60

The Medicine Men

Advice From an Infidel

"Knowledge is the principal thing; therefore get kiionvledge: and NN7itli all t]iN- ,ettiiig get understanding." Proverbs, 4:7

Is N-our flesh crawling? I hope so. I hope I have instilled some doubt into you, some doubt about the efficacy of the ceremonials of American medicine men. In doubt lies the beginning of wisdom.

If x~oti can't put faith in your doctor, what can you do'-' First, forget the faith. That word shouldn't apply to doctors. Next, do some hard thinking. You want physical iiiimortality, of course. Well, that's impossible. Then do you want to prolong the years of your life? Not at all, if that means being blind, deaf, doddering, incontinent, a stinking Struldbrug, a painful burden to your children, a living inemento i7wri. You want to live in full possession of your faculties, to enjoy eatiiicy and drinking and sex, to be vigorous and alert.

So how do you achieve those glorious goals? I can offer you a few guide points.

Don't regard your doctor as a wizard but as a niortal man who sees in the world a microcosm of ailments. And because of his specialized vision remember that he is sliortsi(rlite(l. He xn,aiits to solve one problem and he often can, but to -,N71iat end? NN'liat's the use of treating ilietiiiiatoid artliritis NN,itli effecti\,e aiitiiiialarial drugs if blindness ii-tay occtti-? NN']iNorder iodized salt to prevent ,~oiter and end tip with severe aciie in adolescents? lIoNNvaluable is an orcyaii transplant -,N,Iieii the coijclitioii that caused the trotil)le in the original oi-glill persists ( as arteriosclerosis, in the case of Di-. Blail)ei-g) ?

Don't expect more of the doctoi- than an honest and iiitelli(,eiit application of his leariiii)g. That means what lie does lie should do well and wliat lie can't do lie slioti](I let alone or (,et help in doing it. It also means that lie should not order laboratory work as a routine \N,itliotit specific need for it, and he should explain its iiecessitn- to .-oti.

 Don't ask him to work miracles. He cannot resurrect the dead iioi- restore power to linil)s paralyzed by severance of the spiiial cord. He cannot foretell the exact hour of birth nor prognosticate the moment when life will depart. He cannot make the blind see without eyes, nor tl-ie deaf hear without auditory nerves. He

can't e\,ei) promise your backache \x-ill not i-ectir nor ,,,our litir not turn gray.

Don't foi-tret there are no top secrets in medical care. Doctors like to cro\N, al)otit their sticc,esses: they hasten to I)til)lisli tlieii- good results. Once ~t pi-ocediii-e is no

~7)

loii,,ei- experimental, its use becomes iii)i\-ei-sal. Once a di-ti,, est~il)lislies its iiierit, eNer\, (loctoi- will prescribe it \N,Iieii it is ii)(licated. OiilN,, charlatans pi-eteiid to have secret remedies. The (la\7 after the clti-e for cancer is (liscoN-ei-ed, \-Our doctor will know about it. Don't think ~iii\,oiie else kiio\N-s iio\N, and won't tell.

Don't demand of the doctor the tenderness and love ~-oti may be iiiissiii(j- in votir life. "A kiss on your hand makes \7ott feel (,ood but a diamond bracelet lasts a long time." The doctor is not a substitute for wife or ii-iother or I)iisl)aiicl or father. His jol) is to keep you well and fit.

That means a radical change in your attitude toward doctors. Don't be a gttllil)le participant in the s6aiice. Don't regard doctors as wizards, omniscient and possi1)1\- omnipotent. Renieiiil:)er the dialectic relationship: \"Iitliotit voti lie wotildii't be a doctor. Therefore-don't let N-otir I)odN- I)e poisoi-ied by paradoxically useful and tiseless drugs. Ask, ask, ask about the dangers in the prescriptions. Let the doctor think you're an overcautiotis iitit. His opinion won't hurt you as much as a liarniftil medication. Don't submit yourself to diagiiostic procedures of doubtful value and doubtless possil)ilities for, hari-i-i. Insist oi-i knowing why they are being ordered. Don't be a guinea pig for the latest medical fads just because the joneses are falling for them. And don't go to the other extreme-don't set \,our itidgmerit against your doctor's as to what is good and what is ])ad in medicine. Presumably he gets his information from better sources than you do. just make sure be knows what lie is doing ai-id why. Your own common sense must be used. If a technique or a procedure or a drug doesn't make sense to you, ask your doctor to explain. Don't be put off by medical double-talk; if he says you won't understand, rest assured he doesn't ei
Advice From an Infidel

ther. Making him speak straight English will make him oftener so much in a hurry that they do instead of

think straight too.

