Prompted by an article by Professor Vinay Prasad, Bernard asks whether more science will improve health, or whether the better question is what kind of science, and why he calls medicine an art.
This is the title of an article written by Professor Vinay Prasad, a haematologist-oncologist and health researcher. (https://www.drvinayprasad.com/p/is-more-science-better-than-less.)
Yes, he is a rebel, but nevertheless he is also a specialist well trained in science. This question intrigued me as I have written many times about the illusionary nature of conventional science. Mark Twain is attributed as saying, to paraphrase: “It’s not what we know that gets us into trouble, it’s what we think we know and don’t know that is the problem.”
The truth is that what we know is just a small part of the whole, perhaps only 4% I read somewhere, and based on this 4% we make major calculations, statistics and design programmes to treat ill-health. Stats can be a way of manipulating data to make it seem that the results could be applied to the whole population, even though a very small part of the population took part in the trial. Imagine that. We are dealing with astonishing complexity and individual variations throughout the population of human beings, and it seems okay to take a very small section of the population and, based on this small group, design programmes of management to cover the whole population. Think about it. Every individual has a unique profile of biochemical variations. It may be within the so called “healthy normal” profile; nevertheless it is unique to that person and suggests that there are different end-points or balancing processes that healthy functions are maintaining.
It is for this reason that the same drug has different effects and side-effects in each person. Increasing the size of the group tested increases the variation. The stats blend out the variations, and this is why the conclusions of the study don’t really help when dealing with the individual.
A clever patient will ask: “Tell me doctor, I hear the stats, but how does it help me? Where do I fit in? Are you not just guessing my profile, my body’s responses? The truth is that I cannot assure the person that what I am suggesting is the best, or even the right, response. The science is useful for developing protocols and for governments and other agencies to formulate general approaches, but for the doctor in practice the science is less helpful than most people would assume.
