Understanding the World: The Hidden Costs of Healing
Exploring Medical Misadventure, Iatrogenic Illness, and Diverse Healing Traditions
Note: This essay was prepared with the assistance of LLM-AI as research assistant and ghostwriter. No LLM-AI were harmed in this process, although sometimes they were threatened.
Author's Preface
I have long been troubled by the staggering number of annual deaths attributed to medical misadventure in the United States. When I first encountered these numbers, my reaction was one of disbelief. How could the very system designed to heal be responsible for such a significant loss of life? Yet, as I delved deeper, the same alarming statistics surfaced repeatedly across various sources, leaving me to question not just the numbers but the entire structure of Western medicine.
This topic has become much more personal and pressing for me as I advance in years and face my own health challenges. Recently, I was prescribed statins, a medication I had long been wary of due to the negative views I’ve encountered in my reading. After taking them for a while, I began to notice that my memory seemed impaired, and I was experiencing more aches and pains than I considered appropriate for my age and fitness level. While I couldn't be sure whether these issues were directly related to the statins or other factors, my growing concern led me to stop taking the medication a few months ago.
Since then, I believe my memory has slightly improved, and the aches and pains have diminished. However, the presence of confounding factors makes it difficult to know for certain whether these changes were due to discontinuing the statins or were the result of other causes. This personal experience has deepened my interest in the broader issue of medical misadventure and the risks associated with various treatments, especially when the evidence is subject to multiple interpretations, as is often the case with alternative researchers and healers.
It is easy to assume that this issue is unique to the U.S., but I suspect the situation is similarly dire in other countries. This raises several critical questions: How many people are harmed versus those who benefit from medical intervention? What does the evidence say about the risks and benefits? Are we truly better off with Western medicine, or might some alternative approaches offer a safer, more effective path to health?
The majority of people seem to accept Western medicine without question, but a growing minority rejects it, opting instead for alternative methods. Do these individuals fare better or worse, or is it impossible to determine? Perhaps the evidence is unclear, or worse, unavailable.
Alternative approaches to what is often labelled "allopathic medicine" exist in every country, and many individuals find these methods more appealing. There is a pervasive sentiment that Western medicine, at its core, is a corrupt and dogmatic discipline, driven more by profit than by a genuine concern for health. Some argue that there is greater financial incentive in keeping people ill rather than curing them. This view may be cynical, but it is not without merit.
While the average general practitioner or specialist may not be venal, they are often guided—perhaps unknowingly—by forces driven by financial interests. These influences manifest through a variety of channels, including sponsored conferences, biased journals, corruption within the educational system, fraudulent research, and a culture of groupthink. Scholars like John P. Ioannidis have shed light on these issues, but the question remains: Where does the truth lie, and how can we navigate this complex landscape to improve our own health outcomes?
To answer these questions, we must consider not only the failures and successes of Western medicine but also the practices and principles of other healing traditions that have persisted over centuries. Whether it's the ancient wisdom of Traditional Chinese Medicine or the shamanic rituals of indigenous cultures, every approach offers its own perspective on what it means to heal. As skeptics in the tradition of the Pyrrhonian skeptics, we must approach all these traditions with an open mind, rigorously seeking out evidence and questioning assumptions without falling into the trap of cynicism.
Thought I could give you comfy answers did you? Nah, maybe you should flip a coin.
Introduction
Medical care, for all its advances, carries inherent risks. The very interventions designed to cure or manage diseases can sometimes cause harm, leading to what is known as iatrogenic illness. This term, derived from the Greek words for "physician" and "origin," refers to conditions that are induced unintentionally by medical treatment. In extreme cases, these misadventures can lead to death, raising profound ethical and practical concerns.
The question that looms large is whether the benefits of Western medicine truly outweigh the costs. This essay will explore the prevalence of iatrogenic illness and death, examining the evidence behind these incidents and questioning the integrity of the systems in place to prevent them. Beyond Western medicine, we will explore the practices of various medical traditions—some ancient, some modern—to better understand the full spectrum of healing approaches available. From Traditional Chinese Medicine to Ayurvedic practices, from shamanic healing rituals to chiropractic adjustments, each system of medicine offers its own worldview and methods, all of which merit close scrutiny. I do not endorse any these alternative methods, but then again, I have grave, grave reservations about allopathic medicine as well.
Section 1: The Scope of the Problem in Western Medicine
The numbers surrounding iatrogenic illness are sobering. Estimates suggest that hundreds of thousands of deaths annually in the United States alone can be attributed to medical errors, adverse drug reactions, and other forms of medical misadventure. These figures place iatrogenic causes of death among the leading causes of mortality, rivaling conditions such as heart disease and cancer.
