The Unsung Sentinel: How Our Immune System Protects Us Every Mome

 

First, before I write, I was reflecting since two days ago how our body protects us after a patient who was constantly ill asked me how to defend himself against infection  

1. Our Fearfully and Wonderfully Made Immune System: The Silent Guardian of Life

2. The Body’s Invisible Army: A Tribute to the Marvel of Immunity

3. Immunology: Nature’s Masterpiece in Defense and Healing

4. The Unsung Sentinel: How Our Immune System Protects Us Every Moment

5. When Cells Stand Watch: The Symphony of Human Immunity

In my previous reflection titled “The Healing Properties of Our Body: Is Prevention Better Than Cure?”, I explored the body’s remarkable ability to heal from wounds, bleeding, and fractures. These injuries, though painful and sometimes traumatic, are occasional occurrences in our lives. In contrast, what we face every single moment is the constant, invisible threat of pathogenic organisms, bacteria, viruses, fungi, and parasites—that surround us in the air we breathe, the food we eat, and the surfaces we touch. These ever-present invaders pose a far greater threat to our survival than the visible injuries of trauma. It is therefore only fitting to devote deeper attention to the body's incredible defense mechanism, our immune system.

The human immune system is a sophisticated, multi-layered marvel designed to protect us against these microbial assaults. It is broadly divided into two interdependent arms: innate (non-specific) immunity and adaptive (specific) immunity. Together, they form a seamless and dynamic response to danger, swift and general at first, and then precise and enduring.

Innate immunity is the body’s first line of defense. It includes physical and chemical barriers that act instantly to block invaders. The skin, our largest organ, forms a resilient wall that prevents pathogens from entering. Mucous membranes lining our respiratory, digestive, and genitourinary tracts secrete mucus that traps pathogens before they can cause harm. Secretions like tears, saliva, and mucus contain enzymes such as lysozymes that dismantle bacterial cell walls. Meanwhile, the stomach’s acidic environment destroys most ingested microbes, and the cilia in the respiratory tract rhythmically sweep mucus and trapped pathogens upward and out of the lungs.

If pathogens breach these outer defenses, cellular defenders spring into action. White blood cells patrol the bloodstream and tissues, ready to detect and eliminate invaders. Among them, neutrophils are the most abundant and respond swiftly to infection sites. Macrophages, residing in tissues, engulf pathogens and clean up cellular debris. Dendritic cells act as scouts that gather foreign antigens and present them to the adaptive immune system. Natural Killer (NK) cells roam the body looking for virus-infected or cancerous cells, triggering programmed cell death or apoptosis in those deemed dangerous.

Inflammation is a hallmark of innate immunity. When tissues are injured or infected, the inflammatory response increases blood flow to the affected area, leading to redness and warmth. Blood vessels become more permeable, allowing immune cells and proteins to move into the tissue and create swelling. This targeted influx of immune components helps isolate the threat and initiate repair. The complement system, a group of proteins in the blood, also plays a role by enhancing phagocytosis, forming pore-like complexes in microbial membranes, and marking pathogens for destruction. Additionally, virus-infected cells release interferons to warn neighboring cells and inhibit viral replication.

If the innate system is the rapid response team, the adaptive immune system is the elite intelligence force. Though slower to act initially, it provides long-lasting protection through specificity and memory. Adaptive immunity is mediated by lymphocytes: B cells and T cells. B cells, upon encountering a foreign antigen, transform into plasma cells that produce antibodies, proteins precisely tailored to bind and neutralize that specific invader. Some B cells become memory cells, which persist long after the infection is cleared and provide rapid protection if the pathogen returns.

T cells come in two main types. Helper T cells (CD4+) coordinate immune responses by releasing signaling molecules called cytokines, which activate B cells, macrophages, and other T cells. Cytotoxic T cells (CD8+) directly kill infected or cancerous cells. These functions rely on the presentation of antigens by the major histocompatibility complex (MHC) molecules. MHC Class I molecules, found on all nucleated cells, present antigens to cytotoxic T cells, while MHC Class II molecules on specialized antigen-presenting cells present antigens to helper T cells.

The body ensures that only the lymphocytes needed for a particular infection multiply through a process called clonal selection. When a lymphocyte binds its specific antigen, it rapidly multiplies, creating an army of identical cells ready to fight. Some of these become effector cells that actively combat the infection, while others become memory cells that provide immunity in the future.

Central to the adaptive response are antibodies, also known as immunoglobulins. These Y-shaped proteins bind to pathogens in several ways. They neutralize toxins and viruses, mark invaders for phagocytosis (opsonization), activate the complement system, and clump pathogens together (agglutination) for easier elimination. There are five primary classes of antibodies, each with specific roles.

Immunoglobulin G (IgG) is the most abundant and provides long-term protection. It can cross the placenta to protect the developing fetus. IgA is found in mucosal secretions such as tears, saliva, and breast milk, guarding mucosal surfaces from infection. IgM is the first antibody produced during an infection and is highly effective at forming immune complexes. IgE is involved in allergic responses and defense against parasites, while IgD is found on the surface of immature B cells and plays a role in their activation.

Some antibody classes have subclasses that offer specialized functions. IgG1 and IgG3 are highly effective in complement activation and opsonization, while IgG4 is involved in allergen responses. IgA1 predominates in blood, and IgA2 in secretions. Beyond natural antibodies, modern medicine now uses engineered monoclonal antibodies to target diseases such as cancer and autoimmune disorders. Examples include rituximab for lymphoma, trastuzumab for breast cancer, and omalizumab for allergic asthma.

Innate and adaptive immunity are deeply interconnected. Cytokines, chemokines, and antigen-presenting cells bridge the two systems, ensuring a coordinated and efficient defense. The beauty of this system lies not only in its power but in its constant vigilance. Every moment of our lives, this invisible army stands on guard, monitoring, responding, and remembering, without us even being aware.

Yet despite this natural marvel, modern medicine often rushes to intervene with antibiotics for every minor infection. This over-prescription has led to a crisis of antimicrobial resistance, where bacteria evolve to survive even the strongest drugs. Many of these infections could have been resolved by the immune system alone, had it been given the chance and support to do so.

