Progressive Politics Infects Primary Care Medicine

A new system of medicine is posting across the net, aiding and abetting the appropriation of the practice of medicine by the computer. Computerised axial tomography arrived in the late 1970s and soon after, magnetic resonance and positron emission technologies were digitalised, computerised and medicalised. Those new body-imaging capabilities gave such a boost to diagnostic confidence that doctors took to sending their “headaches” for brain scans and their hypochondriacs for “pan-man-scans” instead of referring them for consultant opinions. The scanners took work away from the specialists in the last century, and come the new millennium, the user-friendly computer was dashing off legible scripts, conducting telehealth consultations, leading group therapy teams and performing telesurgery. The computer is now entrenched between the doctor and the patient. “The healing hand” has been reduced to digits on a keyboard and the doctor to a handmaiden of the computer-patient relationship.

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For more than a decade now, legions of desktop workers have been digitating torrents of data into their computers. They have been digitalising more data every year than was generated in the whole of pre-desktop history. Data is fed through filtering algorithms and sifted into clouds of information. Cloud workers at hubs and databases like Cochrane delve into that ether with algorithms that tease out information of medical interest. That material gets channelled through Systems Medicine (SM) which specialises in phenotypic and genotypic substrates and by officiating centres like LANL. Those functionaries and others feed medical information into a deep-thinking artificial intelligence (AI) which models and remodels information of clinical interest and decants it into the precision medicine that finds its way into the computers of the health-care delivery system of the new millennium.

In the more progressive parts of the world, the AI-managed clinic is the preferred provider of primary health-care services for the social media generations. SM employs the most progressive software. It can access and amass via the internet data from any body passing through any kind of scanner anywhere. Collected and collated information can be sent directly to any accredited clinical computer for diagnostic and therapeutic purposes or to some reviewing “centre of excellence” for collaborative opinions, codification and contingency filing in some dark cumulus cloud.

SM presents as a harmoniously networking hybrid but the volume, speed and “modelled” nature of COVID-19-linked machinations pervading the net suggest that SM’s affectations are more machine than human. When you think about it, only the artificially intelligent would have the gall to go posting (boasting) online that the world is “moving from the Oslerian Paradigm to the Post Genomic Era”.

The Oslerian era of medical practice was the twentieth century. William Osler was a Canadian clinician and teacher of medicine whose textbook The Principles and Practice of Medicine is a classic of medical writing. It was first published in 1892 and its ethos, style and gravity exemplified medical practice for the twentieth century. At the heart of the Oslerian medical paradigm was the doctor-patient relationship, the clinical examination and the clinical diagnosis. Osler abided by the Hippocratic tradition and he taught that medicine was a science and an art.

The computer can now gather a clinical history, diagnose disease, design a therapeutic protocol and treat a patient with complete clinical detachment. SM builds a medical practice by assembling biomedical models of consumers of medical services, and it manages them as if they were medical systems that can be measured and analysed at all levels of functioning from the molecular to the social.

SM is an interdisciplinary practice module for servicing the health consumer. It is assembled from the bottom up, from the genomic, phenotypic and other omic facts of the life-sciences. SM and its ilk are works in never-ending progress. They learn by trial and error through their global neuro-imitating networks, they are driven by chance and necessity, and they consume mega-giga-bytes of clinical data to keep proving to the world that progressive medicine is the best medicine.

SM has posted online that it acknowledges the “art” of medicine, that it recognises and respects personal uniqueness and that it treats multimorbidity (the human condition) like a balance disturbance, a bodily disequilibrium. SM restores normality by manipulating the “elements” of precision medicine, including the genomic, proteomic, neuroendocrine, immune and mitochondrial bioenergetic systems of the internal milieu, while effecting harmony with the external environment through progressive health care, social and cultural networks.

The Galenic humoral system of medicine pursued balance and harmony also, employing just four elemental “vital fluids”. Galenism was practised by a diversity of cultures for eons before the advent of SM and it flourished for eons because humoralism was a holistic, hands-on, patient-centred system. Galenic medicine was a “techne” a useful art. The doctor looked after the patient as best he could while nature took care of the disease. Quite often, the doctor was just as effective doing nothing as when he was doing something. That approach effected some of humoralism’s most sanguine outcomes. During the Black Death, for example, decamerons of orgies were more effective than medically-prescribed quarantine for preventing long-Covid-like syndromes.

