Wednesday, August 10, 2011

Salvaging Health

The old chestnut about living in interesting times may not actually be a Chinese curse, as today’s urban folklore claims, but it certainly comes to mind when glancing back over the smoldering wreckage of the past week. In the wake of a political crisis here in America that left both sides looking more than ever like cranky six-year-olds, a long-overdue downgrade of America’s unpayable debt, and yet another round of fiscal crisis in the Eurozone, stock and commodity markets around the globe roared into a power dive from which, as I write this, they show no sign of recovering any time soon.

In England, meanwhile, one of those incidents Americans learned to dread in the long hot summers of the Sixties—a traffic stop in a poor minority neighborhood, a black man shot dead by police under dubious circumstances—has triggered four nights of looting and rioting, as mobs in London and elsewhere organized via text messages and social media, brushed aside an ineffectual police presence, plundered shops and torched police stations, and ripped gaping holes in their nation’s already shredding social fabric. It seems that “Tottenham” is how the English pronounce “Watts,” except that the fire this time is being spread rather more efficiently with the aid of Blackberries and flashmobs.

Government officials denounced the riots as “mindless thuggery,” but it’s considerably more than that. As one looter cited in the media said, “this is my banker’s bonus”—the response of the bottom of the social pyramid, that is, to a culture of nearly limitless corruption further up. It bears remembering that the risings earlier this year in Tunisia, Egypt, and elsewhere began with exactly this sort of inchoate explosion of rage against governments that responded to economic crisis by tightening the screws on the poor; it was only when the riots showed the weakness of the existing order that more organized and ambitious movements took shape amid the chaos. It’s thus not outside the bounds of possibility, if the British government keeps on managing the situation as hamhandedly as it’s done so far, that the much-ballyhooed Arab Spring may be followed by an English Summer—and just possibly thereafter by a European Autumn.

One way or another, this is what history looks like as it’s happening. Those of my readers who have been following along for a year or two, and have made at least a decent fraction of the preparations I’ve suggested, are probably as well prepared for the unfolding mess as anyone is likely to be. Those who have just joined the conversation, or were putting aside preparations for some later date—well, once the rubble stops bouncing and the smoke clears, you’ll have the chance to assess what possibilities are still open and what you have the resources to accomplish. In the meantime, I want to continue the sequence of posts already under way, and discuss another of the things that’s going to have to be salvaged as the current system grinds awkwardly to a halt.

The theme of this week’s discussion, I’m sorry to say, is another issue split down the middle by the nearly Gnostic dualisms that bedevil contemporary American society. Just as Democrats and Republicans denounce each other in incandescent fury, and fundamentalist atheists compete with fundamentalist Christians in some sort of Olympics of ideological intolerance, the issues surrounding health care in America these days have morphed unhelpfully into a bitter opposition between the partisans of mainstream medicine and the proponents of alternative healing. The radicals on both sides dismiss the other side as a bunch of murderous quacks, while even those with more moderate views tend to regard the other end of the spectrum through a haze of suspicion tinged with bad experiences and limited knowledge.

I stay out of such debates as often as I can, but this one hasn’t given me that choice. Ironically, that’s because I’ve experienced both sides of the issue. On the one hand, I’m alive today because of modern medicine. At the age of seven, I came down with a serious case of scarlet fever. That’s a disease that used to kill children quite regularly, and in a premodern setting, it almost certainly would have killed me. As it was, I spent two weeks flat on my back, and pulled through mostly because of horse doctor’s doses of penicillin, administered first with syringes that to my seven-year-old eyes looked better suited for young elephants, and thereafter in oral form, made palatable with an imitation banana flavoring I can still call instantly to mind.

Then there’s the other side of the balance. My wife has lifelong birth defects in her legs and feet, because her mother’s obstetrician prescribed a drug that was contraindicated for pregnant women because it causes abnormalities in fetal limb development. My only child died at birth because my wife’s obstetrician did exactly the same thing, this time with a drug that was well known to cause fatal lung abnormalities. Several years later we found out by way of a media exposé that the latter doctor had done the same thing to quite a few other women, leaving a string of dead babies in his wake. The response of the medical board, once the media exposure forced them to do something, was quite standard; they administered a mild reprimand. If this reminds you of the Vatican’s handling of pedophile priests, well, let’s just say the comparison has occurred to me as well.

Deaths directly caused by American health care are appallingly common. A widely cited 2000 study by public health specialist Dr. Barbara Starwood presented evidence that bad medical care kills more Americans every year than anything but heart disease and cancer, with adverse drug effects and nosocomial (hospital- and clinic-spread) infections the most common culprits. A more comprehensive study prepared outside the medical mainstream, but based entirely on data from peer-reviewed medical journals, argued that the actual rate was much higher—higher, in fact, than any other single cause. That’s part of what makes the controversies over American health care so challenging; mainstream medical care saves a lot of lives in America, but because of the pressures of the profit motive, and the extent to which institutional barriers protect incompetent practitioners and dangerous and ineffective remedies, it also costs a lot of lives as well.

Even so, if I could find a competent, affordable general practitioner to give me annual checkups and help me deal with the ordinary health issues middle-aged men tend to encounter, I’d be happy to do so. The catch here is that little word "affordable." Along with those birth defects, my wife has celiac disease, a couple of food allergies, and a family history with some chronic health problems in it; for that matter, my family history is by no means squeaky clean; we’re both self-employed, and so health insurance would cost us substantially more than our mortgage. That’s money we simply don’t have. Like a large and growing fraction of Americans, therefore, we’ve turned to alternative medicine for our health care.

The more dogmatic end of the mainstream medical industry tends to dismiss all alternative healing methods as ineffective by definition. That’s self-serving nonsense; the core alternative healing modalities, after all, are precisely the methods of health care that were known and practiced in the late 19th century, before today’s chemical and surgical medicine came on the scene, and they embody decades or centuries of careful study of health and illness. There are things that alternative health methods can’t treat as effectively as the current mainstream, of course, but the reverse is also true.

Still, behind the rhetoric of the medical industry lies a fact worth noting: alternative medical methods are almost all much less intensive than today’s chemical and surgical medicine. The best way to grasp the difference is to compare it to other differences between life in the late 19th century and life today—say, the difference between walking and driving a car. Like alternative medicine, walking is much slower, it requires more personal effort, and there are destinations that, realistically speaking, are out of its reach; on the other hand, it has fewer negative side effects, costs a lot less, and dramatically cuts your risk of ending up buttered across the grill of a semi because somebody else made a mistake.

Those differences mean that you can’t use alternative medicine the way you use the mainstream kind. If I neglect a winter cold, for example, I tend to end up with bacterial bronchitis. A physician nowadays can treat that with a simple prescription of antibiotics, and unless the bacterium happens to be resistant—an issue I’ll be discussing in more detail in a bit—that’s all there is to it. If you’re using herbs, on the other hand, handling bacterial bronchitis is a more complex matter. There are very effective herbal treatments, and if you know them, you know exactly what you’re getting and what the effects will be. On the other hand, you can’t simply pop a pill and go on with your day; you have to combine the herbal infusions with rest and steam inhalation, and pay attention to your symptoms so you can treat for fever or other complications if they arise. You very quickly learn, also, that if you don’t want the bronchitis at all, you can’t simply ignore the first signs of an oncoming cold; you have to notice it and treat it.

Here’s another example. I practice t’ai chi, and one of the reasons is that it’s been documented via controlled studies to be effective preventive medicine for many of the chronic health problems Americans tend to get as they get old. You can treat those same problems with drugs, to be sure, if you’re willing to risk the side effects, but again, you can’t just pop a t’ai chi pill and plop yourself back down on the sofa. You’ve got to put in at least fifteen minutes of practice a day, every day, to get any serious health benefits out of it. (I do more like forty-five minutes a day, but then I’m not just practicing it for health.) It takes time and effort, and if you’ve spent a lifetime damaging your health and turn to t’ai chi when you’re already seriously ill, it’s unlikely to do the trick.

All these points are relevant to the core project of this blog, in turn, because there’s another difference between alternative health care and the medical mainstream. All the core alternative modalities were all developed before the age of cheap abundant fossil fuel energy, and require very little in the way of energy and raw material inputs. Conventional chemical and surgical medicine is another thing entirely. It’s wholly a creation of the age of petroleum; without modern transport and communications networks, gargantuan supply chains for everything from bandages through exotic pharmaceuticals to spare parts for lab equipment, a robust electrical supply, and many other products derived from or powered by cheap fossil fuels, the modern American medical system would grind to a halt.

In the age of peak oil, that level of dependency is not a survival trait, and it’s made worse by two other trends. The first, mentioned earlier in this post, is the accelerating spread of antibiotic resistance in microbes. The penicillin that saved my life in 1969 almost certainly wouldn’t cure a case of scarlet fever today; decades of antibiotic overuse created a textbook case of evolution in action, putting ferocious selection pressure on microbes in the direction of resistance. The resulting chemical arms race is one that the microbes are winning, as efforts by the pharmaceutical industry to find new antibiotics faster than microbes can adapt to them fall further and further behind. Epidemiologists are seriously discussing the possibility that within a few decades, mortality rates from bacterial diseases may return to19th-century levels, when they were the leading cause of death.

The second trend is economic. The United States has built an extraordinarily costly and elaborate health care system, far and away the most expensive in the world, on the twin pillars of government subsidies and employer-paid health benefits. As we lurch further into what Paul Kennedy called "imperial overstretch"—the terminal phase of hegemony, when the costs of empire outweigh the benefits but the hegemonic power can’t or won’t draw back from its foreign entanglements—the government subsidies are going away, while health benefits on the job are being gutted by rising unemployment rates and the frantic efforts of the nation’s rentier class to maintain its standards of living at the expense of the middle classes and the poor.

Requiring people who can’t afford health insurance at today’s exorbitant rates to pay for it anyway under penalty of law—the centerpiece of Obama’s health care "reform"—was a desperation move in this latter struggle, and one that risks a prodigious political backlash. If Obama’s legislation takes effect as written in 2014, and millions of struggling American families find themselves facing a Hobson’s choice between paying a couple of thousand a month or more for health insurance they can’t afford, or paying heavy fines they can’t afford either, it’s probably a safe bet that the US will elect a Tea Party president in 2016 and repeal that—along with much else. Whether that happens or not, it’s clear at this point that the United States can no longer afford the extraordinarily costly health care system it’s got, and the question at this point is simply what will replace it.

In the best of all possible worlds, the existing medical system would come to terms with the bleak limits closing in around it, and begin building a framework that could provide basic health care at a reasonable price to the poor and working classes. It actually wouldn’t be that difficult, but it would require the medical industry to remove at least some of the barriers that restrict medical practice to a small number of very highly paid professionals, and to accept significant declines in quarterly profits, doctors’ salaries, and the like. Maybe that could happen, but so far there doesn’t seem to be any sign of a movement in that direction. Instead, health care costs continue to rise as the economy stalls, moving us deeper into a situation where elaborate and expensive health care is available to a steadily narrowing circle of the well-to-do, while everyone outside the circle has to make do with what they can afford—which, more and more often, amounts to the 19th-century medicine provided by alternative health care.

Thus I’m not especially worried about the survival of alternative healing. Despite the fulminations of authority figures and the occasional FDA witch hunt, the alternative healing scene is alive and well, and its reliance on medicines and techniques that were viable before the age of cheap abundant fossil fuels means that it will be well equipped to deal with conditions after cheap energy of any kind is a thing of the past. No, what concerns me is the legacy of today’s mainstream medicine—the medicine that saved my life at age seven, and continues, despite its difficulties and dysfunctions, to heal cases that the best doctors in the world a century and a quarter ago had to give up as hopeless.

Even if a movement of the sort I’ve suggested above were to take place, a great deal of that would be lost or, at best, filed away for better times. The most advanced medical procedures at present require inputs that a deindustrial society simply isn’t going to be able to provide. Still, there’s quite a bit that could be saved, if those who have access to the techniques in question were to grasp the necessity of saving them. As it stands, the only people who can salvage those things are the physicians who are legally authorized to use them; the rest of us can at best get a working grasp of sanitation and sterile procedure, the sort of wilderness-centered first aid training that assumes that a paramedic won’t be there in ten minutes, and the sort of home nursing skills that the Red Cross used to teach in the 1950s and 1960s—you can still find the Red Cross Home Nursing Manual in the used book market, and it’s well worth getting a copy and studying it.

Other than that, it’s up to the physicians and the various institutions they staff and advise. If they step up to the plate, the deindustrial future will have the raw materials from which to evolve ways of healing that combine the best of mainstream and alternative methods. If they don’t, well, maybe enough written material will survive to enable the healers of the future to laboriously rediscover and reinvent some of today’s medical knowledge a few centuries down the road. While the decision is being made, those of us who don’t have a voice in it have our own decisions to make: if we have the money and are willing to accept one set of risks, to make use of today’s chemical and surgical medicine while it’s still around; if we have the interest and are willing to accept another set of risks, to make use of one or more methods of alternative medicine; or if neither option seems workable or desirable, to come to terms with a reality that all of us are eventually going to have to accept anyway, which is that life and health are fragile transitory things, and that despite drugs and surgeries on the one hand, or herbs and healing practices on the other, the guy with the scythe is going to settle the matter sooner or later with the one answer every human being gets at last.

208 comments:

1 – 200 of 208   Newer›   Newest»
John Michael Greer said...

This post, like the one two weeks ago, touches on issues about which people tend to have very strong feelings, and I'd like to ask everyone to make an extra effort to be polite and fair. Regular readers know that the paragraph above the comment box is not there for decoration; I'd strongly encourage others to read it before posting -- and if you're wading in here for the purpose of slagging alternative medicine, or mainstream medicine, or me, save your breath, because I'm just going to hit the delete button. That said, as always, "courteous, concise comments relevant to the topic of the current week's post are welcome."

tOM said...

Move to Canada! We could use a little more sanity.

. said...

While I am 100% in sync with your ideas about the long descent and the unwinding of our overcomplex, wasteful society, I feel it is rather Kunstlerian of you to equate the civil disorder over a few days in several English cities with the governmental overthrow of Egypt and Tunisia's Arab Spring. The disorder has died down already, and it will be many years, if not decades, in my opinion, before that sort of disorder is the daily order of things in countries like the US and Britain. I enjoy Kunstler as much as anyone, but your usually reasoned arguments and pleasing reluctance to predict a timetable contast nicely with his "next month it all falls apart... ok, next month" themes. I guess that why I found the first paragraphs of your post this week a bit jarring.

Eric said...

You remind me of Dr. Roeder (pronounced Raider). He was my Vet in the 90's when I lived in Cincinnati and had border collies. He was the best Vet I have ever encountered. At the time he was something like 85 years old and worked crazy office hours with NO appointments. The hours were something like this: Tues 10-11:30 and 5-7 pm. Everyday was different - Thursday could have been: 7am - 10 then 1 - 3:30 pm. His office was a desk that was piled super high with pharma samples and other vet correspondence. If your dog got sick he would usually end up looking for some medicine or another that he had read about and give you the sample for free so you wouldn't have to buy it. He couldn't believe that people would spend thousands of dollars on their dogs and felt that we had gone crazy. While you could tell he loved animals, he had been around them before penicillin, etc. and still had that kind of an attitude. I'm not trying to be callous here or portray him that way. He loved animals, as I said. And he knew how to keep them healthy and how to get them healthy when they had issues. But, at the same time, he is the only doctor I have encountered that DIRECTLY would talk about how much things cost and would give his personal recommendation about if he thought it was worth the money or not. That is what you are getting at in your final line. We are all going to die someday. The question is how? and How much will it cost?

John Michael Greer said...

tOm, I know it's hopelessly old-fashioned, but my country is more to me than a convenience to be discarded when it doesn't happen to give me what I want.

Dot, well, we'll see. The disorder seems to have died down for the moment, but I'd encourage you not to be too confident.

Eric, that's high praise. One of the things that's made American health care so pathological is our culture's stark staring terror of the simple fact that all human beings die.

johnomd said...

Bravo. A very fair, balanced piece. As a physician, I have had an up close and personal look at the ever growing medico-industrial complex over the last 20 years. While many individuals such as myself try to do the right thing, and strive to be part of the solution, each day that becomes more difficult as the strictures of government regulation and mindless corporatism tie my hands tighter behind my back. Sadly, despite any noble intentions, I fully realize and agree that modern medicine is just one more complex,greedy resource consumer that is going to drive the whole system into collapse very soon. Keep doing what you do every week, it is greatly appreciated.

hapibeli said...

"the guy with the scythe is going to settle the matter sooner or later with the one answer every human being gets at last. "
LOL!! LOL!! Yep! That in the end, is...the end! LOL!
And to TOM, the same industry hunger for profit is trying to destroy Canada's good system as has been doing south of me. Still, I and many I know use alternative med here in BC, as well as the allopathic system still in place here. A much finer system than the USA can offer by the way!

tOM said...

For the post-deluge, the book "Medicine for Mountaineering & Other Wilderness Activities" may be very useful. It has been released regularly for 20 years or so. Although concentrated on accidents, it also covers acute conditions like appendicitis. Ideally though, you should volunteer for a search and rescue team of some sort and take the free first aid courses for a good base. See the Amazon reviews for more suggestions.

Alternative medicines will also suffer post-crisis since they too are dependent on fossil-dependent transportation. Ideally, you should have a good book on healing herbs you can trust - and have the garden and seeds for them.

Basic health supplies can be cheap, eg bleach for water & sanitation safety, but need to be stocked before any crisis.

I'm not greatly in favour of alternative medicine - hopes and dreams in a desperate time are not very dependable. But many modern medicines developed out of traditional remedies, eg, aspirin (ASA) from willow branches, and we still don't know how aspirin works...

Blockhill (NZ) said...

Besides providing an element of power over your own health, being proficient in natural remedies and healing may prove a valuable skill for exchange and earning social credit with your peers or neighbours.... if you don't mind being exposed to potentially contagious ailments.

I have just nursed myself through a rather overwhelming cold using healthy doses of lemon, honey, garlic, thyme, sage, pepermint and home grown chicken stock and I can confirm that it is a slow process. Having said that, my recent experience with health care 'professionals' often boils down to "if it's still a problem in a couple of days then come back and see me", not the kind of advice you expect to pay for.

Apple Jack Creek said...

I am never so glad to be Canadian as when discussions of health care arise. Our system is far from perfect - we have serious gaps in home care, elder care, native health, and so on - but I am overwhelmingly grateful that my tax dollars are spent ensuring that everyone has access to at least basic care. The thought of having to assess whether or not my symptoms are “worth” spending $50 to see the doctor is frightening and I hope I never see the day when that is a question people here need to ask themselves before getting help. I realize it’s a question routinely asked south of the border, and I have nothing to say about that that except that I am sorry it is so.
I am not sure if it is universal here in Canada, but I suspect it is nearly so:. most of the physicians I have dealt with were quite comfortable with patients pursuing 'alternative' methods of health management in conjunction with the ‘official’ services they offered. My old GP recommended I try reiki when I was diagnosed with a mild form of arthritis; my current doctor is quite pleased that I go for acupuncture treatments; and I have never had a health care professional scoff at my use of ‘alternative’ treatments. For most of us, I think, it is not an either/or question … we are able to use the ‘big guns’ for the things they are well suited for, and seek alternative therapy where it is appropriate (although alternative therapy is usually not funded as generously, I admit). I think it is important that people don't have to wait until it's a crisis before they are seen. We have hotlines we can call 24 hours a day for advice on what to do on our own and when we need to go in, and I am immensely grateful for it. I’m sure it saves on a lot of unnecessary ER visits, and it gives a lot of people information about self-care that they may not otherwise have had ready access to.
I do realize, of course, that in a low energy future, this infrastructure will not be in place, certainly not like it is now. I hope that the Canadian cultural belief in the universal right to basic health care will continue, even after the world looks much different, and that communities will band together to pay the doctor/nurse/acupuncturist/herbalist's salary so that everyone - regardless of ability to pay - will be cared for. I cannot say for sure that this will happen, but I suspect that most of us Canadians would feel that it’s how “things ought to be”. I realize not everybody feels the same way, especially in other parts of the world … but it is part of our Canadian cultural identity, I think.
As for taking care of oneself in the absence of a ‘structured system’ (either because you can’t afford it or because it is not there), I wholeheartedly agree that everyone needs to learn the basics of germ theory, wound care, herbal and other remedies for common ailments, and the signs and symptoms of problems that warrant professional intervention (while it exists). And, knowing that the “guy with the scythe” comes for us all in the end is essential. People die. What is awful is when people die in unnecessary pain, when we refuse to see that there are things worse than dying, when we insist that pretending we are immortal if only we try hard enough/use the right drugs/see the right specialist/whatever. I requested the DNR order for my own infant daughter who would have suffered terribly if anyone had tried to interfere with Nature’s path for her - I know there are things worse than dying, and I did not want them for her. I also know that losing a child is heartbreaking, and I offer my sympathy, JMG, even now, these many years later, on the loss of your child. How sad that it was due to the interference of ‘medicine’.

Isis said...

About the affordability of modern medicine: I know someone who once got mugged, received a blow to the head in the process, and then went to the ER to get checked up. They dutifully examined him, told him there's nothing seriously wrong with him, gave him some mild painkillers, and sent him on his way. And then he received a $2000 bill in the mail. What his experience taught me is that if I ever get a blow to the head, I should make [unpublishable word] sure I stay out of a doctor's way. Because, you see, if there's nothing wrong with me, then I'd rather keep my $2000, and if there is something wrong with me, then that's just too bad because I simply cannot afford the treatment (I mean, if determining that there's nothin' wrong with you costs $2000, then I don't particularly care to find out how much it costs to get treated if there is something wrong with you).

Ozark Chinquapin said...

I have been consulting with a homeopath since last winter and have had significant improvement in some long-standing chronic issues, more than any other method I've tried has been able to. It's one of the most derided of alternative medicines in the mainstream world, even by many who don;t have a problem with herbalism and acupuncture, mainly because of disbelief that the method of potentizing remedies by dilution could actually accomplish anything. However, just because we don't know the exact mechanism of something doesn't mean it doesn't work.

It is also commonly said that homeopathy has been proven ineffective, however looking at the evidence that is not what I interpret. I have read a few of the studies that these people use to "debunk" homeopathy, and the ones I've seen don't follow good homeopathic practices, generally giving a single remedy to a group of people with the same allopathic diagnosis, and then saying it's no better than a placebo. In actuality, homeopathic diagnosis is not based on the same criteria, and to try to prove whether a method effective you should at least follow it the correct way. Some scientific studies have in fact shown effectiveness of homeopathic remedies, some are listed at http://johnbenneth.wordpress.com/about/

However what really convinced me was my own personal experience, and I can feel the remedy's effect in my body, sometimes quite dramatically as in going from chilly to hot in minutes with no change in activity or outside temperature, and other distinct changes. Most people won't feel them so intensely because I'm exceptionally hypersensitive. Each different remedy has a different effect, and some help and some actually make things worse.

Like doctors any other skilled profession, some homeopaths do a much better job than others, and there are many different methods within homeopathy.

A couple of other things I want to mention about medicine in general. A society in which allopathic medicine predominates seems destined to fail, even if there's a lot of success for a while. The reason being that if no attention is paid to the vitality of people and all the emphasis is placed on removing disease (such as our mainstream system), basically allowing people to survive in weaker and weaker states, the end result would bring people to something like blobs of blubber plugged into machines that they couldn't live without. That, of course, could only happen with cheap energy, but put that trajectory up against the decline of the industrial age and you have even more of a disaster since so many people have become dependent on the system for their survival.

I'm not saying that allopathic intervention is never appropriate, it is in emergencies, but some sort of healing method(s) that works to support the person rather than just fight the disease seems pretty important to me. Of course the way nature uses to keep populations from weakening a Darwinian environment that kills everyone who's not fit. I'm sure we will be seeing that again, and that's all the more reason to focus efforts on a holistic approach to health that may keep you fit enough to make the difference in your survival.

In my mind, having a diversity of healing systems makes sense. Although I clearly have my biases, I don't try to force everyone else into one system. Just as biodiversity increases resilience in ecosystems, so does a diversity of healing systems in human society. The fervor of some to condemn all other healing systems in favor of their preferred one (usually mainstream medicine but sometimes a particular alternative system too) strikes me as very similar to the attitude of a religious fundamentalist trying to "save" people, which isn't surprising since the modern medical system has taken on religious qualities in many people's minds.

SophieGale said...

Rice University is doing fascinating research on appropriate technology in global health care.

http://beyondtraditionalborders.rice.edu/

Check out their You Tube video on Community Healthcare Workers in Malawi. The CHW workers here are volunteers, but many African organizations are moving toward paid workers:

http://www.youtube.com/watch?v=t2XbRZZ6JFs

Also take a look at their Design Challenge Projects:

http://beyondtraditionalborders.rice.edu/design.cfm?doc_id=12096

Hesperian is the publisher of Where There Is No Doctor: A Village Health care Handbook as well as many other village health care books. Many blessings upon them, their publications are available for download.

http://hesperian.org/publications_download.php

Or you can buy the hard copy.

Don Mason said...

Disclaimer: I’ve been in and out of medicine. Thirty years ago, I was trained in podiatric medicine, did foot surgery for a while, invented a pediatric orthopedic bracing system, taught myself how to manufacture it, and then eventually shut the whole operation down when I realized that I wouldn’t be able to comply with updated FDA regulations, which are heavily influenced by the major medical manufacturers to prevent competition. (When there are companies that are “too big to fail” there will inevitably be companies that are “too small to succeed”.) If I were still in medicine, I would probably be dead from the stress; fortunately, I’ve been out of the industry for two decades, and now I re-roof and re-side and rewire our dilapidated $30,000 inner-city houses. We have little money, but I’m a happy boy.

This week’s article got me to thinking about some of the things I learned during my time in medicine.

One of the most important lessons is: “All medicines have side effects; and the more powerful the medicine, the more powerful the side effects.”

I learned to pay no attention to attempts to differentiate between “artificial drug” or “natural substance”, or “legal” vs. “illegal”, or “medication” vs. “food”. To me, everything fell into one big category: “substances” that people put into their bodies. “Substances” that they swallow, inhale, inject, smear on their skin, or cram into other bodily orifices which will not be mentioned on a family-rated site like this.

The only relevant question was whether the substance was helping them, hurting them, or having no discernable effect at all on them.

I learned to be very, very careful about putting any substance into the human body: you need to know exactly what the substance is intended to do (its desired pharmacological effects), the dosage, any impurities that the preparation may contain, what the side effects might be; and know how to manage any side effects that may arise.