However, immunity can be compromised. One of the most pervasive causes is malnutrition. Both macronutrient (caloric and protein) and micronutrient deficiencies impair the immune system. Protein-energy malnutrition leads to reduced production of immune cells, weakening both innate and adaptive responses. Deficiencies in vitamins A, D, E, C, and minerals such as zinc, selenium, and iron reduce the body’s ability to generate antibodies, mount T cell responses, and maintain the integrity of mucosal barriers. Malnourished children, especially in poorer regions, are more susceptible to measles, tuberculosis, diarrheal diseases, and respiratory infections, with longer recovery times and higher mortality.

Chronic stress and sleep deprivation also impair immune function. Stress hormones like cortisol dampen lymphocyte activity and suppress inflammation, leaving the body vulnerable. Similarly, inadequate sleep reduces the activity of natural killer cells and weakens immune surveillance.

Environmental pollutants such as cigarette smoke, industrial chemicals, and heavy metals like lead and mercury further compromise immune defenses. Some medications, particularly immunosuppressants used for autoimmune disorders and organ transplants, as well as chemotherapy, suppress the immune system deliberately, increasing infection risk.

The good news is that immune health can be supported and enhanced. A balanced, antioxidant-rich diet, rich in fresh fruits, vegetables, legumes, and lean proteins, nourishes the immune system. Regular moderate exercise enhances immune surveillance and cellular function. Sufficient sleep and sunlight, particularly for vitamin D synthesis, contribute significantly to immune regulation. Probiotics help maintain gut microbiota, a key component in immune homeostasis. Immunization, too, remains one of the most powerful tools to train and protect the immune system.

Reflecting on all these intricacies, one cannot help but marvel at the immune system’s design. Its complexity, adaptability, and intelligence defy mere randomness. It is not just a system, it is a silent, unceasing guardian that works around the clock to protect and heal us. Truly, as the Psalmist proclaimed, we are “fearfully and wonderfully made.”

Let us not take this guardian for granted. Let us nourish, respect, and support it—not only as individuals but as a society. The immune system is our first and last line of defense, and in honoring its design, we honor the miracle of life itself.

References:

1. Abbas, A. K., Lichtman, A. H., & Pillai, S. (2022). Basic Immunology: Functions and Disorders of the Immune System (6th ed.). Elsevier.
2. A foundational textbook covering innate and adaptive immunity, antibody classes, cytokines, antigen presentation, and more.
3. Parham, P. (2020). The Immune System (5th ed.). Garland Science.
4. Provides detailed explanations on MHC, T cell and B cell functions, and immune memory.
5. Janeway, C. A., Travers, P., Walport, M., & Shlomchik, M. J. (2001). Immunobiology: The Immune System in Health and Disease (5th ed.). Garland Science.
6. A classical reference for understanding the molecular and cellular basis of immunity.
7. Calder, P. C., Jackson, A. A., et al. (2000). Undernutrition, infection and immune function. Nutrition Research Reviews, 13(1), 3–29.
8. https://doi.org/10.1079/095442200108728982
9. Discusses the impact of protein-energy malnutrition and micronutrient deficiencies on immunity.
10. Katona, P., & Katona-Apte, J. (2008). The Interaction between Nutrition and Infection. Clinical Infectious Diseases, 46(10), 1582–1588.
11. https://doi.org/10.1086/587658
12. Explores how infection worsens malnutrition and how poor nutrition impairs immune response.
13. World Health Organization (WHO). Nutrition and immune function.
14. https://www.who.int/news-room/fact-sheets/detail/malnutrition
15. A concise overview of nutrition’s role in immune health and disease vulnerability.
16. Chinen, J., & Shearer, W. T. (2004). Secondary immunodeficiencies, including HIV infection. Journal of Allergy and Clinical Immunology, 113(5), 957–968.
17. https://doi.org/10.1016/j.jaci.2004.03.030
18. Miller, A. H., et al. (2009). Chronic stress and immunity: mechanisms and clinical implications. Immunology and Allergy Clinics of North America, 29(2), 293–307.
19. https://doi.org/10.1016/j.iac.2009.02.007
20. Covers how stress and neuroendocrine responses impact immune function.
21. Ventola, C. L. (2015). The Antibiotic Resistance Crisis: Part 1: Causes and Threats. Pharmacy and Therapeutics, 40(4), 277–283.
22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/
23. Explains the danger of antibiotic overuse and rising bacterial resistance.
24. Centers for Disease Control and Prevention (CDC). Antibiotic resistance threats in the United States, 2019.
25. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf
26. Carter, P. J., & Lazar, G. A. (2018). Next generation antibody drugs: pursuit of the “high-hanging fruit”. Nature Reviews Drug Discovery, 17(3), 197–223.
27. https://doi.org/10.1038/nrd.2017.227
28. Discusses monoclonal antibodies used in cancer, autoimmune disease, and allergic conditions.
29. Mahase, E. (2020). Covid-19: What have we learnt about immunity, reinfection, and vaccines? BMJ, 371, m4347.
30. https://doi.org/10.1136/bmj.m4347
31. A recent article touching on immune memory, vaccine responses, and antibody roles.
32. Nieman, D. C., & Wentz, L. M. (2019). The compelling link between physical activity and the body's defense system. Journal of Sport and Health Science, 8(3), 201–217.
33. https://doi.org/10.1016/j.jshs.2018.09.009
34. Demonstrates how moderate exercise enhances immune function.
35. Carr, A. C., & Maggini, S. (2017). Vitamin C and immune function. Nutrients, 9(11), 1211.
36. https://doi.org/10.3390/nu9111211
37. Zhang, Y., et al. (2020). The role of vitamin D in immune function. Nutrients, 12(4), 1031.
38. https://doi.org/10.3390/nu12041031

The Healing Renaissance: Reclaiming Medicine Beyond Pharmaceuticals

The Healing Renaissance: Reclaiming Medicine Beyond Pharmaceuticals

Over the years, I have reflected deeply on the evolution of medicine, from its natural roots to the modern pharmaceutical empire. This transformation, though propelled by scientific discoveries and genuine need, has also been shaped by commercial forces that have steered the course of healthcare in directions that now merit serious re-evaluation.

