charge of your life. Don't let anyone ever bulldoze you. But do let your doctor in on your inner most secrets and fears - once you've sussed him out of course.

Be nice to your doctors

It pays to be nice to your doctors and at the same time recognise they are human - that is, they have their bad days, their knowledge and skills are limited and for a successful consultation they need your help or in put. They aren't vets or clairvoyants. The person before you may have been a difficult individual and knocked your doc off his or her perch. Some people reacting out of fear, pain and frustration can be threatening, aggressive and angry - others can be manipulative, dishonest and unpleasant.

You want him or her on your side. He or she wants to be on yours. If this isn't so, then maybe both should call it a day.

Doctors are pattern recognisers. It's their job to hear your story, clarify it, do tests and examination. If all this information produces a pattern they know, they can respond. If there isn't a fit - then they don't know what's wrong with you and so can not respond or treat you.

Many docs have very high IQs are used to knowing their stuff and feel they should know all the time. Not knowing isn't easy for them. Lots of docs are 'helpers'. They need to help. Now if you've seen a specialist and they haven't come up with a diagnosis either, there's a problem. Your doc is having two of his or her buttons pushed. They don't know and feel they can not help.

This makes for a delicate situation. They are a maybe a wee bit reactive and maybe you are too. After all you are unwell, in pain maybe, and you are scared about what might be wrong with you.

The doc may be wondering whether there is something going on in your life you aren't talking about. Maybe you aren't, out of embarrassment, telling him all your symptoms. Maybe your personal life is a bit of a mess and you haven't admitted this to yourself. You could be underplaying your symptoms or overplaying them. Your doc is probably concerned s/he might be missing something.

This is not an easy time for both parties. Your doctor doesn't want to upset you. He or she may be holding back because of uncertainty - what they are thinking might not be right. You could get all miffy and report him or her to the dreaded HDC.

Doc - please give me your honest opinion - don't hold anything back. Give it to me!

Be prepared to hear something you don't want to hear. Don't fight the opinion. Say thanks - let me think about it if it doesn't sit right with you. It takes courage from your doctor to be forthright and honest. Thank him or her for that!

If you don't have an easily diagnosable situation, the best policy is openness and a forthright expression by both parties. Your doctor needs your permission and encouragement. If you don't give it, you may not get to hear what your doctor thinks. It's too easy for both doctor and patients to avoid the difficult conversation and all too often patients ends up on a tread mill of investigations, specialists and treatments that don't serve them well.

Hatred

What if our thought/feelings have more impact on our physicality than we think. What if anger, not fresh and clean, but putrified, old, unacknowledged and ancient anger, fuels ill-health in ways we as yet don't understand, how is this to be brought into the light, if the spirit of exploration and discovery is denied by political correctness, rules, regulations and tradition.




An old lady years ago in bed and a couple of weeks from dying took my hand and placed it on her stomach. Under the skin I could feel a cricket ball sized craggy hard tumour.

"What do you think this is doctor"

I shrugged not knowing what she meant. "I don't know, what is it?" I ask.

"Hatred", she said

Health, Alternatives

To what extent are people in positions of authority free of their personal agendas about what is best for the rest of us? Does it matter?




Riddled as the modern world is with craziness we do at least have the model of scientific thinking - that is, have a theory, test it, refine it and one day replace it with a theory that coheres better with the latest findings. The final arbiter is beyond the human mind. Well as beyond as one can get. The findings of science are available to all to check out and verfiy. Verification isn't easy. With regards to the human body/mind verification is tricky indeed.

As managers take over the medical world, will it be more or less objectively based than it is now - will the agendas they bring be better or worse?

Homeopathy has not survived, as far as I know, the rigors of double blind cross over trials and yet we go on using it - well some of us do.

"Anyone who has the power to make you believe absurdities also has the power to make you commit atrocities." --Voltaire (1694-1778)

We need to value objectivity more than we do - we need to stop the corporate take over of the medical world. There is enough absurdity already.

The everybody take statin madness is so patently nuts but........!! Well for me it is. Maybe it's more nuts than homeopathy. The latter is at least harmless. That's why it did so well originally back when Haneman (sp) invented it. Back then my colleagues were poisoning folk with mercury and arsenic.

Greed, power, control and status - these are always polluting the waters. But so is agenda pumping - here particular attitudes and beliefs are valued more than what is so. Agenda pumping is all over the show in the 'health' world as is blind and dogged support for the status quo, orthodoxy, even when the evidence is against it.

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There is a demand from people for objective knowledge - what works doc? Prove it. There is also a demand for the mysterious, the healer, the unorthodox remedies, even the slighly 'weird' seems to have appeal. Proof isn't the issue here - procalmation and an unquestioning acquiesence are.

