Sunday, April 15, 2012

The Art of Medicine: A Pursuit of the Truth

I read this morning in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter to orthodox doctrine on these subjects.

No, I don’t think that creationism is science and it should not be disguised as such. Climate change, however, is more nuanced. While it is inarguable that temperatures have been rising, it is not certain and to what extent human activities are responsible for this. Clearly, this issue has been contaminated by politically correct warriors and those who have an agenda against fossil fuel use. Science, like all scholarship, should be a pursuit of the truth.

Just because something sounds true and logical, doesn’t make it so. In addition, repeating an opinion like a mantra isn’t sufficient to confer legitimacy on the view. Many sidestep around these inconvenient truths.

In medicine also, much is presented as true, which is either false or unproven. Consider how many established medical practices have no science to buttress them. Consider the following examples and decide if you agree that each is a good idea that makes sense and that you would support.

  • Patients should have regular physical examinations as an integral part of preventive medicine.
  • Patients should undergo a CAT scan of the chest and abdomen at age 50 in order to detect any silent lesions that may be present, before they have an opportunity to grow and threaten the patient.
  • Medical care is superior in large medical centers because physicians there have access to the best minds and technology.
  • If you have fever and a cough, it’s best to begin antibiotics early before pneumonia can develop.
  • Everyone should restrict their salt intake.
  • Probiotics facilitate good digestion and should be part of a healthful diet.
  • Placing stents in narrowed arteries helps patients live longer by allowing for increased blood flow.
  • Cardiologists are more skilled at managing high blood pressure than general internists because of additional training and experience.
  • A back x-ray is important to evaluate new back pain to exclude a fracture or other serious condition.
  • Everyone should receive medication to lower their cholesterol levels, even if the levels are ‘normal’, as this will reduce risks of developing heart disease.
  • Alternative and complementary medicine is safe and effective and should be incorporated into mainstream medical practice.
  • Colonoscopy is a fun and exciting event that everyone should enjoy often.
  • Medical bloggers who spew forth sarcasm need to be chastised and reined in.
So, let’s not label the backwoods Tennessee folks as backwards too quickly. Medicine and climate change have common elements. Both are suffused with politics.. Proponents of both make spirited claims without scientific basis, and attack principled dissenters as outlying heretics. Count me as one of them. Someone has to blow the whistle here.

I have something in common with climate change, formerly known as global warming, myself. When I read some of this politically correct pablum, my own temperature starts rising.

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