Paracelsus, the pseudonymous author of First Do No Harm, argues that the American medical system is profoundly and perhaps irretrievably broken. The original Paracelsus, who also used that pseudonym, was a contemporary of Machiavelli and an acquaintance of Erasmus and Luther. He helped revolutionize medicine with modern methods, something that made him a critic of the medical establishment of his time. Our Paracelsus opposes today’s medical establishment for its corruption and stagnation.

Trust in American institutions is at an all-time low. Fewer Americans trust their elected officials, journalists, or business leaders to do what is best for the country than at any time in the past. Perhaps the decayed institutions do not deserve the public’s trust.

Congress seems unable to pass laws or budgets or to oversee the executive branch. Administrative bureaucracies are often captured by industries and narrow interests. The press no longer holds public officials accountable for misdeeds and lies; it promotes its own preferred narratives instead. Universities have become ideology factories. America’s military has waged several wars ineffectively; it has lower standards for admission than in the past. Our public schools achieve less at greater cost than in the past. No college professor honestly thinks students are better than they were a generation ago, nor are the college professors as well educated. Fewer movies have compelling plots or character development.

The list of decaying institutions includes our fake economy, the energy grid, factory farming, churches, air travel, public infrastructure, architecture, and our melting pot of assimilation. Our IQ scores are declining as are sperm counts, while obesity rises. Birth rates are cratering. Marriage formation lags. Americans are shorter on average than we were a generation ago. The list could go on.

Sports like golf and basketball, television, and the culinary arts are arguably better than in the past. Yet late republics specialize in just such bread and circuses. Decaying republics have good booze, tasty cheeses and crackers, and wonderful flat screens to watch girl-boss gladiators on demand.

Medics Under Fire

Could America’s medical system remain free from this general decay? Paracelsus, the pseudonymous author of First Do No Harm, argues that the American medical system is profoundly and perhaps irretrievably broken. The original Paracelsus, who also used that pseudonym, was a contemporary of Machiavelli and an acquaintance of Erasmus and Luther. He helped revolutionize medicine with modern methods, something that made him a critic of the medical establishment of his time. Our Paracelsus opposes today’s medical establishment for its corruption and stagnation.

Paracelsus treads on sacred ground when criticizing modern medicine. Founders of modern science like Francis Bacon and Rene Descartes thought the modern project would stand or fall by its ability to deliver ever greater improvements in health. Modern doctors are indeed able to do far more than their medieval predecessors. In many ways, the authoritative doctor stands in the modern mind as a representative of the entire modern scientific project, so an attack on medicine is an attack on the promise of modernity.

Medicine and science generally have delivered, in a manner of speaking. Life expectancies have indeed risen from 40 years old in 1880 to nearly 80 in 2015. Much of the credit for this rise goes to improved sanitation, better housing, better nutrition, the development of vaccines, and declines in maternal and infant mortality—all products of Baconian modern science. The health care system gets too much credit for the rise in life expectancy (life expectancy was almost 60 before by the 1920s), but it is a factor in rising life expectancies. No one appreciates medical advances more than I do. I would have been a widower had my wife given birth to our first in the 1850s. My daughter, diagnosed with stage four cancer when she was very young, is now a thriving adult cancer survivor: she would have been a goner in the 1920s or 1950s.

My positive experiences with the medical system happened well over a decade ago. Paracelsus dates our decayed medical system to around then. No system is perfect, of course. Anyone attempting to establish Paracelsus’s conclusions must present a “before” picture to compare against the decadent system. Paracelsus accomplishes this through a rich, mostly narrative clinical dissection of America’s system. According to Paracelsus, the goals of perpetuating the health system and providing quality health care are diverging, to the detriment of patient health. As more money and prestige come from perpetuating the system, the patient-centered goal of health is compromised. Health care’s glittering exterior (white-coated doctors, nice buildings, big staffs, lots of research money) masks an interior that is increasingly rotten and dysfunctional.

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