Highly Evolved

Is your doctor trying to kill you? 

In the USA, medical errors are claimed to be the third leading cause of death (1), accounting for as many as a quarter of a million fatalities every year (2). In one review, published by the USA Dept Health & Human Services Inspector General, 1 in 7 Medicare patients (ie aged over 65) experienced a serious treatment-related adverse event (3), resulting in 180,000 deaths / year.

According to these papers, patients are harmed and killed by eight broad categories of medical error. These include:

1. Diagnostic Errors. 
2. Medication Errors
3. Surgical Errors
4. Labor and Delivery Errors
5. Anesthesia Errors
6. Failure to Obtain Informed Consent
7. Communication Errors
8. Infections and Secondary Complications

But is medical error really the third leading cause of death? There are substantial and systemic problems with the pharmacentric model of healthcare, but this statistic is not as solid as some people claim. The first two papers extrapolated death rates from earlier samples of hospital populations, some of which were small and uniquely vulnerable. And, in many cases, proving a direct causal relationship between a medical intervention and a subsequent medical problem is difficult or impossible.

On the other hand, an unknown but potentially large number of iatrogenic deaths occur after the patient has left hospital, and are either not well documented or missed altogether. Some medical harms can take months or even years to play out, and these events are generally not caught in the statistics either. And in some cases – perhaps many, but we don’t know – medical records are buried or amended to prevent lawsuits.

With these confounders in mind, a handful of recent investigations have provided broadly similar numbers. They suggest that about 5% of patients are harmed by treatment in hospitals, with a death rate ranging between 0.5 and 4% (4-6). In the USA, where there are 36 million admissions/year (7), this extrapolates to roughly 1,500,000 harms with somewhere between 36,000 and 250,000 deaths per annum.

The real total is likely to be towards the upper end of that range when you consider delayed post-operative prosthetic infections, which can occur several years after surgery (ie 8, 9) and are generally not counted; and the fact that emergency room mis-diagnoses alone have been calculated to kill up to 250,000 Americans a year (10).

Could doctors do better? Probably not.

Medics make mistakes, as we all do. There are self-checking systems in place to reduce the risk of these mistakes, but there is a deeper problem; the treatments themselves. The pharma model of medicine, which emphasizes specificity, is fundamentally mis-directed. The chronic, non-communicable ‘diseases’ which dominate the public health landscape today are not diseases in the classical sense at all but syndromes with multiple causative factors (11). This is why the drugs we use are non-curative, and why adverse effects are so common.

To make matters worse, doctors are flying blind. They are supposed to be practicing evidence-based medicine (EBM), an idea first mooted in the early ‘90’s. This is self-evidently based on evidence, specifically evidence derived from scientific publications – and here there be monsters.

The inestimable John P.A. Ioannidis, the Stanford-based epidemiologist, statistician and meta-researcher, has published substantial criticisms of medical research as it is currently performed. He points out that due to problems with inter alia funding, experimental bias and peer review bias, most published work cannot be trusted (12-15). In his most recent paper (15), he and his co-authors concluded: ‘Most healthcare interventions studied within recent Cochrane Reviews are not supported by high quality evidence, and harms are under-reported.’

There is, it is fair to say, a crisis of credibility at the heart of EBM, and at the heart of medical evidence. And Ioannidis is not alone in his criticisms.

In 2009 Marcia Angell, former editor-in-chief of the august New England Journal of Medicine (NEJM), stated that ‘It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor’ (16).

In 2015 Richard Horton, editor-in-chief of the equally prestigious Lancet, concurred: ‘Much of the scientific literature, perhaps half, may simply be untrue’ (17). In 2021 Richard Smith, a long-term editor of the long-established British Medical Journal (BMJ), went further. ‘It is time to assume that health research is fraudulent until proved otherwise’ (18). 

A significant level of fraudulent or at least badly conceived data helps to explain why, despite the fevered advocacy of hospital administrators and lawyers, there is no evidence that EBM produces better patient outcomes or experiences (19).

Unfortunately, even if a caring, intelligent and conscientious doctor looks at EBM data and finds holes in it, he or she has less freedom than ever to step beyond it. In California, a law pushed through by the ‘Vaccine Work Group’ means that dissenting doctors accused of spreading ‘misinformation’ can now have their state license suspended or revoked. 

As ‘misinformation’ defined in the bill means failing to adhere to the contemporary scientific consensus, which the state determines, this law means that any doctor who contradicts the state will be subject to punishment up to and including loss of their livelihood (20).

