Tell him to come on by and bring his wings; I'd love to meet him. The house has no provisions for safe storage of burning material, so the sword will have to stay outside.
I was thinking more that if 1/10 of the resources were spent on diagnosis and management of the diseases of aging (and other chronic diseases) that were spent on dramatic interventions, we would probably have much better quality of life in late middle and old age. If we think of scientific medicine as a weapon, well, there's an awfully lot of pain and misery and sometimes even death from friendly fire.
I agree it would be great if more funding were available for improving diagnosis and management of chronic diseases. I'm not quite sure what "friendly fire" has to do with that, in this context. Are you trying to say that dramatic interventions cause chronic disease? Or just that they keep people alive long enough for chronic disease to become an issue?
Whichever it is, "I take my *tools* from science" would also express XKCD's idea perfectly well, I think.
As to "friendly fire", I was thinking of iatrogenic diseases, which are distressingly common in the management of chronic diseases and in long-term medication regimes. It is purely amazing how poor many doctors, at least US doctors, are at listening to patient reports of drug reactions. Maybe sleep deprivation in medical school permanently alters their brains.
With elders, sometimes interventions prolong life by a relative short time, and do it by keeping the patient disabled and in pain. Some long-term medications also disable to some degree, including some of the widely-prescribed medications intended to treat coronary artery disease.
I was also thinking of how much effort is focused on supporting dramatic interventions, and how little effort is focused on preventing the conditions which make them necessary, and how poor management generally is after interventions. "Scientific" medical practice has failed numerous times in this area. To take two widely known and accepted instances, consider the treatment of gastric ulcers and bowel inflammation. For many years common practice was to prescribe a diet that actually made the conditions worse. It is not so very long--five decades, perhaps--since there were many orthopedic surgeons who "did not believe" in physical therapy. Had research effort been focused on these issues, rather than on improving surgical procedures, it is likely that much pain and misery would have been saved. In the case of physical therapy, I suspect alternative medicine played a role in improving conventional practice. (One can scarcely write "scientific medicine" in that context, since the rejection of PT was the opposite of scientific.)
Even using the term "tools" still tends to lead to thinking in terms of interventions and finished jobs. These are important: broken bones are set, blocked arteries are opened, and so forth. But thinking in terms of long-term health practices is also important, and Munroe probably hasn't had a lot of experience of that. Not much like war, or even machine repair.
There's a lot more to this--there have been, literally, books written on it, and I suppose I could write another, but for sure I do not want to. My general take, though, is that much of what is called "scientific" in medical practice is distressingly like what is called "scientific" in science fiction: a matter of style rather than substance. I don't have a lot of use for most alternative medicine, but I am also made uncomfortable by too-broad claims for conventional medicine; our understanding of health and healing is much less than most such claims allow.
Wouldn't iatrogenic diseases (I assume you're thinking of illness caused by viruses and bacteria the patient is exposed to in the hospital) be a result of a *failure* to follow scientifically established principles of care?--failure to wash hands, failure to follow sterile technique, et cetera? I don't really see how that can be laid at the door of science; it's not like scientists discourage handwashing or sterile technique.
Plenty of conditions are still untreatable or minimally treatable, sometimes the treatment is worse than the disease, more thought and effort ought to be given to prevention, sure. But like I said, refusing care is always an option.
Until I'm ready to die, which I don't expect to happen soon, I'll still take medicine over the alternatives, imperfect as it is. But if other people want to visit a temple or something instead, I won't stop them.
Of course, I also try to do the right things to take care of myself--exercise, eat reasonably, not smoke, get enough sleep, keep my weight under control--to reduce the likelihood or severity of chronic conditions. Now, having had two herniated disks, I recognize this can't eliminate the possibility of developing a chronic condition, but it can reduce it, and I have the resources to do it, so it seems like a good idea.
I didn't know you'd had two herniated disks. Ouch!
I was thinking more of the mismanagement of long-term medication, sometimes with the glossiest of "scientific" justifications, though I do also know of a gruesome instance of inappropriate surgery. I know personally of two instances of long-term medication mismanagement which had major harmful effects, and a third likely one.
The practice of medicine is informed by science, but it is not itself a science, or even an engineering practice. Our "scientifically" based medical training has huge problems. There are far too many semi-competent doctors. Our understanding of the practice of surgery is still too much informed by our understanding of mechanical engineering. Biological systems are capable of healing, mechanical devices are not, and medical practice still does not take this enough into account. Cardiology is not plumbing, though many cardiologists seem to think it is. (Really. They're scary.) I know a research pathologist who practically spits when he talks about how medical practitioners (don't) understand statistics.
One doesn't have to bow down to the unknown, the ineffable, or even the old gods to think that our medical professions are far too over-confident and that we have much left to learn about the subject. All our modern practices were once "alternative," and almost all of them were fought tooth and nail by educated doctors.
The practice of medicine is informed by science, but it is not itself a science
Right. That's what I was saying. Medicine's tools come (largely) from science. That doesn't make doctors scientists, as I have been known to observe myself.
I didn't say that medicine couldn't be improved; I agree that it can.
I once said, loudly, at a (British) SF con, that mankind invented religion to control the world, but science and technology works better. Funnily enough, that got a cheer and a round of applause.
