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America's highway design has improved markedly since the 1950s, when many of the long-haul routes were merely two-lane roads. Most of the rural/farm-to-market roads between smaller towns still are two-lane asphalt. We are a trusting sort, hurtling down the road at 60 or 70 miles per hour, listening to the radio, talking on the cell phone, or just enjoying the scenery.
At a closure rate of 140 mph, two 2000-pound vehicles will compress easily into tortured piles of metal and plastic should they collide head on. Certainly you wouldn't be so careless as to drift across the centerline into opposing traffic. After all, you value your life, and you expect to enjoy your family for years to come.
But … what about the other guy? Is he cautious and considerate like you? Is she preoccupied because she just had a dispute with her husband or her boss? Is he a newly minted teen driver? Or perhaps a young adult is at the wheel, wanting to demonstrate his bravado to a new girlfriend? Worse, is she tipsy from just a little bit of alcohol – or a whole lot more – or stoned on marijuana or opiates? Something as simple as a phone call or text message being sent or received could evaporate the lives of two or more people, literally in the blink of an eye.
Some 30,000-plus Americans die in motor vehicle accidents each year. Head-on collisions that they certainly didn't expect account for only 2% of such tragedies – but they result in 10.1% of all fatal crashes. Each of these folks, innocent or not, have just taken a "five times" shortcut to their Final Judgment.
But the question remains – are you facing a more serious crash that virtually everyone is risking, some almost daily?
Clash of Values, Crashing Lives
Sadly, the clash of values in medical care can have consequences every bit as serious and with the finality of a head-on crash. We shake our heads, believing that the deadly motor vehicle accident was so avoidable, so unnecessary. But when friends and family suffer or die from modern conventional medical care (or surgery), we softly murmur to each other, forgivingly, "The doctors tried their very best, they did everything they could."
And often, that would be a lie. Perhaps a comforting one, but nevertheless a lie. Not a little white lie, not a slight twist on the truth, not an innocent or even deliberate misrepresentation. A lie.
Stay In Your Lane!
Physician training – medical school and residency/fellowship programs – are closely coordinated in the US. Curricular planning and escalating clinical responsibilities are designed to produce graduates with reasonably consistent skill sets and adequate judgment for patient care situations. Sadly, this regimentation also narrows the viewpoints of most new physicians, who obviously seek to gain favor and approval of their faculty or practice seniors.
One worrisome correlate is a uniform suspicion of technologies to which they were not exposed in their class work, clinical experiences, journals, or continuing education conferences. CME credits, controlled tightly by "AMA-types," are granted to groups and programs that meet ofttimes rigid criteria that discourage deviation from "the norm," only accrediting the topics from approved teaching and work experiences. Hospital "quality control/utilization review" investigations can be a powerful incentive for every physician to conform – or to come to heel if possibly stepping out. Membership on the medical staff or privileges granted for hospital activities can be imperiled as a more serious gradient. Another enforcement option: whether the insurance carrier will approve reimbursement for something different, something new, which brings to bear efforts of administrative officers or colleagues to discourage any "deviations."
Who's Holding Up Traffic?
Galen of Pergamon (129–ca. 200 AD, Greece), for all his observational and analytical skills, so dominated and influenced Western medical science that his teachings retarded advances in physiology for 1300 years. The scenario can be encapsulated as "See one, do one, teach only the same." Understanding the actual circulation of the blood in a circuit through the heart and to the brain and body and back would wait until William Harvey (royal Physician Extraordinary to James I and Physician in Ordinary to Charles I of England) boldly parted with tradition. In 1628 he rather easily demonstrated the correctness of his explanation. His detractors insured that his social prestige and professional stature suffered dearly and enduringly.
All too often now, local colleagues and professional organizations successfully suppress questions, research, or practices that could lead to more perfect understandings. When a questioning "transgressor" meanders too far astray of the "prevailing manifesto," senior staffers can always report such deviations to the state medical board to rein in performance that could disturb the status quo. Sadly, a clear majority of articles published in "indexed" medical publications (those 5300+ cataloged for computer searching [since 1966] in Medline/PubMed – out of 13,000+ biomedical journals worldwide) reinforce "the way to do things," as they are sponsored by major pharmaceutical companies with branded products to hawk and more than just a commercial bias as well. All in all, the profession does a respectable job of insuring that the same uninspired level of clinical care is offered by most every local physician, generalist, and specialist, both town and gown.
My Way or the Highway
In such an oppressive hospital, clinic, or office environment, how are recent advances to be integrated into the practice setting? Whenever journal articles or CME conferences introduce different approaches, they might slowly become adopted. Resistance, though, is often high, especially if the postulates appear at radical variance to standard practice, or if in-depth learning is required, or if a complicated and expensive technology must be employed. Only slowly does the cadre of practitioners become trained and skilled and then, of course, "Everyone knows that this is the way to do it." As the German philosopher Arthur Schopenhauer (1788–1860) succinctly noted: "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."1
Marked resistance flared against breast "lumpectomy" espoused by Harvard-educated Cleveland Clinic surgeon George Crile Jr., MD, from the 1950s until its reluctant adoption over 30 years later. He is said to have stated, "I came home from World War II convinced that operations in many fields of surgery were either too radical, or not even necessary. Universal acceptance of a procedure does not necessarily make it right."2
With the adoption of pretended "evidence-based" protocols, promulgation of "standards of care" by specialty societies, and "compliance documentation" by reimbursement-driven checklists embedded in electronic medical records, the regimentation in clinical practice ever more successfully ostracizes divergence from the "expert"-asseverated norms.
