After a grueling fucking twenty minute conversation with my VA healthcare professional, a person whom I can barely understand much less say her name or even try to spell it, I made the choice to speak with her civilian counterpart in the sector of private medicine. I was solely looking for confirmation of the information I was given in regards to my diabetes and how the peripheral neuropathy in my feet is getting worse over time instead of better. I currently take Pregabalin (which is used to relieve neuropathic pain from damaged nerves that can occur in your arms, hands, fingers, legs, feet, or toes if you have diabetes. Pregabalin is in a class of medications called anticonvulsants. It works by decreasing the number of pain signals that are sent out by damaged nerves in the body.) after being prescribed two others which made me sick to my stomach and didn’t work for me personally. As of lately, the Pregabalin seems to have just stopped working with a considerable increase in the pain in my feet. I called for consultation to see if I had other options. But, as she read straight out of the “VA doctor to patient book of protocol bullshit”, she explained that this treatment prescribed by her IS working for me and any idea it isn’t working is just my imagination.
She don’t even know about my imagination first of all and I have spent less than fifteen minutes total in the three times I have been in her presence so how in the hell can she claim such bullshit. Yes, I understand they are busy doctoring and shit but the dirt under my fingernails has more bedside manner than she could ever hope to have. So, I phoned my civilian doctor, who tells me that no treatment is 100% foolproof and our bodies get nonreactive to most medication we take on a regular basis. No shit! How do I fix it? I hate the awkward silence that happens after an unexpected question or answer because I wonder if I crossed that all to visible line we’re never supposed to cross. Anyway. What my point? The conversation that I had with each doctor got me thinking about the below article I read not to long ago and I just wanted to explain WHY I was sharing it out of the blue like I am. It also made me think of the above sketch, because I do see doctors as “angels” and the serpents they battle within when confronted with doing the right thing or doing only how they are taught. No, I don’t think all doctors are quacks selling snake-oil remedies, but many get tied up in being a doctor before being a human being. I would love to hear your opinions if y’all don’t mind taking a minute.
Why Health Professionals Become Quacks
William T. Jarvis, Ph.D.
It is especially disappointing when an individual trained in the health sciences turns to promoting quackery. Friends and colleagues often wonder how this can happen. Some reasons appear to be:
Boredom
Daily practice can become humdrum. Pseudoscientific ideas can be exciting. The late Carl Sagan believed that the qualities that make pseudoscience appealing are the same that make scientific enterprises so fascinating. He said, “I make a distinction between those who perpetuate and promote borderline belief systems and those who accept them. The latter are often taken by the novelty of the systems, and the feeling of insight and grandeur they provide” [1] Sagan lamented the fact that so many are willing to settle for pseudoscience when true science offers so much to those willing to work at it.
Low professional esteem
Nonphysicians who don’t believe their professions is sufficiently appreciated sometimes compensate by making extravagant claims. Dental renegades have said “All diseases can be seen in a patient’s mouth.” Fringe podiatrists may claim to be able to judge health entirely by examining the feet. Iridologists point to the eye, chiropractors the spine, auriculotherapists the ear, Registered Nurses an alleged “human energy field,” and so on. Even physicians are not immune from raising their personal status by pretension. By claiming to cure cancer or to reverse heart disease without bypass surgery, general physicians can elevate themselves above the highly trained specialists in oncology or cardiology. By claiming to heal diseases that doctors cannot, faith healers advance above physicians on the social status chart (physicians are normally at the top of the chart while preachers have been slipping in modern times). Psychologists, physicians, actors, or others who become health gurus often become darlings of the popular press.
Paranormal tendencies
Many health systems are actually hygienic religions with deeply-held, emotionally significant beliefs about the nature of reality, salvation, and proper lifestyles. Vegetarianism, chiropractic, naturopathy, homeopathy, energy medicine, therapeutic touch, crystal healing, and many more are rooted in vitalism, which has been defined as “a doctrine that the functions of a living organism are due to a vital principle [“life force”] distinct from physicochemical forces” and “the theory that biological activities are directed by a supernatural force.” [2,3] Vitalists are not just nonscientific, they are antiscientific because they abhor the reductionism, materialism, and mechanistic causal processes of science. They prefer subjective experience to objective testing, and place intuitiveness above reason and logic. Vitalism is linked to the concept of an immortal human soul, which also links it to religious ideologies [4].
Paranoid mental state
Some people are prone to seeing conspiracies everywhere. Such people may readily believe that fluoridation is a conspiracy to poison America, that AIDS was invented and spread to destroy Africans or homosexuals, and that organized medicine is withholding the cure for cancer. Whereas individuals who complain about conspiracies directed toward themselves are likely to be regarded as mentally ill, those who perceive them as directed against a nation, culture, or way of life may seem more rational. Perceiving their political passions are unselfish and patriotic intensifies their feelings of righteousness and moral indignation [5]. Many such people belong to the world of American fascism, Holocaust deniers, tax rebels, the radical militia movement, and other anti-government extremists who would eliminate the FDA and other regulatory agencies that help protect consumers from health fraud. Liberty Lobby’s newspaper The Spotlight champions such causes and also promotes quack cancer cures and attacks fluoridation.
