A few months ago, an interesting article popped up in my feed reader. It was a piece written about an anarchist medical collective calling themselves four thieves vinegar.
Their stated goal was to make badly needed medicines accessible to people who were prevented from obtaining them due to the their socio economic status. They have created 3d printer plans for a 30 dollar, reusable insulin pen and possibly even more impressive, open-source plans for a lab reactor that can be made with off the shelf parts.
In other words, people can make their own medicines,
I had 2 immediate reactions:
1) This is amazing!
2) This is Terrifying!
When it comes to medical knowledge. The adage of ‘a little knowledge can be a dangerous thing’ holds very true. The body’s byzantine collection of interweaving biochemical reactions have massive butterfly effects on whenever you change something. This is why prescription medicines have a side effects list a mile long. If someone incorrectly self diagnosed their illness and created the wrong medicine, or even made a small mistake with the measurements, something I myself am very prone to do, the effects could be catastrophic. Now the collective themselves are very aware of this, and are researching into methods to minimise the risk.
However, the fact that I know so many friends with chronic illnesses who have to struggle to get the treatment they need gives me pause on this line of thought, Most of them struggle not with the financial burden (thank you NHS) but with struggling against gatekeeping GP’s and practitioners who simply ignore or discredit their knowledge and input garnered from living with their illnesses day to day, everyday. Many struggled for much longer than they should have to be referred to the specialist they needed, despite through self experimentation and research knew where the problems lay.
This is not an uncommon story. There are countless tales of people who are overweight who cant receive help for completely unrelated medical problems because their Doctor, contrary to the presented experience of the patient, will insist it must be due to their weight. Recent studies have pointed to an alarming disparity in how black people in The US are systematically under-treated for pain related problems https://www.pnas.org/content/113/16/4296.short
I should at this point make clear I’m not disparaging all doctors. GP’s have an incredibly tough job, and the time constraints many are under really cripple their ability to do their job.
So the question is, how do you give power and agency back to the people who need it whilst also making sure levels of safety are kept for those who don’t possess the in-depth knowledge needed to practice medicine? Its a tricky subject, and while writing this I couldn’t’ve up with a stable idea of how I think access to medicines should be structured, only vague ideas.
For starters, Having a doctor be the sole point of contact and sole authority on access to medical infrastructure seems like a bad idea. This creates a pressure point where doctors must deal with every problem that can’t be solved with over the counter items and everything below emergency room immediacy. This is a really large band to deal with. Instead I’m thinking it may be a good idea to bring back an old idea; the local apothecary.
The apothecary was the forebear of the modern pharmacy. Unlike today’s pharmacy which only dispenses medicines, the apothecary made them. Unlike physicians who were trained in universities, apothecaries learnt through apprenticeships and guilds. They also provided the main support for women’s healthcare, as women were barred from the university system and physicians often would not deal with female reproductive issues.
This is where it loops back to the inventions of the four thieves vinegar collective. A modern Apothecary could make use of the tools they have developed to act as a community resource. Both offering a specialised knowledge of medicine creation, enabled by access to modern equipment, and offering more generalised medical advice and knowledge. They could even use 3d printers to create prosthetics and other medical devices for peoples specific needs. This would free up doctors to deal with more specific or hard to diagnose issues.
It could also be a safe route for further democratising access to medical knowledge, acting as a place of teaching for people wishing to learn but can’t commit to a full medical education and specialisation.
Again I will repeat, this is a rough idea, and I’m sure people can very easily pick up flaws but I think its an idea worth exploring and building upon.