This post follows on from The Fog of a Special Medical Operation.
Joe Biden says we have to resist Putin’s Special Military Operation. If we don’t resist this SMO, we are told, Putin will use it as a precedent to extend his reach beyond Ukraine. I don’t know enough about all this, but, perhaps just manipulated by propaganda, while figuring the War is crazy and there must be Win-Win ways to sort things out, I support the right of (all) Ukrainians to resist.
Joe Biden also has a Special Medical/Military Operation (SMMO), of which the vaccine offensive is the most serious escalation so far. [Unlike Putin (probably), Biden seems likely to be something of a glove puppet in his operation].
This SMMO is something I know a lot more about. Pretty well everyone reading this post can likely see significant changes in healthcare happening around them, rather than just coming their way through the media. The changes you see contrast with the propaganda we are all fed, and point to an SMMO. Unless we resist, this escalation is unlikely to be the last. The US Military Industrial Complex, that Eisenhower warned about in 1960, will be emboldened to take further steps we may not like.
We are facing a relentless advance toward technocracy. Like Putin, Biden thinks he is setting out to help ‘brothers’. Unlike the Ukrainians and Putin, most of Us (in the West) have welcomed Biden’s advances. Putin must envy Joe having it so easy – people laying flowers in the path of his advancing troops.
Shipwreck of the Singular covers the relatively recent emergence of modern medicine. The defense establishments have been the greatest driver behind this development. In War, armies who lost the fewest troops from disease won. It became clear that to win wars you needed surgery and public health. The first war in which more were lost to combat than disease was the 1904 War in which, availing of medical advances resulting from the American Civil War, the Japanese beat the Russians.
Even modern public health was a military thing – starting with the French wanting to make sure they weren’t outnumbered by the Germans.
The role of the military may not come out as clearly in Shipwreck as it does in The Decapitation of Care, above, because in an effort to contain Shipwreck to a reasonable word limit, I scrapped developments linked to the Korean, Vietnam and other wars leaving the Civil War, and the World Wars to illustrate the point.
The developments that came from War are largely good things but there is another side to the interface between War and Medicine.
Over the last thirty years the US Medical Industrial Complex has steadily encroached on areas once considered sacred to most people working in health. And we have been ever less likely to resist as they have done so.
As outlined in a Letter to Joe Biden on October 4 2021, the medico-military complex now support:
Where is the medico-military complex in all this? Well Brook Jackson’s False Claims Act against Pfizer has revealed that it is the US Department of Defense who contracted to get the vaccine and are prepared to tolerate it seems pretty well anything to get their product into us – Military Maneuvers in the Dark.
In terms of public health, the approach taken now began with John Graunt’s Bills of Mortality in the 1660s. Prior to Graunt people took responsibility for events that happened. Graunt introduced another truth – that events like deaths in workplaces happened with a statistical regularity. For some this introduced the idea they were going to happen anyway and no one was therefore responsible.
So people injured while working in the new industrial enterprises then opening up for the most part ended up thrown on the scrap heap – looked after by religious orders in the hostels (later called hospitals) for the medically indigent (unable to work).
There was a slow recognition that employers might be responsible for accidents that happened in factory settings like slipping on a banana skin the employer had dropped. This came to a head in a series of deaths in mine disasters in the North of France around 1900, which because these were predictable were viewed in old style thinking as Murder but by others as grounds for health insurance and workers compensation.
The American military led the way on this in setting up services for veterans after the Civil War. For many doctors in America, however, this was later viewed as a problem and any efforts to extend it to the rest of the population were branded as socialized medicine. It was incompatible with the relationship between a doctor and patient needed for good medical care.
So, changing one word from the original, we might say
The web of our history is of a mingled yarn, good and ill together: our virtues would be proud, if our faults whipped them not; and our crimes would despair, if they were not cherished by our virtues.
Military medicine learnt to look after the troops, provided they behaved themselves. Discipline is a central military virtue. An army only functions if people obey orders.
When dealing with the wider world, one way to solve the discipline problem is to replace people with machines. Machines don’t disobey.
After World War II it was clear that Tech would be the way forward. The military had a new need to contract with industry for planes, battleships, submarines, munitions (bombs) etc. Businesses like Boeing had the factories and the skilled workers to provide the goods. Some in the military, however, saw skilled workers as a possible fifth column. They could go on strike. They could tell the bosses they were making mistakes.
Telling the boss he was making a mistake was particularly the case when officers coming home from the War were put through MBA programs and moved into management jobs in the companies the military were working with. These managers who drew up the flowcharts for how the operation – building a missile – would be carried out often figured they knew more than the skilled workers.
