‘Modern medicine is like the medieval church’

Emily Hourican – Independent.ie Jan 28, 2019

Dr Seamus O’Mahony. Click to enlarge

‘I don’t think I could have written this even 15 years ago,” says Seamus O’Mahony, consultant gastroenterologist at Cork University Hospital, of his remarkable new book Can Medicine Be Cured?

The book tackles the state of modern medicine, from the highest reaches of technological research, down to the GP’s surgery and front- line healthcare workers. “The perspective of three-and-a-half decades is fantastic,” he continues. “It gives you knowledge, experience.” And daring, I suggest – the book is subtitled The Corruption Of A Profession.

Might he have been wary, even afraid, at an earlier point in his career? “I might have been,” he says. “I’m at a stage in my life and my career – I’ll be 59 next month – where I’m not looking for promotion or advancement so I’m not worried about any fallout in that regard. I think writing it at this stage gives you the freedom to say what you want to say.”

That said, he also believes that “the overwhelming majority of doctors who read this would be in agreement with what I say. All I’ve done in this book is put together what people in medicine and medical science have agreed is happening”.

So, what does he say? Plenty – this is a book shored up by deep medical, historical and sociological knowledge and research, which it wears so lightly that it is, as well as deeply provoking, even game-changing, a compulsive read.

He challenges the usefulness and credibility of medical research; the illusion of progress; our stubborn belief that we can be perfected; over-prescribing; poly-prescribing; the efficacy of many drugs that are routinely administered; the corruption of academic medical research; our collective failure to accept that medicine cannot cure everything, and indeed can cause trouble of its own; over-reliance on metrics; the pharmaceutical industry and its vast reach and influence, and far more.

There was, he points out, a ‘Golden Age’ of medicine, from the 1930s to the 1980s, during which a number of huge advances were made. TB, smallpox, polio, all huge killers, were effectively eradicated in the developed world. This Golden Age ended “just as I came into it, I caught the end of it. There have been very big advances since then, but nothing like that accelerated level of discovery and innovation that occurred in those 50 years.” Since then, medicine has increasingly lost its way.

Starting with ‘research’ – that great hope that will save us all – he is fairly scathing. I suspect that many of us believe (as I did) that medical research is being conducted in a coherent, structured, completely credible way, such that it will gradually solve all ills. That all one has to do is wait, and research will do the rest, finding cures for sicknesses long before we succumb to them. Maybe not, it seems. “Contemporary bio-medical research is itself very sick as an endeavour,” O’Mahony says. “There is even an acknowledgement and a consensus within bio-medical science that it has lost its way. It’s been estimated that anything up to 85pc of all bio-medical research is a waste of time. And that’s at a cost of $170bn (€150bn) annually.”

So what about the Human Genome Project, another shining light to many lay people with health issues? “The clinical applications from the humane genome project have been very few. And even the people who led the project, freely admit that the practical applications have been very disappointing. We’re nearly two decades on from it now and very little has emerged that has been useful to sick people. It’s a way of doing science, not a way of doing medicine.”

There is a fairly negative trickle-down effect to this; “frontline workers, GPs, hospital doctors, who may not be carrying out any of the research, who just do what they’re told in a way. I’ve drawn a parallel between modern medicine and medieval church: the higher level lay out dogma, the lower level work on the front line and implement it. They are not supposed to question any of it”.

At a more practical level, there’s the routine over-prescribing that goes on. “Pushing people into patient-hood,” as O’Mahony describes it, “for marginally elevated cholesterol levels, for example. The statin story is a great example of how the medical-industrial complex works. The overwhelming majority of people prescribed statins for high cholesterol levels are never going to benefit from taking this medication, and may experience harm.”

Connected with that, is poly-pharmacy, in which patients are prescribed further medication to deal with the side effects resulting from the primary medication, to the point where many elderly patients in particular are now taking five or more medications daily, all with their own side effects and possible complications.

This is O’Mahony’s second book. His first, The Way We Die Now, published in 2016, won a British Medical Association book award, and this is very much a follow-on. “One of the themes that emerged from that book was that modern medicine has become this culture of excess, this technological runaway train. I took that theme and ran with it for this book.”

Seamus studied medicine at UCC – he was the first person on his father’s side to go to university. “There’s a big thing in Ireland for doctors’ children to become doctors,” he says, “but I didn’t come from any kind of medical background. My father worked in Ford’s in Cork, he was a plasterer by trade and worked in the maintenance department. He was 20 years older than my mother. My mother’s 86 now, my dad died 34 years ago; he was 71. I was only a year qualified when he died.”

