Getting Better: The Progress of Medicine

I’ve noted before that it’s remarkable how quickly medicine can progress. Most of the therapeutics I learned in pharmacy school is now obsolete. When I started practicing, HIV was treated with only three drugs: AZT, ddI, and ddC. They were modestly effective, and the disease was invariably fatal. Today, the management of HIV has been completely transformed – it can be managed almost like a chronic disease. There’s been remarkable progress in ulcer treatments, too. Peptic ulcers used to be treatable, but usually recurred. Now that the bacterial cause is understood, we can heal ulcers – permanently. The progress in cancer has also been amazing. Some have gone from quickly fatal to highly manageable, and the number of cancers we can cautiously call “curable” is growing. All of this is due to the progress of science in medicine. As new scientific evidence emerge, our understanding of illness changes, and so do our treatments. That’s the long-term view, anyway. Up close, and taking a short-term view, the progress of medicine doesn’t look at smooth. New drugs come on the market, only to be withdrawn. New medical procedures are touted to be panaceas, yet they’re ultimately found to have little effect. We can fool ourselves into thinking we’re helping, when we’re not. When you take short-term perspective, it’s no wonder that people are confused by new medical findings. Information doesn’t emerge in a linear fashion – it’s more like a branching tree, with a lot of dead ends. It’s the dead ends, the controversies, and the contradictory data that get the media attention – the modest but real incremental benefits that are discovered and put into practice each year don’t seem to get the press of the latest wonder/killer drug.9781402792335_FC.225x225-75 Continue reading