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October 11, 2012

Annals of Human Folly

Although humans can take some justifiable pride in being the only species to exhibit our advanced cognitive abilities, there are so many examples, even within my own profession, of humanity's amazing ignorance and willful stupidity- that it probably behooves all of us to restrain whatever impulse we have for the kind of self-congratulatory rhetoric typically heard during political campaigns.

Two glaring examples of human fallibility in the realm of Medicine illustrate that point. The first was that of James Lind, an Eighteenth Century Scottish physician who correctly observed that the consumption of lemons and limes prevented scurvy, a dreaded condition afflicting sailors on the long sea voyages that had become common following discovery of the Americas. Given the role of the its navy in both protecting England from attack and enlarging its empire, scurvy represented a particularly serious problem for the British. The good news was that Lind wasn’t persecuted for his unconventional views on scurvy; he was simply ignored; a development that prompted him to design what is now considered by many to be the first example of clinical research and earned him an honored place in history.

About a hundred years later, a Hungarian-born physician was far less fortunate. Although Medicine was still deeply mired in relative therapeutic ignorance, there had been advances in overall understanding and physicians were enjoying some increase in prestige. A junior instructor at the more highly regarded of two Obstetrical clinics in Vienna named Ignaz Semmelweis noted a clinical phenomenon, which like the one noted by Lind, had also been observed by others: after being examined by professors, young women in childbirth often came down with child bed fever, a dreaded condition with a high mortality. Long before bacteria would be discovered by Pasteur, Semmelweis correctly surmised that the professors were spreading child bed fever from patient to patient with their hands and made his own students wash theirs between different patients, a practice that dramatically reduced its incidence, but offended his senior physicians because it was interpreted as impugning them and contradicting existing beliefs. To make a long story short, Semmelweis, who turned his observations into a campaign, was never taken seriously during his lifetime, even after he left Vienna, moved to London, and published his results.

The continued skepticism of colleagues in two nations ultimately drove Semmelweis into an asylum where he died- ironically of septicemia- at the age of 47. Although possibly mentally unstable in an era when mental problems were poorly understood, the serial collegial rejection of his clinical truth in two nations must have played a major role in what must be regarded as a personal and professional tragedy.

To an uncanny degree, the current American and global folly aka the “War on Drugs” is orders of magnitude worse than either of the examples just cited. Not only does a global Drug War affect millions and promote violence everywhere, it is based on rhetorical nonsense promulgated by two notorious, medically ignorant liars. Even worse, the alleged medical harms of cannabis were easily refuted by clinical histories taken from long term users. Beyond that, wannabe doctors in the cannabis reform movement, have, so far been cool to the idea that their own repetitive use as adolescents was occasioned by the anxiolytic effects of cannabis when it is inhaled.

Thus troubled patients who have been effectively self-medicating serious symptoms, are still being arrested and prosecuted as criminals in the US and around the world, while the planet's political leaders have yet to notice.

Is it any wonder the same leaders are equally unable to deal with two far more serious problems: the closely related threats of rapid climate change and the energy demands of a human population that has grown spectacularly to seven billion since 1800; roughly about the same time the United States became a nation and the Industrial Revolution started in earnest?

Doctor Tom

Posted by tjeffo at October 11, 2012 10:15 PM