Reductionist teachers of medicine are not impressed. They have been lamenting since 1965 at least: “Galen held back the progress of medicine for thirteen hundred years!” But now, in the age of left-brain dominance, interventionist medicine is in the ascendant and the SMs are extolling “the medicalisation of health and life itself”.

They are manipulating primary care into SM, the world into a hysterical pandemic, and blaming a virus for it all. The Covid virus arrived in a pandemic of analogue data and because the analogue is kryptonite to the digital, pandemonium erupted amid the SMs. They were thrown off balance and flummoxed into deploying the Big Pharma jab. It all happened whilst the definition of vaccine was being updated and that was necessary because of online claims that Oslerian nomenclature endorsed suboptimal management of conditions such as bronchitis and asthma. Those maladies have numerous aetiologies and precipitants, and according to DuckDuckGo they were subject to one-size-fits-all regimens by outmoded Oslerian-era terminology. A more liberal medical taxonomy was said to be indicated. A consumer-targeting clinical usage and a culturally correct computer on every desk would sharpen the diagnostic process, widen treatment options and enable all accredited providers to participate fully in modern integrated multidisciplinary care of a diversity of multifactorial conditions including airway maladies and Covid variants. A more progressive medical argot would also make for better genomic research outcomes.

It was therefore reasonable to suppose that a fully computerised health care and wellness delivery system would take the heat and bile out of social media’s tantrums, appease the net’s nocebo tendencies, re-set the placebo-nocebo imbalance and fragment the Covid pandemic into any number of phlegmatically minded epidemics, leave “pandemic” with no good reason to exist. It was optimistically asserted that digitalisation would take the hysteria out of the apocalyptic alpha-to-omega Covid caper and relieve chief medical officers of the free-floating anxiety that is sending legions of over-demonstrative snowflakes into hysterical panpanics.

All the while, the SMs have been twittering: Oslerian principles and practices are regressive, sexist and no longer tenable! SM has posted online that Osler has failed in the domains of disease prevention, health optimisation, affordability and gender equity. Oslerian medicine is mocked as the “Four O” system of medicine: over-testing, over-diagnosing, over-treating and over-charging. SM belittles Oslerian medicine four times over and then prescribes 4P Medicine for the millennial generations.

4P Medicine (predictive, preventive, personalised and participatory) is the clinical face of SM. It predicts disease in non-symptomatic persons through close monitoring, extensive biomarker testing and deep statistical analysis. Constant surveillance by specialised algorithms red-flags suspicious-looking genotypes and precision medicine stops them (academically speaking) from turning into mischievous phenotypes. Meanwhile at the coalface of clinical medicine, “Covidcare” predictive and preventive strategies are impacting disturbingly on the neurological development of young children, the sensitivity and resilience of millennials, and the duty of care to the older generations.

It is within the remit of primary care medicine to clarify the facts of Covid to its clientele. But the SM clinics have failed in that duty of care. They have failed to shame Big Pharma for tarnishing the name of Edward Jenner and failed to call out the CDC and WHO for manipulating the definition of “vaccination”. Had 4P Medicine practitioners used clinical judgment (common sense) instead of practising by algorithm, Big Pharma would not have got away with calling their jabs “vaccines” and their method of immunisation “vaccination”. They continue to flag (flog) vaccination as the right thing for everybody to do while jabbing anybody of any age with spikes and strands of RNA encrypted with goodness knows what. They even have the hide to call anti-jabbers anti-vaxxers! Genomic jabs may induce quick-acting antibodies, but there is more than antibodies to the story of vaccination.

Edward Jenner coined vaccinae from the Latin word for cow, and used the term in the title of a book on cowpox that he published in 1798. As he explained, cowpox had appeared in several counties of the English West Country and had spread without attracting serious medical attention. Folklore, moreover, had it that cowpox protected the human constitution against smallpox, and as a doctor practising in dairy country, Jenner saw it as his duty to inquire into the causes and effects.