Historically, humanity relied on nature’s pharmacy. Ancient civilizations such as those in Mesopotamia, Egypt, China, India, and Greece all documented extensive use of herbs, minerals, and dietary interventions to promote healing. Texts like the Mesopotamian clay tablets, the Ebers Papyrus, and the Chinese Materia Medica are testament to an era when medicine was intimately intertwined with natural substances and holistic wisdom. The teachings of Dioscorides and Theophrastus further underscore the prominence of botanicals and diet in health management.

The transformation from natural to synthetic began in earnest in the industrial age. A striking example is the journey of aspirin. Originally derived from willow bark, its active ingredient, salicin, was eventually synthesized by Bayer into acetylsalicylic acid. Once patented, it marked the beginning of a new pharmaceutical era. When the patent expired, it opened the floodgates for the development of other non-steroidal anti-inflammatory drugs (NSAIDs), each slightly modified to become a new, patentable and profitable product.

This strategy became a recurring theme in the pharmaceutical industry. The discovery of penicillin by Alexander Fleming revolutionised medicine, but its mass production only became viable through industrial efforts during World War II, spearheaded by companies like Pfizer. Again, once the patent protections faded, pharmaceutical firms rapidly pivoted towards newer, broader-spectrum antibiotics, often more expensive and sometimes less effective than the original.

This pattern raises fundamental ethical concerns. Has modern medicine become more focused on healing or on sustaining business models built around patents, dependency, and profit? While there is no denying that synthetic drugs have saved countless lives, especially in emergencies, the prioritisation of profit over accessibility and root-cause healing has introduced serious imbalances in healthcare.

Today, many patients are unaware of the origin, nature, or long-term implications of the medications they take. A significant number of physicians openly acknowledge that chronic, lifestyle-related illnesses such as hypertension, Type 2 diabetes, and hyperlipidemia cannot be cured by pharmaceuticals alone. Instead, these conditions are managed, often indefinitely, without addressing the underlying causes such as poor diet, inactivity, stress, and environmental toxins.

For millennia, the ancient Greeks, Chinese, Indians, and other traditional cultures embraced nature’s solutions, namely, using herbs, foods, and lifestyle changes. This practice continued until the early 20th century when figures like John D. Rockefeller helped redirect medicine’s course towards petroleum-based synthetic drugs. This shift was not purely scientific, it was deeply influenced by commercial interest.

Many modern doctors are now expressing concern about the long-term use of pharmaceuticals, especially those known to accumulate in the liver and kidneys, potentially causing harm over time. Some doctors actively discourage their extended use, instead advocating for a more holistic approach. Indeed, a growing number of physicians and patients alike are returning to natural medicine, recognising that chronic dependency on drugs is not the same as true healing.

This has given rise to new paradigms like integrative and functional medicine. These approaches go beyond managing symptoms; they seek to uncover and treat root causes. Chronic inflammation, gut dysbiosis, nutritional deficiencies, toxin accumulation, and unmanaged stress are now recognised as key drivers of modern diseases. Integrative medicine seeks to understand the whole person, not just the pathology, and to harness the healing potential of the body through nutrition, exercise, mindfulness, and botanicals.

From my perspective, the future of medicine must be a harmonious integration of both conventional and traditional practices. Pharmaceuticals are essential in acute and life-threatening situations such as heart attacks, infections, trauma, and surgeries. However, for long-term health maintenance and chronic disease prevention, a more natural, lifestyle-based approach is indispensable.

This future vision of medicine would emphasise food as the foundation of health. Preventative medicine must be rooted in anti-inflammatory diets, gut microbiome integrity, and optimal nutrient intake. Equally, mind-body practices such as meditation, tai chi, yoga, and breathwork must become essential components of disease prevention and management. Treatments should be personalised, guided by genetic, microbiome, and metabolic assessments, while safe and effective plant-based medicines like curcumin, resveratrol, berberine, and adaptogens should be more widely adopted. Environmental toxins, including endocrine disruptors, petrochemicals, and heavy metals, must be minimised through public health efforts and education.

Yet despite the compelling case for such a model, we must contend with strong resistance. The pharmaceutical industry has vested interests in maintaining the status quo. There is a great deal of money at stake. I have personally known many doctors, some my close colleagues during my time at the Institute for Medical Research, who confided that when they themselves fall ill, they often turn to traditional or natural medicine, despite prescribing pharmaceuticals to their patients.

One close friend, a Professor and Chair of Psychiatry at the University of Malaya, shared with me a telling story. After suffering from chronic pain for years, unrelieved by conventional rheumatology treatments and a long list of NSAIDs, he finally sought care from a Traditional Chinese Medicine (TCM) practitioner. After just a few sessions, his chronic pain vanished, at a mere RM30 per session, with no harsh side effects. He expressed great frustration with the limitations of the drug-based system he had spent his life studying and practising.

Others I know have quietly begun integrating natural therapies into their private practices. Malaysia, to its credit, permits licensed and qualified traditional and complementary medicine practitioners to operate legally, just as many other countries do. Nations such as Singapore, China, Japan, South Korea, India, Australia, the UK, and the United States now recognise the importance of traditional systems of medicine, often with the encouragement of the World Health Organization (WHO).

Indeed, the WHO estimates that over 80% of the global population continues to rely on traditional medicine in some form. We are witnessing a slow but visible shift in public awareness. Media outlets regularly feature discussions on diet, exercise, natural therapies, stress reduction, and holistic wellness. This shift, while welcome, is unsettling to pharmaceutical corporations whose business models depend on a steady stream of patented drug sales.

It is not uncommon to see suppression or dismissal of effective natural remedies and off-patent therapies, not because they lack efficacy, but because they lack profitability. Medical professionals who champion natural approaches often face institutional resistance, ridicule, or even disciplinary action. Nevertheless, a growing number of physicians are speaking out, recognising that real healing must go beyond symptom control.

