29Chapter 24. Beyond the Clinic Walls: A Boundless Formula

Until this page, the reader was entitled to think that the pandemic of madness was a disease of one territory. That it lives somewhere between psychiatry and “para-psychology”: constellations, ThetaHealing, regressions, Dianetics. That all you have to do is stay away from the market of soul services—and you’re safe.

That is not the case. And this chapter is about why the title of the book speaks specifically of a pandemic.

The formula of madness knows no disciplinary boundaries. It works wherever three conditions meet: a suffering person, a pinch of truth, and a seller ready to inflate that pinch into a panacea. Oncology. Gastroenterology. Dietetics. Pediatrics. Religion. I’ll show you with examples—and you’ll see that you have encountered every one of them. Possibly in your own relatives’ kitchen.

The case of shark cartilage.

The pinch of truth: cartilage is tissue with almost no blood vessels, and in the laboratory, cartilage components really are capable of suppressing blood vessel growth. And tumors need blood vessels to grow.

The early 1990s. A book crashes onto the shelves. Its title sounds like a verdict: “Sharks Don’t Get Cancer.” The seller’s logic is childishly transparent, but ruthless. Sharks have lots of cartilage. Sharks don’t get cancer. Eat shark cartilage—and don’t get cancer. Feel the catch? The overgeneralization worked. The formula struck millions of minds. The method: capsules of ground cartilage. The industry: a global market for supplements worth hundreds of millions of dollars. The result: millions of slaughtered sharks. And f•••-all.

And now—the facts. Only the facts. First. Sharks do get cancer. Documented. Confirmed. On the record. And here comes the blow of fate with its cruel irony. Tumors strike the shark’s cartilage itself. The very cartilage that millions of people fervently swallow in hope of a cure. Think about it. People are swallowing the thing that cancer destroys in the shark. Second. Let’s run a thought experiment. Suppose for a minute—sharks don’t get cancer. What then? Nothing. Absolutely nothing. Because the swallowed cartilage plunges into the acid bath of the stomach. Enzymes ruthlessly tear it into amino acids. Like any protein. Like a piece of meat. Not a single molecule reaches the tumor in an active form. Third. The main blow. The hypothesis was finally tested properly—in controlled clinical trials on cancer patients. Tested for real. With a control group. With a protocol. With numbers. And what? Shark cartilage showed no effect. Not on the tumor. Not on survival. Zero.

The f•••-all of this affair is not just the sharks. It’s the patients who delayed chemotherapy “while the natural remedy works.” In oncology, delay is measured in lives.

The case of serotonin from the gut.

This case is the most instructive because the pinch of truth here is especially large. Yes, about ninety-five percent of the body’s serotonin is indeed synthesized not in the brain but in the gut, in enterochromaffin cells. That is a fact from a physiology textbook.

Watch what this formula does to the truth. “Serotonin is the happiness hormone. Ninety-five percent of it is in the gut. Therefore, depression comes from the gut. So cleanse your intestines—and depression will vanish.” And then come the detoxes, “toxin flushes,” proprietary dietary protocols “for depression and anxiety,” gut-health marathons promising to ditch antidepressants by week four.

The flaw in this logic reveals itself at step two. And it’s fundamental. Gut serotonin never reaches the brain. Never. The blood-brain barrier stands in its way—an impenetrable wall. Gut serotonin is locked below, busy with grunt work: regulating intestinal motility, maintaining vascular tone, triggering blood clotting. And the brain? The brain synthesizes its own serotonin. On-site. From tryptophan. Those ninety-five percent the salesman waves around have as much to do with your mood as the water in your radiator has to do with the tea in your cup. The liquid may look similar. The systems are entirely separate.

The gut whispers to the brain. That’s not poetry—it’s anatomy. The vagus nerve is a live wire. Immune mechanisms are hidden gears. The microbiome? Trillions of bacteria genuinely pulling the strings of behavior. A living, pulsing, unfinished science. Here, everything is honest. Now look closer. From the fact that “the gut-brain axis exists and is being studied,” the salesman extracts one single conclusion. Just one leap. “Enemas cure depression.” That’s it. Think about what just happened. An observation turned into a verdict. Between them lies an abyss—and they vaulted over it in a single bound. We’ve seen this before. Remember: “fever kills spirochetes.” Observation? Yes. And so came sulfa crosses—fever as a weapon, the patient as a scorched battlefield. The same crude stitching. The same logic. The same chasm between what was seen and what was decreed. Depression is treated with what’s proven. Psychotherapy. Primarily cognitive behavioral therapy. Antidepressants. When indicated. Full stop. Not a single “cleanse” protocol has ever passed that test. Not one.