Jenner was one of those rare GPs who did house calls. While clip-clopping along in his carriage, he would notice other horses hobbling along on painfully inflamed heels and he would make a spot diagnosis of “the grease”. Further along the road, he would ruminate upon contented-looking cows grazing in the fields and diagnose a pox upon their nipples. He wasn’t the first to notice that farriers and milkmaids appeared to be secure from contagion during smallpox visitations. He conjectured that the benign cowpox was “a variety” of the virulent smallpox and he imagined that it had been degraded by the inflammatory processes that challenged it after seeping into horses’ hooves. It seemed to him that the benighted pox was passed along by stable hands that went on to milk the cows. After all, cowpox was unknown in Ireland where men never milked cows. Jenner likened the process of viral degradation to turning a wolf into a lapdog. By disarming it of its ferocity, its better and useful nature was revealed. At the time, smallpox was thought of as a poison, a virulently venomous substance, and long before bacteria, let alone viruses, were recognised as agents of disease Jenner wrote:

but what renders the cow pox virus so extremely singular, is, that the person who has been thus affected is for ever after secure from the infection of the small pox; neither exposure to the variolous effluvia, nor the insertion of the matter into the skin producing this distemper …

Jenner was often consulted by anxious dairymaids who presented with a few pearly nodules on fingers, hands or forearms. The lesions matured into livid pustules that blistered and burst, leaving behind crusted craters surrounded and contained by red inflammatory halos. On examination, tender lumps could sometimes be felt in the corresponding axilla, indicating that the infection had spread but that it didn’t get very far. Those typical signs of cowpox were accompanied by a few transient, unpleasant but non-alarming symptoms. Jenner was good at reassuring rosy-cheeked dairypersons that their pox would clear completely and it would not leave them with pocked faces.

Smallpox was an endemic disease beyond the English Channel. It made periodic forays into the West Country and every visitation carried away a goodly number of the locals. It left behind the maimed, the blind and the disfigured. Survivors were consoled with immunity to further infection and, for the more enterprising, a business opportunity as well.

Variolation was an English export industry during the Industrial Revolution. Itinerant variolators went about swabbing “variolous effluvia” from cases touched only lightly by smallpox. The scabs would be concocted imaginatively and offered to the unvariolated at home and abroad for a fee and a warning to quarantine.

Variolation was an art and a gamble. It was taken mainly by the international elites, including Maria Teresa and her family, all of whom were endowed with the wherewithal and the constitution to get inoculated and survive. It was otherwise for the unwashed classes. Their human condition set the odds against them and moreover, they couldn’t afford to take a few days off work, let alone a quarantine. There was also a perception that the variolated were a greater threat to the unvariolated than variolation was to the elites. Variolation was the first attempt at immunising whole populations. It was profitable for the variolators but it was an emotive and politically divisive practice from beginning to end.

Jenner was of the elite, and he was variolated when he was an eight-year-old lad. That experience was so awful that he decided to become a doctor and immunise his eight-month-old son by vaccination instead of variolation. He inoculated a little bit of pus taken from a pox on a nipple of a cow. That vaccination and a score of other cases that he recorded demonstrate clearly that vaccination delivers a jolt to the constitution just like smallpox but it does so without the nasty effects of variolation or the need for booster shots.

The cowpox vaccine passed into history when the pharmaceutical industry took to producing smallpox antigens in the labs of what were once known as “ethical pharmaceutical manufacturers”. Those firms used to publicise their work in New Ethicals, a journal that was posted gratis to all practising doctors.

The pharmaceutical industry doesn’t publish an ethical journal any more, and they stopped making commercial quantities of the smallpox vaccine  long ago. But the May 1968 edition of New Ethicals carries an article about how Big Pharma adapted their smallpox vaccine-making infrastructure to the production of flu and other vaccines. That article is very telling on the lab-based processes whereby wild viruses are cultivated in vivo and in vitro, on how the lab passes viruses through serial embryonated eggs to attenuate, weaken and tame them and turn them into useful antigens. It implied that lab-produced vaccines can never be as effective as naturally generated vaccine antigens.

In nature, wild viruses go meandering randomly through animals and the human constitution. They engage with the body’s protective immune systems and they are transformed by fighting the body’s inflammatory response to invasion. The outcomes of those encounters can be good, bad or indifferent, for either the parasite or the host, depending (as every gardener knows) on the quality of the soil and the seed. In case of the flu vaccine, research has shown that it may only be 60 per cent effective at best. In terms of Jenner’s canine analogy, a wolf loses much more ferocity passing through a farm than a pharm, and his published research proved that the very best vaccines are made in bovo and come from contented cows.