The entrepreneurs who had set up the factories, in contrast, knew well that their skilled staff knew more than them – just as the priests and nuns who set up hospitals never figured they knew more medicine than the doctors or nurses they employed.
In manufacturing industries, the new management pushed for increased automation replacing skilled machine operators with machines tended by unskilled staff. The number of people employed in manufacturing plummeted. See Religion, Technology and Management.
Many went into service industries like the Fast Food industry then just starting up. Others went into healthcare which looked like a place where skilled staff would always be needed. A wonderful book – The Next Shift – outlines the fall of manufacturing industry and the switch of staff to the emerging health services in rust belt America.
In healthcare new technologies were appearing. Starting in the 1950s there was a steady increase in technologies for measuring blood pressure or blood sugars initially to sophisticated scanners and now mood and other behavioural Apps. (See Brain Health for what may be a particularly naive and dangerous application of these Apps).
These technologies have slowly transformed healthcare into health services. A skilled diagnostician has been steadily been replaced by someone who oversees the machine and acts on the basis of a print-out.
Someone skilled in taking on the problems we bring them has been replaced by a system that gives us problems we didn’t know we had.
Key to this transformation is the elimination of judgement – both the judgements of doctors and of us who go to them. This was brought about by a parasitization of randomized controlled trials (RCT).
As originally envisaged RCTs hinged on clinical judgements – randomization was just a technique for fair allocation.
Instead randomization has been elevated to an almost mystical entity that delivers objectivity. Objectivity no longer comes from doctors consulting with us or grappling with issues among themselves – in the way juries do – as outlined in The Fault Lies in our Stars and Fawlty Stars.
In 1962, after thalidomide, in an effort to contribute to drug safety, companies were required to demonstrate their drugs worked, which a few thought could now be done by using a new but poorly understood technique – RCTs.
Companies initially protested but soon went quiet when they realised that RCTs could be transformed into Randomized Controlled Assays (RCAs).
What’s an Assay. It’s a test that comes with a standard. If this dipstick turns red you have an acid and if it turns blue you have an alkali. If there is this amount of these fats in this brown material you have chocolate and if not you have Cadbury’s which the European Union said could not be called chocolate.
Rather than a way to evaluate a drug, RCAs transform exercises that look like science into simple systems in which all that is required is to hit a target – such as a lowering of depression rating scale scores slightly more than placebo does in order to be called an antidepressant, or producing antibodies in order to be called a vaccine.
With a box to tick, the bureaucrats in FDA or EMA will license this as an antidepressant or that as a vaccine even if there are more lives lost and more hospitalizations on treatment than placebo, and in the absence of any evidence that function has been restored. The same holds true for lipid lowering, blood sugar lowering, bone thickening and all other drugs.
In the modern world, numbers trump judgement. When our weight on a weighing scale, or blood pressure figures, or a country’s rate of inflation deviates from a norm, there is an imperative to restore normality. We feel happiest when normal or when our doctor (or leader) is happy our measurements are normal – even to the point of him being will to give and us being willing individually to take a ‘poison’, or collectively to swallow austerity, to get us there.
This triumph of numbers over judgement underpins economic and medical neoliberalism. Our experience of health services today offers us an up close and personal look at the dynamics of economic neoliberalism – The Deep Neoliberal State and Neo-Medicalism.
Neo-medicalism adds a chilling note to Pfizer’s Science Will Win. This Pfizer mantra gives the game away. Science is a journey into uncertainty. Follow the Science mantras offer us the comforts of certainty – that our vaccine or SSRI has been shown to work, claims supposedly endorsed by the super-scientists in FDA. The reality is that our new sacrament has been certified by some bureaucrats as meeting some artificial criteria and we have no idea if it works, or is safe. But we, the faithful, the people who want a father figure to protect us, swallow it.
In the 1960s, doctors recognized the adverse effects of new drugs within months of them being on the market, often simply by accepting what we who were on the drugs told them was happening. This began changing as RCAs, which are the best possible way to hide adverse effects, took hold. The mantra that the RCTs (RCAs) had not shown this could happen steadily anesthetized doctors and flummoxed us and it now takes decades for adverse effects to be accepted.
The SSRIs brought with them the idea that any discussion of the adverse effects of drugs was misinformation and the authorities had a duty to clamp down on it. In 2000, I mentioned in a lecture in Toronto that SSRIs might have side effects and we needed access to Trial (Assay) data in order to be able to assess and work out how to best manage this. The Dean of Medicine claimed this was like someone crying Fire in a Crowded Theatre and it should not be allowed. I was right but I lost my job – Burn Baby Burn.