I would be astonished if the ‘Work Group’, who are also pushing for children over 12 to get Covid ‘vaccinated’ without parental consent (21), were not in receipt of generous pharma funding. And now we have to dig a little deeper again. How has science been so betrayed? 

According to Arnold Relman, another former editor of the NEJM, ‘The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry’ (22). That includes the editors of medical journals, who can be and doubtless are bribed (23-25).

The regulators are equally compromised, and willing to license ineffective drugs if the price is right (26).

So it is about money, and it is about politics – but I am repeating myself. And it is part of a larger, deeper and darker problem. 

The USA has one of the most corrupt and inefficient healthcare systems in the world, thanks in no small measure to the Rockefeller and Sackler families (27), and warm and fuzzy pharma folk such as Johnson and Johnson. Too many regulatory and medical professionals are either terminally gullible or actively complicit (27-29).

The pharmaceutical industry in general, which is the most profitable of all industries (30), uses the illusion of evidence-based medicine as a screen. EBM uses algorithms that Big Pharma can influence in many ways, and which are designed to discriminate against small competitors and natural medicine, including pharmaconutrition.

This is deeply unethical and it used to be illegal, but the rule of law is now a two-tier system. It is biased against the individual and available to the highest bidder (31, 32). The paper (31) and the 5’ video (32) explain very clearly how corporations buy and shape the law for their own purposes, how we got to lockdown, facemasks and mRNA ‘vaccines’, and why the integrity of medical journals and professionals is so damaged.

It explains why the FDA licenses ineffective drugs (33) while banning useful natural compounds (34), and why the FDA’s culture is characterized by ‘indecisiveness, inaction and constant turmoil’ (35). There are good scientists there, but they are overruled and demotivated by commercial interests. The CDC has fallen, if anything, even further from grace (36-38).

It is worth repeating that the pharmaceutical approach to chronic degenerative diseases, while a highly successful strategy for the drug industry, is off-target and thus doomed to medical failure (11). The latest predictable disappointment was the failure of gantenerumab, a monoclonal antibody which targets beta amyloid, to help patients with early Alzheimer’s disease (38). There are so many other examples …

Finally, there are issues of teaching, training and prioritization. In a recent Medscape survey of 1005 physicians (39), over half the medics agreed that their patients needed nutritional advice, but two thirds of them could not allocate time for this because they did not feel competent to provide it and were not paid for it. It is hardly surprising that most medics prefer to focus on pharmaceuticals which do little more than pour water on the oil fires of chronic degenerative disease.

In the background the pharmaceutical industry continues to corner the market, with new drugs costing an average $222,000 per annum (40). The continuous marketing of dangerous, over-priced and dubious drugs is profoundly immoral. The ‘ethical industry’ is completely amoral, however, and has purchased general immunity for itself – as with the ‘vaccines’ (37, 41) – together with large sections of the law, as mentioned above, so no problems here. 

Bernie Madoff’s Ponzi scheme broke in 2008, nearly broke the stock market and left thousands destitute. Bernie prospered for half a century because he had been able to corrupt the financial watchdog, the Securities & Exchange Commission. To put this in perspective, the similarly fox and henhouse relationship between Big Pharma and the FDA has killed and damaged millions (42). 

It is killing the natural health sector too.

For example, drug companies can and do request the regulators to seize natural ingredients and have them designated as drugs. The notorious FDA ‘back-channel’ is a classic 3-step bureaucratic reach-around which applies to all supplements launched after 1994.

Step 1. Identify natural compounds so safe and effective that they might harm Drug Co. sales.

Step 2. Request the Supplement Co. to produce a New Dietary Ingredient (NDI) dossier. This will take millions of dollars and years to complete to the FDA’s satisfaction.

Step 3. Before the NDI is approved, Drug Co. files an Investigational New Drug Application (IND). The natural compound can no longer be sold as a supplement.

Such was the fate of NAC, the memory product vinpocetine (in some markets) and the B6 variant pyridoxamine (pending). More natural molecules are being forced into the funnel, and Big Pharma clearly wants all supplements off the market.

Hedge accordingly. Here are a few steps you can take to protect yourself. 

1. Minimise your risk of acquiring a non-communicable degenerative disease by re-establishing a pre-transitional nutritional and metabolic profile. There will be occasions when you will need medical support, but with a pre-transitional metabolome you should be able to keep them to a minimum. Your need for implanted and other medical devices will be reduced also. As the medical devices industry has effectively suborned the regulators, the ethical and medical problems associated with this sector are at least as bad as those associated with pharmaceuticals (43).

