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Why we shouldn’t treat acute cases

It’s dissertation season again, and a student emails me:

Dear Practitioner, I am undertaking a research project into the transition from acute to chronic. The aim of the research is to understand how practitioners identify, manage and treat risk factors for chronic pain.

What an important issue, but one that is very badly understood. So I reply:

Dear Student.

I tend not to answer these emails anymore, because undergraduate research places us in between two realities: the holistic healing reality of a living self-righting system always doing the best it can to survive under the circumstances; and the medico-research reality, where physiology is what just happens until pathology just happens at which stage the body’s natural compensatory mechanism is to get a prescription.

In other words, it becomes impossible to answer the questions truthfully and still convey the truth!

What may not help you now, but will save you many years of anguish later on, is if I tell you this:

Acute situations are the symptomatic expression of healing. Symptoms are the healing process, and in the patient experience they convey the information the patient needs. The pain/fatigue/nausea/whatever tells them what they need to do to have a chance to recover.

Chronicity is the result of suppression of the acute;

…or some other failure of the body to respond completely to an acute challenge. For instance, taking anti-inflammatories and going back to work, lowering of fever with drugs, and cracking of specific sore joints, all remove the natural healing or protective mechanism and allow the patient to keep going when nature is telling them to stop. They mask the problem and thus sabotage the natural responses as well as the actual healing process.

The other cause of chronicity is repeat or sustained stress, ie. maintaining factors. This becomes more possible if we palliate the patient, ie. treat the symptoms not the cause. They feel ok initially, so they have no reason to change their strategies in life. And so then they become dependent on therapy. Eventually the therapy stops working as the body adapts to cope with both the stress of life and the confusion of therapy. The cause of the problem hasn’t gone away, and so the body changes its structure and function around it instead, usually to create limitation. Chronicity is adaptation, and it comes with complete deniability for the practitioner (Just the ageing process mate! Go see a surgeon).

[Stress doesn’t always lead to disease. Some stresses do lead to strength, but they always depend on sufficient chance of recovery in order to do so. Athletes don’t get fitter while they are training, they get fitter while they are resting. If they hit the wall from overtraining they can be limited for a very long time afterwards.]

Chronicity resolves through acute episodes. For instance, a chronically inflamed wrist, knee, pancreas or whatever is continually attempting to repair itself – that is what inflammation is. But it is unable to finish the job for some reason or usually reasons. It is those reasons we must deal with. But the inflammation itself is the healing process, it has to happen or the patient will never get out of the mess. Do our job properly and it will be transient and not too unpleasant.

Likewise, fever, vomiting, diarrhoea, skin eruptions, fatigue etc. These are all ways for the body to sort out a problem. Nobody in their right mind would want to stop them if they need to happen. But they are all temporary, providing a) you don’t fight them and b) the body has its basic needs. The answer to fatigue is to sleep, with diarrhoea you sit on the toilet. You have to obey your symptoms, support the body, and then seek help for the underlying causes. Suppression achieves nothing. Making the patient comfortable without sowing the seeds of a worse problem later on means managing their symptoms not making them go away. We are not taught this in college. We certainly learn the role of these things, for instance everybody understands why drinking too much tequila leads to vomiting, and why the body needs to do that. And that the person who is so intoxicated they cannot vomit is actually in much worse trouble. But translating these broader principles of healing into practice in the teaching clinic simply does not happen anymore: it all boils down to ‘symptoms reduced, job done’.

Pain is not a malfunction

Pain is not an outdated response of lower life forms; some kind of primitive bodily function we no longer need. It is our oldest and therefore most highly evolved protective mechanism, and is right virtually 100% of the time. It is usually what our patients want us to make go away. Their experience of pain will diminish once the body no longer needs the signal. If, however, they have adapted to continued stress then the adaptations maintain their pain. But the patient is usually taught it is their weakness, their age; or of course, their ‘condition’, chronic pain. Nothing to do with their actions, habits or environment! So they never address those things, or else are give all the wrong advice: go jogging, make yourself eat something to keep your strength up, put ice on it, strengthen the muscles around that damaged knee, bring down that fever. These all make me cringe!

The worst is take painkillers and keep going, then you won’t establish a pathway. As if keeping going and ignoring what their body is telling them isn’t how they got into the mess in the first place.

And these strategies don’t work. So now they are told it is all in the brain, and sent off for thinking lessons. Perhaps every prescription for Cognitive Behavioural Therapy should include the words: ‘sorry we failed last time’.

If we start dismissing the body’s responses as irrelevant or unhelpful, then we are moving away from our claims to work with nature, with the body’s own healing mechanisms.

Yes, there may be times to palliate. For instance, if I had the chance to play a violin solo for the Queen, but I had a thumping headache, I might take nurofen, but always aware of the price of doing so. You can’t just magic a problem away: holistic healers live in a world of cause and effect. It isn’t logical to think you can make a problem go away without actually changing anything.

If the acute is the healing process, then it is a lie to try and treat it.

We are taught to treat acute and manage chronic, in fact what we should do is the opposite. The acute body is already dealing with the problem, the best we can offer is to provide the conditions where it can succeed. I would never go to a practitioner of any kind who claimed to be a specialist in acute problems. It proves to me straight away they don’t understand what they are doing.

We don’t heal anybody. Healing is what the person does, not us. They don’t leave our office healed, they go away and heal afterwards. The best results are the ones that creep up slowly, the patient often doesn’t notice, sometimes they need reminding that they ever had a problem. Or else they have an unpleasant acute episode that is well managed without drugs, and afterwards feel much better.

So, the real challenge is treating the chronic, which in turn means managing the acute symptoms of recovery. And of course, selling this to the patient isn’t easy either.

How to identify the patient who is chronic, or at risk of becoming chronic

You can often tell who is on the way to chronicity from various possible clues. There is no perfect formula, and remember, every case is unique. For instance one patient may push away good advice: but another may take all advice going, and the hard part is getting them to be selective.

  • Increasing dependence on therapy
  • Patient knows all the medical details of their problem
  • They have been given all the wrong advice
  • They have ‘tried everything’
  • They blame somebody else for their problems (external locus of control)
  • Their problem has a ‘name’ and they are stuck with it
  • Their problem has been blamed on: genetics, virus, autoimmunity, their age, or the alignment of the planets, and they are happy with that, because it means they can ‘get on with their life’
  • They believe it is incurable, rare, unknown, there is something special about it
  • They are worried because tests have found nothing wrong (perhaps that should be taken as good news)
  • Their life has become structured around their disease, ie they would lose something if they got better
  • Multiple therapists on the case (too many cooks)
  • Reliance on quick fixes
  • Strong emotional reaction to help (often resistance)
  • Absence of physical response to treatment
  • There is some kind of glamour or uniqueness in their problem, it gives them something to talk about at dinner parties.
  • Getting better would cause them a problem
  • Insurance claim for injury or illness
  • They are sick because they need a more expensive doctor
  • Their diet/herbs/pilates etc works, which is why they keep doing it (except it hasn’t worked, or they wouldn’t still have a problem)
  • They know more about health than anybody
  • But for some reason the principles of health, which they understand completely, don’t apply to them: they are the exception

And of course:

  • persistence of symptoms, but often with a confusing pattern, eg their headaches come on their days off, not when they are working
  • Low vitality
  • Unhealthy appearance
  • Bad sleep, bowel movements etc
  • Always getting minor ‘infections’
  • Achey joints
  • High medication load
  • Problem slow to develop
  • Habitual behaviour, unable to break

But there is no exact formula, every case is different. For instance people on autoimmune meds are often the picture of health externally, because their body doesn’t react, they internalise their issues. It is an overall picture that the patient has in some way come to terms with their problem that is the thing.

