zero-sum

Why Do Doctors Close Their Eyes to Medical Injuries?

by A Midwestern Doctor | May 7, 2022

In the first two articles of the series, I have introduced the concept that doctors (and other health care providers) frequently cannot see adverse reactions to pharmaceuticals (iatrogenesis) such as vaccinations in their patients.  Because of this medical blindness, it frequently results in patients being “gaslighted,” which is a terrible experience for them to endure.

I believe two phenomena are responsible for this medical blindness: doctors lacking the ability to see iatrogenesis and doctors being unwilling to see iatrogenesis.  Frequently, these occur concurrently in varying degrees.

In the previous article, I attempted to illustrate why doctors are unable to see iatrogenesis and concluded with a case where this was occurring in parallel with a doctor not wanting to see iatrogenesis.  For reference, the case was as follows:

Patient: Hello doctor.  Since our last visit, I have been having terrible pain in my legs and it is difficult for me to exercise.  At our last visit, you started me on a statin (note: I can no longer remember which statin the patient named).  After I had these symptoms for two weeks, I realized that they began after I started statin.  I went online and found out that many other people have had the same reaction I have been having.  Do you think it could be causing my symptoms, and should I stop it?

Doctor (who gets slightly emotional): In my twenty years in practice, I have never seen a patient have a negative reaction to a statin!  In fact, they recently did a study on this and they found the negative side effects people claim to experience were actually due to the nocebo effect.  You are at high risk for heart disease (he was not) and it is critical you do not stop taking this medication or you are extremely likely to have a fatal heart attack.

Immediately after I witnessed this, my first thought was “well, now we know why you have never seen a negative reaction from a statin.”  From an outside observer’s perspective, it seems absurd that someone could use their repeated unwillingness to recognize an injury as proof the injuries never occurred.  However, from the doctor’s perspective, this is an internally consistent argument and because of that, they have no reason to question it.

This case was particularly memorable to me because the injury he reported was a textbook adverse reaction to statin drugs which is acknowledged even in conventional sources.  Additionally, while I feel the nocebo effect was never demonstrated to account for adverse reactions to statins, it must be noted that the patient only connected the adverse events to the statin after the adverse events occurred.  This means that even if the nocebo effect contributed to statin iatrogenesis, it could not have accounted for his symptoms as he did not have a negative bias towards statins prior to the onset of his muscle pain.

Based on the doctor’s final statement that stressed the life-or-death importance of following their advice, it can also be inferred that the doctor was emotionally invested in the situation.

Whenever I look at cases of medical gaslighting, it is often not clear cut if the primary issue is an inability for the doctor to see the injury or an unwillingness to see it.  Often, the term “idiopathic” (meaning unknown cause) is attached to a disorder when the disease actually has an iatrogenic cause.  Recently, there seems to have been a shift away from using the term idiopathic for mystery conditions (perhaps because it makes the doctor sound like an “idiot”), and now terms like functional are used instead.

For example, functional abdominal pain (FAP) represents repeating abdomen pain with no identified cause that worsens with stress.  In many cases, I find FAP has an easily identifiable and treatable cause, such as an abdominal cutaneous nerve entrapment.

The example I most commonly encounter now is functional neurologic disorder (FND).  I was originally introduced to this concept through a neurologist friend after they sent me this instagram video as an example of FND.  The top comment summarizes the video: “I’m a neurologist. This appears to be a functional neurologic disorder, which is a psychiatric manifestation of inner stressors. I hope you get the therapy you need. THIS SHOULD NOT DISCOURAGE ANYONE FROM GETTING THE VACCINE.”

My friend likewise argued that FND is like irritable bowel syndrome or fibromyalgia, a physical manifestation of a psychological condition.  My friend believed this diagnosis helps a lot of patients because those patients are often desperate for a neurological diagnosis (like Epilepsy or Multiple Sclerosis) to explain what is going on for them, and FND provides a way to explain their deeply troubling experiences, which they can then receive psychological and spiritual counseling for.

I argued the individual in the video likely had a vaccine injury and FND (described here) was essentially a meaningless diagnosis as the exact cause of FND is unknown other than that it is affected by injuries and stress.  I stated it was clearly medical gaslighting, and simply represented a neurological injury conventional neurology lacks the ability to properly diagnose (as nothing can be seen on an MRI while minor changes are seen on fMRI).

Despite the apparent animosity in this exchange, this neurologist is a good friend of mine, I respect their opinion, and I frequently seek it out.  From observing the current vaccination propaganda, FND appears to be one of main labels that is being settled on to explain the neurologic damage that both sounds empathetic and caring while also maintaining a position of authority over the disease despite lacking any understanding of it or willingness to blame the vaccine.

