To see what none have seen before, you must look where none have looked before.
Dear Fiona Godlee,
Timely warning, thank you. Good that money is running out on the
modern “so called” health care where health of the well person is the
first casualty. One of my non-medical friends, Bala Shenoy, wrote
“Philosophies of Karl Marx, Malthus, Darwin and Newton are at work in the
boiling pot where humanity is evolving to face the rapidly changing
lifestyles due to technological advances and the greed of Investors.” This
has resulted in medicine becoming a business where the profits are more
than in any other business. Modern medical world has become a huge money
spinning business out of human misery. The swine ‘flu has been a blessing
in disguise to the plummeting stocks of many companies. Even the NHS does
not seem to have seen the writing on the wall is surprising.
Now that every one is in the red, thanks to the depression, it is
time to take stock of the past misdeeds and go forward for better model of
“health preservation” with the help of the wonderful human immune system
and lessen our focus and spending on the “disease model” as our primary
goal. How else can one explain what Jo Macfarlane of the Mail on line
(15th August) wrote about the new business of Swine ‘Flu vaccine being
released on the gullible public bypassing the safety net? “Swine flu jab
link to killer nerve disease: Leaked letter reveals concern of
neurologists over 25 deaths in America.”I am also told that in Australia
insurers have refused malpractice cover for doctors injecting this
untested vaccine! (1, 2)
The problem is with our scientific base of organ based disease
classification which has led to mushrooming of sub-specialties to the
detriment of holistic care of patients with chronic diseases.
Investigations refine the bed side diagnosis only by 8% but the spending
on investigations without making a bedside diagnosis runs into billions of
pounds every year in the UK and all over! Peabody was right when he said
in 1927 that “patient care is caring for the patient.” The latter needs a
multipronged approach and not the one based, as it is now, on the two
pillars of anatomic division based on the 450 year old Vesalius model and
the Mendalian genetic inheritance. Both need a change of approach. While
most, if not all, chronic diseases are not single organ based, they are
also controlled by a newer model of genetic predisposition. “First, human
diseases affecting a wide range of organs could result from systemic
defects in energy metabolism and, second, hereditary human diseases could
result from mutations in the non-Mendelian mtDNA. Consequently,
mitochondrial biology and genetics become excellent candidates for
expanding the anatomical and Mendelian paradigms to address the
complexities of the age-related diseases, ageing, and cancer.”(3)
All organs are made of cells which are basically the same functional
units that started as unicellular living organisms. They run this human
body, basically a self correcting system, which goes contrary to our
concept of quick-fixes based on the reductionist model. Let us examine how
we can use natural methods to get the damaged cells back to normalcy. The
ten thousand odd proteins (part of the soft ware) in each cell are
functionally better than our supercomputers. They have two energy systems-
the Low energy system and the High energy system. Initially, the proteins
process all the information they collect from the body as also the outside
world into a low energy information system which primes the other proteins
to a high energy functional system that could power the body as a whole.
In this milieu there are certain specific proteins that do the directing
or chaperoning job very effectively. One such chaperone protein is the
Heat Shock Protein, HSP 70. It is otherwise called Stress Responsive
Protein (SRP 70) as it responds to every kind of stress in the cells.
Others are Nitric Oxide synthase that runs all vessels as the EDRF along
with VEGF 165 gene protein which is angiogenetic, capable of growing new
vessels. (4)
Chemical drugs invariably damage the hard ware (mitochondrial system)
in the cell. (5) The cytosol soft ware needs the energy boosters while
the hard ware could make do with different kind of drugs that could
stimulate the encoded mitochondrial genes (mtDNA) in addition. When the
mutant mtDNA accumulates in ageing cells, they erode into the cellular
energy systems leading to decline in organ function, loss of cell numbers,
tissue failure, and ageing. Whereas mitochondrial damage is systemic,
clinical manifestations might be organ specific as some organs like the
retina, cochlea, some parts of the CNS, the heart, the muscles and the
kidney might suffer faster than the rest of the body parts. Some tissues
store energy in their fat and suffer less. Liver maintains energy
homeostasis maintaining the serum glucose level within acceptable limits.