After UCC, he spent about four years doing junior hospital jobs in Cork, “then I emigrated to the UK”. He worked in Edinburgh, Yorkshire and finally as a consultant in Leeds for five years, then moved back to Ireland in 2001.

“A job came up, and at the time I was about 40, and it was then or never. I was very happy working where I was, but I did have this feeling of questioning myself: ‘Do you want to grow old and spend the rest of your life in England?’ The answer to that was I’m not sure, I don’t think so. So I came back to Ireland, at peak Celtic Tiger.”

He was married with two children – “I met my wife in Edinburgh. She’s Scottish. We met while she was doing a PhD in the same lab but her background was science, not medicine. She subsequently retrained as a solicitor, working mainly in medical negligence.”

The move back wasn’t without its traumas. “My wife liked the idea of Cork so she was happy to move. My daughter was five and my son was seven; he found it difficult to adjust to school in Ireland. He found it hard going. I found it hard going too, I’ll be honest, coming back after 14 years. I left in the 1980s, I came back and everything’s crazy. It’s the Celtic Tiger. It took a long time to adjust.” But, as time has gone on, he says, “I’m very glad I did make the decision”.

What would he like readers to take away from this book? “I write about the bogus contract between doctor and patient that has existed for several decades. The basis of this contract is that we can diagnose everything, fix most things, we never make mistakes and medicine is not dangerous. All of these things are untrue. We have limited powers. Medicine is very often ineffective and sometimes dangerous. We can’t fix everything, particularly social and existential problems. I think society needs to lower its expectations around what medicine can deliver. That’s one message I’d like people to take away with them.

“Then, there’s this cultural thing in Ireland where a consultation with a doctor must conclude with a prescription. I’d like people to think, ‘Is this medication really going to help me?’ I’d think about that in particular when it comes to drugs like statins, drugs for high blood pressure, high cholesterol, osteoporosis – these drugs that you’re going to take for the rest of your life, maybe 40 years, with an overwhelming likelihood that it will not give you any benefit whatsoever.”

As for where the evidence is coming from that such drugs “will not give any benefit”, there’s a thing called Number Needed To Treat (NNT), which is simply the number of patients you need to treat to prevent one additional bad outcome. The ideal NNT is 1. Statins have an NNT of 104. Meaning that 103 people will not benefit, and may well suffer side effects.

The industry side effect is that, because the money is in drugs taken over the long-term, that’s where the money and research goes. There is, O’Mahony says, “no money, or very little, going into antibiotic development, because a prescription for antibiotics is for seven days; a prescription for dementia, they’ll take it for 10-20 years. The return for a drug company on a new antibiotic is pretty low. The return on a drug for Parkinson’s, chronic lung failure, dementia – they’re huge returns.”

On the subject of patient support groups and ‘raising awareness’, he is scathing. “Ireland is stuffed with patient support groups. We’re a tiny country, but the number of these groups… it’s quite a big sector. Often, they are paying relatively well-known people reasonable wages to be chief executives.” The real problem is that the raising awareness leads to a kind of ‘my disease is better than your disease’ type scenario, where those who shout the loudest get the most, even where, as in the case of Orkambi, one of the best-known drugs and used to treat cystic fibrosis, the cost is around €100,000 per patient per year.

“Funding treatment on the basis of those who can best advocate – those who shout loudest – is bad. It’s unfair, it’s unscientific. It isn’t how we should be allocating what is a finite resource.”

And of course there is a particularly nasty downside to the whole ‘raising awareness’ notion: the neglect of those who don’t fit the profile or tick the virtue boxes. “I deal with a lot of people who suffer from chronic liver disease – this is a relatively young population, in their 30s, 40s, 50s, with established liver cirrhosis due to alcohol. It has a worse outcome than most cancers, but because it is perceived as self-induced and because it afflicts poorer, less-educated people by and large, you don’t have awareness campaigns for investing in treatment for chronic liver disease.”

Perhaps most alarming of all is his analysis of the future of the world of digital health – “Anyone with a smartphone will be monitoring themselves, or – more likely – will be monitored by some external agency. Health and life insurance companies will offer financial inducements to people to be monitored, and big corporations will undoubtedly make the wearing of health-tracking devices mandatory. The danger of all of this is that in countries where health care is paid for by insurance, a new underclass of uninsured people will emerge. Digital health,” he points out, “is presented as something empowering, but the reality is that it will lead to forms of enslavement that we can barely imagine. Facebook and Google have shown how easily people hand over their privacy and personal data in return for a few shiny trinkets. They have also shown how this personal data can be monetised.”

There isn’t a single bit of that analysis that seems far-fetched, indeed much of it is happening already, but it is chilling.