As public awareness grows, so too does the momentum for reform. Some medical schools are beginning to incorporate lifestyle medicine into their curricula, albeit slowly. Functional medicine, nutritional therapy, and integrative health are gaining legitimacy and public demand.

The future of healthcare must not be an either-or debate between modern and traditional medicine, but a balanced, integrative synthesis. We must preserve the life-saving power of pharmaceuticals in emergencies while embracing the ancient wisdom of food, herbs, movement, and mindfulness for long-term wellness. This is not a return to the past, but a forward-looking renaissance of medical understanding.

I am grateful to share these insights with colleagues, patients, and the wider public. The need for change is real, and while resistance is formidable, the call for a more humane, intelligent, and patient-centred system of care is growing louder.

To quote the father of medicine:

“Let food be thy medicine, and not medicine be thy food.” — Hippocrates

Even as early as 1935, Clive McCay demonstrated that calorie restriction could extend lifespan in laboratory animals. Subsequent research has confirmed that moderate caloric restriction, when practiced without malnutrition, can significantly reduce the risk of chronic illnesses including cardiovascular disease, diabetes, cancer, and neurodegenerative disorders. Caloric restriction is itself a natural, evidence-based therapeutic strategy, requiring no pills, only understanding and discipline.

It is one of nature’s simplest, most powerful interventions. It demonstrates how, by cooperating with the body’s natural rhythms, we can unlock its extraordinary ability to heal, renew, and thrive, without lifelong dependence on drugs.

This, I believe, is the direction in which medicine must evolve. And I remain hopeful that governments, medical schools, and healthcare institutions will eventually embrace this shift, not just for the sake of progress, but for the healing of humanity.

From Nature to Petrochemicals: How Medicine Lost Its Way – and the Journey Toward a New Dawn in Medicine

by: lim ju boo

Professor Dr Marilyn Li Ching who is a regular contributor in a WhatsApp group recently sent me this video for my comment. 

1. How Medicine was Hijacked 

https://www.youtube.com/watch?v=0KN9A8tbULU

Professor Dr Ling Siew Ching also separately sent me another video last month for my attention 

2. Dr Peter Gotzsche on drugs as 3rd leading cause of death

https://www.youtube.com/watch?v=dozpAshvtsA

There is also another video I saw here: 

3. Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare

https://www.goodreads.com/book/show/18428805-deadly-medicines-and-or-

After viewing all these videos. here's my comment. 

But first, let me write very briefly on the history of medicine.  

History of medicine: 

The transition from natural remedies to synthetic drugs was driven by scientific advancements but also by corporate profit motives. While synthetic drugs have saved lives, the modern pharmaceutical industry prioritizes patents, high pricing, and market control over accessibility and affordability. The challenge remains in balancing innovation with ethical medicine.

As far as I know the earliest records of natural products were depicted on clay tablets in cuneiform from Mesopotamia (2600 B.C.) which documented oils from Cupressus sempervirens (Cypress) and Commiphora species (myrrh) which are still used today to treat coughs, colds and inflammation . The Ebers Papyrus (2900 B.C.) is an Egyptian pharmaceutical record, which documents over 700 plant-based drugs ranging from gargles, pills, infusions, to ointments. The Chinese Materia Medica (1100 B.C.) (Wu Shi Er Bing Fang, contains 52 prescriptions), Shennong Herbal (~100 B.C., 365 drugs) and the Tang Herbal (659 A.D., 850 drugs) are documented records of the uses of natural products . The Greek physician, Dioscorides, (100 A.D.), recorded the collection, storage and the uses of medicinal herbs, whilst the Greek philosopher and natural scientist, Theophrastus (~300 B.C.) dealt with medicinal herbs. 

Aspirin's discovery began with the ancient use of willow bark for pain relief, leading to the synthesis of acetylsalicylic acid (aspirin) by Felix Hoffmann at Bayer in 1897, which was then marketed as a pain reliever in 1899. The use of willow bark for pain relief and fever reduction dates back thousands of years, with Sumerians and Egyptians using it for medicinal purposes. The synthesis of Aspirin started in 1897, when Felix Hoffmann, a chemist at the Bayer company, synthesized acetylsalicylic acid (ASA), the active ingredient in aspirin, by modifying salicylic acid. Bayer, was a German pharmaceutical company that patented the process and marketed the drug under the name "Aspirin" in 1899. After Aspirin lost its patent rights, other pharmaceutical companies began to manufacture other analgesics such as NSAID (non-steroidal anti-inflammatory drugs). 

The same scenario is with other antibiotics after the discovery of penicillin after the Scottish bacteriologist Alexander Fleming accidentally discovered penicillin in 1928 while working at St. Mary's Hospital in London, noticing a mold inhibiting bacterial growth on a contaminated petri dish, leading to the development of the first 

First of all, I must straight away say it is not entirely true that drugs are unless. There are many drugs that are life-saving and irreplaceable as they can act very fast to stabilize a patient especially in a medical emergency. I have written some examples here:

https://scientificlogic.blogspot.com/search?q=pharmacology

https://scientificlogic.blogspot.com/search?q=Emergency+drugs

 

 Here are further examples:

1. Epinephrine (Adrenaline) – Used in anaphylaxis (severe allergic reactions) and cardiac arrest.
2. Aspirin – Essential for heart attack and stroke prevention.
3. Insulin – Vital for type 1 diabetes management.
4. Antibiotics (Penicillin, Vancomycin, Meropenem, etc.) – Critical for bacterial infections and sepsis.
5. Steroids (Dexamethasone, Prednisone) – Used for severe inflammatory conditions and autoimmune disorders.
6. Anticoagulants (Heparin, Warfarin, DOACs) – Prevent blood clots that could cause strokes or pulmonary embolisms.
7. Antiviral Drugs (Tamiflu, Paxlovid, Remdesivir, etc.) – Used for severe viral infections, including influenza, COVID-19, and HIV/AIDS.
8. Chemotherapy Drugs (Cisplatin, Doxorubicin, Imatinib, etc.) – Essential for treating various cancers.
9. IV Fluids and Electrolytes – Lifesaving in dehydration, shock, and metabolic imbalances.
10. Oxygen Therapy & Ventilators – Indispensable in respiratory failure, pneumonia, and critical care settings.

