Having read the Open Letter to Dr. J Douglas Bremner of Emory University published on September 12, 2009 by Dr. David Gorski in Science-Based Medicine Blog in defense of Dr. Peter Lipson’s criticism of Dr Bremner I was immediately brought back to three articles all published in the 1999 medical literature.

One was by Dr Elliot Fisher from Dartmouth who was among the very first to dare to ask the basic question about “more possibly being worse” in US bio-medicine in JAMA. The second and third articles were from Dr Larry Dossey who then edited The Journal of Alternative and Complementary Medicine who wrote eloquently about intolerance among bio-medical scientists toward even considering Alternative Medicine. (see references below)

I would ask Drs Gorski and Lipson if an iconoclast like Dr Bremner might be serving a valuable role as gadfly to an entrenched failing status quo in bio-medicine who have made the mistake of deifying science? I would posit that the very essence of science is always and incessantly asking the question- “is it possible that I may be wrong?”. And I strongly support the return of narrative- the patient’s individual story- to the practice of medicine. The incomparable Sir William Osler, one of my heros in medicine, knew that well.

I believe that of all the determinants of successful US bio-medicine medicine going forward that a strong dose of humility is in very tall order.

To make progress our egos must die first- a basic psychiatric principle. It is much better and much more important to be tolerant and kind than to be right.

I support Dr Doug Bremner’s role as a colorful and passionate iconoclast. We need more like him.

Dr.Rick Lippin
Southampton,Pa
http://medicalcrises.blogspot.com

Ref-

-Fisher ES, Welch HG. Avoiding the unintended consequences
of growth in medical care: how might more be worse? JAMA 1999;
281:446-53.11.

— Dossey, Larry‘You people’: intolerance and alternative medicine. 1999;5(2):12-
17,109-112

A recent study from the National Cancer Institute has found that most cancer drugs are not worth the money. For instance, Erbitux, the drug used for the treatment of lung cancer, extends life by only an average of 1.2 months, hardly worth the expense of $80,000 for treatment. The authors calculated that extending life by one year for the 55,000 Americans who die of cancer would cost $440 billion. Other examples of basically useless treatments that will cost you the farm include Avastin and Nexavar, both costing more than $34,000 for a course of treatment.

Of course the usual suspects were trotted out in the form of doctors who stated that for some patients Erbitux is a miracle.

More egregious practices mentioned included doctors using drugs off label or aggressively treating people with Mercedes like drugs who had advanced stages of cancer. Of course Americans don’t like to talk about rationing of healthcare, which Rick Lippin MD has been talking about in the email circuit as well as the fact that more care can be worse care, and that profiting off of the dying should be prosecuted as a crime.

Hear, hear! (or is it Here, here?)

Maybe we as doctors should teach people to grieve their dead and dying, rather than enable them to flee from reality by throwing our expensive technology at their loved ones and colluding in the myth that everyone can live forever (e.g. “Aunt Mabel is fighting her cancer and gonna win” kind of nonsense).

Hat tap to John Mack (@pharmaguy).

The second swine flu death in the US was confirmed today, in Texas, where the first death occurred which really wasn’t an American death since it was a Mexican who crossed the border and happened to die in Houston. And the true numbers of deaths are unclear, with the original reports of 150 deaths in Mexico being ratcheted down as now only about 20 deaths or so are actually confirmed as swine flu. The 36,000 deaths per year trotted out every year by the Centers for Disease Control (CDC) here in my hometown of Atlanta, GA, are of course a lie, meant to instill paranoia and justify why we are paying for all of these people at the CDC to protect us from this big bogeyman. It is estimated that less than half of those people actually die from the flu, and that the others are usually very elderly who were immucompromised or on their way out from natural causes anyway. And the hand wringing about so many young people dying in Mexico? Well there aren’t that many actually confirmed deaths now that collective officials stopped letting their heads spin around on their necks and started actually looking at the data.

Fact is, that the swine flu contains elements that have been seen in previous versions of the flu, thus there is some immunity already built in in the population. And if you multiply the 403 confirmed cases in the US in the first month of the presence of the virus times 12 months you get a much smaller number than the hundreds of thousands that get conventional flu, and a much lower death rate! Everybody freaked out about the bird flu, but as I have said repeatedly over the past two years, if it mutated from an H5 version so that it could be transmitted to humans it would probably be less deadly.

But that doesn’t stop Richard Besser MD, acting head of the CDC, Janet Napolitano, head of Homeland Security (doesn’t that title give you the chills?) and Margaret Chan PhD, head of the World Health Organization (whom my blogger friend Rick Lippin MD recently called on to resign given her fear mongering in elevating the pandemic rating to Phase 5) from continuing to stir up fear and paranoia in the interest of keeping the public “informed”. I mean after all if there is no world wide catastrophe (as there won’t be) they can always just say better safe than sorry.

But anyhoo since we now have two deaths, that means that swine flu jumps ahead of bear attacks as a cause of mortality in the US. That is if you live in Alaska. Since only one person dies from bear attack every other year and that is usually in Alaska. They have whole magazines about it.

Deaths from swine flu surge past bear attacks

The more interesting question is when the musical chairs are gonna stop and everyone is gonna realize that this is all just one big bs media debacle. Alas, we can always claim that we have to wait until the fall when the ‘big one’ pandemic hits big time.

I’m sure former CDC Director Julie Geberding is glad that she resigned when she did. It was one of those political fall on your swords things, like she was a Bush girl and now time to go. But lets not dwell on many of the CDC trip ups of her reign, like ignoring the fact that the formaldihyde in trailers of Hurricane Katrina was making people sick, or ignoring Hurricane Katrina for that matter, or allowing her report on global warming to be edited by the Bush White House, or distorting research data on obesity to get more funding for her agency, or lying about the case of Andrew Speaker who was trumped up as a drug resistant XDR TB case (he wasn’t) which came about as part of the CDC strategy to get more funding by publicizing XDR TB as reported in the Atlanta Journal Constitution, or distorting obesity research findings for same purpose, or causing massive numbers of competent and respected scientists to leave CDC for her politicies and decisions, etc etc. So she is now riding into the sunset. Bye the bye, Julie.

Goodbye, Julie. Thank you for your years of "leadership" at CDC. You will not be missed.

 See you.. in September…