At this stage in time, based on select journal publications patients send me and the repetition of the arguments I hear said to gaslight patients, I am convinced there are marketing teams hired by pharmaceutical teams to develop “credible” arguments to remove the blame from pharmaceutical drugs causing medical injuries.  A common tactic, first pioneered with SSRI antidepressants (which frequently cause other psychiatric problems, particularly Bipolar I disorder), was to say rather than the drug causing an injury, it simply “unmasked” a pre-existing condition (that would have never been “unmasked” had they not taken the drug).  Most psychiatrists I speak to actually believe this argument, and with the COVID-19 injuries, I’ve frequently heard patients be told the issue was not the vaccine but rather a pre-existing condition being unmasked by the stress of vaccination.

Blaming anxiety for an iatrogenic injury, as discussed in part 2 of this series, is one of the most common tactics that has been done for centuries, but as time has moved forward, as shown with FND, has gotten more sophisticated.  I know this may seem hard to believe, but throughout the 1800s, doctors would frequently declare the underlying issue in a variety of diseases was women becoming hysterical if they were not regularly having intercourse, and the doctor’s prescription was often manual stimulation of female genitalia.

The logic behind all of these psychosomatic disease classifications typically is:
•We have no explanation for what is happening, but as doctors we need to have an explanation.
•The severity of your symptoms appear to be correlated with anxiety or stress.
•Therefore, the cause of your disease is anxiety or stress (or a related psychiatric condition).

I believe the more correct logic is:
•The agent you were exposed to caused neurologic damage.
•The neurologic damage you experienced causes multiple issues including psychiatric symptoms.
•If the neurologic cause of your disease temporarily worsens, many of your symptoms will as well.
•The nervous system is sensitive to a variety of inputs including stress and anxiety.  •Many of these changes are caused by these emotional states being linked to excessive sympathetic (fight or flight) activation and deficient parasympathic (rest and relax) activation.

I will also note there are a certain portion of people who have harmful unconscious patterning (typically due to a previous trauma) which in some cases directly contributes to a disease process.  When these issues are resolved in the appropriate cases, it can create profound healing for the individual.  However, very few emotional therapists can consistently resolve deep unconscious patterning.  Conversely, many emotional therapists who have occasional success addressing retained traumatic emotions and resolving complex illness erroneously label most complex diseases as being primarily emotional in origin when the majority are in fact not.

Cognitive Dissonance

One of my favorite topics in psychology is “Cognitive Dissonance.”  Briefly, it means that most individuals have great difficulty in simultaneously holding two conflicting thoughts in their mind and will typically choose to deny the existence of one idea rather than experience a dissonance between the conflicting cognitions.  Exploiting cognitive dissonance is a commonly utilized tool in all forms marketing and propaganda.

In medicine, I feel there are two major forms of cognitive dissonance that affect doctors.  The investment they have made to become physicians and the unwillingness to believe they could have harmed a patient.

Becoming a doctor takes a lot of work, and many people devote 15 years of their life to get there at the expense of many of the normal things individuals would experience (as they simply must study all day long).  This creates a scenario for many of them where they have nothing to base their identity or sense of self-worth from besides the identity of being a doctor (and is why medical students commonly become distraught after receiving average grades on examinations).  This is further reinforced by the continual societal messages saying doctors represent the pinnacle of society, which is what allows many to justify their time commitment to becoming a doctor and the various forms of entitlement they feel once they become doctor.

Many of the best doctors I have come across are people of faith, and I account for this by their spiritual system being their reason for existing rather than their identity as a physician.  Because they are less invested in their identity as a doctor, they are more willing to see data that challenges their sanctity as a physician.  Similarly, most of the doctors who have spoken out against the vaccine are practicing Christians who have said their devotion to God is more important to them than the repercussions of speaking out against the vaccine.

Many methods of exploiting cognitive dissonance propaganda are based on the sunk cost fallacy, which can be summarized as: “If people have invested a lot into something, they will hesitate to stop investing into it once it becomes objectively clear it is a bad investment.”  Sunk cost for example is a common reason people stay in bad relationships, and one of the reasons I believe have been successful in life has arisen from my willingness to cut off bad investments I really wanted to succeed and had invested a great deal into.

Medical Hazing

Here, I will define hazing as an unpleasant initiation ritual someone most go through to join a group.  Many groups throughout history have hazed their applicants for the purpose of exploiting cognitive dissonance through the sunk cost fallacy.

