to health and happiness for all.
The perverse consequence of all these unsuccessful attempts to hammer, pole-vault, circumvent and undermine the brick wall is that medicine has sustained, even enhanced, its dominantposition within Western society. Medicine has never been so powerful, and yet its success is seriously compromised by another ârule of fourâ, the four-fold paradox noted in the Introduction.
The causes of these four paradoxes are diverse and complex. Nonetheless, as was suggested in the Introduction, an historical perspective suggests they can also be seen as the multi-faceted side of the singular phenomenon of medicineâs Rise and Fall.
Paradox 1 : Disillusioned Doctors
Medicine is, sadly, no longer as satisfying as in the past. Many of the most interesting diseases that tested the doctorâs clinical acumen have simply disappeared, and a family doctor is lucky to see a patient with a serious acute medical problem from one week to the next. This lack of satisfaction has been compounded by the rise of specialisation, so the cardiac surgeon who in the early days of the pump was faced by the challenge of repairing many different complex anatomical defects of the heart now spends all his time routinely doing coronary artery bypass grafts. Further, the dearth in therapeutic innovation now means that doctors are doing much the same as they were twenty years ago and what seemed very exciting in the 1960s and 1970s, such as transplantation and CT scans, has become routine. In short, medicine is duller, as can readily be ascertained by contrasting the sparkle and interest of medical journals from two or three decades ago with those of today, where impenetrable genetics and improbable epidemiology jostle for space and no one is any the wiser.
Paradox 2 : The Worried Well
It is most peculiar that as medicine has become more successful, the proportion of the public who apparently are âworriedâ about their health has increased. This could be because people âdonât know when they are well offâ, certainly when compared to their parentsâ generation, who lived through the privations of the Depression and war. But equally importantly they have been encouraged by the falsehoods of The Social Theory to become more neurotic. If it were correct that so innocent a pleasure as eating bacon and eggs for breakfast can lead to an untimely demise from a heart attack, then there is no reason to doubt the myriad other hazards of everyday life that have been identified over the last decade. It would be most surprising if people did not, as a result, become more alarmed about their health. This in turn has compounded the professional discontent of Paradox 1 as an excessive concern about âhealthâ can only too obviously encourage people to see their doctors unnecessarily. They in turn become frustrated at the time they have to spend dealing with the âWorried Wellâ. 3
Paradox 3 : The Soaring Popularity of Alternative Medicine
The âalternativesâ â in their various different guises of homeopathy, naturopathy, acupuncture and so on â are now so popular, being used by one-third of adults in any one year, that it is difficult to appreciate that prior to the 1980s they were very much a minority interest and widely perceived as quackery. The surging popularity of these alternatives might be explained by the undivided attention offered by its practitioners which, tomany, might seem preferable to being expensively overinvestigated and overtreated in a hospital bed.
But these alternatives are more than just âfeel-good therapiesâ. The effectiveness of the modern drugs that came tumbling out of the drug companies in the 1960s and 1970s led to the neglect of simpler, more traditional remedies and the dismissal of anything that did not fit the âscientificâ ideas of the nature of disease. Thus, following the discovery of cortisone and other
The perverse consequence of all these unsuccessful attempts to hammer, pole-vault, circumvent and undermine the brick wall is that medicine has sustained, even enhanced, its dominantposition within Western society. Medicine has never been so powerful, and yet its success is seriously compromised by another ârule of fourâ, the four-fold paradox noted in the Introduction.
The causes of these four paradoxes are diverse and complex. Nonetheless, as was suggested in the Introduction, an historical perspective suggests they can also be seen as the multi-faceted side of the singular phenomenon of medicineâs Rise and Fall.
Paradox 1 : Disillusioned Doctors
Medicine is, sadly, no longer as satisfying as in the past. Many of the most interesting diseases that tested the doctorâs clinical acumen have simply disappeared, and a family doctor is lucky to see a patient with a serious acute medical problem from one week to the next. This lack of satisfaction has been compounded by the rise of specialisation, so the cardiac surgeon who in the early days of the pump was faced by the challenge of repairing many different complex anatomical defects of the heart now spends all his time routinely doing coronary artery bypass grafts. Further, the dearth in therapeutic innovation now means that doctors are doing much the same as they were twenty years ago and what seemed very exciting in the 1960s and 1970s, such as transplantation and CT scans, has become routine. In short, medicine is duller, as can readily be ascertained by contrasting the sparkle and interest of medical journals from two or three decades ago with those of today, where impenetrable genetics and improbable epidemiology jostle for space and no one is any the wiser.
Paradox 2 : The Worried Well
It is most peculiar that as medicine has become more successful, the proportion of the public who apparently are âworriedâ about their health has increased. This could be because people âdonât know when they are well offâ, certainly when compared to their parentsâ generation, who lived through the privations of the Depression and war. But equally importantly they have been encouraged by the falsehoods of The Social Theory to become more neurotic. If it were correct that so innocent a pleasure as eating bacon and eggs for breakfast can lead to an untimely demise from a heart attack, then there is no reason to doubt the myriad other hazards of everyday life that have been identified over the last decade. It would be most surprising if people did not, as a result, become more alarmed about their health. This in turn has compounded the professional discontent of Paradox 1 as an excessive concern about âhealthâ can only too obviously encourage people to see their doctors unnecessarily. They in turn become frustrated at the time they have to spend dealing with the âWorried Wellâ. 3
Paradox 3 : The Soaring Popularity of Alternative Medicine
The âalternativesâ â in their various different guises of homeopathy, naturopathy, acupuncture and so on â are now so popular, being used by one-third of adults in any one year, that it is difficult to appreciate that prior to the 1980s they were very much a minority interest and widely perceived as quackery. The surging popularity of these alternatives might be explained by the undivided attention offered by its practitioners which, tomany, might seem preferable to being expensively overinvestigated and overtreated in a hospital bed.
But these alternatives are more than just âfeel-good therapiesâ. The effectiveness of the modern drugs that came tumbling out of the drug companies in the 1960s and 1970s led to the neglect of simpler, more traditional remedies and the dismissal of anything that did not fit the âscientificâ ideas of the nature of disease. Thus, following the discovery of cortisone and other
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