Click here to see part 1 of this post.

The author Ivan Illich coined the term “social iatrogenesis” for the process by which the medical profession destroys public health by eroding people’s ability to cope on their own with the aches and pains and dysfunctions to which the flesh is heir. A recent experience has emphasized to me how pervasive this process is.

Two weeks ago, I damaged my patellar tendon. The scary thing is, I don’t even know how I did it. I just know that on Friday, my knee hurt while I was walking home from one of my four jobs. On Saturday, I was limping, and on Sunday I was in agony. I’ve been staggering about with a cane ever since.

I’m an adjunct professor, which means I do the work of two professors, for half the salary of one. It’s people like me who are keeping our nation’s colleges and universities in the black so they can afford to pay for health insurance for their “full-time” employees. So I’m certainly glad that my “full-time” colleagues, some of who I have known for years, have taken the time to express the full extent of their concern for me by asking, “Did you see a doctor?”

No, I haven’t seen a doctor. None of my four jobs comes with health insurance. Recently I purchased at my own expense, a policy with a $10,000 deductible (not a typo). That’s there just so that, in the unlikely event that I suffer a serious accident or illness, I can say I did everything right when I tell my sob story to Mike Moore. I’m not interested in paying hundreds of dollars to a physician so he can tell me I need to take it easy on my knee. I could get the same advice from a bartender. (“Gosh darn it, Charlie, my knee is killing me!” “Well geez, Pat -- ya better take it easy!”)

Besides, in this day and age, going to see a physician is like being arrested – anything you say can and will be used against you, to prevent you from collecting should you ever have the temerity to file a claim, or to keep you from purchasing coverage in the first place.

But it’s been an enlightening experience, just for the conversations I’ve been having with my students. They always go something like this:

“Have you seen a doctor?”

“No. All a doctor is going to do is to tell me I need to take it easy on my knee. I already know that.”

“Well, they could give you medicine.”

“What medicine? Is there a pill I can take that will make my knee heal?”

“Well, they could give you painkillers.”

“I don’t want painkillers.” At this point they look at me as if I have just said something obscene. Don’t we all have an inalienable right to go through life without experiencing pain? “If my knee hurts, that means I’m doing further damage to it. If that’s the case I want to know about it.”

“Well,” they start to sputter, clearly at a loss for something to say. “They could take an X-ray.”

“Is an X-ray going to heal my knee? All an X-ray is going to do is tell me my knee is hurt. I already know that.”

At this point they get this look like a religious believer who is wondering if she is standing too close to a blasphemer who is about to be struck by lightning. They walk away shaking their heads, probably wondering who let this lunatic out of the asylum. It clearly bothers a lot of people that I am not willing to pay hundreds of dollars for the privilege of participating in what is essentially an empty ritual.

In a previous post, I argued that, for most people, medicine has become the new substitute for religion. And like true believers of every stripe, they get really annoyed if you ask them for some evidence for their beliefs. It is worth quoting Illich at some length here: “This gaudy enterprise is supported, like a liturgy of old, by the extortion of taxes, by the solicitation of gifts, and by the procurement of victims.”

The good news is, our bodies have tremendous power to heal themselves. After two weeks, my knee no longer hurts like the fires of Hell, and it feels like a rusty hinge when it bends, which is a huge improvement over not bending at all. I stopped using the cane yesterday. And I don’t need an M.D. to tell me that means I’m getting better.