I gave a talk about the new weight loss drug Ozempic, largely pointing out the many dangers and pitfalls that occur when you medicalize weight loss rather than confront it holistically through diet, behavior change, and exercise. After the talk, someone in the audience told a patient of mine: He was pretty harsh about that drug, but it saved my life. My doctor said I’d be dead if I hadn’t gotten on it, and he put me on it just in the nick of time!
Now, under no reality can Ozempic save anyone’s life. It’s just not possible; in fact, you’re lucky if it doesn’t paralyze your bowel, destroy your muscles, and turn you into a perpetually hungry eating machine. And frankly, there is hardly a medicine, test, procedure, or medical intervention done outside of the realm of medical emergencies (acute heart attack, auto accident, ruptured appendix, sepsis, ect) that allows us as doctors to claim we have saved your life. In areas of the world that have limited access to doctors, and who take virtually no medicines and have virtually no tests or medical procedures, they live far longer than we do without so much chronic illness. And yet, our medical community—and especially our doctors—incessantly claim to be saving your life, just in the nick of time, even though we are sicker and live shorter lives than most people in the world.
A few of the most common examples are in order, statements made by patients:
• They told me not to get a mammogram because I’m too old, but I got one anyway and lo and behold, there was cancer there. And so, thank God, my doctor cured me, just in the nick of time, or I’d be dead right now!
• My primary care doctor questioned the need for a PSA blood test for prostate cancer, but I said, get it anyway, and you know what, it was high and thankfully a thorough urologist took it seriously and found cancer. He said a few more months without treatment and I’d be dead. So I got that prostate out, got radiation and hormones, and now my cancer is gone and my PSA unmeasurable. Sure I have problems from the treatment, but at least I’m alive!
• I went to my cardiologist just for a checkup, I was feeling fine but just to be safe he did a nuclear stress test which he could do right in his office. And guess what, it was abnormal. So I got a catheter that showed a 90% blockage, and they shipped me to the university and put in a stent, just in the nick of time. He said I was a time bomb and would have died any day had I not had that stress test. Thank God for thorough doctors!
• My primary doctor didn’t take my diabetes seriously and thought that keeping the A1C under 9 was enough, and he talked more about exercise and diet than real treatment. Thankfully my daughter had me see an endocrinologist who said if I kept up the same inadequate treatment I’d be on dialysis and likely lose my legs within the year. She had me check my sugars three times a day, put me on two medicines and a statin medicine, sent me to a cardiologist and kidney doctor who gave me more lifesaving medicines, and now I am thank God safe, not feeling great, but my life was saved, just in the nick of time!
Honestly, I can go on and on. So many of my patients have had their lives saved, usually just in the nick of time, by “thorough” and “caring” doctors who measure and fix abnormalities, load them with medicines, increase their medical surveillance including having them see more and more specialists and getting more and more tests, and convince them that they are sick and on the verge of death unless they dive into the medical abyss that they assure them is necessary and lifesaving. Doctors like to be heroes, and there is no easier way to play the role of superhero than to find abnormal numbers, equate those numbers to a dreadful disease, and then provide number-fixing treatment that is associated with lifesaving feats, usually couched as being done just on the brink of their medical demise.
And yet, with all this heroic bravado, all this measuring and number fixing, all these specialist visits and medicine overload, we are sicker, we’re suffering from more chronic disease, and we’re dying sooner. Where is the common sense in all of this? If these interventions are so lifesaving, why are people who don’t go down that road overall healthier? Part of the reason is that the numerical diseases discovered by inappropriate testing are not as harmful as doctors preach; in fact, they may be perfectly normal or even necessary. And the other reason is that all this testing, all these interventions, themselves have adverse implications. Cancer treatment, polypharmacy—too many drugs—and stents all cause severe bodily harm. They may fix numbers, they may create an illusion of cure, but science weaves a different yarn than the heroic declarations of deceptive doctors.