2. Medical institutions are incubators for antibiotic-resistant bacteria, due to high levels of antibiotic use and large numbers of wounded and immuno-compromised patients. If you are due for in-hospital treatment, prime your immune system beforehand with yeast-derived 1-3, 1-6 beta glucans. Add the micro- and phytonutrients required for the key innate immune enzyme lactoperoxidase, and vitamin D if needed.

3. Seek out a patient advocate. I have seen truly shocking cases of financially driven malpractice. One of the worst was a woman a few days from dying of cancer who was given an artificial hip, making her dying more profitable and vastly more painful. An informed and impartial third party could have protected that patient and made her death easier.

Plenty of excellent doctors and nursing staff remain in the system, but many tell me the system makes it increasingly difficult for them to work to what they consider to be acceptable standards. It will take a systemic collapse and re-set to ‘build back better’. 

For those interested in the larger picture, take a road trip across the USA and you will see endless small towns sinking in poverty but dominated by shiny new medical facilities. Then look at what people eat. The industrial diet on offer in the stores, restaurants and fast-food outlets creates a diseased population, a constant demand for medical palliatives, job security for pharmaceutical reps and obscene profits for the drug industry. 

A number of good books cover the issues outlined here in considerably more detail.

The Truth About the Drug Companies (2004) by Marcia Angell. Random House

Bad Pharma (2012) by Ben Goldacre. Fourth Estate

Deadly Medicines and Organised Crime (2013) by Peter Gøtzsche. CRC Press

The Illusion of Evidence-Based Medicine: Exposing the crisis of credibility in clinical research (2020) by Jon Jureidini & Leemon McHenry. Wakefield

The Song of our Scars (2022), by Haider Warraich. Basic Books

CONFLICT OF INTEREST STATEMENT

Paul Clayton consults with companies in the natural medicine sector. He owns a few shares in several of them but not enough, sadly, to make him independently wealthy. He has plenty of wild theories about the relationship between diet and health, but generally tries to present them in testable forms. 

Next week: The disease of kings, democratized.

