12 February 2007

How little we know

One of the neurologists for whom I work offered this perspective on modern medicene, "we have only two cures, antibiotics and surgery. Everything else is comfort."

I think he's right. Antibiotics actually kill the organisms they are designed to fight; they are an eradication mechanism. Surgery is a more extreme method to accomplish the same; eliminate the contaminant. Neither antibiotics nor surgery (if administered or performed correctly) create any additional illness or lasting ill effect.

No other treatment can say the same. Take, for example, chemotherapy. There are people who have experienced life-long remission after chemotherapy, but they also have life-long side effects. Bone loss and immune damage to name just two. Many people laughed at a recent episode of Gray's anatomy in which a cancer patient had "toxic blood" due to taking an herbal supplement while on her chemotherapy. The portrayal may have been extreme, but cancer patients are warned not to take herbal supplements because of exactly that reason; it can cause serious, toxic interactions.

Many medications are intended to provide something your body cannot self-regulate. Examples would be insulin and thyroid hormone. Less obvious ones are vasopressors and anticonvulsents. These medications do not eliminate the condition; they alleviate the symptoms to improve quality of life.

Then there are the whole host of illnesses we cannot even begin to address. How do you treat Alzheimers or Parkinsons? MS? HIV? All we can really do there is slow the progression, sedate the patient, or mask the pain.

I am not arguing that medicene has no worth or that these treatments should not be given. Quality of life for a patient with any condition, from heachache to leukemia is of paramount importance and should be continuously addressed. But I think there is something to be said for perspective. Doctors are not gods or miracle workers and we cannot and should not hold them to that standard.

There may be much we can treat, but there is very little we can cure.

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