geb@cadre.ARPA (Gordon E. Banks) (08/21/85)
References: I recently picked up a copy of Discovery (Aug '85, p. 85) in a waiting room, and saw a good essay by Lewis Thomas which bears on some of the issues we have been discussing. It is called "Medicine needs more research, not more `caring'." It isn't a whitewash of all the problems engendered by the high-tech approach to medicine, but it puts in perspective just how significant the contributions of research have been. Some excepts: "The diseases that ranked as the great menaces to human health when I was a medical student ...were...tertiary syphillis of the brain (which filled more asylum beds than schizophrenia), pulmonary tuberculosis (especially in the very young and very old, for whom it was a flat death sentence), and acute rheumatic fever (far and away the commonest cause of disabling heart disease and early death). Also, of course, poliomyelitis. These four were feared by everyone, as cancer is today. Thanks to some excellent basic science, and some exceedingly classy clinical research, all four have nearly vanished as public health problems, and the vanishing involved the expenditure of pennies compared to what we would be spending if any of them were still with us...depending on how hard the investigators in our youngest generation work and how lucky they are, we'll do as neat a job on schizophrenia and Alzheimer's..." "Pay attention to what the social scientists are saying about medicine, but don't let them argue you away from science. If anyone tells you--- and many will---that today's doctor is too obsessed with the disease of his patient, and not enough concerned with the patient who has the disease, don't let the moment pass without comment. Remind the critic that the disease is the main point, not the only point but the main point, of the encounter between physician and patient. Until that question is settled---and it can only be settled by science---nothing else matters, not the home environment, nor the family relationships, nor the patient's job satisfaction, nor the time of day. The first task of the doctor is to learn whether there is a disease, then its nature, then what to do about it. If, as turns out in about 80 percent of encounters, there's no disease, there'll be other things to do for comfort and caring, but these must come later, after the question is settled. If I become ill, I want a doctor who can look for, and quickly recognize, the earliest signs of cancer, or heart disease, or whatever. I'll be more comforted by the presence of a physician who knows how to feel for the tip of my spleen, and what it means if it's there, than by any doctor whose education prepares him first of all to feel for my mind. My mind can wait a while, but none of the disorders which enlarge my spleen can." I don't entirely agree with his sentiments, but about 90% of it. Well said.
wws@whuxlm.UUCP (Stoll W William) (08/23/85)
(disclaimer: I am not Walt Stoll) > "Pay attention to what the social scientists are saying about medicine, > but don't let them argue you away from science. If anyone tells you--- > and many will---that today's doctor is too obsessed with the disease > of his patient, and not enough concerned with the patient who has the > disease, don't let the moment pass without comment. Remind the critic that > the disease is the main point, not the only point but the main point, > of the encounter between physician and patient. > . . . > I want a doctor who can look for, and quickly recognize, the earliest > signs of cancer, or heart disease, or whatever. I'll be more comforted > by the presence of a physician who knows how to feel for the tip of my > spleen, and what it means if it's there, than by any doctor whose > education prepares him first of all to feel for my mind. My mind can > wait a while, but none of the disorders which enlarge my spleen can." I think that Holistic physicians agree with this sentiment as far as it goes. They would not tell a patient with cancer to "eat the nut of the jum jum tree for three weeks, get your aerobics every other day, and call me in two weeks". They DO treat the disease, using conventional methods "where appropriate" (quoted because conventional doesn't always mean best). But at the same time, they educate patients about nutrition, stress, exercise, and skilled relaxation so that they will be healthier humans in the long run. It's the "My mind can wait a while" philosophy that holistic doctors don't like to see. Once the disease has been treated, the patient all too often says "thanks, see you when I get sick again". The struggle against this attitude is what's new here, and that's why the prevention aspect has been stressed in these postings. Bill Stoll, ..!whuxlm!wws
peter@baylor.UUCP (Peter da Silva) (08/29/85)
> humans in the long run. It's the "My mind can wait a while" philosophy > that holistic doctors don't like to see. Once the disease has been > treated, the patient all too often says "thanks, see you when I get sick > again". The struggle against this attitude is what's new here, and > that's why the prevention aspect has been stressed in these postings. Well, if the patient has this attitude he's not going to go to a holistic doctor in the first place. If he does he's certainly not going to hang around paying doctor's fees once the problem clears up. If the patient is predisposed to listen to the holist, he's probably already doing aerobics and yoga. -- Peter (Made in Australia) da Silva UUCP: ...!shell!neuro1!{hyd-ptd,baylor,datafac}!peter MCI: PDASILVA; CIS: 70216,1076