(6)
Let us put our heads together to train a future breed of good
generalists that make a good clinical diagnosis and manage patients based
on that with minimum investigations. Sub–specialists could be roped in
only when the initial management strategy requires individual organ based
intervention to avoid a tunnel vision approach to illnesses. The treatment
must take the poor patient into confidence as a responsible partner to
know what s/he wants done. I am sure many old elderly would opt for
minimum intervention in place of the present attitude to do cosmetic CABG
even at the age of 90! Angioplasty and CABG are done for blocked epi-
cardial vessels and not to help the ischaemic myocardium that is fed by
the diminished coronary reserve of the millions of perforating vessels at
that age! Bulk of the health budget could go to run “wellness clinics” in
every hospital to educate and keep the well healthy which makes better
economic sense. These clinics could also get help from proven methods of
health protection from complementary systems.
3) Wallace D. C., mitochondrial genetics: A paradigm for aging and
degenerative diseases? Science 1992; 256: 628–632.
4) Gray, M. W., Burger G and Lang BF. Mitochondrial evolution. Science
1999; 283: 1476–1481
5) Fried S. Bitter Pills: Inside The Hazardous World of Legal Drugs.
Bantam Books, New York, 1998.
6) Michikawa Y, Mazzucchelli F, Bresolin N, G. Scarleto G and Attardi G,
Aging-dependent large accumulation of point mutations in the human mtDNA
control region for replication. Science 1999; 286: 774–779
Competing interests:
None declared
Competing interests:
No competing interests
30 August 2009
BM Hegde
Editor-in-Chief, Journal of the Science of Healing Outcomes
Rapid Response:
To see what none have seen before, you must look where none have looked before.
Dear Fiona Godlee,
Timely warning, thank you. Good that money is running out on the
modern “so called” health care where health of the well person is the
first casualty. One of my non-medical friends, Bala Shenoy, wrote
“Philosophies of Karl Marx, Malthus, Darwin and Newton are at work in the
boiling pot where humanity is evolving to face the rapidly changing
lifestyles due to technological advances and the greed of Investors.” This
has resulted in medicine becoming a business where the profits are more
than in any other business. Modern medical world has become a huge money
spinning business out of human misery. The swine ‘flu has been a blessing
in disguise to the plummeting stocks of many companies. Even the NHS does
not seem to have seen the writing on the wall is surprising.
Now that every one is in the red, thanks to the depression, it is
time to take stock of the past misdeeds and go forward for better model of
“health preservation” with the help of the wonderful human immune system
and lessen our focus and spending on the “disease model” as our primary
goal. How else can one explain what Jo Macfarlane of the Mail on line
(15th August) wrote about the new business of Swine ‘Flu vaccine being
released on the gullible public bypassing the safety net? “Swine flu jab
link to killer nerve disease: Leaked letter reveals concern of
neurologists over 25 deaths in America.”I am also told that in Australia
insurers have refused malpractice cover for doctors injecting this
untested vaccine! (1, 2)
The problem is with our scientific base of organ based disease
classification which has led to mushrooming of sub-specialties to the
detriment of holistic care of patients with chronic diseases.
