Medical reversals – when doctors hurt patients

I’ve been asked why I’m so skeptical when it comes to health and medical science. My answer is because I’ve spent many hours studying medical history, and I’ve seen how much damage doctors have done over the centuries. If you were to select a patient-doctor consultation at random from all the ones that have happened throughout history, your odds are probably better of selecting one in which the doctor harmed the patient than one in which the doctor helped the patient. That is certainly true if you only look at consultations happening before the year 1900.

It’s a shame that medical history generally isn’t part of the curriculum in medical school. If it was, maybe doctors would be more humble about what they know, and what they don’t know. If I were to design a medical school curriculum, I would make the first five to ten weeks of medical school an in-depth course in medical history, with a particular focus on all the mistakes doctors and scientists have made through the centuries, and why they made those mistakes. To quote a well worn cliché, those who don’t know history are doomed to repeat it.

Personally, I wear my skepticism as a badge of pride. If I were to seek out a doctor for some medical condition I was suffering from, I would want that person to be a natural skeptic. I would want someone who won’t believe something just because that’s what they were taught in medical school, or because it’s what they heard from a salesperson working for a pharmaceutical company.

I’m going to present four different cases from recent history, that I think show clearly why it’s important to be highly skeptical when it comes to the area of health and medicine. Things can often seem to be very beneficial after a few early studies, or because common sense suggests they should be beneficial. Then when more data comes in, sometimes decades after a certain treatment has become the “gold standard” of therapy, it becomes clear that the intervention is actively harmful. In some cases, millions of people have died prematurely as a result of the intervention by this point. When this happens, when something goes from being the recommended therapy to turning around 180 degrees and becoming something that doctors recommend against, it is known as a medical reversal. Unfortunately, medical reversals are common.

Another thing that I think is unfortunate is that scientific methodology is not really something that is taught in school. People even leave university with very limited training in scientific method. This causes the large majority of the population to be unable to weigh scientific evidence themselves, and it makes them totally beholden to the opinions of others. That’s why I try to use this blog to educate in scientific method. Science, just like democracy, thrives when lots of people are able to examine different pieces of evidence and think for themselves.

Anyway, let’s get to the four cases.

Lobotomy was first developed in the 1930’s by Portuguese neurologist Egas Moniz, and further refined by two American doctors, neurologist Walter Freeman and neurosurgeon James Watts. A lobotomy is basically a surgical intervention in which parts of the frontal cortex of the brain are destroyed. It was developed as a treatment for psychiatric disorders, based on the hypothesis that destroying parts of the frontal lobe would allow destructive mental patterns to “reset” themselves.

After his first surgeries in 1935, Moniz presented a case report of twenty psychiatric patients. He claimed that a third were significantly improved in their underlying psychiatric illness, while a third were mildly improved, and a third were unimproved. None were apparently harmed. This claim was immediately countered by the psychiatrist that had provided the patients to Moniz, who responded that all the patients had suffered a “degradation” of personality.

The frontal cortex is responsible for complex goal oriented behavior, self-control, and higher order thinking, pretty much the things that separate humans from other animals. So, knowing what we know today about the function of the frontal lobe, destroying large chunks of it is likely to turn a person in to an apathetic, lethargic zombie. And this is what happened to the people who were lobotomized, as was clear early on to those who cared to look.

In spite of the limited evidence of benefit, and early suggestion of harm, the procedure was taken up enthusiastically in several parts of the world. By 1949, when lobotomies were at their most popular, thousands of people were being lobotomized around the world each year. That same year Egas Moniz was awarded the Nobel prize in medicine for his efforts.

Then the truth started to catch up with the hype. It became clear that somewhere between 5% and 15% of all patients undergoing lobotomy were being killed by the procedure, either dying on the operating table or shortly after surgery. It was not uncommon for arteries in the brain to become accidentally nicked, resulting in major intracranial bleeding and strokes. When this didn’t kill outright, it often resulted in severe physical handicaps.

It also became more widely known that, although the patients might become more “placid” after the procedure, they were hardly being cured. People who had been institutionalized before the procedure, continued to be institutionalized after the procedure. Few people were able to function independently after undergoing a lobotomy. So lobotomies gradually fell out of favor, although they were still being carried out on patients in some countries as late as the 1980’s.

Let’s move on to our next medical reversal. Starting in the 1960’s, public health authorities around the world started recommending that parents have their babies sleep on their stomachs. The recommendation was not based on any scientific studies, rather it was based on “common sense”, that all too frequent destroyer of lives.

There were multiple hypotheses floating around that together constituted the basis for the recommendation. One was that it would decrease the risk of hip dysplasia, another was that it would prevent scoliosis, a third that it would decrease the risk of aspiration of milk (accidentally getting milk in to the airways), a fourth that it would prevent babies developing “flat heads”.

In the late 1980’s, observational data started to appear suggesting that prone sleeping was causing a huge increase in the number of children dying of cot death, a.k.a. SIDS (Sudden Infant Death Syndrome). Children sleeping on their bellies appeared to be around 500% more likely to die of SIDS than children sleeping on their backs.

Pretty much over night, government health authorities switched from recommending that babies sleep on their bellies to recommending that they sleep on their backs. And virtually over night, the rate of cot death dropped. Dramatically. Here in Sweden, the number of children dying of SIDS decreased by 85% over the course of a few years.

How many children died unnecessarily during the few decades in which prone sleeping was being recommended by public health authorities? Probably millions.

It amazes me how keen government agencies often are to offer recommendations based on little or no evidence, especially when we have such clear examples of situations in which this has resulted in mind-boggling harm. If only public health professionals bothered to follow the first credo of the medical profession, which is “first, do no harm”.

Let’s move on to our next case.

Non-steroidal anti-inflammatory drugs (NSAID’s) have been around for a long time. Aspirin was invented in the 1890’s, and ibuprofen has been around since the early 1960’s. One problem with these drugs, which has been recognized since the early days, is that they can cause stomach ulcers. In fact, over-use of NSAID’s is one of the most common reasons for emergency hospital admissions due to bleeding ulcers.

