So Long and Thanks for all the Fish portrayed doctors in a rather flattering light – the victims of a tragedy. They were portrayed as losing out in a Faustian bargain when they failed to realize the hazards in making all new drugs available on prescription only. The bargain offered them a chance to entrench themselves inescapably in healthcare as the only legal source of all treatments that worked instead of having to achieve this position because of their professional values or the benefits they, rather than their drugs, might bring to the table.
Forcing people into coming to see you rather than having them come because of something distinctive you offer turns out to have been a first unwitting step toward tyranny. In the process medicine has lost its soul.
Before 1962, the acme of the medical art lay in a concern for the safety of patients. Once doctors were made the conduit for new drugs, all of which were supposedly efficacious, they lost sight of safety.
Doctors now report as few as 1% of the fatal adverse events that happen on treatment. Doctors take 10-15 years after new and notable hazards of prescription drugs are first described to finally concede that these risks may be real. Even after treatment hazards come flagged up in Black Boxes, many doctors still deny that treatment could cause the problem. Many doctors have patients who are on 10-15 drugs at the same time and for indefinite periods, a recipe for treatment induced injury and death, so that unsurprisingly Pharmacosis – treatment induced injury and death – has become a leading cause of death.
But is the Lord of the Rings saga a better analogy for what has happened than the Faust story? Prescription-only privileges are the Precious that Gollum-Smedicine clutches tightly to itself, unaware that prescriptions are the key element in the route to power of the most powerful force on earth – the pharmaceutical industry.
The marketing departments of pharmaceutical companies focus in on the ring-bearers just as the Eye of Sauron focused in on Gollum and later Frodo. Once the Eye fixes on a ring-bearer, it hypnotizes him into submission. If any demur, it directs its Black Riders (Medical Academics) to enforce compliance with its Will.
At present the focus is to the tune of roughly $60,000 per doctor per annum in the United States. Under the intensity of this gaze doctors have learnt to shun the light of disclosure and are complicit in letting the industry get away with non-disclosure of clinical trial results. Doctors have visibly shrunk the way Gollum did.
In recent years prescription-only privileges have fallen into the hands of nurses and pharmacists – a set of hobbits. They are as yet less affected by the influence of Sauron. They still hope they can put things right.
The lesson from Lord of the Rings though is that Hobbits cannot save us. However good their intentions, they too succumb to the power of the Ring. In the end it was Gollum-Smedicine desperately trying to reclaim his Precious who tumbled into the chasm of Mount MooD and in so doing saved us all.
One Script to rule them all
One Script to find them
One Script to bring them all
and in the darkness bind them
in the Land of Mordough where the shadows lie