Yet, the true scale of the problem is difficult to determine. Data collection on medical errors is fraught with challenges, including under reporting and inconsistent definitions of what constitutes a medical misadventure. The complexity of modern medical care further complicates the issue, as multiple factors—ranging from misdiagnosis to equipment failure—can contribute to patient harm.
Despite these challenges, the available evidence suggests that the risks associated with medical care are substantial. For every life saved or illness cured, there may be other negative and unintended consequences of medical intervention. The question, then, is whether these costs are an acceptable trade-off for the benefits that modern medicine provides.
Section 2: Exploring Alternative Medical Traditions
Given the concerns about iatrogenic illness in Western medicine, it is essential to explore other healing traditions that have developed over millennia. These practices, rooted in diverse cultural and philosophical frameworks, offer alternative perspectives on health and healing. However, they too must be examined critically, with a skeptical eye that seeks evidence of efficacy and safety.
Traditional Chinese Medicine (TCM): TCM is a system of medicine that has been practised in China for thousands of years. It is based on the concept of balancing yin and yang, the two opposing forces believed to influence health. Treatments include acupuncture, herbal remedies, and qigong (a form of movement meditation). While some aspects of TCM, such as acupuncture , have gained acceptance in the West and are supported by certain studies, others remain controversial or lack robust evidence.
Langevin and Wayne critique the current state of acupuncture research, emphasizing the methodological challenges and biases that undermine findings. They argue that the complexities of acupuncture, combined with research limitations, result in inconclusive and contradictory outcomes, necessitating a reevaluation of research approaches to better understand acupuncture's effects and address broader issues in the field (Langevin & Wayne, 2018).
Ayurvedic Medicine: Originating in India, Ayurveda is one of the world's oldest holistic healing systems. It emphasizes the balance of mind, body, and spirit and uses a variety of techniques, including diet, herbal treatments, and yoga, to promote health. Like TCM, Ayurveda has gained some recognition in the West, but the scientific evidence supporting its practices varies widely, with some treatments supported by clinical trials and others remaining speculative.
Shamanism: Shamanic practices, found in many indigenous cultures, involve rituals aimed at healing by connecting with spiritual realms. These practices often include the use of medicinal plants, drumming, and trance states. While shamanism is deeply rooted in the cultural and spiritual contexts of the societies that practice it, its efficacy as a medical treatment is difficult to assess using conventional scientific methods.
Herbal Healing: Herbal medicine is the use of plants for medicinal purposes. It is a cornerstone of both TCM and Ayurveda and is practiced in many cultures worldwide. While some herbal remedies have been validated by scientific research, others are used based on traditional knowledge, with varying degrees of success. The challenge with herbal medicine is the variability in potency and the lack of regulation, which can lead to inconsistent results and potential harm.
Bodywork Disciplines: Practices such as chiropractic care, Rolfing, and massage therapy focus on the manipulation of the body's musculoskeletal system to promote healing. Chiropractic, for instance, involves spinal adjustments to correct misalignments, which proponents claim can alleviate a range of ailments. While some bodywork therapies are supported by evidence for certain conditions, others remain controversial or lack rigorous scientific validation.
Energy Work: Energy healing practices, such as Reiki and therapeutic touch, are based on the idea that manipulating the body's energy fields can promote healing. These practices are highly controversial, with critics arguing that they lack a scientific basis and rely on placebo effects. From a skeptical perspective, energy work is particularly suspect, as its claims often defy the principles of physics and biology.
Holistic Medicine: Often considered an offshoot of allopathic medicine, holistic medicine emphasizes treating the patient as a whole, rather than focusing solely on the disease. This approach integrates physical, mental, and emotional health, often combining conventional medical treatments with alternative therapies. While holistic medicine is gaining popularity, it remains a field where scientific validation varies, and claims of efficacy must be carefully scrutinized.
Osteopathy: Osteopathy is a distinct branch of medical practice that originated in the United States in the late 19th century. It emphasizes the interrelationship between the body's structure and function, using techniques such as manipulation and mobilization to promote health. There are differences between British and North American traditions in osteopathy, with the former often focusing more on manual therapy and the latter incorporating more conventional medical practices. The evidence supporting osteopathy varies, with some studies showing benefits for certain conditions, while others suggest limited efficacy.
Bone Setting: Bone setting is a traditional practice found in various cultures, including the Philippines and parts of Africa and Asia. It involves the manual manipulation of bones and joints to treat fractures, dislocations, and other musculoskeletal issues. While bone setting has a long history, it is often practiced outside of formal medical systems, and its efficacy and safety can vary widely depending on the skill of the practitioner and the complexity of the injury.
