Iatrogenesis

This, by my standards, is a rather long post.

Iatrogenesis, for me, is a new word. I had never heard of it before. Apparently it from the Greek for "brought forth by the healer" and refers to (quote), “any effect on a person, resulting from any activity of one or more persons acting as healthcare professionals or promoting products or services as beneficial to health, that does not support a goal of the person affected”.

This is a rather long-winded way of saying that a medical professional, instead of doing “no harm”, is actually causing harm.

The fact that word “Iatrogenesis” even exists gives cause for concern and gets me on my “high horse”, again! This is particularly so in relation to mental health.

NOTE - In case you were unaware:-
Common adverse effects of antidepressant medications include headache, nausea, agitation, sedation, sexual dysfunction, cognitive changes, weight gain, and metabolic abnormalities.

Rarer, more serious adverse events include cardiac, neurologic, and hepatic effects. Possible increased risk of suicidality is also an issue in certain patient populations.

In this regard there is quite surprising information in the 2012 report of the Australian National Mental Health Commission. According to this report:

“…. there is little or no accountability as to what improvements we are getting for such a significant investment, whether it improves the health and wellbeing of people with a

mental illness and provides them with the services they need.

Most Australians may not know that treatments with prescribed psychiatric drugs may lead to worse physical health. There are increased risks for some specific treatments such as antipsychotics and for those with underlying vulnerabilities such as diabetes. This can mean that the antipsychotic medications that are prescribed to manage severe mental illnesses such as schizophrenia, contribute to the risk of having severe physical illnesses.”

Interesting. I wonder why this information is not widely disseminated?

If, as many mental health professionals assert, mental disorders are genetic in origin it is interesting to note the curiously plaintive comment made by David Kupfer, MD, Chair of Diagnostic and Statistical Manual, version 5 (DSM 5) Task Force, in the American Psychological Association (APA) press release No. 13-33, dated 3^rd May 2013 wherein he stated:

“The promise of the science of mental disorders is great. In the future, we hope to be able to identify disorders using biological and genetic markers that provide precise diagnoses that can be delivered with complete reliability and validity. Yet this promise, which we have anticipated since the 1970s, remains disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”

In all this the human brain remains a 1.4 kilogram (3 pound) lump of grey matter, alive but without any sense of touch (it has no pain receptors).

Now I fully appreciate that, often, with mental health, “the facts are uncertain, values are in dispute, stakes are high and decisions are urgent”. In such circumstances it is difficult to resist the temptation to cherry pick data to suit whatever popular theory is being promoted at the time.

Mental health, however, cannot ever be “cured” by drugs alone – in fact antipsychotic and antidepressant drugs are not as effective as “big Pharma” would like us to believe.  I read somewhere (source unknown) that one can hardly prescribe drugs without knowing what is wrong with the patient - and that requires the delivery of a diagnosis – but diagnosing problems in mental health is fraught. There is currently no way – repeat no way – to accurately diagnose a mental health “problem” – apart from Alzheimer’s disease.

The reasons for relying on drugs is an important question that is more often than not ducked by “Health Professionals” and left unanswered. There is, however, a great deal of information available, that is both alarming and illuminating, if one is prepared to dig around.

My point is IF (and it is a big if) these drugs - which have been around in one form or another for over fifty years - are so effective, and if the percentage of people with mental health issues has remained constant for years, at (so we are told) about 1 person in 5, why then is the use of these drugs increasing – not just in Australia, but worldwide?

The medicines, the pharmaceutical drugs that have been developed for use in situations when a person’s mind is deemed to be unhinged or they are behaving in a manner considered to be “abnormal”, work up to a point, to maybe calm the patient. But no one (psychiatrists, psychologists, neuroscientists, pharmacologists et al) knows WHY or HOW they work.

Using the same methods over and over again expecting different results each time is not very clever – in fact I believe this is an indication of some mental problem! Following the same course of action – prescribing medications that cause problems that further application of more powerful medications cannot alleviate is, also, not very clever. And yet this is the current approach to mental health!!!

So there!!!

It has been admirably stated by others that, “If you talk to God you are praying. If God talks to you, you are schizophrenic.”