The more substances that you have floating around in you, and the more powerful those substances are, then the more likely you will end up like kids who are left alone in a chemistry lab who start randomly throwing things into a flask and then heating it over a Bunsen burner to see what happens. The potential for catastrophic interactions goes up exponentially.

My general rule was: try a physical modality first; then a medication; and if all else fails, then try surgery. That doesn’t always hold true (elevated WBC and lower right-quadrant tenderness and you’re immediately going to surgery to have your appendix removed); but in general, always try a conservative modality first – since most conditions will resolve themselves without treatment anyway.

“First, do no harm.”

John Michael Greer said...

Johnomd, thank you!

Hapibeli, well, frankly, Canada would have to have a pretty dismal system to be worse than the US. We have the worst health care in the industrial world, bar none.

tOm, er, I take it you don't know a lot about alternative health care. The varieties I practice don't require any transportation at all -- and they have a lot more to offer than "hopes and dreams."

Blockhill, that'll do it! I tend to use a different set of herbs and back it up with acupressure, but to each their own.

Apple Jack, thank you. I hope that Canada can manage the approaching mess better than we're likely to.

Stacy said...

My husband and I have read your blog posts with pleasure for quite awhile now, and we were saddened to hear about the death of your child. We are so sorry.

Robert said...
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GHung said...

Since Eric mentioned his vet,,, it may seem odd to some that much of what I've learned about medicine has come from treating animals. Many treatments that apply to livestock and pets translate well to humans, and many don't. While it's important to know the difference, much can be learned from vetting one's own animals. I've learned to give injections, diagnose certain conditions, sucher wounds (recently learned how to glue wounds), and that some medications, such as antibiotics, available only with a prescription for humans, are essentially the same as those available at the feed store for swine, as are the doses. While I'm not going to the feed store for my meds any time soon, these are good things to know, and the medical kit that I maintain for my animals is essentially the same as our own medical kit. While I haven't had much practice on humans, I'm sure I could handle setting a simple bone fracture, sucher or glue a wound, and give an injection properly, as these are all things I've done in the past, albeit on animals. I'm not suggesting that folks start to experiment on their dogs, just some thoughts.

This discussion can be divided into several categories such as maintaining health, restoring health, first aid, etc. In our current system, all of these have become specialties to a fault. Even general practitioners often rely on specialists once the basic diagnosis (best guess?) has been made. One wonders how we get back to a point where the Doc is the "Jack of all medical trades", though likely master of none.

Apple Jack: 50 dollars?! In the US? You're about 20 years behind the times. My last trip to the doc was nearly $200, and that was for a quick follow-up. After that, I've started going to the county health dept. or hoping for the best.

Anyway, I hope this discussion doesn't get bogged down in a debate about the current state of healthcare, especially in the US. It seems pointless when folks can be discussing what our alternatives will be. Some suggestions: Midwifery; medicinal plants and remedies; end of life care; pain management; (dare I?) euthanasia....(now were'd I put that hemlock?)

hales said...

Hi JMG, - my first post after following your site since early 2007.
Last time I tried to post, I couldnt get past the sign on page where I needed a mobile phone number! - go figure.

In Australia we are lucky to have a still functioning Public Health system (just). It's under heavy attack by those that want to subsidise private health care and starve it of funds but at least everyone can get emergency care from hospitals and cheap medicine if they have a low income.

There has also been the odd article in the press over the last few years from ethicists and Health economists about the cost of treatment for various state of the art medical procedures and whether the money would be better spent elsewhere in the system.

For your budding Green wizards, check out The Victorian pharmacy, a four part series looking at pharmacies in England from the 1830's to the end of the century. http://en.wikipedia.org/wiki/Victorian_Pharmacy

At the start of Victorias reign, health care was still essentially Medieval and develops through to the beginnings of modern pharmacy.

I still shudder at the thought of the Everlasting Pill and removing Miasma as the basis of medical care.

Red Neck Girl said...

I still think we ought to follow good old Mary Alice (Andre) Norton's idea of a medical / priestly class mentioned briefly in -Moon of Three Rings-. Not everyone is suited to do medical care for people and such an arrangement could be open for recruitment from anybody else with the gift and desire to heal and help. Makes sense to me, but then a lot of people tend to think I'm weird!

I've got a story to tell you JMG about a blond g,grandfather and a Cherokee healer/doctor. You can decide for yourself if hubris caused the loss of an invaluable cure for skin cancer.

The doctor was the kind you're talking about in your post, he served an apprenticeship with a horse and buggy doctor riding with him when he went out on calls. But at the same time he was also studying with a traditional Cherokee healer.

My g'grandfather was a fair skinned man, blond, blue eyed and very prone to skin cancer. He went to the doctor when he had a growth on his neck and the Doctor looked at it and commented he knew what that was. He told the g'grandfather to come back in three days, he would have everything ready to treat the cancer.

When the g'grandfather returned the Cherokee put a poultice on his neck and shoulder and taped the edges down. Then he told g'grandfather to leave it on for five days and come back. He emphasized he NOT disturb the poultice in any way.

G'grandfather waited the week and returned, the doctor lifted a corner of the poultice and shook his head saying it wasn't ready yet and to come back in three more days.

G'grandfather was a farmer and the day before he was to return to the doctor he was out plowing his fields behind his team. He felt like something was crawling on his neck and reflexively
he reached up to brush it off. When he did his rough farmer's hand caught the cloth of the poultice and pulled the whole poultice off. He said it hurt, a lot but when he looked at the poultice in his hand the entire cancer had come out, sticking to the poultice. He said it looked like a tree root.

When my mother was a teenager she saw the large deeply indented scar on my g'grand father's neck and shoulder. She had a chance to ask the Cherokee Dr. did he ever tell the white doctors what was in the poultice. He said "I did. They laughed at me, they can go to H***!"

BTW, I have 'conjectured' what might have been in that poultice, medicinal clay, crushed horseradish, crushed garlic and/or possibly powdered silver sage. I don't know for sure but from what I've read recently about horseradish the juice has anti cancer properties when applied directly to the area.

Wadulisi Tsalagi

Kevin said...

Arab Spring, English Summer, European Autumn: and an American Winter of Our Discontent.

As you suggest, in my case it's time to assess what I can do now in the limited time available. So far I've really only gotten going on the veggie gardening. For over two years I've been horribly hampered by lack of funds. But now it appears I may (don't want to jinx it) be able to get together a tiny operating budget. Tools, materials, books must be acquired with the greatest care, and skills chosen also with an eye to the best possible use of precious time.

I'll keep an eye out for that Red Cross book.

Damir said...

Thank you John for yet another excellent post. I would like to comment that one of our local famous "alternative" medicine practitioners said: the so called mainstream medicine should in fact be termed alternative, as it is only couple of centuries old versus several millenia of "alternative" medicine. Regarding the herbal medicine, one should be careful where to purchase or pick the medicinal herbs; extensively grown herbs tend to have much less active substances (not to mention the "energy" that every creature posseses!) than the ones that grow in wilderness. Also it is becoming increasingly difficult to find herbs even in the wild which do not contain poisonous byproducts of our civilisation, which can turn normally useful plant even into poisonous! I'd like to recommenda the books of French Master of the Herbs Maurice Messague to everybody who is interested into detailed information on medicinal herbs.

greatblue said...

JMG, I was somewhat surprised that you didn't mention nutrition as a method of "alternative medicine." Food as medicine is an ancient concept, and to me, it seems the absolute best place to start. Even the most casual inspection of Americans in groups (try comparing photos of the crowd at a Fourth of July parade from today with one from the 1950s or 1960s; I won't even talk about the People of Walmart website) shows that we have serious problems with food in this country. You would expect our culture of convenience to produce out-of-shape adults, but the number of obese **children** in the U.S. is truly shocking.

I use a number of supplements (vitamins, fish oil, etc.) to combat various ailments or as preventive measures. I use a lot of sources now, but the book that started me on the nutrition path was Let's Get Well, by Adelle Davis, copyright 1965. Concentrated supplements will become rarer as we descend, but we can work to make our food more nutritious as we abandon harmful industrial agricultural practices and begin to build up the soil again.

Being a bit on the hypochondriac side, I've had quite a few medical books over the years. But one I keep coming back to, in spite of its hippie-dippyness by today's standards, is The Well Body Book by Mike Samuels, M.D. and Hal Bennett. "The authors describe how to do a complete physical exam, how to diagnose common diseases, how to practice preventive medicine and how to get the most from your doctor." It follows a basic commonsense approach to taking care of yourself that I find very reassuring. JMG, you won't be surprised to discover that this book was published in 1973.

I've had a lot of success in removing muscular pain using a book called Pain Erasure by Bonnie Prudden, copyright 1980. By pressing on a painful muscle at various points, you make it relax. It's a great "physical modality" you can do yourself that obviates the need for a lot of painkillers. It really relieves pain.

Kieran O'Neill said...

I think you picked an excellent title for today's post -- "salvaging health".

And, as you hinted at, but perhaps didn't say explicitly, health is made up of far than just medicine -- traditional or conventional.

Good exercise, a balanced diet, and activities to maintain mental (as well, some of us might say, as spiritual) wellbeing are far more important than medical treatment of the end-point of their lack.

And while these all have their own industries turning a profit selling instant solutions, they can also be easily practiced at home with the kind of knowledge a public library provides. (Although in more extreme situations they would need the help of a professional.)

I also feel that these are some of the most important bits of learning we can take with us if everything goes completely post-industrial.

I hope everyone doesn't get distracted by the medicine dichotomy to miss this entire other aspect of the discussion.

Cherokee Organics said...

Hey JMG,

Medical professionals are people, they have bad days, make mistakes, some are careful, whilst others aren't. A misdiagnosis cost my wife’s mothers life. As a general rule, if it doesn't sound right, get a second opinion.

You may be interested in some figures too:
Health care costs per capita in the US are US$8,000 per year.
The same number over in OZ is about $3,450 - and it is universal here - everyone pays between 1.5% and 2.5% of their income through the tax system with the wealthier paying the extra percentage. If you don't earn, you don't pay but still get access to the healthcare.
Someone is making money somewhere over in the US.

As to both the London riots and the turmoil on the money markets, band aids have been applied - but the fundamental issues have not been addressed. Watch this space. Already, there is speculation about Frances ability to service its debt load. We haven't heard the last of it - maybe for the immediate future we have though.

The riots are being framed as a criminal issue across a broad spectrum of the population - but people act that way when they think they have nothing to lose. The broad spectrum they are parading before the media are the exceptions and not the rule.

Regards

Chris

Mean Mr Mustard said...

I'm a Type 1 diabetic, ie, insulin dependent. Fortunately, I'm also British. This means that for now, I get free medical treatment, including the insulin which keeps me alive. Most other places in the industrial world, I'd be paying heavily, and outside that area, I'd have been a goner ten years ago. Though I'd imagine that effective UK Type 1 life-support will also be a vanishingly short blip, coincident with the Oil Age, say 1950 to 2040?

I was given a 5 day training course at my huge sprawling university hospital, with occasional refresher sessions since, in how to effectively manage the condition and avoid / deal with complications. Though that course cost the taxpayer £500, it's a bargain compared to the costs of an avoidable hospital admission. Preventative treatment is always best.

As we currently have mostly free medical treatment at the point of use, that does free us Brits from one casue of indentured servitude, in needing to work for a Dickensian employer simply to maintain medical coverage. Though many must work to pay the taxes to keep the National Health Service running. Where your taxes maintain a huge military and limited medicare, ours fund the impressive NHS and an emasculated military. Though where there's money (for now) it seems the multi-national corporates are not far behind. As they own our politicians, they are looking to exploit profit opportunities within the NHS.

I've built up a stockpile of meds - a precaution against most sudden discontinuities, but not long term decline. As for outbreaks of anarchy, not seen any riots in my village, but the financial and social underpinnings just lurched in unison this week. Did someone out there once call catabolic collapse?

Andrew said...

I think it should be mentioned that "herbal therapy" is a very broad term, ranging from home remedies like using an onion to clear the nose to professional herbalists who have years of training and are able to prescribe very strong herbal medicinals for very precisely diagnosed conditions, for essential any condition that doesn't require surgical intervention.
Readers of this blog may also be interested to know that strategies to combat serious threats like tuberculosis in low-resource areas with the help of traditional medicine are being explored already. It may turn out that these projects have as much to offer the US as the places they are targeted at right now.

Those wanting to explore home remedies, I encourage looking into cupping therapy, which is nowadays usually presented as a "Chinese" therapy, but the reason I am a big fan of it is that my European grandmother used to do it quite often.

It starred in the 2010 movie "Karate Kid" with Jackie Chan, and while the cupping done in that movie has as much to do with the real thing as the kicks and punches in the movie have to do with real martial arts, it is an easy, safe and much-overlooked method to treat colds, aches and several other problems cheaply.

Lizzy said...

Hello,

I've been thinking about medicines a bit, recently. You see, I had a kidney stone - extremely painful. My colleague here had gallstones; he was completely disabled by the pain. I understand we will need to develop a whole range of natural remedies, but I've been thinking about pain-killers. Making aspirin is quite straight forward, my chemist friend tells me, from white-willow bark. Making morphine - which saved me during the kidney-stone episode - is also quite straight forward (opium poppies are easy to access and grow and not illegal if being used for decorative purposes).
As well, honey is a good antisceptic; nurses and doctors use ordinary, unperfumed soap to clean their hands thoroughly; our awareness of germs in general should put us in good-ish stead. I hope.
The idea of dental care is a bit scary. But then, if you have to have a tooth pulled out, and are braced with opium, it's not so unbearable.
Early man, in the pre-sugar, pre-grain days, had great teeth. But they died young.

ChemEng said...

Some years ago I was involved with the start-up of a monthly newsletter to do with the safety of large petrochemical plants and oil refineries. The publishing company concerned happened, by chance, to start a similar newsletter to do with safety and health in hospitals at the same time.

Both letters were edited by the same lady, who was new to both industries. After a year her conclusion was that "Even though chemical plants handle hundreds of tons of toxic and flammable materials, they mare much safer than hospitals".

Unknown said...

A while ago it came to my attention that there is a free book online called "When there is no Doctor" by the Hesperian Foundation. Does this book have effective treatments? They also have "When there is no Dentist"

I agree with JMG about the English riots - I was thinking the same thing myself - and looking at the flash mobs in Philly and wondering of that was a genesis of unrest here. I do not think it is wise to underestimate social unrest; police in the US are as prone to heavy handed tactics here as anywhere. John, you did say "Watts" didn't you - anybody also remember Rodney King? I remember someone writting a while ago that no country is more than 3 meals away from a revolution.

PS - how the heck do I get my name here instead of "Unknown"?

lambert said...

JMG:

Wonderful post, but I'm surprised that you -- and the readers who refer to Canada -- don't mention that every single payer country in the world has significantly lower costs and significantly better health care outcomes than the United States.

The change to a better health care system need, and should not, come solely from "the medical industry." There are services that are better provided by institutions were profit is not the driver, and health care is one such.

Lance Michael Foster said...

There was a computer game called "SimEarth" I had back in the 90s. You could play different variants, including evolution-tinkering. One of the variants focused on human civilization. You had a limited amount of "energy" that you could allocate to different areas, such as health technology, energy (conventional, nuclear, etc.), manufacturing, technology, war, communication, environment, philosophy, agriculture/food, etc. The goal was continually balancing and allocating resources to see how long you could get civilization to survive.

The thing was, no matter what you did, or how careful you were, almost any route you went eventually led either to nuclear war, or overpopulation which led to starvation and disease (and sometimes war). Whether it took decades or a couple of hundred years, the result was a devastated planet and crumbled civilization.

Then one day, I did a radical rethinking and allocated most of the energy to "philosophy" (which in this game represented acceptance of death, enjoyment of life, ethical behavior), and very little or nothing to any of the others, including health technology. After all, improvements in health tech meant more people survived, so more food was needed, which eventually meant more energy was taken from other areas, which resulted in environmental destruction and war over remnant resources.

Low health tech meant a natural balance of steady depopulation to a sustainable level of low population. That meant less competition over limited resources. High "philosophy" meant people accepted life for what it was and treated each other ethically, both within a civilization as well as neighboring states. The result? Civilization, such that it was, lasted tens of thousands of years. The game said I had won.

Lance Michael Foster said...

I am currently in the same boat and about the same age as you JMG. I used to have a good fulltime job with health insurance 5 years ago. But it was a high stress job. Three trips to the hospital with heart issues, high blood pressure, anxiety, etc. The doctor said I was killing myself and pumped me full of psyhodrugs for anxiety as well as betablockers for blood pressure. I was in my late 40s and the spiral had begun.

But I jumped ship. For those health reasons and other personal reasons, I resigned. My income dropped to zero. I moved and for the first couple of years on my savings I was able to afford to go to a doctor for bronchitis, pneumonia, get my blood pressure meds etc. I applied for jobs, but either I was "overqualified"/overeducated or didn't have the connections ...or, I suspect, too old to compete for the few jobs available.

I weaned myself slowly off the betablockers I could no longer afford ($50 a month), used natural stress relief and walking to drop some pounds, and got more into Marcus Aurelius, tribal religion, art and nature to deal, as well as part time teaching to pay rent and food (which is pretty much all I could afford, and even that was hard).

Since then I have survived several bouts of pneumonia and bronchitis, the shingles, liver problems, fevers, kidney stone passage, etc. entirely through self-care (hot baths, herbs, sleep, avoiding or eating certain foods, etc.). Eventually I will fail and I will die. On a long enough time scale, everyone fails and dies.

Lance Michael Foster said...

I lost my mother to bowel and liver cancer this year in May. I watched her dying for two months, first in the hospital and then at the end at home. They didn't know what was going on at first. She had been in the hospital a year ago with meningitis. The they saw she had a bowel cancer that metathesized into liver cancer that riddled her liver. They figured she had had the bowel cancer for at least ten years. So why didn't they see anything wrong when she was in the hospital a year ago? Biomedicine has overspecialized from what I see, everyone a specialist who only knows how to look for, and ONLY looks for, their own specialty. The focus is on billing for various procedures. My brother is a pharmacist and he took time to be my mom's primary advocate while she was dying, and he stopped them several times for improper drug interactions, etc.

She had a good job with insurance. She had gone regularly to doctor. No one caught her bowel cancer for a decade. It cost her tens of thousands of dollars, and in the end everything ended up the same anyways.

I don't have any choice or money. There aren't many general practitioners who seem to have the patient's big picture anymore, not in this town anyways. And like you JMG, I don't have the money to see them if there were. If I get a broken bone or end up in some kind of accident I can't treat myself, I will have to be on the mercy of the county at that point. That's life. We aren't exempt. We WILL ALL die. So live while you can :-)

The Grimms had a story to remind us about all this.
http://hengruh.livejournal.com/141611.html

Sixbears said...

The current health care situation cannot continue. We are going to have to deal with massive change -one way or the other.

When my wife worked as a medical lab technician, she was unable to get the lab to turn off an unused freezer. The thing sat empty next to big windows and ran constantly. They kept it running just in case they needed it, but never did. For someone living with off-grid energy, the waste bothered her tremendously. As energy prices when up, they put little please turn off the lights signs on the switches in the public restroom but wouldn't really examine where their energy was going.

Throw in all the plastics used in a hospital, and it's obvious things won't continue on as collapse progresses.

Like you, my family medical history is a mixed bag of modern miracles and mistakes, along with the hard work of alternative medicine.

I think if we can somehow retain the scientific knowledge, we'll have gained something valuable from this cheap energy spike. That is, if the chaos of the decline doesn't burn all the libraries.

peacegarden said...

JMG

Thank you for sharing you and your wife’s tragic experiences. My heart goes out to you both. You are admirably able to look at modern medicine with objectivity and dispassion. The product of a disciplined mind, it seems. We need that objectivity and keen insight as we go forward.

I have been straddling the two healing modalities for the past year or so in an effort to become as healthy as possible. While I do have insurance now, I believe the days of health care as we know it are dwindling.

I am learning all I can in the way of Traditional Medicine, planting as many of the herbs that will grow here, making medicine and becoming healthy enough to be able to serve others if that becomes necessary.

This week has been a little “wake up” call…time may be shorter than we thought.

Peace

Gail

nate said...

JMG

Sorry to see my post was too inflammatory. The studies that you quote are seriously flawed. And my viewpoint is one who sits on a quality committee at one on the largest hospitals in the country. I see medical errors. Those that did the studies had an idological axe to grind.

By the way I am not opposed to universal health care. I maintain however it is not a human right.

Nathan Walters MD.
Anesthesiologist Ft. Worth, Tx.

Andy Brown said...

Eventually most of us run up against something that probably would have killed us if not for these new-fangled dicings and dosings. So it's too bad that we've built it all on a system that is so fragile. I'm assuming it's very likely that life expectancy will sink from the 70's to the 50's, but as we all know, it's the quality not the quantity that's most important, and in large part the quality of our lives is still up to us.

Yupped said...

It’s interesting how the mainstream medical system has become such a major limb of the economy – great for launching careers, inventing for-profit technology/drugs, making money and finding employment. A good chunk of US job growth from 2000 – 2008 came from the health sector, and the system’s business model is completely dependent on economic growth and government spending of various sorts. Also, it is of course focused on treating diseases that are caused directly or indirectly by our society’s various dysfunctions (dietary-driven diseases, problems of emotional stress, some cancers, etc), which have been a growth business for a few decades now. So as the economy and society continue to shift and contract, and the money flows dry up, I would expect the medical system to come unglued and crash at some point, rather than to evolve.

Alternative care providers seem to be better positioned to evolve. They are generally less interested in and dependent on making a lot of money and haven’t yet figured out how to combine themselves into great networks of providers with complicated payment models and supply chains. So I think they are going to be better positioned for the long-term. It’s possible that local general practitioners could evolve to combine some mainstream and alternative therapies into a viable local health practice, which would be a good thing. There’s tremendous opportunity, for example, to include therapies such as meditation, yoga, tai chi, etc in preventive care. My current GP doesn’t have a lot of interest in those things, but she might when the pharma-stress pills just aren’t there to pop. But overall, I see the alternative sector picking up the pieces while the mainstream clinicians, administrators, researchers, technologists and suppliers wonder what hit them. We’ll see, of course.

Rocco said...

I've been following your blog with increasing regularity for a year now. Blogs have been something I chose to avoid, for reasons that only start with the ugly word itself. However, yours is a breath of fresh air. The consistently high level of writing is as unexpected as it is appreciated. But the content, of course, is the thing that matters most. I liken your thought to that of John Taylor Gatto, who writes so uncompromisingly about our education system, its origin, and its miserable failures. The primary thing that you and Gatto have in common is what I would call simple sanity in the face of immense problems and looming, inevitable collapse. I have often wondered why I never hear Gatto's name or his thought referred to in the mass media. And now I wonder the same about you. I watch a fair amount of TV, and I watch it every day, and I rationalize this ultimately time-wasting practice by taking note of what is offered to me through that medium and, more to the point, what is not offered. I have heard that Gatto has been described as a Libertarian, which may account for the lack of references to him and what he has to say about our society. (The powers that be prefer to squelch dissenting voices and viewpoints, especially when they are sane and well documented, for any convenient reason, and being a Libertarian is the same as being a member of the lunatic fringe for them. So, Gatto doesn't exist for most of our fellow citizens.) My theory is that the same thing may be true about you, given that you are not just a Druid, but an Arch one. Ergo, his thoughts don't count. My point is that I would love to see open and thorough debate of the issues that people like you and Gatto raise so urgently and convincingly. But such widespread knowledge extending to the lulled masses who seem to care about nothing much as long as they have the latest technological gadgets and still have fuel to operate their vehicles. So, I offer my thanks to you for your continuing efforts, even though it makes me think of myself as a member of some sort of reverse "elite".

Siani said...

A month or so ago I was terribly ill, running a temp around 102 for a few days with sinuses so plugged I could not breathe through them most of the time. I dealt with it myself at home with various homeopathic remedies (and fell in love with the neti pot I might add) and recovered after three weeks or so. When I informed my primary care doc at the VA of it, I was roundly chastised for not coming in and getting proper medicines. I suppose it was a sinus infection, and a bad one, but...well, I dislike being dependent on modern chemicals.

It is a risk, to treat oneself..then again, risk is life and unlike many, I have no fear of death as you know. Besides, I once got an infection in a hospital; subcutaneous staph. Ears ringing from antibiotics, yep..it was resistant. And really, I'd be a lot worse off without the modern care I got after the car tried to smear me across the pavement.

I prefer, for as long as I can, to mix the two methods.

Excellent post, btw.

Don Plummer said...

I've got a "friend" on Facebook--an old high school classmate, in fact, who works as an acupuncturist. She tells me that people tend to come to her as a last resort. I'm not surprised about that.

I don't know a lot about acupuncture, but a co-worker of my wife's, who has had gall bladder inflammation but without gallstones--meaning the doctors don't want to remove it--has been helped by acupuncture.

GHung said...

Red Neck Girl: What cured your G'Grandad's skin cancer was likely Mayapple, also known as American Mandrake, Indian Apple, Duck's Foot...

I know an oldtimer who treated his skin cancer for years with a paste his wife made from Mayapple. It is known to interupt cell division, especially of an abnormal type, and the Cherokees used it for many things including warts. We have several large patches on our place.

Caution: Extremely toxic/fatal if ingested improperly.

Bill Pulliam said...

You certainly touched on this point; I'd like to elaborate a bit. Systems such as t'ai chi or yoga are not treatments, nor are they just the exercise regimens they often get treated like in the U.S. They are practices that involve a synthesis of the physical, mental, and metaphysical. I wonder if anyone has ever compared the health benefits of yoga or t'ai chi when taught just as a physical activity versus when taught along with the meditative-contemplative-energy parts? For people who are already comfortable with meditation and ideas similar to chi or prana, it is easy to take up. But for those of a more strictly materialist view, all that stuff is often viewed as woohoo hoohah lalala nonsense ("What do they mean send your breath down in to your pelvis?? That is just ridiculous!") and be a barrier. Anyway, back to my point, these practices are more akin to beneficial lifestyle changes, such as quitting smoking and adopting a better diet, than to medical treatments. And unfortunately, people prove EXTREMELY resistant to lifestyle changes no matter how many times their doctor or spouse or whoever pushes it, usually until a medical crisis forces the issue (if it does not kill or debilitate them first).

As for the English Summer... I suspect we may have just seen a preview of the potential for the future, not the beginning of anything big and sustained yet. Let's see what happens when the "austerity" cuts really begin to hit, and how many of those presently tut-tutting about "mindless criminality" wind up shouting in the streets themselves.