Don't think that by stiing the doctor when he makes a mistake that yoi-i're goina to improve the qualit-,7 of medical care. All you're doing is making his malpractice insurance rate go up and that expense is inevitably -added to ~rotir ])ill. \Ialpractice su:ts make lawyers richer, not you healthier. You're mistaken if you think a le,,al jtidgment can alter a i-iiystic ritual.

Don't i~iiterfere in the doctor's practice, except to poke fun at his antics. You don't know the details of what is necessary to turn the art into a science. Wellr~ieaiiiiig reformers tried to cure alcoholism by Prohibit-loii and ended tip with Capone. Demai-idiiig medical care audits, uniformity of records, compulsory laboratory teStiDg-all lead to an increase of l~)urdensome bureaucracy and an increase in the cost of medical care, not in its quality. Likewise, don't get carried away I)x, the idea that So\-iet-style polyclinics or Britisb-style panel medicine will automatically bring about superior medical care. '\IaN,I)e you won't have to wait so long for the witch doctor to come, but when he does he'll have the same old bag of tricks. Nor is prepaid health insuran(,e the answer. What difference will it make if the witch do~,tqr,:- -oid by the state if the mummery's the same?

Remember that, altho~,igh doctors make a great deal of moiie),, iiione), is seldom their sole aim when they treat you. They actually want you to get well. Don't attribute mercenary motives to tliei-i-i when they advise an operation or diagnostic tests. just be sure that the

--~---feasons they give for those procedures make sense to vou. Doctors are Dot conscious charlatai-is or ignorant irauds, but they are often intellectually lazy and even

think.

Change doctors if the one you have is not candid with you. Change if his treatment is not giving results or if it has added complications to what you started with. Chai-ige if he promises miraculous cures. Change if he treats you like a child or an idiot. Change if he gets angry when you question him about his diagnosis or treatment. There are plenty of good doctors around. You have to look for them and from personal experience I can tell you the search will not be easy, but it is well worth the trouble.

"Every country has the government it deserves" runs the adage. And every country has the doctors it deserves. If y*ott want to get away from witchcraft, start throwing out your own superstitions. Be open-minded and receptive to fresh ideas. If you hanker for the good old days when Doc tramped through the snow carrying a heavy black bag, you'll keep right on being satisfied with Doctor in a shiny office radiating sympathy. What's needed in this country is a new kind of medical practice, one that won't be dependent on your good will oi- your willingness to be amused, one whose function will be to prevent illness and to cure or alleviate those illnesses that cad't be prevented, one that will help you to reach your goal of a long, happy and healthy life.

flow that will come about I don't know, but I do know that an intelligent, informed public can help to eliminate much of the ceremonial nonsense that attends present-day ryiedical practice.

I didn't mean to eiid by giving advice but I did, ann,way. That's what comes of being a doctor for so long. Out of habit I clon the mask and give a solemn opinion.
Do you trust your doctor? Does he really know what he's doing? To most Americans, the answer to such questions is an immediate "Of course," and to this extent our blind faith in the wisdom and powers of physicians is little different from the belief of primitive peoples in their witch doctors' incantations and spells.

THE MEDICINE MEN is a well-documented and witty book which exrlodes the myth of quality medical care in the United States. Dr. Leonard Tushnet, a respected doctor of almost forty years' experience, here analyzes many of the recent ''breakthroughs" in medical technology, diagnosis and treatment, and finds that they' have been dangerously overemphasized and not fully Linderstood by many in the medical profession. THE MEDICINE MEN gives the layman an insider's view of both general practitioners and special ists-i nte rn ists, obstetrician,-~., psychiatrists, gynecologists and surgeons, among others-and some of their commonly used and often dangerous treatments. The author also casts serious doubt on the effectiveness of some of our most honored articles of

medical faith: the annual check-up, laboratory ''tests," and medical "consul

tations. '' This is a book which pulls no punche

It is not an indictment of all doctors, b_-_,, it does offer sound advice on how to tell a coiiipetent physician from a highly educated wilch doctor. THE MEDICINE MEN is a book which could conceivably save yolr life, and is required reading before you keep your next.appointment with your doctor!

Dr. Leonard Tushnet has recently retired from his New Jersey Medical practice after almost forty years of serviceHe is the author of numerous medical and historical articles, and has had more than sixty short stories published in the past ten years. Two of his previous books have dealt with the history of the Warsaw Ghetto.

THE MEDICINE MEN is his first fulllength analysis of the profession to which he has devoted most of his life.

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