Ok, I hope that helps

Best regards

 

[Disclaimer: the above is not medical advice]

Surviving Healthcare – Letters from India

Healthcare has come to mean large and highly structured institutions, with ideas and agendas of their own. Before you get sick and need them, it is vital to understand the basic nature of institutions and administrative systems. It can save your life. (Opinion)

Would you believe that your health is not the highest priority of a hospital? In fact, making money isn’t either, even in the private sector. The highest priority of institutions is maintaining their own existence. And the priority of the people within them is to keep their own jobs. Anything that challenges that (our individual needs and quirks as patients, for instance) can meet a surprising level of resistance. The needs of the system will often conflict with the needs of the patient. And when that happens, any strong institution will tend to prevail. It takes constant effort to keep the system working for us.

Britain’s National Health Service has achieved Holy Cow status in the UK. And it seems the bigger it gets, and the more problems it acquires, the harder it becomes to criticise it. Kind, caring, dedicated, well-meaning, highly qualified staff abound, but they do have to function within the established norms of a system that will easily crush them if they don’t fit in. It is a brave doctor or nurse who does things differently just because the patient needs it. Speaking out about problems can cost them very dearly.
https://www.independent.co.uk/news/uk/home-news/whistleblowing-law-inadequate-nhs-staff-blacklisted-public-interest-disclosure-act-norman-lamb-a8442621.html

In this video I have tried to explain how large institutions in ‘The Administration Age’, by their very nature, are an actual threat to the health of the unwary patient, and what we can do about it. It is too easy to become just another commodity to be processed by a machine that values its smooth functioning above the function it is there to perform. When we ‘hand ourselves over’ to healthcare, we must always remember we are the reason for the hospital’s existence: we are the reason for all those jobs. We must insist that the system keeps working for us, and doesn’t use us as fodder for its own survival – especially in so-called ‘free’ healthcare.
https://www.bitchute.com/video/T7EBFn74zhUT/

The meaning of the title ‘Letters from India’ is explained in the first few minutes.

Sorry about the quality of the sound and video. My poor old camera is showing its age. I will continue to post while I save up for better equipment.

Disclaimer: the above is absolutely health advice. Institutions, administrators, and those who blindly follow rules and norms, can seriously damage your health. I cannot accept any responsibility for your failure to act on this information.

Practical psychology in a nutshell

We gravitate unconsciously toward the familiar and manifest through our deeds. We pursue and settle on outcomes that feel normal, whether or not ‘normal’ makes us feel good. If we want to change our lives then we must also want to change how we feel.

 

[Disclaimer: observation, reflection and comment only. Not to be taken as advice. For specific medical or psychological help please consult a licenced professional.]

Give Me Fever

The first time I left my osteopath’s office and got overcome by a fever, I was amazed.

I had no idea about the cascades of natural responses, that could be triggered after the release of physical tension from the spine, nor about the healing effects they could offer. And yet the benefits of fever, and various ways to provoke and exploit fever, have been understood and highly prized in natural healing for hundreds, if not thousands, of years.

Natural childhood diseases are associated with better health later in life.

It took me a while to associate my fever with the treatment, but I didn’t need to wait long for the benefits. I just knew I needed to get home and rest. So I got into bed, and as long as I stayed there and didn’t try to exert myself, it was actually quite nice. When I emerged two days later, all my aches and pains had gone and I felt great.

Fever can be a routine seasonal event, and it can also be a response to a dangerous problem. But the fever itself is not dangerous, even high fever. It is in fact a survival mechanism, and some consider it to be the highest healing process of all. It hugely increases immune system activity and seems to purge the body of cancer cells. Routine childhood illnesses are associated with fewer chronic diseases later in life. Why would anybody want to stop that? And yet one imagines if a cancer patient is lucky enough to get a fever in a modern setting, they may be told “that’s all you need on top of everything else”, and given drugs to lower it. In fact a fever may be EXACTLY what they do need.

Since my interest in natural healing began, I have had to knock on a lot of doors to find explanations for these things, to learn what they signify, and more importantly, whether there are ways to exploit these principles.

Natural healers have always known about the benefits of fever. From ”Human Life: its philosophy and laws”, Herbert Shelton 1928

Every so often, medicine takes an interest in fever and tries to ‘productise’ it. Dr William Coley was injecting ‘Coley’s Toxins’ into cancer patients, to provoke a strong fever response, and thereby cure cancer. He had a lot of success, and it was only medical politics, not results, that favoured radiotherapy instead.

And now certain other injectables use similar principles, such as the experimental innoculation of genetically modified measles in the treatment of cancer. Perhaps the technical glamour of the concoction is a way to justify commercial investment. But it belies the essential crudity of the principle: any morbid matter introduced into the body will provoke a strong immune response.  What had originally alerted Coley to the therapeutic potential of fever was the observation that cancer remission following surgery was found to be more likely prior to the routine sterilisation of surgical instruments.

This all depends on the patient having an already intact natural immune system, of course, and surviving the procedure. It is the strong who produce the most spectacular fevers and other symptoms. The weak and depleted, less able to react, are more likely simply to wither to any toxic insult. We cannot escape the fact that natural immunity is the only immunity.

So why are we trying to stop natural measles – knowing it probably protects against cancer and other diseases – only to reintroduce a synthetic version to combat the ‘unexplained’ explosion of adult cancers a generation later? Surely at root it is all about money, not health.

Perhaps modern researchers should be asking if it is really such a great idea to be tampering with the natural balance of the immune system; when most childhood illnesses are safe if properly managed and help the child’s immune system to develop properly. And perhaps Coley should have asked himself some similar questions: why were his patients diseased in the first place, and how would they fare in the longer term?

The principles modern research has brought to our attention are fascinating, but not new. It does seem these ideas only ever attract research funding if a patentable product might come out of it. And so the whole situation gets spun to commercial advantage, with heroic headlines saying things like ‘new vaccine for cancer on the horizon – clever scientists use modified viruses to rid the world of disease’ etc. Promises, promises…

In natural healing the most important thing to know is when to intervene and when to leave things alone. Sometimes the best medicine is to do nothing and let nature take its course. The biggest mistake in healing is to believe that we can improve upon nature.