Ozark -- I am in no position to judge whether or not homeopathy works. But I feel reasonably comfortable saying that if indeed it does work, it almost surely works by magic more than by biochemistry. And if it does work by magic, there might be other routes to the same ends that do not require concoctions or the spending of any money. But on the other hand, if you can afford it, and you like it, and it works for you, no need to fix what is not broken.

GHung said...

Unknown - Thanks for the tip. Download full book (pdf) here:

Where There Is No Doctor

Jason said...

Great post; I agree with your take on the riots here in the UK (Tunisia started with a similar event I think), but I also 'deem the time [somewhat] unripe' for the complete arab spring type event. After the current reforms have obviously failed and real financial turmoil sets in, the street battles will involve more political causes than appeared this time -- then, yes, anything is certainly possible. Meanwhile, indeed, the government makes noises rather like those of the Gadaffi regime but hardly seems to notice the irony!

On medicine I think it's important to point out that maintaining wellness with alt med methods is as important and effective as dealing with illness. By contrast with its unwieldy 'power' when it comes to fixing things when they are obvious problems, mainstream medicine is absolutely terrible at fixing them before that point. A deeper practitioner of these things (such as you are, JMG, I'm sure), will be on the watch all the time for subtle signs that can be checked with extra work on a few acupoints, etc. etc. Stitches in time.

Learning to sense the inner is part of the deeper application of those methods. That's not something materialist medicine has even admitted is possible most of the time. The spiritual element of alt healing has a strong evidential base -- see the multitude of papers summarised in here, for example, which show that there have been more controlled trials for spiritual healing than almost any other alt med modality. Placebo is completely ruled out, and two thirds of the studies whose design holds water show statistically significant results.

Under these conditions a Norton-style medical/priestly class certainly is a doable thing, and one of my projects may be to put together a network of practitioners -- on a multi-disciplinary basis, but centred around a code perhaps. In the UK of today there may be a lot of takers for this.

A small point which I think is unquestionably true: misuse of fossil fuels to pump raw wattage around has caused a lot of illness in nervous systems by interfering with bioelectrical systems such as t'ai chi and ch'i kung work with. (See Becker for proof.) This is one health threat we won't be able to maintain at least.

Bill Pulliam said...

Ghung -- extracts of Mayapple are used in mainstream medicine. Not long ago they were the treatment of choice (applied topically ONLY!!!) for HPV warts.

Just to make sure that a widespread confusion isn't coming up here -- homeopathy is a very specific field that involves herbal extracts that have been EXTREMELY diluted and hence are taken in miniscule quantities. The term is often used casually as though it were synonymous with all herbal treatments, which is most definitely is not.

Two things I would nominate from the mainstream as worth saving are vaccines and antibiotics. I know some people have very strong feelings about vaccines; it' your choice but I would still like to have access to them. Polio, measles, tetanus, diphtheria, etc. are still out there, and smallpox can be reintroduced with the opening of one small vial. Don't approve of them? Don't get them. I want them around to the extent possible.

As for antibiotics... one thing about evolution. These bugs all have to spend energy to maintain their antibiotic resistance. In the absence of continuing selective pressure, the antibiotic resistance fades away gradually over the generations -- and a generation in bacteria is often measured in hours, not years. If they were just used appropriately, cautiously, and correctly, they would regain and maintain their usefulness. Every doctor who has given someone an antibiotic prescription for a cold in the absence of any signs of bacterial infection should have his or her license stripped. Which would be nearly every doctor in Tennessee.

cave said...

JMG, my full comment would exceed the character limit, but I will try to summarize.

I, as an Australian surgeon, also feel we have passed the point of diminishing returns with our health care systems, even outside the United States with it's particular problems outlined so eloquently in your essay.

It is, however, important to make the point that Western medicine is not the problem. I feel very sure that any medical system, exposed to equivalent political and financial power, would find it's way into becoming a similar industrialized and bureaucratized mess.

The core of western medicine is not the funding, or the industry, or it's position as the dominant paradigm. The core is an understanding that illness is caused by perturbations in the body's homeostasis caused by various processes - nutritional, infectious, traumatic, psychological and so on - and a drive to further this understanding through observation and measurement. This is in no way incompatible with what are considered alternative treatments - acupuncture, St John's wort, psychotherapy, radiotherapy and even surgery were all considered "alternative" in their day.

I would encourage those intent on salvaging health through alternative means to first read your essay on salvaging science; it is exactly the sorts of small-scale measurements and experiments that you describe that can be extraordinarily useful in moving alternative medicine forward. There has been a persistent resistance to adopting scientific method in the alternative medicine communities, with most published information coming from interested western-trained medical students or physicians. There are well-established means for looking for even small differences in outcomes over many years; the only barriers are the willingness to put the time, training and resources into doing the necessary studies. This move has to come from alternative practitioners themselves, or they will remain stuck where Western medicine was in the mid-1800s.

Zach said...

...the end result would bring people to something like blobs of blubber plugged into machines that they couldn't live without.

That is precisely the future vision of humanity shown in the movie "WALL-E.

I should add, blobs of blubber who, even when physically next to each other, communicated via electronic screens rather than face-to-face...


peace,
Zach

Wendy said...

I'm very sorry about your baby. It must have been a very difficult for you.

I'm in the same boat as you with regard to my feelings about health care - I'm here today because of modern medicine (after suffering a severe vehicular accident), and one of my children was diagnosed with spinal meningitis at four days old and would have died if not for the three weeks' worth of antibiotics, but I've also been, personally, injured by an overzealous (or impatient) doctor, but the "injury" was not something that anyone in authority would have considered the doctor incompetent or liable for.

Also, like you, I'm pretty convinced that modern medicine can not be sustained in a lower energy future, and our best bet is to know a little bit about ways to stave off and/or treat illness.

I see someone has already mentioned Hesperian Press's books - free for download, but also available in print form, and they've been translated into Spanish. They are a great resource.

Robin Datta said...

That was a great post, Archdruid John.

The lamentation about salvaging information from high-tech medicine is quite justified. The system has cut itself a deep channel that gets deeper with the passage of time: diverting the flow is increasingly unlikely.

And the diminishing returns from increasing complexity are beginning to show, both in the resources used in technology and in increasing compartmentalization with specialization. Advances in care and therapy are based on controlled studies. These studies may show an advantage of a few percentage points for a new drug (that cost millions of dollars to develop), it then becomes the preferred drug.

A patient with a strained chest muscle (left pectoralis minor) underwent a radionuclide cardiac scan and then a cardiac catheterization both negative, for chest pain: I got to see him in the emergency department because of his concern when the pain had been present for two without an explanation.

In emergency departments, a patient with right lower quadrant abdominal pain and the appropriate associated additional findings will get a CT scan to check for appendicits: the scan may be read by a radiologist in another town, state or country. Whether the emergency physician calls the surgeon or not depends to a large extent on the radiologist's reading.

Trying to change course of the system is like taking a train off the rails. There is no room for the concept of transitioning to a low-tech mode.

Although the mortar and pestle is a widely recognized symbol of pharmacy, most pharmacists these days have not used it. They have an extensive and detailed knowledge of pharmacology, which includes intessive study of chemistry and physiology. But they would be at a loss to go out into the woods and collect plants and process them to extract useful preparations: even the counting of pills is done by machines.

Yet today's high-tech medicine retains items that were gleaned from the wisdom of yore.

William Withering's observation of the treatment of dropsy by rural womenfolk with purple foxglove (Digitalis purpurea) tea led to the extract of the plant, digitalis, and the active ingredient digoxin that is still used today. The bark of the white willow, Salix alba, used in a tea to treat fevers, led to acetylsalicylic acid, sold under the proprietary name Aspirin by Bayer until Bayer lost the trademark during the second world war.

The arrow poison from Strychnos toxifera used by South American natives led to curare and a host of related compounds used as muscle relaxers in today's medicine. They can also be credited wih the medicinal use of the bark of Cinchona, of which the active ingredient quinine is used treatment of malaria.

Chinese medicine had been using the herb Artemisia annua for two thousand years in the treatment of malaria, from which we have artemisinin now used in the treatment of drug-resistant malaria.

A lot more useful information may have been lost with the vanishing of indigenous cultures. Unfortunately, a lot of useful information from high-tech medicine may also be lost in the transition to deindustrialization.

Odin's Raven said...

Why does taking foreign substances into the body produce healing at all?

Perhaps you could follow up the old Doctrine of Correspondences and relate it to magical ritual. As people get poorer they may become more willing to relate better to their subconscious and the subtle world, and so avoid some problems before they get to the point of needing a surgeon to chop them out.

Some of the healing seems to be related to the personality of the healer. This may account for some of the success of allopathic medicine.

There seem to be a number of different alternative cures for things like cancer; all may have some success but none seems to be a panacea.Perhaps we should not look for a single 'right' answer.

In Britain the National Health Service is a sacred cow, people don't like to accept that the previous government poured so much money into it that they achieved diminishing returns in terms of health results.

Regarding the riots in Britain, the underlying cause is decades of politically correct multicultural nonsense, which has produced a generation of feral youth which has no respect for god or man, as they know they will never be punished, whatever they do.

See, for instance:
http://charlescrawford.biz/blog/those-riots-the-multiculturalists-murder-of-common-sense

Here's a book review which shows that the police and judicial system has been so perverted that it has collapsed:
http://www.brusselsjournal.com/node/4807

Here's a policeman's blog that shows politically correct multiculturalism has so infected the upper levels of the police forces that they are afraid to do their job properly:
http://inspectorgadget.wordpress.com/2011/08/10/r...

Here's pictures of some of the guilty:
http://prodicus.blogspot.com/2011/08/british-vah-lews-whirlwind-arrives.html

Here's a blogger who blames both the banksters for setting a bad example:
http://eureferendum.blogspot.com/2011/08/got-it-in-one.html

and the pc multis for alienating the police from the public:
http://eureferendum.blogspot.com/2011/08/dont-forget-alienated-middle-class.html

Here's someone who grew up poor and is annoyed by the lefty excuses made for evil vermin:
http://obotheclown.blogspot.com/2011/08/i-didnt-predict-riot.html

Here's someone who finds some humour in the situation:
http://niklowe.blogspot.com/2011/08/london-olympics-2012.html

kjmclark said...

I had a thought while donating blood this week. The volunteer staffing the sign-in desk has multiple sclerosis, or something like it. She's very pretty and friendly, was once married, supposedly, and the disease is clearly wrecking her life. I'd be very happy to see some of my health care money, which my family rarely uses, go to find a cure or good treatment for MS and things like it.

Later, I took a walk to the hardware store nearby, and realized how many people are seriously overweight. My thought was, here we are spending a fortune to treat people with type 2 diabetes and other diseases related to being overweight, when recent studies have shown that a lot of type 2 diabetes can be reduced or eliminated by strict diets and exercise (a diet and exercise that seems pretty normal to me). But we can't afford to spend enough to find a treatment for things like MS.

A second note, while the health care act requires everyone to have coverage, it will be subsidized for the poor and working class. A lot of people will get it for free, and you may be one of them.

Maria said...

JMG, I was saddened to read about the loss of your child. My heart goes out to you and your wife.

Casey said...

I also lost a child at birth due to medical failings. I am truly sorry for your loss. after my first son, I had a second son who was born via cesarean, and more than likely saved by that surgery. This past Monday he was diagnosed with scarlet fever. He is four and became sick on the thursday prior. He has always been a strong healthy child, who has been in daycare since he was 4 months old, and has only taken an antibiotic once prior. It was scary to get the diagnoses based on the histoey of this illness and the recent deaths in China. I am very grateful to say he had a very minor case, and was back in school by wednesday and will be on antibiotics for the next 10 days. I have been very diligent in his life to nuture and strengthen his immune system...I left him play in the dirt, only use vinegar, tea tree oil and baking soda to clean, and give him doses of homemade elderberry syrup every flu season to help prevent illness. What shocked me about the scarlet fever was how quickly it came over him. The night prior he was his normal self and by morning he was in a sad state. I think it is extremely important that we embrace homeopathic and allopathic medine,when vailable. i worry for the future, but I channel that energy in educating myself. I live in S florida... The tropics, and all the issues that come with that in a deindustrial society. I am collecting medicinal seeds and planting them, learning how to use them, and finding alternatives when the traditional herb will not grow in my climate. i am collecting as much information concerning ayurvedic medicine as I can, as their climate is similar. Having said this, I take full advantage of modern medicine when needed, but do not take it for granted or abuse it. I don't understand the vitriol of some of the posts. Why do the two have to be mutually exclusive?? why can they not be complementary? The only logical reason I can see for the reason people fight over this has to do with making money. How very sad.

Cathy McGuire said...

Part 1:
This is an important post, and as you say, the subject is difficult. One of the big issues that I don’t think you touched on is our gradual assumption that we are owed healthcare. Even though I consider myself pretty liberal, I am dismayed at the growing number of things that people claim as “basic rights” – when did we ever get the right to have others provide for us without some concomitant responsibility to provide for them? Which is what it comes down to. I do strongly believe that healthcare (and other social services) are essential for a functioning society, especially a democracy – so they are a “social good” (but not a right).

And even more, most people I talk to have lost sight of the fact that 99.9% of us can not afford healthcare in its present form! Last night at a picnic I listened to story after story of surgery, batteries of lab tests (this was a middle-aged and older crowd) and not one of them seemed aware that someone else had paid for all of that! One reason this is important is that as medical techniques improved AND got much more expensive, we didn’t have the discussion about whether these new techniques were affordable; whether the improvement or risk reduction they provided was worth the cost… and now we have to have that discussion on a huge level! And that is causing many people to have a kind of “brain lock” (“It’s unthinkable I couldn’t afford a hip replacement!”… “I need a lung transplant!” or more tragically, “my child needs a lung transplant”). The simple fact is that only the wealthiest 1% can afford healthcare as it’s being offered, and most of us act as if we can do anything to our bodies because someone will patch them up later.

And as you say, our super-expensive healthcare isn’t even very good. When I worked as a therapist in a psych ward, I remember the head of the hospital had gone off to some third-world country to “show them modern medicine”. The doctors told us that what he’d said when he got back was, “they have a better system of medicine than we do!” This was in the ‘90’s. Of course, no one official would say that for publication.

Cathy McGuire said...

Part 2:
I have used most of the alternative healthcare techniques and I recommend them – in the hands of a good practitioner. Just like do-it-yourself health requires individual awareness and discipline, so good health care (alternative or allopathic) really requires a well-trained and aware practitioner. But I have had incredible results with acupuncture, chiropractic, naturopathy, homeopathic and reiki… and as you say, they are less resource-intensive and less expensive than allopathic medicine. I have had family members who have been saved by surgery and antibiotics, and I did recover from a severe bout of pneumonia thanks to antibiotics (but first had to go through a week of hell with one I was unknowingly allergic to!) but it was my acupuncturist who made the housecall and did cupping and needling to help the antibiotics along. (I have also had some family members suffer from bad doctoring, and I'm sorry, JMG, about your loss of your child).

Now that I’m uninsured, I’m working very hard to prevent illness and accidents, under the assumption that it’s totally my responsibility. (At this point, I’d be hard pressed to afford alternative healthcare, so I’m learning herbs and increasing my awareness of symptoms to catch things before they really start.) Just in case, I’ve downloaded and printed “Where there is No Doctor” and added it to my green wizard binders. (which are getting big). As you say – it’s a different discipline from “run to the fix-it clinic”, but it’s in line with all the other green wizard disciplines (ie: if I want food I have to start in the spring, or winter wood, I start in the summer). It’s part of getting used to a different rhythm of life, and all in all, I like this rhythm much better.

And I’m really pleased that a few of us green wizards who are within an hour of each other (more or less) have been gathering monthly to talk green wizardry and see each other’s “homesteads”. So, thanks JMG, for bringing us together!!

@Apple Jack Creek: The thought of having to assess whether or not my symptoms are “worth” spending $50 to see the doctor is frightening

$50?? Try $200! An appointment with my nurse practitioner costs at least $160 for 15 minutes…

John Michael Greer said...

Isis, that sounds about right. I don't think the phrase "rank profiteering" is out of line in a system that routinely bills $100 for a bandaid.

Ozark, I've also had good results with homeopathy, and noted the same dishonesties in studies claiming to debunk it. The fact that its causal mechanism isn't understood, and appears to challenge widely accepted principles, ought to be an incentive to research; instead, it's gotten the "this can't happen, therefore it doesn't happen" treatment.

Sophie, thank you for the links!

Don, that seems quite reasonable as a rule of thumb. I'd widen the second stage: first a low-intensity (homeopathic or herbsl) medicine, then a concentrated pharmaceutical, but that's a matter of detail.

Stacy, thank you. It was just over twenty years ago; I still don't tend to talk about it much.

Robert, the link didn't come through! Please repost it.

Ghung, I've heard from a fair number of people in the prepper community who've gotten a solid grasp of farm veterinary care, and are ready to use it on themselves and their families when things come unglued. It's certainly one option.

Hales, thank you for the link! That sounds interesting.

Red Neck, now there's a name that brings back memories! I haven't read anything by Norton in years; I wonder if her books are still available. (A lot of my favorite children's and young adult books have been discarded by libraries and aren't in print any more.)

As for the Cherokee remedy, most of the traditional medical systems had very good treatments for a lot of today's chronic illnesses. What they couldn't handle, and what drove the development of today's medicine, was the explosive spread of epidemic diseases in the age of European colonization. Vaccines, antibiotics, and sterile technique all evolved in response to that global health crisis -- but those aren't the only health issues that need attention today, and the traditional systems have options that modern medicine doesn't.

Your Name Here said...

Thank you for the timely essay on a subject quite close to home. I've been an Emergency Department RN for over 22 years, which makes me an angel or the devil depending on your perspective.

This experience has made me realize several things. The first realization is that more "health care" is not necessarily better for a variety of reasons, the lion's share of which you've already covered in your post. I would like to add my own "Law of Unintended Consequences" which is that the potential unintended consequences of a given therapy are proportionate to the proported benefits.

The second realization is that the profit motive, er ahem, business model that has made health care an industry proves the law of unintended consequences.

The third realization is that, in an industry dependent on profit and growth, health care depends on ever increasing numbers of ill and injured people. Health executives fret at the thought of fewer people coming through the door; at least fewer people with good insurance. Now I can't prove a causal relationship between the motives of industry and the increasingly sick people I see every day, some on over 20 different medications with up to 6 specialists, but one can't help wonder who we're really helping.

Nobody, and I mean nobody, in my field has any idea what's happening in the world as regards the reality of our energy predicament. There is no conversation that doesn't include a plan to continue with more of the same, with money/energy conjured out of good intentions apparently. The alternative health modalities you've mentioned will probably be the only ones around after the dust settles, because the fourth realization I've had is that, without petrochemicals and all they provide, I'll be using medicinal plants and being creative with what's on hand and teaching the value of patience and fortitude in the face of morbidity and mortality.
medicinal plants

John Michael Greer said...

Kevin, you're quite right -- there's an American winter en route; it's going to be long and very bitter, and made much worse because next to nobody saved up the harvest of autumn.

Damir, Messague's books are well worth having. As for the purity and strength of herbs, where wild herbs are scarce or threatened -- which is all too common over here -- I find it works well to grow them yourself using organic methods.

Greatblue, I didn't get into that because most Americans are stark staring loony about dietary issues. I figure it's an offshoot of our Puritan heritage; every other person you meet has identified some food or type of food as the dietary equivalent of Satan incarnate, and is convinced that by banishing it into the outer darkness with wailing and gnashing of teeth, he or she will get right with good health. I figured it was best to stay well away from that territory.

Kieran, that's quite true, of course.

Cherokee, health care is one of the most profitable industries over here. A lot of people are making a lot of money; again, the phrase "rank profiteering" comes to mind.

Mustard, it'll be interesting to see what happens to the NHS and other European social programs when US hegemony collapses and the US military no longer guarantees the security of western Europe. I hope you can hold onto some of the social services you've got.

Andrew, thanks for the links!

Lizzy, you might also look into acupuncture anesthesia for pain treatment -- but your general point is good; there's a lot that can be done with natural compounds.

ChemEng, that sounds about right.

Unknown, I wish I could help! I don't know how Google assigns labels, though. Yes, I said Watts rather than LA -- could have used either, or Detroit, but it was simply a matter of what would communicate clearly.

Lambert, well, I said that the US has the most expensive medical system in the industrial world, and that it provides the worst health care in the industrial world; I think that more or less sums up what you were trying to say, doesn't it? I don't know that single payer is the only way to go; you could probably get the same results by removing the barriers that restrict who can provide health care.

Lance, that's an intriguing story about the SimEarth strategy. I've suggested before that a truly advanced society may not look anything like what we imagine an advanced society would be...

Bill Pulliam said...

Odin -- I might just note that in my experience, those who use the term "politically correct" to slander those they disagree with actually seem to themselves come from a rather narrow, rigid, and and monolithic political sphere; perhaps even more so than those they critique.

Somewhere long ago it was forgotten that "PC" was a term originally coined by liberal activists as a joke on THEMSELVES and a chuckling self-caution about getting too dogmatic. As usual, the mainstream didn't get the joke...

Verification word "scruf" speaking of humor...

Jonathan Blake said...

It seems prudent for anyone concerned with their health to do their homework and research whatever source of medicine/healing they are considering.

In my area, there is a large immigrant population that often doesn't have the means to avail themselves of modern medicine. Instead, they find a local botanica where they can buy their traditional herbal remedies or a traditional practitioner. However, there has been a rash of deaths when botanica staff have performed medical procedures without a license.

Health care is an area where a skeptical attitude about a practitioner's claims can be, in a very literal way, a healthy attitude.

sgage said...

As we contemplate the health care systems of the future, always bear in mind that many of the "Green Wizardry" kind of things we've been talking about are predicated upon a certain amount of physical health and capability - gardening, woodlot management, building, climbing ladders, etc. I believe I've mentioned this before, but it bears repeating in the context of this week's essay, and the whole Green Wizardry project...

I was well along in my GW preparations - i.e., the above mentioned gardening, heating with wood from my own woodlot (which I worked with my horse), etc., etc.

I was in my early 50's, in great shape, gettin' 'er done, etc. Then, about 3 years ago, out of the blue, medical catastrophe struck. No more chainsaw work (though I still split firewood against doctor's orders), no more working with the horse (she died the same day I got my diagnosis - no kidding - you can't make this stuff up), nothing more than very light gardening, absolutely no more shoveling snow, no going on ladders, and on and on. It took me a full year's cycle on the farm to realize how completely OVER my way of life was, and I grieved for a while.

I don't tell you this to make you feel sorry for me - I'm just saying everything can change in an instant, and you ought to think about it. This is why we need community, family and friends. Nobody is an island. To whit...

I will never forget how, a day after word got out of my situation, a small army showed up with chainsaws and splitting mauls to work up the logs I'd dragged in with my horse just the day before...

So tend to your neighborhood and your neighbors. Especially in rural situations, it can be a very fine line between helping and butting in, showing concern and being nosy. But be aware if someone needs help - it can be done in a fashion that leaves everyone's dignity intact. I was amazed at the subtle skill of folks around here at just that, and I am giving back as best I can in the ways that I can.

One final note regarding the hubris or not of "conventional" medicine. After many (many) thousands of dollars' worth of MRI's and CAT's and an amazing amount bloodwork (for a while I thought I had stumbled into a ring of vampires)(but at least I learned for a fact that I didn't have syphilis :-) it turned out that, indeed, there was absolutely nothing to be done - what was going to happen happened.

My final interaction with the medical establishment was odd. After being told what my situation was, and what I could and couldn't do, and what to expect in the future, I asked my neurologist (who by then was familiar with my way of life) "what am I going to do?"

She looked me right in the eye and said, "you're going to get used to it". Maybe someday.

John Michael Greer said...

Sixbears, that's one of the reasons I want to get as much knowledge as possible out of the libraries and into people's heads and homes.

PeaceGarden, thank you. If you've got the opportunity, balancing the systems against one another is probably a good choice.

Nate, thanks for posting something less belligerent. Would you like to provide some evidence to support your blanket dismissal of the papers I cited, though? Between them, they reference well over a hundred studies published in peer-reviewed medical journals, documenting high rates of morbidity and mortality from medical errors and bad practice; if all those studies were fatally flawed, as you've suggested, that argues for catastrophic problems in current medical research.

As for the issue of what is and isn't a human right, that's one of those subjects about which Americans in particular seem unable to think clearly. We'll be discussing that down the road a bit.

Andy, true enough.

Yupped, that's basically my guess as well. My hope is that alternative practitioners are able to pick up as much knowledge as possible about sanitation, sterile technique, wound care, and the other things conventional medicine is (at least in theory -- not always in practice) good at, so that those don't get lost when the industry implodes financially.

Rocco, I don't think Gatto's being ignored because he's a libertarian; he's being ignored because what he has to say contradicts both the conventional wisdom in this country and a large, vocal, and influential set of bureaucratic institutions. No doubt the fact that I belong to a minority faith has something to do with the fact that the media has zero interest in my ideas, but I think much more of it is that if I'm right, the future most Americans believe they're owed is an empty fantasy, and nearly all the significant institutions of American life -- including the medie itself -- have been busily if unintentionally fostering their own destruction and that of the United States for decades now. That's not something most people are able to hear.

Siani, thank you! As I mentioned, I'd mix the two if I could afford to.

Don, I've seen people with quite a variety of conditions get dramatic and lasting relief from acupuncture. It's a very thoroughly tested modality, especially when combined with the rest of traditional Chinese medicine.

Bill, that's a fascinating question. The t'ai chi studies I know of weren't controlled for involvement in the philosophical and mystical dimension of the art; most of them, from the research protocols, don't seem to have taken the time to teach anything but the form, and yet they got excellent results on a range of health conditions extending from arthritis to high blood pressure. So, yes, it's partly lifestyle change, but it's also a technique in its own right with measurable physical effects.

Kieran O'Neill said...

@Odin's Raven:
Hmmm - I'm a little concerned that your comment is quite some way into the long-screed-proclaiming-irrelevant-ideology territory. The bits dealing with British politics are certainly very partisan and inflammatory.

I'll avoid responding to those parts, other than to observe that the tendency on the right to call the London rioters "feral", or "vermin" is a disturbing indicator of how little it might take in terms of further destabilisation to reach 1944 Germany or 1994 Rwanda. It's not a long way from talking about human beings as though they were beasts to talking about and rationalising "extermination".

