The twin disciplines that build the foundation of our health care system are pathology and epidemiology. Pathology studies the actual diseases, such as an erosion in the lining of the stomach (ulcer) or a growth on the skin (skin cancer). The classic instrument of this study is the microscope. The pathologist learns by cutting away a piece of tissue, e.g the stomach or skin, observing it under his microscope, and categorizing it based on what he observes. Note the act of “cutting away.” It’s an important idea, because the piece of tissue is now separate from you, sitting under his microscope. In non-diagnostic systems of medicine (traditional chinese medicine, classical homeopathy, Ayurveda are examples), this concept of “cutting away” does not exist.
Epidemiogy statistically applies what the pathologist finds to a population of people. We could do a survey of people older than 50 years and conclude that 3% of them develop a condition that looks a certain way under the microscope--colon cancer for example. This type of information forms the basis of the many health recommendations you hear from your doctor and read in the news. For example, after finding that 3% of this population has colon cancer, the epidemiologist might then find that 95% of this colon cancer population happened to eat beef every day, as opposed to the non-colon cancer population, 50% of which ate beef each day. So then the recommendation might come to you, “avoid beef to avoid colon cancer.” This might be worth considering. Nevertheless, the question remains... on the whole, is this good information? In other words, does it apply to you. The answer, unfortunately, is often “no.” Read this paragraph from an article Sunday in the New York Times Magazine ( Do We Really Know What Makes Us Healthy?):
“Many explanations have been offered to make sense of the here-today-gone-tomorrow nature of medical wisdom — what we are advised with confidence one year is reversed the next — but the simplest one is that it is the natural rhythm of science. An observation leads to a hypothesis. The hypothesis (last year’s advice) is tested, and it fails this year’s test, which is always the most likely outcome in any scientific endeavor. There are, after all, an infinite number of wrong hypotheses for every right one, and so the odds are always against any particular hypothesis being true, no matter how obvious or vitally important it might seem.”
A recent example mentioned in the Times article is the “estrogen debacle.” When I was a medical resident, I was told that giving estrogen to menopausal women was good for them. There was solid evidence for this, information I could depend on. Did I believe it? No, but being a good medical resident at the time, I did what I was told. Then medical researchers released studies contradicting this. One of the hallmarks of our age is there is a wealth of information, but little true knowledge. “Here today, gone tomorrow” is not good enough advice for my health. Is it good enough for yours?
The article cautiously suggests that this situation is “part of the natural rhythm of science.” In other words, this is the way medical science is, and the medical advice “given with confidence one year and reversed the next” is something you are going to have to accept. I disagree. Let’s not beat around the bush. Any science of medicine where you can expect to have yesterday’s advice reversed tomorrow is bad science. Fine, it makes people nervous to realize that a good portion of the medicine they place their faith in is built on sand, but it’s the truth. What it means is that much “standard advice” your doctor gives you can calmly ignore. It means that when your doctor gives you advice, it makes sense to ask, “Is this benefitting me or is this benefitting the pharmaceutical company who funded this statistical study?” Of course, you will drive your doctor crazy by taking this stance, but it’s not your fault.
In the end, you as an individual are not a statistical study. You can expect that the recommendations that are good for Jane Doe are not necessarily good for you. It makes sense to delve to find deeper truths about health that you can live by. That may mean developing your intuition about what is good for you. It may mean branching out to seek the perspectives of different types of healers. It may mean reading this blog.
The crisis in our health care system isn’t just a financial one. It’s a crisis of real knowledge. Perhaps more accurately, it is the triumph of technology over knowledge. Medical researchers tend to disavow anything spiritual, energetic, or immaterial in what is human. The system that cuts their weekly paychecks is based on certain ideas of reality. In certain health conditions, that might not be a big deal, yet the more chronic a disease is, the more problematic it becomes. Let’s begin to change those ideas, trying to learn and understand about health from a broader view of what it means to be human. What is true often takes time to emerge. When we live with those principles in mind, we we will not wake up one morning and find out they have suddenly changed.
Recent Comments