The reason for this side-effect is that NSAID’s block an enzyme called cyclo-oxygenase, generally shortened to just COX (another name for NSAID’s is COX-inhibitors). There are two different versions of COX, COX-1 and COX-2. All the early NSAID’s are unselective COX-inhibitors. In other words, they block both COX-1 and COX-2.

At some point it was discovered that the entire positive effect that comes from NSAID’s, in terms of decreasing inflammation and pain, comes from their inhibition of COX-2, while inhibition of COX-1 is responsible for the side effect of increased bleeding. This naturally led drug companies to seek to develop specific COX-2 inhibitors, that would decrease inflammation, but not cause stomach ulcers.

In 1999, the first two COX-2 selective inhibitors came on the market, rofecoxib (a.k.a. Vioxx), produced by Merck, and celecoxib (a.k.a. Celebrex), produced by Pfizer. They instantly become some of the best selling drugs in the world. Of the two, rofecoxib was much better at blocking COX-2 specifically, and thus far less likely to cause stomach ulcers.

After a few years on the market, signals started to appear that rofecoxib was associated with a heavily increased risk of heart attack and stroke. In fact, people taking rofecoxib had something like a 300% increased risk of having a heart attack compared with people taking non-selective NSAID’s. Merck’s initial response was, unsurprisingly, to try to put the lid on this information. But by 2004, the cat was well and truly out of the bag. In the face of mounting criticism (and lawsuits), Merck chose to withdraw the drug from the market. By that point, 80 million people had been treated with rofecoxib and around 100,000 people had suffered unnecessary heart attacks.

I’m going to end with a slightly more personal example. On my first day of medical school I was told about a fantastic new treatment that had been developed at my new place of study, Karolinska Institutet, and its associated hospital. The developer of the new treatment was a surgeon called Paolo Macchiarini, and the treatment was a stem-cell coated synthetic windpipe. The windpipe could be transplanted in to people who had damaged their windpipes in accidents, or who had to to have their windpipes removed due to cancer. The idea was that the synthetic windpipe would meld with the surrounding tissues and grow in to a fully functioning new windpipe.

Paolo Macchiarini had been head-hunted by Karolinska Institutet in competition with several other top universities. He seemed a shoo-in for the Nobel prize.

The synthetic windpipe transplant surgeries had started in 2010. The first people to be operated on all died relatively soon afterwards, but there was a lot of media hype around them anyway, probably due to the feeling that this was a revolutionary technology, and probably also due to the fact that Machiarini was an excellent salesman.

Since the people he operated on had an annoying habit of dying, Machiarini supposedly felt that he needed healthier specimens to operate on. Thus far, all the people had been suffering from end-stage diseases that would have killed them in the near future even without the surgery. Maybe they were just too sick to begin with to truly benefit?

So he found some people who weren’t actually dying. In 2012 he put synthetic windpipes in to two people who lived with chronic tracheostomies (breathing tubes in the throat) after car accidents, and one in a woman who had suffered accidental damage to her trachea during an earlier surgery. In 2013 he put a synthetic windpipe in to a two-year old who had been born without one. These people were perfectly healthy otherwise, and they were young.

The synthetic windpipes didn’t work. The stem cells didn’t turn in to functional epithelium, as had been hoped. The synthetic windpipes became seeding grounds for bacteria and were attacked by the immune system. They failed to meld with the surrounding tissues. They literally fell apart within months. And the patients died.

What is particularly galling is that there was no need for the synthetic windpipes. Windpipes could have been taken from cadavers instead. In fact, Machiarini had started out doing surgeries with windpipes from cadavers, which had on the whole been successful, but had then chosen to switch over to synthetic windpipes, apparently because it seemed more high-tech and was therefore more likely to generate media attention. The entire exercise was a PR-stunt, primarily intended to speed Paolo Machiarini on the path to a Nobel prize.

By the time I first heard of the synthetic wind pipes, on my first day of medical school in September 2014, things were already starting to come apart. The patients were dying like flies – even the ones who had been healthy before their surgery. Yet Machiarini was continuing to publish articles in prestigious scientific journals, in which he claimed that the stem cell treated synthetic windpipes were holding up well, and integrating with the surrounding tissues, just as planned.

Everything came crashing down very suddenly, in 2016, when Swedish public television aired a documentary that told the truth about Machiarini’s surgeries. Apart from making clear that the surgeries were nowhere near as successful as was being claimed, it became clear that Machiarini had never tested any of his synthetic windpipes on animals before moving on to humans(!), and it also surfaced that colleagues at Karolinska University Hospital had tried to blow the whistle on Machiarini two years earlier, in 2014, but had been threatened in to silence by the leadership at the university and the hospital.

I guess this last case isn’t really a medical reversal, since the synthetic windpipes never actually became standard practice. But I think it’s an interesting cautionary tale. There are lots of charlatans out there, masquerading as serious scientists. Some of them get discovered early on, like Paolo Machiarini, and some of them don’t get discovered until decades have passed and many people have had their lives ruined, like Egas Moniz.

My main point from these cases is that doctors and health authorities harming patients is not even remotely something that is in the distant past. We’re not talking blood letting here, a practice that resulted in millions of unnecessary deaths, but that doctors thankfully stopped doing on a regular basis two hundred years ago. Serious medical reversals have happened in the recent past, and they will happen again. They are particularly likely when new interventions get rushed out based on scant evidence.

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75 thoughts on “Medical reversals – when doctors hurt patients”

  1. That’s scary. And I guess its not a coincidence that this text is posted in the moment where we have an absolutely safe, non-experimental, messenger-RNA vaccine. Scary
    Thank you. Im enjoing this blog immensly

  2. Scary and sad, to say the least. Most galling is the apparent nonchalance with which many in the medical profession experiment on real, actual human beings. And when things go wrong, the attitude seems to be ‘Oops, oh well.., let’s try something else.’ ‘At least Dr. Jones meant well…’ In engineering, or the military, or 100 other professions, no one cares what you meant to do, and if things go wrong, hasta la vista baby. Glad to see a doctor calling these things out. One further, related pet peeve….the recent use and glorification of the term ‘evidence-based medicine.’ People trot that out like they deserve an instant merit badge for simply parroting it. Excuse me, but what the heck were you practicing previously? Hunch-based, whim-based, the wind is blowing this direction-based medicine? I would’ve thought medicine would always have been evidence-based!

