SHORT explanation Suppose a drug slows the rate of healing by 20%.  ALL 1,500 WHO Took THE DRUGS HAVE DONE WORSE THAN THOSE ON THE SUGAR PILLS, which means the entire bell curve has moved to the let—GOT IT?  Suppose that it is Neurontin, and for depression the average is 20% worse at 500 days. The average for a 3,000 patient is 100 days longer compared to the group who were given sugar pills (1,500 sugar pills and 1,500 got Neurontin).  Since the whole bell curve is moved to the left, those in the far-right end, the 2.1% in the Neurotin cohort took 20% longer than the 2.1% with the sugar pills.  Everyone did worse on Neurontin.  Though the 2.1% depression was less than the 97.9% of Neurotin pill poppers, they were worse off than the 2.1% on sugar pills.  To assume that some benefited, the top 15.8% on Neurontin is false since they did worse than the 15,8% on the sugar pills—apples to apples. 

LONGER explanation:  The bell-curve fallacy, patient, physician, pharma, and FDA.  Those to the right of μ (Mu) do better than average, while those to the left of the μ line (middle) do worse. Suppose being measure is a particular type of fungal skin infection, average duration of which is 100 days.[1]  A drugs which slows healing will make everyone worse off than if they weren’t medicated, including those who become fungal free with the drug in less than 50 days, for they would have healed sooner without that drug.[2]  Secondly pharma does all it can to hide the side effects, including running when possible a trial for just 6 week, using a select healthy population, a washout period, which drops typically one forth of volunteers, then starts logging the results, last observation carried forward, and down-right scientific fraud by dropping out results that are unfavorable.[3]  Side effects are not subtracted from the positive results [4]  

Meat on the bone:  now suppose for the un-medicated, those at the +20 line have the skin infection for 60 days and those to the left at -20 have the infection for 140 days (minus 40 and plus 40 days).  Now if a drug results in the condition lasting on an average 20 days longer, those to the right at the 20 line will be infected for 80 days (60 + 20), and those at the left 20 line will have the infection for 160 days (140 + 20).  Not known the average for the infection, the patient will assume that the drug works if it takes 180 days to clear up, or if it takes her 80 days; after all their physician wrote a prescription of an FDA approved drug, and one is a pill pusher and the other a pill popper. 

          Medical treatments should be based on the unbiased evidence for a large group of real-world people.  The physician would NOT prescribe the drug Weltgone that slowed healing if he knew that it slowed healing.  The FDA doesn’t review journal articles on Weltgone for FRUB (fraudulent bias); thus, pharma cooks the books on the trial, writes journal articles which “shows” Welton reduced duration infection by 20 days based on FRUB.  The journals can’t review the articles for FRUB because pharma doesn’t give the reviewer the raw data, which would expose their FRUB.  The doctor based on FRUB prescribes the drug.  His false belief causes the patient to assume that the 120 days of infection would have been longer if he wasn’t taking those pills.  (Why the hell give a pill for a skin infection?)  The patient whose skin clear up in 80 days also assume it would have been longer without Weltgone.  Neither understand the FRUB and the bell-curve fallacy.

A typical physician will likely assume all patients benefit; he reasons that the FDA wouldn’t approve the drug if it didn’t work—which is false (evidence in footnote near end).  He will assume that the patient who with treatment was infected for 140 days had a particular virulent form of the fungus, and would have had the infection longer if he wasn’t given the pills.  He will also assume the patient with 80 days would have had a longer infection.  I call this the bell-curve fallacy. The physician is cherry picking the positive results and excusing the negative.  Since for most conditions the physician doesn’t know the standard duration, since that information is likely not in the medical books or presented in his required-by-law CME (continuing medical education) classes.  Add to this the 15 minutes assembly line work schedule; he won’t have the time to go through records to see what the average is or to remember on a subsequent visit what went before, he will just have a synopsis on the computer, which probably won’t include his visual assessment of the severity of the condition.  Clinical experience given assembly-line clinics removes observational analysis; consequentially, the recognition of the bell curve moving to the left doesn’t register in the physician’s brain.

There is an even larger causal factor, humans are a social animal, thus social reinforcers shape brain responses and often prevent seeing the obvious.  In this case the duration of illness and how the patients are doing isn‘t obvious.  The very concept of a bell-curve fallacy, probably not-one-in-50 physicians are aware of, and even it so aware, the social conditioning would preclude its application to treatments.  In visually obvious situations, doctors don’t see the obvious when social conditioning is used.  Most doctors for examples smoked in the 1940s through the 1960s, and the health consequences and obvious harm from inhalation of chemical and carbon monoxide had to be known to the physician smoker and non-smoker.  Social conditioning causes blindness to the obvious, and the brain rules (a saying accepted most neuroscientists).  We are a social animal.  As Prof. Ben Goldacre says, you can’t change human nature.  He is referring to the behavior of pharma executives, physicians and the public—pill pusher and pill poppers.  He concludes that the change must come at the highest level of government.  As I say dream on, there is regulatory capture. 

Doctors are dupes of pharma:  like good soldiers with group behavior, physicians have been shaped into pill pushers.  We have a system of medicine that is worse than you can imagine.  Billions of dollars spent by pharma for happy actors taking the miracle drugs in television informationals;[5] that message has been poured into the consumers’ brain.  They spend 4 times as much shaping the medical professional than they spend on consumers.  That figure includes their writing the evidence basis for the use of drugs and the clinical guidelines.  The leading 5 English journals once published up to a decade ago articles exposing this corruption.[6]  Pharma is in the business of treating illnesses, and Pfizer doesn’t care for your heath any more than R. J. Reynolds cares for my father who smoked 2 packs of Camel daily until he was 53. 

Often the FDA approves a drug for a surrogate outcome, the example of fungal infection could be the culture petri dish that grows slower with the drug than without.  That benefit in the petri dish weakly translates to the skin, more weakly since the medium used was the one which produced the most positive results.  Need I point out again whose side the FDA is on.  Patients wouldn’t take Lipitor for lowering cholesterol, if they knew that in real world situation, there is an increase in ischemic events, and all the CAWD.  For the elderly the death rate from ischemic events and congestive heart failure gone up significantly because statins reduced the production of ATP around 40% (depending on dose reducing CoQ10 an essential cofactor in the Krebs cycle).  ATP is the energy molecule that all muscles use to contract, including the heart.  The heart needs more ATP when stressed by an ischemic event.  So, pharma in their trials of statin don’t use the elderly,[7] morbidly obese, or those with congestive heart failure.  With 60% of men by the 7^th decade have taken statins for years. It is a major cause for CAWD.  Think of statins as a pill form cigarette, a drug that causes ischemic events, cancer. dementia, and on and on.  The rate of smoking is 1/3^rd the rate of 1960, yet ischemic events haven’t been reduced:  rather the reduction comes from increases in other causes of death such as dementia and cancer.  The B-5 explain the shift in death and statins significant increase B-5. 

So why isn’t this message getting out:  you know, money talks louder and social shaping causes the rational module of the brain to be silent; it knows but is muzzled.  I have yet to meet a true believer with terminal cancer who in their heart is thanking Yahweh for getting them to the heavenly Eden early.  Like the soldiers of Yahweh on the Crusades, we have a population of pill poppers taking slow acting poisons, and they know in their rational module what they are doing.  Civilized man has screwed up the biological systems first with fructose, then with unsaturated fats and weird chemicals called drugs including most recreational ones.  We are the sickest of animals, quite different than the old elephant, old ape, and old Galapagos tortoise.  This book is about growing old as evolution designed, and a few tricks to slow the process.  I love you all.