The Summer of '68...

"There's no politics in medicine, Dad.......

Has it really been almost FIFTY-FIVE years?    Yes, I guess it has.

Those were times that still are bright memories to me.  The music of Simon and Garfunkel with Mrs. Robinson, Vietnam and the My Lai massacre, the horrible killings of Martin Luther King, Jr. and Robert F. Kennedy, the crushing of the Prague Spring, MacArthur Park was melting (never did understand that)…And the movies: Rosemary’s Baby, Barbarella, 2001, Romeo and Juliet and, of course, Bullitt and Planet of the Apes. 

Looking back, they really were NOT such great times!  But I was young and was looking at life through hopeful eyes.  I had just finished my first year at Boston College in the Summer of ’68.  I had played soccer and thought that grades were not that important.  So, the D in calculus was just a bump in the road.  Then reality set in and I realized I had probably made a big “error in judgement” if I wanted to be accepted into medical school.  But I wasn’t sure I wanted to go to medical school.  I vacillated between medicine and international law, contemplating eventual grad school at the Georgetown School of Foreign Service.

That summer I needed to finally set a course. I couldn’t go on bouncing.  So, I decided to get a summer job in a hospital to see if I liked the medical field.  This was complicated by the fact that I always was a bit nervous in hospitals.  I kept on thinking they were the place where bad things happened. (As it turns out now, those thoughts may not have been so far off the mark….)

I became an orderly in surgery at what was then the premier hospital in Milwaukee.  I was assigned to the Recovery Room, where I basically would pick up patients in the morning for surgery, assist in their recovery (which involved a lot of messy and smelly things to clean up) and then push them back to their rooms.  But I also had a chance to observe surgery, and I was hooked.  I could talk with the surgeons and could experience the excitement of this area of medicine.  I remember conversations with a surgeon who had spent his younger years as a missionary in India.  It sounded captivating.

So, I remember, so clearly, coming home and talking with my Dad.  My Dad had enlisted in the Navy at age 17 during World War II.  He had to finish high school via the GRE after the war and worked as a lithographer.  Nobody in my family had ever graduated from college.  My maternal grandfather came to this country as what would now be called an Unaccompanied Minor, worked as a laborer on the railroad and then proceeded to become a butcher and the owner of a small grocery store.  He spoke English with a thick accent but was one of the wisest men I ever knew….

Anyway, I said: “Dad, I finally made up my mind.  I want to go into medicine.  You know, politics do not play a role in medicine like they do in international law or foreign service. You can seek the truth.”

Thinking back on that now, it seems surreal.  I had a stylized view of what medicine was all about, but it satisfied me to the point that I quit the soccer team and went about trying to reverse my dismal academic record.  As it turns out, I probably only made it into medical school because I overslept one day, but that is a story for another time.

I continued to have this dream of being a missionary surgeon to India.  My life took twists and turns.  “Fate” or “Providence” led me to spend my Junior year as an undergrad at the University of Vienna in Austria.  Somehow, I did indeed raise my academic standing and was accepted into medical school.  I saw that there just may be some politics in medicine after all, but these were the politics of hospitals and medical schools where advancement was often not decided by merit alone.  I was disappointed but realized that my earlier thought that medicine was completely devoid of politics was probably naïve.  After all, “politics” is the study of human interaction, right?  I thought at least it didn’t impact upon the relationship with the patient…...One could still do what was “right”.

This was subsequently tested during the rapid transformation of medicine in the 1990’s, when HMOs made their initial inroads and corporatization of medicine increased the role of administrators and cost cutting.  But there was a huge, welcome reprieve from that moral wilderness when the work of Brent James at Intermountain Healthcare got some traction.  I had risen to the position of chief of quality at a major hospital, and we were elated to hear that “doing the right thing the first time and every time” could cut out the quality waste and everybody could be happy—the patients, the staff and the administrators.  It worked very well for a few years, but little by little that too was eroded.  Money…... greed and power became more and more important in the way medicine was practiced.

Then 2020 hit, and nothing has been the same since. For the first time in my memory, the editorial board of a major medical journal came out in favor of a particular candidate for President of the United States.  But so did Scientific American.  Also, for the first time in my memory the official recommendation of the federal public health agencies was to “sicken at home” if stricken with a potentially fatal illness, despite credible reports that the repurposed, inexpensive and off-patent medicine, hydroxychloroquine, seemed to help if given early in the course of the disease and in the proper dose along with other agents:

https://www.pubmed.ncbi.nlm.nih.gov/33387997

This piqued the academic interest of some of us, and we conducted a study of possible author biases on this drug and the timing of the changing landscape in the literature on its effectiveness as it related to its being touted by President Trump.  The findings were astounding, but we couldn’t find a journal that would review it.  Most just termed it “inappropriate”.  Finally, it was published months later:

https://pubmed.ncbi.nlm.nih.gov/33792262/

The results, using the website

https://www.followthemoney.org/

showed a definite connection between political donations and the slant taken by the authors on the use of hydroxychloroquine.  It seemed to us that the medical literature was being used by both authors and editors to push an unconscious political agenda at the very least.  This has been confirmed by numerous editorial decisions on manuscripts being accepted or published papers being retracted.

