Medicine: Why I would rather be a change agent.
In the discussions around good doctors and good scientists I try to be a good patient (or bad maybe).
Any medical system depends upon two things; health outcomes and patient satisfaction. Any medical system has at its core two things; the patient and the doctor. Without the former the latter would not exist. The patient is interested in cures and health. Science matters to him if it achieves the objectives.
What are the health outcomes after a monopoly of 100 years and an existence of around 300? Have diseases disappeared? Has health appeared? What we are witnessing is a shift from self limiting acute illnesses to epidemics of chronic disorders. This shift benefits whom? Who is dissatisfied?
Medicine has organized itself according to the needs of an industrialized society; battling disease so the workforce can be exploited to the maximum. In the process it itself is the largest industry in the market. There is less time for rest and recuperation. There is less time for reflection. There is little scope for change as the pharma industry is an unwieldy elephant that cannot dance. Therefore it is convenient to attack and eliminate critics than to disappoint shareholders.
Our discussions in this forum therefore will remain discussions. Change in this scenario can unfortunately only come from public opinion and rejection.
Health is essential for life. An unhealthy life is a curse as is reflected in the worsening mental health crisis and increasing number of suicides in society. An unhealthy extended life is a nightmare.
What does science say today? The emerging subjects are microbiome, mycobiome, epigenetics, mitochondrial energy, immunotoxicity, acidic and alkaline environments, nutrition based healing, circadian rhythms, and the body mind connection. All of this points towards holism and is sceptical of the war against disease names. It will take decades for the findings to become mainstream for the elephant cannot dance.
I would rather be a change agent. I envision a paradigm shift so that health may resurface again. In spite of my difficulties and passion for the profession I could not be a part of I do realize that I am of greater value to society being external to the system.
It is extremely important to look beyond. It is extremely important to probe the findings of other systems and understand their underlying premises. The barrier is a wall that emerged post Osler and needs to be critically examined. Once again, who benefits from the status quo? Who has erected that wall?
A human body does not function as per evolving science. It does not have an immune system or a circulatory system after it is discovered. It does not lose any function if it is debunked. Such assertions or negations centered mostly around drug discoveries do not change the way it functions. Neither is a human being just a body or a standalone unit in creation. He is an essential part of the universe as much as the universe is essential for his existence. The two are inseparable. Things become even more interesting when the mental world and connections are probed. This is exactly why Osler was philosophical in his approach.
What is the microbiome? It is in essence the link and communication between the inner and external world. And that world is not just physical. The microbiome controls our mind and emotions. While studying the microbiome one cannot but come to the conclusion that it is geared towards maintaining health and extending life. And it needs to be stressed that life emerged from it.
We need to develop long term visions and view interactions as per their outcomes. Life is a constant flux; creating, maintaining, destroying and renewing to emerge stronger again. Are acute diseases a part of that process? This is a vital question that needs to be impartially researched and answered.
If we go by our present premises life should have disappeared without expert help. Rather left to itself life would have been more diverse without destructive anthropogenic interventions. Holistic health sciences stress on the need for coexistence and adaptation as the route to health. They assume that the body knows best and external help ought to go with the natural processes than against them.
Doctor satisfaction is directly related to patient satisfaction. Understanding the whole brings with it more responsibility and self enhancement. The current conflicts provide an opportunity to grow. Science can follow.