I’ve been wondering today what’s the matter with the medical profession, and what to do about it (aside from firing half the doctors), and I began to wonder whether it was because the medical profession had collectively decided that “prevention is better than cure.” Rather than wait for people to get sick, they’ve decided to prevent them getting sick in the first place.
And that’s a rather attractive idea, on the face of it. Or it is at least rather attractive if you know what makes people get sick.
With diseases like malaria, it’s pretty well known how it’s caused. Malaria is transmitted by mosquitoes that bite humans, and inject the malaria parasite that many of them carry – Plasmodium falciparum – into the bloodstream in the process. So the incidence of malaria can be greatly reduced if people prevent mosquitoes from biting them, by keeping them away with nets and sprays and smoke, or prevent mosquitoes from multiplying by removing the stagnant ponds in which they breed. There are a variety of effective preventative measures that can be taken that will stop a great many people getting malaria in the first place.
The problems come when more or less anything can cause something. Take broken legs, for example. There isn’t one single cause of broken legs. Any number of things can cause them. People can break their legs by falling out of bed, or down stairs, or tripping over something, or playing football, or being hit by cars. There are an almost infinite number of causes of broken legs, and it’s never going to be possible to prevent broken legs, except in glaringly obvious cases – like cordoning off holes in roads so that people don’t fall into them.
It’s arguably even worse when you don’t really know what causes it, but pretend that you do. With both malaria and broken legs, there’s no real argument about the causes. But that isn’t the case with cancer. Nobody really has much of a clue what causes cancer. But that hasn’t stopped some medics claiming that it’s caused by smoking cigarettes. In fact tobacco has become the default cause of more or less every malady known unto man. If you don’t know what else might cause it, blame it on smoking. So now smoking causes everything. Including malaria and broken legs.
But then, once medicine flipped over to prevention instead of cure, the new preventative medical model required some way of preventing cancer, and so needed something that had been assigned as the prime cause of cancer, because otherwise there’d be no preventative measures that could be taken. And that would be an awfully big hole in preventative medicine. So something had to be found as the cause of cancer, even if nobody knew what the cause really was. And that something was tobacco smoke. It gave the preventers something to prevent. It gave them something that they could restrict and ban, and show that they were actively preventing cancer.
But it’s not just that. If you think you know what causes something, and you fail to take the appropriate preventive measures, then it’s your fault if you come down with cancer/malaria/broken legs. So people now have only themselves to blame if they get sick. And since every disease is now known to be caused by smoking tobacco, people can only be sick because they smoke, or because they inhaled somebody else’s smoke, possibly from another town. And so increasingly the only preventive health measure that can be taken is to restrict smoking even more tightly.
And that’s another thing. Preventative medicine is highly intrusive, and requires behavioural changes. If you want to really prevent people from breaking their legs, you should make them wear knee and shin guards, and inflatable rubber leggings, and helmets, all the time. And they should only ever walk anywhere using walking sticks or frames or crutches, in case they fall over. In fact, they shouldn’t be allowed to do stupid things like walk up and down stairs, or step off kerbs, or climb up ladders. It makes for a ‘health and safety’ culture, in which more or less everything is perceived as dangerous. Although, as we now know, smoking is the single most dangerous thing anyone can do.
But also preventative medicine must result in the decline of old-fashioned after-the-fact-reactive medicine. After all, once you’ve prevented everyone from smoking, and smoking is the cause of every malady, then there is no further need for doctors or hospitals or ambulances. Because it’s all been prevented, you see. Once people have been prevented from getting cancer and malaria and broken legs, there’s simply no longer any need for the kind of doctor who arrives in an emergency, and ties a splint around the broken leg, because there won’t be any broken legs any more. So the traditional medical profession will wither away. And the hospitals will close, and the emergency services. Because they will no longer be needed once everything has been prevented.
But even if old-fashioned reactive medicine – doctors, hospitals, ambulances, etc – remains largely in place at present, it is essentially in rivalry with preventative medicine. You either prevent disease from happening, or you cure it once it’s happened. You either make your ship unsinkable, or you provide it with lifeboats. It makes no sense to do both. And you can’t afford to do both anyway. And so preventative medicine must be taking funds from traditional medicine. If your local hospital has just closed down, it must in part be because the money has been spent on antismoking measures, or rubber leggings.
Preventative medicine means the end of traditional medicine. It necessarily entails the closure of hospitals and emergency services. And it also necessarily entails increasingly intrusive restrictions on what people can and can’t do. It makes for a sort of prison world. And a prison in which people only have themselves to blame if they ever get ill.
Add to that the fact that preventative measures like smoking bans destroy communities, fragment society, bankrupt pubs, undermine trust, and depress the economy, and you get an idea of just horribly bad preventative medicine really is.
Preventative medicine, in short, is the death of medicine. And the death of pretty well everything else as well.
It’s not that prevention is better than cure. It’s that prevention is much, much, much worse than cure. It may have looked like an attractive idea, but it was actually a terrible, terrible idea.
And so we are all going to have to go back to the old-fashioned reactive medicine, with doctors and ambulances waiting until people break their legs, or catch malaria, and not trying to prevent them from doing so in the first place, and in the process imposing crushing and inhuman and mostly ineffective controls on everyone. We can’t afford not to.
Anyway, Happy Easter. And here’s Lana Del Rey, smoking cigarettes (or did in the first video I tried):