    1. Mike,
      I consider that you have plenty of reason and I thought that through the centuries every act to treat or to cure has always been based on the evidence then available. I am not thinking of criminals: these were not doctors.
      We cannot compare any evidence based medical act on the last half of a century with what was was evident centuries before.
      Dr Sebastian Rushworth seems to be an intelligent person. But he is too much young to tell horror stories. Reminds me how the Grimms brothers started.
      Here, in Portugal we had an annual discipline called History of Medicine in a span of more than 35 years.
      We had a worldwide know doctor who wrote: physicians who only know Medicine, do not know what is Medicine.

    2. Dear Mike

      When we aren’t observing evidence based, we’re observing models. Neil Ferguson can explain the difference between the two. He’s a huge fan of models.

      Sebastian, thank you for the blog. It is very informative.

  3. A 74-year-old woman being hassled by my GP practice, I reproduce below the email I sent to them…

    Regarding the Covid-19 vaccination, I am still undecided as to whether I am prepared to accept a medical intervention which is unlicensed and still in an experimental phase of development. I believe that I, along with the rest of the UK population, have been denied the information on which to give properly informed consent to a procedure which is not even due to finish its Phase 3 trials until the end of 2022 at the earliest.

    Leaflets claiming that the vaccine has raised ‘no safety concerns’ in ’studies of more than 20,000 people’, together with veiled threats of sanctions for those remaining unvaccinated, hardly count as information. Add to that the indemnity for the drug companies in case of disaster, and you may understand why I am cautious about becoming an unpaid guinea pig.

    When, and if, I decide that I am prepared to risk having this vaccination, I will contact the surgery or book online.

  4. The older I’ve got, the more I’ve trusted my own judgement over experts, if only because my health, building work or legal matters etc. are much more important to me than to any expert, however much I am paying him.

    (Back in 1989, I put my baby daughter in her cot on her tummy. Once. She looked so uncomfortable with her little head screwed round to the side that I turned her over, in spite of the unanimous advice at the time.)

  5. Brilliant article. I’ve met countless doctors over the past two decades through my wife’s struggle with chronic issues and while some have been good or outright brilliant, some were bad and downright arrogant.

    Please do vaccines next. For instance, look into why SIDS rates dropped dramatically in the US during lockdowns in early Covid days – when people were skipping the well baby visits.

  6. Another example; patients with back pain were put to bed and “rested”, sometimes in traction, for 2 weeks until, about 30 years back, a proper study showed that such patients did far worse than those who w ere encourage to exercise.

  7. Congradulations doctor for really rational medical thinking. I tend to put it a little more harshly because I am the doctor who coined the word pharmaceutical terrorism about 15 years ago when I wrote a book about vaccines entitled The Terror of Pediatric Medicine. During the pandemic I have published a lot about this but funny was not till this week that I was censored by Facebook with this….

    It offers really good news…..too good…..research out of Brazil, where I have been living for the last 30 years…..nebulization of bicarbonate resolved lung issues for COVID patients in ICU…..

  8. Thank you. Very fine article. Even if I am a little jolted by it.
    Just a very small point: it is Shoo-in not shoe in.

  9. Great article as always. However, in relation to cot deaths, I understood that the reduction in SIDS was due more to parents being advised not to smoke beside babies or sleep with them when under the influence of alcohol which happened at the same time as the back to sleep campaign? There was also a change in the manufacture of mattresses making them more breathable. I’m currently interested in this because a family member has insisted on her baby sleeping on her back when she clearly sleeps better on her stomach. It leaves me wondering if advice either way is helpful?

    1. Also, mattress chemicals… our own criterium was to rotate the baby between every position, sideways, on his back, on his tummy, and see. Of course we didn’t try standing, sitting nor upside down, *LOL* No flat head and also no health problems.

  10. Doctors overmedication and overtreatment is the 3:rd highest cause of death in US today after heart deceases, and cancer, according to recent studies, the reason of course being that Big Pharma has pushed very hard to sell medications, and thus make money. With this in mind, it’s very important to know what (by far) is Big Pharmas greatest economic success, Vaccin.

    I recently read an outstandingly good and informative book called ”Virus Mania”, by MD Claus Köhnlein, and medical journalist Torsten Engelbrecht, it effectively and scientifically lays out all the flaws and missconceptions regarding viruses and vaccins during the last century or so, it’s a must read in my opinion. MD Claus Köhnlein was a personal friend with Kary Mullis, the Noble Prize winner, and inventer of the PCR-test, and he reveals that in Kary Mullis own opinion a PCR-test should be used for science, in a lab, it’s totally unsuited for testing on humans to decide if you have an infection or not, it can’t do it. One of the best book I ever read.

  11. Anecdotal but:

    I almost didn’t survive vaccination-induced Guillaume Barre syndrome in 1966, at age 16.

    Creeping paralysis, including breathing muscles, and nerve damage that has never quite recovered.

    The gold standard treatment at the time was (very strictly) enforced bed rest and steroid injections. Apparently this is now thought to be ‘the worst thing you could do’…

    I keep well clear of the medical profession whenever possible. You don’t need to ask my opinion of vaccination!

  12. I can’t help wondering whether you yourself have ever been “threatened into silence” because of any uneasy information that you have been offering us. I sincerely hope not though. Thank you and please keep up your good work.