In 1968 with the crushing of the Prague Spring, Eastern Europe seemed in the grip of a grim totalitarian system. There were assasinations in the United States and riots in Chicago and Paris but, aside from a few people like Norman Mailer who said America was as totalitarian as the USSR, most of us contrasted Eastern darkness with Western light and freedom.
By the 1970s Eastern Europeans like Vaclav Havel were keenly aware of the constraints on their abilities to live the lives they wanted to live – but they did not want to ‘join’ the West. They saw Westerners as just as unfree as they were. We have an advantage they said – we can see the enemy but you can’t.
While Easterners were becoming ever more keenly aware of the constraints on them, Westerners became less aware of the surveillance state taking over their lives, capabilities dramatically enhanced by DARPA’s creation of the internet.
There are Bills currently before Californian and Australian legislatures aimed at stopping doctors from spreading misinformation about medical conditions or treatments. Many doctors are protesting that patients need their doctors to have the freedom to recognize problems and review with them their best options.
The scenario envisaged by those concerned about the developing censorship sees the good doctor as like the Catholic priest Grahame Greene wrote about in the The Power and the Glory scuttling around from safe house to safe house, very aware of his limitations but spurred on by the Mission.
This will come as a surprise to many who write for or comment on RxISK posts, where the central theme is that we take our problems or our children’s problems to doctors, who do not believe us, who laugh at us, but we often to our regret end up doing what our doctor says because we have a residual sense they have our interests at heart.
We are at a point where the question of whether Drug A has caused Problem B has for many been replaced as the central question by Why Do You Not Believe Me?
Perhaps when these bills pass we will be able to see the enemy more clearly. See the soft power and propaganda that we are up against. We may be enabled to look after ourselves better as a result – see our reliance on doctors as a central part of the problem. Without a faithful relationship, Care is not possible.
The military approach to adverse events was brought out very clearly in a recent post If You Wake at Midnight and by posts on RxISK Sanctuary Trauma, the Invisible Doctor, and way back in If I Find You Ten Just Doctors.
With vaccines we have the apogee of a military medicine. Vaccine mandates are like orders given to troops – they must be obeyed. They have copperfastened body-snatching of doctors and us – see Strangers in the Room.
There is a certain poetry to all this. Around the time when French mines were collapsing killing miners, a century or more before we began tolerating the death of minors from Covid vaccines or SSRIs, the words immunity and self-defense began to change meaning.
They had been solely legal terms for two millenia. But now when we hear immunity or self-defense systems we are more likely to think in medical terms and in our individual selves rather than communities.
This too has reached something of an apogee with the vaccines.
The worry, though, is that our propaganda techniques are even better than our medical techniques in that the mRNA vaccines don’t seem to do anything useful. Besides leading to many premature deaths, their main consequence seems likely to be an evisceration of Health Care.
Just before the Berlin Wall came down, Helmut Schmidt, then a former German Chancellor, referred to the USSR as Upper Volta with missiles – it had lots of military technologies but was economically and socially backward.
In terms of Healthcare, has the West now become Upper Volta with Vaccines?
After the Berlin Wall came down, Vaclav Havel became the president of the Czech Republic. In 2010, just before he died, he said that he and other Czechs were less free than they had been in the 1980s.
It is not clear that technocracy can be fought with more technologies. Fight may not the right word. We are facing something more like a matter of personal responsibilities.
So, changing one word from Havel’s 1978 original in The Power of the Powerless:
A Specter is haunting Health… the Specter of Dissent. You do not become a ‘dissident’ just because you decide one day to take up this most unusual career. You are thrown into it by your personal sense of responsibility… You are cast out of the existing structures and placed in a position of conflict with them. It begins as an attempt to do your work well and ends with being branded an enemy of society. …
The dissident is not seeking power.He has no desire for office and does not gather votes. He does not attempt to charm the public. He offers nothing and promises nothing. He can offer, if anything, only his own skin— He offers it solely because he has no other way of affirming the truth he stands for.
[Applied to Health, she would be more appropriate than he]
With the pandemic, Blogs have been replaced by Substacks, which often note a subscription would help keep things going.
Published by Samizdat, Shipwreck of the Singular. Healthcare’s Castaways rolled out with the Vaccines. Its descriptions of a dystopian medical future seem all too present now.
It is priced at $18.95, and $8.99 in kindle from each of which Samizdat gets $5, and even less as El Naufragio de lo Singular.
Samizdat aims at the middle ground in health, enabling conversations to happen. A copy of any of its books for you or a friend, in lieu of an hypnotic, might help us all find a way to wake up.