“Knowledge is the process of piling up facts; wisdom lies in their simplification.”

Martin H. Fisher.





I was saddened reading this morning the New Year week edition of the British Medical Journal. One report was talking about the new controversy around a much hyped pain killer, the COX 2 inhibitor, sold at a phenomenal price all over. While a reputed National Institute of Cancer study in the US revealed that this pain killer was responsible for a large number of heart attacks and strokes in those that take the drug on a long term basis to suppress pain, the manufacturer refuses to believe that report and is not recalling the drug from the market. The remedy suggested is that the authorities in the US send emails to all doctors to refrain from prescribing that drug.



The media, on the contrary, is going to town painting this drug as the best pain killer. I feel the media should do a bit of soul searching before publishing articles on health and drugs: some of them are dangerous to read, even. I think the magazines do not get sold in the market if they wrote the truth that “science works slowly and many a time gets things wrong, before it gets it right, if ever it gets them right!” On the contrary, what we see is a new drug for cancer cure, a cure all for sex problems, a quick fix for overweight etcetera. With all the fanfare, cancer is yet to be cured. Sex is still an enigma and obesity is threatening to be an epidemic. The war on any one of them is anything but won!



The problem with science is the language barrier between various sub-specialists. They never can understand one another and will not sit together to talk even. This reminds me of the story in Genesis, where the people of Babel wanted to build a tower to reach heaven. God, in His wisdom, stops this project by giving different people different languages. Since they could not communicate the tower could not be built! In science this is the reason why they are not able to get things right. Specialization and reductionism has killed the real progress there. David Ewing Duncan of the San Francisco Chronicle calls this the bio-Babel. First Law of thermodynamics says that “anything that divides eventually disappears.” Today science has divided so much that in medical science we have right ear specialists and the left ear ones that do not seem to see eye to eye on any ear!



My writings in the last forty odd years have not been welcome in the lay media although many of them have published them reluctantly. When I am invited to speak in scientific meetings some in the audience give me an impression that I am the “Genghis Khan come to represent the tyrants view to the world peace summit or I am like Gavin Newsom trying to defend gay marriages at the John Birch Society.” Drug companies have become a Frankenstein which is difficult to be put back in the bottle: some of their annual profits could buy up the US government. Having tasted blood they are not going to keep quiet and listen to sermons from anyone. When some of the “thought leaders” in our profession deliver their talks in “scientific” meetings with beautiful company made slides to illustrate their points of view, they again talk a different language like the people of Babel. They mean goodbye when they say hello.



Writing in her excellent book The Truth About Drug Companies: How they Deceive Us and What we Could Do About it, the author, Marcia Angell, who teaches at Harvard, gives a graphic description of the drug company deception. In another book Overdo$ed America, a family physician in the US, John Abramson, cites instances of how the medical world is taken to the market place to the detriment of the hapless suffering humanity. Eric Schlosser, writing about the second book, has this to say and that says it all. “Some of the nation’s worst drug dealers aren’t peddling on street corners, they are occupying corporate suites. Overdo$ed America reveals the greed and corruption that drive the health care costs skyward and threaten the public health. Before you see a doctor, you should read this book.”



What is the remedy? Scientists should try to be humble and try to understand one another. Reductionism does not work in dynamic systems of this universe and never works in the dynamic human body. There is always the danger of the “butterfly effect” in most interventions that we doctors attempt. If we understand one another there is a good hope that we will be able to “cure rarely, comfort mostly, but console always.” This has been the motto of medicine in the past. Those days should come back and most of the divine interventions to palliate symptoms should give place to more mundane things like life style changes of the population that save more lives than all the hi-tech stuff that we talk about. The media goes to town with it to spread the false message far and wide.



An audit recently showed that the life style changes, education, better sanitary conditions and affluence reduced the burden of most diseases and the doctors and hospitals have only added to the burden. The reduced mortality in Israel when doctors went on strike, the Institute of Medicine report in the US which showed that doctors and hospitals are the third most important cause of death and disability and the adverse drug reactions as the fourth cause, should awaken scientists of all hues from their deep slumber.



The bio-technologists should realize that what happens between molecules, atoms and cells need not replicate in organs and definitely not in organisms. The debate about ultimate medical care should be holistic and should never be Balkanized among the different castes of scientists. The “star performers” in the field of medicine and surgery should be humble enough to audit their results on long term basis. Whereas Philadelphia did ten times more bypass surgeries compared to Ontario, cities with identical populations, in the immediate post heart attack scenario, at the end of a year and five years there were more people alive in Ontario in this group than in Philadelphia. This should make anyone sit up and take notice. Time has come to forget our differences and sit together using the same language to talk of the future of science and technology. Mere economic growth is not true progress. True progress depends on progressive thinking in a healthy way in society with all people talking the same language.



“There are few men who dare to publish to the world the prayers they make to Almighty God”

Michel de Montaigne.