  13. Your post brought tears to my eyes.  I have Dystonia –  a neurological condition that causes odd-looking body spasms and tremors.  Currently, mainstream neurology liberally offers pharmaceuticals with a proven low effective rate and side effects usually worse than the condition itself, botulin injections often put into wrong muscles and in doses too high that infiltrate others areas of body, and worse still Deep Brain Stimulation surgery (which may have benefit for cases who are suffering tremendously, but neurologists are offering it out now like candy…..).  I know a recent case of a 12 year old girl who had the surgery for a simple leg dystonia – such a tragedy!
    The historical retrospective is way more chilling.  Even as recently as the 1970’s Dystonia patients were institutionalized (as it was considered solely a psychiatric disorder). Although psychiatric comorbidities are common with dystonia, most are mild and it was the irregular body movements that cinched the trend to commit patients to psychiatric facilities.  Go back in history further to Exorcisms (think Linda Blair in the Exorcist with a neck torticollis – twisting neck spasms out of control).  Many Exorcisms were in fact done on who we now know as Dystonia patients.
    The dystonia community does have Dr. Farias from the Neuroplastic Training Institute, pioneering a more logical way to recover function and manage the condition – through exercises for hypotonic muscles, relaxation techniques, breathing exercises, eye exercises, choreographed movements put into dances to once again inhibit childhood reflex poses that become uninhibited with dystonia.  It’s an all natural approach to a complex problem – after 5 years and lots of work my condition has improved 95%, with no medications whatsoever.  
    There are some awesome doctors out there looking for a better way – thanks for being one of them, Sebastian.  

  14. Between 1950 and 1960 my father was repeatedly sent to mental hospital for ‘depression’. He was given Electrical Shock Treatment. It was ‘advised’ he should have the lobotomy, but a friend advised not.
    He died at 60 years old probably bronchitis, he’d always had ‘a weak chest’.
    NEVER did he have suicidal thoughts. I remember nothing that could be described as depression. His ‘nerves were bad’ but then he had driven an ambulance in France in WW1.
    On the other hand my mother considered suicide when I was a toddler. Near the end of life she was constantly threatening it and eventually made an attempt.

  15. Hi Sebastian
    I love the articles keep up the great work.
    Just a idea, are you familiar with the virus strangles??. And how that is linked to the basics of the now corona virus… also what is the most efficient way to kill a virus in a hospital or human body.. i have plenty of theories but im intreagued how your research will enlighten me. Keep up the great work.

  16. Thank you for the examples of medical reversals. There was a PBS special in the US about 10 years ago on the sad history of lobotomies.

    Perhaps much of a War on Covid might be remembered like the practices above . Lockdowns and isolation of healthy people, face masks in public settings, constant hysteria from authorities, and perhaps even rushed vaccines might cause more harm than good.

  17. Thank you, Dr. Rushworth. Indeed, bad medicine hasn’t gone away, and won’t, as long as great gobs of money are to be made, and academic prestige to be garnered. A glaring example today are the unnecessary coronavirus vaccines. Vast fortunes have already been made from these, and it won’t end well for too many of the victims of fear who have taken them. My 87-year-old neighbor, who is in excellent health, just took them. When I told her they are unapproved experimental medical procedures, she insisted they are approved!

  18. Interesting today that doctors are trying to cure a mental illness (gender dysphoria) with mutilating surgeries and it is not only acceptable by physician organizations but by governments and special interest groups. How people just never learn from history.

  19. Thank you for this interesting article. If you ever repeat this, i suggest you include radical mastectomy as an example of what was thought to be good treatment based purely on blind application of first principles.

    It might be a good move to ask people to confine their comments to the subject matter of your article. Some seem to use the comment section as an opportunity for tub thumping on their favorite rant, eg vaccinations etc

  20. Excellent article! thank you. You could continue with the inherent and persistent resistance in traditional medicine to embrace data correction, new scientific evidence that criticize procedures, etc. That is, expand on the Simmelweis Effect.

  21. Really interesting article. Perhaps a reason for the trust in widely and officially promoted remedies is the pervasive belief that we now know everything. This belief seems to be rooted in the fact that we really do know hugely more than we knew say 200 or 100 years ago giving the illusion that compared to those days we know everything when in fact we are only at the beginning of understanding life. A pie chart of what we know versus what we don’t know would need a very fine draughtman’s pen to define the segment of our actual knowledge in fact it is amusing to consider that the vastness of what we don’t know could never be represented on just one pie chart. Things like the current panic pandemic and its seemingly pointless remedies so show how we can as always see what happens but we are so guessing at why it happens resulting in a weird zealotry to support unconvincing evidence.

  22. Another reversal, still in process, was the recommendation to cut fat out of the diet and replace it with carbohydrates.

  23. Thank you Dr. Rushworth, for another great article. I’m wondering if you think low-dose aspirin therapy might be one of those treatments that ends up doing more harm than good? My husband was advised to take it due to a partially blocked artery even though he has absolutely no risk factors, no symptoms, no illnesses. I don’t like the idea of taking any medication on a permanent basis. Do you believe aspirin’s benefits outweigh the potential harm?

    1. This is a topic where medical opinion has shifted significantly in recent years. Previously, aspiring was given out liberally to everyone who was considered to be at even slight risk of cardiovascular disease. Then data came out showing that for people who aren’t at very high risk, the risks outweigh the benefits. So now aspirin is only recommended to people who have already had a heart attack or stroke.

  24. I ALWAYS read your blogs in amidst the many articles around at the moment because I value them so much.

    This hits the mark again. As well as the examples you mention, I recall a Dr who was vilified in the 1940s (I think) for encouraging heart patients to move around. He was likened to a Nazi but if his advice had been followed, millions of lives would have been saved.

    A modern day brave Dr is Dr Clare Jones, a GP in Hereford, who has written to her MP after being told to have the Covid 19 “vaccine” or be struck off!

    It’s not about health, it’s about money.

    ‘A GP Protests “No Jab, No Job” ‘

  25. I see I was not the only one to think your post is very timely. And

    About MD Claus Köhnlein there is a nice interview made by Dr Sam, an interesting woman from New Zealand with a typical accent (!!!). Köhnlein says exactly what you are saying, that doctors are killing their patients….

    A curiosity, I saw a Larousse (in French) from 1923 that recomend talking blood for hepatitis.