Some of these drugs especially emergency drugs, and powerful antibiotics are very life savings. 

While many chronic diseases require lifestyle-based solutions, there are pharmaceutical drugs that have undoubtedly saved millions of lives. 

As I have some training in emergency medicine let me very briefly in a nutshell explore this area.  

Here are more key examples of life-saving drugs that are absolutely essential. 

A. Emergency & Critical Care Drugs

1. Epinephrine (Adrenaline) – Used for anaphylactic shock, severe asthma attacks, and cardiac arrest.
2. Atropine – Used in emergencies to increase heart rate during severe bradycardia (slow heartbeat).
3. Norepinephrine & Dopamine – Critical for septic shock to maintain blood pressure and circulation.
4. Aspirin (Acetylsalicylic Acid) – Rapidly given during heart attacks to prevent clot expansion.
5. Nitroglycerin – Used to relieve angina (chest pain) and heart attacks by dilating coronary arteries.
6. Thrombolytics (e.g., Alteplase, Streptokinase, Tenecteplase) – Dissolve blood clots in strokes and heart attacks.

B. Life-Saving Antibiotics & Antivirals

1. Penicillin & Cephalosporins – Still crucial for treating bacterial infections like pneumonia, syphilis, and meningitis.
2. Vancomycin – One of the last-resort antibiotics for MRSA (Methicillin-resistant Staphylococcus aureus) infections.
3. Doxycycline & Azithromycin – Effective against malaria, bacterial pneumonia, and Lyme disease.
4. Rifampin & Isoniazid – Key drugs for tuberculosis treatment.
5. Oseltamivir (Tamiflu) & Remdesivir – Used for severe cases of influenza and COVID-19.
6. HIV Antiretroviral Therapy (ART) – Drugs like Tenofovir, Efavirenz, and Dolutegravir allow HIV-positive individuals to live long lives with undetectable viral loads.

C. Surgical & Anesthetic Drugs

1. Propofol & Midazolam – Used in surgeries and intensive care for anesthesia and sedation.
2. Lidocaine & Bupivacaine – Local anesthetics for pain relief during procedures.
3. Heparin & Warfarin – Essential for preventing deadly blood clots during surgeries.

These drugs are not lifestyle medicines but true life-saving interventions. They remain indispensable for acute, life-threatening conditions.

The Problem with Pharmaceutical Dominance in Chronic Diseases

Let me point out, chronic lifestyle diseases (diabetes, heart disease, high blood pressure, etc.) cannot be  "cured" by drugs, they are simply managed indefinitely. This benefits Big Pharma, which profits from lifelong patients.

Examples of chronic disease drugs that do not "cure" are: 

Statins (e.g., Lipitor, Crestor) – Reduce cholesterol but don’t address the root cause of cardiovascular disease.

Unfortunately most of the diseases today are chronic illnesses that do not require fast-acting emergency drugs. 

 

It’s always a pleasure for me to engage in thought-provoking discussions with my medical colleagues, including highly qualified physicians, patients and lay readers on the current state of pharmaceutical medicine and compare them with other more natural systems of medicine that were already practised for over 5,000 years. 

Instead of using drugs let us dive into integrative medicine first.    

Integrative medicine is an approach that combines conventional allopathic (western) medicine with evidence-based complementary therapies to treat the whole person - body, mind, and spirit, rather than just the symptoms of disease. It focuses on lifestyle, nutrition, mind-body connection, and natural therapies alongside conventional treatments like pharmaceuticals and surgery.

I see several key strengths and considerations regarding integrative medicine:

Strengths of Integrative Medicine

1. Holistic Approach – It considers not just the disease but also the patient’s overall well-being, including diet, stress, sleep, exercise, and emotional health. This is in line with modern understanding that lifestyle factors significantly impact chronic diseases like diabetes, cardiovascular diseases, and even cancer.

2. Personalized Treatment -  Integrative medicine often tailors treatments to individual patients, considering genetic, environmental, and lifestyle factors. This agrees well with the emerging field of personalized medicine.

 3. Preventive Care Focus -  Unlike conventional medicine, which often focuses on treating diseases after they appear, integrative medicine strongly emphasizes prevention, which is key to reducing the burden of chronic diseases.

4. Less Dependence on Pharmaceuticals - While conventional medicine heavily relies on drugs, integrative medicine incorporates non-pharmaceutical treatments like acupuncture, herbal medicine, meditation, and nutritional therapy, which can sometimes be equally effective and have fewer side effects.

5. Scientific Basis for Some Complementary Therapies - Some integrative approaches, such as mindfulness, yoga, and plant-based nutrition, have strong scientific backing in improving health outcomes, especially in mental health, inflammation reduction, and chronic pain management.

Challenges and Considerations

1. Lack of Regulation and Standardization -  Unlike pharmaceuticals, many complementary therapies do not undergo rigorous clinical trials, making quality control and efficacy harder to verify. Some herbal remedies, for example, may have variable potency or interact with prescription drugs.

2. Risk of Pseudoscience - Some practitioners incorporate unproven or even harmful treatments. It is crucial to differentiate evidence-based integrative medicine from pseudoscientific or exaggerated health claims.

3. Mainstream Resistance - Despite growing interest, some conventional doctors view integrative medicine with skepticism, often due to the lack of extensive large-scale clinical trials for many complementary therapies.

4. Economic and Industry Influence - The pharmaceutical industry has long shaped modern medicine, sometimes limiting the integration of alternative approaches. This raises concerns about conflicts of interest and whether the best treatment options are always prioritized.

I see integrative medicine as a promising approach if it is grounded in scientific evidence. The future of medicine should not be a battle between conventional and alternative medicine but rather a fusion of the best, based on rigorous scientific validation. The ultimate goal should always be what benefits patients the most with the least harm.

The list of 50 integrative doctors I like to provide here as examples including well-known figures like Dr. Mark Hyman and Dr. Andrew Weil who show that even highly trained conventional physicians see the value in integrating nutrition, lifestyle, and natural therapies into medical practice. This is an encouraging trend.

