Medicine is easy

“What we do here, it isn’t that hard,” my pediatrics professor said in his Peruvian accent, an accent we came to associate with humor and brilliance.

The child’s cold hadn’t resolved with erythromycin, so the ER doctor changed her to azithromycin. The similarity in drug names is not coincidental; they are quite similar.

With a single sentence the lesson was taught: most upper respiratory infections do not respond to antibiotics, and if an antibiotic does fail, it probably isn’t all that sharp to switch to a nearly identical drug.

Medicine really isn’t all that hard. Once you understand the basic science, the clinical reasoning, and the necessary social skills, it’s pretty fun. This struck me today after my run. I felt great, and I ran into a guy who had completely controlled his diabetes through smart dietary choices and a vigorous exercise program. It wan’t rocket surgery.

What surprises me about much of the alternative medicine movement is how hard they make it look. Sure, they promote “easy” cures, magic pills, coffee enemas, but really, it’s all the same thing done over and over to a different tune. The diets are difficult to follow and based largely on how well they can sell a supplement or a book. Procedures such as chiropractic and acupuncture come with long, complicated, fictitious explanations.

Real medicine is a lot easier. The science is complicated to be sure, but armed with medical and statistical knowledge (and, once again, social skills), it’s not that hard. The guy who controlled his diabetes didn’t need to buy books or magic potions; he needed to want to get better and to work hard to achieve it (and importantly was in a position to buy healthy foods and exercise in a safe environment). If he hadn’t been able to make the necessary changes, he could have been treated fairly easily from a pharmacopoeia of effective and relatively inexpensive drugs.

These treatments—for diabetes, high blood pressure, heart disease—aren’t magic and don’t claim to be. They all follow the same science (unlike altmed where one person’s meridian is another’s subluxation). And they change as our understanding changes.

The magic pills “As Seen On Dr. Oz” are different every year, and not because of a change in our scientific understanding. One year, hCG is the magic diet medicine, the next year raspberry ketone, and so on. If the magic is so strong, why do these magic pills change every year?

When magic fails, people move on to new magic. Magic is attractive. But since none of these patent medicines actually works as advertised, sideshow barkers like Oz have to come up with new “scientific explanations” behind a disease to sell the new pill. Sometimes it’s “inflammation”, sometimes “toxins”, sometimes “unbalanced qi”.

When real medicine fails, we don’t have to change our basic understanding of the physical world, rather we tweak our understanding within the laws that govern our universe. It’s hard, but easier than making up a whole new universe to explain each new failure and each new potion.

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  1. Toni

     /  September 8, 2013

    Thank you for pointing out that sometimes even with the desire for exercise and diet to be able to control diabetes/whatever, it’s okay if we need to resort to meds. And, honestly, there is a lot of similarity between altmed and the Weight Loss Industry (caps intentional).

  2. Brilliant post, as always!

  3. Shannon

     /  September 8, 2013

    I remember that Peruvian professor. He once paid for a meal (at a Peruvian restaurant on North and Damen), when I ran into him randomly after my peds rotation. Good man. Always remembered that small kindness.

  4. Craig

     /  September 8, 2013

    Fundamental. Correct. Brilliant. Easy.
    Barnum and Bailey are still making big bucks!!! But they are hucksters not practitioners.

  5. Also, awesome beard.

  6. Yes doc! Well put, and ultra digestible. Your candor and thoughtful opinions are always appreciated by this reader.

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