Healing Traditions Across Cultures: Every culture has its own healing traditions, many of which have persisted for centuries. In Hawaii, for example, traditional healing practices include the use of herbal remedies, lomilomi massage, and spiritual healing. In North America, indigenous healing practices often involve herbal medicine, sweat lodges, and ceremonies to restore balance and harmony. Europe has also contributed to the diversity of healing practices, with traditions such as homeopathy and naturopathy. Each of these practices reflects the cultural values and worldviews of the societies in which they developed. While some have been integrated into mainstream medical practices, others remain on the fringes, embraced by those seeking alternatives to conventional care. The effectiveness of these traditions varies widely, with some supported by empirical evidence and others reliant on anecdotal accounts or long-standing belief systems.
However, the challenge remains: how do we evaluate these diverse approaches to healing? The key lies in distinguishing between costs and benefits on one hand, and threats and opportunities on the other. Costs and benefits are tangible, often measurable outcomes—such as the relief of symptoms or the side effects of treatment. Threats and opportunities, on the other hand, involve probabilistic thinking, where risk is understood as a combination of potential harms (threats) and potential gains (opportunities).
Section 3: The Role of Skepticism in Evaluating Healing Practices
As we explore these various medical traditions, it is crucial to approach them with a true spirit of skepticism—not cynicism. The Pyrrhonian skeptics of ancient Greece taught that we should suspend judgment on matters where evidence is inconclusive, and this principle is particularly relevant in the field of medicine.
For each of the practices described above, the question remains: What does the evidence show? Are these approaches effective, and if so, under what conditions? Are they safe, or do they carry risks similar to those found in Western medicine? To answer these questions, we must rely on rigorous research, critical analysis, and a willingness to question even our most deeply held beliefs.
It's also important to recognize that not all evidence is created equal. Anecdotal evidence1, while valuable in understanding individual experiences, is not sufficient to establish the efficacy of a treatment. Scientific evidence, derived from controlled studies and clinical trials, provides a more reliable basis for evaluating medical practices. However, even scientific evidence is not without its challenges—results can be inconclusive, studies can be biased, and interpretations can vary.
In the end, we are left with a complex landscape of conflicting views, where certainty is elusive, and the best course of action is often unclear. This is particularly true in areas where medical traditions overlap or contradict one another, such as the use of food and nutrition as medicine—a topic that has gained significant traction in recent years.
Section 4: Food as Medicine and Nutritional Approaches
The concept of "food as medicine" has a long history, with roots in various medical traditions, including Ayurveda and Traditional Chinese Medicine. In these systems, diet is seen as a key component of health, with specific foods prescribed to balance the body's energies or treat specific ailments. In recent years, this idea has gained popularity in the West, driven by growing awareness of the impact of diet on health and the rise of movements such as functional medicine and integrative nutrition.
Nutritional approaches to health are diverse, ranging from the promotion of plant-based diets to the advocacy of low-carbohydrate, high-fat regimes like the ketogenic diet. Each approach makes claims about its benefits, often supported by studies, testimonials, or historical precedent. However, these claims are frequently in conflict, leading to confusion and debate.
For example, proponents of a plant-based diet argue that it reduces the risk of chronic diseases, while supporters of the ketogenic diet claim it is more effective for weight loss and managing conditions like diabetes. Both sides present evidence to support their views, but the conflicting assertions highlight the difficulty in establishing definitive truths in the realm of nutrition.
As with other medical practices, the challenge in evaluating nutritional approaches lies in the complexity of human health and the variability in individual responses to diet. What works for one person may not work for another, and the long-term effects of specific dietary patterns are often unknown. This underscores the need for a cautious, evidence-based approach when considering food as medicine.
Summary
The issue of iatrogenic illness and death in Western medicine is a complex and deeply troubling one. The evidence suggests that while modern medical care has the potential to save lives and alleviate suffering, it also carries significant risks that cannot be ignored. Financial interests and the potential for corruption further complicate the picture, raising questions about the integrity of the healthcare system and the motivations behind medical practice.
At the same time, alternative medical traditions offer their own perspectives on healing, each with its strengths and weaknesses. From Traditional Chinese Medicine to Ayurvedic practices, from shamanic rituals to energy healing, these approaches provide a wide array of options for those seeking to improve their health. However, they too must be evaluated critically, with a focus on evidence and safety.
The concept of "food as medicine" further complicates the landscape, as nutritional approaches are often intertwined with cultural beliefs and personal preferences. The conflicting claims in the field of nutrition mirror those in other areas of medicine, where certainty is elusive, and the truth is often difficult to ascertain.