    Keep the good work

  26. It’s very heartening to see there are doctors who are prepared to speak out and tell the truth – something that is generally strongly discouraged within the medical profession.

    I have a request, but can’t see how I can contact you, Sebastian …could I have your permission to publish the part of this post just about NSAID’s on my blog? Of course I’d provide full attribution along with a link to your original post.

    Thank you, and keep up the great work!

  27. Well said. Thank you all for questioning ‘authority’ and the pharmaceutical companies who have profits as their main objective. It’s not to say that certain drugs do save lives and for that we are all grateful but I do wonder who is at the top of these companies driving their agendas.

  28. The problem with assuming the harm caused by medical intervention is just an unfortunate side effect of the slipshod pursuit of profit or prestige is just that, an assumption. When the damage stacks up so high it outweighs the benefit, cognitive dissonance leads us to another assumption: the system is just broken.

    What if the system is working exactly as it was designed? If I were a medical professional, I wold have a particularly hard time coming to terms with this possibility.

    But there is more history to look into.

    And more still.

  29. Robert F. Kennedy Jr., in his eye-opening introduction to Judy Mikovitz’ book “Plague of Corruption” discusses several innovators who had their lives ruined by the establishment scientists and industrialists of their time. Not exactly the same phenomena, but the flip side of the same coin.

    1. When reading about lobotomies the first name that popped into my mind was Robert and John F. Kennedy’s sister, Rose Marie, having endured a lobotomy at age 23.

  30. @iankestin, but it is actually a subject of the article. An experimental procedure forced on the public who were made to believe in it. And just as with the others nefarious procedures mentioned in the article, in 10 years or so Covid vaccinations will be included in that list.

  31. Some ideas from a field I have formal training in (philosophy of science) perhaps offer the basis of a constructive critique. Your views appear to be consistent with a position called the ‘pessimistic meta-induction’. In the scientific context, this roughly means that because most scientific theories in the past turned out to be false, or flawed, we should assume our current theories will also (eventually) be found to be false or flawed. Your arguments for skepticism are similar. Others like scientific realists adopt contrary positions such as the ‘optimistic meta-induction’. One can argue for real scientific progress such that we ought to have greater confidence in current theories (or current practices and theories in medicine?) because of real epistemic advances and so forth, particularly for older (more “mature”) sciences or related fields that can build on the accumulation of scientific knowledge.

    This brings me to your choice of cases. Psychiatric and cognitive sciences are young (“immature”) sciences, and pediatrics is a relatively new branch of medicine. (Another case is more a case of a charlatan, as you noted). Stronger cases would be ones in which major errors were recently discovered in more well-established branches of medicine (and/or related mature sciences).

    1. “Your views appear to be consistent with a position called the ‘pessimistic meta-induction’. In the scientific context, this roughly means that because most scientific theories in the past turned out to be false, or flawed, we should assume our current theories will also (eventually) be found to be false or flawed.”

      With all due respect, I think that’s an overstatement. I think the article is simply pointing out that we should be aware of the possibility that current theories *may* be faulty.

      See John Ioannidis, for example, about the accuracy and lack thereof in something like 1/3 of published scientific articles.

      And many of us can speak from personal experience (multiple instances for me). In that case I don’t give a fig for the philosophy of it all.

  32. A related argument you might like to consider is that one’s level of skepticism ought to be tailored to the relative maturity of the science and/or related practice one is considering, rather than being a ‘blanket’ default attitude (or a rigid philosophical position, such as can be seen in some more extreme philosophical positions like radical skepticism). This also implies that the right degree of skepticism to adopt often ought to be carefully judged on a case-by-case basis.

    Additionally, it seems possible that a medical doctor who adopts the blanket default attitude of intense skepticism may also exhibit insufficient openness to new ideas (e.g. the discovery of a new medical condition, or emerging ideas about new treatments for a disease), and such doctors may consequently be a danger to their patients for different reasons to the insufficiently skeptical doctor. In other words, excessive skepticism may be just as problematic – in some cases – as being too credulous.

    What seems at first like a clear, uncontroversial epistemic virtue may turn out to often be a vice (on this see vice epistemology).

  33. Stephen McGrail, tell your constructive theories to the families of those who died unnecessary deaths.

  34. Andre,

    With respect, I think your comment appears to reflect a misunderstanding of what I was arguing. Clearly all the cases cited by Dr Rushworth are horrible episodes in the history of medicine (and are deserved of our critique, and sympathy to those affected), but the central question I’m attempting to pose is whether they (along with a wider reading of medical history) provide a credible warrant for the intensely skeptical attitude adopted/promoted by Dr Rushworth.

  35. Dear Dr. Sebastian, congratulations on this article, although a sad reality is exposed. But we have to point these facts. Nevertheless, your article touches on a huge problem: the powerful pharma industry can push as safe and effective many dangerous and poorly studied compounds while demand high standards for approval of new drugs aimed mostly to protect their proprietary compounds from the competition with newcomers and influence regulatory organs like FDA because they pay the agency to conduct studies of its drugs. The tragedy of COVID-19 deaths shows this clearly: no effort was made by the regulators and, of course by the industry to check the immense evidence for the inclusion of early treatment. The media is complicit because they can be easily bought. Besides ivermectin that you recently reviewed, the same impact is clear from hydroxychloroquine (HCQ), zinc, and azithromycin and Dr. Zev Zelenko just unveiled a new route to administer HCQ direct to the lungs by aerosol, achieving one-day relief of symptoms! Why is ambulatory treatment shunned instead of being added to high complexity hospital treatment and vaccination? The possible answers are nauseating and criminal. And doctors are also currently hurting patients by inaction, by acting as unthinking zombies, waiting for authorization from NIH, FDA, OMS to treat COVID-19 patients, ignoring the many successful treatments championed by the many fellow doctors that are actively pursuing lifesaving treatments, backed by published articles. FG Nobrega, MD, Ph.D

  36. A great article. What about the dictatorial advice about fats and heart health and the about-turn when they find that sugar is the culprit? Sadly history will repeat itself, as we are seeing with the experimental preventive treatment for C19. Approved too quickly, hopped over animal testing and no knowledge of longterm effects. The wellbeing of the trusting recipients is overshadowed by prestige and financial reward.