Personally, I would re-edit "the ineffability of reality" into " the 'inevitability' of reality," but that's just me. Otherwise, I see the wisdom of the comic.
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no subject
Date: 2010-12-20 04:24 pm (UTC)no subject
Date: 2010-12-20 10:38 pm (UTC)no subject
Date: 2010-12-20 04:47 pm (UTC)no subject
Date: 2010-12-20 10:39 pm (UTC)no subject
Date: 2010-12-20 11:25 pm (UTC)Perhaps medicine is not best thought of a weapon.
no subject
Date: 2010-12-20 11:51 pm (UTC)Whichever it is, "I take my *tools* from science" would also express XKCD's idea perfectly well, I think.
no subject
Date: 2010-12-21 02:25 am (UTC)With elders, sometimes interventions prolong life by a relative short time, and do it by keeping the patient disabled and in pain. Some long-term medications also disable to some degree, including some of the widely-prescribed medications intended to treat coronary artery disease.
I was also thinking of how much effort is focused on supporting dramatic interventions, and how little effort is focused on preventing the conditions which make them necessary, and how poor management generally is after interventions. "Scientific" medical practice has failed numerous times in this area. To take two widely known and accepted instances, consider the treatment of gastric ulcers and bowel inflammation. For many years common practice was to prescribe a diet that actually made the conditions worse. It is not so very long--five decades, perhaps--since there were many orthopedic surgeons who "did not believe" in physical therapy. Had research effort been focused on these issues, rather than on improving surgical procedures, it is likely that much pain and misery would have been saved. In the case of physical therapy, I suspect alternative medicine played a role in improving conventional practice. (One can scarcely write "scientific medicine" in that context, since the rejection of PT was the opposite of scientific.)
Even using the term "tools" still tends to lead to thinking in terms of interventions and finished jobs. These are important: broken bones are set, blocked arteries are opened, and so forth. But thinking in terms of long-term health practices is also important, and Munroe probably hasn't had a lot of experience of that. Not much like war, or even machine repair.
There's a lot more to this--there have been, literally, books written on it, and I suppose I could write another, but for sure I do not want to. My general take, though, is that much of what is called "scientific" in medical practice is distressingly like what is called "scientific" in science fiction: a matter of style rather than substance. I don't have a lot of use for most alternative medicine, but I am also made uncomfortable by too-broad claims for conventional medicine; our understanding of health and healing is much less than most such claims allow.
no subject
Date: 2010-12-21 02:36 am (UTC)Plenty of conditions are still untreatable or minimally treatable, sometimes the treatment is worse than the disease, more thought and effort ought to be given to prevention, sure. But like I said, refusing care is always an option.
Until I'm ready to die, which I don't expect to happen soon, I'll still take medicine over the alternatives, imperfect as it is. But if other people want to visit a temple or something instead, I won't stop them.
Of course, I also try to do the right things to take care of myself--exercise, eat reasonably, not smoke, get enough sleep, keep my weight under control--to reduce the likelihood or severity of chronic conditions. Now, having had two herniated disks, I recognize this can't eliminate the possibility of developing a chronic condition, but it can reduce it, and I have the resources to do it, so it seems like a good idea.
no subject
Date: 2010-12-21 06:54 am (UTC)I was thinking more of the mismanagement of long-term medication, sometimes with the glossiest of "scientific" justifications, though I do also know of a gruesome instance of inappropriate surgery. I know personally of two instances of long-term medication mismanagement which had major harmful effects, and a third likely one.
The practice of medicine is informed by science, but it is not itself a science, or even an engineering practice. Our "scientifically" based medical training has huge problems. There are far too many semi-competent doctors. Our understanding of the practice of surgery is still too much informed by our understanding of mechanical engineering. Biological systems are capable of healing, mechanical devices are not, and medical practice still does not take this enough into account. Cardiology is not plumbing, though many cardiologists seem to think it is. (Really. They're scary.) I know a research pathologist who practically spits when he talks about how medical practitioners (don't) understand statistics.
One doesn't have to bow down to the unknown, the ineffable, or even the old gods to think that our medical professions are far too over-confident and that we have much left to learn about the subject. All our modern practices were once "alternative," and almost all of them were fought tooth and nail by educated doctors.
(Ironically, my girlfriend just sent me a link to this short essay on medical practice that covers some of this ground: https://www.nytimes.com/2010/12/21/opinion/21iht-edlim21.html)
no subject
Date: 2010-12-21 02:29 pm (UTC)Right. That's what I was saying. Medicine's tools come (largely) from science. That doesn't make doctors scientists, as I have been known to observe myself.
I didn't say that medicine couldn't be improved; I agree that it can.
no subject
Date: 2010-12-20 07:55 pm (UTC)I once said, loudly, at a (British) SF con, that mankind invented religion to control the world, but science and technology works better. Funnily enough, that got a cheer and a round of applause.
no subject
Date: 2010-12-20 10:39 pm (UTC)no subject
Date: 2010-12-20 09:34 pm (UTC)no subject
Date: 2010-12-20 10:44 pm (UTC)But "inevitability" would work too.
no subject
Date: 2010-12-21 04:15 am (UTC)no subject
Date: 2010-12-21 02:26 pm (UTC)And my very best wishes for her continuing recovery and improvement.