In the end, the decision of how to approach one's health is a deeply personal one, informed by individual values, beliefs, and experiences. This essay does not seek to provide definitive answers, but rather to provoke thought and encourage readers to engage with the complexities of medical care, recognizing both its potential and its pitfalls.
References
Ioannidis, J. P. (2005). Why most published research findings are false. PLoS Medicine, 2(8), e124.
Capsule Description: This seminal paper by Ioannidis explores why many published research findings may be incorrect, highlighting issues such as bias, small sample sizes, and methodological flaws. It is relevant to the essay’s discussion on the reliability of medical research and the skepticism required when interpreting study results.
Available at: https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0020124&type=printable
Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. BMJ, 353, i2139.
Capsule Description: This article argues that medical errors are the third leading cause of death in the United States, underscoring the significant risks associated with medical care. It supports the essay’s focus on the prevalence and impact of iatrogenic illness.
Available at: https://www.bmj.com/content/353/bmj.i2139
Starfield, B. (2000). Is US health really the best in the world? JAMA, 284(4), 483-485.
Capsule Description: Starfield’s article critiques the U.S. healthcare system, pointing out the high rates of iatrogenic illness and questioning whether the benefits of medical interventions outweigh the risks. It is relevant to the essay’s examination of the effectiveness and dangers of Western medicine.
Available at: https://jamanetwork.com/journals/jama/fullarticle/192908
Langevin, H. M., & Wayne, P. M. (2018). What is the point? The problem with acupuncture research that no one wants to talk about. The Journal of Alternative and Complementary Medicine, 24(3), Article
Capsule Description: The article by Langevin and Wayne (2018) critiques the current state of acupuncture research, highlighting the significant methodological challenges and biases that undermine the validity of findings. The authors argue that the inherent complexities of acupuncture as a treatment modality, combined with the limitations of existing research frameworks, have led to inconclusive and often contradictory results. They call for a reevaluation of research approaches to better capture the nuanced effects of acupuncture and to address the broader issues that impede progress in the field.
Available at: https://doi.org/10.1089/acm.2017.0366
Ernst, E. (2000). Prevalence of use of complementary/alternative medicine: a systematic review. Bulletin of the World Health Organization, 78(2), 258-266.
Capsule Description: Ernst’s systematic review provides an overview of the prevalence of complementary and alternative medicine practices worldwide, offering statistical context for the essay’s discussion on the use of these therapies across different cultures and their perceived efficacy.
Available at: https://pubmed.ncbi.nlm.nih.gov/10743298/
Davis, C., & Golembiewski, E. (2020). The science of nutrition: Debunking diet myths and the role of food in health. The American Journal of Clinical Nutrition, 111(6), 1247-1253.
Capsule Description: This article critically examines common dietary myths and the scientific evidence surrounding various nutritional approaches, making it directly relevant to the essay’s exploration of “food as medicine” and the often contradictory claims made by different dietary philosophies.
Available at: https://www.amazon.ca/Science-Nutrition-Debunk-Responsibly-Happiness/dp/0744039894
Anecdotal Evidence: A common refrain among pseudo-skeptics is that "the plural of anecdote is not data." This phrase is often used to dismiss anecdotal evidence as inherently unreliable or unscientific. However, this is a misstatement of the original idea. The phrase "the plural of anecdote is data" was first articulated by political scientist Raymond Wolfinger during a graduate seminar at Stanford University in the 1969-70 academic year. Wolfinger used it in response to a student's dismissal of a factual statement as merely anecdotal, emphasizing that when multiple anecdotes point in the same direction, they can collectively form a type of data worthy of consideration.
This concept was later echoed in published works, such as Roger G. Noll's 1980 book chapter "The Game of Health Care Regulation," which highlighted that consistent anecdotes could indeed serve as valuable data, especially in contexts where systematic data collection is challenging.
While anecdotal evidence is not as robust as data derived from randomized controlled trials or large-scale studies, it plays a crucial role in the early stages of research. Anecdotes often serve as a starting point for generating hypotheses or identifying patterns that may warrant further investigation. In some contexts, particularly where large-scale studies are impractical, unethical, or prohibitively expensive, anecdotal evidence may be the best available option.
This does not mean that anecdotal evidence should be treated with the same weight as more rigorous forms of research. However, dismissing it outright ignores the reality that all data originates from individual observations, and trends often emerge from these small beginnings. While more structured and systematic methods of research are crucial for validating these observations, anecdotal evidence remains an important piece of the puzzle in understanding complex phenomena, particularly in areas like medicine where individual responses to treatments can vary widely.