Reality shock
Everyone is vulnerable to death anxiety. Health personnel who regularly deal with terminally ill patients must make psychological adjustments. Some are simply not up to it. Investigation of quack cancer clinics have found physicians, nurses, and others who became disillusioned with standard care because of the harsh realities of the side effects or acknowledged limitations of proven therapies.
Beliefs encroachment
Science is limited to dealing with observable, measurable, and repeatable phenomena. Beliefs that transcend science fall into the realms of philosophy and religion. Some people allow such beliefs to encroach upon their practices. While one may exercise religious or philosophical values of compassion, generosity, mercy and integrity (which is the foundation of the scientific method’s search for objective truth), it is not appropriate for a health professional to permit metaphysical (supernatural) notions to displace or distort scientific diagnostic, prescriptive or therapeutic procedures. Individuals who wish to work in the area of religious belief should pursue a different career.
The profit motive
Quackery can be extremely lucrative. Claiming to have a “better mousetrap” can cause the world to beat a path to one’s door. Greed can motivate entrepreneurial practitioners to set ethical principles aside.
The prophet motive
Just as Old Testament prophets called for conversion and repentance, doctors have to “convert” patients away from smoking, obesity, stress, alcohol and other indulgences [6]. As prognosticators, doctors foretell what is going to happen if patients don’t change their way of life. The prophet role provides power over people. Some doctors consciously avoid it. They encourage patients to be self-reliant rather than dependent, but in doing so they may fail to meet important emotional needs. Quacks, on the other hand, revel in, encourage, and exploit this power. Egomania is commonly found among quacks. They enjoy the adulation and discipleship their pretense of superiority evokes.
Psychopathic tendencies
Studies of the psychopathic personality provide insight into the psychodynamics of quackery. Dr. Robert Hare who investigated for more than twenty years, states, “You find psychopaths in all professions. . . the shyster lawyer, the physician always on the verge of losing his license, the businessman with a string of deals where his partners always lost out.” [7] Hare describes psychopaths as lacking a capacity to feel compassion or pangs of conscience, and as exhibiting glibness, superficial charm, grandiosity, pathological lying, conning/manipulative behavior, lack of guilt, proneness to boredom, lack of empathy, and other traits often seen in quacks. According to Hare, such people suffer from a cognitive defect that prevents them from experiencing sympathy or remorse.
The conversion phenomenon
The “brainwashing” that North Koreans used on American prisoners of war involved stress to the point that it produced protective inhibition and dysfunction. In some cases, positive conditioning causes the victim to love what he had previously hated, and vice-versa; and in other cases, the brain stops computing critically the impressions received. Many individuals who become quacks undergo a midlife crisis, painful divorce, life-threatening disease, or another severely stressful experience. The conversion theory is supported by a study of why physicians had taken up “holistic” practices. By far the greatest reason given (51.7%) was “spiritual or religious experiences.” [8]
Many people ”including far too many health professionals, law enforcement officials, and judges’ exhibit a cavalier attitude toward quackery. Although most reject the idea that quackery is “worth a try” for a sick person [9], it is important to reinforce and mobilize those who understand quackery’s harmful potential.
References
Reid WH and others. Unmasking the Psychopath. New York: W.W. Norton and Company, 1986.Webster’s New Collegiate Dictionary.Dorland’s Illustrated Medical Dictionary, 25th Edition. Philadelphia: WB Saunders Co. 1974.Sarton G. A History of Science, Volume I. New York: W.W. Norton & Company, 1952, p.497.Hofstadter R. The Paranoid Style in American Politics and Other Essays. New York: Alfred A. Knopf, 1966.Dominian J. Doctor as prophet. British Medical Journal 287:1925-1927, 1983.Goleman D. Brain defect tied to utter amorality of the psychopath. The New York Times, July 7, 1987.Goldstein MS, Jaffe DT, Sutherland C. Physicians at a holistic medical conference: Who and why?” Health Values 10:3-13, Sept/Oct 1986.Morris LA, Gregory J D, Klimberg R. Focusing an advertising campaign to combat medical quackery. Journal of Pharmaceutical Marketing and Management 2:(1):83-96, 1987.
About the Author
William Jarvis, Ph.D, is a retired professor of public health and preventive medicine at the Loma Linda University School of Medicine. Jarvis is founder and president of the National Council Against Health Care Fraud and is co-author of a textbook, Consumer Health: A Guide to Intelligent Decisions, 7th Edition.
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