The case of urine.

London, 1944. War rages outside, but John Armstrong unleashes a literary bomb—one whose shockwave won’t engulf the planet for another half-century. The Water of Life—his instruction manual for curing all diseases. The remedy? Drinking your own urine. But the true triumph of this absurdity was yet to come. The 1990s. The post-Soviet world. Bookshelves groan under the weight of bestsellers on “urine therapy.” Print runs in the millions. In clinics lacking even basic medicines, people whisper about “intake protocols.” A nation in collapse clutches at this straw. Sniffs another’s scent. Drinks. Hopes. Fact: urine is sterile—but only while confined to a healthy bladder. Period. That’s where the science ends. Beyond that—it’s fraud. A meticulously crafted pipeline: method, industry, millions deceived. This isn’t medieval superstition. These are your nineties. Your neighbors. Possibly your parents. The devil isn’t in the dates—it’s in our forgetfulness. Madness doesn’t come from the past. It’s always right here.

The case of the “psychosomatic seven.

In 1950, the psychoanalyst Franz Alexander published a list of seven diseases he believed were caused by repressed emotional conflicts: bronchial asthma, peptic ulcer, hypertension, hyperthyroidism, rheumatoid arthritis, ulcerative colitis, and neurodermatitis. “The Chicago Seven,” “the holy seven of psychosomatics” — under these names the list has survived to the present day and become the sacred scripture of an entire industry.

There is a grain of truth here, and not a small one: stress really does affect the course of these diseases. Asthma attacks triggered by anxiety are a clinical reality. Hypertension and chronic stress are linked. All true.

But the formula, as always, turns “affects the course” into “is the cause,” and “is the cause” into “remove the emotion and the disease will go away.” And now the modern “psychosomatologist” runs their practice off charts where every disease is assigned an emotion: asthma — “suppressed weeping,” ulcers — “devouring anxiety,” cancer — “a grudge held in silence.” Meditate, forgive, relax — and the ulcer will scar over.

Here is the denouement, which I consider one of the most beautiful stories in twentieth-century medicine. Peptic ulcer disease. The crowning act of psychosomatics. The disease of “the anxious and the ambitious.” It turned out to be an infection. The 1980s. Australia. Two men — Barry Marshall and Robin Warren — open up the stomachs of ulcer patients and find a bacterium there. Helicobacter pylori. In hydrochloric acid. Where life, according to every textbook, is impossible. Nobody believes them. What bacterium could survive in gastric juice? Everyone knows: ulcers come from nerves. From stress. From personality. This is psychosomatics, not microbiology. So Marshall does what not everyone would dare to do. He drinks a culture of the bacteria. His own body is the final argument. And he comes down with gastritis. Real. Genuine. An inflamed stomach from a test tube. Then he treats it with antibiotics — and the gastritis goes away. 2005. Both men receive the Nobel Prize. Today ulcers are cured with a course of antibiotics in a matter of weeks.

Consider what happened here. For decades, science clung to the psychosomatic hypothesis of ulcers — its own, respected, taught in university departments. Then the data came in — and science discarded it. Admitted the error, retrained, rewrote the textbooks, rewarded the very people who had refuted it. That is what the self-correction mechanism looks like in action.

Now look at the “psychosomatics” industry in 2026. Ulcers have been an infection for forty years — yet in the charts of “psychosomatologists” they are still “devouring anxiety.” The data arrived — and changed nothing. Because the chart was never drawn up to be correct. It was drawn up to sell.