 

Notes and Warnings:

  • Discussion of natural healing principles and not medical advice.
  • I do not treat or give advice on cancer, or any medical condition. I treat people, not conditions, and I advise on health, not disease.
  • For advice on management of fever or the treatment and diagnosis of cancer, please seek individual advice.
  • Fever may not be dangerous in itself, but the causes of fever can be, such as sepsis, or malaria. These things need proper attention.
  • People often ask “what about febrile convulsions?”. That is a separate subject in itself, but suffice here to say that giving drugs to a fevered child to bring down the fever does not prevent convulsions, and shouldn’t be done (Source: NICE guidelines). See Robert Mendelsohn MD “How to Raise a Healthy Child in Spite of your Doctor” for more information on managing childhood fevers.

Why we need a Slow Healing Movement

Is time really the greatest healer? Perhaps not, but change can’t happen without it.

Everyone’s heard of the Slow Food Movement: eating for people who realise the good things in life can take time. Well the same applies to healing. We all want to get healthy quickly, but the truth is Mother Nature can’t be rushed.

It is possible to make changes to the body very quickly and mistake that for healing. In much the same way you can buy plants in pots, put them in the yard and imagine it is gardening. But the lasting changes in nature happen at the rate things grow, and according to certain rhythms and cycles. Real gardening involves preparation, and it can be a long time before there is anything to show for the work. Cut too many corners and nothing will flourish. Buying in turf on a lorry will get things looking green very quickly. But the turf only becomes a lawn when the roots establish themselves.

The difference is structural change. Healing, like gardening, requires growth, renewal and integration, and the job of the healer is to create the conditions. We might not be aware of the role of structure in a supposedly ‘metabolic’ problem: in fact modern medicine ignores it almost entirely. But from the smallest molecule to the largest society, structure is vital to who we are and how we function. A broken leg is a metabolic problem as much as a structural one: and an inflamed organ is one that is undergoing change in its composition. Both are affected by the properties of the blood and the strength of the arteries that bring it, and by the stresses and strains upon the body.

Benefit is not the same as health.

We can feel benefit if we go on a detox, eat some nutrients or take some exercise. But if we then return to the same sets of stresses and strains, in a few days we will be right back where we started, or worse. A visit to the gym can get us pumped: it fires up the circulation and makes us alert. But actual fitness is something else, something that one training session can’t provide.

Vitamin C gives immediate benefits, that last as long as it is in our systems. If we keep taking it over time, then the body will actually grow physically stronger and more resilient in every way. And it is this strength and resilience that signifies the real healing, not the temporary support of the vitamin itself. We cannot store the vitamin but we can store some of the changes it enables.

‘Adrenal support’ can help a fatigued person to keep going. But it is ‘keeping going’ that has got them into the mess they are in. Burnout can take many years to get over properly, and shortcuts used carelessly can lead to real setbacks.

Every osteopath knows that if a joint is subject to stress it will become rigid. And if the stress on a joint is reduced, in time the joint will become mobile once more. And so the job of the osteopath is NOT to loosen the tight parts, but to reduce the stress upon them. Loosening the tight parts alone is no better than giving drugs, and it can be damaging over the long term.

Hence I have never healed anybody in my life, and this is what I tell my patients. What I do is treatment, and healing is what their body does afterwards.

And so real healing is not about a quick change in signs and symptoms but a much deeper process of nourishment, growth, elimination, regeneration; and the building up of reserves. The body actually restructures itself continually. Some parts change very rapidly, others much more slowly. Even the bones remodel, and it is thought that after many years we have a new skeleton. Some say that teeth can regenerate to an extent under the right conditions, although not very many of us have ever put this to the test. These processes cannot easily be rushed or controlled, but they can be supported.

Healing also involves learning, and the healing person will often develop new habits, appetites and interests. Their environment can even seem to change around them.

Slow Healing does not mean taking longer than necessary to get well, but doing a thorough job.

Slow Healing means doing the necessary groundwork, addressing the causes, and appreciating the importance of change. Ironically, Slow Healing done well can bring pleasant improvement very quickly indeed. I have seen Slow Healing resolve infections faster than antibiotics, fix joints faster than intensive physiotherapy, bring down blood pressure faster than drugs, solve many problems that were supposedly not solvable at all, and keep various people out of hospital, including yours truly. And so the principles do not only apply to chronic situations, once we understand the relationship between chronic and acute.

What it isn’t, is accelerating recovery in a way that might leave one worse off in the longer term. I’m afraid that ‘natural’ therapies can just as easily be quick fixes as pharmaceuticals, and when used without vision they can also worsen health. For example, many forms of therapy can make a single headache go away, but it is only healing if the person stops getting regular headaches.

Safety First

I do not advocate leaving life-threatening problems without the necessary care. This is what hospitals are very good for.

That said, where the line is drawn can be a moot point. Hospitals tend to treat most acute problems in the same sorts of ways, whether or not the body can actually cope on its own. It was not always so. Remember the doctors of earlier times, who used to say ‘come back in a few days if it isn’t getting better’? Of course they didn’t always get this right, but by being generally more aggressive with situations they still don’t. The job of the GP used to be protecting the patient from a diagnosis and keeping them out of hospital, because they recognised medicine is dangerous. Not only that, a natural recovery can leave you a lot stronger, with permanent resistence to future threats.

Whether or not the ’emergency’ has been well managed, once out of danger is when the important and sometimes painstaking process of getting strong again actually begins.

Slow Healing is inherently natural healing, and follows a few important principles:

  • The human body can be trusted to know what it is doing
  • Drugs are poisons. They may save a life but only nutrients can heal
  • Natural immunity is by far the best kind of immunity. It has no downside and it lasts a lifetime
  • Health is a reflection of the structure, and vice versa
  • The body seeks health as surely as water seeks the lowest point, and it only stops because of obstacles
  • Symptoms are usually healing processes, and seldom malfunctions. The body will sometimes deviate massively from ‘normal’ in order to survive
  • A person is a complex system, like the weather; and not a machine, like a car or a computer. The effect of tampering with its functions can be highly unpredictable, and forcing change can easily backfire
  • Causation of disease is a multifactorial, non-linear problem with no limits, where things both small and large, near and far, can matter
  • Often the very best medicine is to leave well alone and let nature take its course. The skill of the practitioner is in making that judgment
  • How we are in a day matters less than how we are in a year
  • Getting people better is not the highest priority. Doing no harm is

Ok, if that looks a little bit like Slow Healing means doing nothing, that is because I haven’t said anything yet about how we go about it. That subject is huge. But when we talk about working with nature, with the body not against it and so on, that means giving all the support the person can use, but not forcing the recovery or controlling the direction it takes. It means treating predispositions to disease rather than disease itself, and going after factors that can be changed, instead of getting hung up on factors that cannot be changed. And again, where the lines are drawn is a moot point.