Investigations refine the bed side diagnosis only by 8% but the spending
on investigations without making a bedside diagnosis runs into billions of
pounds every year in the UK and all over! Peabody was right when he said
in 1927 that “patient care is caring for the patient.” The latter needs a
multipronged approach and not the one based, as it is now, on the two
pillars of anatomic division based on the 450 year old Vesalius model and
the Mendalian genetic inheritance. Both need a change of approach. While
most, if not all, chronic diseases are not single organ based, they are
also controlled by a newer model of genetic predisposition. “First, human
diseases affecting a wide range of organs could result from systemic
defects in energy metabolism and, second, hereditary human diseases could
result from mutations in the non-Mendelian mtDNA. Consequently,
mitochondrial biology and genetics become excellent candidates for
expanding the anatomical and Mendelian paradigms to address the
complexities of the age-related diseases, ageing, and cancer.”(3)
All organs are made of cells which are basically the same functional
units that started as unicellular living organisms. They run this human
body, basically a self correcting system, which goes contrary to our
concept of quick-fixes based on the reductionist model. Let us examine how
we can use natural methods to get the damaged cells back to normalcy. The
ten thousand odd proteins (part of the soft ware) in each cell are
functionally better than our supercomputers. They have two energy systems-
the Low energy system and the High energy system. Initially, the proteins
process all the information they collect from the body as also the outside
world into a low energy information system which primes the other proteins
to a high energy functional system that could power the body as a whole.
In this milieu there are certain specific proteins that do the directing
or chaperoning job very effectively. One such chaperone protein is the
Heat Shock Protein, HSP 70. It is otherwise called Stress Responsive
Protein (SRP 70) as it responds to every kind of stress in the cells.
Others are Nitric Oxide synthase that runs all vessels as the EDRF along
with VEGF 165 gene protein which is angiogenetic, capable of growing new
vessels. (4)
Chemical drugs invariably damage the hard ware (mitochondrial system)
in the cell. (5) The cytosol soft ware needs the energy boosters while
the hard ware could make do with different kind of drugs that could
stimulate the encoded mitochondrial genes (mtDNA) in addition. When the
mutant mtDNA accumulates in ageing cells, they erode into the cellular
energy systems leading to decline in organ function, loss of cell numbers,
tissue failure, and ageing. Whereas mitochondrial damage is systemic,
clinical manifestations might be organ specific as some organs like the
retina, cochlea, some parts of the CNS, the heart, the muscles and the
kidney might suffer faster than the rest of the body parts. Some tissues
store energy in their fat and suffer less. Liver maintains energy
homeostasis maintaining the serum glucose level within acceptable limits.
(6)
Let us put our heads together to train a future breed of good
generalists that make a good clinical diagnosis and manage patients based
on that with minimum investigations. Sub–specialists could be roped in
only when the initial management strategy requires individual organ based
intervention to avoid a tunnel vision approach to illnesses. The treatment
must take the poor patient into confidence as a responsible partner to
know what s/he wants done. I am sure many old elderly would opt for
minimum intervention in place of the present attitude to do cosmetic CABG
even at the age of 90! Angioplasty and CABG are done for blocked epi-
cardial vessels and not to help the ischaemic myocardium that is fed by
the diminished coronary reserve of the millions of perforating vessels at
that age! Bulk of the health budget could go to run “wellness clinics” in
every hospital to educate and keep the well healthy which makes better
economic sense. These clinics could also get help from proven methods of
health protection from complementary systems.
Yours ever,
bmhegde
References:
1) http://www.theage.com.au/national/swine-flu-vaccine-program-in-
jeopardy-20090827-f16m.html
2) http://www.dailymail.co.uk/news/article-1206807/Swine-flu-jab-link-
killer-nerve-disease-Leaked-letter-reveals-concern-neurologists-25-deaths-
America.html
3) Wallace D. C., mitochondrial genetics: A paradigm for aging and
degenerative diseases? Science 1992; 256: 628–632.
4) Gray, M. W., Burger G and Lang BF. Mitochondrial evolution. Science
1999; 283: 1476–1481
5) Fried S. Bitter Pills: Inside The Hazardous World of Legal Drugs.
Bantam Books, New York, 1998.
6) Michikawa Y, Mazzucchelli F, Bresolin N, G. Scarleto G and Attardi G,
Aging-dependent large accumulation of point mutations in the human mtDNA
control region for replication. Science 1999; 286: 774–779
Competing interests:
None declared
Competing interests: No competing interests