If science is considered as a journey towards truth,.. knowledge, data, and statistics are the key companions in this infinite voyage to an unknown destination. While hundreds & thousands of scientists do travel in this turbulent road daily, pursuing their mundane work, there are very few researchers worried about the true purpose of their journey, the quality of the road they travel, the dangerous fault lines they create.
It has become a taboo topic to criticize medical science even after realizing the fact that we are compelled to follow and glorify some of the best nonsense.
Dr. Jhon Loannidhis Professor of statistics and public health from Stanford University is of a different genre. He became so popular after his landmark paper
I haven’t clearly understood the true meaning of customary Dr tag, my name carries for more than 3 decades, till I saw this. Wish, this video is played to all young medical students on their graduation day.
I am realizing with guilt, it requires a Holywood movie buff to remind us the true meaning of the famous WHO – definition of Health, done in the most holistic fashion in the year 1948.
Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
So, technically, whoever serves to improve these three components and alleviate human suffering becomes a doctor.
Happy to share this on July 1st, the official Doctor’s day in India in memory of the Bharat Ratna Dr.B.C.Roy of Bengal.
Reference
The clip is from the movie Patch Adams, Directed by Tom Shadyac. A Hollywood celebrity movie maker, Virginian professor of communication turned philanthropist, now retired to a minimalist life. He is also known for his famous documentary I amthat talks about the problems faced by the world. Though his works are much appreciated, I must say, they are underrated. Deserves more than an Oscar for communicating his thoughts on the medical profession perfectly and for social equality.
I think it is an Invalid question. Whether you like it or not , medical science and philosophy are always bonded together and its relationship is eternal. It doesn’t make sense to separate them. I think we have misunderstood the meaning of philosophy. While science is presumed truths, philosophy is trying to believe in unknown truths. Philosophical truths are built-into every decision a medical professional takes.
If the expected natural history of any disease is science, unexpected deviations are philosophy. (RT PCR testing for diagnosing Corona is science, why 90% of them are not infective and don’t transform disease is philosophy) When something is not seen or quantifiable like human immunity, it is a perfect example of concealed science or manifest philosophy.
Taking about what we think we know is science, Talking about what we really don’t know is philosophy. The term Idiopathic syndrome finds a proud of the place in every specialty in medicine, Isn’t?
What will be your answer when your patient wants an assurance that a stent, you had just implanted will not get occluded in the next 6 months or so.“I don’t know, I cant assure you about that” will be your most likely answer. (Though, we do it in style, hiding behind the scientific hyperbole decorated with numbers, also referred to as statistics) Please realize, this is the expression of medical philosophy in the finest form.
Final message
My Impression is, philosophical truths should be liberally used in a regular fashion right from the first-year medical school to advanced specialty teaching. This seems essential as science in the current times suffers from too much sanctity. This has spilled over to the doctor population as well, and make them appear invincible.
If only we realize science often trailsbehind the philosophical truths at least by a few decades, our patients will not be injured inappropriately and prematurely. Mixing science with philosophy in the right composition ( aperfect academic cocktail ) will bring out the best from the noble profession.
Postamble
Can anyone guess, why scientists are given a doctorate in Philosophy degree (PhD ) ?
Yes, Medicine is a funny science ( some don’t agree , Isn’t Art ?) Many of the noble professionals are silently pursuing their job of saving lives and removing human suffering .Meanwhile, people like this author are needlessly bothered about some Imaginary Issues and write stuff like this one , . . that you are reading now !
Yes, there is an invisible tectonic shift taking place in the name of science.The way we practice medicine currently, it fits in with any of the following descriptions . Divine, Godly,dramatic,miraculous , comical ,cruel or even outright brutal ! (I dare not quantify the weightage of each adjectives used above !)
The field of cardiology as I know personally for the past three decades is challenged by uncontrolled growth (How about proposing 1000 dollar PCSK blocker Evolocumab for a meaningless reduction of few mg of LDL over and above Statin ) Further,the technology goes on to Implode at every corners of wall street ,(Mitra clip for mild MR of DCM ! TAVR for aged Aortic valve ) hijacking commonsense and cost (where is the effectiveness ?) of every stake holder .
In the process ,the critical healing power that resides within every biological system is ignored and ridiculed upon.(You become a fool if you say endothelial tissue plasminogen activator and lytic system will take care of a bulk of the intravascular vascular thrombus if we wait, and we shall permanently defer an Intervention! Current space aged physicians want to invade every existing (or non existing ) problem with multi pronged military strategy and guess what will happen to the humble body which becomes the battle ground.
