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It is unlikely that there will be breakthrough in medicine?


kenny1999

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Over the last few decades we have breakthrough in communications, from the time that we can only call by landline and hear only sound from another side to now that we are carrying a mini computer around (e.g. smartphone) that we can do many things with it.

However, it looks like that there isn't any breakthrough in medicine (If I am not wrong). Yes, there may be better technologies, better methods, better analysis and understanding of a patient and a disease but it looks like the root of problem cannot be solved, for example, if one has diabetes, he cannot be cured totally but has to manage for a life time, if one is found cancer at its advanced stage there is little thing a doctor can do to change or wish for miracles.

Do you agree?

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14 minutes ago, kenny1999 said:

Over the last few decades we have breakthrough in communications, from the time that we can only call by landline and hear only sound from another side to now that we are carrying a mini computer around (e.g. smartphone) that we can do many things with it.

However, it looks like that there isn't any breakthrough in medicine (If I am not wrong). Yes, there may be better technologies, better methods, better analysis and understanding of a patient and a disease but it looks like the root of problem cannot be solved, for example, if one has diabetes, he cannot be cured totally but has to manage for a life time, if one is found cancer at its advanced stage there is little thing a doctor can do to change or wish for miracles.

Do you agree?

 

Are you talking about disease of the young or the old? There's a difference. During my lifetime there have been significant global reductions in mortality of the young and one would hope that this positive trend will continue.

However, as one who has seen most of his former friends and work colleagues pass on, I would suggest that there are positives in not exiting this world to a fanfare of dementia and double incontinence.

We are mortal and sooner or later something will get us. There are a whole raft of fatal conditions that evolution has not eradicated because there is no advantage to the survival of our genes in doing so. This is part of the human condition whether we choose to accept it or not.

There does come a time when the survival of our offspring is best served by the removal of our burden on them. It would seem selfish not to accept this. Better to make peace with oneself, and when the time comes, accept pneumonia as the old person's friend. There are many much worse ways to go.

 

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11 hours ago, kenny1999 said:

However, it looks like that there isn't any breakthrough in medicine

 

I would say more on the philosophic approach to mortality, but Seth has covered much of it quite well.  I would add only that modern medicine has been a string of remarkable breakthroughs in treating conditions that either result in early mortality, or lives of suffering and reduced capacity/mobility.  (it would be good to see these breakthroughs distributed more evenly throughout the human population - that would require a breakthrough in politics, I'm sure)  For example, I am grateful for advances in nutrition and wellness routines that result in me suffering far less from the familial curse of joint problems than previous generations.  In spite of the high noise-to-signal ratio of the Web, we have a society with access to far more information on how to stay reasonably vital and fit well into old age.   Advances in holistic health have been nothing short of astonishing. (a quick thank you to those who worked out the anti-inflammatory powers of algae oil)  Also advances in the replacement of failed joints, limbs, anatomical structures in the ears and eyes, and most of the internal organs.  Surgery can now do amazing reconstructions on the most grievous facial disfigurements, and we are not that far from a fully functional artificial eye.  People can run and do gymnastics with prosthetic limbs.  Thanks to advances in blood pressure regulation, fewer people have their lives cut short by stroke and the average age for a first stroke has been pushed back a decade or more.

These are all game-changers that have radically altered the experience of middle and old age for billions of people.  And also the lives of young daredevils who get out there and shatter their bones and tear up internal organs on a regular basis.  The most important task for a civilized planet would be to extend the fruits of these breakthroughs to the 2-3 billion people who were not fortunate enough to emerge from the right wombs and have access to modern healthcare. (this would also help reduce population growth, because people who are confident their children will live to adulthood tend to have fewer children - it's what population biologists call the demographic shift)

 

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I also disagree with the premise and the comparison with modern telecommunication. The development of the latter was not so much breakthrough, but rather incremental developments of a range of different related technologies. And while it has influence on the society (in positive and negative ways) and especially on habits, I am not so sure about what the "breakthrough" really would be. 

It had a higher impact on lower-income countries, where cell phones put a computer into almost everyone's reach. But elsewhere I am not that sure what the breakthrough really is, other than convenience and more distraction (yes, I am getting old). So as such I do no think that the technology has actually "solved" much and I am not sure whether that would be the correct or fair way to look at medical progress either.

On the medical side of things, breakthrough developments were many, with vaccines for each new disease pretty much on top of the list, as each new effective vaccine radically changes the way we can manage a given infectious disease. Better and safer anesthetics has revolutionized what can be done in surgical practice.  Antibiotics were breakthrough developments and we might live to see what happens if they don't work anymore. Insulin is not a cure and not sexy, but just imagine a world without it. I think the impact would be much more immediate than the need to use a landline.

Even mundane things such as better health recording system, screening and so on that improves our everyday health so in that regard I do think that the focus on shiny things that we call breakthrough can be a bit misguided, at least when it comes to population-wide impact.

 

11 hours ago, sethoflagos said:

Better to make peace with oneself, and when the time comes, accept pneumonia as the old person's friend. There are many much worse ways to go.

Well, pneumonia can be a pretty bad way to go, depending on its form, not to mention that one might spread pathogens. I have quite a few more items on my list that I'd prefer over pneumonia.

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19 minutes ago, CharonY said:

Well, pneumonia can be a pretty bad way to go, depending on its form, not to mention that one might spread pathogens. I have quite a few more items on my list that I'd prefer over pneumonia.

Since COVID, my lab worked on VAP for a few years. FUUUUUUUCK drowning to death in your own lung fluid. If I'm ever on a ventilator and my SpO2 is still crashing, please just throw me out on the road under a bus. 

I'd also just state that modern medicine and hygiene doubled human life expectancy in 2 generations. Washing your hands/autoclaves/penicillin aren't sexy, but comparing my iphone to being dead at 35 makes it pretty clear. 

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13 minutes ago, CharonY said:

Well, pneumonia can be a pretty bad way to go, depending on its form, not to mention that one might spread pathogens. I have quite a few more items on my list that I'd prefer over pneumonia.

It's a very old metaphor for a quick, natural exit.   

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18 hours ago, kenny1999 said:

but it looks like the root of problem cannot be solved, for example, if one has diabetes, he cannot be cured totally but has to manage for a life time, if one is found cancer at its advanced stage there is little thing a doctor can do to change or wish for miracles.

Not all chronic ailments have yet been cured, but there is promising research in many of those areas, such as lifestyle and environmental factors https://www.frontiersin.org/articles/10.3389/fmed.2020.585744/full, cell based therapy https://research.uga.edu/news/medical-researcher-is-using-our-own-cells-to-cure-disease/ and microbiomes https://research.ucalgary.ca/research/research-plan/infections-inflammation-and-chronic-diseases ; so, no, they're not sitting idle, saying, "You'll just have to manage it."

Not all diseases will ever be cured, because as we cure more of them and live longer, new viruses, toxins and malfunctions come after us.

5 hours ago, Arete said:

please just throw me out on the road under a bus. 

What've you got against bus drivers?  I do agree, though; patients ought to have a voluntary emergency exit. 

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