97103Dr Hegde: What is Medical Science?
- Aug 22, 2014Medical science-what is science?http://www.moneylife.in/article/medical-science-what-is-science/38526.html?utm_source=PoweRelayEDM&utm_medium=Email&utm_content=Subscriber%2327374&utm_campaign=Weekly%20Newsletter%2022%20August%202014Science simply is curiosity. It is the scientist that could be good or bad. The inner secrets of science are not shared outside a small group. The idea of science is enmeshed in philosophy, in myths, in theories, in smugness, in heroism, even in superstition, in fear, and in hindsight what actually happens inside is rarely told openly
“The fact that we live at the bottom of a deep gravity well, on the surface of a gas covered planet going around a nuclear fireball 90 million miles away and think this to be normal is obviously some indication of how skewed our perspective tends to be.”
We talk and write about medical science, evidence-based medicine, epidemiological evidence, randomised controlled studies, treatment guidelines, and some medical people even get Nobel for their “so called” discoveries. Do any or all of these stand up to a strict audit and is it admissible as evidence in a court of law? I wonder. I think I have had a reasonably long association with this phenomenon ever since I joined the medical school in 1956. I have been expressing my distress, on and off, on many occasions, but never did I articulate my thoughts cogently in one place at any time in the past. Time has now come to give expression to my despair so that those of my colleagues, who are not sure of what I am about to write, might clarify their thoughts or those few who are angry with me, can express their anger giving valid reasons. Either way there can be progress.
Somehow or the other the western reductionist science has got into this mess and got itself locked in its own closed box from where it finds it hard to get out now. Is this world made up of bouncing particles looking like golf balls which together try and make this world? What is the big bang? What was there before the big bang? If the universe is expanding what is it expanding to? Did all the money that went down the drain at the European Organization for Nuclear Research (CERN) reactor bring out the basic building block of this universe the (God)dem particle? When is the “Theory of Everything” coming out, if ever? Western science is good at describing small things inside the universe, like how long does it take the earth to go round the sun once and how long does Mars take to rotate in its axis. But when it comes to the crucial question of the nature of this universe, science is both blind and mute.
For a keen observer, life teaches many lessons, which science cannot comprehend. How did we explain the various relationships of the forces in this universe? When we look at a beautiful rainbow, or watch the birds talk to each other with love, we can understand that and enjoy them but science can never explain or measure them. It is so naïve to think that a few cells in our brain can comprehend the beauty of the full moon! In short, life teaches us that we can comprehend much more than what we can grasp with our senses and sense-based science. Finally, we must admit that science is conceived by man; therefore science is only a perception.
Medicine basically is an art based on the western reductionist imperfect science. Lately, we have been trying to say that western medicine is a science and has therefore to be true. Recent studies have shown that finally it is the placebo effect of the faith of the patient in his doctor (two consciousnesses meeting) that matters and not what we do or administer. Newer studies have also elegantly shown that the chemical molecules that we use in therapeutics mainly damage the system as they are alien to the human system resulting in unacceptable adverse drug reactions. No one has been able to pin point consciousness to any part of the brain so far. Roger Walcott Sperry, a 1981 Nobel Laureate in Medicine for his work on brain function had this to say about it: “The centre most part of the brain with which consciousnesses is presumably associated with, are simply not understood. They are far beyond our comprehension that no one that I know of has been able to imagine their nature.”
“Medicine is not science,” wrote Clifford and Donald Miller from Washington University, Seattle and London, UK in their article by the same name in the European Journal of Person Centred Health Care. They go on to state that “science, in the sense of the conventional conception of the scientific method applied in chemistry and physics, is not the only route to and is limited in the extent to which and the fields in which it and it alone can deliver, reliable knowledge. There is an urgent need for a fundamental reappraisal of the nature of knowledge and how it is and can better be obtained. The practice of medicine is largely observational and functions without the level of certainty essential to science.”
Evidence-based medicine has serious crippling flaws. We need “evidence-informed” individualized care. Cohort studies like the RCTs do not apply to individuals. Statistically significant changes in a heterogeneous cohort cannot and should not be applied to a unique dynamic human being. That is where modern western medicine has lost its track resulting in the medical establishment there becoming one of the leading causes of death and disability!
