Six Steps to recognize Dogmatism in Doctoring

The real art of medicine is amusing the patient till nature cures the disease-Voltaire

ChildBed Fever: The “Toxic” Hands of Doctors.

Once you have lost your sight it does not matter which side the sun will rise-Kanadasan.

In the late 1800’s, women were dying of “childbed” fever which was the fever they had soon after childbirth. The mortality rate ( rate at which women were dying following childbirth) was 40%. In other words 4 out of 10 women who gave birth to a child died due to a fever they developed soon after delivery.

This was the era in which conventional wisdom was that all diseases were caused by an imbalance in the four humors- blood, yellow bile, black bile, and phlegm. A lot of the treatments were related to bloodletting and inducing emesis.

Along came Dr.Ignaz Philipp Semmelweis a hungarian doctor. He was an Associate head of the Obstetrical Clinic of the Vienna General Hospital. His main job was to organize the educational curriculum for medical students oversee difficult deliveries. He was in charge of two of the clinics.

One clinic gave free service to the women and in turn they were worked upon by the medical students. This clinic had a maternal death rate of 10%. The second clinic had midwives conducting the deliveries and had a maternal mortality rate of 4%.

Even the women knew that patients that delivered in the first clinic had a higher chance of dying so they would pretend to go into labor outside in the streets and seemed to have a better outcome.

Dr. Semmelweis was frustrated by this, as he expected them to have increased death from delivering in the streets. The exact cause of the fever and death eluded him.

Then one of his friends, a colleague died, developing a similar presentation like the postpartum fever and autopsy findings similar to the women who died of the same. This happened after he was accidentally nicked during an autopsy with a scalpel by a medical student. Dr. Semmelweis, felt that something was transferred from the scalpel to his friend.

He applied this logic and felt that students who did autopsy, and then went on to deliver the babies in the ward transferred some “toxin” from the corpses to these women.

So he recommended that every student and physician “wash “ their hands in chlorinated water before they delivered babies. By implementing this he reduced the mortality to 0.85%!

Now such a feat you would think would be applauded and rewarded. However the medical establishment rejected and in fact condemned his suggestion that somehow physicians did not have “clean hands”. Further his theory of a toxin being carried by hands flew against the face of conventional wisdom.

His discovery was in 1848 and as late as 1861 it was still not accepted. In fact at the time of his death also he was ridiculed. All of this because he was unable to offer a scientific explanation.

It was decades later with the discovery of the bacteria, antibiotics by Louis Pasteur and Joseph Lister a true explanation was obtained and his contribution acknowledged.

X-rays:The Death of Children

If you don’t stand for something you will fall for everything ― Gordon A. Eadie

Alice Stewart was an unique physician. She was female, she was an epidemiologist. She took on a unique subject to study in the early 1950’s. Children born to affluent mothers were at a much higher risk of dying from cancers.

Dr. Stewart was given limited funding and with this she was able to send out questionnaires to mothers. Statistically she noted that mothers who had prenatal X rays, which was done routinely those days for those who could afford it, had kids who developed childhood cancers.

She felt radiation was harmful and mothers should not have x rays when pregnant.

She hurried to present her findings. She was criticized for inaccurate use of statistics. Once again she put forth a theory that flew against the practice of medicine then.

Her discovery was in 1950’s. It was not until 1970’s that her work was acknowledged and the danger of exposure of X rays to the unborn child was documented and the standard of care in medicine changed.

Two decades of continued exposure to dangerous X rays because the medical community needed more science and less “bullshit”.

Stories of Drs. Semmelweis and Stewart are numerous in the history of medicine. They say we ought to learn from history.

What we unfortunately do is repeat history because we can never recognize it.

Vaccines the modern day murder of medicine or disease?

“You never know how much you really believe anything until its truth or falsehood becomes a matter of life and death to you.”
― C.S. Lewis

Let me preface this section, by saying I am a pro-vaccine physician. My kids have been vaccinated. I myself have received the smallpox vaccine and polio vaccine and the BCG( Tuberculosis).