Spontaneous Recovery is not a derogatory term: it is by far the sharpest tool in the box.

During my contact with many practitioners over the years I have gravitated to the ones who value lasting results over flashy displays of technique and instant fixes. Healing at its best is really mundane.

As a patient there have been times I have left the session wondering why the therapist had not done much with the problem areas: and then failing to notice the problems melting quietly away on their own. Some might call this coincidence, and put it down to ‘spontaneous recovery’. Experienced healers see these ‘coincidences’ rather often, and prize them very highly.

Of course, like anyone, I am impressed with quick results and skillful intervention. But I have also acquired a huge trust in the ability of the body to recover, once it is given a chance: and joined the increasing ranks of those with a general distrust of any new rocket science that is supposed to do the fixing for us.

Whether Slow Healing is what you want depends on whether you want to be back playing sport in time for Saturday’s game, or whether you want to live to 100 with all your faculties intact and still enjoying life. It if turned out we couldn’t have both, which would you go for?

Just remember that it takes over six months to build a Rolls Royce, and only 13 hours to build a Toyota.

Good health!

Copyright 2016 Kuno van der Post

The Osteopathy Paradox

On the one hand osteopaths can hardly claim to treat anyone or anything, but on the other hand millions of people visit osteopaths for anything and everything, and are delighted with the results. And nowhere in osteopathic theory does it say that manipulation cures back pain. What is going on? (Opinion)

Is that an elephant in the room?

Is that an elephant in the room?

1) I’m the first to admit osteopathy can’t cure anything. Yet millions of people consult osteopaths and are extremely happy with the results.

2) There is very little proof that osteopathy can make a difference outside of back pain and a few associated issues. But when osteopaths need help with their own general health, most will ask another osteopath for an opinion before anybody else.

3) The accepted evidence for osteopathy is contradictory or inconclusive, even in everyday matters like back pain. And yet our patients swear by the benefits, and send their friends too.

And the more bizarre, confusing and complex the problem seems to be, the more some people feel let down by conventional medicine, and the more they seem drawn to alternatives such as osteopathy.

Alternative therapy makes more sense to many people, because it seems to match their own world views. In particular, osteopaths do not settle for labelling the patient and consigning them to a lifetime of incurability and drugs: we look for practical, easy, cheap and safe steps to make life better, whatever the problem. And alternatives obey the Hippocratic prime-directive far better than mainstream medicine: that is, to do no harm.

There is no shortage of research into alternative medicine, so why is there so little official acceptance for the benefits?

Do not adjust your reality, there is a fault in research…

When I learned about science, it was not observation that was supposed to validate theory: it was theory that was supposed to explain observation. It no longer seems to be that way.

Until now, the mismatch between research findings and the clinic experience has been blamed on many things, such as deluded practitioners or over-optimistic patients. But at some point we need to turn the spotlight onto research itself and see if that is where the problem lies. Is it really testing what it needs to test, in a way that will find out the truth? Or is it asking all the wrong questions, and relying on false assumptions?

The thing is, osteopaths don’t claim to take a medical diagnosis and then cure it with a prescription, and so it is a mistake to test whether or not we can. For instance, nowhere in osteopathic theory does it say that a consistentlly specified product called manipulation cures a disease called back pain. There have been many rigorous studies asking the question, but absolutely none deconstructing the question itself. If there were, they would reveal the logical holes very quickly. For one thing, back pain is not a disease: it is a symptom with countless possible causes. We keep telling people we don’t treat symptoms, don’t we?

This is why I pay no attention to research into manipulation and back pain, whether the findings are supportive or not. It is like asking if spanners fix engines. I have a box of spanners at home, and I have never seen them fix an engine. That doesn’t mean all engineering is rubbish: but this is the sort of inference many commentators seem entitled to make.

The latest study on neural mobilisation and cervical radiculopathy is really a glorified example of ‘manipulation vs. pain’. No matter that it shows the technique in a positive light, because the whole question is meaningless.

Osteopathic theory starts with a different kind of analysis of the situation, and different outcome intentions. Yes, your symptoms are important, but if the medical paradigm – symptoms: disease: diagnosis: treatment – so often leads nowhere except a worsening of health, then we really should challenge the value of this construct.

What is far more important is why the problem has occured. And the reasons are different for everybody. When the bulk of researchers in our field finally cotton on to this, then they might at last find answers that match the experience of millions of people.

If you want to test what osteopaths do, you need to research what osteopaths do

Forget manipulations and back pain for a minute, and even manipulations and colic. I am far more interested in whether osteopathic principles form a good overall strategy for raising health, and if that is a better route to lasting recovery. Over a century of real world observation suggests they do, and it is. When research begins there, I want to be involved.

It is inconvenient for research that health cannot be measured precisely. We can’t count the people who have avoided illness, or the times we have prevented worsening and complications. When our highest aim is to promote spontaneous natural recovery from within, there is no direct way to measure the difference made by our involvement. I have nothing against measuring outcomes, except that I have no idea how to measure the outcomes osteopathy is concerned with. Too bad: that is the problem researchers have to get over.

Furthermore, trials cannot encompass a patient simply ‘feeling better’ who cannot articulate why, or who gets better in an unexpected way or after a trial is finished. Exceptional recoveries are dismissed as outliers, and complex cases (the sort we are often really good at) don’t qualify for trials because of ‘confounding factors’. Individual case-studies, once the mainstay of medical learning, are now ‘anecdotes’ and not ‘evidence’. And all by some miraculous set of God-given rules, apparently.

For every critic who says osteopaths are resistant to research, there must be hundreds or thousands of people who say things like ‘I no longer need to take my antacids’, or ‘I made it to my grandchild’s wedding’, and who unequivocally credit osteopathy with making a difference.

Patient satisfaction is probably as good a way as any to find out if ‘osteopathy works’. And if something a little more objective is required, we could see how many users live to be 100, or something like that. To be any more precise, there first needs to be a thorough deconstruction of the dogma embedded in research theory.

Positive patient and practitioner experience is largely dismissed as ‘unqualified’, or ‘lacking in objectivity’. Typical justification is circular – there is no evidence this is possible: therefore the practitioner is biased, the patient is probably wrong: therefore we dismiss their testimony etc. Accepting those experiences might require the research community to do some explaining, and so the tail is wagging the dog. Clinicians are expected to alter their own narrative instead, and it isn’t on.

An inappropriate research question is one obvious flaw. On the results side, narrow outcome measures can miss an important effect when it is there. The researcher may be interested in whether a certain intervention will reduce the specified symptom within a month. But I am interested that a general strategy will, via a bespoke intervention, lead to improved overall well-being. In some way. At some point in time. And with no permanent downside. Benefit is benefit.