Writing in his classic Bad Medicine-Doctors Harming Society since Hippocrates, Prof David Wootton so beautifully shows how we doctors have never audited our methods and have been responsible for so much unnecessary deaths almost from the time of Hippocrates. A recent audit of the scene now was done by Hillary Butler in London in 2010, which showed that the present western medicine has become a Corporate Monstrosity on the public. People from outside like Prof Ivan Illich, Karl Popper, Paul Feyerabend, David Wootton, Nortin Hadler, Sherwin Nulund and many others have been warning us but their sane voices get drowned in the din of the claptrap, cacophony, and the expensive brain washing of the medical profession by the very powerful pharma lobby that wants to keep it going the way it is to keep their till moving. Hippocrates was dead right when he wrote that a doctor “cures rarely, comforts mostly but should console always.”
We doctors seem to have sold our soul to the devil for money having lost our divine healing powers by getting and spending money. Our lives seem to exist by money, for money and of money! We have fully believed the industry’s false propaganda that we have the power to cure always, save people from the jaws of death, give a new heart, where extensive coronary artery disease seems to have restricted the blood supply to the major portion of the heart muscle, transplant new lungs for the diseased ones, take over the function of the kidney, liver and what have you. I am surprised that we have even fallen for the false propaganda that by screening the whole healthy population that we will be able to catch diseases (young!) in their asymptomatic stages and start drugging them to keep them away from the ravages of many complications, despite the fact that large studies have shown that treating any disease in its asymptomatic stage is not going to help! Little do we realise that we have NOT BEEN able to reduce the death rate nor have been able to eradicate a single infectious disease with the help of the highly touted vaccinations, except smallpox that was achieved with low tech Indian system of vaccination known for “times out of mind”. Rather, the fact is that at any time anywhere doctors went on strike the death and disability rates fell down precipitously.We have been over diagnosing, over treating and doing interventions when they were not needed. When do we learn that we have a hollow science to back us?
Many of our resident non-Indian (RNI) readers and some editors do not believe what I say unless I supply western data. While I have been extolling the virtues of coconut oil for at least four decades, Indian intelligentsia is slowly waking up to that reality after the US started praising coconut oil as the best fat for man. Robert Lanza and Bob Bermer, in their classic, Biocentrism, have this to say:
“But most of these comprehensive theories (of science) fail to take into account one crucial factor: we are creating them. It is the biological creature that fashions them, that makes the observations, and that gives names to things. And there lies the great expanse of our oversight, that science has not confronted the one thing that is at once most familiar and most mysterious-conscious awareness or consciousness.”
That is why the ether of the last century, relativity of Einstein, and the string theory of this century have all fallen by the wayside. The much touted “Theory of Everything” has been eluding our great scientists for a long time. How does one construct physical laws so very accurately to make biological life possible on this planet? Even if the so called Big Bang were to be a miniscule part more powerful it would have rushed out too fast for life on earth. If the strong nuclear force were to be less by a microscopic fraction atomic nuclei would not hold together. If the gravitational force were reduced by “even a hair’s breadth” our Sun and stars would not have ignited! Who, other than man, (scientist) designed them? While evolution is mainly environmental we still hold on to Darwinism.Darwin and his father-in-law, Erasmus, did eventually believe that Lamarck, who propagated the environmental evolution theory, was right.
While the hard sciences, like physics, have such shaky foundation what about the purely statistical science of medicine? We need to understand that this very universe does come into existence because of our consciousness. Now do not jump to the conclusion that science is all bad. Far from it. It is neither all good as is commonly believed. Science simply is curiosity. It is the scientists that could be good or bad. The inner secrets of science are not shared outside a small group. The idea of science is enmeshed in philosophy, myths, in theories, in smugness, in heroism, even in superstition, in fear, and in hindsight what actually happens inside is rarely told openly, feel Harry Collins and Trevor Pinch, the two physicists who have written a book comparing science to The Golem. Golem is a creature of Jewish mythology. It could, if uncontrolled, destroy the master. In the Yiddish culture a Golem is a “metaphor for any lumbering fool who neither knows his own strength nor the extent of his own clumsiness and ignorance.”
I agree with those two physicists fully. Anything that does not change is not science. Having now understood science as it is let us put our heads together to see if it could be made safer, powerful and more useful to society. Otherwise, using wrong medical science might (is already) endanger human life on this planet negating all efforts (by whom) to construct a world precariously balanced for human existence.
“One thing I have learned in a long life: that all our science, measured against reality, is primitive and childlike -- and yet it is the most precious thing we have.”
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London.)==================================================================
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