I’m biking too… just more slowly. ^_^

In my somewhat medical entry earlier this week, I portrayed the lung specialist as an incarnation of Big Pharma.  Even as a snapshot of the moment this is not quite as nuanced as my real feelings, and in perspective even less so.

Then again, regular readers will know that I cannot even use the phrase “Big Pharma” without irony, for it is a concept typical of a very different subculture.  It goes along with a thinking that is not just mythical, but pure fantasy firmly believed to be literal truth.  It is a mainstay of progress haters, vaccine dodgers and people who think everyone can get the green light at the same time with no ill effects. And of course envious socialists, who cannot abide the thought that someone may earn money on other people’s illness.

While I eagerly support people’s right to choose shamanism and witchcraft over modern medicine, I am torn about seeing them expose their children to the same experience in applied Darwinism, and I definitely require them to wear a plague flag in public.  As for the Socialists, their intentions are as always good; it is just their realism that is faulty, as usual. Having worked for the State for 30 years, I know that it has great perseverance but very limited creativity. If you rely on the State for medical progress, you better have a long natural lifespan.

With incorporated pharmaceutical companies, of course, the problem is sometimes the opposite:  Things go entirely too fast.  I personally think there should be more nuance to this. When it comes to treatment for illnesses with a high mortality (including most cancers), side effects should not really be a major concern.  Is it really a problem that 5% die from the treatment if 95% die without it?  But the opposite is the case for what I would call “convenience medicine”.  It is unacceptable to have people die from low-level painkillers, for instance, or breast transplants for that matter. There should not be the same rules for these opposites.

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In any case, do not mistake me just because of my brevity.  I don’t see doctors generally or this particular lung specialist as just greedy salespeople.  I know enough health personnel to realize that most of them are driven, deep down, by a deep urge to help others.  In general, they are better people than me, in the motivations for their work.  (Although I am working on that.) As the Russian journaler Coldheels (I think it was) wrote:  A medical student dissects many frogs not because her heart is cold but because it is warm with love.  (Sorry to mangle the quote, but it has been 10 years.  Feel free to correct me, but I know I got the spirit of it right, because I feel that way too.)

So I do not want to cast aspersion on her motivations.  But she does live and work in the middle of a milieu of “better living through chemistry”.  She went through a long checklist of diagnosis, certainly more advanced than the script of a McDonalds worker, but still very much a script.  Who has written it?  What are the assumptions you make while following it?  It never occurred to her to ask:  “You are a 51 year old man and you are not overweight, but you are not exactly muscular either.  Are you keeping in shape by exercising regularly, or are you simply not eating as much as others?”  (And I did not interrupt her to tell, although to my defense it was only minutes since I thought I would be treated for a chronic throat infection or some such.)

The point for that deviation from the script would be when there was no improvement in my lung function 15 minutes after taking a standard bronchidilating drug.  Hmm… reduced lung function but not disastrously low, no response to common drug, none of the common allergies… childhood asthma….  could it be that this guy simply has spent 45 years meticulously avoiding any strenuous activity, to the point where his lungs simply never grew to the same capacity as the average male?

While I do seem to have some degree of exercise-induced asthma, it is entirely possible that most of my reduced lung capacity as shown by the test simply comes from a life of slow motion, of walking fast but never running, biking but not too fast, always making sure to not get winded.  What does that do to a human lung?  How much is genetics and how much depends on practice?  I know my heart is beating as slowly as an athlete, but I am not an athlete. The heart speed seems to be genetic – in fact, I get the impression that my brother is even more that way than I – but that does not mean lungs follow the same pattern.

I would like to have such thoughts at least considered before committing my only body to a treatment that may be utterly pointless.  (And taxpayer money for the foreseeable future, since this is Norway  and we have socialized health care that Obama can only dream of.)

Not being able to think outside the script is obviously worse if your script is a medieval fantasy, but even a scientist is not immune.  We need to broaden our minds and see things from an ever higher perspective.  This is the path of true progress.