There is also a strong current of social conscience that runs through the book. “Medicine and healthcare has relatively little effect, now, on overall population health,” he points out. “Your health is far more likely to be determined by your education, your income, your job and where you live. Take the USA where they spend around 20pc of the GDP on healthcare and yet they have some of the worst outcomes, healthwise, in the world in terms of infant mortality, longevity and so on. We’re spending an ever-increasing amount of money on healthcare, but the benefit to us as a society is getting less and less as time goes on.” That healthcare budget, he says, should be put into housing, education, the eradication of deprivation, a boost in opportunity, the arts – “that’s a more effective way to treat the health of the population.”

Equally, he has simple, obvious solutions to the growing gap in global health inequality: “If we simply applied evenly and fairly across the world what we know currently works, medicine and society would be transformed. If we never did another new research project, and just took what we know now, and gave everybody access to it, global health would be transformed.”

Why has he written this book? “I’m still at the coalface – I’m down there, working in the medical department, seeing people on trolleys, and it seems an awful long way away from the journals, research departments.

“What I am seeing every day on the wards doesn’t tally up with the narrative that we as a profession present to our patients and our politicians – which is that everything is getting better. We’ve come to believe that our core function in medicine is to cure everything, extend life as far as possible, prevent diseases by putting whole populations on drugs and into screening programmes.”

Which is impossible. Because if there is one piece of ‘raising awareness’ O’Mahony is in favour of, it’s the obvious: “I’ve suggested we should have different awareness campaigns,” he says; “we’re all going to die”.

‘Can Medicine Be Cured?’ by Seamus O’Mahony, €20, is published on February 7 by Head of Zeus

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6 responses to “‘Modern medicine is like the medieval church’”

  1. A good interview with a level-headed and pragmatic doctor. There is much sound sense in his words.

  2. The “health care” system in the USA is hazardous to your health.

  3. Some good points and there may be much more in the book, but I am not sure he has any really helpful solutions which will lead to any reformation of the profession. My wife is a physician and medical scientist and sees other problems and in my own profession I am dealing with the work of physicians everyday.

    That medicine and medical science in our universities is largely controlled by big pharma is a “given” to most observers. Whomever pays the piper calls the tune, and you would think that would be the individual footing the bill either directly or indirectly through his or her taxes. But that is exactly the opposite of what is happening. We the people have little or any control of the process.

    Big pharma and big government have in my nation taken over medicine as in the UK. In the US since 1980 mainly big pharma and the insurance companies have been calling the shots. In both systems since then these institutions have systematically been eradicating the doctor/patient relationship and any sense of personal/professional responsibility. They tend to regard that relationship as archaic. but the real reason is that it is simply too expensive, for the various monolithic bureaucracies to compete. As for medical malpractice, that has virtually disappeared in Canada. Physical & hospital liability was simply “too expensive” for our systems to afford and after all, no one in the health-care industry would want to harm anyone, deceive people, or ignore any negligence, would they?

    For quality in medical care we have chosen a very poor grade of quantity based on government socialism and industry “spin doctor” hype. Everyone must have medical care and everyone must have the same level of care despite the cost. Very few people these would disagree with that statement because with all of the brainwashing it just seems so “unfair” that someone who drives a Bentley can get better medical care than someone who takes the bus. I am sure if the socialists had their way there would be no Bentleys and everyone would waiting for a bus. In my nation it has become illegal for physicians who practice public medicine to do anything private. Physicians are not evil but rather they are very deservingly the most appreciated people in the human family. Like firefighters their calling is to rescue and help, and to refrain from doing any harm. However, they appear to have little or no control of their profession unlike in the past.

    What about looking at the profession from the point of view of the patient. It is very difficult in my area to actually get a personal family physican anymore. You may have a favorite at some clinic that you can see, but no one is really following your chart or is even obligated to do so. As for diagnostics, it manly comes to testing. If you have a gall bladder problem, it will be months before anyone is able to put two and two together, and it is usually after repeated testing. That was not the case before the 1970’s. Patients now selfdom get general checkups. Of course when you finally get so sick to require actual extensive hospital care, that is when your charts are reviewed and someone tells you for the first time that you have had a heart condition for the past 20 years, as indicated on an old ECG which no one bothered to review until now.

    In my nation people are still free to hire a lawyer, an accountant, a naturopath or a treatment provider, and they are still free to some extent to spend their money on many so-called “non-essential” things like cigarettes, alcohol, thriller movies, trips, restaurants, bingo, and lottery tickets”. However, they are not allowed to privately hire their physician to spend any extra time diagnosing them or even listening to their problems, unless they are albe to search around and get one of the very few (3 or 4) physicians in the province who has opted out of the public system.