  37. “Medical reversals – when doctors hurt their patients” is the caption to the article. A couple of years ago I fell across the raging debate in USA over Infant crcumcision, a procedure where “surgeons”,mostly OB-gyns, perform foreskin-amputation on new-born baby boys shortly after delivery. A procedure that removes almost half of the skin of the tiny penis. About 1,2 million newborn boys are subjected to this “surgery” every year, leaving 100-200 babies dead and many more with deavstating complications. How this can go on year after year whitout any debate in the medical field is nothing but a mystery. The trade organisation AAP claims thet there are “potential” medical benefits to foreskin-amputation but they also admit that surgery is not needed for genital health. So why do American doctors operate on healthy babies for simply no good reason?

  38. Thanks for a thought-provoking article showing that caution and skepticism are just as important in medicine as in other areas of life.
    With that in mind, might you be able to give us an update on your view about the three main covid vaccines that you posted last month?

  39. Maybe I am a bit more sanguine about it. Even the medical field will make mistakes that costs people’s lives but in the end the important part is to achieve progress. How many doctors tried new approaches that turned out to be a blessing. The flipside is that some doctors get caught up in their own failed ideas. Medical science is as marvelous and dangerous as any other science. Prudence and slow advances should be valued instead of blockbusters and revolutionary new therapies.

    My biggest gripe is that governments or state institutions give out health advice at all. Within political science and economics we know that governments and their agencies are very prone to be captured by special interests or conversely held back by bureaucratic lethargy and resistance to change. I mean my country’s official agency for nutrition still recommends a majority carbohydrate diet (no more than two servings of meat a week but hey have as much milk as you want) albeit they suggest more whole grains than before. In fact they suggest eating predominantly plants. What am I…a cow? Following this diet gives me diarrhea.

    My suggestion to friends is to ignore official health advice and figure things out for yourself or talk to your doctor. And if your doctor just rehashes official stuff uncritically look for a new doctor. I often had digestive issues until my GP told me that a certain percentage of people have trouble digesting whole grains as they contain natural insecticides (because the plant does not want it’s seed eaten up by insects) that can inflame the intestines and suggested I avoid them for a while. Turned out I actually belong to this group and minimizing whole grain made me feel better.

  40. Stephen,

    The real issue is not the technology or advancements in medical science, it is the people/doctors. You may have had a chance to read Dr Rushworth’s article “Deprescribing: the most important health intervention you’ve never heard of?”. It is increasingly difficult to trust a doctor, realising that that what he/she’s prescribing is the result of the how good the pharmaceutical company salesman is, that there is no real verification of how multiple medications will affect the total health of the patient and that what is prescribed may actually be harmful overall. After being referred to a specialist most often than not you’re advised a surgery/procedure in specialists’ private practice or a public hospital as a private patient. Money and glory seems to be the driver, not the Hippocratic Oath. The comments for this article reflect that.

    1. Andre,

      Yes I did see that article, and medicine is indeed a human activity and therefore susceptible to all the usual hazards like corruption, the influence of bad incentives, fallibility, and the like. In the present context there is both human and corporate influence on medical practice.

      But, to quote an influential science studies scholar (Harry Collins), “we cannot live by skepticism alone” (

      Sentiments like those encouraged the present article we’re commenting on are a useful reminder of human fallibilism, etc, but they can also encourage corrosive forms of skepticism which are potentially just as damaging as the historical events it describes – indeed, I would argue that many of the views expressed by commenters point to such hazards. It would be good to see Dr Rushworth call out such behaviours, in contrast to his tendency to allow the misinformation free-for-alls which I’ve sometimes seen develop in the comments section under his COVID-related articles.

  41. Dr. Malcolm Kendrick has talked about the standard treatment many years ago for people who suffered (non-fatal) heart attacks: strict bed rest for long periods of time. Kendrick claims that many thousands of patients have died due to this ‘treatment’. I believe the ‘bed rest’ treatment is now a thing of the past.

    1. Fulfilling his title, “Doctor”, derived from word describing one who is inclined to, and qualified to impart knowledge, to Teach.
      Thank you !

  42. My favourite would be ….. a ‘novel’,,, use of that Evil Weed, – Tobacco. – for a formal description.

    Also in recent times….

    We in Western Australia were very lucky, for when the Plague loomed… our Leadership discovered that our hospitals were not over-burdened with ‘Ventilators’, rusltling up a heap of second-hand CPAP and BiPAP machines was the best we could do. Luckily, we had few acute cases (proper use of word “case” ) and the snoring machinery coped ! As we now know, aggressive ‘ventilation’ killed as many as it saved. Or more.