As for cancer and alternative vs mainstream medicine ("allopathic medicine" seems to be a pejorative, as far as I can tell?), maintaining a good state of health in general is likely to play a part in avoiding getting cancer in the first place; alternative medicine as well as extra-medicinal "good health" measures are pretty good at that. However, once you have cancer, alternative medicine isn't going to come close to matching the right combination of chemotherapy, radiotherapy, surgery, and, for some cancers, more targeted drugs (e.g. imatinib for CML). Mainstream medicine isn't perfect, either, though it is a lot better than anything mainstream or alternative from 100, 50 or even 20 years ago. This is all pretty well documented in cancer survival rates as they relate to choices of therapy.

Of course, cancer is also a very complex disease, and the scientific models of it, although constantly improving, will likely never be able to describe it fully. And no therapy for cancer is 100% effective. So there is definitely a role for alternative therapies in giving you the extra edge.

As for your question, "Why does taking foreign substances into the body produce healing at all?", I would refer you to an introductory pharmacology textbook, with maybe a biochemistry text to supplement it. It's a rather large question, when you get into the details, to which we don't have all the answers (especially at the systems level for the human body). But we do have a pretty good idea.

John Michael Greer said...

Jason, very much so. The system of acupressure with which I have the most experience puts a lot of emphasis on checking important points daily, and using them to gauge the body's state of health, so that illness can be headed off in advance. It seems to work fairly well, too.

Cave, I certainly agree that there's a lot worth saving in mainstream Western medicine, and that the core difficulties are with the institutional and economic context rather than the system itself. Still, it's just a little disingenuous to criticize alternative practitioners for not doing enough experimental trials.

Have you ever tried to get funding for a study of alternative health care that wasn't explicitly framed as an attempt to disprove and debunk? For that matter, have you ever seen what happens when a favorable study, however well run, gets submitted to a standard medical journal? There's actually been some first-rate research done, especially on homeopathy and some branches of traditional Chinese medicine, but those same institutional and economic barriers have been used repeatedly to exclude anything outside the current paradigm.

Zach, E.M. Forster was there a century ago. Have you ever read "The Machine Stops"?

Wendy, thank you. It's not an uncommon place to be in; mainstream medicine does still save quite a few lives.

Robin, exactly. It's the transition that concerns me, and the isolation of valuable knowledge behind the steep walls of professional privilege is not going to be easy to get through.

Raven, that's an interesting philosophical question; nonetheless it's quite true that taking foreign substances into the body can very definitely cause healing, and that practical fact needs to be kept in mind here.

Kjmclark, under Obama's health care legislation, the poor are supposed to get their health insurance paid out of Federal revenue -- there is no such thing as "free." Even if those subsidies don't get cut in a future round of budget wars, most of the working class won't benefit from them. For the great majority of working Americans, Obamacare amounts to a huge new Federal tax on their income -- and I don't think I'm unreasonable to expect that to cause a political explosion of quite some magnitude.

Kieran O'Neill said...

I'd like to add my strong concurrence with Bill's statements about both tai chi and homoeopathy. I'd had exactly the same thoughts, but he's articulated them perfectly.

And JMG, thank-you for the reminder about tai chi. It's something I've been neglecting, particularly with the many times I've moved city (or continent) over the past decade, but today I think I'll make the time to go down to the exercise room and run through the form a few times.

Richard Larson said...

My mother had polio at a young age and spent a year in the hospital, and I highly doubt I would be here today without medical advances.

I am, but maybe not should be.

There has to be something that limits growing human population before the resources are exhausted and most everyone dies at once...

Larson

John Michael Greer said...

Maria, thank you.

Casey, thank you. Scarlet fever's nothing to mess with, and I'm glad your child got prompt treatment! As for the quarrels over mainstream vs. alternative medicine, yes, it's sad -- and yes, it does have a great deal to do with money. One of those things about living in America...

Cathy, as I mentioned to Nate, we'll be having quite a conversation about the concept of rights down the road a ways! You're quite right, of course; the culture of privilege and entitlement that pervades modern America is not helpful, and when it collides with hard reality in the decades ahead, the result is going to be a very loud splat. The notion of taking personal responsibility for health, unpopular as it is, is a good deal more useful.

Your Name, thank you for the inside glimpse. I've had my worries for some time that profit-based health care was fostering illness to improve its bottom line. It's very worrisome, though not surprising, that nobody in the industry seems to be thinking about the medical implications of peak oil; that increases the likelihood that the whole kit and caboodle may crash -- perhaps for financial reasons -- and leave only the herbalists and acupuncturists to pick up the pieces.

Jonathan, caveat emptor is good advice when dealing with any service provider, in or out of the health care field.

Sgage, sometimes the world taps you on the shoulder and says, "No, you're not going to have the future you planned." One of the things I've been trying to say in these green wizardry posts is that there are many different ways of managing the deindustrial transition, and not all of them require robust physical health!

Kieran, "allopathic" is a technical term from homeopathy -- it's not a pejorative. It reflects the fact that homeopathic medicine cures by using minute doses of compounds that, in large doses, cause the condition being treated -- thus "homeopathic." "Allopathic" simply means "treating with compounds that cause the opposite effect of the condition being treated."

Peter said...

Good post JMG. I have tried to address some of these issues in my website www.PostPeakMedicine.com. I think that as industrial society and the industrial economy winds down, physicians will have to lower their fee and income expectations to something closer to what the average person can afford, or we risk putting ourselves out of business. If we charge unaffordable fees, the end result is likely to be no income for us.

John Michael Greer said...

Kieran, glad to hear it. I'd guess from what you said that you learned one of the short forms; if you have the chance, pick up a basic qigong form such as Baduanjin, and maybe the simplified sword form, and you've got something you can work with and develop for the rest of your life.

Richard, one way or another the world's human population is going to contract to a fraction of its current size. The question is simply how, how horrifically, and what's going to be left on the other end of the process. That's the core theme of this blog, really.

sgage said...

JMG -

"One of the things I've been trying to say in these green wizardry posts is that there are many different ways of managing the deindustrial transition, and not all of them require robust physical health!"

That's why I said "many" and not "most" or "all"... :-)

As far as plans, here's one of my favorite aphorisms:

If you want to hear the Gods laugh, tell them your plans.

Shiva said...

Great post. I learned a long time back that it was much better to keep up good health than to fix it once it was broken. In addition to using herbs and such, I have found that the greatest way to good health is good nutrition. I chose a raw food path for a while and experience a massive detox and excellent health. I have since incorporated some cooked food back into my diet, but still eat plenty of raw food and superfoods (i.e. foods that are very high in nutrition...blue green algae, maca, goji berries etc). Things that I have taken completely (or almost) out of my diet include cooked oil, wheat, white sugar and cooked (including pasteurized) dairy. My health is outstanding and I look and feel far younger than most people my age (47). I'd strongly recommend people interested in maintaining good health to seriously look at their diet. Finally I want to share this excellent video on self dental health that I just found: http://www.google.com/search?q=youtube+dental+health+daniel+vitalis&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a

cheers! ~shiva

Ekkar said...

Good post. I really enjoyed the flow and the bright analogies. I have been practicing various traditional forms, as well as forms I've developed geared towards me personally, of Yoga for many years. I understand first hand what you mean by the difference of popping a pill and flopping back down on the sofa, and the attention and effort required for taking a more active roll in health and happiness.
I also own my own landscaping company. Landscaping is a very interesting profession for various reasons. Specifically as it relates to this post, is my costumer base. At least 60% of my customers are over sixty. I am 35. This over sixty generation is an odd bunch to me. In the sense that they are a generation that seems to have completely swallowed this idea of better living through science. That it is foolish, if not dangerous, to take responsibility for your own health. That whatever a doctor says (any doctor) is basically indisputable, especially say by their landscaper. I have pretty much given up on trying to give advice to them. Even something as simple as a posture that could alleviate certain back problems. Usually their eyes glaze over before I finish the first sentience, let alone that I can feel that they are now a bit scared of me for fear that I am a witch, and will probably put a Taliban Voodoo spell on them.
The last thought I'd like to share is about, not only their unnecessarily unhealthiness, due to lack of self knowledge, but their seemingly stubborn denial that they are edging ever closer to death. That a lot of their ailments that they are taking loads of medication for each day in the hopes of "getting over this" is actually their bodies breaking down and that there will in fact be no getting over it. Contrast this with someone like you or me, who do things such as T'ai chi or Yoga that very much set us into the reality, and mortality of these human bodies. So I think these fundamentally different approaches to health, spotlight not only a changing perception in the collective conscious, but also the disenchantment of those who are living in the dust of the better living through science generation, and those in that generation who have put all their eggs in that basket and are now too old to even consider to consider a different way for the world to operate.
Thanks.

Twilight said...

Like you I have been both saved and victimized by our modern health industry, the later a result of vaccines and the hot potato politics of lyme disease. In a broader sense, much of what our modern industrial medical system treats are problems directly caused by our modern industrial society, in a self perpetuating spiral of diminishing returns. It's quite unclear, had my wife and I been born in an earlier age, if I would have lived past 1 month or never had an issue at all, or if my wife would have died in childbirth with our first or delivered without complication somewhat later. It's quite clear I would not have had to be reassembled following a horrific car crash, nor would my son have struggled so as a result of vaccines.

I believe that native populations had learned to be quite effective in their treatments and method in the places where they lived. What happened in the Americas was that a large number of people were transplanted into an environment they did not know with with different local plants, separated from the knowledge of their own people, unable to learn or adopt the practices on the local natives, and exposed to a mixture of new illnesses from around the globe. From that was born a whole new approach to medicine which evolved intertwined with industrial society. But that does not mean that older knowledge was not effective. By necessity we end up with a mixture of approaches – for an ironic example, we have not found an effective remedy for lyme disease in either area.

@Sgage - your story has not been lost on me, I think of it often while busting my butt around here, and understand quite well what it would mean if I or my wife got seriously injured.

John Michael Greer said...

Peter, many thanks for the link! The issue of fees is a big one; I hope you're also exploring the need for doctors to relearn how to do their own lab work, compound their own medicines, and train the next generation of physicians via apprenticeship rather than medical schools. Even so, it's good to see that somebody in the medical profession is asking the hard questions.

Sgage, actually, I was agreeing with you!

Shiva, I noted a while back that different people thrive on different diets -- it's emphatically not a one size fits all thing -- and if you've found the diet that works for you, that's great.

Ekkar, that's a perspective worth noting. I've had plenty of encounters with people who have the same attitudes as your customers; in some cases, it's quite literally killing them -- most of their health problems are side effects from medications, and they know as much, but the doctor is not to be questioned. It's the younger and savvier people who are asking the hard questions and making their own choices.

Twilight, well, that's part of it, but remember that most of the basics of modern medicine were invented in western Europe in the 19th century. There's a tangle of cultural pressures behind both the strengths and the weaknesses of today's medical mainstream.

John Michael Greer said...

Rita (offlist), er, if you'll delete the profanity from your post and resubmit it I'd be happy to put it through.

Rainbow (also offlist), that's two angry and abusive attempted comments in a row. You might want to calm down a bit before flying off the handle again.

LewisLucanBooks said...

Picked up a book the other day called "The Village Herbalist" by Phillips. Anyone familiar with it? Comments?

Re: The Reaper (why so grim?) I haven't had insurance in a number of years. When people ask me, "What will you do if you get sick?" "Well, I suppose I'll die." The reactions I get to this are interesting and informative. Everything from horror to an unspoken, "I always knew this guy was a whack job."

I did a little hospice work, now, many years back. I learned so much. Such as, not everyone can tend or help the sick or dying. Much to my surprise, it came quit naturally to me. And, I lost the fear of my own mortality.

If things get bad at the end, a sharpened razor blade and a basic grasp of anatomy will help me out (thank you, Roman studies.) Hypothermia is a nice way to go. But that only works in winter. To quote another poster, "Now where DID I put that hemlock?"

Justin said...

JMG,
It was either a gross oversight, or maybe there is a part II, but this post needed some component of the state and pathos of mental health care to really slam home the case.

Ekkar said...

Your ability to respond to all the comments is quite impressive. That being said I wish to leave my second of the day. After I read your post I went into my garden for my usual routine of watering the chickens, and tomatoes, etc. While I was watching my honey bees I started to think about varroa mites. They are are a bee mite that has been really causing problems (especially in commercial bee keeping). Certain strains of bees have over time developed resistances to the mites. This sometimes requires the loss of billions of bees over a time period, but resulting in a new bee, better equipped, and resistant to the disease which brought its species to the brink. Now I am not insinuating that we sit back and let diseases kill millions of people so that we may build up resistance in our species. It is a very interesting thing to think about. Are we actually keeping through the use of antibiotics, non resistant genes from dying out? Are we not only hindering our own collective immune systems evolution, but in the process making potential super germs that will wipe out huge parts of the population regardless? I know it's an almost crass question, but in the search for truth one must look at the dark as well as the light.

Mary said...

First, a quick aside. Scarlet fever is a sequelae to an untreated Strep Type A infection. Strep is still susceptible to penicillin and, for those allergic to the beta lactam family, to erythromycin. That's not to quibble: just don't let strep go untreated folks. It is a very easy to diagnose and still very treatable infection which, left untreated, can lead to scarlet fever, rheumatic fever (and permanent heart damage, and glomerulonephritis (kidney damage).

That said, antibiotic resistance will continue to spread due both to bacterial evolution in realtime and the ability of bacteria to share resistance genes in multiple ways. Also due to people *not* taking all their medicine (particularly true, unfortunately, with "high maintenance" diseases like tb), thus allowing the more resistant bacteria to survive and reproduce. Also due in a large way to factory farming animals that are fed antibiotics to "control" disease in their high-stress, closed environments. Also the disposal of antibiotics, which then end up in water and soil. It's a serious mess and may also lead, ultimately, to less resistant plants.

I work in a hospital surrounded by nursing homes, which is where we see the nosocomial infections. We glove up, gown up, wash hands before and after each patient (thus twice between patients), but patients and their families still sneeze, cough, wipe their noses with their hands, don't wash their hands, etc.

Funny how the pharmas and FDA keep trying to go after plant medicine, since most pharmaceuticals start out as extracts from plants. They just take the phytochemicals that are the most obvious in their action, but leave out the dozens or hundreds of "lesser" compounds that work in concert with the obvious one, either negating side effects or boosting efficacy of the compound of choice.

Western medicine is very good at some things. "Alternative" medicine is very good at other things. Personally, I go for the best of both worlds. The *best* treatment I ever got was for cash at the Ayurvedic Center that used to be located in Lancaster, Mass. After Deepak Chopra left, the physician was another "double degree," both a western MD and an Indian Ayuvedic medical degree. The cost for a 2 hour exam (including 30 minutes to take your pulse) was the same as a brusque 15 minutes with an Md.

Luckily I live in an area rich with alternative practioners...

And the best thing, of course, is to take good care of yourself in mind and body.

Andrew said...

@cave: As someone trained in one of the Japanese schools of acupuncture I agree with you that small-scale high-quality research can be done on a small budget and that not all "alternative medicine" practitioners are as aware of this as they should be. However, the Archdruid is right in that it is very difficult to get these kind of modest studies published in respected magazines where they will have an impact. Nevertheless, research is available with the click of a mousebutton. 1, 2, 4, 5, 6, 7.

For the question as what to salvage from modern Western medicine, my wish is not a specific remedy or therapy, but rather the detailed knowledge we have now gathered about human anatomy and the way it maintains homeostasis. This knowledge truly will be immensely valuable for all physicians of the future, regardless of what and how they practice and is not easily reproduced in a post-peak world.

JMG, I feel you have not addressed one important aspect of modern Western medicine, namely logistics. The fact that an ambulance can be dispatched on short notice to an emergency, that in a serious case quickly several doctors can be consulted all with their specific experience, that there can be 24/7 observations, with a full team on standby... these things depend on a lot of resources and cannot really be replaced by individuals, however hard they may try and whatever therapies they use. When these logistics eventually cannot be maintained any longer, there will be a lot of suffering, little to do with modern medicine itself, but rather with society's (in)ability to administer it. Eventually, in an Ecotech future, it may be possible to replace this with teams of healers of course, much like monks and nuns used to take care of the sick in the Middle Ages.

As a bonus, for the readers who have to do without healthcare: there are many Community Acupuncture Clinics now in the US, who use sliding scales within $15 - $ 40 p/ treatment and may be worth checking out.

Robert said...

Just getting back to the economy for a moment here's an article by Paul Craig Roberts that's well worth a look. He's basically saying among other things that much of the damage to the economy is the result of a turf war between the Pentagon and Wall Street for control of Americas resources.

http://www.informationclearinghouse.info/article28800.htm

Wullow said...

John, another health care system that's worth salvaging is that of the many fraternal, mutual aid societies, which used to exist before the AMA was formed and carried out its mission of stamping out low-cost health care. At least that's the story as I understand it. Here's a link to the full story: Medical Insurance that Worked — Until Government "Fixed" It

wall0159 said...

this, and other posts, remind me of a quote:
"Civilization advances by extending the number of important operations which we can perform without thinking about them."

I think what you're talking about here relates to your other posts on salvaging knowledge, science, etc.
We have a heck of a lot of highly specialised, highly contextualised knowledge that is dependent on the (non-overlapping) knowledge and expertise of others.
If energy descent and sociatal breakdown occur, we will desparately need generalists who are able to integrate disparate knowledge and processes from different fields. We also need mechanisms for teaching specialised knowledge and processes to non-specialists.

It's also vital that these are not taught as recipes or dogma. As I think you've said in a previous post, we don't need a "bible of science." We need a narrative that describes our current understanding of things, why we believe it to be so, and underlines that this understanding is only approximate and pends further investigation.


On an unrelated note, I think that there's a lot to "alternative medicines," but I think it's vital that we maintain an evidence-based approach to medicine. Once it descends into mysticism*, it becomes a haven for profiteers and shonks (maybe this has already happened with modern scientific medicine!).
For this reason, I'm highly skeptical of homeopathy -- I just haven't seen any evidence that it works. When coupled with the fact that it violates some of our fundamental beliefs about how the universe works, I wouldn't be trying it myself. Herbal remedies, acupuncture, and lots of others, have merit in my opinion -- because they are explainable/testable/plausible.

*I don't have a particular problem with mysticism, per se (though I consider myself an atheist) but I think it has a habit of clouding unrelated and otherwise clear subjects in people's minds.

Cheers...

Ozark Chinquapin said...

Bill,
I admit I don't have much knowledge of magic so don't really understand what it entails if what you're saying is true. Would that account for the effects shown on animals, mycelium and single-celled organisms shown in the link I posted previously. I am not a biochemist either so can't confirm or refute the technical terminology, it's my personal experience that matters the most to me.

I agree with you that there might be some other methodology that could be just as effective, however I have tried several and homeopathy has been by far the most effective for me, that doesn't mean there aren't others out there that would be more effective. As for the expense, that's one of the reasons that it took me so long to actually try seeing a homeopath. However it's still cheaper for me than health insurance would be. Homeopathy has gotten itself dependent on the industrial system too, although it's not nearly as energy intensive as mainstream medicine and could adapt itself to a deindustrial world, as it began before fossil fuels were used on a major scale. Haven't heard of any peak oil homeopaths yet though.


Something else already touched upon that I consider very crucial is taking responsibility for your health and having an active role even when you need professional help. This is true whatever path you choose to follow, mainstream or alternative. Most people seem to prefer blindly following their doctors, and that may be fine if you're lucky, but I have seen far too many cases of that path leading to disaster.

buzzy said...

@Your Name,

I agree that in general there is no recognition of the limits soon to be imposed by diminishing energy resources within healthcare. However, as a pharmacist I can attest that we are already dealing with the first tremors of limited resources. A significant aspect of a profit-driven industry is the lack of incentive to continue producing unprofitable products. Thus pharmaceutical companies often stop making unprofitable medicines that are fundamental to care but are cheap to make and thus purchase, or have their production stopped by the FDA when they try to ramp up inventory and commit blatant safety violations. There are already crippling medication shortages for inpatient practice. It is only a matter of time before they are routine in outpatient settings. I dread the day my husband and I are routinely rationing basics to desperate dying patients.

In the same vein, a significant reason there are fewer antibiotics being developed is that after 14 days of taking the drug you're cured, i.e. there's no long term income for the drug company like there would be for lifestyle disease drugs. Industry folks will freely admit in professional settings that antibiotics and vaccines are unprofitable, which just proves how kindhearted they are to continue to make these money pits.

John Michael Greer said...

Lewis, I worked in nursing homes for four and a half years, back when I was doing the struggling and unpublished writer thing. You definitely get a different take on life and death when a lot of your job consists of being the last human face a dying person is going to see -- trust me, there was rarely a family member around -- and another part consists of cleaning up the corpses for the undertakers. I won't say the guy with the scythe is a friend of mine, but we certainly used to hang out together a lot.

Justin, not a gross oversight, just a lack of knowing what to say. I know the mental health situation is sixteen different kinds of mess, and that it's only going to get worse; right now a sixth of the US population is on antidepressants, and I bet most of my readers aren't aware that several of the most popular antidepressants cause the body to put on lots of extra weight -- have you ever heard anybody reference that in the discussions of American obesity? -- but beyond that, I'll leave it to those who have the knowledge that, fortunately, I don't.

Ekkar, it's a horrific question, but a valid one. I don't know the answer.

Mary, the obsession of the FDA with banning herbs at the drop of a hat is really fascinating, in a sick sort of way. Ephedra got banned after two deaths, caused by egregious overuse -- but how many people had to die before Fen-Phen got pulled from the market? It's hard to think of a good reason for the double standard, though all too easy to think of bad ones.

Andrew, the issue of logistics is a good one, and you're right that I hadn't brought it up. A great deal of modern medical practice isn't even possible unless, say, you can rush somebody to a hospital at highway speeds. Thanks for the acupuncture links, also!

Robert, many thanks.

Wullow, good heavens -- I thought I was the only one around who still knew about that! (I learned about it as a lodge member of a couple of orders that used to have such programs.) Your link doesn't seem to work, though -- could you try reposting?

Wall0159, er, it seems to me that you're confusing evidence with relationship to current theory. There's quite a bit of evidence, including repeated controlled double-blind studies, that homeopathy works -- but it's been my consistent experience that atheists of the scientific-materialist kind won't consider that evidence, because it impinges too closely on what they tend to label "mysticism." (Misuse of a good word, by the way.) Still, if that's an issue for you, it's an issue; you can certainly get very good at herbal medicine from a strictly materialist, biochemical point of view, and it seems generally to be a good idea to make your preferred healing modality consistent with your religious (or, in your case, nonreligious) worldview.

MaineCelt said...

Thank you for this post-- and for taking the risk to put your personal stories in the mix to help us understand the depth and breadth of the challenges we face.

I spent a good portion of this day in the woods, trying to teach myself about local mushrooms: their growth habits, their favoured locations and conditions, etc. This new discipline was prompted by reading Paul Stamets' "Mycelium Running" and David Spahr's "Edible and Medicinal Mushrooms of New England & Eastern Canada."

Both authors describe and document a range of proven medicinal mushrooms--maitake, shiitake, turkey tail, chaga, etc.--and explain how to find and/or grow them, suggesting that homesteaders would do well to add mushrooms to the range of things they grow and store for health support, illness prevention, and the treatment of certain types of illness.

I am among the uninsured and also have strong allergies to most antibiotics, so I'm particularly interested in natural substances that provide immune system support. A number of mushrooms can be safely grown, cooked, and eaten for just this sort of benefit.

I like the analogy of folk/alternative medicine being like walking--it does indeed take more work, bring more balance, and put certain destinations out of reach. That said, it brings me peace to live within natural limits, and that peace contributes to my health. I'm reminded of my eventual end every time I sharpen and swing my own scythe. When the singing blade finally takes me down, I hope I compost nicely...and I hope a few health-enhancing mushrooms spring up from the pile.

Wullow said...

John, here's the corrected link to Medical Insurance that Worked — Until Government "Fixed" It

wall0159 said...

Hi John,

There's a summary of evidence for homeopathy on Wikipedia:
http://en.wikipedia.org/wiki/Homeopathy#Evidence

I have not seen a single study that has convinced me of the efficacy of homeopathy. It is possible that I am wrong, but if so, homeopathy would imply a range of physical phenomena completely unknown to mainstream science. To me, the principle of Occam's razor makes me think that such enormous claims require very strong evidence indeed (evidence which is completely lacking, in my opinion).
Having said this, if anyone can point me to some convincing studies, I would be interested in reading about them.

With regards to mysticism, I view myself as a somewhat mystical person, and often have periods of wonder and awe at the beauty/sophistication of natural systems. I agree with your comment about a material and biochemical basis for herbal remedies.

LewisLucanBooks said...

@ Andrew - Several years ago, I got the flu. It was a doozy. Late one night it suddenly dawned on me that I hadn't even been able to keep water down. For three days. And that I was probably dehydrated. I live alone. I called an ambulance. A night in the ER and home I went with anti-nausea meds. Luckily, it was back when I had insurance, but the bill was over $800 for that little four mile ride. If it happens again, I'll drive myself, crawl or die.

Flu kills 35,000 people in the US every year. I know vaccines can be controversial, but now I get a flu shot every year.

@ JMG - My longest stint of hospice care was for a friend. At his home. Two of us full time and two in rotation. But, I seemed to spend a lot of time comforting mutual friends who just couldn't bring themselves to visit. I understand. Those who can, do.

In talking to other people who have been in the same situation, it's interesting that the Reaper apparently doesn't like an audience. How many stories have I heard where "I just stepped out for a cup of coffee, to use the bathroom, to get a quick smoke and when I got back, he / she were gone."

Antibiotics - I had a friend (now gone) who anytime he got the sniffles, DEMANDED that his doctor give him antibiotics. Told him he'd find a doctor who would prescribe. A reasonably intelligent person who kept insisting they made him feel better. No amount of information or authority could convince him otherwise. Sad and silly.

Zach said...

Zach, E.M. Forster was there a century ago. Have you ever read "The Machine Stops"?

I have, although it's been a long time and I didn't connect it to WALL-E.

I am under the impression that "The Machine Stops" is fairly obscure these days, except to hardcore science-fiction nerds or perhaps to English professors. :) On the other hand, WALL-E was a hit Pixar movie, so it's a touch more prominent in the mass consciousness.

(re-reading...)

Forster was frighteningly prescient, wasn't he? Although I think his ending is a bit bleak for a feel-good children's film. :)


peace,
Zach

John Michael Greer said...

MaineCelt, excellent! I don't know a great deal about mushrooms, but I know that the old Taoists used to do quite a bit with them; it's a lore worth learning.