Many (but not all) fraternities for example are pretty dumb.  When you boil it down, all you really do is get drunk with other male alcoholics all the time.  However, if you have to go through a horrific initiation process (every once in a while, someone dies in one of these) to be given the privilege of being admitted to the fraternity, it makes the fraternity seem like an incredible the brotherhood you were fortunate to be able to join.

Because of the suffering one went through during the hazing process, admitting to yourself that the fraternity is not worth being in would be equivalent to admitting you were conned (which people really do not like to do).  However, with the aid of cognitive dissonance, it is possible to stop recognizing the fraternity is worthless and instead embrace it.

For most young doctors (medical students or residents), the medical education process is immensely challenging, and under that pressure many have psychiatric incidents and a sizable number commit suicide (Pamela Wible MD tracks these deaths).  I cannot prove this, but I believe the increasing trend in physician suicide is due to the various agents (such as vaccines) they are now exposed to which weaken the stamina of the nervous system and make it more likely to crack under the pressure young doctors are regularly exposed to.

There are so many responsibilities you carry as a doctor and so much you have to learn to become a doctor that it does necessitate a rigorous educational process.  However, a lot of what physicians have to go through is excessive, and in the opinion of many, constitutes deliberate hazing.

Medicine also uses carrots at each goalpost to entice young doctors to work as hard as they can to remain in contention for a good carrot and many are in a continual state of stress over not doing well enough at any of these hoops to reach the goal.  Sadly, even once one becomes a doctor, due to the huge student loan debt most doctors have to take on, they are still under immense pressure to comply with system (this is why most of the doctors who have spoken out against the COVID vaccines are those at the ends of their careers).

The hours many young doctors are required to work are insane (imagine being on for a 48 hour period with the possibility for a few naps or multiple 24 hour periods with a small period of rest time between them).  Most human beings cannot handle that degree of sleep deprivation.  There are also many other factors that further exacerbate this problem (ie. I have also done a few small experiments that found the fluorescent tube lighting found in most hospitals significantly worsen the body’s response to these disrupted sleep cycles).

Absolute subservience to supervising doctors is required to graduate, and some of these physicians will berate or emotional abuse the young doctors under their supervision.  In many cases, the abusive physicians act this way because they never addressed the traumatic process they experienced during their own medical education, and through the psychological defense mechanism of displacement, like other abusers, they pass it onto the next generation of physicians.

Beyond hostile supervising doctors, many of the experiences in the medical training process are inherently traumatizing.  Examples include: dissecting animals that were recently alive, having someone you were working with die in your hands, having to tell a patient you became very close to who has young children they have a terminal cancer, having a patient try to assault you, or taking care of a child in the ER immediately following severe abuse from his mother’s boyfriend.

In most cases, when young doctors begin to crack from the pressure, they can’t turn to anyone for help.  If they complain about the institution they are in or the abuse they suffered, they normally face some degree of retaliation and very little is done to correct the issue.  If they admit they are having any type of psychiatric issue, instead of help they just receive a variety of penalties (many medical boards for example require physicians to disclose applying physicians if they have ever had a psychiatric episode, which then flags them as a doctor who is a risk to practice medicine).

Because of all of this, there are many doctors who have not been unable to receive the mental health care they need (or even admit an issue is there) and they carry this with them into their practice of medicine.  A little-known fact is that there is also a small network of psychiatrists who charge a lot to discretely provide care to these doctors outside of the insurance system so the doctors have a way to get mental health care without a paper trail that can come back to the medical schools or medical boards.

When I discussed observing complexity in the previous article, I highlighted that an individual’s ability to observe complexity decreases when the nervous system becomes weakened.  Likewise, when physicians are burned out, or under periods of stress the hazing of medical education creates, they are much more likely to default to cognitive patterns that were taught during their medical training and not consciously question their cognitive dissonance response.

In summary, I believe the purpose of the hazing process in the medical system is twofold.  First, it’s designed to put so much pressure on you (especially during the periods of long-term sleep deprivation) that it becomes very difficult to maintain your own reality.  Allopathic medicine fills your mind and displaces everything else.  Second, because of the sunk cost fallacy, doctors become immensely invested in the value of their medical education and through the mechanisms of cognitive dissonance, habitually reject things that question the worth of their education or social status as a doctor.

Almost all of you have observed cases of doctors that get very upset when their authority or advice is being challenged.  While the immediate explanation for this phenomenon is many doctors carrying a disgusting ego, I believe the previously described mechanisms are often the actual reason why challenges to one’s authority is so upsetting to a large subset of the medical profession.