Besides this list there are also other medical doctors and immunologists and scientists who too believe the body can heal itself if injured or diseased given the appropriate stimuli. 

Among the medical doctors are: 

1. Professor Dr Chang Jia Rui, MD a Taiwanese physician who wrote the book “The Body’s Natural Instinct: Understanding Your Body’s Healing Ability” . Professor Chang is the Honorary Professor and Chairman of the World Natural Medicine Foundation 

2.  Dr Vernon Coleman MD who wrote several books about the body as a natural medicine that can heal itself. Among the many books he wrote are: 1. Body Power 2. How To Stop Your Doctor Killing You 3. Anyone Who Tells You Vaccines Are Safe and Effective is Lying 4. Twelve essential medical secrets which could save your life 5. Mindpower: How to Use Your Mind to Heal Your Body. 

3.  Dr Jau-Fei Chen PhD who is a Nutritional Immunologist 

4. Dr Niwa MD, PhD (Med), a well-known Japanese physician, immunologist and researcher who wrote a book called “Drugs Do Not Cure Disease” 

Integrative medicine continues to gain recognition as healthcare professionals worldwide acknowledge the body's inherent ability to heal when provided with appropriate support. Beyond the practitioners I  mentioned, numerous other doctors and scientists advocate for combining conventional medical treatments with complementary therapies to promote holistic healing. Here are some further notable figures in the field:

1. Dr. Andrew Weil, MD

Background: A pioneer in integrative medicine, Dr. Weil is the founder and director of the Andrew Weil Center for Integrative Medicine at the University of Arizona.

Contributions: He emphasizes the body's natural healing capacity and advocates for a balanced approach that includes nutrition, mind-body interventions, and botanical medicines.

2. Dr. Mark Hyman, MD

Background: A family physician and a leading advocate for functional medicine, Dr. Hyman is the Head of Strategy and Innovation at the Cleveland Clinic Center for Functional Medicine.

Contributions: He focuses on identifying and addressing the root causes of chronic diseases through personalized treatments, including dietary changes and lifestyle modifications.

3. Dr. Avni Sali, MD, PhD

Background: An Australian surgeon and academic, Dr. Sali is the founder of the National Institute of Integrative Medicine (NIIM) in Melbourne.

Contributions: He has been instrumental in promoting integrative medicine in Australia, emphasizing evidence-based complementary therapies alongside conventional treatments.

4. Dr. Deepak Chopra, MD

Background: An endocrinologist and a prominent figure in mind-body medicine, Dr. Chopra has authored numerous books on health and wellness.

Contributions: He integrates principles from Ayurveda with modern medicine, focusing on meditation, yoga, and the mind's role in health and healing.

5. Dr. Joseph Mercola, DO

Background: An osteopathic physician, Dr. Mercola advocates for natural health approaches and preventive care.

Contributions: He emphasizes the importance of nutrition, exercise, and natural therapies in maintaining health and preventing disease.

6. Dr. Tieraona Low Dog, MD

Background: A physician with extensive training in herbal medicine, midwifery, and massage therapy, Dr. Low Dog has served on the faculty of the University of Arizona Center for Integrative Medicine.

Contributions: She focuses on women's health, dietary supplements, and integrative approaches to health and wellness.

7. Dr. David Katz, MD, MPH

Background: A preventive medicine specialist and founder of the Yale-Griffin Prevention Research Center.

Contributions: Dr. Katz emphasizes the role of lifestyle and nutrition in preventing chronic diseases and advocates for integrative approaches to healthcare.

These practitioners, among others, have significantly contributed to the field of integrative medicine, promoting a holistic approach that combines the best of conventional and complementary therapies to support the body's natural healing processes.

There is also a very thick and voluminous book I have called: “Integrative Medicine” 

This book is edited by Dr David Rakel MD who is a Professor and Chair Dept. of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico. 

He edited this massive book written and contributed by over 100 specialist physicians, most of them with not just a medical MD degree, but also armed with additional qualifications such as,  MSc, MS, ND, MPH, MHS, DO, ABIHM, FACOFP, RD, ABOIM, FAAFP, FRCP, MTS. 

They all contributed chapters on conventional medicine together with other systems of medicine covering evidence-based references on medicine that incorporated botanicals, supplements, mind-body, lifestyle medicine, nutrition, exercise, spirituality, chelation therapy, disease-orientated approach among others.

I  think of doctors and other people these days are reverting to other therapeutic modalities especially integrative medicine rather than depending solely on pharmaceuticals that are actually chemicals derived from petrochemicals as what the link above "How modern medicine has been highjacked" clearly revealed. 

The book Integrative Medicine edited by Dr. David Rakel seems to be a monumental work in the field, reflecting the growing acceptance of integrative approaches by highly qualified medical professionals.

So Why Are More Doctors and Patients Turning to Integrative Medicine today? 

The shift towards integrative medicine and away from a sole reliance on pharmaceuticals is driven by several interrelated factors:

1. The Limitations of Pharmaceuticals

While pharmaceuticals have revolutionized medicine, their over-reliance has led to concerns about side effects, drug resistance, toxicity, and long-term dependency.

Many drugs treat symptoms rather than root causes, especially in chronic diseases like diabetes, hypertension, and autoimmune disorders.

Petrochemical origins of many drugs raise concerns about biocompatibility and environmental impact, leading some to explore plant-based or holistic alternatives.

2. The Rise of Chronic Diseases and the Failure of Conventional Models

The modern world is facing an epidemic of lifestyle-related diseases (obesity, metabolic syndrome, cardiovascular diseases, autoimmune disorders).

Pharmaceuticals manage these conditions but rarely cure them.

Integrative medicine addresses lifestyle factors - diet, stress, exercise, environmental toxins, rather than just medicating symptoms.

3. Scientific Validation of Traditional & Complementary Therapies

Research has increasingly validated many traditional and alternative treatments:

Botanicals: Curcumin (turmeric) for inflammation, berberine for diabetes, and resveratrol for cardiovascular health.