Wullow, thank you! It wasn't just the government that killed the old fraternal system of hiring a doctor for a fixed annual sum to take care of the lodge members -- the AMA did its level best to squeeze it out of existence, since it forced doctors to compete against one another for lodge business, and thus kept health care prices down.

Wall0159, yes, that's pretty much what materialist atheists always say. Everyone else I know who's given homeopathy a fair trial on its own terms finds that it works, but hey -- you've got to make your own choices, and use health care that fits your own core beliefs.

Lewis, I'm not sure if he makes an exception for nurses aides, or what, but I was there at the moment fairly often -- in one case, taking a blood pressure as it fluttered down to zero. All part of the job.

Bill Pulliam said...

Re: The guy with the scythe -- I never really appreciated that metaphor until last summer when I got my first scythe and put it to use. The blade slices through the grass (grain, weeds, whatever) with a soft whisper, and the stalks just fall over silently right where they stood. No dramatic whirling blades, no roaring motors, no shredded vegetation flying through the air. Just *swish* and *plop*.

I expect coming generations will become much more familiar with guys wielding scythes, both literal and metaphorical.

Also on dying.. when my father died in a hospital, it seemed so strange to me that 15 minutes later all we assembled family members just walked out of the room and were done with it. Teams of professionals then slipped in while no one else was looking to take him away and deal with him as though he were nothing but toxic waste. I kept feeling like "shouldn't at least one of us stay with him, escort him, accompany him?" But not only were we not needed, we were most definitely not wanted. Off you go, nothing to see or do here. It was very strange.

Don Mason said...

Robin Datta wrote:

“In emergency departments, a patient with right lower quadrant abdominal pain and the appropriate associated additional findings will get a CT scan to check for appendicits: the scan may be read by a radiologist in another town, state or country. Whether the emergency physician calls the surgeon or not depends to a large extent on the radiologist's reading.

Trying to change course of the system is like taking a train off the rails. There is no room for the concept of transitioning to a low-tech mode…

A lot more useful information may have been lost with the vanishing of indigenous cultures. Unfortunately, a lot of useful information from high-tech medicine may also be lost in the transition to deindustrialization.”

Thanks for your post. It made me think about how the diagnosis and treatment of appendicitis has changed over the years, and how it might change again as we deindustrialize.

CT Scans: My training was in the days before the widespread use of CT scans. CAT scanners (back when they were “Axial”) were just becoming available. Every hospital wanted a scanner because it was as big as a boxcar; it cost about the equivalent of the GDP of some nations in Africa; and it was so state-of-the-art that nobody had the foggiest idea of what to do with it. Simply irresistible. So the very few that were available back then weren’t used to help diagnose appendicitis. (Too mundane.)

As we deindustrialize, my hunch is that the first part of the system to derail will be using a CT scan to diagnose appendicitis. As the CT scanners disappear, a lot of radiologists will also disappear, since they won’t be needed to read scans from expensive CT scanners that no longer exist.

Blood work: The equipment used to analyze blood samples will probably disappear next. But the analysis of the blood could still be done by humans.

I recall a professor telling us that back in the old days (for him, the 1940’s), the hematologist was at the top of the hospital’s diagnostic pecking order. The hematologist would sit in the lab all day peering through his microscope at blood samples; and his judgment was pretty much accepted as gospel.

But over the years, the hematologist’s experience had been condensed down into machinery; and hematologists had gradually almost disappeared (other than in oncology, etc.). You didn’t see many of them hunched over their microscopes any more.

In a deindustrialized future, perhaps hematology could make a comeback. It doesn’t require expensive technology. All it requires is a good brain, some good books, and a so-so microscope that uses glass-grinding technologies that have been around for many centuries. As other high-technology-dependent specialties fade away (like radiology), hematologists might make a comeback, at least in urbanized settings that permit a degree of specialization.

- Continued Below -

Don Mason said...

- Continued from Above -

Clinical examination: That won’t change much. “Where does it hurt? When did you first notice it? What makes it feel better? What makes it feel worse?”

Surgery: Surgery would still be the treatment of choice for appendicitis; and sterile technique is not something that we would necessarily lose in a deindustrialized world. We should be able to cobble together simple autoclaves to sterilize simple hand instruments; and we will certainly be able to boil water. And hopefully we will remember to wash our hands between surgeries; and for irrigation, to use sterile water instead of spitting copious amounts of saliva into the surgical site.

Anesthesia: I was taught that the Chinese could achieve anesthesia adequate for performing surgery using acupuncture; the only problem was that acupuncture did not achieve sufficient anesthesia as reliably as using Western anesthetic agents: sometimes acupuncture achieved good anesthesia, and sometimes it didn’t.

In an industrial society, the tendency is to go with the most reliable method, even though it is more resource-intensive. In a deindustrialized future, that resource-intensive method wouldn’t be an option, so time- and people-intensive acupuncture might be used instead.

Sutures: Dissolving and non-dissolving synthetic sutures would probably disappear. But dissolving sutures made from sheep intestines have been used since the time of Galen; and non-dissolving sutures have been around even longer. They aren’t as convenient, and they have their drawbacks (e.g., a higher incidence of inflammation), but they are still reasonably functional.

So in a deindustrialized world, we might still be able to do a reasonably effective job of diagnosing and treating appendicitis, at least in urbanized areas. As long as we don’t descend into total barbarism, we might be able to preserve some of the benefits of industrial medicine.

Or we could end up spitting in the surgical site, and blaming the patient’s subsequent demise on his failure to have enough faith in our medical skills…

BlackDove said...

JMG,

Thank you for the great series of posts this year -- they've kept me thinking constantly about the future.

@ Cathy

I enjoy your insightful and well-thoughtout posts.

As one who thinks a lot about human rights (esp. in a political sense), I'm not quite clear on your distinction between "social good" and "basic rights." I've always assumed that the two are essentially linked, since rights without a society in which to exercise them are meaningless in any practical sense. Are you looking at these basic rights from some Constitutional (legalistic) standpoint, or from more of a religious or Natural Law perspective? It seems to me that the perceived origin of our rights is important here, whether it's from God, nature, a Leviathan -- whatever. How does any right to healthcare (assuming it exists) compare to, say, the right to free speech, to a speedy trial, or to keep and bear arms? I'd posit that, in any civilized society, the health of its populace would be very basic indeed.

As to "some concomitant responsibility:" we do in fact provide for our healthcare providers -- I don't know of any practitioner who provides it for free; their compensation comes from somewhere -- insurance, the patient, taxes, etc. After all, it's their job and chosen method of livlihood.

One could argue that no others need to "provide" me with freedom of religion, or of the press, or of the right to petition my government for redress of grievances. But in fact, they most certainly do provide for me -- by paying for our judicial system, and the law enforcement agencies who carry out their judgements. (Rights without enforcement mean nothing -- just look at the ante-Civil Rights Movement south).

Thus, there is no clear reason to me why healthcare cannot be just as important a right as the (alleged) right to own a firearm, or to protest a war.

Tony said...
This comment has been removed by the author.
Lazarette said...

Thanks John, great blog, but please don't join kunstler and the automatic earth in fear mongering.

The UK is not about to have an "English spring" and despite our problems, we have a well functioning democracy, with yes a few corruption problems and the other glitches one expects in a democracy. Unemployed get good benefits, and if you're in trouble there's free healthcare.

The accused London rioters started appearing in court yesterday, they included university students, a rich businessman’s daughter and a boy of 11. None of the several hundred arrested so far could be even close to being described as in poverty or oppression. They were mostly disillusioned youth taking advantage of a situation to get some free trainers. 10x more people turned up to clean up afterwards than took part in the riots, however the media downplayed it as it's not such a great story.

We do have a huge problem whereby young girls are encouraged through a generous benefits system to have children (get pregnant at 16 here and you are given an apartment) then we end up with 20 year olds raising children, with no idea what the job entails, and then, surprise surprise, often making a mess of it. This has given us an underclass with little sense of belonging, and lack of understanding of what community, work, love and responsibility mean.

But massive riots outing the government? People can always vote for a new one, that tends to work.

Matt and Jess said...

Health care ... don't get me started. My daughter, poor thing, has an abscessed tooth ... thing is, I spent 900 bucks last year getting it treated and they must have taken the wrong tooth out! Now I'm stressing out about the cost of getting it re-examined and treated ... any recommendations for alternative dentistry? I doubt it. Ugh.

This is also a case, by the way, for the homemaker--a stay-at-home parent or spouse. I couldn't afford a session with an alternative health practitioner with the amount of money in the bank I have now anyway, but if it's something that you have the time to research and add to your repetoire of skills, well that's another plus for your family.

Jeffrey Kotyk said...

Hi John,

It occurred to me after reading your post here that with the halting of industrial society and all the toxins it is responsible for introducing into our food, water and air, we might have a reduction in modern diseases like cancer.

I don't know if you're aware of this study or not, but the U of Manchester did a study on Egyptian texts and mummies, and discovered that cancer was seldom ever found in the mummies and that the Egyptian texts, though they knew of cancer, reveal it was not the huge deal for them that it is for us in the present day. Here's the link:

http://www.manchester.ac.uk/aboutus/news/display/?id=6243

So on the bright side with the decline of industrial civilization we might find ourselves freed from numerous diseases that haunt us due only to industry.

Cherokee Organics said...

Hi JMG,

A few people have touched on food issues.

Well, how many people think about the nutritional content of the food that they are eating? Industrial agricultural soils are now so lacking in nutrients, flora and fauna that it impacts on the entire human food chain. This must have some sort of impact on people’s health, for sure.

I'm now self-sufficient in eggs and greens and the nutrient cycle is unbroken (I'm an importer of nutrients). Fruit may be still a few years off yet (plant fruit trees whenever you get the chance people as it such a long term proposition). However, when I'm served greens that have been grown elsewhere, they look to me like they are paper thin and have little in the way of flavour. When I think about how these vegetables are grown, and the soils that they are grown in, it doesn't surprise me at all. There must be some health cost to all of this?

My understanding is that the biology of the soil is also apparent to a lesser extent on the leaves and fruits of the plants.

Surely prevention is better than a cure and if it doesn't start with what you put into your body and what work you do with that body then you haven't got the fundamentals right?

Regards

Chris

peacegarden said...

I felt I had to respond to Ekkar’s statements about the over sixty generation who “have put all their eggs in that basket and are now too old to even consider to consider a different way for the world to operate”.

Never say never, grasshopper…a new paradigm can indeed be imagined and implemented by we over sixty types. I know many who are working in various ways to make that different way of operation a reality.

I also observe many younger persons who are not particularly interested in optimizing health, and who are just as stubborn in their denial of death.

Getting in touch with our mortality is very important, and many of your customers may very well never “see the light”. But some will, and that is what I am working toward…be the change you want to see…reveal, not convince…be humble and grateful for any and all blessings…even chronic health issues.

Have compassion for your customers…they bought a bill of goods that guided their lives…did “everything right” and may be starting to see they’ve been hoodwinked. That is not a pleasant experience.

Some of the most stubborn codgers may wind up being leaders in setting up a new/old way of being in this world…you never know.

Peace

Gail

peacegarden said...

I have worked in the health care field many times throughout my life, with a stint as a Montessori teacher thrown in for seasoning. My most recent experience was in a very beautifully designed (for impressing the resident’s families) complex that was billed as a “Rehabilitation” facility, but was in fact a nursing home.

What went on there was what goes on in just about every place I’ve had the privilege of employment: understaffing and high turnover, elders reduced to over medicated “dementia” states, and an unseemly use of Medicare and private insurance to keep people “alive” for as long as procedures and ongoing treatments could be justified.

It was impossible to render the care needed without taking physical risks…leaving someone laying in their own excrement, or hauling them around in the bed by myself, causing injury to myself. After two episodes of Worker’s Comp injuries, my husband begged me to quit, and I did.

I also worked for a time in an institution for intellectually challenged individuals. Again and again, the basic theory of the total institution was proven…the power disparity between the residents and staff resulted in the abusive treatment and lack of humanity towards these captive persons. I was able to “make a difference” for a short while, but had to leave before my soul shriveled up and died.

One aspect of the devolution of industrial health care offers hope. We will need to care for our loved ones (and not so loved ones) at home. There we can be human together, sharing in the processes of illness and dying, offering comfort and compassion to each other. The sick and dying have gifts to give the caregivers, perhaps more important gifts than the caregivers can offer.

Peace

Gail

cracked pot said...

A lot of modern medical practice doesn't rely too heavily on cheap available energy and relies instead on the accumulation of decades of knowledge from experimentation. If you leave pharmaceuticals aside, a lot of lives are still saved by the skills of doctors trained in modern medicine - and skills, like any of the "green wizardry" talked about here, don't require more oil than that necessary to feed the practitioner (and maybe a little bit of energy to boil the water to sterilize the equipment).

idiotgrrl said...

Of extreme importance, guys -- as the availability of health care declines, what about birth control and family planning?

We seriously need to be looking into methods that do not require either high tech, petroleum-based products, nor (considering that bad people exist in every society, and hard times can also bring out the worst in people) male cooperation or consent. Nor, need I also add? infanticide as the method of last resort.

Copper-based IUDs seem to be a pretty good answer, if there are any designs available that work well and do not put you at risk for infection. Any midwife could fit them. But then I am no kind of a health professional, I'm a retired bookkeeper.

Suggestions, anyone?

Bob said...

JMG,
Another excellent and highly important post. You largely avoided the topic of Mental Illness, and I consider that a sign of your wisdom and intelligence, but I will offer up my thoughts here, as someone involved in that system in America. One reason to avoid this segment of the health care system is that, even more than physical health, mental health is poorly defined. Moreover, the vast majority of resources being used in this endeavor are completely unnecessary (as you briefly alluded to when mentioning antidepressants). As a side note, I will quickly mention that all health remedies of any kind do not have "side effects;" they have effects, some you want, and some you don't. The difference between a weight-loss drug that makes you tired and an insomnia remedy that causes you to lose weight is purely semantics. Anyway, while we could spend weeks wasting time about the legitimacy of diagnoses such as depression, anxiety, and dozens of others, AND we can all acknowledge the understated environmental links to mental illnesses even as severe as schizophrenia or bipolar disorder, many people suffer from serious mental illness through no fault of their own, and they have already been essentially neglected by the mainstream medical system (going back at least to Reagan). I work with abused and neglected kids, many of whom will grow up to be violent criminals. The time, methods, and resources at my disposal cannot prevent that. In some ways, I think the way a society defines and treats its mentally ill is as good an indicator as any as to its overall health. Prescribing millions of people anti-depressants isn't just hugely profitable (in a way that addressing more debilitating, less common "ailments" is not); it increases the likelihood that those people will go to work and not question the system which is contributing to their suffering. Take those little pills away, and for every person who refuses to get out of bed, I bet you will have 2 or 3 who manage to channel their pain into political or economic outrage, and the creation of more rebellion. I realize that you would probably have to delete 80% of the comments if you tackled this subject, and I certainly see the huge potential of lifestyle changes and societal shift (upheaval, anyone?) in reducing what we call mental illness (though the current debate around the DSM-V would suggest that, in the near-term, the definition of mental health is being quickly and severely narrowed), but just as the British media is portraying the rioters as mindless thugs (I am sure some are, but many have a variety of legitimate (though different) reasons), our mainstream medical establishment calls people who hate their lives -- filled with dull, meaningless work, consumerism, isolation, and television -- sick and in need of chemical treatment. When this power fades, the backlash will be very ugly for all involved.

Brad K. said...

@ Isis,

"I should make ... sure I stay out of a doctor's way".

Don't confuse American Medical Association/modern physician care with hospitals and most especially not with emergency room (ER) practice.

Emergency rooms, ER care, exist to generate revenue for hospitals. ERs make a plausible argument for insurance purposes, charge many times actual cost, and insurance companies go along with the corruption because it keeps premiums high.

Maybe that is the problem with alternative medicine. Herbal medicines don't lend themselves to ER rooms.

@ Cherokee Organics,

Yes, allopathic medicine maintains weaker and weaker people within the system. I suspect many of those are weaker than they need be, if other health care approaches had been used.

But I don't think maintaining marginally healthy people implies that the general population will be degraded as you describe, to 'blobs'.

Because for all the belief in modern allopathic medicine, it is my understanding that sanitation -- dealing with sewage and keeping water and food clean -- has been the greatest contributor to improving the health of the modern world. Public health places little emphasis on marginal health issues.

I worry that sanitation and public health is as vulnerable, in a post-industrial age, as allopathic medicine.

hawlkeye said...

At the risk of going all conspiratorial, I don't find the pharmaCorp/FDA crackdowns on plant people either "funny" or "fascinating", I find it rather fubar and appalling.

Same with BigAg/FDA crackdowns on the raw food crackpots among the Amish and enzyme-educated. While the press became obsessed with Michelle's organic garden smoke-screen, her husband passed the Food Safety and Modernization Act, a thinly-cloaked way to maintain super-market share and prevent the growing localization of food- supply.

This legislation has as much to do with food safety as No Child Left Behind has to do with improving education.

Revolving door careers between the corporate and government sectors have spun into an entity indistinguishable from each other, has zero interest in the common good compared to their bottom line, and their consistently incestuous behavior certainly smells conspiratorial to me.

And neither of them (it?) is/are embracing any of the sensible, intelligent and brilliant ideas posted here. All these bright bouquets of possibility here are being actively poisoned as they sprout, or have already sprayed pre-emergent sane-icide over these many fields of wizardly endeavor.

hawlkeye said...

I'm so glad to see the mushrooms made it into this round-up; Paul Stamets Mycelium Running deserves a spot on every shelf..

And the bit about bees deserves developing. The health benefits of honey, propolis and other bee by-products make every hive look like a medicine chest to me.

Commercial bee-keeping and its identical over-reliance on antibiotics, is one factor that has led to Colony Collapse Disorder, the AIDS of bees. This is the canary in the coal mine of commercial food-supply; backyard bee-keeping and backyard food-growing go hand in glove, and their mutual benefits compound each other.

Bees resistance to the varroa mite will continue to be undermined by the use of ineffective drugs by an industry that requires their mobilization up and down the pollination freeway. The monocultural disaster of the very $ucce$$ful almond industry is our very predicament in miniature. I recommend Fruitless Fall for details.

Bees resistance to varroa shows up most hopefully in Russian strains, who have learned to groom each other, which knocks off the mites. A behavioral solution! Hmmm...

Ric said...

I worked in health care for a decade-plus, not as a caregiver, but as one of the legions of cubical-dwellers so necessary to keep the dinosaur lumbering on (computer programmer/analyst; Dilbert is my hero).

The problems I witnessed with health care in the United States could fill a book, but my experience leads me to believe the fundamental defect is the strange, public/private hybrid system that has grown up over the last century or so, that seems to combine all the worst features of both. Private companies engage in rampant rent-seeking while the entire alphabet soup of government agencies befuddle any attempts at fiscal transparency that might keep the rent-seekers at bay. The 12 years I spent working in hospitals felt like I was riding on a bus with all the passengers so busy fiddling with the seat-backs and AC that no one noticed the driver was deceased and the bus was hurtling full-throttle towards a cliff.

So I jumped off.

Medical errors: One hospital I worked at made an effort to address the root cause of medical errors. I was immediately struck by how often the narratives from those involved in incidences of "negative patient outcomes" started off with phrases like, "I was at the end of my third double shift in three days when..." or, "I hadn't had any sleep in 28 hours when..." Whenever I pointed this out, the response was usually, "You don't become a nurse/doctor and expect to work 9 to 5!", usually said with a great deal of bravado. I am Superman, and I can do anything is an actively enforced attitude in many hospitals I've dealt with. Granted, when you consider the enormity of their daily work and the disastrous consequences of making the slightest mistake, that attitude is understandable and almost certainly all that keeps most healthcare workers sane. That doesn't make it any less dangerous to the patient, especially when you factor in the hyper-specialization already discussed.

If you are ever in the hospital or at the bedside of an incapacitated loved one, you are the best defense against "medical misadventure". Constantly (politely, of course, but firmly) question everything and everyone. Most of the people you encounter will indulge your "curiosity" to varying degrees. Some will ignore you. Some will react negatively. The worst will threaten you, especially if you are acting on behalf of an incapacitated loved one. Stand firm. It's a matter of life or death.

Bill Pulliam said...

Tony--

I have to ask, are your judgements about reiki etc. based on research or simply opinions derived from what you view as "first principles?" If the latter, I should remind you that dismissing an effect because you cannot envision a mechanism to explain it is unscientific. Weather glasses worked for weather forecasting long before the movements of synoptic high and low pressure systems were understood. Gravity worked just the same before Newton as it has since then.

And what if these treatments just make you "feel better?" Given the ambiguous, often idiopathic nature of many health complaints (headache, joint pain, weakness, general malaise, depression, etc.), often "feeling better" IS "getting better." If your headache is not caused by some serious underlying phenomenon (as in the vast majority of cases it is not), then if you feel like it has gone away, it HAS gone away. If your arthritis troubles you less and you feel that you can go about your daily activities more easily, then you ARE better. Why is that any less "real" than a dose of painkillers to accomplish he exact same ends? Neither actually stops the degenerative joint disease (although in the case of reiki I am not sure that has actually been tested yay or nay), but it helps you live in spite of it.

An interesting story I saw a mass-media summary of a few years ago on placebo effects in antidepressant studies. As most people should already know, often placebos prove to be almost as effective as prescription antidepressants in double-blind trials. But in this study they actually looked at the fMRI of the brains of those whose depression had been alleviated by placebo versus by medication. They found that those who responded to placebo showed changes in brain function that restored it to being closer to that of a normal, not depressed person. In contrast, for those that responded to the "real" medication, their brain function had shifted even farther from "normal" into an altered, artificial, medication-induced, but no longer clinically depressed state. In short, the placebo restored normal brain function. The drug distorted brain function even further.

YOU tell ME which one of these effects represents "getting better!"

John Michael Greer said...

Zach, well, that shows you how connected to popular culture I am. I had no idea who this WALL-E character was.

Bill, that's fascinating -- and it makes the metaphor a good deal more meaningful.

Don, one of the things I'm trying to do with this blog is encourage people to take the steps that will see to it that microscopes, boiling water, simple antiseptics, and other good things remain in use. If enough people do something now, the chance of pulling the best achievements of the last three centuries through the crisis ahead of us will go up sharply.

BlackDove, well, again, we'll be discussing rights in a later post. My take is that they're social constructs, and need to take the realities of our ecological situation into account -- but more on this later.

Tony, you're making a false dichotomy -- a standard one in the materialist ("skeptic") community, by the way, and I do wish people would leave their canned talking points at home! We've already discussed some of the hard scientific evidence that some of the modalities you've dismissed out of hand do have proven medical effects; there's a lot more, if you take off your ideological goggles and go look. Those effects, as I discussed at some length, tend to be a good deal less drastic than those of pharmaceutical medicine, and so your second point, amended to cope with the real biochemical effects of such practices as herbal medicine and acupuncture, still stands; it's good to know what's best treated in a relatively gentle way, and what's best treated with more intensive means.

By the way, insisting that there's no such thing as "alternative" medicine, only medicine that works and medicine that doesn't, is another false dichotomy; on the there's quite a bit of mainstream medicine that doesn't work, or actively harms the patient; on the other, it's a way of ignoring the powerful role of social forces in determining which medical modalities are acceptable and which aren't. This is another of those canned talking points from the materialist community that badly needs to be put out to pasture -- and a little background in the sociology of science wouldn't hurt, either.

Lazarette, it's precisely because you do have a democracy that things like this are a threat. Efficient autocracies don't have to worry about riots unless they're backed by foreign powers, as most "color revolutions" are. In your place, I'd be a little warier.

Phil Knight said...

Don't know if anyone is aware, but Dr. Andrew Weil has over several decades developed what he has called "integrative medicine" i.e. an attempt to integrate the most efficacious aspects of both mainstream and "alternative" medicines, with a view to a viable system in a constrained future.

There's some very interesting dialogues he conducted below with the biologist Rupert Sheldrake ("The Hollyhock Dialogues") in which they discuss the overlap between science, medicine and ecology, and their interrelationship with spiritual matters available here:

http://www.sheldrake.org/D&C/dialogues/

As ever with Sheldrake, atheist-materialists will be better off looking elsewhere.

Bill Pulliam said...

"Is health care a right?"

This question is a corruption of the social contract, designed to let people justify fundamentally immoral positions and actions. Here it the question you should be asking:

"Do I as an individual and we as a society have a moral duty to take care of the sick, injured, young, old, weak, and disabled?"

I think you will find far fewer people willing to answer "no" to the second question than the first.

If you answer "yes" to the "moral duty" issue, THEN you can begin to look at your beliefs about the structure of society, the function of government, and come to a clearer decision about whether or not the *government* specifically has a moral duty to ensure that all its citizens can receive health care. And you will not be basing your decision on a knee-jerk answer to an oversimplified, context-free, slogan-ish question.

LewisLucanBooks said...

@ idiotgrrl - Re: Birth control. Years ago, I read an article about how in ancient times, seeds from Queen Anne's Lace was used for birth control

There was an interesting article today on alternet.org "How America Could Collapse." It talks about how tenuous global supply chains are. One or two factories (usually overseas) that make something vital that if they go down, create huge problems. Medical matters are mentioned several times. Who can forget the Great Eggo Famine of 2010? :-)

http://www.alternet.org/story/151997/how_america_could_collapse/

I was reading a book about libraries in ancient times. Being a refugee from Library-Land, I found it pretty interesting. I found the Roman tombstones of library workers poignant. I could identify. What was interesting is that library workers were slaves, freemen, citizens. And on the staff was a doctor! To take care of the library workers.

Kieran O'Neill said...

@Lazarette: It's important when looking at a phenomenon involving thousands of people to examine cross-sectional data, not the most extreme cases presented by the headlines.

The overwhelming majority of those arrested were young, male and unemployed. University students and members of the middle class were the rare exception, not the norm.

Take a look at the data blog over at the Guardian, where they have data for 246 of the cases so far (and growing). By my calculations:

83% were unemployed
76% were unemployed and male


And the riot cleanup was very encouraging, as was the one in Vancouver. But do you know for sure that ten times as many showed up for the cleanup? The thousand or so arrested so far are just those who were caught. I don't think anyone knows exactly how many were on the streets in the riots. Tens of thousands?

The bigger issue is that the overwhelming response from the press, politicians and "middle Britain" has been one of condemnation, with calls for measures more typical of authoritarian regimes (e.g. banning styles of clothing or restricting/filtering Internet use). Meanwhile, I've seen reports of people in the poor communities
where the riots happened who cautiously support (or at least indicate that they understand) them as a means of calling attention to their troubles.

And yes, there's data showing that the riots happened overwhelmingly in the poor parts of London, too.

