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“Medical Paradoxes: Contradictions in Modern Medicine (English Edition)” by Francisco Kerdel-Vegas

“QUO VADIS MEDICINE? The study of the dilemmas, contradictions and paradoxes of current medicine necessarily leads us to attempt a diagnosis of its present situation and consider the possible corrections of the direction medicine is taking as a liberal profession in a short-term foreseeable future. Attempting a diagnosis of medicine’s direction in the medium and long term is a futile intellectual exercise as it is practically impossible to achieve this with any degree of credibility, given the magnitude and significance of the changes to be expected. Medicine currently relies on support from external sources, not only from the foundation science and technology sectors, but also an imposed administrative sector, which doctors continue to ignore as outside their professional practice. As long as this situation endures, where medicine remains completely dependent on external talent and creativity (something which is greater at times than others), the sense of frustration and uncertainty about the future of our profession will persist to a certain degree. Moreover, politicians (the most disgraced class of our era) have no hesitation in making demagogic and populist promises in this sector, thinking up ill-conceived programmes that are impossible to adequately carry out. Understanding very well the importance attributed to health by the electorate, they are only concerned in obtaining the majority vote in the next elections. This affects the credibility of medicine and doctors, for in this irresponsible and messy confusion, establishing who is to blame is very difficult and politicians always manage to find a scapegoat for any failures. The public is therefore unable to discern whether the original unrealistic objective has been fulfilled. This will most certainly be the final destination of the Chavez administration’s Barrio Adentro programme, with its so-called doctors imported from Cuba who bring the practice of medicine to the most impoverished neighbourhoods in the hills surrounding Caracas and other cities in the country. In addition to their services as doctors, they also provide “Cubanised” Marxist indoctrination, the kind that follows the Fidel model (an idiosyncratic tropical Caribbean hybrid). In the end, the programme will be remembered as the government looking after that sector of society’s medical needs, although they will resent being treated by foreign doctors of doubtful scientific training, who are more interested in political preaching than in their bodily or emotional well-being. At the end of the day, it is men and women outside of the profession itself who are deciding the future of medicine, its objectives, difficulties, and traditions, indeed its very essence. Can we trust this and think for one moment that they will adopt those ideas and principles that have shaped medicine since the time of Hippocrates?”

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