I propose that there are three illusions driving healthcare policy today. I’m sure there are more (cue for you to add those that you want to suggest!) but I’ll focus on these three today:

1)      Life should be extended at all costs

2)      It is possible to conquer disease

3)      Evidence based medicine is real science

All seem reasonable at first sight but upon critical examination we see that they are the rationale for so much of what is worst about healthcare today.

Of course in dealing with the victims of physical trauma and accidents it is difficult to argue with point 1) and this is where modern medicine and modern medical technology in particular has scored its best results. However, turning our focus towards chronic and infectious disease we see that the picture starts to become foggier.

The “extend-life-at-all-cost” argument is a sound bite that assumes that the world is black and white whereas it’s many shades of grey. There comes a time for all of us to die and at the moment of death I doubt that anyone really considers the length of his/her life as more important than the quality of the days spent on this round ball of nature we call planet Earth.

It also assumes that each of us is an isolated phenomenon, whereas, cumulatively, the millions and billions of healthcare decisions made for every individual patient have a profound impact on the health of all of us, on nature, and on those generations to come.

I was told recently that medical schools have dropped the practice of requiring graduating students to take the Hippocratic Oath to “first do no harm”.  This is a pity because not only has this principle faithfully guided best medical practice for millennia but I think we should extend it to encompass society as a whole. As the poet Donne brilliantly pointed out, no man is an island. The interventions taken for every patient add up collectively to have serious consequences for us all.

The most obvious example of this is the over-use of antibiotics which I acknowledge is being slowly addressed although whether the same can be said for its application in intensive farming is doubtful. We continue to pay a heavy price for “cheap food.”

However, looking at the chronic diseases of the developed (and also now developing) world – cancer, heart disease, diabetes and dementia to mention but the four most obvious – we see billions if not trillions of dollars/euros etc… spent on keeping people alive.  Yes, if it was a member of my family I’d probably agree – extend life at all costs – but that’s missing the point. We should be focusing on true prevention rather than trying to throwing everything at cure or even early detection.

We need to strike a balance between accepting that some of us are going to die earlier than others and trying to postpone the inevitable, especially if the consequence of the latter results in a quality of life that is so poor that most of us would probably take the option of death rather than life.

The second illusion assumes that we can wage war on disease. Even a superficial analysis shows how ridiculous this concept is. Health and disease are relative terms. Everyone is to a degree both healthy and sick at the same time. It’s where you are along the scale towards death and/or an intolerable quality of life that determines whether we use the adjective “healthy” or “sick.”

But we buy into this concept of war and of course big business helps us ease into the delusion by supplying the chemical tools to fight the enemies: chemotherapy for cancer, statins for heart disease, antibiotics or vaccines for infectious disease (to mention but three). They map out the battle terrain by delineating the markers of the enemy (cancerous cells, cholesterol, bacteria, viruses, etc..).

We have neatly bought into the language of “good” and “bad” wherever the incongruities of this illusion need to be papered over. As a result there are blood tests for “good and bad” cholesterol or comprehensive stool tests for “good and bad” bacteria. What to do next when the results come back? Why, attack the bad guys of course.

No one seems to stop to question whether the “bad guys” aren’t just those parts of us that come to the fore in states where disease predominates. The 12 principles of natural medicine listed elsewhere on this web site are worth a second look. Not least of them is the primacy of the terrain over the minutiae of the disease state.

And what of the terrain? Well, it’s weakening all the time, because we’re so busy attacking the bad guys that we can’t see the damage done to the terrain, inside and outside the body. The decisions we make today will come back to haunt future generations. OK, pollution cannot be blamed solely on medicine but the latter plays a prominent role especially in introducing the iatrogenic toxins that pollute not only us but our children.

Yes, all chronic diseases share a small number of causative factors. Yes, most of them are preventable by lifestyle or treatable with intelligent medicine. There is no us and them, no war to wage, no enemy to kill. Disease is the other side of the physiological coin; the dark side made physical.

Last but not least is our infatuation with the new kid on the block, evidence based medicine (EBM). Who in the courtroom dares to argue with evidence? So who can argue with medicine based on evidence? Nobody, it seems, as everyone on all sides of the conventional versus alternative medicine divide clamber onto the EBM platform to tell us how his or her approach is “proven to work” and “better than everyone else’s”.

Nothing is more insidious than EBM. It is a distorted, cut-down, dumbed-down piece of the scientific process removed from the real thing and paraded before us all just like the wonderfully naked Emperor. This illusion frightens us all because it’s “scientific” and so we all stay quiet when confronted by the arguments that it makes for all manner of questionable treatments claimed as “proven” using the unimpeachable, evidence based medicine.

I have to confess, I admire the sheer brilliance of the lie. It’s a sales pitch worthy of any dodgy second hand car salesman. Whichever marketing professional first thought this one up was verging on Machiavellian genius. However, deep down we all know it is a lie. There’s an un-easiness about it all but the good doctors, the scientists, the governments and big business wave it in our faces like unquestionable proof. Oh for the wisdom of poor scholars like Churchill who could see through learned prattle by seeing the “lies, damned lies and statistics” for what they were.

What we need in medicine today is not more evidence based medicine or more technology but better philosophy. The medical revolution we need to bring to life is about software not hardware. I’m not talking about the machine code that drives programmes on computers but the depth of understanding in our minds – true wisdom rather than more knowledge.

Only by combining better philosophy and a dedication to real science can we be guided in this journey out of the nightmare we call chronic disease treatment.  Let’s begin by throwing these three illusions into the dustbin.