That I can marshal this small army of chemical bullets is the ordinary evidence of the “wonders of modern medicine” that keep me alive (or reduce my pains and fears). They are part of the vast armory of devices, techniques, and procedures that are a stunning reminder of my personal, physical fragility. At the same time, they are the basis of the amazing increase in human longevity worked by the application of many branches of the “scientific revolution” which has characterized the modern world over the past five hundred years and especially over the past two hundred.
The concept of inoculation against disease (smallpox) came to the “West” from the Ottoman Empire in the 18C. Germ theory was developed in the 19C. A complex of chemistry, biology, metallurgy and other materials sciences, epidemiology, physics has (incrementally, but seemingly continuously) advanced our knowledge of bodily malfunctions and the potential for prevention or remediation.
As a layman, I have to say that it's awesome. As the great SciFi writer Arthur C. Clarke once said: “Any technology sufficiently advanced is indistinguishable from magic.” And so it seems: laparoscopic surgery, CRISPR gene-splicing techniques, drugs with all manner of unpronounceable names (the FDA lists over 100,000). The deluge shows no sign of letting up: genetic treatments, drugs personalized for each individual, robotic surgery (although we are still waiting for Dr. McCoy’s tricorder on Star Trek).
It's easy to take it all for granted (especially for those with some decent health insurance). Since it all seems like magic, it’s hard to accept that there are limits. There’s frustration when a battery of orthopods, physical therapists, and acupuncturists using MRIs (3), X-rays (2), creams (2), exercises (at least 6), electro-shock, hypervolt, and drugs (at least 4), finally throw up their hands after a year and say that the cause of the pain near my right knee is “patella-femoral syndrome.” You know you’re in trouble when they use the word “syndrome,” because “syndrome” is doctor talk for “We don’t know what is hurting you.” Even worse is the ever-popular diagnostic dismissal: “you’re getting older.”
So, part of the resultant unhappiness is the physical pain, part is the uncertainty, part is anger at a body that (apparently) continues to age (i.e., break down), and part is the disappointment that the “wonders of modern medicine” don’t go so far as to solve my particular ailment.
My historian’s perspective tells me that things are getting better all the time and my personal experience confirms it. New therapies are coming on line every year. We all know versions of story A) in which someone (just a bit older than me) was born with a serious condition that, had she been born ten years earlier, she would likely have died quickly and had she been born twenty years later, she would be pretty healthy and spared a life of seizures and treatments. Or, in story B, a friend diagnosed with cancer is living a pretty complete life following innovative semi-customized treatments that may well have killed her ten years earlier. Or, in story C, a few weeks ago, I had a cardiac procedure that was first done forty years ago and has since expanded and specialized and is now “routine,” and I went home that afternoon.
Does forty years make it “old hat” or is it still “gee whiz”?
I suspect that taking the “gee whiz” approach is likely to contribute to a health-fostering “positive mental attitude;” so, I will stick with that. In the meantime (and, hopefully, for a considerable time thereafter), I will be counting out my life in pills.
Btw, while I’m talking medicine, can I express my bewilderment at the advertising for relatively uncommon ailments? I’m sure smart people who have studied such things believe that this is cost effective, but its amazing to me that the relatively small number of people with “moderate-to-severe rheumatoid arthritis” (~1.5M in the US have some degree of RA, so the “moderate-to-severe” group must be well under 1M; let’s just call it ? of 1% of the population) are worth all that airtime/ink. And then there’s all the bad news portion of the ads which consist of disclaimers and warnings (75%), pretty pictures and optimism (15%), and specific therapeutics (10%) (plausibly required by the FDA); again, it’s hard to see how this makes for an effective way to convince people to ask for the treatment. Big Pharma’s profits are legendary, but still…. It’s a mystery