Medications are not well understood
Modern medications are still commonly derived from natural sources, as it is usually cheaper than synthesising from scratch. Opioid medications are still produced from poppy seeds, blood pressure medication from a species of milkweed, and laxatives from senna. Some medicines have been developed through building on thousands of years of discoveries, and others by happy accident. Some medicines have a well-understood mechanism in the body, but a surprisingly majority are still a mystery. That may seem strange, but according to the drug review boards, the study only has to show effectiveness and side effects, not a mechanism of action. This explains why a drug could work for one person and not another. If you add in the fact that we still can’t account for most of the differences between patients, our stab in the dark approach to disease treatment starts making sense.
Doctors cannot know everything
When a doctor is faced with a patient who is suffering, they must rely on their medical training to guide their actions. Every doctor is expected to know a vast array of information about human physiology, as well as stay up to date with the latest research. This is particularly challenging for overworked GPs, who couldn’t possibly hope to research every new development in every new condition alongside their daily clinic. Therefore, doctors must have faith in the work of scientists and the peer-review process to provide them with clear directions regarding which drugs to use. If a doctor were to question everything they are told, it would be impossible practice as a doctor due to the depth of research that would be required.
The best a GP can do is defer to specialists when they think it is necessary. How does a doctor decide which specialist to send their patient to? Well, if the patient has a complaint with their head, choose a neurologist. If it’s their throat, an ENT. For the stomach, a gastroenterologist. The skin, a dermatologist. Name a body part, there’s a specialist. So what happens when you sit in front of your GP and list a dozen symptoms? The recommendation is often a visit to a psychologist, psychiatric medications, and a diagnosis of hypochondriac or somatisation disorder.
A specialist approach, not a holistic approach
There is a disconnect between the understanding of disease. The common approach is to consider each body part sick with a unique illness that has been studied to the exclusion of all else. This thinking allows the unspoken assumption “a person should only get sick with one or two illnesses at once” to permeate. This does make intuitive sense, but the scope of ‘illness’ has become too myopic in the ecosystem of specialists. Dizziness could be diagnosed as ‘benign paroxysmal positional vertigo’ by a neurologist, ‘orthostatic hypotension’ by an endocrinologist, or ‘fibromyalgia’ by a rheumatologist. I know this, because these were my diagnoses. The specialists are not trained to account for additional symptoms outside their speciality. It is uncommon for a specialist to do a full symptom assessment, as this is considered irrelevant to the condition the patient was referred with.
The outcome of this unfortunate constellation is a patient with a laundry list of seemingly disconnected illnesses, a medication to treat the symptoms of each, plus some more for the side effects, but no cure. The worst outcome is a patient who is relegated to live with a broken and painful body, with no support from anyone, as they are labelled an attention-seeking malingerer. This convenient excuse allows carers to unburden themselves from the painful thought that these people are really suffering, and they are powerless to do something to help. The incidence of real malingering has never been proven, and given the prevalence of mysterious chronic whole-body illnesses is growing across the globe, there must be unifying factors present.
Why studies often fail to provide real answers
It is clear to anyone of moderate intelligence that scientific studies vary in quality and reliability. Most people also understand that an industry funded study is more likely to favour the industry funding it. Those who have spent some time reading studies will know how authors can amplify certain data, and downplay rest, if they feel pressure to support a hypothesis due to funding, institutional or personal beliefs. When discussed theoretically, these are rather pedestrian truths about the reality of fallible humans doing science.
Yet, because of the necessity of daily functioning, doctors and other specialists must work on the premise that their medical knowledge is correct, and guidelines given to them ‘from above’ must have undergone rigorous scrutiny before hitting their desk. An assumption that is reasonable, and based on the idea that if they were in the position of writing such guidelines, they would ensure that the science is sound, therefore the selected experts must be equally diligent, if not more-so. But we know that, unfortunately, this is not how the world works.
Doctors feel trapped too
This leaves doctors giving medications that manage symptoms instead of treating the cause, medications that have little effect or even hasten decline. This is not why doctors dedicated their lives to the profession. They get up and go to work every day because they want to help improve the lives of sick people, but they only have a few hammers to pound on everything with. This leaves doctors emotionally drained, with compassion fatigue, as an endless parade of people of every demographic come through their doors with ever-worsening health.
Most doctors would like to have treatments that actually cure their patients of their suffering, but within the paradigm of allopathic medicine, it is impossible. Their education focused soley on the management of disease with medications, and thus they have little understanding of the underlying causal mechanisms. Those who have performed independent research are still unable to use such knowledge to help their patients, as strict rules require them to only recommend approved treatments. For example, if they recommend a dietary intervention that is contrary to the current carbohydrate food pyramid, they must first explain the official diet guidelines, then carefully word their own suggestions so as not to invite potential legal action. This leaves doctors in a difficult position; risk their careers to help their patients, or give advice that they know is causing health problems.
This is why so many sick people have turned to the Internet for help, as this is where they can access the knowledge they need to heal. They may need to try many things before finding the answer, but if they are earnest in their search, and honest about how they feel in response to their trials, they can be healed.