  43. Stephen,

    Your comments are certainly valid, however paraphrasing Harry Collins with regards to Dr Rushworth’s article the message it conveys is “Without scepticism we may not live long”.
    Taking a risk of being a bore let me add my experience. Despite of being healthy and a fitness enthusiast I had 4 unexplained cases of Atrial Fibrillation (AF). The first, 35 years ago when I lived in Canada and was on a business trip in Huston. When I reverted in a hospital where I was admitted after a diligent verification whether I have sufficient funds on my Visa, I was prescribed Digitalis and advised to avoid exercising. The drug made me feel bad and soon, back in Calgary I was prescribed antidepressants. It didn’t really help. One day walking by a gym and looking at people exercising I started crying. I decided to stop the treatments and went back to the gym and to a normal, happy life. The next episode was 12 years later when I moved to France, no drugs just the echo and other tests with a diagnose, nothing wrong with your health, continue living. The third episode was 8 years ago when we already moved to Melbourne. As in Paris, after a treadmill stress test, the advice from a cardiologist was the same, continue with your life, no need to see me. The last one, six months ago however was very different in the same hospital. Previously I stayed in the area I was admitted to and released right after reverting 2 hours later. This time I was moved to 3 different areas, still reverted in 2 hours but was released in more than 4 hours when a doctor came and gave me a prescription for a blood thinner and asked me to be permanently on it. When I said that taking into account the previous experience and the frequency, I don’t think that this might be necessary, she left, offended. Would it be beneficial for me to be on a blood thinner for 6 months now ? What about the risk of internal bleeding?
    As previously, I went for a stress test. I asked the technician who was doing the echo in preparation whether I will be able to take the mask off doing the test. He said that it depends on the doctor, some will allow to take it off towards the end when you are breathing heavily. The objective of the treadmill stress test is to go as far and as hard as you are able to and to get the ECG right after so it is can be strenuous. Unfortunately, the doctor that came didn’t allow me to take the test without a mask. The cardiologist asked me to do a CT scan to compensate for the missing test. When I saw him afterwards, he said that while the reasons for AF are still not well known, aside of precautions, his practice can do a procedure that might eliminate it by going into the heart via the artery and doing a little surgery on a nerve there. Seeing my reaction, he said that perhaps we may consider a less intrusive procedure first that still goes into the heart. At the end we agreed on a medication that I’m to take when the next episode happens which supposed to help me reverting faster and a blood thinner taken at the same time and continuing for 2 weeks afterwards.
    The main issue was though, the gyms were closed because of the lockdown. I cannot run anymore but can get a very good exercise on a cross-trainer and using weights. I got very lucky, my elderly neighbour who I help mowing the grass and doing other garden work said that he had an exercise machine that he hasn’t been using for a long time as well as some weights rusting away. The exercise machine turned out to be an old but functional cross-trainer. I continued exercising and started building a home gym on our veranda getting more weights from neighbours, buying cables, pulleys on line and most construction materials from Bunnings Warehouse. After 3 months and a lot of work (I’m an IT guys not a tradesman) we (my sons use it as well) have a very functional gym. I posted a video on our YouTube channel with instruction how to build a home gym to help others.
    The message from Dr Rushworth’s article is pessimistic, it warns that unfortunately you need to keep in mind that the advice and medication/procedure given or prescribed to you are not necessary the best for you. That they might be given based on wrong recommended process, or to avoid liability (like my case for being permanently on blood thinners) or simply for a financial gain. The biggest issue of course is how a patient can decide for himself/herself what to take and what to avoid and why he/she has to.
    I might be wrong but I think you are a young person in a good health that did not have to see many doctors, especially for serious issues. That comes later in life.

    1. Andre it is a common fault….going to see a cardiologist….or almost any other doctor….I often only half jokingly tell people better to go to a gas station for medical advice…at least they know what they are doing, know to put the gas in the gas tank……two huge things, and I have published much through the years and even a book….magnesium is the ultimate heart medicine….so many decades of research sustain that statement and title of my book….but do they prescribe it? No…..and what does that make them? Second they still and you too ignore the science of heart rate variability….you want to see whats going on with your heart that is the ultimate test and easy to do at home with the right equipment…..get a real handle on the stress of the heart and the entire body…I use a device from Russia called the VedaPulse….amazing device even in its less expensive consumer version….I started an essay this morning where I will feature Dr. Rushworth’s view from this thread it starts like this:

      Ruining People’s Lives With Modern Medicine

      In writing my essays these days, I frequently sit in amazement. If our media did any honest reporting about medicine or health care, more people would be alive, and fewer people would be facing terrible suffering. Based on the runaway hysteria about viruses and other catastrophic medical failures in the areas of cancer, heart disease, and diabetes, it seems that the pharmaceutical industry, which is the backbone of the medical-industrial complex, has it in for the human race and is doing its best to ruin as many lives as possible. I call this pharmaceutical and medical terrorism.

      We know something is wrong with doctors and our medical system, but most people still trust them with their lives. Investing trust in the wrong people is usually ruinous. How much dishonesty/ignorance does it take before the public stops putting blind faith in doctors and their deadly medications? The publics’ widespread acceptance of the medical-industrial complex suggests we enjoy the abuse.

      Sadly, when things get terrible, as they have throughout this pandemic, no one and no part of the world will be entirely immune. We will all feel the pain, and the suffering will be off the charts. Adding financial, emotional, mental, and spiritual considerations takes us to places humanity has never been before. Yet we are a million miles from taking out the pitchforks and gathering tar and feathers.

    2. Andre,

      Thanks for sharing your own experiences which help me to better appreciate your response to Dr Rushworth’s article. As for my own age and health, I’m middle-aged so older that you thought but I am in reasonable health (no chronic illnesses or other conditions). My elderly parents have ongoing health challenges and issues in their own interactions with the healthcare and doctors, and my intimate familiarity with this means I don’t have a simple “black and white” view of these issues.

      Here in Australia the doctrine of patient autonomy holds, declaring that competent adults can make informed decisions about their own medical care. I sounds like you’re doing your best to make these decisions for yourself. Whether most people are capable of doing this effectively, or whether they are more often than not better served by “outsourcing” decision-making to trained experts is a complex question requiring careful consideration of the case in question.

      I have seen cases of the worst kind of autonomy where people essentially shop around for the “right” diagnosis (i.e. the one they want) and ignore the advice of doctors which is contrary to their own judgment about their condition (or what’s right for them), and I have seen the consequences of over-treatment and over-confidence in the medical profession in which the people involved perhaps ought to have trusted doctors less (and perhaps trusted their own judgment more).

      But judging by the sorts of comments that often appear under Dr Rushworth’s articles his intensely skeptical outlook seems to more often be responded to in ways that seems to legitimise nonsense (it’s interpreted as validating this), rather than encouraging healthy well-informed skepticism which defers where appropriate to expert judgment and related knowledge. It seems that because experts are fallible (and medicine flawed) people think their judgment is just as good and, moreover, they frequently judge themselves to have expertise where they in fact do not.

