Review of Dr. David Healy's "The Decapitation of Care"

If you lose your head, you lose your mind. Our healthcare system has lost its head, but also its heart, as seen in this excellent polemic by Dr. David Healy.

I came to this book primarily because my wife is a victim of iatrogenic harm. The term iatrogenesis means harm from medical examination or treatment, but after reading Dr. Healy’s book, the more accurate and precise phrase would be “I read this book because my wife was poisoned.”

In the middle of a pandemic, we turn to the medical professionals for advice and guidance. Modern medicine has proven quite effective over time to protect us from communicable diseases. Covid-19 falls right into that realm.

But this isn’t the “care” that is addressed in this volume. Intriguingly, it was a pandemic from earlier in my life, the AIDS crisis, that produced the only new drugs seen favorably in the book, where benefits and risks were actually evaluated and used, rather than the benefits to the bottom line.

This is a book about the black box pharmaceutical companies keep doctors and patients in about the side effects of the medications. A black box so dark and a system so effective for pharmaceutical companies that our life expectancies are shrinking. How short does you or your family’s life expectancy need to become before you pay attention?

Our drugs are currently tested for efficacy for a proposed treatment per FDA guidelines, not safety. As Healy points out this is an absurd position for an administrative agency. Overloading planes and ignoring maintenance logs is cheaper and more efficient, but that is not what the FAA allows. Insider trading is an extremely effective trading tool, but that unfair effectiveness is exactly why the SEC investigates. Our agencies should be about overall safety, not effectiveness.

Ironically, the FDA system for warning us of the danger of our pharmaceutical medications are called “Black Box Warnings.” These warnings are added to a medication only after it has been released into society. The trials for drug approvals do not create the warnings. The warnings come only after the public is poisoned. (And although not mentioned in the book, side effect data is gathered by the FDA by voluntary reporting. If you do have a drug side effect you can report it here, but voluntary reporting seems woefully inadequate after reading this book, but if you experience drug side effects reporting those side effects is currently the most subversive individual act you can commit against the Drug Industry.)

For over thirty years, I’ve worked as a consumer bankruptcy attorney. Medicine doesn’t only impact our physical lives, it can decimate our financial lives as well. The financial side of medicine is a key aspect to the book, coming at it from a slightly different perspective than I do in my legal practice. The basic premise is that by structuring our system as health “care”, turns the “care” into a commodity that is then promoted through propaganda (marketing).

The shift in thinking that Healy calls for is a shift to thinking of health services, not health care. To overcome the pharmaceutical propaganda machine, our views of medicine must change.

As the Covid-19 pandemic shows, even infectious disease healthcare has become politicized. Money (lots of money) and careers are at stake, but so are people’s lives. Entire industries exist to deliver us up to medications, regardless of the impact on individual lives. The goal of these companies is to make money, not to make us feel better or have better lives.

The book is published by a new writing collective, Samizdat Health. The book and the historical background on medicine it provides, also lays the groundwork for standing up to the current system that isn’t working. As costs soar, profits rise, and healthcare outcomes for more people fall, when will the rebellion take place? What will be the tipping point? How long will the samizdat be distributed amongst the silent rebels?

I was struck mightily by a quote in the book by the pollster Raymond Wolfinger, “the plural of anecdote is data.” I heard this quote and realized just how bamboozled we have been by the propaganda machine of the pharmaceutical companies. If there is ever a story by someone who has been negatively impacted by a medicine, it is dismissed as anecdotal, as if that person’s experience and existence does not matter. Yet the same anecdotal evidence compiled millions of times is exactly the thing that Facebook relies on when it sells an ad, and if it is good enough for a multi-billion dollar tech giant, why is it not good enough for our health?

I prefer to live in a world like the one Healy describes where health services are based on as much reliable information as possible. Clinical drug trials should all be disclosed and available (they are not). Anonymous reporting of drug side effects should be a mandatory reporting requirement for doctors. We need to change the national trajectory or our life expectancy from down to up. We need to change the national trajectory of those disabled by depression from up to down. Care has become a commodity and I care that it changes. This book can show you why you should care too.