While the UK is a democracy, right now it has the problem that none of the major parties actually represent the poor. The Tories have a long history of actively stamping them into the pavement, the Lib Dems are too associated with the guiltier feeling of the middle class, and Labour gave up its place as the champion of the poor when it added the "New" prefix (and sold the country to the banks).

So with the response from the "haves" being "beat them down harder", I don't see the "have-nots" who felt so angry with their lot that they went on a rampage getting any less angry.

To quote Gordon Lightfoot:

"But the shapes of gutted buildings
Strike terror to the heart
And you say how did it happen?
And you say how did it start?
Why can't we all be brothers?
Why can't we live in peace?
But the hands of the have-nots
Keep falling out of reach"

John Michael Greer said...

Jess, I don't have any recommendations for alternative dentistry; I do know, from experience, that root canals give me permanent chronic sinus infections, which go away permanently when the dead tooth is extracted. You're quite right about the homemaker issue, of course; the family member who works in the household economy can certainly learn an assortment of health modalities and use them.

Jeffrey, that's true enough. In the late 19th century, cancer in children was so rare that individual cases got written up in the medical journals, and in general it was an uncommon disease. Nowadays, well, the one thing the American Cancer Society won't discuss at all is the role of the vast amount of artificial chemicals in our environment in making cancer the second leading cause of death in America. (The fact that the ACS gets a chunk of its funding from the chemical industry has nothing to do with that refusal, of course.) The one problem is that a fair number of the chemicals we've dumped into the biosphere are fairly persistent, and so there will be a lot of cancer deaths for a long time to come as the legacies of industrialism finally break down.

Cherokee, that's almost certainly an important factor; I'd like to see some good experimental studies, but getting funding for them -- well, let's just say it would be interesting. In the meantime, it's one more reason to grow at least some of your own food.

Peacegarden, that was pretty much what I experienced in my stint in the nursing home industry, too.

Pot, er, when's the last time you saw what was going on inside a hospital? Almost everything these days depends on vast amounts of fossil fuels -- the skills of the surgeon are a small element in a vast machine. To cite just one example out of very many, how many petroleum-based supply chains feed into providing the IV bag that hangs beside every patient who comes out of surgery?

Now of course it would be possible to rebuild a medicine that uses a lot less fossil fuel energy, and makes the most of human skill, but that's not the kind we have -- and unless physicians get to work creating such a medicine, it's not going to be there as the energy-intensive system we have runs down.

Grrl, that's a challenge. Condoms made from sheep gut were in common use in the eighteenth century -- they were washed and reused after each use, in fact -- but that doesn't fit the criteria you've outlined, of course. As for IUDs, I don't know enough about the subject to have an educated opinion. Anyone else?

Bob, thanks for the info. There are a lot of factors feeding into the way that Americans these days are basically cowering under their beds, hoping that things don't get too bad until after they're dead; spectacular overmedication with psychiatric drugs is certainly part of the picture.

Hawlkeye, I don't see that as conspiratorial, simply as old-fashioned corruption and graft, of the sort that's pervaded American society since about a week after those guys hopped out of the boat at Jamestown. Of course it's an issue; I've learned to take a philosophical attitude toward it, and work toward changing the things I can change -- which in this case involves motivating people to make changes in their own lives that move them away from participation in corrupt institutions.

As for mushrooms and bees, no argument there; I hadn't heard of the Russian bees, and that's very good to hear. I've mostly been concentrating on doing what I can to foster native pollinators -- and I'm pleased to say that they seem to be taking me up on the deal.

John Michael Greer said...

Ric, that certainly corresponds to part of my experience, though there's more to it than exhaustion; a lot of bad medicine gets done outside the hospital setting, where doctors and staff are tolerably well rested!

Bill, that's fascinating! If you can find a link to the brain study involving placebos, could you post it? I've long thought that in a sane medical system, the attitude toward the placebo effect wouldn't be "drat, the placebo effect keeps messing up our research," but something more like "that much healing happened with sugar pills? How can we make this effect work more powerfully?" Of course that would lead to paying attention to emotionally powerful symbols and ritual psychodrama -- that is to say, magic -- and there are potent institutional biases in the way of that, but it would still make more sense.

Phil, thanks for the link and the reference! I find Sheldrake entertaining and sometimes useful; some of his experiments are fascinating, and the apoplectic frenzy he ignites in materialists is always worth watching.

Bill, good. And of course the question that intersects with the one that you've proposed is "How far does that obligation go, given the need to meet other, potentially conflicting obligations and the hard limits of resources available to our society?" Once both those questions are assessed, we have the basis for a reasonable discussion about what rights our society should agree to offer its members.

LewisLucanBooks said...

Appendicitis seems to be a major plot point in end-of-the-world / disaster porn. Stephen King's "The Stand," and even Kunstler's last book "Witch of Hebron."

I worry more about my teeth. If I'm not constantly vigilant, I have problems.

In Brin's "The Postman" the hero mentions that early on in the disintegration of society, several of his comrades died of tooth problems.

I use a pretty complicated combination of different kinds of flosses and picks, mostly made in China. I spend a lot of time puzzling over possible alternatives.

Off topic, but speaking of long supply lines, I recently bought 4 bottles of a store brand of dill pickle relish at a locally owned grocery store. 4 for $5! When I was washing out the bottle last night, I was stunned to find it was "A Product of India."

anneathema said...

Hello! Speaking as a student of what is inaccurately termed "western medicine" I think I can bring a few other points into the conversation. First, the gap between western and alternative medicine is sited almost exclusively over the question of practitioner certification, not practice. Many people who would sneer at penicillin would happily drink reishi tea for an infection, substituting one fungal antibacterial allelochemical for another. Physicians are rarely taught that Peter Safar developed CPR from an oral tradition practiced by midwives. The difference is, I have to sit through years of lectures and abuse to pass out aspirin, an herbalist (or self-medicating consumer) can get willow bark for a few dollars. Or, a lucky encounter with a downed tree and a knife.

More relevant to my current anxieties, though, and I write this after reading that the insurance mandate has been struck down nationwide, is that medical students like myself are caught in a fascinatingly fertile contradiction. On the one hand, we are paying outrageous costs, mostly in the form of student loans, which seem to be little more than a quick-and-dirty way to liquefy the assets of future generations, just as aggressive mortgaging liquefied the assets of previous generations. On the other hand, we are likely to graduate into a job market where too few consumers will be in a position to hire us, and at some point that will mean fewer practicing doctors, at lower wages.

I expect, by the time I finish a residency, that public health will be the only health sector still expanding, and public health physicians have traditionally been paid something in the area of upper schoolteacher. Given that non-payment of student loans already can cost you your professional (i.e. medical) license, and in some states even your drivers license, many of today's medical students are looking at an outlaw future comparable to midwives, herbalists, and medicine men.

I do have one pet peeve with your post. I am not particularly brilliant, and plenty of physicians are stupider than I. Why won't blogs like yours, or "preparedness" manuals, take seriously the idea that learning and studying western medicine, for home care, is on the same order of magnitude, in terms of difficulty, as herbalism or acupuncture? The message seems to be "you will never be able to make productive use of those leftover antibiotics in your bathroom; become an undertrained and inexperienced herbalist instead." I would say: "Learning to practice *any* kind of medicine effectively is damned hard, but an old copy of Harrison's Internal Medicine on the bookshelf would do you good."

Keep up the good work,
A

hunt gather study medicine

John Michael Greer said...

Lewis, agreed about teeth. Emergency dentistry can be done, but you have to know how, and you also have to know what antibacterials are strong enough to matter if you've got a dental abscess or infection.

Anneathema, first of all, I don't at all recommend that people become undertrained and inexperienced herbalists; I encourage them to become competent, well-educated herbalists instead. As for your broader question, er, you do know that people do jail time in this country for attempting to practice mainstream medicine without a licence, don't you? Since we're not talking about the kind of overnight collapse in which the FDA and AMA both disappear in a puff of glowing smoke, anybody making plans for their own healthcare in the US for the foreseeable future needs to stay well away from trying to use mainstream medicine themselves, because the medical industry defends its turf with every legal trick it has available. I don't think that mainstream medicine requires more brains than, say, acupuncture -- I have a fairly good idea of what it takes to become a capable acupuncturist, and it's pretty demanding -- but the legal status of self-care with the two systems is completely different, and I'm not going to advise people to do anything that could end up with them doing time.

tubaplayer said...

Hi JMG,

Well, that post was not at all what I expected, but once again I find myself agreeing with all you wrote.

I don't do t’ai chi, but I do some serious gardening and looking after goats.

Your point about "old" medicine versus "new" rings many bells with me. Way back in 1967 I had a serious motorcycle accident. My left leg was smashed to pieces. Had I had a similar horse accident half a century earlier they would no doubt have given me ether and sawn the leg off. Even then in 1967 the health care in the UK meant that they made every effort to save my leg.

You know, I am now 64 and I really wish that they hadn't. Fourty four years and I have lived with pain every single day. I am quite sure that had they cut it off and given me a wooden leg I would have endured so much less pain.

Maybe in the coming days of oil depletion they will make different decisions in a case like mine.

Houyhnhnm said...

re: antidepressants and the placebo effect

I'm not sure what specific article Bill is referring to, but I've been following this issue for some time since I have friends who swear by antidepressants and others who swear at them.

Back in 2004 the Scientific Review of Mental Health Practice published “Antidepressant-Placebo Debate in the Media: Balanced Coverage or Placebo Hype?" This concluded antidepressants were better than placebos although the difference was "not nearly as large as most individuals believe, or as many of the pharmaceutical companies would have the public believe."

Another study by Rhode Island Hospital researchers and published in the August 2007 Journal of Clinical Psychiatry reinforced the importance of the placebo effect. Psychcentral has a discussion of this study here.

Here's a more recent article from The Daily Beast:
“The Depressing News about Antidepressants."

Houyhnhnm

Jonathan Blake said...

There are many cases where treatments seem to work but where medical science has not discovered the mechanism behind it. That doesn't mean that we should therefore accept the mechanisms put forward by proponents of the treatments.

The proposed mechanisms for how homeopathy works (and it does seem to work) go counter to what we've learned so far from science and logic. Statistically, a 30C dilution is just water. Logically, if water under dilution can remember a therapeutic agent that has been diluted away, then it would also remember other potentially harmful substances that have also been diluted in it over its history. Perhaps I'm ignorant of more sophisticated homeopathic ideas, but it fails the sniff test in my case.

Many of these treatments (like so many drugs and medical treatments in clinical trials) perform about as well as a placebo, so as a materialist/naturalist/physicalist/whatever, I wonder how the placebo effect works. What is it about a mere belief that affects how a physical system behaves?

I'm pretty big on finding out the truth, but the placebo effect challenges me. If the choice is between a treatment that heals me purely through the placebo effect and a life of misery, I might just take the blue pill and live in blissful ignorance of the truth.

That may be a dilemma we face more often as we face medical scarcity.

greatblue said...

What did people use for heavy-duty sanitation before chlorine bleach was available? Was burning contaminated items the only option?

Ric said...

Thank you for the balance expressed in your post. I have health insurance, and use it when helpful, but avoid the docs when I don't think it will help.

If I could salvage parts of mainstream medicine, I would certainly keep birth control, vaccines, antibiotics carefully used, surgery when it can save decades of life and health at reasonable cost, and for the surgery don't forget anesthesia!

If this proves too much to save, a clear-eyed view will foresee a great deal of suffering now avoided by the richer slice of humanity. As already noted, some things do not yield to diet, herbs, etc.

Just among close loved ones, basically young and healthy, I have seen serious treatable infections, C-sections after months of happy pre-natal visits to the midwife and prolonged labor, and perimenopausal bleeding for no particular reason that surely would have been fatal without surgery. Readers here are probably well aware of overuse of C-sections and hysterectomies, but don't forget that some of them are still lifesaving. Think back to before they were available for comparison.

If you women are feeling a bit put upon about conditions unique to the childbearers, you can be forgiven a twinge of Schadenfreude about abdominal hernias, which come in several varieties and severities, but are far more prevalent in men, by no means all of them old and unfit. They are seldom fatal, though they can be if untreated, and are usually very well handled with a relatively simple surgery, which I recommend if your case is damaging your health. Even if you have to pay out of pocket, if you can possibly manage it.

Frustrating as it is to contemplate the waste and errors within our current hidebound medical establishment, no one should underestimate the genuine services now available, as JMG and many commenters can testify from examples close to home.

PS For reasons unknown to me, comments don't seem to show up with my whole name, though I have supplied it to my Google Account used to submit.

Ric Merritt (different from the Ric above)

Whitewater said...

DENTAL-I fear that most of us do not understand the links between oral health and the viability of the rest of the organism and how critically important oral health is to general health. Consider gingivitis aka swollen gums. Most consider it just a nuisance, this slight swelling and reddening of the gums.This is inflammation caused by the body’s host response to bacterial biofilms that are allowed to establish and flourish. This response causes destruction of the gingival tissue-the soft tissues that are attached to the tooth and form the seal around them. Ever notice when your gums are in this state that they sometimes bleed when even slight pressure or a disturbance is present-brushing for example? That comes from the tissue destruction. How about an unpleasant odor? The results of the accumulation of bacterial emissions and putrefaction in an anaerobic environment.

Gingivitis can progress to periodontal disease. Periodontal disease is the destruction of the soft tissue and the bone supporting the tooth. Perio (for short) is comprised of lesions. If these accumulated Perio lesions were where we could see them and joined all together, it could comprise an open oozing wound about the size of your palm. The most frightening part is it is only inches from your brain and we are constantly swallowing the ooze. The toxins and organisms pass freely into the blood stream to be carried all around the body.Ever notice that if you have to have dental procedures when you have had a history of artificial replacements or heart diseases that you have to be covered by an antibiotic course before the dental professional will even work on you? Some of these organisms, that form the plaque on your teeth, can also form plaques elsewhere in the body. They particularly are attracted to heart tissue.

Root canals? RUN AWAY! Your teeth are actually living tissue on the inside beneath and behind the enamel. Consider the connections of the brain to the oral cavity. Each tooth is full of blood vessels and nerves. When a tooth dies it is, most often, not immediately apparent. The body tries to isolate it and get rid of it. Pockets of dead tissue surround it. An abscess can form. In a root canal procedure the tooth is left in place. The nerve chamber is somewhat cleaned out to kill and remove the nerve and the blood vessels. The underlying and surrounding pocket of dead tissue and bacteria can not be completely drained and cleaned out. The dental professional then puts some antibiotic in and stuffs and caps the remaining void with a slight amount of a substance, comprised of chemical compounds that are foreign to the body and its processes.This substance is then in direct contact with what remains of the nerve. Now consider-what remains of the nerve is connected to the brain via a chemical/liquid pathway. The pocket of dead tissue and bacteria is also connected via this same pathway. The now dead tooth also remains and the body still tries to rid itself of the same and to try and fill in the voids.This remaining pocket of death, formed by processes that have dissolved and modified bone, is many times within millimeters of a sinus where additional destruction of bone occurs until it can penetrate the sinus cavity and voila! the recurring sinus infection. The second prong of this assault is the chemicals introduced and in contact with nerve tissue that now have an easy path to the brain. It may be totally anecdotal but have you ever noticed that some folks with lots of root canals seem to be plagued by oddball syndromes and auto-immune problems?
End of part 1

Whitewater said...

Part 2-DENTAL
Don’t even get me started on amalgam fillings. Amalgam is NOT an alloy. It is a slurry, a mixture of metals given workability when bound together by elemental liquid mercury. The folks in a dental setting are required to treat it as the toxic substance it is-even what is left after the procedure-but somehow it miraculously is OK once it is in your mouth surrounded by liquids and acids? Ever heard of schools being evacuated and treated as toxic sites for a couple of days when a student breaks a mercury filled thermometer? Yet the mainstream dental business puts it in your mouth? After a few years the mercury is almost undetectable in the filling. It is gone. It has been taken into your body with every swallow and inhalation.

With the divergence of the dental and medical fields, most physicians are oblivious to the roll of dental health in the whole health of the being.

You must take responsibility for your oral health to insure your continued general health. Disrupt the bacterial biofilm daily-this is also known as brush and floss. Flossing disrupts the biofilm between the teeth where brushing does not have much of an effect.

Rita said...

Sorry, I don’t recall using any profanity in yesterday’s post. I’ll have to try to recreate the post, since I wrote directly into Blogger.
My first point was about homeopathy, which I have been using for almost 30 years, starting mainly to work on chronic depression, and other problems as they have come up. For those who may regard depression as a “soft diagnosis” I will add that it has remedied a hiatal hernia which was causing me to randomly be unable to swallow any food for up to ½ hour at a time. One thing about homeopathy is that it is not a quick fix. It may take some time to find the correct remedy or to work through layers of repressed symptoms. Like many alternative healing methods I think homeopathy suffers from being a last resort. So, not only does it have to fight the original problem, it also has to combat the side effects of whatever else the patient has tried. In terms of the future of homeopathy, I wonder how many practitioners would be able to compound their own remedies. The remedies for sale seem to be mostly made in France, so availability might become a problem.
I encountered a prime example of the disconnect in many people’s minds in a book blurb on the Science Fiction Book Club site. The book is _Ready Player One_ by Ernest Cline and is described as being set in 2044 when the oil is gone and most of humanity escapes the wars, famine, etc. , by logging into a gigantic online game. Does no one reading that wonder where the power to run the internet game is coming from?

17bbrown87 said...

Our descendants will be lucky if there is a priestly/shaman/healer type group around. The Gauls, and the Celts all over Europe, had the Druids who specialized in different fields such as law and medicine. None of their knowledge being written down we rely on the winners of the wars, such as the Romans, to tell us about them. They wrote nothing down, it was all memorized. I suspect that their skill in Medicine came from keen observation as anything else - my late mother's doctor read you like a book as you walked into his examination room(his surname was Scottish). The druids were not "illiterate", when the Romans caught up with the Helvetian's supply wagon train they found detailed inventories - written in Greek!

Tony said...

I have modified my previous post that JMG responded to in order to remove a personal detail that was a little too personal, but everything else is reproduced identically below.
-
Two things:

One - I think people are getting hung up on the definition of 'alternative medicine' here. This can reference two VERY different things. One is simple lifestyle, diet, activity, and physical therapy type things (tai chi, chiropraction, etc) that are effective in MAINTAINING health by reducing stress (both psychological and patently physical) on a person or heading off chronic problems or dealing with a problem in a direct and simple way, combined with things like many herbs which do indeed have active substances with biological effects. NO ONE in their right mind contends that these are bad/ineffective, if used wisely.

The second kind are treatments like homeopathy or acupuncture or reiki. As I am heavily involved in the biologial sciences and find the general scientific/skeptical consensus about these things extremely convincing I do not know how well my ideas will go over in this forum, but after extensive research on my part it APPEARS that what most of these treatments do is not have any sort of causal effect on health, but rather let you perform an action that FEELS like you are doing something, and has no real biological effects positive or negative, and thus lets your body's (more formidable than many realize) natural healing powers go to work unmolested while producing a better mental attitude, which is in itself conducive to general health. Thus its effects on health are most likely more like the people who demand they get antibiotics for the sniffles, and insist that when they got better it was due to the drugs, except without the negative effects of overuse of antibiotics. It made them feel like they had some direct control over the situation.

This second sphere of 'alternative' medicine is also more closely allied in most peoples minds with quacks, clinics in mexico that try to cure cancer with coffee enemas, etc, which I think is why it gets violent reactions from skeptics rather than simple annoyance.

Two - This is NOT to say that I particularly like the way that modern medicine is practiced – my family does plenty of research about EVERYTHING that is proposed to be done with us before we proceed, and have made connections that the doctors do not and thus taken a simple step that clears up the problem completely. The system as it exists is too concerned with symptom management and quick fixes and one-size-fits-all-by-the-checklist treatment. But it seems to me that a lot of what certain forms of 'alternative' medicine does could be better accomplished with a thorough knowledge of when it is worth taking some interventional measure, and when it is better to just trust in your own biological restorative powers and work on your attitude and thought patterns to keep them conducive to health. This, like all good medicine, requires careful thought and familiarity with the human systems involved, and isn't exactly favored by the current medical system either. But even so it can be practiced at the individual level.

(note: the quotes around 'alternative' are there to indicate my annoyance at the fact that the term exists: there is medicine that can be shown to work and medicine that doesn't seem to work, and I dislike making distinctions other than that.)

Tony said...

In response to the response: I apologize if I seemed to be just running talking points or not being constructive. I certainly did not mean to dismiss the sociological category of alternative medicine as nonexistant or to imply that mainstream medicine was free of treatments that do nothing or more harm than good, this is certainly not the case; I meant that I wish it were simpler for people to simply use therapies that work reliably and not use unproductive ones regardless of their origins, but I suppose you are right that given human psychology and social dynamics that is easier said than done.

I am slightly confused by the use/definition of the term 'materialist' in the context of your response, but something tells me my confusion is due to semantics that would not be particularly productive or useful to explore in this forum.

I'm glad there is an agreement about the need to know when and when not to make intense interventions - this I think is one of the fundamental failings of standard medical practice. As for a mode of action of some of the mentioned gentle modes... no intent to troll, but I have to add my thoughts to the dissensus on this particular issue, which interestingly enough puts me in the position of wanting to explore the likely effectiveness of symbols and psychodrama on healing that you mentioned in response to Bill (a thought that I've had many times myself and am glad that someone else has had).

John Michael Greer said...

Tubaplayer, very likely. One of the reasons amputation was a common surgery in the days before modern antiseptics is that the amputation wound was a lot easier to keep clean and uninfected, and of course the capacity to rebuild bones, blood vessels, etc. didn't exist; a lot of lives were saved by taking off crushed or mangled limbs.

Jonathan, er, the first paragraph of your comment contradicts the second paragraph. Of course homeopaths may be wrong about the mechanism that makes homeopathy work; that doesn't mean that it doesn't work -- and indeed it does. The bizarre modern habit of insisting that something can't happen unless its causal mechanism is understood is not helpful here; nor is the assumption that whatever you haven't researched must be equivalent to a placebo.

As for how the placebo effect works, it amazes me how many people forget that the nervous system -- which is evidently involved in things like perception and belief -- is part of the body, and does things that have biological effects. It would be stunning if mental states acting through the nervous system didn't have dramatic effects on health!

Greatblue, not at all. There's a wide range of compounds that kill microbes, and some of them -- carbolic acid, the first commonly used surgical antiseptic, comes to mind -- are quite easy to make with 19th century chemical technology. For that matter, a concentrated solution of St. Johns' wort flowers in olive oil was standard wound care in the Middle Ages -- knights going on crusade would stuff wineskins full of the flowers, fill them with oil, and hang 'em from the saddlebows of their horses before leaving on the trip; by the time they got to where the fighting was, the oil was blood red and had significant antibacterial properties.

Ric M., a lot of people are going to die in the future of things that can be treated today. That's baked into the cake at this point. The question is simply just how bad it's going to get.

Whitewater, thanks for the info! My experience with root canals leads me to think you may be on to something.

Rita, there are half a dozen homeopathic manufacturers in the US that I know of, so that's taken care of -- Boiron, the big French firm, has a large share of the upscale market but they're far from the only option. I've had good results ordering from Luyties, which is in St. Louis. As for the disconnect -- that's a whopper, yes. Thanks for bringing it to my attention!

Bbrown, true enough -- the Gauls used the Greek alphabet generally, and archeologists have turned up quite a few inscriptions in Gaulish written in Greek letters. Fortunately Druids these days are a lot less squeamish about writing things down.

Tony, fair enough -- but you know, it doesn't help any to SHOUT.

Seaweed Shark said...

Wow, how do you manage to keep up with all these lengthy responses? Many thanks for yet another well-turned and heartening essay, a calm and reasoned word in troubling times. "So shines a good deed, in a weary world."

My sense is that most doctors today regret the limitations of the system they work in, more than anyone. If true, that offers some grounds for hope.

John Michael Greer said...

Tony, excellent! Symbols and ritual are core elements of the toolkit of occultism, of course -- which is not at all supernatural, though we would probably have a few disagreements about what is and isn't natural. Magic was perhaps best defined by Dion Fortune, among the premier occult theorists and pracitioners of the 20th century, as the art and science of causing change in consciousness in accordance with will; Harry Potter fantasies need not apply.

At the core of ritual magic is a recognition of the fact that most of the individual's perception of him- or herself and the universe is structured by nonconscious and irrational patterns that can't be accessed by the thinking mind, but can be changed by other means -- and that these changes can very nearly redefine reality for the individual. It's far from omnipotent, but it has some remarkable potentials, and of course one thing about it that makes it particularly relevant here and now is that it can be done entirely without fossil fuels.

Shark, these discussions are half the fun of doing the blog, and there's almost always something useful to learn, too. As for the doctors, I hope more of them start to act on that weariness. That's the single most likely way that constructive change is going to happen, if in fact it's going to happen at all.

Jonathan Blake said...

For what it's worth, what I meant is that the placebo effect is very powerful and useful, and homeopathy seems to be one way of harnessing it. If there's more to homeopathy, then we haven't found it in the lab. I doubt that the mechanisms proposed for why homeopathy is more than a placebo have it right. I hope we someday understand the mechanisms that underlie the placebo effect, presumed nervous system mechanisms included, and maybe then we can harness it even more effectively without needing to keep the patient in the dark.

SophieGale said...

A right to basic health: A growing body of research indicates that your basic health is highly dependent upon your position in the social hierarchy.

"A professor of biological sciences and of neurology and neurological sciences, [Robert] Sapolsky has spent more than three decades studying the physiological effects of stress on health. His pioneering work includes ongoing studies of laboratory rats and wild baboons in the African wilderness...

"It turns out that unhealthy baboons, like unhealthy people, often have elevated resting levels of stress hormones. 'Their reproductive system doesn't work as well, their wounds heal more slowly, they have elevated blood pressure and the anti-anxiety chemicals in their brain, which have a structural similarity to Valium, work differently,' Sapolsky said. "So they're not in great shape.'"

http://news.stanford.edu/news/2007/march7/sapolskysr-030707.html

The National Geographic Special, "Killer Stress" goes into more detail about Sapolsky's work.

http://www.pbs.org/stress/

The program discusses research on British civil servants. Much the same physical environment, same health care access, but in a highly stratified bureaucracy, the low men and women on the totem pole had significantly more health problems than the Alphas at the top.

