[p2p-research] The bigger picture on health care (was Re: NY Times...Cancer from the Kitchen)

[Paul D. Fernhout]

Ryan Lanham wrote:
> http://www.nytimes.com/2009/12/06/opinion/06kristof.html?_r=1&em

 From there:
"""
But what about broader public health challenges? What if breast cancer in 
the United States has less to do with insurance or mammograms and more to do 
with contaminants in our water or air -- or in certain plastic containers in 
our kitchens? What if the surge in asthma and childhood leukemia reflect, in 
part, the poisons we impose upon ourselves?
   This last week I attended a fascinating symposium at Mount Sinai School 
of Medicine in New York, exploring whether certain common chemicals are 
linked to breast cancer and other ailments.
"""

An article that relates to that from another angle:
"Even If Obama Passed Single Payer, Primary Care Doctors Still Wouldn't Get It"
   http://www.counterpunch.org/mckenna12072009.html
"""
   Sociologist Zygmunt Bauman has recently written a series of books that 
describes our “Liquid Life” and “Liquid Times.” By liquid he elaborates 
Marx’s idea that under capitalism, “all that is solid melts into air.” 
Bauman describes our current culture as moving from a solid to liquid phase 
in which social forms can no longer keep their shape for long, leaving us 
unable to keep up with change. This is made worse by the “gradual yet 
consistent withdrawal or curtailment of communal, state-endorsed insurance 
against individual failure and ill fortune [which] deprives collective 
action of much of its past attraction and saps the social foundations of 
social solidarity.” According to Bauman, “this promotes division, not unity; 
it puts a premium on competitive attitudes, while degrading ... team work to 
the rank of temporary strategems that need to be ... terminated the moment 
their benefits have been used up (Bauman 2007:2-3).”
   Simply put, we are in need of communal care now more than ever.
   Doctors call themselves primary caregivers. Are they fitting the bill?
   Let’s be frank. The primary causes of preventable illness, injury and 
disease – capitalist social relations – need to become the “primary cares” 
of medicine. The Alma Ata Declaration of 1978, for all its imperfections, 
came close to implying as much.
   As David Sanders, MD, argued long ago, the fundamental causes of ill 
health are out of the control of [the biomedical profession], and “indeed, 
any open recognition of the real causes would call into question the very 
system that allows [medical professionals] to own and market their commodity 
(Sanders p. 117).”
"""

In my own life I'm seeing that several health issues I've had or others in 
my family have had could be more signs of nutritional deficiencies (or 
reactions) than anything else (because nutritional issues can lead to 
weaknesses that lead to specific problems, some reparable by improving 
nutrition, some not). But having been to doctors about such issues, the 
advice we get in terms of time spent in discussions is generally not about 
nutrition (or related behavior) but about drugs and surgeries or coping 
strategies.  I have no doubt drugs and surgeries are useful in the right 
situation, but one would think they should come after the basics are fixed 
up if they are still needed. Compare, say, the lengthy advice one might get 
from a doctor on a common issue for computer users, dry eyes, with the 
details here:
   "Dry Eye Syndrome: What is the Cause? Is there a Cure? "
   http://www.xenophilia.com/zb0061.htm
"""
     Doctors can often know what is wrong with us better than we know 
ourselves, but not always. With scientific curiosity and experimentation 
I've already cured myself of several things my doctors said I would live 
with for the rest of my life! Here are the "incurable" things I've beaten 
(or were mis-diagnosed) so far:
         1. back problems (exercise, eat right, get a better bed!)
         2. cavities including the need for a root canal (info here)
         3. gastric reflux (stop sugar, red spagetti sauce & caffine, loosen 
belt, stop stomach acid drugs, sleep slightly elevated.)
         4. asthma (caused in my case by air pollution and stomach acid 
coming up and causing shortness of breath. Exercise, take vitamin c daily, 
drink enough water)
         5. " panic attacks " (caused, again in my case, by stomach acid 
coming up and getting in my lungs causing shortness of breath, plus the 
shakes and some heart irregularities as a side effect of the stomach acid 
drugs, and sleep deprivation from being a workaholic. I've been under much 
more mental stress subsequently, to the point of not being able to sleep for 
three days straight, but never did my misdiagnosed 'panic' symptoms 
re-appear. Regular moderate exercise is important here too.)
     So, Dry Eye Syndrome is said by experts to be incurable, but I don't 
buy it.
"""

But doctors are constrained in the time they have with people who come to 
see them, as well as how involved they can get in the lives of others. Patch 
Adams talks about that (Robin Williams in the movie on his life has a scene 
on that), that he likes to see people at home an snoop in their closets -- 
to really understand people and their health needs.

That point is made in the counterpunch article in another way, in the 
context of essentially peer medicine, where the journalist goes to the home 
of someone who came in with a problem that is in good part just loneliness. 
 From there:
"""
After the doctor left, Neal “confessed” that her “sweet tooth” prevented her 
from follow ing the recommended diet. Almost as proof, she invited me over 
for some homemade mince pie.
   Neal seemed eager to have someone listen to her troubles and welcomed the 
chance to share details of her life story. Her story was indeed one of 
suffering. Years ago her husband had lost both arms in a chain saw accident 
and he had recently died. She had lost a middle-aged son to can cer and a 
brother to a tractor accident. “He was pulling up stumps for firewood and 
the wheels ran over him.” Neal’s three other children had long ago left for 
distant parts of the country. In 1979, the wiring company where she worked 
moved south to Missis sippi. In the ensuing months she had sought mental 
health counseling but found that she could not afford it. She had been 
unemployed since then. Her husband, near the end of his life, had “found the 
Lord” but Neal found his proselytizing difficult to handle. “I’d rather he’d 
have been an alcoholic,” she said.
   Neal told none this to her physician. But behind the clinical 
constructions of “presenting complaints” was a world of struggle that went 
unelicited, unattended, and untreated.
"""

So, there is a real difference in that sense in what peer medicine or 
community-based medicine can do compared to what a "doctor" in an "office" 
can do. I'm not saying medical knowledge is not important, or that 
scientific studies are not important. I'm more saying the system is deeply 
broken. Somehow peers can be part of fixing it. Somehow.

--Paul Fernhout
http://www.pdfernhout.net/