January 24, 2012
Larry Malerba, D.O.
With all the buzz surrounding the specter of cataclysmic change that may soon be upon us as the Mayan calendar comes to an end in December, it's a good time to take stock of life here on planet Earth. While doomsday predictions will no doubt garner much of the attention from the mainstream media, I don't plan on building a fallout shelter or taking any other extreme precautions for that matter. Nevertheless, there are big changes coming and I do believe that it is possible to discern the outlines of a new cultural paradigm that has been slowly taking shape for quite some time. What it holds in store for medicine should be of interest to us all.
On a global scale, signs of the shift are already evident. In just a short span of time we have witnessed floods, tsunamis, earthquakes, melting polar ice caps, the Fukushima disaster, and dramatic changes in weather patterns. In socioeconomic and geopolitical terms, we have seen the fall of the Twin Towers, the Wall Street financial meltdown, the burst of the housing bubble, the Iraq and Afghanistan wars, the European monetary crisis, and an ever-widening income gap between the haves and have-nots.
On a more positive note, we have also seen sweeping changes in the ethnic diversity of America, election of the first black American president, positive gains in terms of LGBT rights, powerful calls for democratic change represented by the Arab Spring, and the rise of the Tea Party and Occupy Wall Street movements. The issues of personal freedom, respect for differences, and the right to truly pursue life, liberty, and happiness that were swept in with the sixties generation are making their way to the cultural forefront once again.
Although freedom of expression, economic prosperity, and basic human rights are benefits that many have come to enjoy, there are many others who have been left behind. America's remarkable coming of age and rise to power has a very dark side to it and comes at great expense to our collective well-being. The pendulum has swung far in the direction of economic and cultural imperialism, militarism under the guise of peacekeeping, and unprecedented materialism and consumerism. We are now reaping the harvest of the long-term and unapologetic exploitation of resources and people both here and abroad.
At the root of it all may be an economic philosophy that condones and even encourages the runaway growth of corporate abuse, power, and control at the expense of individual considerations. And the Supreme Court's ruling on the Citizen's United case, which gave personhood status to corporations, may be the straw that has broken the camel's back. Government is broken and it has sold its soul to corporate interests. Perhaps the greatest long-term impact of corporate influence has been the persistent and insidious homogenization, commodification, and commercialization of American culture, accompanied by the soul-deadening depersonalization that goes hand-in-hand with these trends. People everywhere are feeling the impact of these influences in their daily lives, whether they can identify it as such or not.
It has taken the severe hardship that accompanies unemployment, losing one's home, and being unable to afford basic health care in time of need, to waken the commercially pacified public from their material comfort and political apathy. They have woken to an America where they find that the corporate fox is guarding the henhouse. It seems that 2012 may well set the stage for an epic struggle between the American people's best and worst impulses. Their fear and blind rage have spawned a variety of reactions, both negative and positive -- from a call to eliminate most if not all government, blaming America's woes on immigrants, and a return to fundamentalist religious intolerance -- to a recognition that basic democratic principles have been eroded by a relative few with too much power, wealth, and control.
Those who wish to maintain the status quo are inclined to distort the Occupy movement's message as a call for the redistribution of wealth, as if to imply that Occupy supporters are anti-capitalist. Of course, nothing could be further from the truth. But the movement is a call for greater fairness and the leveling of a playing field that has been tilted in favor of those already in control for quite some time now. People are not demanding that the wealthy hand over the goods as much as they are fed up with being gouged and manipulated at every turn by forces that they cannot control.
My own personal concern here is with an issue that I hold dear to me -- health care. The medical establishment has become but a reflection of corporate culture with its caste system of privilege, indifference to the poor, and enslavement to corporate product and profit. The stranglehold of Pharma, the insurance and health maintenance middlemen, and a few powerful entities like the FDA, AMA, and a few elite medical journals has created an oppressive environment of intolerance that stifles creativity and crushes dissent. It should not be surprising, and it is only fitting, that a consumer culture would adopt such a commercial form of medicine. In a world full of exciting medical alternatives -- many of which are cheaper, safer, and often more effective -- the only criteria that seems to meet establishment standards for a viable therapy is that it come in the form of a synthetic and often toxic chemical pill manufactured by an unscrupulous pharmaceutical behemoth.