Even more startling is the work of Arline Geronimus who began her research career in 1976 studying teenage pregnancy. Common wisdom said that "teen pregnancy was a crucial cause of ghetto poverty and ill health among America’s urban blacks." After examining infant mortality rates, she came to the conclusion that "Black teenage mothers had lower infant death rates than black mothers in their 20s. Because infant health is a decent predictor of maternal health, Geronimus’ data meant the average black woman might be less healthy at 25 than she was at 15."

Geronimus came up with a theory of "weathering". That is, "American minorities face a bevy of chronic obstacles that whites and the socioeconomically advantaged cope with far less often: environmental pollution, high crime, poor health care, overt racism, concentrated poverty. Over the course of a person’s life, the psychological and physiological response to this kind of stress leads to dire health problems, advanced aging and early death."

http://www.miller-mccune.com/health/racisms-hidden-toll-3643/

And, of course, poor health has become an issue of "moral probity." You're sick because you're fat, you're lazy, you are ignorant, you make bad choices, etc, etc., etc. Have another heap of stress, why don't you?

Ah, well! For folks who are printing out health info for their green wizard manuals (grimoires or "Book of Shadows" for us Pagan folk)here's Captain Morgan's guide for hip dislocations:

http://www.npr.org/blogs/health/2011/08/12/139573713/captain-morgan-the-rum-pirate-lends-a-knee-to-hip-dislocation?

BTW, re. anesthesia: ether has been used since the 1840's (and abused by huffers since the 1850's)so you probably won't have to bite on the leather strap when you have surgery.

Cherokee Organics said...

Hi Brad K,

I think you may have confused someone else's comments for mine.

I know lots of stuff about things, but don't have the slightest clue about allopathic medicine!

Have a good one!

Chris

Cherokee Organics said...

Hi JMG,

Some commenters here have commented on the concept of human rights.

It always seemed to me that human rights is a strange concept. It doesn't help that it is a legal concept and as such it can be taken away.

Another way to look at it would be as a benefit of empire to it's citizens and this has historically been the case too.

However, you may be interested to note that over here there is no bill of rights for citizens.

This situation came about probably because the country started as an offshore prison and farm for England. This raison d'entre didn't really change from 1788 through to about 1850 when the gold rush kicked off and it stopped making sense transporting prisoners to somewhere they wanted to go. It lacked the fear factor plus the locals also started getting a bit upset about all of the malcontents being foisted upon them! Oh well.

Anyway, history aside, we don't have a bill of rights in place. Does it make any difference - I'd say not. All the people arguing about human rights need to consider that what can be given can also be taken away.

In addition to this, the term human rights is a misnomer because I often wonder how people quickly apply it to their own situation for their own benefit and forget about others rights. A good example is that some have commented this week that good health care is basic human right when the evidence suggests otherwise. Anyone who has travelled to a third world country quickly understands that the health care that we take for granted is not universally applied across the human population.

Perhaps I can suggest the term "Empires Bounty"?

Regards

Chris

Cherokee Organics said...

Hi JMG,

I just read greatblue's comment about chlorine bleach and it reminded me about the extreme cleaning products that people use around their houses with little thought.

There is too dirty, but it is just as bad (probably worse) to live in a too clean house as well.

We are a product of the environment and not separate to it.

Dogs, chooks and generally getting your hands dirty in the garden are all challenging activities to your immune system, but that's what it's there for.

On another note, eucalyptus oil is a powerful anti bacterial and anti fungal. The old timers used to use it for all sorts of things + it smells nice.

You can see that in the drip line of the trees the soil is just not as biologically active. I do like showing this to visitors as there is an almost solid line between the forest and the orchard and the only difference is the eucalyptus trees.

It also interesting to note that within the dripline, logs that are laying around on the ground can be almost perfect inside even up to 30 years later. Outside the drip line the same logs tend to break down far quicker. No wonder our local soils are garbage.

Regards

Chris

Mark said...

You used the term "fundamentalist atheist" in your essay. What do you mean by this?

Can there be such a thing as a non-fundamentalist atheist? If yes, what is the difference? If not, why use the term "fundamentalist atheist" in the first place (since it would clearly be redundant)?

hawlkeye said...

In addition to the St. Johnswort oil for preventing infections, the application of pure honey as a wound dressing may prove popular once again as well. If folks are going to drop a few hundred dollars on homeopathics, then bee-keeping gear is also within range: suit, gloves, veil and smoker. Then boxes and books and the odd tool or two, and you're ready for hives. I consider these acquisitions part of the medical preparations on topic here.

And you know, sometimes it may SOUND like some of us are shouting, but I suspect we might only be attempting to ITALICIZE!

And someday I'll learn that neat trick of masking links under pithy blue text...

Hah! Verification word: greed

Bert L. said...

JMG
While we are decrying the greed of the mainstream medical industry, it would be wise not to forget that our friends in the alternative medicine business are not immune to the ugly face of profit either. I would think that the profit margin on a typical homeopathic remedy would be enough to make Merck drool with envy, although the bottom line may be much smaller. “Natural”, “Alternative”, “Green”, etc., even when used appropriately, should not constitute an excuse for unreasonable profit.

Cathy McGuire said...

In the light of this week's post, I have to consider this article a positive bit of news:

http://www.oregonlive.com/health/index.ssf/2011/08/tribal_doctors_return_to_the_o.html

Modern medicine's fractured approach conflicts with traditional holistic healing practices of Native Americans, who have the worst health problems in the nation, said a doctor addressing a conference of Native American physicians in Portland through Sunday.

"We've gotten away from the art of medicine," said Dr. Donald Warne, member of the Oglala Lakota tribe and director of the Office of Native American Health in Sioux Falls, S.D. "We are focused on the science of medicine."

More than 200 members of the Association of American Indian Physicians at a six-day conference are looking at ways to reduce high death rates afflicting tribes across the country.
"We need to address the underlying wounded spirits, the loss of culture, the loss of land and how that affects people's spirits," Warne said.
[more]

Matt and Jess said...

About birth control -- I've thought about this a lot. Fortunately for us vasectomy was an option since we've already had our kids. I had my IUD removed because it only lasts 10 years and I was concerned about the availability of medical care to me that far into the future. I've heard certain things about some herbs, like wild carrot seeds, that sound interesting but I wouldn't trust them. I think that Natural Family Planning wins the award for longest-lasting method into the future, and that will of course not eliminate all births but hopefully will drastically cut down on the number of undesired births. (That's basically female fertility self-awareness and can be googled.)

By the way JMG, are you a fan of David Eddings? For some reason when I read your posts I'm reminded of his writing.

Cathy McGuire said...

@BlackDove: I've always assumed that the two are essentially linked, since rights without a society in which to exercise them are meaningless in any practical sense. Sometimes you have to tease apart the differences in order to be sure you’re not going off on a wrong trail. As a former philosophy major, I was looking at it from a social contract perspective, trying to keep Divine edicts out, such that any reasonable person could see that it was an essential part of a good social contract. The difference between a basic right and a social good is that the latter has some reciprocal responsibilities – and right now, that is important to keep in mind. As far as I can see, there are many who act and talk as if someone owed them a lot just for being alive! And those people don’t seem to talk about what they owe society in return. That’s a dangerous place to get to. As to reciprocal responsibility, I’m referring to the people who are receiving the healthcare – do they have any responsibility for keeping themselves healthy to the best of their ability, or to “pay” for the services by providing other services even if they can’t pay in money? The insurance system has spread the cost to the extent that too many people don’t even think about how much someone else has picked up their tab. In a single-payer system, taxes would cover some of the tab; taxes also cover so much of what people call “rights” – so I call taxes one way that an individual pays for his/her “rights”. That said, I don’t think our current system of regulations, insurance and taxes is a fair way to ensure that the individual pays for his/her healthcare. Much work would need to be done.

I'd posit that, in any civilized society, the health of its populace would be very basic indeed.
I absolutely agree, which is why I support single payer system in the US. I don’t quite get why so many otherwise intelligent people can’t see that basic health care (and unfortunately I don’t include organ replacement or extraordinary life support in that category) is one of the core blocks of a functioning society.

Kieran O'Neill said...

Something related to health which I hope we don't lose going forward is a working knowledge of nutrition. And by this I don't meant the thousands of fad diets going around today (although personalising your diet does have some value), but rather a knowledge of what micro and macro nutrients everyone needs to prevent serious diseases.

In other words, rather than "I think I got sick because I haven't had enough vitamin C" or "maybe I'm depressed because I'm not getting enough vitamin D", I'm talking about "I'm bleeding out of every orifice and my teeth are falling out" (scurvy) or "my child's limbs are weak and crooked" (rickets).

That kind of information was one of the most importance advances in human health of the 20th century, and one which can contribute to the standard of living being higher than it was in the 19th as we descend to a society living on the same available energy as then.

I hope it's something we can preserve. And again, it's an area where we can learn from modern interventions in the developing world.

John Michael Greer said...

Jonathan, the reason you haven't found the homeopathic effect in the lab is that you're not looking for it. Controlled, double-blind conducted by homeopaths -- as already cited here -- have repeatedly found anomalous effects, which the scientific mainstream won't look at because nobody's been able to come up with a causal mechanism that fits within the bounds of current thought. Yes, the placebo effect is also an important tool, but there's something else going on with homeopathy.

As for keeping the patient in the dark, you're stuck, because the placebo effect works best when both the patient and (because of the Pygmalion effect) the practitioner both believe uncritically and enthusiastically in the effectiveness of what they're doing. A critical, detached, objective attitude interferes with the placebo effect. That's the trouble you get into, once you start dealing with the impact of mental states...

Sophie, that's fascinating. It would be interesting to see if participation in some kind of alternate or underground social network that isn't so hierarchical helps counter that effect.

Cherokee, I think the concept of human rights is a useful one, but only if it's remembered that human rights are a social construct -- something that certain societies choose collectively to offer to their members, and other societies don't. Once you get into "natural rights" territory, the concept very quickly descends into gibberish.

Mark, of course there are non-fundamentalist atheists. Most of the atheists I know are courteous, reasonable people who don't think their opinion about the existence or nonexistence of gods gives them the right to ram that belief down everybody else's throat. Unfortunately there are some atheists who are intolerant, dogmatic, and convinced that nobody on Earth has the right to disagree with them, and I don't think it's out of line to call them fundamentalist atheists -- just as most Christians are courteous and reasonable about their faith, and those who aren't can be called fundamentalists.

Hawlkeye, you can italicize by using simple HTML tags -- put the letter i in angle brackets before the word you want to italicize, and /i after it, and you're there. As for blue highlighting, you need the following code:

a href="PUT URL HERE"

between angle brackets before the link, and /a between angle brackets after it. (Angle brackets? On an ordinary keyboard, they're the upper case equivalent of the comma and the period.)

Bert, you really need to do some basic research before making claims like that. A bottle of 500 tablets of homeopathic Kali Phos. in 6x, 12x, or 30x potency from Luyties, one of the standard US brands, is $8.95 plus shipping and handling. Most prescription drugs cost multiples of that for a single dose.

Cathy, thanks for the link!

Jess, that's fascinating. I read Eddings' first series years ago, and enjoyed it, but his style of fantasy isn't really my cup of tea these days.

Kieran, okay, it's time to bring up the hard question: what do you personally propose to do to make this happen? One of the core realizations I hope to get across in these posts is that wishing that something will make it to the future isn't that useful; talk, as the Zen masters say, does not cook the rice.

skymetalsmith said...

Years ago I was bitten by a spider at the air base where I worked. I got an allergic reaction right away and my eyes started swelling shut and light was extremely painful. I went to the emergency room and was dismayed that they told me that without seeing the spider they could not administer and anti venom. They sent me home without treatment.
So I went to visit my friend the herbalist and asked if she could help me. She put a plantain salve on the bite and she gave me these white pills that were apis (bee poison). I took the pills every 4 hours and it seemed to accelerate my symptoms. She later explained to me that the bee venom was fighting off the spider poison by creating white blood cells. She didn't need to know the type of spider to treat me, but they did.

kayxyz said...

Yesterday I read a new biography of the patriot Ethan Allen, during his time, smallpox hypotheses and vaccination generated as much controversy as health care reform does today. Ministers especially came down on both sides, and there was a fatality, "if it's your time to go, it's your time to go and the Lord willed you to catch smallpox." I've heard the same thing used to justify drunk driving in modern times. Speaking of alcohol, my state publishes a state wide magazine for the medical profession. It only goes to doctors, but I'm certain if you visited an academic medical center's library, you could find archived copies. Lead article was on how the medical society protects doctors who are alcoholics, instead of calling for their loss of license.

siddrudge said...

On nutrition:

At my recent yearly physical, I had a brief conversation with my doctor regarding nutrition and my newfound interest in probiotics (via fermented foods.) He gave me that 'deer in the headlights' look, then sort of apologized for his ignorance on the topic. He also revealed to me that nutrition isn't part of a doctor's training in medical school. I'm not sure how true that is, but it was stunning to hear. Is that true? Doctor's aren't required to study nutrition?

John Michael Greer said...

Sky, the behavior of the folks at the hospital was frankly bizarre. If you were having a serious allergic reaction, which is what it sounds like, youd didn't need antivenin -- you needed something to calm down a hyperactive immune system, which Apis mel. ought to do very nicely, but which mainstream medicine also has effective drugs to do.

Kayxyz, it's what almost always happens when you've got a privileged class of specialists who are supposed to be self-policing: getting along with your peers and maintaining the prestige of the institution eclipses the need to protect the health and well-being of the public. The results are not pretty.

Sid, last I heard, most medical schools require physicians to take one class in nutrition, it's a very general overview. and most of them will never reference that information again. Yes, it seems bizarre to me, too.

John Michael Greer said...

Um, folks, I just deleted two more good posts for profanity. It's gotten to the point that I delete as many for that as for trolling. You all know what the words are; you know, or ought to, that if they're in your comment, it's not going to be posted; I don't have the travel funds to go around and wash your mouths out with soap individually so it sticks in your memory; so I'm just going to keep on rolling my eyes and hitting the delete button. If your post didn't appear, that's probably why!

siddrudge said...

Regarding mental health care:
It seems to me that we are uncomfortable with the treatment of mental health in the context of sustainable care in a post-industrial society. But isn't that really the elephant in the room?

Our advanced society is a fertile breeding ground for mental illness. How can we possibly address the proper allocation of public funds for physical healthcare without taking a real good look at the mental health of our society?

We have that highly respected Office of the Surgeon General overseeing the public health, but you can bet that we'll never see anything like a 'Phychologist General? LOL! He'd have to close the whole country down for violating just about every aspect of our human nature - - starting with the 'nine-to-five' work schedule!

Call me naive- - I'm not a medical professional, but for god's sake, is anyone looking around at the obvious problem? Look at the faces of the people at the malls - - listen to their conversations. The insanity is palpable. And many of these are middle and upper class people with accessible healthcare. To say nothing of the current crop of politicians and the mainstream "journalists," with their dull dead eyes, and who seem to be the ones writing the script these days. Such madness!

It seems as though we're collectively operating with just a veneer of sanity left. I can't help but think that it might have been easier on the human mind when living within an agrarian culture. We are so profoundly detached from our natural rhythms. When I see troubled people, roaming the streets or the malls or the boardrooms, I imagine that they could find purpose, meaning, and most of all dignity, in the arms of nature - - in the fields and the forests.

siddrudge said...

So what does graphic design have to do with healthcare? Nothing -- or so I thought.

I teach an advanced course in graphic design. It's an evening continuing education course. Last semester I discovered that one of my students was an emergency room doctor at one of the busy local hospitals. He was a very bright young man in his early thirties, and he'd rush from my class to work the night shift at the hospital.

He displayed some real talent and skill with design and when I discovered that he was a medical doctor, I asked him what brought him to my course. Surely, he wasn't contemplating changing careers?!

His reason for taking my course stunned me. The hospital where he works made headlines a few times recently for very serious medical mistakes; operating on the wrong limb, wrong eye, wrong person . . . unbelievable stories!

He attributed at least some of the cause of these mistakes to antiquated internal forms and checklists. The quality and design of the paper forms were very poor; many were copies of copies of copies. He told me that sometimes one form has to go through many many hands before it's completed. And many of the forms are filled in by hand - - adding another level of complexity to the communication.

So he took it on his own to become the in-house champion for reforming the dysfunctional internal paper communications system. No surprise that his proposal was challenged by the hospital administration who resisted any changes. I'm not sure if his project ever saw the light of day, but I have great respect and admiration for this young man for thinking outside the "check" box.

So, moral of the story . . . paperwork isn't going to go away with the collapse. Even mundane forms, if poorly designed, can become a deadly medical instrument. And let's not forget Florida during that historic 2000 Presidential election - - - dysfunctional ballot designs may have been part of the reason for the outcome.

Don Mason said...

Re: Mechanism of Action of Homeopathic vs. Allopathic Remedies

Disclaimer: My training was in allopathic medicine; I have no training whatsoever in homeopathic medicine. The only homeopathic remedy I’ve ever used was lozenges containing zinc for a few colds (It was an experiment for me, and it seemed to reduce the severity and length of the colds.) So I can’t say yea or nay on the subject of homeopathy, since I don’t know much about it. However, I would like to comment on some of the above comments which essentially said that unless the mechanism of action of a therapy can be explained in a scientific manner, then the treatment should be regarded as unscientific.

Allopathic medicine is replete with standard procedures and medications whose mechanism of action is either poorly understood; not even remotely understood; or firmly believed to be understood, only to be proven later to be completely misunderstood – and then that new understanding is in turn overturned, and then overturned again, seemingly ad infinitum.

And yet some of these procedures and medications have helped vast numbers of patients. We just can’t explain why.

Below is an example from a paper in a medical journal concerning the mechanism of action of statins. As you read it, keep the following phrase in mind: “The author of this medical paper is desperately trying to come up with an explanation for why statins are effective at reducing the incidence of cardiac events.” (Note: The formal definition of “pleiotropic” is “multiple”, but in this paper you could almost substitute the word “mysterious”.)

Here’s the abstract:

“Pleiotropic effects of a drug are actions other than those for which the agent was specifically developed. These effects may be related or unrelated to the primary mechanism of action of the drug, and they are usually unanticipated. Pleiotropic effects may be undesirable (such as side effects or toxicity), neutral, or, as is especially the case with HMG-CoA reductase inhibitors (statins), beneficial. Pleiotropic effects of statins include improvement of endothelial dysfunction, increased nitric oxide bioavailability, antioxidant properties, inhibition of inflammatory responses, and stabilization of atherosclerotic plaques. These and several other emergent properties could act in concert with the potent low-density lipoprotein cholesterol-lowering effects of statins to exert early as well as lasting cardiovascular protective effects. Understanding the pleiotropic effects of statins is important to optimize their use in treatment and prevention of cardiovascular disease.”

circ.ahajournals.org/content/109/23_suppl_1/III-39.full

Now consider that other researchers adamantly deny that the benefits of statins are due to any pleiotropic effects. Then consider that other researchers deny that lowering LDL’s – the primary reason for prescribing statins – has anything to do with their benefit, and that their benefit is entirely due to these pleiotropic effects.

Then consider that statins are the most commonly prescribed class of medications in America. Over 20% of American adults 45 years or older are taking statins (my wife and I among them).

And if you want to see an example of throw-your-hands-in-the-air scientific befuddlement, ask a neurologist to explain the mechanism of action that creates this everyday thing we call “consciousness.”

Determining the mechanism of action can be extremely difficult; and if we limited our therapies to only those with a scientifically-proven mechanism of action, then we wouldn’t have much to work with, because it is so difficult to achieve that level of confidence in any scientific study performed with living human beings.

The bottom line in medicine is always: does this particular therapy appear to be helping this particular patient?

Mary said...

Skymetalsmith,
Unless you had prior exposure to that type of spider, you weren't having an allergic reaction to the bite, but probably were having an immune reaction to its toxin. In that case, an anti-histamine such as benadryl, which would be standard treatment for an allergic reaction, would not be helpful. And since anti-venoms are specific for the toxin involved, without knowing what kind of spider bit you the ER wouldn't know what anti-venom to give you.

It is surprising that they didn't monitor your symptoms. But unless you were in immediate danger, they weren't going to try to treat an undiagnosed problem. First do no harm and all that.

Also, your herbalist friend was incorrect. Apis or bee poison does not make white blood cells. Your body, specifically your bone marrow, makes white blood cells and you have them circulating in you blood all the time as part of your immune system. The apis, which you wrote is a poison, further stimulated your immune system, which includes activating your circulating white cells, and is why your symptoms "accelerated."

Ana's Daughter said...

@Jonathan Blake re: homeopathy --- it's kind of telling that you went straight for the 30C dilution, which is very rarely used and only by seasoned professionals. It's more or less the homepathic equivalent of chemotherapy.

On the other hand, the 3x and 6x dilutions are commonly used not only by homeopaths but, crucially, by millions of folks who take homeopathic remedies instead of allopathic OTC products. Those two dilutions are the most commonly sold to the general public, and the most commonly used in combination remedies, salves, sprays, and other OTC products.

Properly prepared, the 3x dilution contains 1 part per 10,000 of the substance and the 6x dilution contains 1 PPM (part per million) of the substance. Given that we know many chemicals affect human health in single-digit PPM dilutions, and that people with celiac disease and/or gluten-sensitive enteropathy can react to as little as 2 or 3 PPM of gluten, it seems quite reasonable that homeopathic remedies in the 3x and 6x dilutions would be effective. They're simply not going to work in exactly the same way as pharmaceuticals work.

spottedwolf said...

John...I have an old Blackberry 8830 World Edition sitting idle....would you like to cause some calamity ?

spottedwolf said...

Oh...and contrary to tOM.....I say stay where you are my good man....your 'saneness' is needed yonder....we're beyond hope...lol.

Kieran O'Neill said...

@JMG It's something I'm still mulling over, though the thought occurs to me to start gathering resources about post-peak science in one place. That would be a mammoth project, however, and one I'm perhaps not ready to take on.

Meanwhile, keeping a good book on nutrition around couldn't hurt. The Heinz Handbook of Nutrition seems like a good start.

Also, I'm learning a bit about getting enough nutrients on a diet based on in-season foods. I think a few months ago, you posted about getting your vitamin C from raspberry jam in the Winter. That actually doesn't seem to be a very good idea, as jam is pretty low in vitamin C relative to the sugar content. Vegetables in the Brassica family, squash, and preserved peppers (ajvar is delicious) are pretty good options, though.

Ken D. Berry said...

An enjoyable thought-provoking piece. I have a unique view of this entire process and industry. As a Family Physician in a small town, I can readily see the de-industrialization, and de-"everything else" happening in America right now. Being "inside the loop" of Medicine, I can also see that upstream, the Medical Powers That Be are not aware and have no desire to become aware. I am actively integrating Alternative Medicine and true Preventative Medicine into my practice, but I see no danger of Modern Medicine doing like-wise...

I fear the only "solution" that will turn Modern Medicine around is the societal pain coming from these two very large objects (Modern Medicine going one way vs. Modern American Society going the other) grinding against each other. Some would call this a crash, but I'm afraid that word (crash) is deceptive to most. What will probably happen will be like a large ship rubbing against a large iceberg; to those aboard ship it will only feel like an uncomfortable tremor initially...

Jonathan Blake said...

Hi, Ana's Daughter. I didn't post in order to change anyone's mind about homeopathy. Some here were characterizing materialism/naturalism/whatever in ways that made me want to represent my own views in a way that showed that they aren't unconsidered. So I'm not really interested in a extended debate about homeopathy, but I'll address your points.

I agree at low dilution levels like 6X, we have everyday examples of substances having an effect. This makes sense because they are statistically likely to have more than water molecules.

Please correct me if I've misunderstood, but I believe that homeopathy posits that the strength of the treatment increases with increasing dilution, so a 30C dilution should be even stronger than 6X (i.e 3C). That's where my doubts about homeopath's proposed explanations for why homeopathy works begin because statistics tells us that it is astronomically unlikely that any molecules of the original substance remain in a 30C dilution.

I also believe that there are homeopathic remedies readily available that involve even higher dilutions than 30C. Oscillococcinum at 200C (!) gets a lot of attention.

Don Mason, to your point, I think the reason that homeopathy gets so much attention from skeptics is more than just that the mechanism is unknown. It's that, in principle, the mechanism should have nothing to do with the physical characteristics of the remedy itself. Of course this doesn't necessarily apply to other alternative treatments.

Jared said...

John, when considering health, I often think of the health risks of living near any industrial operation. For instance, if you live in the east coast (which you now do), you are probably within 150 miles of a nuclear power facility no matter where you live.

Particularly on my mind as of late are predictions for solar flares in 2013 that may cause nation/worldwide blackouts; I wonder how safe we are living near nuclear facilities that can reportedly stay online with generators for days at most and may not be able to cool reactors if electricity is lost long-term. If solar flares don't occur, as you said yourself in The Long Descent, blackouts may be a common reality in the near future.

Have you given this thought when choosing Maryland?

Tony said...

Re: placebo effect and the improvement/alteration thereof

Regarding the fact that placebo effects work best when the patient believes completely in the effectiveness of what is being done to them - couldn't the patient have a complete belief in the idea that the placebo effect itself could help them? Directly and knowingly using the causal connections between the mind and other bodily systems?

I've actually used this myself to some small degree. I naturally react to injections or blood draws with plummeting blood pressure to the point that I very nearly pass out and my lips go white (I've needed blood drawn several times for my job, and I get flu shots). Several years ago, I realized that there was no physical reason for this from the needles themselves and it had to be induced by my mind, and went into an injection confident that I would not let it happen - and since I knew it was my mind that was causing it in the first place, I kept it from happening and have kept it from happening ever since. It works the other way too - I can (but haven't after one success, it's not exactly pleasant) make my blood pressure plummet like that simply by knowing that it is going to happen and that I can cause it. I am entirely aware it is all in my mind.

Granted, there is a fairly direct and simple connection between the nervous system and blood pressure as compared to many other bodily systems, but it would not surprise me if people could figure out ways to directly and knowingly harness more general placebo effects without thinking they were doing something that acted through something other than their own mind.

Bill Pulliam said...

Re: the homeopathy discussion...

The mechanism or lack of one is hardly the most important question. The primary question is that of efficacy, which can be tested directly enough (re: last week's post about salvaging science). Personally, homeopathy is not a path I have investigated in detail, but others here who know more say that some of these tests have been done and have demonstrated efficacy in at least some circumstances. So, sure, the *mechanism* of how it works becomes an interesting question, but the more critical question is how it works in a *practical* sense -- preparations, dilutions, dosages can all be tested, they don't need to be based entirely on intuition and anecdotes. This is what really matters when you are deciding whether you want to include it in your medical toolkit for the resource-scarce future.