Take migraine. Stopping a migraine is one thing: I don’t call it much of an accomplishment. Drugs can do it cheaply and easily, while still leaving the patient in a total maze. Stopping the patient from getting migraines every week: that is something else altogether. If we do our job properly, we treat the patient, not the migraine: migraines cease to be a feature in their life, and credit goes to Mother Nature. This isn’t hypothetical: I have seen case after case go like that. Wise patients appreciate that long-term improvement may be incompatible with a quick, direct fix.

The key to all of this is in whether we treat diseases, or whether we treat patients: things we say, but what do they really mean?

We humans heal ourselves. Osteopathy assumes a fundamental acceptance of this, because we would otherwise all be dead. Even doctors promote the idea, I just seldom see clinicians betting their reputations on it. The trick is to remove the obstacles to recovery. We see all the time the staggering ability of the human body to recover once obstacles are addressed, and so that is what the smarter patients are asking for.

[This relates to the osteopatic principle that ‘the body has its own medicine chest’. This does not mean we secrete drugs from some gland: it means that our bodies are self-righting systems, always doing their utmost with the resources available. Health is the default, and symptoms are the manifestations of the body’s drive to maintain health.]

An Alternative Narrative of Health and Disease

In its broadest interpretation, osteopathy says that health is the only real solution to disease. It is a myth that you can make a disease just go away while life goes on unchanged. Once we get comfortable that the only cure comes from within, this is actually very empowering.

Even the idea of diseases – consistently identifiable syndromes with consistent causes and symptoms – may be a myth. It it were true, we ought to know by now the precise cause and cure of every disease. And the medical classification of disease conforms to no consistent rational system. It is totally haphazard in fact. If this paradigm were leading to cures, hospitals ought to be getting smaller, one might think, not bigger. The more we seek health by fighting against things called diseases, the more unhealthy and disease-prone we seem to become.

Our awareness of un-health is usually through healing processes – symptoms – which are generally the body’s healthy reactions to stress and strain. To call this disease is to misrepresent what is going on and then fire missiles at the wrong target.

A Holistic Osteopathy Paradigm

What we find is that two people with exactly the same symptoms can have completely different circumstances: the causes are not the same. And yet two people with similar lifestyles and similar patterns of stress can have completely different health problems.

Medical philosophy emphasises the weakest link in the chain, and makes that the diagnosis. Osteopathic diagnosis and treatment are more to do with the stresses upon or within the system, mechanical stress being number one. But there are many other forms of stress – emotional, nutritional, toxic, occupational, social, to name a few – and they can all create obstacles to healing. Sometimes the most osteopathic thing you can do is to drink a glass of water, or have an early night, because manipulating a tired and dehydrated body achieves absolutely nothing.

And so osteopathic scope of practice is not limited to certain types of disease (as medical specialists are), or to certain parts of the body (like physiotherapy), or to certain techniques (massage therapy). Our scope of practice is determined by the obstacles to recovery, and is as broad as our ability to address them.

Anybody who has ever felt they could sleep for a month after treatment will realise just how much stress can be held in the structure.

Most natural therapy focuses on diet, and rightly so. But complex disease also has structural and postural elements, a fact that modern diet-centred therapies have missed. The need for good mechanical adjustment was already appreciated in natural therapy before Osteopaths took it on. These ideas have very much gone out of fashion, but for mainly political reasons, not because they lack sound reasoning or clinical success.

[Note on osteopathic principles: ‘Structure governs function’, although true, was a later alteration of the much richer ‘Structural integrity, natural immunity’.]

So it is all very well eating the best nutrients possible, but if they aren’t being properly processed and distributed, they won’t solve your problems. Stress is a major disruptor to metabolism: at a fundamental level it alters the balance of circulation, and with it the internal economy of the body.

[Osteopathic principles: The ‘rule of the artery reigns supreme…’ etc. refers to the constantly changing diameter of the blood vessels. Diet is what we eat: nutrition is also about what our bodies do with nutrients. Structural adjustment addresses the processing and internal distribution of resources, by optimising regulation, and limiting unnecessary demands for energy.]

Whether or not the above ideas are currently accepted, they are what shaped Traditional Osteopathy theory and practice. One other vital point of the philosophy is that in a living system, you have to get the whole thing working, and that way all the parts are supported and can take care of themselves. Although we can learn lot from dead machines, they do not behave in this way.

[Osteopathic principles: ‘The body as a unit’ refers to treating the body as a whole, not as lots of parts.]

And hence Traditional or Classical Osteopathy is concerned first and foremost with tuning up the whole person, rather than going straight to the bit that hurts, and then understanding the natural reaction to the changes. And if you want to be safe, it makes sense to set out that way, and not go straight at inflamed tissue, hoping the diagnosis is correct.

A Traditional Osteopathic Method

Our job is not to create change, but to create the conditions for change, and then allow the intelligence of the body to determine what happens next. Osteopathic adjustment is very different from chiropractic manipulation, in a number of ways. The clicks and pops (if they happen) are the product of change not the cause, and so an audible release is not crucial to the result. Many people say osteopathy is gentler and more holistic than chiropractic, and hopefully this explains why. We are not putting bones back in place: we are looking to deal with the reasons they are out of place, and then allow them to adopt a position of better ease. We trust that the body knows what it is doing, and do not try to micromanage it. Acute symptoms are  the body’s cure in action, and so we manage the acute, while treating the underlying chronic background; the opposite of standard practice.

Summary

The difference these ideas make in technique is not something that can be explained in a hurry. Suffice to say not everybody gets their heads around it, even with one-to-one teaching. During osteopaths’ training there is a lot of academic discussion about concepts. But this is largely treated as a matter of historic interest, and it does not translate well into the environment of the modern teaching clinic. The number of teachers able to bridge the gap is very small indeed.

If Traditional Osteopathy is an antidote to anything, it is to high-tech medical healthcare that many feel they have exhausted. It is more concerned with the basic necessities of life than glamorous and heroic intervention. It addresses the bigger picture, because when we do that, the details tend to take care of themselves. It is about supporting the system to find a better equilibrium, rather than controlling everything in sight.

When influential critics (and there are some real busybodies out there) say something ‘works’ or doesn’t, we have to ask what they mean by ‘works’. Drugs don’t ‘work’ either, if what we mean is making sick people healthy by poisoning them.

Every other branch of science now recognises that complex systems behave in non-linear ways. There is no predictable mapping of cause onto effect as we would like, and so we have to find smarter ways of interacting with living things. Controlling all the bits is far too crude an approach. If healthcare is going to talk holism it is time we moved beyond the linear mechanical consciousness of the 20th century.

The pursuit of narrow outcome measures, means that helping the patient now, frequently stacks the odds against them in future, and with complete deniability for us. Most of us are blind to long-term benefit and harm because we are not trained to recognise these broader patterns.

