If you think there is an objective way to describe reality, health or illness, listen to these 3 part series to see that all of our reality is constructed with ideas wrapped in words. They change over time and space. /1
https://twitter.com/michelaccad/status/1318992781839273984
While listening think who has the ability or power to define what health or illness is. Who constructs knowledge? Whose knowledge matters?
Recently I moved from using the word health in my tweets because the word got corrupted. I opt for well(ness). /2
Recently I moved from using the word health in my tweets because the word got corrupted. I opt for well(ness). /2
Important underpinnings of the scientific method as it emerged in the 17th century had to do with Judeo-Christian idea of one god thus one truth existed; reality is objective and logical; people have ability to accurately perceive reality; all reality can be explained. /3
Some Trojan horses are still firmly implanted in scientific thought and medical practice - Aristotle’s idea that a female is a deformed male. /4
An interesting question raised in the talk - do you tell a person that you see an abnormality and do you treat it? Good discussion with examples. These decisions take place within legal context in the US and cultural context in many other countries. /5
Will telling a person he has something not obvious to him upset their order of life? This isn’t much of a question in the US context because doctors view themselves as people in whose power it is to fix what must be fixed. /6
An example. A person in his 60’s lived with a severe “untreated” congenital heart defect. At birth prognosis was immediate death, then by 1-3-5-puberty. At 14 this person decided to not go to doctors any more./7
He quit smoking early when all around smoked. Exercised. Walked to work in all weather. Never used elevators. Zero meds or any medical oversight. One summer a respiratory/GI virus cause prolonged worsening illness. /8
Cough got progressively worse. Then I noticed swelling in the legs. I knew it was in “heart failure”. Technically an emergency. Three month total after the virus with my slight suggestions the family went to a family doctor with my letter asking for min work up for CHF. /9
Upon presentation GP went into frenzy and called an ambulance which the family refused. “You are going to die” was the tactic but it wasn’t working because of childhood experience. Family got into their car and went to critical care unit. /10
When I arrived to review records, objective reality by four doctors resembled four gospels. An approximation of reality. Person was full code which was changed into DNR before I left. A fib and CHF were treated. Person went home and within a month was off all drugs. /11
The only drug still in use is digoxin albeit in sub therapeutic dose. Person is forced to f/u with GP and cardiologist by insurance. They must fill scripts because of some punitive measures against GP for non-compliance. /12
Of note, congenital heart defect is not the same as typical cardiovascular disease although symptomatically they present similarly. This person is otherwise healthy (BP, bloodwork). Tx algorithms are identical with poor research behind it. /13
Family also refused referral to cardio surgery. Of note doctors were more agitated and scared. than family about what was taking place. /14
Cardiologist when seeing the person immediately says “I see you don’t need me”. It’s been six years since the original issue. Had the person been “treated”, he would be poorer and sicker than now. /15
This type of scenario is only possible where people retain ability to care for themselves and view wellness and healing located within them not granted from the outside. /16
Two weeks ago two people in their early 70’s were sitting in my kitchen. One born to die with a visibly deformed chest from the heart defect but well and thriving because he abandoned medicine. Another born healthy but now tethered to an LVAD because he believed in medicine. /17
Different views of who is responsible for wellness and what causes disease led these people to make different decisions throughout life. Of note person with LVAD is afraid to die. Person living “a perilous life” without med supervision world rather be dead than “saved”. /18
A doctor in America today cannot take the liberty to treat a patient not as a machine. A parish doctor of the past shared common views on life and death with the patients he saw this was free to do as he deemed fit to reveal or conceal “reality”. /19
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