As for super high dilutions, my understanding is that some of the ingredients in those ultra dilutions are really toxic things, and if you can get a beneficial effect from them without actually introducing a single molecule into your body, so much the better! If that effect arises from some mysterious, inexplicable, unknown mechanism, that is fascinating. But it doesn't change the first fact.

And if they can't be demonstrated to work, then chuck 'em.

We're looking at a ruthlessly pragmatic future, folks.

LewisLucanBooks said...

@ siddrudge - Back when I worked in Library-Land, we had a holiday, pot-luck get together. Since significant others were welcome, it was a pretty good cross reference of sex and age. Probably, around 30 people.

Somehow or another, we got on the topic of who was taking what medications. Prescribed medications. I was pretty horrified to find out that I was the only one in the group who took none.

luna said...

Whitewater - totally agree about mercury amalgam. And the poison sticks in your body and nervous system for years, decades even. I still suffer major neurological symptoms on account of this (alleviated by herbs such as St John's Wort - thank heaven for mother nature, as she allows me to lead a normal life).

I very much hope that post-collapse, some alternative will still be viable.

luna said...

PS. to my previous post - I understand that dentists still use mercury amalgam because it's cheap and easy, compared the the alternative "white" fillings. Quite worrying to think which will be the preferred option in a post-peak world...

Matt and Jess said...

I'd just like to take a moment to recommend a book. It's from Penguin Canada so is a little--well, a lot--harder to find in the US, but it's good. "There's Lead In Your Lipstick" by Gillian Deacon.

Rocco said...

John T. Gatto was on my mind because of your comments on education a couple of posts back. You are right of course about the reasons he (and you) don't exist for the mainstream, but this doesn't exactly address my point, which I may not have made clear. Carefully thought out and expressed ideas that are the result of hard effort to formulate through experience, research and lots of pondering desperately need to be widespread and subjected to long and intensive debate, by everybody and everywhere--around kitchen tables, in small town newspapers, as well as in the big media. The thing I keep thinking about when I read you and especially when I read your readers' responses is, "He's preaching to the choir." It's fine to catch the attention of a soft, average American (like me) here and there, but that doesn't go very far and the degree of inertia and ignorance that I see constantly and nearly everywhere around me is very depressing.

If you infer that this is a criticism of you and your efforts on this blog, then you are wrong. Maybe what I am feeling is just impatience, and maybe the solution for my impatience is to turn away from the depressing signs I see and start doing the things that I can do to look after myself and my family and my descendants.

In the meantime, keep up the good work, and I'll keep up with your very interesting and useful ideas.

. josé . said...

John Michael,

Thank you again for an insightful post, and particularly for moderating such a wonderful discussion in the comments thread. I only started reading your posts a few months ago, and discovered the comments a few weeks ago, but when I catch up to the current one, I end up going back to a previous post to read the discussion.

Quick note on Andre Norton. You ask, "I wonder if her books are still available"? In fact, many of her books are available for free download, either through Project Gutenberg or directly from Apple (iTunes download into iBooks reader). I've been reading the Time Traders on my iPad, and I'm surprised at how I still enjoy it, four decades later.

Ozark Chinquapin said...

Homeopathic potency is more complicated than simply a higher potency being stronger. High potencies are better in some circumstances and low potencies in others. High potencies have the potential to cause deeper and more lasting effects, which is why they're usually only used with the guidance of a homeopath, while the lower potencies are used for home treatment. This article describes more,

http://hpathy.com/homeopathy-philosophy/homeopathic-potency-selection/

John Michael Greer said...

Sid, you're not naive at all. Most if not all human cultures have their typical neuroses and psychoses; ours arguably has more than most, and as the gap between what our culture promises and what it can provide grows wider, the result is a psychological pressure cooker with no relief valve worth mentioning -- so a lot of psyches get splattered all over the ceiling. Getting back to the natural world is certainly one important part of a return to sanity, though there's more involved, I think. I may post on this down the road a bit. Thanks also for the story about graphic design -- a good example of how thinking about whole systems can help unclog a very tangled situation.

Don, I remember well the definition given to me by a nurse in a nursing home where I worked for a while, when she was discussing a patient with an "idiosyncratic" condition: "idiosyndratic means that we're idiots and have no idea what causes it." In the real world, a great deal of health and illness falls under that label.

Spottedwolf, thank you, but the only blackberries I have any use for are the kind I can bake in a pie.

Kieran, you might try tea made from the freshly sprouted tips of conifers -- high in vitamin C, and the resins also have strong antibacterial and antiviral effects.

Ken, thank you -- that's good to hear. I think we're already feeling the tremors of the collision, for what it's worth -- the fact that nearly half of Americans can't afford to participate in the medical industry as currently constituted is a sign of no small importance.

Jared, those predictions of solar flares are handwaving -- nobody knows enough about the sun to be able to predict flares two years in advance. As for nuclear plants, it's hard to find a corner of the US that doesn't have something handy to kill you, whether it's something exotic like a nuclear meltdown or something more pedestrian like earthquakes, hurricanes, or a high prospect of civil war. Given the prevailing wind patterns, we're well out of range of the nearby nukes, as well as most of the other potential threats, and if something untoward happens -- well, something's going to kill each and every one of us sooner or later, you know.

John Michael Greer said...

Tony, that's a common idea -- the New Age movement, or more precisely its predecessor the New Thought movement, schismed out of older occult traditions over exactly this issue. Yes, you can do a certain amount by using the power of conscious thinking. Of course the New Age ended up becoming wildly uncritical about what conscious thinking can do, with very mixed results. In effect, they got so uncritically enthusiastic about the power of positive thinking that they lost the ability to notice when it didn't work!

The older occult approach is based on the suggestion that working with the conscious mind isn't enough; you have to go into the irrational, to use symbol and ritual, if you want to get serious results. The use of the symbolic also allows a certain amount of distance from the process, since the conscious mind isn't quite so important; it's easier to pay attention to what works and what doesn't, because uncritical belief on the conscious level isn't quite so important, as the unconscious listens to its own nonverbal language first.

Bill, no argument there. That's one of the reasons I push for dissensus; what works will be clear soon enough; the crucial point is to get as many options into circulation as possible, so nothing useful will get lost because nobody thought to try it.

Luna, it'll probably come to what it was for centuries before amalgam fillings -- extraction, followed by dentures.

Jess, thanks for the link!

Rocco, oh, granted. I've come to think that at some level, most Americans are aware that they're living a lie, one that's going to come crashing down around their heads in due time, but they're basically squeezing their eyes shut and plugging their ears and hoping that nothing happens until after they're dead. Thus the last thing they want to do is to listen to a discussion of what's wrong and what can be done about it.

Jose, thank you! I admit I'm fond of reading physical books, but if I can't locate my favorite Norton books -- Star Man's Son, Breed To Come, and some of the Witch World novels -- I'll keep the downloadable options in mind.

Ozark, it's also worth noting that there are various schools of thought and practice associated with homeopathy, some of which don't use higher potencies at all. The system I tend to use is Schussler's biochemic tissue salt approach, which basically doesn't go past 6x, and gets very respectable results with those part-per-million doses.

August Johnson said...

JMG - If you're looking for Andre Norton books, I'd recommend trying AbeBooks

A search there shows >20,000 Andre Norton books available from stores around the world starting at $1 + shipping.

idiotgrrl said...

I would very much like to see something (book, pamphlet, whatever) from you on ritual and magical theory for the witch with 20 years of hit-and-miss training and self-education.

BTW - I own all of Dion Fortune's books (I think, may have missed one or two) and the only quibbles I have with her are, first, her flat statement that the 'tides' (of human history) she mentions are a century long. No, they are not, and have not been since the American Civil War period. The Anglo-American ones have been very carefully tracked by a pair of (Boomer) historians since the last cycle of the English Middle Ages and the modern ones are more on the order of 80 years. Think "1929-2008." Or for Russians, "1914-1989"

Second are her notions of sexual repression (OVER-solved these days) and homosexuality; but then, she was a woman of her times. However -- small flaws, like the casual racism of her Bull God novel, which would not sit well today but was an accurate picture of what her contemporaries would think.

Anyway, if you have the words of wisdom, I still have some money on Max the VISA card.

Ana's Daughter said...

@Jonathan Blake: You might be interested to know that a lot of homeopaths agree that the C potency dilutions don't work or have at best very limited use. Several schools of homeopathy don't use any of the C dilutions (in fact some don't use anything above 6x), and of those who do, several only use C potency dilutions for psychosomatic or otherwise psychologically-based ailments. The use of C potencies is highly ballyhooed among some schools of homeopathy, yes, but by no means everyone who practices or uses homeopathy considers the C potencies worthwhile. (Yes, it's true --- homeopathy isn't a monolithic cult, it's a diverse and highly divergent modality.)

I personally don't use anything above a 6x potency because after 25 years of experience using homeopathic OTC remedies I've found that for me, at least, the potencies above 6x don't work. 6x nd 3x? Yep; use 'em all the time. 12x on up? Waste of cupboard space.

Also, what Bill Pulliam said.

John Michael Greer said...

August, thanks for the suggestion!

Grrl, I've tried twice now to write really serious works in the esoteric field -- one was my book on magical lodge practice, the other my book on the philosophy of religion from the point of view of traditional polytheism -- and both of them bombed; they're still in print, and they sell fewer than a hundred copies a year (which puts them ahead of my one SF novel, but only just). I would love to have the freedom to write what I want and not have to worry about paying the bills, but a serious work on magical and ritual theory will have to wait until that pleasant day arrives, as such a book will probably sell about ten copies total.

As for Dion Fortune, of course she had her problems -- and you've named a couple of the major ones. A careful study of The Cosmic Doctrine, keeping very much in mind that little and crucial passage about how the material in it is meant to train the mind rather than to inform it, will still teach you more about magical theory than any other ten books I can think of.

Beth Hansen-Buth said...

Ozark said: "Of course the way nature uses to keep populations from weakening a Darwinian environment that kills everyone who's not fit. I'm sure we will be seeing that again, and that's all the more reason to focus efforts on a holistic approach to health that may keep you fit enough to make the difference in your survival."

Holistic medicine can do nothing for those who are paralyzed. We are brighter than than, and should keep in mind that people in wheelchairs are people too, and are in need of much more intervention than the rest of us. Writing off the disabled lacks a degree of compassion. Saying it is Darwinian and natural selection is dehumanizing and makes it easier for us emotionally, than to think that we are condemning people to death because we refuse to come up with sustainable healthcare.

idiotgrrl said...

Let me check your book list. If I don't see your two or don't recognize them, I'll ask you for titles and a link. If I do, I'll send in a check.

Thanks,

Pat, headed out of town for Worldcon in Reno starting early tomorrow morning.

huntgathermedicine.com said...

"most medical schools require physicians to take one class in nutrition, it's a very general overview"

Not even. At least not at my school. And remember- nutrition is not stable ground on which to stand either; plenty of nutrition textbooks are much more concerned with gross deficiencies in a few vitamins than in anything folks here would be concerned with. Kwashiorkor is bad, so is pellagra, but avoiding them won't avoid cancer or diabetes. If you've survived grade school cafeterias, or god-help-you a prison, nursing home or rehab hospital, that food is what you get from orthodox med-school nutrition. Enough meat, enough calories, some calcium, a vegetable side, and big helping of stop complaining.

Anyway, to JMG in re practicing without a license. It is indeed a delicate question, but not as absolute as all that. Some practices are unregulated, others are effectively regulated only if you pursue them for profit, others you can freely use to care for yourself but not for people outside your family, etc. Making things more complex, many doctors are willing to prescribe, say, antibiotics "for use as directed" to international or backcountry travelers, whom they believe are capable and responsible enough to understand when and how to use them. Ditto wound care supplies, many of which are unregulated anyway. Having a prescription like that covers you legally, though you can still mess yourself up if you don't know what you're doing!

Most importantly, I would say, is understanding the diagnostic and management paradigm which largely predates modern surgery and pharmacology. Information is still free and available, and the textbooks given to doctors are an excellent place to start. Even with a strong disclaimer- "DO NOT EXPECT EVER TO HAVE THE OPPORTUNITY TO USE THIS KNOWLEDGE FULLY!" (again for the reasons stated above, I sure don't expect to!) I strongly recommend anyone who lives near a med school check the local used-bookstore for a solid internal medicine or family practice text, and a manual of physical diagnosis.

And yes, folks, stay out of jail!

A

(this is a blog I write- nothing so spectacular)

Ozark Chinquapin said...

Beth, I'm not advocating condemning people to death, just stating about what sort of future we're likely headed to. Being in a wheelchair isn't necessarily a death sentence, It won't be easy for sure and disabled people probably won't be traveling much in the future, but wheelchairs, wooden legs etc. were around before fossil fuels, and in any society that isn't nomadic there are jobs immobile people can do. The meaning of my statement was just to do what you can to minimize dependence on the medical system.


As far as homeopathic potencies, this is another case where it's a good thing that there's different schools of thought because some work better for some people. I have taken low potency remedies before and although I do notice their effect, high potencies have worked better for me. The 1M (1000c) potency that I have been given by my homeopath have worked well for me.

Joel said...

I had no idea that celiac disease was affecting your family. I was struck by Carol Deppe's treatment (in three senses of the word "treat": discourse, cuisine, and medicine) in The Resilient Gardener, because it included family lore and biochemistry, energy/labor efficient food preparation and careful self-experimentation.

The book is worth reading just for her methods of addressing her own health issues (especially celiac sprue), but it's broadly a good source on the creation of a viable home economy.

Thijs Goverde said...

Good grief, mr Greer!
My sympathies - losing a child may well be the very worst thing that can happen in anyone's life. I certainly couldn't imagine anything worse.

It seemse rather out of place to continue a discussion after a personal story of that magnitude, but, well, it's what you do, so I will too.

First off, let me start by sharing Dot's disappointment. Your reflections on the possibility of an English Summer did seem somewhat hasty. This immediately struck me as a case of Rampaging Underprivileged Youth, and though I would agree this sort of event has been occurring disturbingly often in Europe over the last two decades (and it may well be picking up speed), it's very far removed from the sort of goings-on in the Arabian world. Over there, the anger has a direction (against the government). Over here, it doesn't.
Also, the dissatisfaction of the Arabian youngsters was shared by sizeable parts of the population.
In Europe, the Verelendung hasn't gone far enough for that. Working-class people forced to spend 70% of their income on food are very, very rare here.

More to the point of the discussion at hand:
I immediately realised how medicine could be another part of science easily salvaged. It shouldn't take a great deal of resources to do a carefully double-blinded, controlled study of the effects of an alt-med cure. The salvaged bit would be the scientific method (double-blinded etc.)

But while reading the comments I slowly lost my enthousiasm. Bill Pulliams' comment drove it home for me.
Without a search for the underlying mechanism it wouldn't really be science. It would be bookkeeping. Very useful bookkeeping, no doubt - a lot better than just hoping for the accumulated wisdom of the ages to get it right.
But not science.
The future loss still makes me sad.

Well, back to my garden. And see if I can manage to squeeze in time for a first-aid fresh-up course.

Shining Hector said...

Wow, says something about my unheatlhy schedule that it's taken me this long to reach the end of the ever growing list of comments and feel like I can finally make my own.

Responding to a few scattered comments, it always seems strange to me when people have this odd idea that doctors don't have any appreciation for nutrition. Like this is some gaping hole in our knowledge base and is a field we've ceded to alternative medicine. We don't commit X amount of hours in medical school specifically to "nutrition", therefore it's not important to us. That's not really how it works, not at all. You can't understand metabolism without understanding nutrition. You can't understand renal or hepatic function without understanding nutrition. Diabetes, blood pressure, cholesterol, pregnancy, alcoholism, burns, poisons, forget about it. We have to pick the right diet for every hospitalized patient, consider vitamin deficiencies for large constellations of symptoms, diagnose and correct any manner of metabolic derangements, the list goes on.

Asking doctors if they know about nutrition is sort of like asking truck drivers if they understand physics. Of course they do, they couldn't do their jobs for 30 seconds otherwise, even though if you asked them how many hours they've dedicated to studying it you might get a blank look. If doctors don't seem to spend a lot of time talking about it, maybe it's because it's mostly a settled subject and therefore not terribly interesting.

We do ideally try our best to educate patients, but there's a certain amount of jaded triage that likely takes place. Habits are devilishly difficult to change, even more so some outside authority figure admonishes you to, so you start to keep an unconscious tally. How many diabetics did I cure with 10 minute lectures on cutting down on the sodas, versus how many did I cure with 10 second prescriptions for metformin? Hmm, I've got other patients lined up out the door to see me, what do I do? The truth is, when someone comes to you looking for nutrition advice, the battle has already been won. The fact that we quite often don't start with a patient base already motivated to make positive lifestyle changes doesn't diminish us or make us mindless pill pushers, there is a certain method behind the madness.

Ok, off the soapbox, just something I felt like mentioning.

John Michael Greer said...

Grrl, thank you, but don't send the check to me! Your favorite full service bookstore is the place to order 'em -- I don't have copies for sale, partly because I'm the world's worst businessman and partly because I have too many books already.

Huntgather, thank you for the info! That's good to know.

Joel, thank you! I have a copy, courtesy of another reader of this blog -- a very good book.

Thijs, thank you. In your place, I'd be more concerned about the rampaging youth than you seem to be; yes, it's becoming fairly common, and there are good reasons for that; also, as I pointed out in my post, it's not the youth who are the ones to worry about, it's the ambitious people who organize something more serious amid the chaos. European history has some very unwelcome examples of the ways this can lead to trouble.

As far as understanding the reasons behind medicine, there are good points to be made on both sides. You're right that it would be good to preserve as much of that knowledge as would be useful in a less energy-intensive setting; Bill's right that in the crisis years ahead of us, there's going to be a lot of ruthless winnowing, and whether a medicine is understood will take a back seat to whether it works. The question -- a central issue in the project of this blog -- is how to find a point of balance between those two factors.

Hector, thanks for the perspective from the other side of the stethoscope. It's interesting that alternative health practitioners seem to have much better luck convincing people to try different diets -- I'd be interested to know if you have any sense of why that is.

Shining Hector said...

JMG: "Hector, thanks for the perspective from the other side of the stethoscope. It's interesting that alternative health practitioners seem to have much better luck convincing people to try different diets -- I'd be interested to know if you have any sense of why that is."

My guess? Selection bias. That's like asking why personal trainers have better luck at convincing people to exercise than their doctor. Few people get a personal trainer who haven't already made up their mind to exercise, the only question at that point is how. When the general public shows up at their doctor wondering why they're overweight and feel terrible and the suggestion is invariably made to try exercise, they've got to make up their own mind on the matter and overcome their bad habits and inertia, which no doctor however knowledgeable or charismatic is going to be able to do for them. As you said in the original post, alternative medicine generally takes effort on the part of the patient, as the general providers of first and last resort, we are still expected to treat those unwilling to care for themselves, and given those rather unfavorable circumstances it's a small miracle we have as much success as we do.

Meg said...

Having recently read most of "Where There Is No Doctor", skimmed its companion books on dentistry and women's health care, and looked into the scholarly reviews, I'd like to contribute my two cents.

Strengths:

* Easy to read. Simple, concise, non-technical language with a good glossary, and plenty of illustrations.

* Good, non-condescending discussion of psychosomatic illness, the placebo effect, 'bedside manner', and the psychological effects of taboos and superstitions.

* Rules of thumb for how to judge if folk remedies or traditional practices are helpful or harmful, and how to test remedies for effectiveness. Recipes for simple home remedies such as honey-lemon cough syrup.

* Focus on prevention and non-invasive methods. A whole chapter is devoted to 'healing without medicine' using oral rehydration, compresses, etc., and another chapter to 'nutrition on a budget'.

* Diagnostic section recognizes the confusion that can result when laypeople and professionals use the same words to mean very different things (e.g. 'the flu' meaning 'minor stomach bug' vs 'the flu' meaning 'deadly epidemic respiratory disease'.)

* A recognition that many health problems - malnutrition, poor sanitation, STDs - are partly social/economic problems, and suggestions for collective action towards solutions.

Its weaknesses:

* Many errors, dubious recommendations, and out of date information. In particular, dosages for children are calculated incorrectly and may cause overdose. In many cases, safer and/or more effective treatments exist than those given. This was the biggest concern mentioned by medical reviewers.

* Last updated almost twenty years ago. For comparison, most public libraries won't keep a medical text that's more than five years out of date.

* Intended for the 'Global South.' Some of its content, e.g. on tropical diseases, may not be relevant to more northern audiences.

* The actual instructions vary widely in the level of expertise they presume/require from the user. A book that begins a chapter on calculating medication dosages with a brief lesson on what '+' and '=' symbols stand for seems uncertain of its audience. That the same book presumes readers have enough mathematical skill to use the calendar method of birth control does not fill me with confidence.

In summary:

This book is massively popular in the developing world, and many health professionals who wince at the errors it contains still consider it a good stop-gap. While specific diagnoses and remedies should be taken with a grain of salt, it gives the reader a good 'common sense' grounding in sanitation, nutrition, and treatment of simple illnesses.

Cherokee Organics said...

Hi JMG,

JMG - "I think the concept of human rights is a useful one, but only if it's remembered that human rights are a social construct -- something that certain societies choose collectively to offer to their members, and other societies don't."

I agree with you, however, I think there may also be a disconnect in people in our current society.

The disconnect arises out of the very difference between a social and legal construct.

A social construct implies mutual obligations between members.

A legal construct implies an imposition of that social construct from a mutual third party.

The difference between the two is that benefits may accrue to members without those members also incurring social obligations. I think that we find ourselves in this spot currently.

I think back to your thoughts a few weeks ago on mutual obligations during the middle ages as I was previously unaware of this concept. It's a system that works on mutual obligations and as such it is quite a strong system.

On the other hand, a legal construct is also kind of like a fiat currency in that you are removed from a lot of mutual obligations. This is a bad thing, because the costs eventually outweigh the provision of those benefits.

I'm fascinated to see what you think.

To all of those that think that the recent economic events have now been sorted and we can all now get on with our lives, listen to this:

There have been 10 major economic panics since the Dutch tulip craze of the 17th century. However, 7 of those have occurred since the early 1970's. Any thoughts why people?

Does this not ring any alarm bells?

There is also the tendancy in people to downplay unpleasant events - like the riots in the UK - because, we all really just want to get on with our lives. I noticed a common theme amongst (vox pop) interviews with the people affected in that they are saying that the people come from elsewhere. ie. they weren't locals. Mmmm, food for thought.

Regards

Chris

Thijs Goverde said...

Oh, I wouldn't say Im not worried enough - here in the Netherlands we have one of the most notorious and terrifying 'ambitious people' currently on the European scene.* He's rather the type to build a power base on a hard crackdown against the rampagers, rather than on the rampagers themselves.

Rereading, I see your post can be read as referring to that sort of thing, but as it's more or less the opposite of the Arabian Spring I missed the full width of your remark the first time around.

*This creep's niece, a very kind and intelligent girl, actually babysits for my daughter. It's a funny old thing, life.

Whitewater said...

Cherokee Organics said-
"There have been 10 major economic panics since the Dutch tulip craze of the 17th century. However, 7 of those have occurred since the early 1970's. Any thoughts why people?"


My take (your results may vary):
The Bretton Woods System created a system of fixed exchange rates that allowed governments to sell their gold to the United States treasury at the price of $35/ounce. The Bretton Woods system ended on August 15, 1971, when President Richard Nixon ended trading of gold at the fixed price of $35/ounce. The gold standard has not been used in any major economy since that time.

Jason said...

All this stuff about placebo and magic, but nothing about hypnosis! That's he one form of magic (consciousness-alteration in line with will) that has achieved a high degree of respectability, and certainly has a mountain of evidence to support it.

I'm in the midst of becoming qualified because it is bound to be so useful -- one of the things I'll specialise in is pain relief, for a start. The deeper methods of Ericksonian hypno-analysis are also beautiful and fascinating. All the techniques can be used for other, non-medical forms if altered states as well, and combining the protocols with simple qigong, (say zhan zhuang as taught by Lam Kam Chuen) gives something very powerful that's also very easy to use.

JMG: in a sane medical system, the attitude toward the placebo effect [... would be...] "How can we make this effect work more powerfully?" Of course that would lead to paying attention to emotionally powerful symbols and ritual psychodrama -- that is to say, magic -- and there are potent institutional biases in the way of that...

That can certainly be done with hypnosis, and there would be far less resistance to it. The moves in the UK towards getting a national qualification system together will completely legitimise entry of trance states here, for a heap of applications, many of which are of course not completely explicable in terms of theory... Notably, Emile Coue (he of 'every day in every way I am getting better and better' fame) began as an apothecary who noticed how much better medicines worked if suggestion was used -- and graduated to the use of suggestion alone (plus qi if you read between the lines of contemporary reports). So it has been done and can be done.

Jason said...

Oh and once again, spiritual healing of the 'reiki' type works and has been proven to work in randomised controlled trials -- and all the evidence is easily found, see for example Benor's Spiritual Healing: Professional Supplement. Please, please, read the research!

Since the effects have been applied to animals, plants, bacteria, enzymes, etc., with great success, there is no room for a just-placebo definition either. Even hypnosis can be done on animals.

People who say they would like answers on these questions often are mystifyingly incapable of finding them. Of course the status of people who use such methods is, in some quarters, rather that of a German Jew in 1937 -- forgive a dramatic example but the opprobrium from the Dawkins camp currently is very intensely filled with hatred, and the economic roots of the dislike aren't dissimilar.

Mean Mr Mustard said...

Hawlkeye said -

"And someday I'll learn that neat trick of masking links under pithy blue text..."

I recently worked it out with the help of this link...

Houyhnhnm said...

JMG--

Thank you for the book recommendation. My "new" copy of American Red Cross Home Nursing Textbook, 7th ed. 1963, arrived this afternoon.

Not only did it arrive within a week, but it's in VG or better condition and cost under $4.50--including shipping. So also, thank you, AbeBooks.com and my faithful “Bookfinder".

Better yet, I remember reading this many years ago when my dad was taking first aid instruction, so I'm bringing up memories as I flip pages.

Houyhnhnm

jeffinwa said...

Wow! Luyties homeopathics and HTML code lesson in one post; and the high level discussion start to finish.

Many thanks

hawlkeye said...

Thanks John and Mustard for the blog coaching. Not sure I understand the link instructions, though... testing...

Under the wire on a Wednesday after 200+ posts, but I have to put in a word for hydrosols. Last summer we made these simple stove-top plant-oil extractions from the garden and have been using them as cleansers. I'm betting the oils have a big role to play in post peak health care, and hydrosols are a great way to access them in the home economy.

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