One of best examples of this is that I always see my old classmates complain about on social media is “I did not spend four years going to medical school just so my patients could go to Dr. Google.”  While this meme is widely promoted by the medical community, many people I know with severe chronic iatrogenic injuries have all told me that their biggest regret in life was trusting their doctor and not consulting Dr. Google (that said, now you often have to go somewhere else because Google has started aggressively censoring information on iatrogenesis).

Iatrogenesis

One of my earliest memories of medical school was a medical professor inserting a soap box about vaccines into his lecture.  After stating his contempt for anti-vaxxers he remarked “and think, do you think physicians would ever give children vaccines if they thought they were dangerous?

When I heard this, it immediately clicked.  A major reason why doctors refuse to acknowledge any type of iatrogenesis is because of the cognitive dissonance they would experience by acknowledging their complicity in the injury.  If we go back to the original case of Ignaz Semmelweiss (discussed in the previous article in this series), a sad fact is that one of his early supporters Gustav Michaelis MD subsequently committed suicide once he realized Semmelweiss was correct and by not washing his hands before delivering his cousins baby, he was directly responsible for killing her.

On the surface this it might seem hard to believe that compassionate and caring doctors will deny iatrogenesis, but once one understands the degree of cognitive dissonance knowing you injured a patient creates, it makes much more sense.  It’s an even more difficult psychological obstacle to surmount when the physician was forced to do the injurious practice for a long time without even thinking to question it.

In the same vein, I have thought the primary reason all medical students are required to get a lot of vaccines is to create the initial cognitive dissonance that will make them become resistant to later questioning the safety or efficacy of vaccination as they meet vaccine injured patients.  Conversely this is also why physicians tend to aggressively vaccinate and often harm their children (which another large but mostly unacknowledged problem).

Two commonly used idioms are “all roads lead to Rome” and “there are a thousand paths to the Buddha.”  I likewise believe the same could be said for how many trends in medicine inevitably converge at gaslighting of patients with iatrogenic conditions.

Medical Hypnosis

Because of specialized training I have received, I can often recognize if individuals are mentally dissociating or going into a hypnotic state.  One of the fascinating human behaviors I have repeatedly observed over the years occurs when someone who is emotionally invested to a mainstream position is presented with evidence clearly disproving their belief system.  Presumably due to cognitive dissonance, a part of their brain suddenly turns off, they lose the ability to see the evidence and they disassociate into a trance where they no longer be reached.

One case I never forgot occurred with a very pro-vaccine pediatrician (who in most regards was an excellent physician and human being) was as follows:

An infant shows up with a severe red and white rash covering most of his body.  From the look of it, my first thought was that it was a vaccine reaction or the body trying to detoxify something.

Doctor: (Very concerned) That rash looks terrible.
Patient: At our last visit two months ago, after he received his vaccines, he broke out with a high fever, and we followed your suggestion to give him Tylenol, and immediately afterwards this rash erupted.  Do you think it [at this point, the doctor entered a trance state] could have been related to the vaccine? 
Doctor: [Going back to the infant] This rash is completely normal, and you see these spots? We call them leukoplakia (this means “white patches” and is not the correct term for the rash the infant had, so I may have forgotten the exact phrasing used).  [pulls up growth chart] If we look at his growth chart, you child is doing great and because he’s grown, we will need to adjust his Tylenol dosing [pulls up tool to calculate the dose on his computer] in case he has a fever after his vaccines today and he should now be taking this much Tylenol instead.  Ok?  Great. See you in two months.

Trances are surprisingly common.  Sometimes they are due to wanting to escape uncomfortable cognitive dissonance.  In some cases, they emerge in response to the nervous system being under significant stress (such as during sleep deprivation) to be able to maintain operational functionality.  In other cases, they occur as a response to monotonous and repetitive tasks, such as robotic patient visits that largely revolve around meeting the EMR requirements for documentation.

Conflicts of Interest

Thus far I have explored subconscious mechanisms for gaslighting.  In some cases unfortunately, the desire to not acknowledge iatrogenesis is conscious and deliberate.  If a doctor causes iatrogenesis in their patient, they are open themselves up to a malpractice lawsuit for the injury.  Because of this, they are frequently incentivized to pressure the patient into believing no injury occurred or that the symptoms they are experiencing have no correlation with the medical intervention (ie. surgery or pharmaceutical) that is suspected to have caused the injury.

While most physicians are terrified of malpractice suits, whenever this topic is researched, it is found that if the doctor is honest about what happened and has a good bedside manner, patients will not sue, whereas when the doctors gaslight their patients, patients sometimes do sue.  Despite this being taught in many medical education programs, many doctors still gaslight to “protect” themselves.

