Richard Smith: The most devastating critique of medicine since Medical Nemesis by Ivan Illich in 1975
Seamus O’Mahony, a gastroenterologist from Cork, has written the most devastating critique of modern medicine since Ivan Illich in Medical Nemesis in 1975. O’Mahony cites Illich and argues that many of his warnings of the medicalisation of life and death; runaway costs; ever declining value; patients reduced to consumers; growing empires of doctors, other health workers, and researchers; and the industrialisation of healthcare have come true. There is a widespread feeling that medicine has lost its way, and Can Medicine Be Cured? The Corruption of Medicine, which has been published this month, describes the loss. The book is as readable as O’Mahony’s last book The Way We Die Now, and the book provides a strange cocktail of pleasure and despair.
From a golden age to the age of disappointment
Unlike Illich, who believed that modern medicine counterproductively created sickness, O’Mahony does see what he calls a golden age of medicine that began after the Second World War with the appearance of antibiotics, vaccines, a swathe of effective drugs, surgical innovations, better anaesthetics, and universal health coverage for most of those in rich countries. It ended in the late 1970s, meaning that O’Mahony, who graduated in 1983 and is still practising, enjoyed little of the golden age. We are now “in the age of unmet and unrealistic expectations, the age of disappointment.”
Unlike Illich, who believed that modern medicine counterproductively created sickness, O’Mahony does see what he calls a golden age of medicine that began after the Second World War with the appearance of antibiotics, vaccines, a swathe of effective drugs, surgical innovations, better anaesthetics, and universal health coverage for most of those in rich countries. It ended in the late 1970s, meaning that O’Mahony, who graduated in 1983 and is still practising, enjoyed little of the golden age. We are now “in the age of unmet and unrealistic expectations, the age of disappointment.”
Golden ages are always in the past or the future and never now (except perhaps for television), but many older people who remember when people died of polio, diphtheria, and tuberculosis would agree that a golden age did begin around the birth of the NHS in 1948; many older doctors also see that time as a golden age when there was more curing of diseases, patients were mostly grateful and respectful, and doctors had clearer roles and more power and status.
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