Copyright ©1995 by Jack Challem, The Nutrition Reporter™
All rights reserved.
If the average political reporter related what a senator or president said - without seeking a contrasting opinion - he'd be little more than a public relations hack posing as a journalist. Of course, no political reporter in his right mind would accept statements at face value from a politician.
Yet this lack of critical perspective permeates medical reporting. Most medical reporters report only what's described by "the experts" and by the public relations folks who work for hospitals, pharmaceutical manufacturers, and other companies that make their profits from health care.
For example, most medical reporters ignore the fact that "nonprofit" hospitals compete as fiercely for market share as profit-making businesses. They report high-tech advances as if they are miraculous benefits for humankind, rather than new profit centers for their makers and users. Reporters dutifully describe the value of carpal tunnel surgery for hand pain, but ignore highly effective, low-cost nonsurgical treatments. And they faithfully exhort the need for more donor hearts for transplants, but again remain oblivious to the medical literature supporting the use of effective and inexpensive nonsurgical treatments.
Although the average citizen believes that medical officialdom has his welfare in mind, the reality is that medicine is every bit as political as life in Washington, D.C. For all the different types of people and organizations within it, orthodox medicine remains a one-party system bent on promoting itself and castigating those who dare to disagree.
Whether covering the political or business beats, every reporter is taught to get a statement from the "other side" to ensure some semblance of balanced reporting. In politics, it may be calling a liberal when a conservative makes an announcement, or getting a comment from a consumer group when a company makes a pronouncement that sounds too good to be true.
Medical reporting has largely been devoid of this system of checks and balances. Why? In my opinion, medical reporters have been convinced that they cannot understand medicine or details of how the body works. And doctors serving as reporters aren't likely to take stands unpopular with their fellow physicians.
Behind the scenes, medicine teems with controversy. Put two cardiologists in the same room, and they're likely to disagree about something as seemingly noncontroversial as how to do a balloon angioplasty. Widen your field of vision, and you'll find there's not just one minority party in medicine, so to speak, but dozens of them.
And as in politics, medical decisions aren't always discussed rationally or made for honorable reasons. Even when intelligent discourse is encouraged, it's rare to see all the facts on the table. The name of the game is too often power, not truth.
In my experience, medicine is no more difficult to grasp than nuclear power, a field in which a lot of reporters profess expertise. Of course, I'm not a physician, and I recognize my limitations. I bite off medicine a small piece at a time.
Most reporters let themselves be spoon fed whatever the American Medical Association, Food and Drug Administration, drug companies, or hospitals want them to know and report, and little real investigative reporting is done. In fact, most reporters seem glad to have someone walk them through the maze of medicine. But they pay a high price for this hand holding.
There aren't any big conspiracies out there. Just a seamy underbelly that most people never see. If they did, they might change their opinion of medicine and the health-care system.
Not long ago, an administrator of hospital cardiology programs explained to me the realities of her business. Federal cutbacks for Medicare coverage? She said the docs would simply do more bypass surgeries and balloon angioplasties to make up the difference so their income wouldn't be affected.
Meanwhile, the same administrator treats her heart doctors with kid gloves because she knows the principal competing hospital will try to woo them by offering them a new car or a plush office.
One hospital in my area has tried to become a heart-transplant center as a wedge against the competition. Only one reporter here (at the alternative weekly) has questioned whether two or three heart-transplant centers are needed in a metropolitan area where only 30 such procedures are performed annually.
All of these activities are done under the guise of being a "nonprofit" hospital system, even as the hospital soft pedals its $20-million surplus at the end of the year. Wearing the collar "nonprofit" should not ensure sanctity.
Reporters would discover more surprises if they'd scan the medical literature. Granted, it was a difficult task just a few years ago. But the Medline computer database makes searching through medical journals as easy as an on-line search for a business press release.
Medline contains abstracts of the thousands of medical journal articles published each month - and a 20-year total of more than 8 million abstracts. It literally doesn't take more than a few keystrokes to find information and to narrow your focus.
Medline is an amazing tool, yet it is vastly under utilized by both doctors and reporters. Let me give you a couple of examples.