Let’s look at these few examples. Elderly women (over 75) who are discovered to have a breast cancer and undergo treatment don’t live a day longer than people who don’t get treatment; all they get are the side effects of the treatment and a knowledge that the cancer is gone. Most such cancers either are dormant or resolve on their own, and those that will kill you are going to do that regardless of treatment. This has been so well established that it is part of our protocols; we even know that simply getting a mammogram after age 75 increases a woman’s risk of dying. Finding a cancer isn’t lifesaving; it only exposes women to unnecessary drugs, surgery, and stress, all of which diminish her quality of life and her longevity. PSA’s can find prostate cancers, but treating that cancer isn’t going to help you. Long-term studies of men with prostate cancer show that the death rate is between 1-3% after 10-15 years of followup, and all the lifesaving treatment with toxic drugs, hormones, surgery, and radiation does not improve outcome; these only make men sick and lower their PSA, without helping them live a day longer. They get sicker but still die at the same rate as nontreated people, the only benefit of treatment being a diminution of their PSA number. Merely getting a PSA is a risk factor for living shorter lives. As far as finding a blockage in a heart blood vessel in a person without symptoms, that science is as clear as day. It doesn’t help. Yes, it may seem like opening a blocked artery will save lives, but every single study shows otherwise. In fact, the risks of catheterizations and stents far exceeds any benefit; people who go down this road have more strokes, bleeding, and higher death rates than people who never walked into the cardiology office. Sure, they may have no more blockage after their lifesaving stent, but they are at much higher risk because of it. And tight control of both diabetes and hypertension—driving down sugars and blood pressure and seeing an army of specialists to fix every possible abnormality—leads to higher death rates, more kidney disease, more strokes, and a general feeling of being sick. Again, numbers look better, patients feel and do worse. This is a common theme that can take up an entire book. In fact, I wrote more than one book about this (as have many others), including my newest one A Return to Healing.
Maybe doctors should just wear capes and swoop down just in the nick of time to test and treat everyone with their magical potions. They’ll tell you they saved you regardless of the science. It makes them feel better, it makes them richer, and ironically it makes you feel better. It’s nice to have your life saved, especially if you were on the brink of death and didn’t even know it. And look, your numbers are better, so how can anyone argue with the results!
Too much of our health care expenditure is squandered on these lifesaving interventions that don’t work. Insurance barely pays for diet, for mental health services, for rehab and family care, for caregiver support, for exercise programs, and for anything that actually helps people live longer and better. Doctors and the system thrive on making people feel sick and purporting to save their lives with draconian interventions. If they were well, if their doctors treated them as people instead of their numbers, then how could those doctors make so much money, how could anyone?
Some people estimate that up to 40% of our healthcare dollars are paid for useless interventions that are wrapped in a nice bow and sold to patients as thorough and caring treatments; that’s about $2 trillion a year. Imagine what we could do with that kind of money? We could provide universal healthcare, we could end food deserts, we could enhance lifestyle programs. But those “soft” interventions don’t pay the bills of people who have learned how to feast at the healthcare buffet. And so doctors give lip service to them without giving them much credence. Even a doctor whose lecture I recently attended who is gung-ho about lifestyle changes used numerical improvements to show the benefit of diet and exercise. We are so stuck in this deceptive mud pit of believing that we are just a series of measurements that need to be fixed that even we believe the logic of number fixing. Even if science has shown it to be deceptive and dangerous.
So, no, it’s very unlikely your doctor saved your life just in the nick of time. In fact, it’s more likely she hurt you, maimed you, and deceived you. Our medical system, designed to use science to replace the quackery of the olden days, has only replaced one form of quackery for another, similarly shoving science and patient care in the trashcan. Don’t be fooled by this rhetoric. It will cause you to make decisions that are not best for you. Always question everything; it’s your body and you have a right to be a skeptic. If a doctor is turned off by your questions, then it’s the wrong doctor. And if the doctor insists that your numbers and fabricated diseases must be treated or you will die (or lose a leg or get a stroke) tomorrow, that’s also not the right doctor. We live in an era where healthcare has taken on a religious tinge. Doctors act as priests who use their authority to frighten patients by quoting bogus statistics and touting their expert status. Patients are willing to follow the gospel and praise the numerical-fixing success of the liturgy because they trust their doctor and they don’t want to die. If you want to be healthy, and if we want a functional and universal healthcare system, we must eschew such nonsense. You want your life saved? You know what to do. And it’s not a bunch of medicines and tests and doctor visits and procedures. It’s right in your cupboard where the food is, right in the gym, right in the yoga studio, right in the friendships you make. Living a healthy life doesn’t require you to be scared and to sacrifice your body in the name of numerical improvements and dangerous fearmongering. Sure, diet and exercise won’t save your life just in the nick of time, but it will save your life, it will make you feel better and have less chronic disease, it’s cheap and effective, even if it doesn’t result in perfect numbers.
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