Consider Moses (Exodus 3.2) - he heard the voice of the Lord coming from a burning bush but no one thinks that’s odd. Now if I presented myself to a medical professional and said that I heard the voice of the Lord coming from a burning bush I know that I would be diagnosed as schizophrenic and immediately medicated!!

A “mental illness” may affect a person’s behaviour - something that they DO.  How can anyone, except the person concerned, determine if such behaviour is “wrong” or “abnormal”? To my knowledge there is no universally accepted definition of “normal” – what is “normal” for me may not necessarily be “normal” for you.  Is it not conceivable that certain behaviours  may be considered eccentric? Surely there are enough “odd-ball” and eccentric people in the broader community to allow for the odd extremes without hospitalising and forcing pharmaceutical drugs on them against their will.

Fixed name diseases – a patient “is” psychotic; or “is” schizophrenic. Whereas another patient may “be a” diabetic; or may “have” breast cancer. Note the difference – the patient is not “breast cancer”. At least with cancers and diabetes there is a physiological condition – something that may be confirmed with a biopsy, a blood test or by other medical means.

What chemical, hormonal or neurological predisposition is there for psychosis, schizophrenia or depression? There are none. That people do suffer from mental problems is indisputable – but what is the cause? And what is the “best” remedy? Is there a “remedy”? If so, why and how would the remedy “work”?

Is it not possible that any and all “mental problems” are the result of the sufferer’s retreat from a perceived threat; a shutting down of “normal” reactions and defence mechanisms; an overwhelmed emotional system; the result of some “unconscious” fear?

More drugs are not the answer!

Tread softly – on the Planet

I came across a (not so) curious fact the other day.

A cotton handkerchief can be washed 520 times – (apparently, but who is counting?) - and needs about 165 litres (about 44 gallons) of water to manufacture. Think of it – cotton requires a lot of water to grow, then once picked it must be processed into threads, dyed, then woven into cotton material (using water, chemicals and energy). But, and it is a big but, a handkerchief may be washed and re-used many, many times (apparently – as mentioned – 520 times).

Whereas, apparently, 1 paper tissue (one tissue) requires about 2.2.litres - (just short of 1 gallon) of water to manufacture. Think of it – trees chopped down (energy); timber pulped (energy and water); pulp needing to be bleached (chemicals and water); bleached pulp then processed into tissue paper.  Every stage of the process requires water, chemicals and energy.

I am aware of the convenience of paper tissues (for various purposes), I’ve used them for years, but they just add to the land-fill problem.  

Just look at the maths – 75 tissues (165/2.2) = 1 hanky. Multiply that by 520 and the figure arrived at is 39000 tissues needed to equal the life of one hanky. And that is a lot of water and a lot of trees. I know, I know, that water is needed to wash (520 times) the afore mentioned handkerchief – but it will be washed together with other items. Then there are the chemicals used and various forms of energy required during manufacture. Then there is the air pollution – for both. But even so I think there is no contest.

I still have quite a few handkerchiefs at the back of my socks (sorry “sox” for those readers in the US of A!!).

They are now being resurrected.

Quiet times

It is during times like these – frenetic and somewhat unnerving times – that I recall my youth and the support I received from my parents and other family members.

I know that I was a “war baby” – born during the Second World War, but I never experienced any of that violence, being too far removed from any front line. I was thinking about my emotional state and support. In this I believe I was very fortunate, more fortunate than many.

My parents were loving parents. They were highly intelligent, well-educated and literate people. It is from them that I learned about great literature, poetry and classical music and established a pattern of reading and listening to music that is with me still. For that I am very grateful.

They were gentle people.

This is a poem that, to me, says it all.

TWILIGHT

Twilight it is, and the far woods are dim, and the rooks

            cry and call.

Down in the valley the lamps, and the mist, and a star

            over all,

There by the rick, where they thresh, is the drone at an end,

Twilight it is, and I travel the road with my friend.

I think of the friends who are dead, who were dear long ago

            in the past,

Beautiful friends who are dead, though I know that death

            cannot last;

Friends with the beautiful eyes that the dust has defiled,

Beautiful souls who were gentle when I was a child.

                                                                                    John Masefield

Desiderata - a prose poem to touch the soul.

In today’s chaotic world there is (to me at least) a calming influence in words that touch the soul.

