Look - I get the point you are trying to make.
If you discount infectious diseases and surgeries, there are a lot of things off the table as far as a 'cure' full stop goes.
But that is incredibly disingenuous to medicine. You're removing all the things we do incredibly well - to the point where infectious diseases, for the most part - until we reach this disaster warned about in the article we are commenting on - have ceased to be a major burden of disease in the modern world.
That is just remarkable. The reason people are able to make claims like 'all we do is treat sick people, we don't cure them' is because the things that we do well, we do so fucking well it isn't a major issue anymore.
I know very well that my job in a modern first world country hospital revolves largely around treating people with chronic diseases, and that for the most part, I can't do much for them.
For example, when I work in the Emergency Department (Most of my work these days) It is rare for me to 'pick up' a patient that has never had a hospital admission. Most people swing in and out and and out and in and out until one day they don't make it out again.
They have chronic diseases caused by a lifetime of either 'just living' or living hard (smoking, drinking, eating too much) and the accumulated damage is BEYOND modern medicine's ability to fix it.
Personally, I think that for many of these chronic diseases, we are beyond any quick fix ever being developed - i envisage a future world where we literally grow someone a new body and attach their head to it so they can go again... the damage occurs on such a cellular (and slightly above that) level - and is so widespread that it is beyond my comprehension how any treatment we are looking at could fix it - although I am an optimist and who would have ever thought we would have the biological treatments we have now for certain diseases, modern miracles that they are.
But we are still WINNING - as pointed out elsewhere in the comments, we now have a cure for Hepatitis C.
Hepatitis C is a horrible condition. When I was at med school (graduated 2013) we were taught the 'Rule of 20' for Hep C: 20% clear it, of the remaining 80 20% have no issue, of that remaining 80 20% go on to develop fulminant liver failure. Now we can cure the fucking thing. Absolutely amazing. And there's talk of stem cell injections for damaged cardiac muscle; and since I left Med School the average life expectancy for Malignant Melanoma has risen from <12 months to close to 4 years and growing. This is remarkable. and anyone who says differently doesn't understand the facts, and is being willfully ignorant of the enormous efforts of thousands upon thousands of people who work tirelessly in labs and hospitals all over the world to bring about a better quality of life for the sick
The point was that mainstream medicine is good for structurual and acute problems. Majority of other stuff it actually probably makes worse and there is low motivation for actually doing it better given that chronic deases keep the buisnis running. When cancer is in question, it actually can't be worse because price of the medication may destroy not only a person but entire families.
That's because people in general, probably you too, are willing to take the tradeoff for resolution of acute problem over long term consequences. Most people are willing to pay for expensive cancer treatments even with the socioeconomic consequences because the alternative is death. Now whether they should or not is a different discussion altogether. Every medical intervention has associated risks and side effects - from the most routine blood draw to a simple laparoscopic hysterectomy to the antipsychotic to treat your schizophrenia. We are willing to take those risks because we decide that it is worth it.
And I would be careful to not make sweeping generalizations about how mainstream medicine makes chronic problems worse. First, most chronic problems are due to population and socioeconomic determinants of health that are often well out of the scope of healthcare providers at least in the inpatient setting. Second, even with chronic problems we have made advances: think about insulin for diabetes, antihypertensives for blood pressure, or statins for heart disease.
That is why I said majority of stuff, some are clearly good, like insulin for TDB1. For TDB2 however, the insulin also kills pateints due to the hypoglicemia (as body adapts to its sympothoms) in what I deem to be unacceptable number, while there may be more promissing treatments in "alternative medical circles". Statins are useful only for small subset of patients - clearly overprescribed just like AB and lead to diabetes, dementia and other adverse effects.
The points you made about the causes of those deseases are irrelevant when we talk about treatments. The reasons for a disease are not the reasons for clearly suboptimal treatments. And you certainly can't justify destroying family to lengthen the life of cancer patient for few months, maybe a year, in a general case ?
> ... are willing to take the tradeoff for resolution of acute problem over long term consequences
Meh... majority of acute treatmets have very low long term consequences. AB is not one of those as evidence shows that gut flora may take very long time to recover (or it may never recover) even after single usage (and we know that disfunctional gut flora is bad). But I can probably take a bet that few doses of ibuprofen will not harm me at all. What I am saying is that standard medicine does have many fenomenal things but that people should probably look elsewhere for help about stuff it doesn't handle good at all. This requires everybody to be very well informed, not something most of humans have time or motivation to do.