We could say that the research community is to blame for this, by placing published trial data at the top of the totem pole, while arbitrarily downplaying or dismissing all other forms of human knowledge. But I think this feeds off a societal desire for short answers and encapsulated solutions, where complex and original ideas have to fight for survival. In fact it is researchers who have also shown us how badly modern medicine is failing, and who are now igniting the motivation to do things better. That requires better vision. Hopefully the old dinosaurs and their specious buzzwords – best practice (read: standardisation), treatment of choice (prescription) and hierarchies of knowledge etc – will soon move over for something more highly evolved.

If there appears to be any paradox in osteopathy, it is only because of asking the wrong questions; of saying one thing and doing another; of research doctrine putting square pegs into round holes. Patients say they get better, but tests in the lab say it doesn’t work. Well, this is a bit like when physicists proved mathematically that bumblebees can’t fly. Science never fails, but scientists frequently do…

Copyright Kuno van der Post 2016

What a surprise – to wake up in 2016 as a climate sceptic!

(credit UCSD, http://earthguide.ucsd.edu/virtualmuseum/climatechange2/07_1.shtml)

(credit UCSD, http://earthguide.ucsd.edu/virtualmuseum/climatechange2/07_1.shtml)

Who remembers the 1980s, and how hard it was to convince anybody to take global warming seriously? Well now it is virtually impossible to pursuade anybody that we might have got this wrong, and that we must never stop considering other possibilities

As in the vaccine debate, there are powerful interests that think certain arguments must be suppressed at all costs, lest the certainty on which social stability rests be demolished. In other words, policy and commerce can too easily take precedence over the truth. Within every area of science, there is an unavoidable dose of dogma, assumption, lobbying, and control, aka bias. And ‘big science’ can suffer ‘big bias’.

Brian Cox’s ‘absolute consensus’ is maintained by systematic exclusion of anything that does not support the prevailing view. Anyone researching areas of climate science that do not imply global warming, can find it very difficult to get funding or peer review. They can be automatically dismissed as ‘not credible climate scientists’. That is not consensus, it is suppression of dissent. I do not think Malcolm Roberts put up a very good fight in the clip, but his demolition by Cox was pure showmanship. I urge the public to choose better reasons for making up their minds.

Environmental sciences were pretty big where I studied my first degree. My father was a high-ranking research director in the publicly-owned gas industry of the 1960s and 1970s, and we heard of the greenhouse concept back then. Prof Cox pulling out graphs is a shoddy example of how science is supposed to be approached.

Putting it on the BBC News website is media support at its finest for an establishment view. Why an establishment view? Because when they realised the level of popular awareness of climate change in the 1980s, some parts of the establishment decided not to fight but to make money out of it. And thus began carbon-trading and carbon quotas on Bill Clinton’s watch, and a war of messages. So no message can be trusted uncritically. And any sincere scientist could in fact be an unwitting disseminator of any agenda.

Those familiar with the vaccine debate will recognise ‘The Graph Trick’. Produce a graph that shows the section of data supporting your hypothesis, and compel others to acknowledge the trend. Give them less than 3 seconds to come back with a complex and detailed rebuttal. But in the case of vaccines, if you go back in time far enough, the graphs actually show that major diseases were well on the way to eradication LONG before their vaccines were introduced, thanks to public health measures that are far more important than immunisation.

How many of us have a better graph in our pockets, just when needed to challenge a point? In fact we don’t actually know what Prof Cox’s graph shows – it could be the inflation-adjusted price of baked beans in Kwachas for all I can tell, yet it raised an instant cheer from the audience.

Take a long view with the atmospheric carbon trends and you see that a similar sleight-of-hand is at play in the media. Because, barring a mere blip since the industrial revolution, atmospheric carbon is at its lowest in geological history. Why? because so much of it has been lost to fossil sinks, in other words oil, gas and coal deep underground.

Some say atmospheric levels are in fact dangerously low, near to the point where plant life can no longer thrive and life on earth could die out if it gets any worse. There is propaganda on all sides, and so the honest position for the layman is to not know what to believe. The savvy layman keeps openly sceptical, and isn’t pursuaded just because it is Brian Cox and a graph.

The more CO2 there is in the atmosphere, the more ‘food’ for plant growth. Plants capture CO2 as they grow, and so there is this kind of homoeostatic mechanism in place (as long as we don’t keep cutting down our forests). In support of the idea that levels are in fact currently low, sceptics point out that horticulturalists actually install CO2 generators in greenhouses to feed their plants.

And when plants die, the carbon they contain is recycled into new life, either directly or by release into the atmosphere and later absorbtion into other plants. But a small amount gets more permanently fixed into fossil sinks. And as the amount of fossil carbon increases in geological time, that leads to a gradual long-term loss of atmospheric CO2. By burning fossil fuels we are merely putting some of it back. There are other mechanisms at play, and the whole picture is unavoidably complicated, meaning certainty here is not the domain of the wise.

Now, I am not here saying unfettered burning of fossil fuel has been a good thing. Dumping hundreds of millions of years’ worth of sunk carbon back into the atmosphere in a few centuries is not a very ‘organic’ approach. And I realise this opens the door to some huge conversations, such as the fate of the coral reefs and so on.

But nor is it a good thing constructing a false-narrative, calling it science, and then using it as a pretext for massive control measures against whole societies. Make no mistake: climate change is big business and power. And that can turn any good intention bad.

Yes earth’s temperatures appear to be rising in parallel with the recent rise in CO2. But we are all aware that statistics can be used to create any picture. Assuming there is overall evidence of a rise, there are other hypotheses worth exploring that can explain it, fully or partly. Admitedly some of them are very complicated and hard to grasp, but that alone should not make them less likely. And it is bad practice scientifically to say these ideas are invalidated by a lack of consensus. The ‘absolute consensus’ was once that the earth was the centre of the solar system, as Brian Cox of all people should know.

And yes, altering the chemistry of the earth’s atmosphere on a grand scale is dangerous. And yes, pollution from fossil hydrocarbons and their many byproducts is one of our worst problems. And yes, clean air, clean water, a sustainable energy future and economic independence from finite resources would not be such a terrible mistake to make: in fact I totally support it. I don’t want to see climate action filibustered.

None of that means that we should allow fair debate and exploration of all ideas to be stifled by mainstream thinking. So it is the official message I always take with a pinch of salt. If the message is that we need to shut down all industry, cover every spare acre in solar panels (with huge up-front energy costs), dump heavy metals into the atmosphere or build giant space-shields to block out the sun, then our mindset is going to kill us just as surely either way.

But my main point is that every ‘mainstream’ idea was once a minority idea, and if we shout down current minority ideas we could be suppressing the next sustainable energy solution, or cure for cancer, or the invention that will get us to the next habitable planet. So I admit being a bit of a supporter of scientific underdogs, not because I think all wierd ideas are right, just because we risk losing some great ideas if we keep saying certain things are ‘settled’ or beyond debate. Being ahead of ones time is even more a disadvantage than being behind, and sometimes ideas need to be kept alive until mankind is ready for them.