For the last few years, I had been hearing people talk about a substance called coenzyme Q10. It helps cells produce energy, and it's similar to antioxidant vitamins.
So finally, I did a Medline search on "coenzyme Q10" and quickly discovered a wealth of medical journal abstracts on its use in the treatment of cardiomyopathy. Cardiomyopathy is considered an "end stage" heart condition, and without a heart transplant, most people with the condition soon die.
The abstracts led me to the original medical journal articles, and I was amazed by what I read. Study after study, case history after case history showed that 3-4 capsules daily of coenzyme Q10 helped people recover from cardiomyopathy and avoid the need for a heart transplant. For roughly $30 a month, people could avoid a $150,000 procedure, incredible surgical stress, and a lifetime on immune-suppressing drugs. The work languishes in the medical journals, when reporters should be asking why it's being ignored and if more heart donors are really needed.
A similar situation exists for carpal tunnel syndrome, a disorder most doctors believe is caused by repetitive hand movements. Yet the medical literature contains at least a dozen articles on the successful treatment of carpal tunnel syndrome with vitamin B6.
One doctor, roughly 20 years ago, realized that all of his carpal tunnel patients were deficient in B6. He and his colleagues found that by increasing B6 intake among these patients, levels of an enzyme reflecting the vitamin's activity in the body went from zero to normal levels in 90 days. Meanwhile, the patients' symptoms progressively disappeared.
In my literature search, I found most of the articles supported the use of B6 in carpal tunnel syndrome. One exception was from a doctor who described B6 as a "conservative" treatment in contrast to a more aggressive surgical approach. But what's wrong with treating something with a $5 bottle of B6 instead of a $3,000 surgery? Even George Phelan, MD, who developed the surgical technique for treating carpal tunnel, said that B6 is the treatment of choice.
But few of these controversies make it to newspapers. Or television.
The problem with medical reporting, however, is much greater than simply vitamins versus surgery. And reporters could tackle why the medical establishment doesn't do a better job of reading and putting into practice its own research. The treatment of Type I diabetes is an example.
The prevailing medical opinion - and I think it's correct - is that a virus or auto-immune (self-allergic) reaction begins destroying the insulin-producing beta cells of the pancreas. Once destroyed, the person (usually a child) must begin a lifelong program of insulin injections. As a Type I diabetic, all of his risk factors for heart and kidney disease will be far above normal. He will be exceptional if he lives to age 50.
Yet most physicians have ignored some remarkable discoveries that languish in the medical literature.
The complete destruction of beta cells is not instantaneous. It can take a year or so. During this time, Type I diabetics typically enter what physicians call a "honeymoon phase" during which beta-cell destruction decreases dramatically. But most endocrinologists and pediatricians don't use this time for anything except helping parents cope with their child's condition.
By reading the medical literature, an enterprising reporter can learn that niacin, or vitamin B3, retards beta-cell destruction and, in a small number of diabetics, prevents the total destruction of these insulin-producing cells.
A reporter can also find that cyclosporine, the immune-system-depressing drug that has made heart transplants successful, also slows the destruction of pancreatic beta cells. Finally, a reporter looking closely enough can discover that BCG, an old and established vaccine for tuberculosis, prevents the destruction of beta cells in mice. My guess is that it would do the same in people, and we know BCG is safe.
In a sense, the treatment of Type I diabetes could be viewed like the treatment of cancer. Both are terminal diseases in that they greatly reduce lifespan. Niacin, cyclosporine, and BCG may not be sure cures for diabetes, but they can buy time for patients and delay the need for and the dangers of insulin. A reporter can ask medical people why these substances aren't used-and push back on evasive answers the way political reporters do.
Today, when everyone seems to understand that health care costs must be reduced, more critical reporting and analysis of traditional medical icons can only help clarify the issues. Consider, in conclusion, the arguments for or against mammography as preventive medicine. It's not preventive - it's diagnostic. And early diagnosis is not the same as prevention. That's one more example of how medical reporters have been brainwashed.
This article was originally published in Editor & Publisher and as a supplement to The Nutrition Reporter newsletter.
The information provided by Jack Challem and The Nutrition Reporter™ newsletter is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.