I have been thinking about writing a few posts about the cliches and how they limit our vision. I will only talk about the cliche in regard to health and medicine here.

It is not that we can avoid forming cliches, they are part of living, but the problem is that they tend to stagnate our perception of the world, which is constantly changing. It is interesting to look at cliches as they are a product of our history, culture, political and social aspirations.

Coming from another culture, the first thing that strikes you is that things are perceived differently in different cultures. I am talking to a client, we are on very friendly terms, and start talking about his heart condition. He sarcastically asks me whether I am a doctor. I am not. The topic is closed. This is beyond me. His heart, his life are in the hands of a doctor with a level of trust that he would not put even in G-d. He does not question his doctors decisions. And this is the same guy, who is critical of everything and everyone else, and who praises himself on having an independent opinion about things.

But it is very common in America. Doctors know what they are doing, and you do what they say or you die. So, if you listen to the doctor, you do not die? And if you do listen to the doctor, do you really live longer? Or you die according to the textbook? Classic example are some cancers, where people, who chose not to undergo radiation and chemo live even longer and with a better quality of life or maintain the quality of life longer.

There is more than only Western (or American), or just one approach to medicine, there is more than only Western (or American), or only one approach to life. The basic problem was and remains that as professional trade, the doctors treat the disease, and not the person. Why? Besides cultural and all other stuff aside, it is just practical. It is easier. Disease is a simple system, meaning that the relation between cause and effect is direct or as close to direct as possible. And this gives us a heck of a confidence that the system is working.

Example: high sugar, take a drug = normal sugar. The goal is achieved. Is it? Who said that the goal was normal sugar? Who cares about sugar. Is a person healthy now? Is it good for him in the long run? Does this mean that he will not get worse from the same disease or the complications from the same disease later?

But this is pretty much, of course, in a simplified way, how the doctors work. There are a lot of diseases, and there are a lot of ways treating these diseases. So, when you visit a highly trained and specialized doctor, you are already not a whole person, as he is not trained to see you as such, you are a manifestation of the disease. And if you have other symptoms, there are other narrowly trained professionals, who would administer a highly specialized treatment for those symptoms.

Eventually, you end up with a handful of pills, where each of them has a list of at least dozens if not more known side effects from unwarranted adoration of your doctor to death of the natural causes at unnaturally early age.

Our fascination with drugs, that magically do the work, is akin to believing in Santa Claus, but with no age limits from puberty to senility. People take drugs with no fear, while the overwhelming majority of drugs simply take over the functions that were supposed to be performed by our body.

The biggest misconception is that medical science is ... actually a science. It is not. It a a compendium of empirical methodologies lacking uniform scientific approach. That's why you get tons of researches saying this drug does something, and another bunch saying it doesn't. A human is a complex system (not necessarily meaning "complicated", but meaning that any change in one parameter causes change or changes in other parameters and these changes can't be simply defined, and foreseen. A cause and effect system is a simple system. Complex system is where cause may have unpredictable effects. A complex system is when the parts of the system put together operate in a different manner than the sum of the functions of the parts.

It comes awkward as I am trying to translate from Russian. I do not have a clue about the terminology here, but I am hoping you get the concept - thank you.

I have no doubt that there are great doctors out there. I am cutting out surgeons from the consideration, as their skills are more of technical nature. But I would like to give one example of treating the person vs treating the disease.

At the end of the 19th century there was a very famous clinicist in Imperial Russia - Sergey Petrovich Botkin. He was once called to a man, whose health was slowly deteriorating, and nobody could diagnose the disease. He was treated by most famous doctors, who were considered stars. Nothing helped. The man was already bedridden and there was no hope left.

Botkin came, walked in the vestibule, went to the bedroom where the patient was waiting for him, stopped in the doorway, and then turned around and went back toward the entrance door without saying a word. While he was putting his boots on (a Russian tradition), puzzled family members and family doctor asked professor Botkin what happened, why he did not even check the patient, did not ask him a single question, did not even approached the bed, he pointed his cane to the walls and said "change the wallpaper". The family members and the family doctor were furious. They paid dearly for the professor's consultation, and this was simply an insult. How dare he?

But they still changed the wallpaper. And the patient get off the bed.

The man was very sensitive to lead. They changed the wall paper to non-lead, and he got his life back.

Botkin saw patients in a larger system than just symptoms, he saw a person. Others tried to treat the symptoms. And while he came out rude and obnoxious, he saved the patient... without actually treating him. He knew the art and science of medicine, not just the trade.

It was 140 years ago. What has changed in the approach? Say you?