Apparently, the Covid virus can be made to behave like a reasonably effective vaccine also. But the clone of genomic engineers that has struggled for the last forty years to put an immunological stop to AIDS has come up with an in silico designer jab that the Big Pharma is marketing as a “vaccine” for Covid. They have made some antigenic proteins more profitable in their predictive (RAT tests) than in their protective role. The ten biggest pharmaceutical companies spent circa US$80 billion on new drug development in 2012, and they have been spending more and more every year since—whilst coming up with fewer and fewer successful drugs. They are also carrying a heavy burden of debt from malpractice convictions and class actions.

The other two Ps of 4P Medicine are “personalised” and “participatory”. They treat a patient as an equal member of the therapeutic team, which has the effect of turning a consultation into a group therapy session. The placebo effect is a marvellous force and research at YouTube university has found that the length and severity of long-haul Covid suffering can be ameliorated by jabbing the jabbed, the unjabbed and even the Covid-naive sufferer on discharge from hospital. In the millennial medical milieu of heightened suggestibility, meditation, yoga and any other ego-enhancing modality can boost the biomarkers, so it should be kept in mind that the placebo effect is only one side of a coin.

4P Medicine is a template for the progressive health care continuum model that operates the SM clinic. 4P optimises health and wellness by facilitating multi-stakeholder collaboration among medicos, nurses, physios, chiropractors and sundry other stakeholders. It supports an orchestrated common language and an integrated model of care that can be universally applied. 4P Medicine’s “technoscientific holism” effects the conversion of the functional into the physical to give substance, weight and credibility to a myriad of long-Covid symptoms, but because “reductionist holism” is a cognitively dissonant oxymoron, it affects reactions, resulting in impersonal, fragmented and inappropriate care.

After twenty-nine months of Covidisruption, and one month after turning RAT positive, a victim of Covid is informed by social media that she has lapsed into a long-Covid syndrome. To find out which one, she hurries along to a 4P clinic, in a melancholic state of mind by the time she gets there. On arrival she is presented with a “new patient information” form to fill in. She is instructed to specify her birth sex, one of five gender identities, and preferred pronoun, before seeing the doctor.

The doctor who is the leader of the multi­disciplinary care team is credentialled to practise Post-Oslerian 4P Medicine. She logs into the client’s personal e-file and responds digitally to the androgenic medical director’s prompts. Her personal protocol address ensures that she doesn’t stray from mandated procedures. Missteps are instantly flagged—a disparaging click against a single strain of Covid can trigger immediate withdrawal of jabbing rights. A digital “don’t like” can lead to suspension, loss of accreditation and even medico-legal complications. The doctor shows the patient the extent of her brain fog on the computer screen and explains that she should repeat the MRI in three months because persisting symptoms indicate irreversible grey matter atrophy.

The SM clinic delivers cutting-edge 4P Medicine with feigned empathy and it fails in its duty of care. The clinic is an oestrogen-soaked environment. Nobody in the SM team has the balls to wave the red flag at the testosterone-powered cabal that is unnaturally, unethically and amorally applying ad nauseam the modelled affectations of the artificial intelligentsia on the practice of primary care medicine. The doctor’s fickle fingers cannot match the sociopathic machinations of all those alpha-male digits that are fiddling and fuelling the pandemic of over-servicing, over-testing, faux vaccines and nocebo effecting remedies. Oslerian medicine abiding by Hippocratic ethics would not have put up with the malpractice that is responsible for the Covid hysterical mess.

Hippocrates is eulogised for imparting to his apprentices the sage advice, “First do no harm.” But what he was probably doing under that plane tree was trying to make a bunch of over-enthusiastic students understand that their therapeutic panoply would be limited to a mere handful of naturally effective pharmaceuticals, a plethora of affecting and affected panaceas and a myriad of therapies with essentially iatrogenic mechanisms of action. He didn’t have a word for either the placebo or the nocebo effect, so he humbly implored the self-centred medical tyros to take care, and not harm their patients, while striving to get the most out of whatever they were prescribing. He was lecturing when the horrors of the plague of 430 BC were a living memory. His counsel still applies to the days of COVID-19.

Online Post Script: There was a fire at the McIntyre building  at McGill University Montreal three years ago. Many books  in the Oslerian Library housed therein were water damaged restoration work has been slow and tedious. The library had been left in limbo. The Dean of Librarians at McGill wanted the Oslerian Library collection dispersed amongst other libraries  because it was an  egregious  symbol  of that dead white European male.  But after much wrangling,  the  Oslerian Library will be rededicated in the original building in November.

Dr John Prineas has a practice in Sydney.

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