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In 1900, John D. Rockefeller controlled approximately 90 percent of all petroleum refining in the United States. He was, by some calculations, the richest private individual who had ever lived. He had a problem. Scientists were discovering that compounds derived from coal tar, a petroleum byproduct, could be used as synthetic medicines. Aspirin, derived from coal tar, had been launched by Bayer in 1899. The petroleum waste stream Rockefeller had previously had to dispose of could now be sold back to the public as medicine at a markup of roughly 10,000 percent. He had another problem. American medicine in 1900 was a competitive ecosystem of homeopaths, herbalists, naturopaths, osteopaths, midwives, and traditional doctors who used food, plants, water, and lifestyle as the primary tools of healing. Approximately half of all American medical schools taught some form of natural or alternative medicine. Rockefeller bought into the German pharmaceutical industry, eventually taking a substantial stake in IG Farben, the conglomerate that included Bayer, BASF, and Hoechst. He then commissioned a report. The report was written by Abraham Flexner, an educator with no medical training, funded by the Rockefeller and Carnegie Foundations, and published in 1910. It declared that natural and alternative medical schools were unscientific quackery. It recommended the closure of more than half of all American medical schools and the standardisation of the rest around medicine based on synthetic patented drugs. Congress acted. Half of American medical schools closed within a decade. The remainder accepted Rockefeller and Carnegie funding on the condition that their curricula be reorganised around pharmaceutical treatment. Nutrition was removed. Herbal medicine was removed. Lifestyle intervention was removed. The doctor's job was redefined: diagnose the symptom, prescribe the drug. The drugs were petroleum-derived. The petroleum was supplied by Rockefeller-controlled refineries. The medical schools were funded by Rockefeller. The journals were funded by Rockefeller. The AMA was supported by Rockefeller. The hospitals were funded by Rockefeller. By 1925, the American medical system was a vertically integrated extension of the petroleum industry, operating under the marketing slogan that it was scientific. This is the system that exists today. The pharmaceutical industry generates approximately $1.5 trillion in annual revenue. The American population, 4 percent of the global total, consumes approximately 50 percent of all pharmaceuticals manufactured. The system was not designed to make people healthy. The system was designed to manage symptoms in a way that produces lifetime customers. A healthy patient is a former customer. A managed patient, who takes the pill every day for the rest of their life, is an annuity. The objective has always been to keep you in that profitable corridor between healthy and dead. Long enough to keep buying. Not so well that you stop. The doctor who advises you to fix your metabolism by changing your diet is, from the point of view of the system that trained him, a defective product. The doctor who prescribes you a statin, a metformin, an antidepressant, and a blood pressure medication for life is performing exactly as designed. The system was designed by an oil baron who needed to sell the waste products of his refineries. It still functions, 116 years after the Flexner Report, exactly the way he designed it. You are the customer. The corridor is where you live.

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