In 1927 the American poet, writer and attorney, Max Ehrmann (September 26, 1872 – September 9, 1945) from Terre Haute, Indiana, wrote the well known prose poem “Desiderata” (Latin for “things desired”). 

I here offer it to my one reader. Even if known, it is well worth another read:-

  

Desiderata.

“Go placidly amid the noise and the haste, and remember what peace there may be in silence. As far as possible, without surrender, be on good terms with all persons.

Speak your truth quietly and clearly; and listen to others, even the dull and the ignorant; they too have their story.

Avoid loud and aggressive persons; they are vexations to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time.

Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism.

Be yourself. Especially, do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment it is as perennial as the grass.

Take kindly the counsel of the years, gracefully surrendering the things of youth.

Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness.

Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here.

And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive Him to be. And whatever your labors and aspirations, in the noisy confusion of life, keep peace with your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.”

                                                                                    Max Ehrmann (1927)

An interesting "Time Line".

I discovered this list of “Definitive moments in Science” in a book called “Why Us” by the science author James Le Fanu.

I have amended it with a couple of very important events – not recorded in the original list (amended 11/09/17).

1940 – I was born!

1945 - The atomic bomb used in anger, for the first and only time, dropped on Japan.

1946 – The electron microscope reveals the internal structure of the cell.

1947 – The invention of the transistor launches the Electronic Age.

1953 – Theory of the formation of the chemical elements of life by nuclear fusion

within stars.

1953 – The laboratory simulation of the “origin of life”.

1953 – James Watson and Francis Crick discover the “Double Helix” of DNA.

1955 – The first polio vaccine.

1957 – The (then) Soviet Union launches Sputnik and the epoch of planetary exploration.

1960 – The oral contraceptive first marketed.

1961 – The genetic code deciphered.

1965 – The theory of the “Big Bang” creation of the Universe confirmed by the discovery of cosmic microwave background radiation.

1967 – The first heart transplant.

1969 – US astronaut Neil Armstrong becomes first man on the moon.

1969 – James Lovelock proposes theory of a life-sustaining atmosphere.

1973 – The advent of genetic engineering.

1973 – First ever call on a mobile (cell) phone.

1973 - The invention of Magnetic Resonance Imaging (MRI) of the brain.

1974 – The discovery of “Lucy”, Australopithecus afarensis, dated 4 million years ago, our earliest known humanoid ancestor.

1974 – The first Grand Unified Theory of particle physics.
1977 - The first personal computer designed for the mass market.

1977 – The first complete genetic sequence of an organism.

1979 – Voyagers I and II relay data from Jupiter, Saturn, Uranus and Neptune (and they are still going – now in deep interstellar space).

1979 – The first “test tube baby”.

1980 – The asteroid impact hypothesis for the mass extinction of dinosaurs.

1984 – The discovery of  “Turkana Boy”, the first complete skeleton of Homo erectus, dated 1.5 million years ago – the precursor of us, Homo sapiens.

1984 – Confirmation of the theory of “plate tectonics” – moving “plates” forming the continents.

1987 – Formulation of the “out of Africa” hypothesis of human evolution.

1989 – Launch of the World Wide Web (the internet).

1990 – The Decade of the Brain (the “plasticity” of the brain discovered – for example).

1999 – The Hubble space telescope observes the birth of stars, for the first time, in the constellation Taurus.

2000 – The first self-balancing, transport machine – the Segway Human Transporter.

2001 – Publication of the Human Genome.

2001 – Apple’s iPod invented.

2001 – Invention of the first “bio-artificial” liver – functioning in place of a liver.

2002 – The first birth control “patch” produced.

2003 – The world’s first battery/petrol “hybrid” car produced by Toyota.

2005 – YouTube invented.

2007 – Apple’s iPhone invented.

2007 – The first “fast radio burst” from interstellar space identified.

2010 – The Neanderthal Genome project completed showing interbreeding with ancient humans.

2015 – Traces of liquid water discovered on Mars.

2016 – Gravitational waves discovered for the first time from a “black hole “ merger”.

2017 – The first Earth-like planet which may have liquid water on its surface, located “just” 21 light                                                                                                                                                                          years away.

Pretty impressive, Huh! All since I was born!! Mmmm.