Having for a time myself become very disillusioned by science, I eventually had my faith restored by realising it was the abuse of science by scientists in the name of science I so deplored. Science is always right, but scientists are often wrong. Part of this return to science now compels me to respect ANY hypothesis, no matter how outlandish it may at first seem. And to be especially wary of herd mentality, consensus and science wrapped in public policy: but to realise that good science requires constant vigillance over details, constant awareness of the interests it serves, and most of all, a realisation that at any moment one new piece of information can turn everything on its head.

Meantime, there is one thing humans can do right now that is virtually free of negative consequences, that will reverse our dependence on fossil fuels, moderate or even reduce atmospheric carbon, and reverse many of the harmful environmental problems of the post-industrial age. And that is to PLANT TREES. More than any other project, restoring the earth’s forests is arguably mankind’s most urgent duty right now.

That’s all…

 

 

Osteopathy or Chiropractic?

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(Opinion)

All the time we get asked what is the difference between osteopathy and chiropractic, and we all have different answers. People often say things like ‘osteopathy is more holistic, chiropractors are mainly interested in the spine’. But this is pretty inaccurate in my view. Both groups tend to say things like ‘holistic’, ‘working with the body’s own healing processes’, ‘treating the causes and not the symptoms’, and other phrases like that. But there is a whole range of interpretations for these things.

You pays your money and you takes your choice. But here is my answer…

At a fundamental level, chiropractic is defined by technique, and osteopathy is defined by its theory. And this is more than an academic distinction: it makes a world of difference to the patient experience, and, I believe, to outcomes.

So in a sense, chiropractic is a statement about the method of treatment, without making any claims for the thinking that guides the application. Osteopathy, on the other hand, defines a way of looking at problems and lets the practicalities follow from that. It is like the difference between a car and a road-map. Clearly osteopathy is not worth much without some practical methods: but Chiropractic theory can be summed up essentially as the art of correcting subluxations. Beyond the idea that subluxations impair nerve function, and correcting subluxations should help, there is no distinctive chiropractic vision of health and disease. It is a pretty linear way to look at the treatment of a highly non-linear system; the living human body.

Whether for any of us this makes one way better than the other, depends on our own world view and what we want from life.

Bear in mind this is a conceptual difference, and says nothing about what an individual practitioner thinks or does. And when all is said and done, what really matters is the vision of the practitioner and not what banner he or she goes under. But a chiropractor can quite legitimately function without any broader hypothesis of health and disease: the medical model will do. You just correct the subluxations and Bob’s your Uncle. Whereas for an osteopath to function without invoking the osteopathic philosophy of what it means to be healthy, and how the body deals with disease, is to fall short of his job description.

This is not so much a matter of right or wrong, but of consumer choice. And so the trademark should stand for something, and it should give the client some clues. And unfortunately when practitioners try to be all things to all people, to mould their practice to the expectations of the client instead of to the definitions of their discipline, the result is a public who are confused about who we are and what we do.

And so in short, chiropractic is to osteopathy as a set of spanners is to the study of engineering. “Chiropractic is nothing if not specific” is the famous catchphrase of DD Palmer, the founder of chiropractic. And that alone speaks volumes as to what matters to chiropractors. And to be fair, specific correction of subluxations (misalignments of bones or joints) can give impressive relief to specific areas of pain, at least in the short term, and even to related organs.

Osteopathy has an alternative view of the subluxation, and we call it the lesion. The osteopathic lesion is the stress or strain that has caused the bone to be misaligned or the joint to be rigid in the first place. And it can exist beyond the bone itself, because it involves the entire pattern of influence upon the bone. Importantly, therefore, when you correct the subluxation directly, you do not reduce the lesion, you merely reduce its appearance. In fact removing the subluxation can increase the lesion, because doing so disturbs the most natural equilibrium. In a way, the lesion is there to help us.

An individual bone, joint, segment or other body part is subject to forces from outside. It is suspended within muscles and ligaments, it moves according to the way the body deals with digestion, elimination, movement, immunity, occupation, chairs, beds, habits, stress, hopes, dreams, fears and loves. And all of these influences are external to the bone or joint in question. To correct the localised subluxation and expect the rest of the universe to de-rotate around it is fanciful at best.

And so, specific adjustment is not enough to correct lesions. The effect is the patient can feel better locally but still be stressed generally. And the removal of the compensatory rigidity or misaligment can in fact make matters worse overall. The smart way to loosen a tight joint – and to keep it loose – is to lessen the stress upon it so that movement will be more useful to the body than rigidity. Don’t expect the change to be immediate however, because these are adaptations that take time to happen. Healing is not what the healer does: it is what the body does afterwards.

If all that is confusing, here is an analogy to help. Imagine taking a piece of wire or string and twisting it from both ends. Waves and kinks will start to form along its length. In order to resolve the pattern you have to untwist the whole system. If you go directly to the kinks and tackle them individually, you actually put more stress and strain into those areas, not less.

Treating all the kinks is no good either, it is simply a more comprehensive way to mess up the system. However it can look initially better; just as in the human body, treating the local area of disturbance can bring some relief. But what we need to realise is that in life, our symptoms are actually protective mechanisms and healing processes. The real disease is usually invisible. When we palliate, ie. treat symptoms above all else, we are in effect suppressing the body’s natural responses: we are taking the system out of its lowest energy state and moving it towards an even less sustainable situation. And that is to suppress healing.

The consequences for human health of treating too specifically are not just conceptual: once aware of these patterns, after a few years of observation in practice we can see these progressions in actual patients. Quick and impressive relief is soon replaced by less relief, or chasing symptoms around the body. Eventually it may stop working altogether. An overall degeneration may ensue, which all the while is interpreted as ageing, or unavoidable disease. And the temporary relief obtained after specific treatment is perceived as keeping the patient going, when the broader effect can in fact be to accelerate the decline.

And if we believe that what happens to the organs and what happens to the spine are reflections of each other (they are), then it is only a matter of time before the stress palliated in the posture shows up as stress on the organs. Of course by the time that happens suddenly the ‘holistic’ practitioner is now quite able to say ‘not my department, go and see a doctor for some drugs’, and wash his hands of the whole case.

But these are not exclusively the problems of chiropractic. Treating everything from head to toe does not get around the problem of specificity, and many practitioners of many disciplines treat the body as lots of parts, the idea being that once you get all the parts working the whole thing will work better. That is how I was taught in college, and it sounds reasonable, because that is how you fix a car. But the body does not work like that. In a living system, the parts are all self-maintaining, self healing, self repairing, providing the whole system is supporting them. And so the real aim of holistic treatment is not to do lots of things to lots of different bits of the body, but to get the whole thing in tune and so that the parts can take care of themselves. Only then are we treating the body as a living system rather than as a dead machine.