We were warned by Baffy, et al:

https://www.sciencedirect.com/science/article/abs/pii/S0002934319306606

even before COVID-19 hit that medical information was being forced through a very narrow funnel, with Big Tech having an ever-increasing role in de facto censoring of medical information.

It is an inescapable conclusion for me that early treatment of COVID-19 was demonized and treated very differently from any other disease for political and economic reasons.  If a treatment were available, the Emergency Use Authorization for the mRNA agents could not be granted and potentially billions or even trillions of dollars of profits for Big Pharma would evaporate.  So would immunity from prosecution. The economic and political interests of Big Pharma, Big Tech and Big Medicine, be it governmental or academic, were aligned. Unfortunately, patients were not part of the mix.

I couldn’t help but think back twenty years to when I was Professor of Ophthalmology and tasked with discussing “ethics” with the residents and medical students.  One of the case reports we discussed explored why it was unethical to accept a lunch, or even a pen, from a drug rep because we, who otherwise dealt with life and death decisions, would easily be corrupted by such a trivial gift.  It was straight out of a Kafka novel.  We were told by Big Medicine that it was unethical to accept a pen, but now it would be even more unethical to recommend a drug that could save a patient’s life (and did for tens of thousands) because it would…...what?  Have potential side effects??  We recommended drugs that had tremendous side effects all the time!  No, recommending a drug that had a 40-year track record of safety over billions of doses was not deemed “misinformation” because it was dangerous, which it wasn’t, or not effective, which it was, but seemingly because it cut into profits and power.

 For political and economic reasons, “medical privacy” was thrown out the window. HIPAA became a sick joke.  I had been told just a year before COVID-19 that I had to be blinded on clinical research on my own patients to insure their “medical privacy”.  I needed a HIPAA variance to investigate their response to a treatment I myself had administered, yet everybody was now entitled to know the results of anyone’s “medical passport”.  Insanity…. Before COVID-19 I was expected to give patients Informed Consent on the risks, benefits and alternatives to any treatment I recommended.  I could lose my license to practice and be prosecuted if I didn’t comply.  Now, I could lose my license to practice and be prosecuted if I actually gave Informed Consent!  Worse than insanity!  I was expected to potentially harm my patients in order to keep seeing patients….

So, Dad, I was profoundly wrong when fifty-five years ago I told you that there were no politics in medicine.  There are now more politics in medicine than there ever would be in law.  I doubt very much that lawyers would stand for it if the American Bar Association told them to intentionally lose cases……

Unfortunately, the story does not end there.  There is something even darker involved, if that were possible.  Early during COVID-19 several people related how they had approached their primary care physician, sometimes one with whom they had a relationship for years.  They fearfully asked if they would contract COVID-19, would their physician prescribe hydroxychloroquine.  The answer from the “physician” was eerily the same: “I would sooner watch you die than prescribe that medication”.

One could perhaps understand (though I would never accept it!) an answer like: “I’d love to, but I’d lose my job here and I can’t do that. Sorry, but you know how that is”.  But this answer, and the fact it was repeated by several physicians, still sends a chill up my spine. “Sooner watch you die”???  Where did that come from?  

A Profound Rotting Evil has entered medicine.  Unless it is decisively and completely excised it will continue to destroy our profession.  We now have so-called medical ethicists who proclaim publicly that it is a moral duty to refuse care to individuals who are not “vaccinated” even though we now know vaccination does not prevent infection or transmission.  We have leaders in academic medicine who tell students that it is their moral duty to treat people differently based upon the color of their skin, ethnic background or their ideological perspective.  We have the widely reported case of the medical student who seemed to proclaim on social medial her satisfaction that a patient who did not share her zeal for preferred pronouns was forced to undergo additional pain. Is this not the seed of a later “I’d sooner watch you die…”?  Unfortunately, the complete eradication of  this Profound Rotting Evil will most likely take years and a complete reform of healthcare education.

We do not, and never had, a “pandemic of the unvaccinated”.  What we did have, and continue to have, is a florid pandemic of the morally bankrupt and it may be far, far more dangerous than COVID-19……...