Tom Cruise: Who Does He Think He Is - 5

If it's wrong for Tom Cruise to speak out against psychiatry because he's not a doctor, the implication is that medicine is an extremely effective, scientific discipline.

I don't intend to take much time on this point, because, while I know a fair amount about psychiatry, I'm know far less about the general field of medicine. But the argument can be made (and has been made) that medicine itself is overvalued as a science. I believe this to be true, but to what extent? – that's beyond me.

Here are a few of the points to consider:

1. Medicine (main-stream Western medicine) has always been a "science", but when we look back at the medicine of the previous century or even of previous decades, we find a great deal that doctors insisted was science (for example, treating people by bleeding them) is now considered pseudo-science.

2. Medicine has always been a very narrowly defined discipline that (via its official bodies) worked hard to exclude, outlaw, label as quackery other highly effective approaches to maintaining good health and treating illness. For example, for many decades medical authorities tried to keep chiropractic and homeopathic practices illegal. These same authorities still dismiss studies that show chelation therapy effective (and more effective than heart by-pass surgery). Doctors are only beginning to catch up to naturopathic practitioners, nutritionists and other alternative practitioners in understanding the importance of good nutrition and proper supplements (vitamins and minerals) and in understanding what is needed to maintain good health (preventive as opposed to reactive medicine).

3. Medicine is perhaps overrated when given credit for the improvement in life-expectancy statistics in industrialized nations. It is difficult to sort out which benefits derive from improvements in medicine as opposed to those that derive from public health measures (sewer systems, clean water, hygiene) and the greater availability of protein and fresh fruits and vegetables.

4. Iatrogenic illness (illness caused by doctors) is the third highest cause of death from illness. For more data on this, click here. Medically caused illness kills hundreds of thousands in the U.S. every year – and that's just the known deaths. The statistics on it are based on deaths of patients while in the hospital receiving treatment. There are not such statistics on people who, having left the hospital, die soon afterwards.

5. Like the psychiatrists, doctors in general know very little about the drugs they prescribe. They believe what they are told buy the drug companies and may or may not read the "countra-indications" and "side-effects". They are "educated" by drug company representatives. When the drug companies and the FDA say that Vioxx is a miracle drug, the doctors prescribe it. When the FDA finally acknowledges that Vioxx kills people and the drug company pulls it off the market, the doctors stop prescribing it. (Duh.)

6. Like the psychiatrists, doctors in general are overly fond of the quick fix, and use drugs to treat conditions that might better be handled by nutrition, exercise and other means.
Much of the "science" of doctors consists of vocabulary (all the jargon that impresses us when we watch ER), knowing something about dosages, knowing how to spot the symptoms of a variety of illnesses, knowing the usual treatments for these illnesses, knowing anatomy, knowing a fair amount about body mechanics and how to open and close up a body (surgery), how to inject, how to scan, etc. There's a lot of knowhow. This doesn't mean that the people with this knowhow know how to use it to get a good result. It just means that they know how to do certain things.

On the other hand, medicine does, at its best, and in its own narrow areas of skill, have a scientific basis:

As mentioned earlier, most medical illnesses have an etiology. That is, sets of symptoms are not labeled illnesses until a specific physical diagnosis (e.g., a blood test) is tested and validated, and, usually, until a specific cause (germ, deficiency, blunt-instrument trauma or whatever) has been found. This differs vastly from psychiatry. As Scharfstein (head of the APA) admitted on TV and as the U.S. Surgeon General told Congress years ago, there are no physical tests for the various "mental illnesses" psychiatrists claim to have discovered. There are no blood tests, no X-Ray or MRI tests, etc., that can be used to diagnose clinical depression or ADHD or anxiety or any of the several hundred other conditions that psychiatrists claim are medical illnesses, just like diabetes.

About a year ago, several members of MindFreedom (an organization of "psychiatric survivors" – people who were diagnosed as mentally ill and treated by psychiatric means, who feel that they were harmed by psychiatry and that psychiatry is a non-science) went on a public hunger strike, pledging to fast until they got an answer to their letters to the head of the APA (Scharfstein). The letters asked the APA to list any valid scientific studies showing that any mental illness was the result of a chemical imbalance in the brain. They eventually got a response, which they turned over to a panel of doctors and psychiatrists (people like neurologist Fred Baughman, for example). The panel analyzed the response and sent the APA a letter, pointing out that the APA letter hadn't pointed to a single study, just asserted that numerous such studies existed. The only specific references the APA sent were to psychiatric textbooks, and these textbooks contained passages indicating that NO such studies existed. The APA responded with another load of PR (never citing a single study). Why? Because no such studies exist.

So when you hear the commercials that tell you that depression "may" or is "believed to" result from a deficiency in serotonin, that's not a scientific pronouncement. It's pure propaganda designed to sell drugs.

The last line of defense for psychiatry as a science is the argument that, hey, we don't know why, but the drugs work, and that's what counts. As pointed out in an earlier rambling of mine, the drugs work about as often as placebos work. (But the placebos don't have such devastating side effects as suicide, violence and psychosis. All the psychiatric drugs DO have such results in a small, but significant percentag of the users – and a few percent of millions is hundreds of thousands of people. And they have other annoying side effects in nearly every user. And the effects of withdrawing from them can also be hellish.)

The most recent "meta-studies" of popular psychiatric drugs show them working about as well as placebos. A meta-study is a study that takes into consideration data from all available studies. The FDA approves these drugs after the manufacturer or its sub-contractors test them in multiple trials. But the manufacturers submit to the FDA only those tests where the drug gets the best results. When meta studies look at ALL the tests, the drugs turn out to be, essentially, ineffective.

When a doctor or psychiatrist says that these psych. drugs help many of his patients, what he's not saying (and perhaps doesn't realize) is that a sugar pill would help just as many of them, and without the negative side effects. And a placebo that causes SOME side effects (called an active placebo) would probably do BETTER than the drugs, since the patients would not realize they were getting a placebo.

In summary, medicine is, just barely, a scientific activity, but psychiatry, though a specialty of medicine, is NOT a scientific activity. It has the superficial appearance of adhering to medical standards of rigor, but it does not. The psychiatrist's medical degree is camouflage for quackery.
So when someone says, "What does HE know? He's not even a doctor," one answer is, why should he have to be a doctor to critique psychiatry? Psychiatry has nothing to do with medical science.

For a bit more detail on the "science" of psychiatry and what it all means (the "peer-reviewed, double-blind studies", etc.), you might find of interest my essay on psychiatric jargon.