(Context-NYTimes sending me repetitive ,monotonous begging emails to get me to subscibe)What have we come to?! A prestigious,high-quality newspaper feels it necessary (probably driven by graduates in MBA marketing programs!) to bombard me with ads to buy a subscription.Have they no shame?! Obviously not.In any case shame is a rare commodity in this society(except of course in cases of sexual assault and abuse- but that seems to be the exception).I can deal with the annoyance factor involved .However there is a much more insidious,perverse effect of this marketing practice.People have lost their capacity to hear! Serious, indeed! People are so tired of this marketing harassment that they metaphorically keep their fingers in their ears-in all situations.It has become a reflex..I still remember standing outside of a mosque giving out flyers about a conference by a visiting Islamic teacher.No charge,no obligations and a subject that would have interested most of the people leaving the prayer site.The vast majority refused to even look at the flyer.They were in an advanced state of marketing burn-out.How many other truths do they and others refuse to hear?Their self-induced deafness prevents them from integrating all kinds of new information.

This phenomenon is by no means limited to attenders at the Jumaa prayer.I see it all the time in doctors.They have been indoctrinated by the scientific equivalent of marketers- peer-reviewed journals,obsessive scientific methodology which often enough obscures the truth instead of revealing it,research studies designed to generate preset results.And they have lost the capacity to think for themselves and the capacity to listen to their patients.Instead what pops into their mind is the latest published article,the most recent algorithm.And the patient in front of them goes unheard.If I were designing a medical school curriculum the first course I would make obligatory would be on analyzing research publications.If you go back to the database in the publication,you can often generate other conclusions never mentioned by the authors.At times you may even generate conclusions opposite to the authors.A relatively recent article in Lancet on Chronic Fatigue Syndrome treated by CBT was another reminder.One of my patients who suffers from this ailment showed me the article enthusiastically.I thought”This is not consistent with what I am observing clinically.”and told my patient I would explore the article.I figured I would have to go in to the depths of the article to find the flaw.It was actually much easier than that.When I looked at the scale of measurement the difference between the control group and treated group turned out to be 10% of the total scale and that was on one symptom only.(There are 8 other symptoms in Chronic Fatigue none of which were tested).I called back my patient to tell him that when I had such changes(10%) on an anti-depressant regime I considered them insignificant.But statistically the result looked significant and this was hailed as a breakthrough!We have lost the depth in favor of the surface.

Salaams,ibrahim