    In addition to the increased reliance on drugs, the profession is much more reliant on technology. No one can complain about all of the technological advances, but because of the expenses of high-tech equipment, many of our private hospitals have disappeared including the non-profit, charitable ones, which in general did a far better job in caring for their patients than the public ones. Centralized hospital and medical care has largely replaced any real autonomy for anything local. As you see with big pharma, big government controls the money and calls the tune, not the people. The way things are going, physicians will become appendages to AI-controlled diagnostics and treatment, and may end up not having any real personal responsibilities at all. That is likely what most bureaucrats think and want these days anyway. However, unless you have an actual person who is really able to understand what is going on and to intervein you are going to have bad medicine.

    Awareness of a host of problems in medicine have emerged over the years, such as loss of the doctor/patient relationship, the abandonment of personal responsibility, the denial of patients’ basic rights, the overly isolated & siloed specialties, the over-reliance on drugs and technology, the absence of preventive medicine, the absence of nutritional training, etc. Not much is being done about them and likely they will remain major problems until people wake up and realize that the people behind the controls and the central programming of the monolithic medical bureaucracies in government and industry, are not really in the business of rendering quality personal health care to individual persons.

    In fact, what we are witnessing today with all of our governments, the major corporations, and medical bureaucracies and administrations, is the total lockstep to some “AI” (Artificial Intelligence) or an “II” (Impersonal Intelligence) grid, carrying out plans for a “greener, smarter, and fairer” world, with a clearly fake medical pandemic. This “medical” pandemic with the oppression and complicity of the entire profession tells us exactly where the practice of medicine is going, and exactly how it will be continued to be abused by the elites behind the money, the levers of power, and the computers in the future.

    If the medical profession and those in medical science can be so lame as to even ignore the actual origin of the virus, buying into and dutifully following all of the government propaganda that it did not come from a lab, and then to make matters worse, present no real resistance to the medical-based deception that the virus is a serious threat requiring all of the insane government restrictions, then the medical profession has no integrity at all. It will be used and prostituted for one establishment psyop after another, until the big one, where a really potent killer virus will be released on us in order to cull the world population, as so many in the elite want to happen and those controlling the keyboards are likely already planning.

    We are supposed to trust the elite, technology and the medical establishment after this? , After this scamdemic? Their answer to this question is that they will control any “trust” problems in the public, through the media, fiat money, and government diktat, just as they are doing with the pandemic. So what we have now in place of real trust, real liberty, real justice, real responsibility, real medicine, real people, real life, and Reality, is virtual trust, virtual liberty, virtual justice, virtual responsibility, virtual medicine, virtual people, virtual life, and Virtual Realty, without any real Virtue to it at all.

    Cannot most physicians in the world wake up and see how devastating the establishment plandemic is. Despite any bigger picture of Great Resets, UN Agendas, or anything else, can they not see that the their integrity and personal trust, and that of the entire medical profession are are being used, abused and destroyed by this heinous mass deception?

  4. Thank you for this article.

    I’ve seen negative comments regarding statins before, but never from an actual medical professional. Last year, at age 48, I saw a private doctor for high blood pressure. He immediately put me on AtorvaSTATIN, at a considerable monthly cost. Subsequent BP readings of 120/80 were still considered “high”, and more medication (this time, beta blockers) was prescribed.

    Within six months I developed osteoarthritis in my knee as well as my hip. At this point both keep cracking and rattling. To leave the house, I need to wear a knee brace. Taking supplements hasn’t improved a thing. Neither have the BP pills – if I as much as delay taking one, it feels like I’m on the verge of a stroke.

    So that’s modern “healthcare”: In order to improve – marginally – one organ or function, we destroy another one.

  5. Doctors live off an illusion of authority. It is very appropriate to take it away from them. Health is not their strong point. They have to be treated as ordinary people.

  6. @Dayne – the best way to keep your health, is to stay away from doctors. I’m 51, the only time I’ve seen any doctors in the last 40 years (apart from being in hospital for a couple of weeks after a bad car crash) was about 3 years ago when I got a form of vertigo.

    Doctor sent me to a specialist…specialist sent me for a scan…resulting in neither of them knowing the cause. But that didn’t stop the doctor writing out a prescription. Instead of collecting it I went home to find out what it was. It was an ati-psycotic drug. Yes, it supposedly had benefits for dizziness, but there was no way I was taking that. I reckon if I had I’d still be on medication now for whatever else it caused.

    No-one has ever become ill due to a lack of drugs.

    @lewis jones – good points.