How is any human being to know what is best in the above strange world?

Vive le difference

We are all different thank God.

The Bogey Man of Defensive Medicine.

In an article titled the Bogey Man of Defensive Medicine the HDC commissioner 's message is pretty much harden up docs. We are doing good work and you should appreciate it. The HDC for some folk is a government appointed guardian of health consumers' interests - a white knight. Others, like myself, don't see it this way.

Change EXPERT to HDC and this cartoon pretty much catches how I felt after the HDC had finished with me 8 years or so ago.

It was a learning experience all right. I've learnt to judge others less. I've learnt that free will, being able to choose my thoughts and feelings, is a fine idea in theory but far from easy to apply in reality. I've learnt that words for the unenlightened, like myself, can hurt and the damage can last for many years. I've learnt, as with the body after trauma, there is emotional scarring.


Sometimes the scarring is keloid in nature and at other times it's almost invisible. I now react in ways I didn't used to - once burnt twice shy as they say. I operate more defensively and I do not interact with patients as openly.

The HDC's promise, intention or claim is that it's job is the fair, simple, speedy and efficient resolutions of complaints.

Resolution is the act or process of resolving. Resolving comes from re- + solvere to loosen or release. There is the meaning here of dissolving or melting, of dealing with something successfully, of clearing something up. This is the soft view of resolution. In this view parties to a dispute expect to be involved in the process and end up experiencing resolution - completion.

Then there is the meaning of an opinion being reached and resolution being a matter of the declaration of that opinion. Here the protagonists are sidelined to one degree or another. They are subjected to the opinion of others. These opinion makers may think the situation has been resolved and that it was resolved fairly, speedily and effectively. The protagonist may not. Who are the HDC's customers? Have they ever been independently surveyed with regards to their level of satisfaction?

From a providers point of view the HDC's job is come up with opinions. The commissioner can keep people on tenter hooks two years or more. He decides on whether or not providers have breached any codes and he comes up with recommendations or 'punishments'. He, in effect, lays charges, decides on what evidence to hear, hears it and passes judgment. He is policeman, attorney for both sides, judge and jury.

Speedy, simple, fair and effective resolution - sounds so soft and cuddly doesn't it. It's mostly firbies. All these words are defined by the act and the commissioner. They do not speak to the the complainant or provider's experience or definitions. It's within the HDC's commissioner's power to impose an opinion but its not within the ability of any third party to resolve anything between me and another. Yes the HDC could help, if asked but how can any of its workers possibly believe that the passage of their opinion will really resolve anything. This is imposition - not resolution. It's crazy thinking.

The quality of these opinions will depend upon the investigating officers level of interest, prejudices and motivations and on the funding of the HDC - maybe even the mood of the commissioner. It may even depend on who whispers in his or her ear. How are we to know? The rules of evidence are as lax as he decides. Providers have no rights to be heard, to see or hear evidence as it is gathered or respond to it. Providers simply wait in ignorance unless the commissioner feels like acting differently. Providers may think that once the opinion has been passed and they have done their 500 hail Marys that it's all over. Well maybe it's not. The commissioner can later change his or her mind and refer a provider for prosecution.

If a provider is referred, ends up in front of the Medical Disciplinary Tribunal and is not found guilty of anything, what happens to the HDC opinion? It stays on the provider's records. Even if it is factually wrong this is so. There is nothing that can be done about this as an HDC opinion can not be appealed. You can ask the medical council to remove it and they will say they can't. When you ask why not, they'll say because of patient safety!!!!!!!! More crazy thinking.

Injustice enrages people Ron. Unfair processes also anger people. You may think you are a fair man - you may well be a fair man, but you don't seem to have an inkling of how unfair your process is to experience. You don't lack intelligence - so why don't you see this. Maybe you can't afford to.

Is the HDC adding to the health of the nation - what are it's benefits and harms - what does it cost? Was it birth based on evidence or agenda?

Does it practice what it preaches? Did I feel respected or treated with dignity - you have got to be kidding. Was I fully informed - of course not.

What about complainants does it work for them? Who knows!

So what's the point of the whole exercise? Who gains from its existence?

Stockholm Syndrome

Click on cartoon to read small print.

We humans have an incredible ability to hang onto what's hurting or harming us, argue for it, rationalise it, make it look good even and have little to no awareness we are so doing. So when we come across a glaringly obvious form of the Stockholm Syndrome we are flabbergasted. We've all done it, the S.S. and probably are doing it to one degree or another. It's so easy to see this in others. There's a theme. We've heard it all before. There are stated intentions. I will change. I will stop. Nothing of substance changes except for maybe temporarily.