References

1. Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ 2016;353:i2139
2. Anderson JG, Abrahamson K. Your Health Care May Kill You: Medical Errors. Stud Health Technol Inform. 2017;234:13-17. PMID: 28186008.
3. Levinson DR. ADVERSE EVENTS IN HOSPITALS: NATIONAL INCIDENCE AMONG MEDICARE BENEFICIARIES. Nov 10, OEI-06-09-00090, https://oig.hhs.gov/oei/reports/OEI-06-09-00090.pdf
4. Rogne T, Nordseth T, Marhaug G, Berg EM, Tromsdal A, Sæther O, Gisvold S, Hatlen P, Hogan H, Solligård E. Rate of avoidable deaths in a Norwegian hospital trust as judged by retrospective chart review. BMJ Qual Saf. 2019 Jan;28(1):49-55.
5. Hogan H, Zipfel R, Neuburger J, Hutchings A, Darzi A, Black N. Avoidability of hospital deaths and association with hospital-wide mortality ratios: retrospective case record review and regression analysis. BMJ. 2015 Jul 14;351:h3239.
6. Panagioti M, Khan K, Keers RN, Abuzour A, Phipps D, Kontopantelis E, Bower P, Campbell S, Haneef R, Avery AJ, Ashcroft DM. Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ. 2019 Jul 17;366:l4185.
7. Total number of hospital admissions in the U.S. from 1946 to 2019. Statista, https://www.statista.com/statistics/459718/total-hospital-admission-number-in-the-us/
8. Schömig F, Putzier M. Clinical presentation and diagnosis of delayed postoperative spinal implant infection. J Spine Surg. 2020 Dec;6(4):772-776.
9. Huotari K, Peltola M, Jämsen E. The incidence of late prosthetic joint infections: a registry-based study of 112,708 primary hip and knee replacements. Acta Orthop. 2015 Jun;86(3):321-5.
10. Newman-Toker DE, Peterson SM, Badihian S, Hassoon A, Nassery N, Parizadeh D, Wilson LM, Jia Y, Omron R, Tharmarajah S, Guerin L, Bastani PB, Fracica EA. Kotwal S, Robison KA. Diagnostic Errors in the Emergency Department: A Systematic Review. Comparative Effectiveness Review No. 258, AHRQ https://effectivehealthcare.ahrq.gov/sites/default/files/related_files/cer-258-diagnostic-errors-research.pdf
11. https://whitesmoke-heron-286383.hostingersite.com/blog/the-drugs-dont-work/
12. Ioannidis JP. Why most published research findings are false. PLoS Med. 2005 Aug;2(8):e124.
13. Ioannidis JPA. Correction: Why Most Published Research Findings Are False. PLoS Med. 2022 Aug 25;19(8):e1004085.
14. Howick J, Koletsi D, Pandis N, Fleming PS, Loef M, Walach H, Schmidt S, Ioannidis JPA. The quality of evidence for medical interventions does not improve or worsen: a metaepidemiological study of Cochrane reviews. J Clin Epidemiol. 2020 Oct;126:154-159.
15. Howick J, Koletsi D, Ioannidis JPA, Madigan C, Pandis N, Loef M, Walach H, Sauer S, Kleijnen J, Seehra J, Johnson T, Schmidt S. Most healthcare interventions tested in Cochrane Reviews are not effective according to high quality evidence: a systematic review and meta-analysis. J Clin Epidemiol. 2022 Apr 18:S0895-4356(22)00100-7.
16. Angell M. Drug Companies & Doctors: A Story of Corruption. New York Review Jan 15, 2009
17. Horton R. Offline: What is medicine’s 5 sigma? (2015) Lancet 385 (9976), 1380
18. https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-research-is-fraudulent-until-proved-otherwise/
19. Simons MR, Zurynski Y, Cullis J, Morgan MK, Davidson AS. Does evidence-based medicine training improve doctors’ knowledge, practice and patient outcomes? A systematic review of the evidence. Med Teach. 2019 May;41(5):532-538.
20. https://www.medpagetoday.com/special-reports/features/100471
21. https://sd11.senate.ca.gov/news/20220121-senator-wiener-introduces-sb-866-%E2%80%94-teens-choose-vaccines-act-%E2%80%94-allow-young-people-12
22. Relman AS, Angell M. America’s other drug problem: how the drug industry distorts medicine and politics. New Repub. 2002 Dec 16;227(25):27-41.
23. Liu JJ, Bell CM, Matelski JJ, Detsky AS, Cram P. Payments by US pharmaceutical and medical device manufacturers to US medical journal editors: retrospective observational study. BMJ. 2017 Oct 26;359:j4619.
24. Wong VSS, Avalos LN, Callaham ML. Industry payments to physician journal editors. PLoS One. 2019 Feb 7;14(2):e0211495.
25. Haque W, Minhajuddin A, Gupta A, Agrawal D. Conflicts of interest of editors of medical journals. PLoS One. 2018 May 18;13(5):e0197141.
26. https://web.archive.org/web/20230101193916/https://energycommerce.house.gov/newsroom/press-releases/maloney-and-pallone-release-staff-report-on-review-approval-and-pricing-of
27. https://www.youtube.com/watch?v=VnL7XWH8uoA
28. https://www.marketplace.org/2017/12/13/opioid/
29. https://eu.usatoday.com/story/opinion/2021/02/03/janet-woodcocks-failure-fda-opioid-epidemic-column/4352787001/
30. Ledley FD, McCoy SS, Vaughan G, Cleary EG. Profitability of Large Pharmaceutical Companies Compared With Other Large Public Companies. JAMA. 2020 Mar 3;323(9):834-843.
31. Gilens M, Page BI. Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens. Perspective on Politics 2014, doi:10.1017/S1537592714001595
32. https://www.youtube.com/watch?v=5tu32CCA_Ig
33. Mullard A. Landmark Alzheimer’s drug approval confounds research community. Nature 594, 309-310 (2021)
34. https://www.fda.gov/food/cfsan-constituent-updates/fda-releases-final-guidance-enforcement-discretion-certain-nac-products
35. Operational Evaluation of the FDA Human Foods Program, Dec ‘22
36. https://reaganudall.org/sites/default/files/2022-12/Human%20Foods%20Program%20Independent%20Expert%20Panel%20Final%20Report%20120622.pdf
37. https://www.medscape.com/viewarticle/984007?src=WNL_infocu8_221116_MSCPEDIT&uac=90527HT&impID=4874060&faf=1
38. https://www.zerohedge.com/markets/cdc-knowingly-left-serious-adverse-events-post-vaccination-surveys-documents-show
39. https://csis-website-prod.s3.amazonaws.com/s3fs-public/publication/230112_Morrison_Building_CDC.pdf?kTKB3urWn1bfZpXuCqixfxzHfT8AUcIM
40. https://www.medscape.com/viewarticle/979806?src=WNL_infocu1_220907_MSCPEDIT&uac=90527HT&impID=4614265&faf=1
41. https://www.reuters.com/business/healthcare-pharmaceuticals/us-new-drug-price-exceeds-200000-median-2022-2023-01-05/
42. https://www.youtube.com/watch?v=-MSKzoI72eU
43. https://twitter.com/hashtag/DirectedEvolution?src=hashtag_click
44. https://www.netflix.com/title/80170862