SHAKEDOWN CRUISES AND THE PRACTICE OF MEDICINE
MORE ALIKE THAN YOU MAY HAVE IMAGINED
It was thirty days around the horn
The captain says it's a thirty-five more
The moon looks mean and the crew ain't staying
"There's gonna be some blood" is what they're all saying
It was a shakedown cruise (Shakedown, shakedown cruise)
And I was just another fool (Shakedown, shakedown cruise)
There ain't no easy way out (Shakedown, shakedown cruise)
They're gonna shake you 'til you shout (Shakedown, shakedown cruise)
From Jay Ferguson's 1979 single, Shakedown Cruise (Real Life Ain't This Way)
When ships started moving from wind power (sails) to steam, hull technology did not always keep pace with the ship's power. In other words, due to the fact that some of the original engines shook like a California earthquake, there was the potential for the ship to do a whole lot of vibrating while under power, which had the potential to cause breeches in the hull or other damage. As engines moved from outside the ship to inside the ship, as paddle wheels were replaced with props, and as the progression of ships moved from steam, to petrol, and even nuclear power, these vibrations (and leaks) continued to be an issue. This lead to something called the "Shakedown Cruise"
The Sea Talk Nautical Dictionary defines Shakedown Cruise thusly, "A limited sea excursion used to test all the mechanical and hull capabilities of a new vessel, or one which has undergone upgrading or maintenance work." The ISR Glossary of Terms describes the time immediately after Shakedown as the period of, "Post Shakedown Availability (PSA) - An availability assigned to newly built, activated or converted ships upon completion of a shakedown cruise. The PSA will normally be of 1.5 - 4 months duration and will be completed no later than the end of the eleventh month after completion of fitting out at which time Ship Construction, Navy (SCN) funding and work authority terminates. Work performed shall be limited to correcting defects noted during the shakedown cruise and those remaining from Acceptance Trails."
So; the Shakedown Cruise is the (short) testing period for a new or remanned ship, so that problems can be visualized, noted, and ironed out ---- in a timely manner. The problem is that all too often we have (improperly) transferred this idea of the Shakedown Cruise over to the practice of medicine.
If you go to the FDA's RAP Page (no, not THAT kind of rap) and look at Gaffney's paper, How Many Drugs has FDA Approved in its Entire History? New Paper Explains, you will see that there have been about 1,500 drugs approved by the FDA since the early 1930's --- certainly at least a few more since this was written a few years ago. Furthermore, according to any number of sources, for every 1,000 or so drugs that BIG PHARMA sets out to get approved by the FDA, only one actually makes it all the way through the process -- a process that can take as long as a decade. Add to it the fact that over the past sixty years ANY NUMBER OF DRUGS have been pulled off the market because they were determined to be dangerous or deadly after being OK'd for public use, sometimes for decades (Vioxx, Thalidomide, etc). What does all this really mean?
When you plug the facts into the calculator and pull the handle, it's rather scary. It should not comfort anyone to know that drugs are so dangerous that only .1% are approved, while others are being removed all the time because long-term testing on you, the HUMAN GUINEA PIG, continues to show how problematic chemical exposure can be over the long haul. All the while, medications that have been around seemingly forever and are considered by most of the public, both medical and non-medical, to be safe (ACETAMINOPHEN or IBUPROFEN for instance) are being increasingly revealed to be far more dangerous than anyone was ever led to believe back in the day. It sort of makes you wonder where slogans like "Tylenol, Nothing Safer" really came from?
One of the best articles on this topic is from Liz Szabo writing for USA Today (Not All FDA-Approved Drugs Get Same Level of Testing). Listen to just a few of the cherry-picked sentences from her revealing piece. "Although the FDA usually requires two trials before approving a drug, a study led by the Yale University School of Medicine found that 37% of approved drugs were backed by a single study. Many studies were quite short, with only 34% of new drug approvals backed by a study that lasted more than six months. And while the FDA may require drugmakers to conduct follow-up studies – to make sure that drugs are safe when used in the real world – many of these studies are never done. Only 32% of drug studies compared a new product with an existing one. Most studies simply compared new therapies to a placebo. In the real world, however, patients don't want to know whether taking a drug is better than taking nothing. instead, patients need to know which drugs are better than others. In 45% of drug approvals, researchers measured a drug's effect on "surrogate endpoints" – such as blood test results or cholesterol scores – instead of its effect on real health conditions, such as heart attacks. While lowering cholesterol sounds impressive, what patients really need are ways to reduce their risk of having a heart attack or dying." And we didn't even get into the whole "OFF-LABEL PRESCRIPTIONS" thing here.
As for the point Szabo makes in her last sentence above, this is a problem I have spoken at length about with both STATINS and DIABETES DRUGS. Sure, they do exactly what they claim to do --- lower cholesterol and blood sugar respectively. However, once the curtain is pulled back, we get to see how really useless they are at preventing heart attacks, strokes, and death in the process. It appears as though the emperor is wearing no clothes. What's my suggestion for you?
If there's one thing we've learned over the years, it's that chemicals are bad for your health and the health of your family. And while some of these chemicals (we call them medications) might be able to force a certain result in your body, they do not change the underlying pathophysiology (HERE). This means that it behooves everyone reading this to take no more medication than is absolutely needed. Between INVISIBLE & ABANDONED STUDIES, the biomedical community's wide array of "RESEARCH TRICKS," and so many financial shenanigans that we couldn't possibly cover them all here (HERE, and start scrolling titles), the problem is far worse than you could have imagined even one short decade ago. And once you throw in the fact that only about one in one hundred "real world" adverse events (side effects) is ever reported to proper authorities (HERE, HERE or HERE), I'll probably have to grab you a trash can in case that queasy feeling you're having, progresses to the point of regurgitation. Fortunately, for many of you there is a viable solution.
First, sit down and create a plan --- an EXIT STRATEGY if you will. A written plan for getting off the MMGR. Secondly, get a thumbs-up from your doctor for whatever you are planning to do (or at least tell them what you are doing). Just be aware that they might not be on board with a "Shakedown Cruise" of your own. That's OK. Find a doctor that is (HERE). Now, WORK THE PLAN. As is the case with every Shakedown Cruise, you'll find some things that need tweaked or addressed. Just realize that you and only you really control your health. What about your doctor? As great a person as they are, they can't do it for you. The cool thing is that if you follow the links, you'll see that I've given you a basic outline for taking your life back -- a GOLD BRICK if you will.
BUSTER KEATON'S 1923 SHAKEDOWN CRUISE
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