This is not just a semantic difference, it makes a massive difference in practice. Because chiropractic is nothing if not specific, whereas osteopathy is by definition anything but specific! Treating lots of parts is not the same as treating the whole. The ‘pathy’ part of osteopathy has often been misinterpreted to mean disease (from bone). In fact it is more to do with pathos – sympathy with the bone, understanding its niche in the ecology of our being. As I have explained, the lesion has a context, and it is this ecology which we are seeking to improve. In doing so the lesioned ‘part’ has a more supportive environment, and therefore the lesion is lessened. The body as a whole becomes more comfortable and the lesion is therefore no longer required.

How ‘treating the whole’ becomes real in practice would be an entire course of study. Suffice to say for now, that the osteopath can treat almost anything but the bit that hurts, improving the relationships and coordination of body parts: the chiropractor seeks out the subluxations, corrects them directly, and perhaps deals with the context as a separate matter. And to be fair, many osteopaths see therapy that way as well.

And I am not saying that therefore chiropractic is wrong and osteopathy is right. I am saying I became an osteopath because it makes more sense to me, for reasons I have tried to explain here. I would hope all practitioners have chosen their direction for good reasons of their own. And I hope to encourage patients to think about what sort of practitioner they want, and why.

A lesson that is never out of date

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Donald Woods is a national hero of my ancestral country, but at one time the government considered him an enemy. He was a fierce critic of apartheid from within South Africa, and it may be hard now to appreciate what a dangerous choice that would have been.

When something is so clearly wrong and when the outside world is able to reflect an image of the situation, as was the case in apartheid South Africa, that must help one to keep a sense of perspective. But in the 21st century we have globalised problems, globalised injustices and globalised mistakes. When the whole world can at times seem a little crazy – when there are conspiracy theories everywhere and when the mainstream media can no longer be relied upon to give us a clear view – where can we turn for a sense of normality, for a baseline of what is right and what is wrong? How do we know what are the lies and what is the truth? Who are the heroes and who are the villains?

I think a man of Woods’ clarity and courage would have been able to help us. He would have recognised many of the lies and hypocrisies we face today, and understood the mind control tricks used to ease people into accepting oppression and injustice. He would have been able to show us how something very wrong, can seem right until it is too late. And he would have had us laughing at ourselves and that so much of what we stand for is ridiculous. If we were unable to see the joke we would be in really big trouble.

Here is Woods explaining to his children with incredible clarity how something as wrong as Nazism can get a hold of a nation.

Dachau Explained To Children – Donald Woods 1976

Many South Africans believed the “World at War” episode dealing with Hitler’s death camps shouldn’t have appeared on our television screens. They claimed this was because they didn’t want their children to see it….

Taking the opposite view, I watched it with my children, and for those who don’t know how to explain such atrocities I can offer the following approach:

You can’t understand why the Nazis murdered all those people? Well it starts with prejudice. Prejudice means judging people without knowing them, having hostile feelings towards people without sensible reason, regarding people as part of a group instead of as individuals.

Prejudice is like a disease, and children usually catch it from parents and other adults. But it can be prevented through good education, and sometimes it can be cured with psychiatric treatment.

Hitler didn’t have a good education, and he grew up prejudiced against Jews. He was never cured of his prejudice because he never had proper treatment. He found that many other people had the same prejudice against Jews, so he became leader of Germany by spreading scare stories about Jews and by promising to save Germany from them. Eventually he told his followers to kill all Jews, and that’s why there were places like Dachau.

Why didn’t they refuse? Well, in a nondemocracy people don’t ask questions when they are told what to do. They just do it. If they don’t they are called disloyal to the country. Yes, a dictatorship is the opposite of a democracy. A dicator is a person who is scared of most of his own countrymen and that is why he won’t let them vote.

Why didn’t someone report Hitler to the police? In a dictatorship you don’t have proper police. You have political police. Proper police fight crime. Political police fight opponents of the government. Yes, Hitler used to imprison people without trial. He used to ban and banish them and house-arrest them. He regarded people who disagreed with him as enemies of the whole country.

No, he didn’t really believe they were, or he would have let judges decide, wouldn’t he? Dictators play on the fears of ignorant people. Hitler knew how much his people feared communism, so he called people who disagreed with him Communists. In that way he got many of his followers to believe that good people were bad people, and that bad things were good things and that lies were truth.

Yes, there were many people here who admired Hitler in those days. Some are in our government today. But they weren’t the government of South Africa then. Our government in those days declared war against Hitler. Yes, the present government came to power in 1948.

What is a patriot? A patriot is someone who wants the best for his country, including the best laws and the best ideals. It’s something other people should call you – you shouldn’t call yourself that. People who call themselves patriots are usually liars. A wise man, Dr. Johnson, once said that patriotism is the last refuge of a scoundrel. He meant that people who praise their own love of country are usually covering up their lack of it.

Yes, it is unpatriotic to love the things in your country that are wrong. When Dachau death camp was built, Hitler’s men put up a sign outside it: MY COUNTRY, RIGHT OR WRONG.

Those are among the most evil words ever written.

Viva Science Democracy!

I am not an advocate of copyright theft and piracy, but I do believe science is public property. We are being deprived of our right to make many important decisions, and that is much worse.

So the sudden release of millions of scientific papers is a fascinating development. http://www.sciencealert.com/this-woman-has-illegally-uploaded-millions-of-journal-articles-in-an-attempt-to-open-up-science

Personally I am fed-up seeing intelligent people labelled ‘anti-science’ when the necessary information to understand the science is being deliberately witheld. What the public are not short of is intelligence, and they can see that science is becoming a racket.

We are being spoon-fed conclusions by vested interests and policy-makers who hold all the knowledge and control every conversation. And they WANT to spin things their way. Vaccines, GMO, pandemics, alternative therapy, agrochemicals, geoengineering, nutrition, crime, mental health, Zika…

The big science publishers are complicit in this through charging unaffordable prices for access to papers. In any other business, the holding of a commodity exclusively by a single company would be called a monopoly. The mainstream media are now completely uncritical of anything labelled ‘science’. If a major pharmaceutical brand were to announce a vaccine against stupidity, I suspect the BBC would report it verbatim.

How many others, like me, have tried to research many important subjects, and been forced to stop because we cannot access the relevant science? Over the centuries amateur researchers have made a colossal contribution to human knowledge.

How can citizens find out for themselves, and exercise their right of informed consent? By reading the core texts themselves? Not unless they can pay more than the cost of a DVD box-set for each of hundreds or thousands of papers. In some places that might be a month’s wages. Abstracts alone are not enough, because the conclusions of many papers do not match the actual results reported within. An informed society needs affordable full-texts, and it is becoming a new human right.

Now that millions of scientific papers have been effectively made available to everybody, the question is where do we go with this? It may be illegal to access these files, and it may be unethical NOT to do so, depending on why you need to. I can’t advise on this, but this ought to strike up an important debate. Perhaps it will force big players like Elsevier to change their strategy. I hope so.

Caveat: opinion only. Please take your own legal advice on accessing leaked material.

sci-hub.io is the portal to the entire database.