The emperor has no clothes!


The Emperor’s New Clothes — A great story that seems to have survived the ages. Like most Americans, I heard the Hans Christian Andersen (19th century) version in childhood. In case you missed it, the subject was two fellows employed as weavers, who offered the emperor a suit that would be invisible to those who were not smart or appropriate for their jobs.  The Emperor wears his new suit for a big public parade in front of the subjects, to great acclaim by all.  Nobody mentions the emperor is wearing nothing but underwear until a kid yells it out at the top of his lungs.

Andersen did not invent the story.  Like many great and timeless tales, it had been around for a very long time. It is only one of several works inspired by Don Juan Manuel’s moralistic , perhaps the earliest book ever written in Castilian Spanish in 1335. tales in  Libro de los ejemplos del conde Lucanor y de Patronio, perhaps the earliest book ever written in Castilian Spanish in 1335. But I loved it instantly, because I thought the child was me. I earned an early reputation for being clever enough to find errors in places where I ought not to have been able to find errors. My mother always said that when I learned to read (I taught myself pretty well by age three) was when I started to frequent the public library and to become “dangerous.” I found a historic public park in Boston misidentified in a guide to that historic city. Mother helped me pen a letter to the publisher, who replied that it would be fixed in the next edition.

I identified an error in a French exam for entrance into a private school I had hoped to enter in the seventh grade.  I naively told the proctor, hoping it would be announced to help other students.  It was not (proctor did not think herself competent enough in French to do that) but I was later confirmed right, and was denied admission to that august school because I was “a poor fit.” That has happened to me a lot — being labeled “a poor fit” or “not a team player” when I refuse to break the law by altering medical records or swindle a patient out of insurance or government benefits by refusing to change the diagnosis I have determined. Here I am, thinking my life is “deja vu all over again.” I never survived terribly well in the world of academic medicine, let alone psychiatry.  I kept coming up with original ideas.  I know they were good, but my “superiors” were always telling me what to research — their ideas, long before anyone could even discuss mine. I had to rise by some “lockstep” process, participating and even reviewing ideas propagated by my elders, although I have seen many of my ideas proven correct since.

The world of academics is dominated by politics and manipulation, not to mention competition for funding — which often in academic psychiatry, comes from drug companies. I am prouder of the research in which I have participated, in nutrition in psychiatry, than I am of any research my name may or may not have been associated with in academics. I identify with — even love — the champions of ethics in the face of materialism and status and the baser aspects of human behavior. Here I am — all over again. I keep finding things.  First, in my own specialty, dangers from excessive and inappropriate use of psychotropic medications.

Now, in nutrition, I find more elements of pseudoscience than of real science.  And in general medicine, treatments for obesity and diabetes that promote and actually exacerbate these illnesses, despite treatments proven to effectively diminish and even reverse these illnesses. The problem seems to be that the front lines of patient treatment lag many years behind the relevant scientific knowledge. It does seem that someone may be making money from maintaining patients in a chronic illness model and giving them more and more drugs. I leave it to others to tease out how private companies and government commissions have brought us to our current state of affairs. It is as if my whole life has brought me to this frightening realization. Every day I find more evidence — from my own memories, or from new data I turn up. When I was connected in French science, I knew enough folks who were in various ways aligned with the Institute Pasteur.  Some were descendants of those who had worked when Pasteur was there and told of what a tyrant he was — even how he may have tried to take credit for work done by others. Elie Metchnikoff was working on Pasteur-type ideas when he left Russia in 1888 and joined the Pasteur Institute in Paris.  I am not sure how his idea was received, but he is the first person I ever heard of who suggested that there were good bacteria in the intestines that were necessary for health. This idea has still not been subjected to the real scientific treatment it deserves.  Metchnikoff’s work in immunology got him a Nobel Prize. He drank sour milk daily and thought Bulgarian peasants lived longer because they ate yogurt. Pasteur was on the payroll of the French wine industry when he claimed wine was the healthiest beverage someone could ever consume.

The one time I happened to watch Dr. Oz, accidentally, he actually said, to someone with some vague digestive complaint, “Try a probiotic.”  Not only are there several studies that suggest they may work, but perilously little as to what constitutes a good or bad one. This is the best overview I have found to date. I am no gastroenterologist, but I am clearly not the first person who thought  that psychiatry could be related to digestive physiology.  I am, however, in the realm of angry internet bloggers and professionals from other fields.  I move forward.  I guess that’s why they call me the Renegade Doctor.

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