A Lovely Afternoon
Walking up a hill for the view is such a nuisance.
I saw a lady drive up the same hill last time. She seemed fat and sick.
We try to buy ourselves freedom and convenience, but often, what we get is just plain illness.
War and Peace and Health and Disease
Us people, we like to have enemies. Don’t believe me? Check any news. Look at any movie. Play nearly any game. While many of them are not of the “slash around with a sword type”, surely you can find an enemy to your liking.
Well, it may be that you are at peace with the world – but still, shouldn’t we at least get rid of that corrupted politician? He is just destructive to society.
As society, we function way more cohesive when we have common enemies, and politicians love to offer people of other nations, colors, hairstyles, whatever, as enemies.
Enemies help define us, and make us stop flowing in that kind of uncertainty that we would find ourselves in in circumstances of perfect peace.
Most nations have a defense and a healthcare budget. They are usually paying for different things though.
A sensible defense minister would probably arrange the funds to target the enemy that is the biggest threat to the life of its citizens. For us living in developed world, this enemy has a name, and it is called vascular disease.
Wait, what?
War and disease are considered totally unrelated in our culture. Both take lives and in both we need to understand the enemy. We should take untreatable disease with the same serious consideration as a threat of a strong nation. We research and make weapons. Then charge and kill.
If the rationale that enemies that require applications of guns require their own budget, we could as well have huge, separate budgets for enemies requiring statins, the enemy requiring chemotherapy etc.
For the one who kills the most – disease, not war, we need to step together, not just leave it to the individual. If another nations army killed your neighbor but not you, wouldn’t you still be outraged? When disease kills someone, why do we prefer so much to ignore it?
It would be outrageous to just let someone kill another person. Whole communities have risen up through history for such unfair cases. In the case of a rare disease, the world is silent. The people and their families silently weep, while nothing some rare random people are making slow strides to some resolution.
The gap between science and medicine; the other persons responsibility
Medicine is presumably based on science. When you go to a doctor, you expect to get the best care possible. In the process there are factors that may add into the process a kind of error that is mostly ignored, or sometimes mentioned as medical mistakes, where the speaker and the audience don’t really want to hear about it – or for that matter, think about it. Why does it happen and what does it do? This article will be my thoughts on this, some arguments on some things; i am not offering an answer here, but rather a question. I think people need to be involved in the process of caring for their own health, not because doctors or medicine are inherently bad, but because i think there are some assumptions that are made in treatment without the patients consent. So let me present some of them.
1. “The doctor knows what is best for me.”
Science today is presented (we could also say, marketed) in the way of scientific articles. From articles on basic science (chemistry, physics etc) medical researchers design treatments (most often in the form of drugs). The treatment is evaluated in a trial (which is strictly regulated by a designated agency from the government). Based on this, the treatment is then marketed (presented) to doctors and patients.
Some considerations on which treatment a doctor will offer to their patients are:
a) cost
b) efficacy
c) safety
When was the last time you spoke with your doctor and compared treatments on all the factors? I believe, most people havent. When a treatment is slightly more efficient, but way more expensive – especially if various forms of insurance are involved – you will be prescribed the treatment that costs less, often, without even being informed of the other treatments existence – unless the cheap treatment fails! It is not that the doctor will tell you there is a expensive treatment (and let you decide or work for it), but you will be prescribed the cheaper version automatically. This is not only relevant to generics vs brand-names, but may be about whole different treatments. Since this is not a medical mistake as agencies will allow the doctor to choose between treatments, you may not even sue the doctor if you suffer side effects from it. In the same way, conflicts in other factors may arise – you may be prescribed a drug that is more effective, but less safe (safety is not a yes-no question, but rather a spectrum), or vice-versa. But if only you know how important it is to you to get cured of a particular ailment, how can this be left to the doctor to decide?
Another point is, is this doesn’t apply only to treatment, but works on diagnostic tools as well. In some places sending people to cheap inaccurate tests many times is very popular. After all, who cares if you have your non-fast-progressing skin disease for a couple more years before getting diagnosed, if it makes the insurance guys less naggy?
So let me recap this point: doctors don’t know what is best for you, as they don’t know what the disease means to you.
2. The doctor’s decision making process is not reviewed
If we had a program that would make a diagnosis based on the imput of symptoms, we could review the structure why a disease has been attributed to the certain symptoms. The weight of a certain symptom would also be known. The structure would be open to improvement. The doctor on the other hand? Well, he kinda remembers it might be this or that – sometimes forgets something completely and gets sued; or mostly just wastes the patients time in the progression in the disease – while getting his hefty paycheck. If you die because you were added to a treatment waiting line to late – well, tough luck. This is not even a medical error.
This is allowed because people (often without being mindful of it) believe that doctors base their work on some kind of magic and intuition, since doctors are actively trained to look caring and knowledgeble (if they don’t, they increase their chance of getting sued after all). Science is not based on intuition. Therefore, since medicine is scientific, it is based on rational thought.
Now, i shall let you in on a secret – if it is based on rationality, it is programmable. Yeah, so what about it you say? If it is programmable, the process can be repeated for trivial cost. And nowadays, people are paying with their lives for a late diagnosis and inferior treatment, of which the first could be obtained for a trivial cost, and the second applied by themselves (so only the cost of making a drug would be there for example).
Dr. J.P.
A little drawing in an empty book.
A thought of deleting it comes to mind, yet i can say it is important to me.
I don’t delete it. It is important to me.
That guy who drew it, he was surfing the sea. Becomming friends with a long passed doctor, that is out of the question for him. I can’t really talk to him, the doc keeps him busy. He is the guy, the one surfing the sea. The one who drew the picture.
Because i know what he was, i keep the picture. Because i can’t accept what he is now i hold onto his past self. Because i can’t accept what he is, i hold onto the picture.
I will delete the picture. It will feel like betraying him. But for myself, i know i need to betray the him of the past to accept the him of the present. Its hard for me to feel so deeply my own cruelty; how i prefer what he can’t ever be anymore. To expect of him to be what he can’t be anymore.
I wonder, how many times have i hurt him before realizing that the problem is really me? Being accepted because you’re mistaken for someone else; and pretend it is kindness. It is so easy to be the kind person. The cruelty in me runs so wild it even hurts me when i look at it. I wanna run from it. Hide in a safe place.
I will delete the picture. The thought of it breaks my heart. His past self dies, a part of the present me dies.
And to accept myself that whether we meet or not, i will become so intimately close with the doc.
zacione 