Mind-body medicine: Meditation, yoga, and tai chi are now scientifically recognized for reducing stress, inflammation, and even altering gene expression.

Gut microbiome: The link between the microbiome and immunity, mental health, and chronic disease has validated probiotic and nutritional interventions.

4. The Public’s Increasing Awareness and Demand

People are more informed these days on nutrition, natural medicine, and preventive health.

There is growing distrust in Big Pharma, partly due to the perception that the industry prioritizes profit over patient well-being.

Social media and global access to research have democratized medical knowledge, allowing individuals to explore alternatives.

5. Shift in Medical Education & Research

Major institutions (Harvard, Stanford, University of Arizona, Cleveland Clinic, etc.) now have integrative medicine departments.

The NIH and other global health bodies fund research into herbal medicine, nutrition, acupuncture, and mind-body therapies.

Even the World Health Organization (WHO) supports traditional medicine integration, recognizing its value in primary healthcare. According to WHO, 80 % or more of the world population including those from advanced countries and highly educated people uses traditional medicine after they became disgruntled with conventional allopathic medicine that did not cure them except to control the disease and symptoms

Patients get very dissatisfied and disappointed when asked just take all these petroleum chemicals called ‘medicines’ for life in their doctors'  beliefs these drugs could cure them of their diseases. 

The Ideal Future: A Balanced Approach

I believe that integrative medicine is the future of healthcare, but it should be:

✔ Science-based, incorporating only therapies that have proven efficacy.
✔ Personalized, considering genetics, environment, and lifestyle.
✔ Preventive, reducing the need for pharmaceuticals in the first place.

Pharmaceuticals still have a vital role in emergency medicine, infections, and critical care, but for chronic disease, a holistic and integrative approach is superior.

Do we think mainstream medicine will eventually shift towards this model, or will resistance from the pharmaceutical industry slow its adoption a prominent physician asked me?

If you were to ask my opinion, I think conventional allopathic medicine that uses petroleum products as ‘medicines’ to ‘cure’ has never ‘cured’ any disease especially lifestyle diseases like heart disease caused by high blood pressure and high cholesterol, stroke, asthma, coronary artery disease, and most types of cancers, etc, etc will not get very far as most patients are now very educated and very intelligent.   

The Big Pharma and the pharmaceutical industry purposely make it this way so that after spending billions of US dollars developing their drugs over 10 - 15 years, they need to continue to reap lifelong profits out of them. The patients themselves too, trust their doctors that their ‘medicines’ could permanently ‘cure’ them.

I think we can blame this on the history of drug industry. Let's have a look how all these problem began with a brief history of profit-driven drug manufacturing. 

For most of human history, medicines were derived from natural sources, plants, minerals, and animal products. Traditional systems like Chinese medicine, Ayurveda, and herbalism relied on these remedies. However, the industrial era and advances in chemistry led to a major shift toward synthetic drugs, transforming medicine into a highly profitable industry.

1. Early Natural Medicines

Before the 19th century, remedies were largely plant-based, such as willow bark (aspirin precursor) and cinchona bark (quinine for malaria). These were often prepared by herbalists, apothecaries, and traditional healers.

2. Rise of Synthetic Pharmaceuticals (19th – Early 20th Century)

• 1804: Morphine was isolated from opium, marking the beginning of pharmaceutical chemistry.
• 1856: William Henry Perkin’s accidental discovery of synthetic dyes inspired the chemical industry, which later contributed to drug synthesis.
• 1897: Aspirin (acetylsalicylic acid) was synthesized by Bayer, one of the first blockbuster drugs, shifting medicine from natural extracts to lab-based production.

3. The Birth of Big Pharma (20th Century)

• 1928: Alexander Fleming discovered penicillin, but it wasn’t until WWII that companies like Pfizer industrialized its production, showing the profit potential of mass-producing antibiotics.

• 1950s – 1970s: The pharmaceutical industry exploded with drugs like corticosteroids, benzodiazepines, and statins. Synthetic drug patents allowed companies to monopolize medicines and generate enormous profits.

• Thalidomide Scandal (1950s-60s): The rush for profit led to ethical failures, such as the thalidomide tragedy, where a sedative caused birth defects.

4. The Patent-Driven Era (Late 20th Century – Present)

1. The 1980s-90s saw the rise of biotech and designer drugs, with companies shifting focus to patenting molecules rather than relying on nature.

2. The 1990s-2000s introduced high-profit chronic disease drugs, like statins and insulin analogs, often priced far beyond production costs.

3. Pharmaceutical lobbying and marketing grew, with companies spending more on advertising than research.

Current Landscape: Profits Over People?

1. The COVID-19 pandemic highlighted the tension between profit-making and public health, as vaccine patents limited global access.

2. Generic drugs remain under threat from evergreening (tweaking formulas to extend patents).

3. Natural medicine is often sidelined or dismissed as "unscientific," despite centuries of proven efficacy.

"Echoes from the Old Schoolyard: Tales of My Naughty Schooldays"

Let me this evening share with my gentle readers vivid recollection that is both heartfelt and humorous, that carries deep nostalgia wrapped in rich cultural and personal history. 

“Across the Streets of Failure to the Cosmos of Curiosity: A Memoir of My School Days”

A dear senior engineer friend Ir. CK Cheong recently shared with me a picture accompanied by a poignant message:

"No one has travelled the road of success without crossing the street of failure. God never promised us an easy journey. He only promised us a great destination."

He went on to confide:

"I had my first failure when I failed my LCE (Lower Certificate of Education) and had to be detained in the same classes with my younger sister. Can you imagine how stressful I was?"

To that, I replied with a slice of my own past.

I, too, once tasted failure, an uncommon flavour in the banquet of my life. In 1956, during Form 3 at Batu Pahat High School, I failed the Malay paper in the newly introduced Lower Certificate of Education (LCE) examination. That year marked a significant shift in Malaya’s education system, the Malay language was included as a compulsory subject, and the experiment was thrust upon us like a sudden eclipse.