  44. It may take years- perhaps decades- but the ultimate medical reversal will be that vaccines are actually “UNsafe and INeffective”:

    Here are 2 sides of the debate (Fauci’s view):

    RFK JR’s recent post:

  45. Wonderful stuff from you – as usual.

    Zero hedge carried a piece recently ( claiming that Professor Jonas Ludvigsson of Sweden’s Karolinska Institute had announced that he would stop all further research on Covid-19 after a campaign of abuse and harassment.

    Apparently, his research suggests that studies showing a low risk to students and teachers from covid are probably right in contradicting the mainstream media narrative and the position of teachers’ unions.

    According to the article, Ludvigsson was attacked and hounded out of further research. Is this really the case? If so, I am disappointed. Sweden has been a beacon of rationality & this is another sign that the lights are going out and the world is heading for a dark future – much as feared by Carl Sagan many years ago.

    One small off-topic thing . . . could you make an RSS feed available? Old fashioned maybe, but I like it.

      1. Thanks for the RSS link.

        Sad news about the removal of yet another real scientist.

      2. Can we have more information on Professor Jonas Ludvigsson of Karolinska? What happened here (Dr Rushworth, I cannot see that the rss feed works, at least not on Chrome on a W10 OS).
        What was his research and why did he leave. For a Karolinska Professor to quit, especially under such circmstances, is pretty high on the Richter scale. Things like this do not happen in Sweden… or surely I have misunderstood.

        This is the text posted by Devonshire Dozer:

        “Ludvigsson researches and teaches clinical epidemiology at Sweden’s Karolinska Institute. His research is consistent with studies that have long found a low risk to students and teachers. This research was highlighted during the Trump Administration in a call for the resumption of classes but largely ignored by the media. The argument for reopening schools, particularly for young children, was portrayed as political and “not following the science.” Commercials ran that calls to returning to the classroom was tantamount to “murder.”

        However, the science has been overwhelmingly supportive of such reopening.

        Indeed, Catholic and other private schools in many states never closed without surges in the virus.

        Ludvigsson looked at children from age 1 to 16 during the first wave of COVID-19 and found that only 15 children went to the ICU, for a rate of 0.77 per 100,000. Moreover, in the 1-16 age group, there was only a slight increase from the four-month period before the pandemic to the four-month period following the period.

        Such studies contradict the media narrative and the position of teacher unions, including many which continue to oppose a return to the classroom despite the science. Accordingly, Ludvigsson was attacked and hounded out of further research.

        The response of the country however has been different from the response in the United States. Various academic leaders and groups are pushing for legislation designed to protect academic freedom. They are citing a Swedish government study in 2018 found “21 out of 26 universities said that there is a risk that researchers will be exposed to harassment, threats and violence.””

        If I recall correctly, kindergartens and primary (UK) or junior schools (US) (ungdom skole i Sverige) remained open throughout the spring and early summer. I belive primary or junior school (ungdomskolen) is up to 14 years of age, while up to 18 is High School (Vidergående). The High Schools (Vidergående) were closed. All the older kids, and also students at Technical college, University and Med school, were “Locked Down”. If so the break on up to 16years of age is not consistent with the scholars and students who stayed at home and the younger ones who went to school every day. I could be mistaken here as regards age groups. But for the epidemiology let us be absolutely clear, the school and college students absolutely in no way “Locked Down”, certainly not in the slumtowns of Sweden, they all just hung out in groups (to use the Americanism) with their SmartPhones, bored out of their minds. Thus by no interpretation could the shutting of schools be argued to curb spread of C19 or any other viral diseases the school kids might have.

        Excellent blog, excellent and constructive blog atmosphere, and great posts. A lot of terrific posts, thank you AhNotepad McGrail et al., and thank you Devonshire Dozer for this on Jonas Ludvigsson.

        regards from Slumdog, writing from the Lost Slums of Sweden

  46. By now I think that most people who commented here, were mainly impressed by what is called medical error.
    Medicals errors exist since the beginning of Medicine. Only social errors have a more long pedigree and ungracefull results.

    I like ones below that tell what humanity is:
    1. People who do things, make errors. {devils}
    2. The best in their activity are those who did fewer. {humans}
    3. People who do nothing, never made a mistake. {saints}
    1. Those who can, do;
    2. Those who cannot do, teach;
    3. Those who cannot teach, administrate

    It is a Brave Old World…

  47. I was aware of the issues around lobotomy as I was a potential candidate for a partial lobotomy to treat complex partial epilepsy. However, the medical team assessing me decided that this would end any career I had planned (in accountancy) before it even started and instead, they opted for selective resection of the amygdala hippocampus area of my brain. Thankfully a success – I am now a qualified accountant and driving licence holder.

  48. Walter Freeman was not a trained surgeon. His operations consisted of hammering an ice pick through thin bone above the eye and wriggling it around. He is believed to have carried out around 3500 of them. Up to 25 a day at the height of the craze. His youngest victim was 12 years old.
    Lombotomies are no longer carried out, but electro-shock therapy is, despite no good evidence of benefit beyond the treatment course, and evidence of fatal consequences and memory loss.
    The whole area of psychiatry is ripe for medical reversal, including the dubious business of psychiatric diagnosis, which largely consists of lumping people into arbitrary and stigmatising categories of no clinical validity. People have been conditioned into feeling the need for labels to justify the way they are, but that doesn’t mean such labels are clinically valid or helpful, or that there are not ways of helping people without them.

  49. I have had at least 4 exposures to Fluoroquinolone antibiotics over the last 30 years. Only once was such a prescription appropriate. This has left me with problems with tendons and cartilage in various parts of my body. Despite long overdue recommendations from the FDA and EMA that this class of antibiotics should no longer be so widely used and never used as a first antibiotic choice if a safer one is possible doctors are still dishing it out inappropriately as evidenced by patients coming onto “floxing” forums . These drugs were developed as ” big guns” to deal with serious infections like anthrax. Sadly there is no money in that so Pharma pushed them for banal conditions like sinusitis and even as prophylaxis for traveller’s diarrhoea. As a result many people have had their health and lives ruined .

  50. that was my perception, this article confirms it, thank you for writing it! Do you recommend some book or other material about the history of iatrogenics?

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