Despite overwhelming patient satisfaction and clinical evidence in support of alternative therapies such as acupuncture, Ayurveda, homeopathy, Chinese medicine, herbal medicine, chiropractic, nutrition, and energy healing, to name just a few, organized medicine tends to dismiss these options as unproven, pseudoscientific practices. Furthermore, mainstream medicine has been known to muster up the audacity to accuse alternative practitioners of attempting to rip off the public -- as if conventional medicine could never be accused of the same. And the irony is that the whole rotten enterprise hides behind the authority of "science" whenever the madness of its methods are questioned. Never mind that one medical study commonly contradicts another, and that medical research is riddled with conflict of interest, cover-ups, and the manipulation of data to conform to desired outcomes.
The medical establishment rewards conformity, enslaves doctor and patient alike by restricting choice and mandating certain practices, and uses supposedly private patient information to threaten job loss, school expulsion, and discontinuation of medical services if patients do not act in accordance with medicine's arbitrary and capricious rules. Relentless fear-based propaganda is designed to convince us that we will die if we don't take cholesterol drugs, be forever unhappy if we don't take antidepressants, fall down and break our bones without drugs to prevent osteoporosis, and lose our manhood if we don't use erectile dysfunction pills. The masses are treated as guinea pigs for an endless string of dangerous and unproven drugs, vaccines, and procedures many of which are withdrawn from the market only after the casualties have mounted to a point where they can no longer be ignored. Do we really need to ask who benefits from this unconscionable merchandising of medicine?
And so I say to you, isn't it also time for an Occupy Big Medicine movement? The basic principles behind these unsettling cultural, economic, and governmental trends are the very same ones that have corrupted medicine: concentration of wealth, the erosion of basic freedoms, authoritarian responses to dissent, and the institutional denial of ethical and moral responsibility. The counterbalance to this trend can only be found in personal autonomy, self-education, the courage to go against the grain, and the will to resist authoritarian impulses. It also requires an unflinching belief in the right to personal medical freedom with an understanding that, unlike what medical science would have us believe, there is rarely only one correct medical choice to any given health problem. There are many more solutions that medicine is willing to acknowledge.
If we truly respect democratic principles, then we understand that there are no right or wrong medical choices -- there are only personal choices. A deep respect for the diversity of medical practices and opinions is of paramount importance. But with this comes the need to accept personal responsibility for the choices we make rather than blaming the medical direction that we have chosen. Human health and healing can be mysterious and unpredictable, and, so, the general public must not fall for the illusion of medicine as a hard science. Although certain therapeutic options may be preferable to others in particular situations, there is no guaranteed, foolproof road to a satisfactory medical outcome.
Are corporations and corporate medicine inherently evil? No, but when corporate interests come before the people that they employ and serve, it ultimately does harm to everyone. The internet has become the great equalizer by virtue of its unfettered flow of information and because it provides people with common interests a way to communicate with one another -- and even that liberty is now being threatened by corporate greed. The Internet will play a crucial role in reclaiming our medical rights to privacy, choice, and basic affordable health care for all.
A swing of the pendulum usually generates an equal and opposite reaction, and with change often comes conflict. As the old medical paradigm informed by its materialistic, reductionist, survival of the fittest worldview resists, a new, greener, more holistic, person-oriented approach that understands the irreducible unity of body, mind, and spirit stands ready to demand its rightful place in history. It will not require the overthrow of the special interests of the old medical order as much as a recognition that the whole is greater than the sum of its parts. Corporate medicine that places profit ahead of people is no longer tenable. Slick advertising and cute slogans that pander to holism won't cut it either.
The new medical paradigm will include a place for everyone. No one will be excluded. We need massage therapists, integrative medicine practitioners, and spiritual healers just as much as we need gynecologists, endocrinologists, and surgeons. We are the owners of our own health, not the corporate-medical-industrial complex. We must reclaim our rights to privacy, our fundamental right to make choices without being hounded by medical big brother, and our personal medical autonomy.