Wilberg on Wednesday - The Illness Is The Cure pt 10/46

When ‘The Cure Becomes the Illness’

“The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis, the name for this new epidemic, comes from iatros, the Greek word for ‘physician’, and genesis, meaning ‘origin’.” 

Ivan Illich Medical Nemesis, The Expropriation of Health

‘Iatrogenesis’ then, means ‘originating from a physician’ and refers to “preventable harm resulting from medical treatment or advice to patients. Professionals who may sometimes cause harm to patients are: physicians; pharmacists; nurses; dentists, psychologists, and therapists. Iatrogenesis can also result from complementary and alternative medicine treatments.” (Wiki)

Medically caused or ‘iatrogenic illness’ is the elephant in the room as regards the whole domain of biomedicine. Hence the deafening silence when a study published in the Journal of the American Medical Association¹ reported that in the United States an estimated 225,000 deaths per year have iatrogenic causes, with only heart disease and cancer causing more deaths”¹ – making biomedicine itself the third leading cause of illness-related death. Since the publication of this studiously ignored article, new figures show that biomedicine may have become the leading cause of death (see appendix 3 on ‘Death by Doctoring’).

“Doctor-inflicted pain and infirmity have always been a part of medical practice. Professional callousness, negligence, and sheer incompetence are age-old forms of malpractice. With the transformation of the doctor from an artisan exercising a skill on personally known individuals into a technician applying scientific rules to classes of patients, malpractice acquired an anonymous, almost respectable status. What had formerly been considered an abuse of confidence and a moral fault can now be rationalized into the occasional breakdown of equipment and operators. In a complex technological hospital, negligence becomes ‘random human error’ or ‘system breakdown’, callousness becomes ‘scientific detachment’, and incompetence becomes "a lack of specialized equipment." The depersonalization of diagnosis and therapy has changed malpractice from an ethical into a technical problem.” Illich

“The pain, dysfunction, disability, and anguish resulting from technical medical intervention now rival the morbidity due to traffic and industrial accidents and even war-related activities, and make the impact of medicine one of the most rapidly spreading epidemics of our time.” Illich

Hence it is also of critical importance to ‘Life Medicine’ and the ‘Life Doctor’ to recognise not only the many ways in which ‘The Illness is the Cure’ but also the converse: how illness itself can result from or be exacerbated by their supposed biomedical ‘cure’, whether in the form of drugs or surgery, hospitalisation, poor doctor-patient communication – not to mention the anxiety and stress induced by the increasingly detached, dehumanising and depersonalised approach to patients by medical practitioners and in ‘modern’ healthcare institutions. This is made worse by what Michael Balint² called ‘the collusion of anonymity’ – the way patients are regularly bounced from one specialist to another with no-one ever taking responsibility for them as a person – and the norm of short, 6-10 minute consultations. Doctors claim that given their workload longer consultations would be quite impossible, ignoring the fact that the ‘Long Consultation’ practiced by Balint – particularly if also approached with a view to exploring connections between the patient’s life history and problems and their medical history and symptoms – would without doubt significantly reduce the number of appointments and consultations sought for or needed by patients and in this way actually reduce the workload of doctors. The Long Consultation – up to an hour or more – would also restore a rich, personal and human dimension to doctor-patient communication. In this way it would also boost the innate potential of doctor-patient communication to fulfill an intrinsically healing function itself.

In contrast, the type of disappointment, dissatisfaction, stress and anxiety so often induced in patients through sheer shortness of standard consultations – not to mention reducing the dangers of negligence, the depersonalized mode of doctor-patient communication and ‘collusion of anonymity’ that go with it – themselves innately iatrogenic. The ‘Great Time Barrier’ to consultations with physicians both mirrors and reinforces a major social dimension of iatrogenesis. This is a social culture of manic economic busy-ness in which people do not have or grant sufficient time to their own bodies and bodily self-awareness, in which health itself is defined purely economically – in terms of the individual’s capacity for work and employment and in which Big Pharma promotes pills for any symptoms which interfere with their jobs – as if these symptoms were not in themselves a meaningful and important form of bodily rebellion against of lives dominated by anxieties and pressures surrounding jobs and employment. A social environment in which ‘making a living’ – living purely to earn money under any circumstances or conditions – dominates life itself is intrinsically pathological.

The biomedical model of illness buttresses and reinforces this social environment and its pathology, its principle being to get patients ‘back on their feet’ i.e. back into employment or wage slavery as quickly as possible, albeit at an essentially counter-productive cost to the health, not just of their bodies but of their lives as a whole – the social dimension of medical iatrogenesis.

As Illich notes:

“People would rebel against such an environment if medicine did not explain their biological disorientation as a defect in their health, rather than as a defect in the way of life which is imposed on them or which they impose on themselves.”

His summary:

“A professional and physician-based health-care system that has grown beyond critical bounds is sickening for three reasons: it must produce clinical damage that outweighs its potential benefits; it cannot but enhance even as it obscures the political conditions that render society unhealthy; and it tends to expropriate the power of the individual to heal himself and shape his or her environment.”

References:

¹ Starfield, Barbara MD MPH Journal of the American Medical Association, 2000

² Balint, Michael The Doctor, His Patient and the Illness