> We are willing to take those risks because we decide that it is worth it.
No, "we" are taking those risks because doctors tells us its safe and that risks are trivial or non existent (while at the same time bashing supplements as dangerious?!). "First do no harm" should probably be deleted from mission statement. You don't really think that random person knows anything about medicine or that it questions doctor ? Its mostly buisnis only.
You're doing a lot of hand waving that is not only not backed by the evidence but smells strongly of drinking the kool aid of alternative medicine.
Modern medicine not having tools to fix chronic disease says more about the second law of thermodynamics than it does about the state of modern medicine, and thinking that alternative modalities (which have been tried and tested ad nauseum) will do any better is complete madness. But you're welcome to waste your money if you wish.
Now when you get to the price of cancer treatments, fortunately I live and practice medicine in a western country with a universal health system - i don't have to have discussions with patients about whether they will be able to afford a treatment - everyone gets everything they need. The US would do well to introduce a good system here, but apparently that smells too much like communism... even if it does create the horrible situations you allude to
> But that is incredibly disingenuous to medicine. You're removing all the things we do incredibly well - to the point where infectious diseases, for the most part - until we reach this disaster warned about in the article we are commenting on - have ceased to be a major burden of disease in the modern world.
Please don't take it this way - I am in no way diminishing the achievements of modern Western medicine. To say that it has saved the lives of millions of people would be a gross understatement and this fact should rightly be celebrated. I was 'discounting' those things only because they are so obvious that you would frankly have to be dumb not to acknowledge them.
Surgery is a more complicated topic of course - someone gave me an example once of a doctor explaining to a patient due for heart surgery operation that they were saving some veins in their body as donor tissue for when they would inevitably be back for a repeat. So, it's not exactly ideal, right? Yet such surgery is proclaimed as a success.
Similarly when the 'cure' involves cutting away parts of the body as a lesser evil (or chemo / radiotherapy which is in a way similar) then there is also much room for improvement?
> For example, when I work in the Emergency Department (Most of my work these days) It is rare for me to 'pick up' a patient that has never had a hospital admission. Most people swing in and out and and out and in and out until one day they don't make it out again. They have chronic diseases caused by a lifetime of either 'just living' or living hard (smoking, drinking, eating too much) and the accumulated damage is BEYOND modern medicine's ability to fix it.
This is the real point that I wanted to get to. You can go a long way with correct nutrition and healthy lifestyle and yet there seems to be relatively little attention paid to it (I don't consider some leaflets in the GP surgery, or an article here and there in the press as adequate attention). And as you said in your earlier comment early diagnosis of a condition before it has chance to really set in and cause irreparable damage. This is not a problem for the individual doctors to solve, but it should be something addressed by medicine in general as well as government policy (and consequently a lot more money than is currently being invested into it it seems). Otherwise what you are doing is the same thing as we call 'firefighting' in IT - constantly fixing up the symptoms and not fixing the root cause of the issue.
And it is here that Chinese medicine could have the biggest impact (alongside Western medicine rather than in opposition to it) with it's emphasis on prevention, in-depth and continuous diagnosis, tailoring the treatment to the individual and holistic treatment of the patient (as an interconnected process rather than a collection of individual parts to be treated or removed as necessary). Uneducated people immediately think of acupuncture and herbs as being what Chinese medicine is about but these are only tools and are considered to be 2nd class medicine anyway compared to preventing illness and enhancing health.
> And it is here that Chinese medicine could have the biggest impact... with it's emphasis on prevention, in-depth and continuous diagnosis, tailoring the treatment to the individual and holistic treatment of the patient (as an interconnected process rather than a collection of individual parts to be treated or removed as necessary).
That is exactly what medical primary care providers do, up to the point of the magical "holistic treatment", where your definition turns muddy. Clearly, doctors understand that the body is an interconnected process. The only difference is the treatments you pay for are actually studied scientifically to validate their efficacy.