There is also a section of the medication community that has a direct financial interest in administering medical therapies to patients and are willing to prioritize their own profit over the patient’s wellbeing.  Commonly, this includes less ethical surgeons (who make most of their salary through surgeries) pushing their patients to have unnecessary or risky surgeries (spinal fusions are the probably the largest offender in this regard), doctors being required to meet a certain quote of vaccinations or prescriptions to maintain their current insurance reimbursement rate (this is very common), or prescribing doctors who receive lavish pharmaceutical payments for pushing those pharmaceuticals on patients who will not benefit from them. In the previous article on corruption within medicine, I also explained how many physician researchers are paid large amounts of money to recruit subjects into clinical trials for dangerous and ineffective drugs.

Regardless of the reason, when a doctor has a patient receive a medical intervention primarily for the doctor’s benefit, that doctor is likely to gaslight any patient who suggests the intervention harmed them.  Overall, I believe this phenomenon is more common in urban centers of medical power and rarer in rural medical centers that have a more direct relationship with their patients.  As I work in the latter, I rarely directly run into this issue, whereas colleagues who do periodically confide events of this nature to me (for example a friend worked with a lead investigator for one of the early American remdesivir trials and was very disturbed by what they observed).

Medical Paternalism

There are different philosophies of how doctors should treat patients.  One model, the paternalistic one (which many doctors follow, and many patients expect) views the patient as a child and the doctors as a wise parent who knows what’s best for the patient and should be obeyed without question.  In most cases, I strongly prefer the collaborative model where you treat the patient as an equal, you explain your thought process and the merits of each choice, and then respect the patient’s eventual decision.

In some cases of medical gaslighting, I see a doctor observe a medical injury and decide through the paternalistic framework that it is not in everyone’s best interest to know it happened.  I will list the three examples I know of:

First, if a patient has a disabling iatrogenic injury, once they realize their disease was iatrogenic, this often makes them hesitant to trust the medical system.  Numerous doctors I have spoken to have shared their opinion that informing the patient of the iatrogenic nature of their disease has no benefit to them (as they lack the ability to treat it regardless), but is damaging to the patient because it will break their trust in the medical system and make them unable to properly receive medical care in the future.  While I recognize there is some basis to the argument and I frequently hear it raised, I strongly disagree with it.

Second, if someone has pre-existing psychiatric instability, finding out their doctor who they trusted lied to them (and gaslighted them) can be psychologically devastating.  Beyond the shock of having an existing belief system shattered, the most common response these patients have is to blame themselves for what happened and go into a cycle of self-harm.

My own philosophy is that knowing the truth should always be prioritized even if it is a harsh reality to swallow.  While I hold that belief system, I have had a few cases early in my career, where near the start of our interactions, before I had gotten to know a patient, I let them know their disease was likely iatrogenic.  I subsequently sincerely regretted doing so after I saw the long-term psychological damage it created for the patient.  This is hence a subject I still find very difficult to have a definitive position on and I’ve largely gotten around the issue by pre-screening for patients who would want to know if they had had an iatrogenic injury.

Lastly, another consideration is it “not being good for the medical community,” which is particularly an issue in small rural communities that only have a few doctors.  If you realize a doctor you share patients with screwed up and injured a patient and then share this observation with the patient, it inevitably results in three things happening.

First, a great deal of animosity is created between you and that doctor (they will say negative things about you to patients and not refer patients to you that you need for your practice).  Second, it will often break the community’s trust in that doctor who is often necessary for many people in the area to receive care from.  Lastly, it can initiate a wave of litigation into a community which breaks up the trust between doctors and patients.

Early in my medical training, I saw one case where a very ill patient was admitted to the hospital for what ultimately was determined to be a terminal cancer.  When the patient’s records were reviewed, it was determined that the initial tumor had been detected years before by their doctor, but the doctor never followed up on monitoring it.  The hospitalist on charge of the case was morally conflicted on the subject, but ultimately decided it was best not to let the patient’s family know as it would “not be good for the medical community”.

Conclusion

In this article I have sought to illustrate some of the reasons why doctors will deny what they see with their own eyes to protect their existing belief systems.  Due to the mechanisms of cognitive dissonance, in some cases this results in them entering what can be best described as trance states to protect their own mental reality.

In the final section of this series, I will attempt to tie these themes together within our political climate, and provide some suggestions for practical ways to reduce medical gaslighting and have your adverse events be acknowledged by physicians.

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