Here is the line. Thin. But I will draw it as a physician — with the precision of a scalpel. On one side — the facts. Psychological support for somatically ill patients is not merely needed. It is evidence-based. Addressing stress improves quality of life and increases adherence to treatment. Sometimes it affects the course of the disease. Relaxation, mindfulness — all of this has been tested. Clinically. In controlled trials. Blinded. But — only as a complement to treatment. Only that way. On the other side — those who offer breathing exercises instead of an inhaler, meditation instead of antibiotics, forgiveness of grievances instead of chemotherapy. They are playing a game whose rules were written by madness. Especially in oncology. There, this formula kills. Literally. “Cancer is a grudge. Forgive — and it will dissolve.” These words are spoken in the offices of “healers” every day. Every day. I have seen what remains of patients who came to an oncologist a year after that kind of “working through their grudge.” Not a person. A shadow. And far too late.

The case I can see from the window.

So far, the examples have been global. Now — what I observe where I live and work.

In Azerbaijan, as in the entire region, the pandemic has an ancient, well-established channel — folk-religious healing. Families take their sick to sacred sites — pirs and ojags — passed down through generations with the belief that curses are lifted here, jinns are expelled here, “fright sickness” is cured here. Prayers are recited over someone with psychosis. Amulets are tied to them. They’re smoked with incense, given ritual drinks, made to spend nights at shrines. I say this without mocking faith itself — faith isn’t illness, and religion as such isn’t my adversary in this book. My adversary is substitution: when ritual is offered instead of treatment, and “possession” instead of diagnosis.

This is the cost of substitution. I measure it in time. A patient experiencing their first psychotic episode doesn’t reach me a week after hearing voices, but months later. These months were given to pirs, mullahs, healers. Voices alone aren’t a diagnosis. Voices are a ticking clock. And psychiatry keeps count: the duration of untreated psychosis. The longer this interval, the worse the long-term prognosis. This isn’t opinion — it’s data. Every month with a healer isn’t a neutral “we tried and it didn’t work.” It’s a worsened prognosis stretching years ahead.

Why do families choose this? Not from stupidity. From stigma. A psychiatric diagnosis in a traditional family is a brand. A clan’s shame. Whispered behind backs: “that house has a madman.” No one gives daughters to such families. No alliances are made with them. A jinn isn’t shameful. A jinn comes from outside. A jinn can be expelled. The family remains clean. The healer isn’t selling treatment. He’s selling families the chance not to acknowledge illness. In this, he’s indistinguishable from a Moscow regression therapist offering clients the chance to deny depression — it’s not depression, just “unprocessed past lives.”

The formula’s identical. Only the costume changes: prayer beads, white coat, lavender cardigan.

The final mechanism: why the purveyor is certain.

One thing remains to explain — the tone. Why does a real oncologist say, “We don’t fully understand this tumor’s mechanisms, here are three treatment options, each with different odds,” while the cartilage peddler says, “Cancer’s cause is solved, here’s a jar”? Why is confidence distributed so unjustly — in inverse proportion to knowledge?

In 1999, psychologists David Dunning and Justin Kruger described the effect now bearing their names: the least competent people in a given area systematically overestimate their abilities — because recognizing one’s gaps requires the very knowledge they lack. Ignorance doesn’t just deprive one of answers. It deprives one of seeing there are no answers.

A zoologist who has studied sharks down to their last cartilaginous cell would never write: “Sharks don’t get cancer.” Only someone who skimmed a single chapter could write that. A gastroenterologist who has dedicated their life to serotonin physiology would never promise to cure depression with an enema. Only someone who swallowed a paragraph about serotonin would. The confidence of a salesman is not a sign of knowledge. In medicine, it almost always means the person hasn’t yet reached the boundary where real questions begin.

Remember this tone. “I know the cause of all diseases”—that’s the sound of a formula. “We know this, we don’t know that, and here’s what that means for you”—that’s the sound of science. You can tell them apart by tone long before you parse their content.

Now we can see the full scale. The insanity pandemic isn’t just about one marketplace. It’s humanity’s way of dealing with any incomprehensible suffering, and psychiatry in this book was merely a prism—the domain where the formula is most visible because it has the least evidence to shove in a salesman’s face and the most despair for them to feed on.

Every pandemic has a pathogen—we’ve described it: the formula. It has vulnerable groups—we’ve seen them: the suffering and the loving. It has transmission mechanisms—seven of them, as outlined in Chapter Eighteen.

That leaves the transmission route. The next chapter is about that. Because over the past fifteen years, humanity has built the perfect ventilation system for this pandemic—and carries it in its pocket.