The Problem with Medicine

Let us begin by examining the nature of the medical profession. Medicine is, most basically, the practice of the prevention and treatment of disease. Disease is an impairment of a vital function of the body. In this sense, doctors are similar to other "repair" professionals, such as auto mechanics or computer technicians. Of course, there are much greater emotional issues with the practice of medicine, which makes the doctor's job unique in its need for compassion. But when you get down to the basic nuts and bolts, a doctor's job is to fix a malfunctioning machine.

But even at this basic level, there is a big difference between a doctor's job and that of other repair technicians. Any machine made by man is potentially understandable at its most fundamental level. No matter how complex a manufactured device is, one can query the creator, obtain manuals, etc. Not so with the human body. Everything we know about the human body has been discovered by reverse engineering. This process is hampered by several factors:

1. The complexity of the human body is much greater than any man made device. There are immensely intricate processes happening at a molecular level that we can only crudely study.

2. Biological systems such as the human body behave very inconsistently. Under similar circumstances, two different individuals (or the same individual at two different times) will react very differently to the same stimulus.

3. Our methods of studying the human body are limited by ethics. Techniques exist to overcome the above described problems, but often would involve actions which are not considered moral when applied to human subjects, such as withholding treatment from an ill person.

I will examine these issues in more detail in later postings, but for now, the point is that the practice of medicine is far more limited than most people realize. In medical school I was taught that medicine is both a science and an art. At the time I thought this meant that medicine went beyond mere science and approached the sublime. I was just a naive snot-nosed kid at the time. Over the years, I have come to realize what this really means. The science of medicine is limited, and doctors often face situations in which there is no clear objective course. At these times, you must "wing it". And doctor do, indeed, wing it.

Next installment we will further examine what we know and what we do not know. In the meantime, stay healthy.