None of us, neither the Chinese, Indian, nor Malay students, had studied Malay as a subject. Our academic world was built entirely upon English. We didn’t even speak our mother tongues among ourselves. We were an English-speaking microcosm, forged by colonial curriculum and camaraderie. So when the Malay paper landed on our desks, it might as well have been written in Sanskrit.

The examination hall on the upper floor grew restless. We smiled nervously at each other, dumbfounded. After a half-hour of incomprehensible questions, an invigilator, perhaps moved by our bewildered faces, called out, "Whosoever cannot answer, stand up." To a man, we rose like a choreographed protest and surrendered our blank scripts. It was a moment of quiet solidarity. I failed only that one subject. Every other paper I passed. That was the only subject - an academic failure I ever had, from primary school to my Ph.D.

Later, in Forms 4 and 5, I wrote many essays in English. But my English teacher was not impressed. If he couldn’t understand my essay, he would erupt like Vesuvius, cursing me and hurling my exercise book out of the classroom onto the veranda, sometimes if violent enough past the veranda into the school drain, a good thirty metres away. Then he’d roared:

"How in the world you came into this class!"

As punishment, I would be asked to write 500 lines:

"I must write an essay that my teacher can understand."

But oh, but if I were to write an essay he could grasp, say, about cycling with friends to Minyak Beku a seaside 10 km away to picnic, swim, and enjoy ten-cent packets of nasi lemak wrapped in banana leaves, he would smile, shake my hand, and proclaim my essay was a true masterpiece.

I would in return grip his hand shaking it to share a similar masterpiece handshake.

Looking back now, I would bring flowers to his grave and silently kneel to forgive him, as my Lord Jesus taught. Those were the innocent and colourful days of youth.

I also remember vividly I was in Form 1, and wasn't eligible to study science until Form 3. But my curiosity refused to wait. My sister, two years my senior was in Form 3  studied at Temenggong Ibrahim Girls School (TIGS), about two kilometers from our boys High School Batu Pahat (HSBP). TIGS then had no science teacher or a science lab. Through some arrangement between schools the girls from TIGS would come over to HSBP for science classes in the afternoon when the HSBP morning sessions were dismissed. After morning classes, my sister would come to our school in the afternoon for science lessons. 

Though uninvited and ineligible, I often returned to my school still in my school uniform at 2 p.m. to sit quietly on the veranda outside the lab or leading by the science lab door watching Mr. Charly, the senior science master teach science to my sister and her classmates. I wasn't allowed inside. Mr Charly must have noticed the lone boy who always was there daily, sitting on the veranda outside the lab or leaning against the lab wooden door with unwavering eyes. He must have felt I was always there to learn something. He must have taken pity on me, and  never shoo me away.

One afternoon, I watched with childlike awe as he demonstrated how heating potassium chlorate (KClO₃) with manganese dioxide (MnO₂) as a catalyst produced oxygen. The gas bubbled through a delivery glass tube attached to the test tube into an inverted water-filled jar on a water trough and when the jar was sealed with a glass cover under water and taken out from the water trough and a glowing wooden splint was introduced, it burst into flame proving the jar was filled with pure oxygen.  I still remember the blinding brilliance when burning magnesium or sulphur was introduced into the jar of oxygen. I was spellbound. That invisible element, oxygen - had just unveiled a secret of the universe. Perhaps it was that spark that first whispered to me, "You could be a scientist".

On another day, Mr. Charly taught the girls about acids, and told them there were three kinds - concentrated nitric acids, concentrated sulphuric, and concentrated hydrochloric acid, and when water is added into each of them they became dilute nitric, dilute sulphuric, and dilute hydrochloric acids, and they were kept in separate bottles and labelled separately. 

Later at home, I challenged my sister asking her.

“How many kinds of acids they are?
“Three,” she said confidently. I told her she was wrong. There are six I told her. She stared at me with a confused frowned face quite a while. She asked me name the six. I rattled them off: concentrated nitric, concentrated sulphuric and concentrated hydrochloric acids,  and dilute nitric, dilute sulphuric and dilute hydrochloric acids - all six of them.
She was stunned and became even more puzzled. Then she retorted 

“But they’re the same acids, just in  diluted forms,” she countered.

 I then replied if they are  the same, then why label them separately and had to be kept separately in different bottles. So there must be six different kinds I challenged her.

She stared at me very confused, and after a short while called me a cheat. She refused to speak to me for a week after that.

Later, as a university chemistry student, I discovered the reality: there are over 80 known inorganic acids, from perchloric to chromosulphuric to hydrofluoric, and countless organic acids defined by the humble -COOH group. Carbon, with its infinite bonding potential, builds molecules that the human mind can only begin to catalogue.

Those early moments of wit and mischief were not confined to science class. I remember my math teacher, a long-sighted, with gapped and goofy teeth. When he read at the math text book he has to hold it at a distance and when he laughed he would hide his goofy teeth with his textbook on general mathematics by CV Durell, the mathematics book we used in Malayan schools then.

When maths class was over, and he left,   I, ever the mimic, would imitate him, to the laughter of my classmates. But he was cunning. He would pretend to leave the classroom, only to return silently by the back of the classroom and spy from the small openings between the tall colonial doors and the walls. Catching me in the act, he would spring out, strike my back, and sentence me to write:

"I must not laugh and imitate my teacher", - 500 lines by morning.

Manual labor followed as part of Saturday detention class by cleaning classrooms, scrubbing the school  latrines, dragging heavy steel rollers along with my other similar mischievous  "school criminals" across the school field to flatten the grass like ancient slaves building pyramids. I was a regular "school criminal" always sent to detention class - twice or three times a month. If not pulling rollers, I’d be made to stand on a chair at the back of the class, arms across my chest, tugging my ears in penance.

Yet, despite all this failures, punishments, detentions, and mischievous antics, these memories shine like stardust in my heart. They remind me that a child’s wonder, curiosity, and humour are not blemishes to erase, but constellations that illuminate the journey of learning.

I’m not only smiling at myself - at my own delightful school tales, but truly cherishing them. The innocence, mischief, and wonder of my youth shine like sunlight on morning dew, pure, nostalgic, and filled with life's poetry. What a privilege to walk with my readers and friends through these timeless corridors of memory.