Heart Hospital – Next Exit
Two specialties that conspicuously reveal the head-on clash of values that needlessly costs lives and promotes suffering are the care of the leading killer in the US, heart and circulatory diseases, whether by medical or surgical means. Skilled physicians who venture into cardiovascular approaches that integrate "alternatives" into (or in place of) conventional care schema are often astounded at their new level of success in controlling or resolving complex problems. Since robust function of the heart and blood vessels is critical to survival and preservation of mental activities and physical capabilities, the comparison of treatment results is easy to demonstrate. Any dalliance into a different way of thinking and treating will bring swift and sure retaliation from their colleagues. Not much has changed in 40 years – even now, conventional physicians and regulatory medical boards foolishly discourage "changing lanes" to pursue honest inquiry, despite clear signals from state and federal courts:
The courts have rather uniformly recognized the patients' rights to receive medical care in accordance with their licensed physician's best judgment and the physician's rights to administer it as it may be derived therefrom. … In People v. Privitera, Cal.App., 141 Cal.Rptr. 764, 774 (1977), the court … stated that,
"To require prior State approval before advising prescribing administering a new treatment modality for an informed consenting patient is to suppress innovation by the person best qualified to make medical progress. The treating doctor, the clinician, is at the cutting edge of medical knowledge. To require the doctor to use only orthodox 'State sanctioned' methods of treatment under threat of criminal penalty for variance is to invite a repetition in California of the Soviet experience with Lysenkoism [false science accepted as real only because politicians endorsed and enforced it]. The mention of a requirement that licensed doctors must prescribe, treat, 'within State sanctioned alternatives' raises the spector [sic] of medical stagnation at the best, statism, paternalistic big brother at worst. It is by the alternatives to orthodoxy that medical progress has been made. A free, progressive society has an enormous stake in recognizing and protecting this right of the physician."3 (emphases added)
NB: Both Drs. Privitera and Evers have long been champions of chelation therapy and nutritional approaches to help those suffering with cardiovascular diseases – and they both weathered several attacks.
Sadly, the crash of such values, which doggedly discourage even a passing exploration into so-called "alternative" approaches, is directly responsible for mangling of bodies, untold suffering, and avoidable death on a daily basis.
Merge Now – Right to Your Bypass or Stent
Assessment and treatment of coronary artery disease is a senseless and bloody battlefield between conventional care and EDTA chelation therapy.4 Rather than adopting chelation, a nonsurgical technology, as complementary and contributing to survival and enhanced patient comfort, cardiologists and surgeons often resort to tacit intimidation. "You're a ticking time bomb, so we need to operate as soon as possible. We can do your operation this Thursday only because our scheduled patient didn't believe his condition was serious." This was a classic line, likely still used today. A study by the National Institutes of Health concluded that patients who resorted to chelation therapy (for removal of toxic metals and improved circulation) had less faith that conventional medications could prevent worsening of their heart disease, increase the quality of life, and give a feeling of control over heart disease.5 Of concern is that major heart bypass studies – from the 1970s and 1980s! – suggest a situation quite the opposite from that described by heart surgeons. The Veterans Administration Cooperative Study, US CASS study, and European CASS study demonstrated that having to endure the side effects and risks of bypass surgery is essential for survival only in about 16% of cases, especially those with left main or left anterior descending (LAD) obstruction.6-8 The remaining 84% of patients can expect to live on and thrive without operative intervention, often for many years.
Are surgical techniques and survival better now? Probably – and I hope so! In 1991, a study of 222 patients showed that bypass grafts gradually accumulated blocking plaque from the very first year, to where 75% of survivors showed "disease" at 10 years after surgery; only 17% of grafts were healthy at 10 years.9 A large Duke University study of coronary stents shows no increase in long-term patient survival.10
Harvard cardiologist Thomas Graboys, MD, reported his famous "Second Opinion" studies in the early 1990s: patients who had declined bypass (or even angiography with the prospect of stents) survived surprisingly well, generally better than those who chose operation.11,12 Technological improvements have helped to reduce the risks of death and major disabilities from operative procedures. Even now, the majority of patients resorting to medical (drug and diet) treatments can safely delay surgical interventions without increasing their risk for untimely death. Those who also choose to undergo chelation therapy might improve so much that they even defer the risks of surgery for years … and years. Given the number of "redo" bypasses or repeat placement of stents, is it odd that conventional specialists have ignored referring their patients to chelation therapy after recovering from successful lifesaving surgery for acute events?
The key to long-lasting relief from cardiovascular blockage, especially often fatal coronary artery obstructions, always involves a nutritional support approach, not just a simple dietary change along with surgery and drugs. Conventional physicians and surgeons seem to loiter in the fast lane at 35 or 40 miles per hour, preventing those who might want to find new roads from easily passing them by. The science, though, is clearly published in well-respected journals and alternative physicians pass along to patients these tactics with ease. While antioxidant approaches have long been valued, only in recent years has cardiovascular obstructive disease been characterized as a debilitating development from chronic ascorbic acid (vitamin C) deficiency – yes, scurvy.13
Your Ticket for Failure to Drive Safely
"My doctor is the very best." I sure hope so! Despite (sometimes deserved) broad criticism of the profession, most patients are trusting that their own personal physician is exceptional, that he or she really is competent, knowledgeable, and trustworthy.14 As one practitioner so keenly stated years ago, "You better find and trust the very best, because your cardiologist doesn't get buried in your casket." But … what if your doctor simply hasn't kept up with the latest advances in care? Or what if she never quite mastered the skill set required to treat complex problems (or even simpler ones) that you have? Or … what if he hasn't ever heard about or studied or understood effective alternative therapies such as chelation, oxygen, nutritional support, even appropriate dietary interventions? My friend and mentor Richard Brennan, MD, explained that professional attacks and crushing criticisms could be encapsulated by a quote from R. Stanton Avery, inventor of peel-off adhesive labels: "You're always down on what you're not up on."
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