The Science and Art of Medicine

Terrified, on my mother's lap, gasping for each breath.  The doctor's office seemed a rather scary place to a seven or eight year old.  I can remember hearing frightening words such as "admit to the hospital" or "let's try this shot."  As poorly as I felt, I didn't even worry about getting the injection.  I just wanted to feel better.  I can't remember the pain of the shot but I can certainly remember my heart pounding nearly out of my chest.  I had been given an injection of epinephrine (adrenaline).  Even more terrified, I clung to my mother.  My breathing slowly improved and thankfully I was able to go home.  Though I am sure I had been in many before, this is the first time that I can remember being in a doctor's office.

A few years later I was in a different office.  It seemed similar, though less terrifying than the first.  I lay on the examining table on my back.  The doctor placed vials of serum on my chest and then held my ankles.  Somehow he could feel differences in my legs and would make notations in his chart.  From this he concocted serum that my father than injected into me once a week to treat my seasonal allergies (no, he is not a physician and yes, it was terrifying).  I was not a happy patient.  I had no trust in this homeopathic doctor's evaluation and resented each shot.  To this day, my mother is convinced that it helped us even in the face of the rude quacking noises coming from her sons' mouths.

These two experiences of mine illustrate a common occurrence in the practice of medicine.  As much as we have learned about the human body and how it functions, there is much we do not know.  Even in the face of accurate knowledge we often lack adequate treatments for some conditions.  That adrenaline injection I received is no longer considered to be an acceptable treatment for asthma.  Thankfully, the science has progressed, and the treatments have gotten better, less toxic and more efficacious.  The second treatment I received may still be offered in some corner of our society but has fallen out of favor.  Such treatments are not studied nor evaluated.  Therefore, there is no improvement.  They are discarded only to be replaced by some other theory.  I have little patience for proposed treatments that claim they offer something "your doctor doesn't want you to know about," claiming a conspiracy theory between scientific medicine and the pharmaceutical companies.  If someone comes up with a valid proposal, it will stand up to the rigors of scientific investigation.  Refusing to study such treatments is tantamount to snake oil in my eyes.

I am not suggesting that only FDA approved medications should be used in the treatment of health conditions.  If you have read my previous posts, you know that I am all for avoiding medications through healthy habits.  Regular cardiovascular exercise has been studied extensively and has found to be beneficial over and over again.  It is getting people to actually make such a habit that is difficult.  Being able to show patients the studies that support my claims helps me to make my point.  One of the favorite parts of my job is eliminating a medication due to a patient having changed his or her behavior.  Seeing people lose weight, stop smoking and drop their cholesterol or blood sugar values is very fulfilling.  Writing prescriptions to treat chronic conditions that could be otherwise controlled, if a patient would just change their life style, is frustrating.

I am grateful to be in a profession that forces me to keep learning.  We still have many inadequacies as a profession, offering "adrenaline" type treatments with the hope that better alternatives are on the way.  As much as we learn and as advanced as our treatments become, though, it is important not to lose sight of the basic tenets of good health.  Nothing will ever substitute for eating a healthy diet, getting plenty of regular exercise and keeping our stresses in check with balanced living.  Remember, keep it simple.