Coming to the content proper
Sometimes I feel God throws some random truths at an unexpected time through some extraordinary men ! Here is a most unusual study of its kind from the Sanctum sanctorum of Medical science , namely Harvard medical school and Massachusetts General hospital .I think it was presented in ACC Scientific sessions 2018 , Orlando and published in Journal of American heart Association.
Cheers and congratulations to the lead author Dr.Anupam B Jena* , Physician and professor , Department of health care policy , and Health economist
* A video profile of author is in the reference
There is no surprise a paper with such a title had a huge media backlash. USA today reacts . . .
My observations and final message
The paper from MGH, Boston dwells a sensitive area ,of course it has come with a gross conclusion (However, I feel it has hit the bull’s eye.) Still, for the critics, I want to tell one thing , who can deny the fact ? the massive evidence base with 100s and thousands of research papers created by cardiology scientific Industry over the decades is largely a damn squib.
(The problem with acquiring this sort of ready to synthesise knowledge stuff is, It sits right inside our brain and bonds irreversibly , refuse to leave even if these dubious practices are proven dangerous ultimately !)
It might appear , the only option to tackle fake science would be through some dramatic ,less than ideal or mediocre research papers (Or even another fake!) As long as final outcome is good for the public don’t bother about methodology of such studies.(Does it sound in any way I am a supporter of Donald Trump ,! No I am not !)
Reference
Now have a look at this (a long post ) which I wrote some time back. Find out whether these scribblings of mine seem to have grown some scientific backing now .
A brief Info about the author of this unusual paper that has put the field of Interventional cardiology into tail spin and fluttering in cross winds !
Today , November 2nd 2013 is Deepawali , Nearly 1 billion people celebrate it
Wishing you all happy and Deepawali , Let goodness and wisdom prevail over evil and Ignorance !
Deepawali is an ancient festival of lights , millions of Hindus celebrate It with sanctity.
It is a war on darkness and ignorance .On this day goodness prevailed over evil (Asura)
Unfortunately , In the current versions , it would seem Asura’s also join Deepawali celebrations and enjoy it with more vigor ! which is supposed to eliminate them !
Please ensure , that doesn’t happen . . . at least in your domain !
God is supreme . . . he will never allow the evil to take over the world ! Be a soldier to God’s Army !
*For more about this great Hindu festival click on the Link here Deepawali
News : In any developed nation , 90 % of total health expenditure is exhausted in prolonging final few days of human life !
When cost of dying . . . exceeds cost of living . . . this world will go nuts !
The current real world experience from India’s five star hospitals indicate, many elderly rich men and women spend their last few days before being buried or burnt .They spent an average of 15 lakh Rs per death. This amounts to the entire “life time” cost of living of majority of Indians .
Image courtesy from Flicker/ Rachel sian photostream
When human organ donation is considered a greatest philanthropic act, there is one more excellent alternative for those who can’t do it .If only every super rich translate their cost of dying into cost of others living ! many new lives will bloom .
The exorbitant rise in cost of dying in India , is a recent development and reflects the affluence , honor , prideand of course lots of prejudice lack of wisdom ! Instead of filling the deep pockets of greedy corporates why not the rich add new lives ? !
Final message
Let all elders with irreversible conditions , who have finished their life , shall die peacefully at home .Why don’t we ( Affluent . . . would be cadavers !) cross sponsor their dying cost to a public health , nutrition or medical fund .
After thought
Oh America , . . . Am I right ,? Obama thought it and implementing it too ! I would believe , his health care policy is a small first step in this direction !
The current fad called EBM has lots of lacunae. Though evidence based approach is considered the ultimate journey towards truth ,lot of non academic factors contaminate it .In it’s current form , it is difficult to comprehend it.
This is an attempt to decode the mystery of EBM expressed in a simplified lay person’s term .They are the ones from whom we learn medicine. They are our teachers in the true sense.
By the way ,it is also my approach to EBM .Sorry , if this post sounds arrogant ! It is not the intention .Truths often times appear brutal .
And . . . the Genius approach to EBM for comparison
The doctrine of modern medicine goes something like this . . .
For most medical problems , there would be a solution. Keep trying . . . till you get it !
*But , just make sure that problem on hand deserves a solution in the first place !
Modern medicine continues to remind us every day , the much hyped solutions often end up in new problems and many times worse than the original problem !
Oh ! what a great a quote ! When I was boasting myself . . . My wife reminded me , this is just plagiarized version of a 2000 year old Hippocratic thought !
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