I come from a country that had tetanus wards for kids that suffered and died because their poverty stricken parents would not take time out of their day to day labor jobs, to immunize their kids.

So is this going to be a pro-vaccine rant?

Absolutely not.

I am taking time to step back and think.

The mounting tension on social media between vaccine supporters and what they call Anti-vaxxers is palpable. The comments made by human beings and more importantly people in the medical field is nothing short of dehumanizing.

Both sides have arguments that can support their case. Some of the arguments are baseless, some completely one sided.

Physicians are “firing” families from their practices if they do not conform to the vaccination “rules’. We are trained to be the advocates of patients and we are ostracizing them.

Physicians who prolong the vaccination schedules are being reprimanded for this practice and being brought in front of the licensing board almost threatening their livelihood.

Physicians who are healers and should love and educate their patients are using abusive language to chastise mothers, who fear giving their children the vaccines.

Mothers who lose their child either due to vaccination reaction or due to a disease that is vaccine preventable, are having to deal with, in addition to the loss of a child , unimaginable cruelty of words from their counterparts on the other side of the issue.

Social media has taken this difficult social difference to a whole new level.

There exist the Vaccine Adverse Events Reporting System or VAERS, for a reason Vaccines do have adverse effects. As a doctor and a patient you need to be aware of this.

There are some serious side effects of vaccines like high fevers, behavioral changes due to fevers and seizures and even inflammation of the lining of the brain (encephalitis). There is an inflammatory state, thrombocytopenic purpura( Blood disorder due to destruction of platelets or clotting cells), and gut issues that do develop from some vaccinations in some patients.

These severe forms of reactions are exceedingly rare. In fact there is no good way today to predict which child would react. To the mother who has a child having this reaction it is a 100% failure of the vaccine for her and her child.

This is where the dogmatism in medicine needs to stop. History, as I have enumerated should not be repeated. We do not need decades of parents and children suffering for us to come up with a plan.

Here is what I see:

1. Fear is the basis of this confusion from a patient standpoint. The only way to eliminate fear is through education. The reason this fear is not eliminated is because there seems to be a correlation of a child receiving a vaccine and then completely changing. This does not mean causation but the uninformed cannot see the difference. No one is taking time to inform the parent what all this means.
2. Who should eliminate this fear? The Doctors , the CDC that provides these vaccines or the companies that make these vaccines?
3. Dogmatism is the problem from the medical side. Doctors like ZDogg who have hundreds and thousands of followers completely trash the anti-vaxxers with no room for discussion.

Vaccination as of today is a very complex issue. It is a murky situation that has doctors, the CDC (Centers of Disease Control), distraught parents,lawyers, lawsuits all pulling the issue apart for different reasons and in different directions.

I think we have to be careful not to make this an issue that will go down in history as another fiasco in medicine.

The steps to take to end dogmatism would be:

1. Listen to the real fears of the parents. Educate when appropriate.Come up with a plan to help allay their fears and work toward the health of their children.
2. Admit that some children may have a reaction to vaccines and we are still not certain how to identify these or even prevent these.
3. Improve the vaccination delivery system, finding newer ways to protect the antigen rather than with what is considered “toxic” substances. Even though the medical establishment may feel that the substances used is negligible. History has shown us that the medical establishment is not always open to change, or easily accepting of a new hypothesis.
4. Provide the education to the ER ( emergency rooms)and to Doctors of the VAERS.
5. Discuss the true VAERS data every year with the community.
6. Keep all discussions respectful. We are dealing with children’s lives , parents futures and true loss in many cases. Once again maybe simply a coincidence but nonetheless important.

This is an important issue that needs the educated medical establishment to be less arrogant and the public to be more responsible.

For us to succeed without taking steps back from the progress made we need to reduce hate.

As Maya Angelou says “ Hate-It has caused a lot of problems in this world but has not solved one yet.

I am not certain where or how this problem is going to get solved but we need to begin to work together.

If you are a parent seeking to learn more here is a checklist for you to ask the right questions.