>Surgery is a more complicated topic of course - someone gave me an example once of a doctor explaining to a patient due for heart surgery operation that they were saving some veins in their body as donor tissue for when they would inevitably be back for a repeat. So, it's not exactly ideal, right? Yet such surgery is proclaimed as a success.
Given the alternative of dying now, it may very well be a success to get whatever time that surgery has granted them even if they'll need repeat surgeries in the future. As the physician you're addressing said- we would love to grow these people new hearts or entire bodies but our medical knowledge hasn't yet reached that point.
As to the bit on correct lifestyle, you're speaking as if this isn't something that all relevant health care professionals are already preaching. The unfortunate reality is that most of our patients would rather slowly kill themselves than adapt the lifestyle changes we recommend. Even without our input they're bombarded daily with nonstop messaging about how they should be slimmer, eat better, and exercise more. Culture is powerful, and a lifetime of overeating and being sedentary isn't going to be remedied in a 15 minute conversation with a physician despite our best efforts.
>This is not a problem for the individual doctors to solve, but it should be something addressed by medicine in general as well as government policy (and consequently a lot more money than is currently being invested into it it seems). Otherwise what you are doing is the same thing as we call 'firefighting' in IT - constantly fixing up the symptoms and not fixing the root cause of the issue.
I agree with you here, you need to incentivise people who would otherwise not plan ahead. We need to design our cities better, we need to get people more active, we need to improve social supports and interactions so that people's mental health is better. Sadly it doesn't look like much of the world is in a hurry to fix these problems.
I do however completely disagree with you in regard to Chinese medicine, which is, from the position of efficacy, utterly worthless.
Show me a well designed study that proves otherwise and I'll eat my hat, but in my years of study and investigation of alternative medicine the only study I am aware of that showed usefulness of Chinese medicine proved that it was 'time with practitioner' that resulted in the improvement, ie. talking to them about your problems, having a sympathetic ear.
This makes sense because so many problems and hospital admissions are psychogenically driven - people derive great comfort from being able to externalise their existential angst. But Chinese medicine is not medicine. Strip the bullshit and hand waving from it and call them therapists, and go to your Chinese therapist - but don't call it medicine because they aren't treating shit
But that is incredibly disingenuous to medicine. You're removing all the things we do incredibly well - to the point where infectious diseases, for the most part - until we reach this disaster warned about in the article we are commenting on - have ceased to be a major burden of disease in the modern world.
That is just remarkable. The reason people are able to make claims like 'all we do is treat sick people, we don't cure them' is because the things that we do well, we do so fucking well it isn't a major issue anymore.
I know very well that my job in a modern first world country hospital revolves largely around treating people with chronic diseases, and that for the most part, I can't do much for them.
For example, when I work in the Emergency Department (Most of my work these days) It is rare for me to 'pick up' a patient that has never had a hospital admission. Most people swing in and out and and out and in and out until one day they don't make it out again. They have chronic diseases caused by a lifetime of either 'just living' or living hard (smoking, drinking, eating too much) and the accumulated damage is BEYOND modern medicine's ability to fix it.
Personally, I think that for many of these chronic diseases, we are beyond any quick fix ever being developed - i envisage a future world where we literally grow someone a new body and attach their head to it so they can go again... the damage occurs on such a cellular (and slightly above that) level - and is so widespread that it is beyond my comprehension how any treatment we are looking at could fix it - although I am an optimist and who would have ever thought we would have the biological treatments we have now for certain diseases, modern miracles that they are.
But we are still WINNING - as pointed out elsewhere in the comments, we now have a cure for Hepatitis C. Hepatitis C is a horrible condition. When I was at med school (graduated 2013) we were taught the 'Rule of 20' for Hep C: 20% clear it, of the remaining 80 20% have no issue, of that remaining 80 20% go on to develop fulminant liver failure. Now we can cure the fucking thing. Absolutely amazing. And there's talk of stem cell injections for damaged cardiac muscle; and since I left Med School the average life expectancy for Malignant Melanoma has risen from <12 months to close to 4 years and growing. This is remarkable. and anyone who says differently doesn't understand the facts, and is being willfully ignorant of the enormous efforts of thousands upon thousands of people who work tirelessly in labs and hospitals all over the world to bring about a better quality of life for the sick