Every week it seems there is a new research report claiming that this or that works. It's confusing. But at least we thought that research was pure.
This excellent report from the Washington Post suggests that we must be more critical about how medical research is done.
Take the case of Avandia - a drug to help diabetes.
"Whether these ties altered the report on Avandia may be impossible for readers to know. But while sorting through the data from more than 4,000 patients, the investigators missed hints of a danger that, when fully realized four years later, would lead to Avandia’s virtual disappearance from the United States:
The drug raised the risk of heart attacks.
A Food and Drug Administration scientist later estimated that the drug had been associated with 83,000 heart attacks and deaths."
The report sheds light on the many conflicts of interest today in so called medical research.
Why is this? Is it just greed? I don't think so. I think that the answer is that we have the wrong model for healthcare. It has a mechanistic worldview that cannot cope with the complex world of health today.
Most of medical research today is done is the context of finding a "Pill for each ill". Each part of the body is seen as separate. Each illness is seen as separate. Most of us believe this too. We Run for the Cure, we buy daffodils for Heart and Stroke. We all want a pill to stop us from getting fat. And the entire medical establishment makes its money because of this belief. They sell pills, tests and procedures. They do not sell health. Healthcare is a transaction business based on a mechanistic view of reality that is as off base as thinking that the world is flat.
It would appear to the naked eye that the world is flat. But now we know that it isn't. It might appear that each disease and each part of the body are separate but of course they are not.
Our health is part of a complex system that includes not only each of us but all of us and all of the environments physical and social that we interact with today and for millions of years in the past.
For instance our gut is not just an organ but it is an ecosystem.
Here is a snip from this excellent article in the Economist
"A healthy adult human harbours some 100 trillion bacteria in his gut alone. That is ten times as many bacterial cells as he has cells descended from the sperm and egg of his parents. These bugs, moreover, are diverse. Egg and sperm provide about 23,000 different genes. The microbiome, as the body’s commensal bacteria are collectively known, is reckoned to have around 3m. Admittedly, many of those millions are variations on common themes, but equally many are not, and even the number of those that are adds something to the body’s genetic mix.
And it really is a system, for evolution has aligned the interests of host and bugs. In exchange for raw materials and shelter the microbes that live in and on people feed and protect their hosts, and are thus integral to that host’s well-being. Neither wishes the other harm. In bad times, though, this alignment of interest can break down. Then, the microbiome may misbehave in ways which cause disease.
That bacteria can cause disease is no revelation. But the diseases in question are. Often, they are not acute infections of the sort 20th-century medicine has been so good at dealing with (and which have coloured doctors’ views of bacteria in ways that have made medical science slow to appreciate the richness and relevance of people’s microbial ecosystems). They are, rather, the chronic illnesses that are now, at least in the rich world, the main focus of medical attention. For, from obesity and diabetes, via heart disease, asthma and multiple sclerosis, to neurological conditions such as autism, the microbiome seems to play a crucial role."
THIS is the kind of research that makes sense. It is not based on trying to find a silver bullet that can be sold. It is looking at the total ecosystem that is how health really works. Humans have a massive internal and complex system that interacts with itself AND with everything outside both social and physical AND with all that has shaped us in the past NOT just in our own life but for millions of year prior.
We are not machines.
The revolution in medicine that I will describe in my next book - You Don't Need Medicine - To Get Healthy - will describe how this systems perspective will overturn the mechanistic worldview that dominates medicine today.
Here is a glimpse of the thinking that will shatter the old system.
Dear Readers, It is time to start to think critically about medicine the same way that we are thinking about media and education.