bad medicine or bad science or just plain bad

Allow me to preface this all by saying that I am coming out of (I hope) a raging migraine.  This is relevant because when I’m migrained, I find that I tend to be either hyperverbal or nearly aphasic.  This migraine and epimigraine period, I’ve found I’m vacillating between times when all I can do is utter sentences like “it’s in the….uh….thing…thingy, over uh by the um, the uh…the table, thing, no the thingy…with doors…cabinet thing.  It’s black…it’s in there,” and periods when I can have a discussion with my husband on the etymology and implications (archaic usage and otherwise) of the words “conscience” vs. “conscious” while laying flat on my back on the nicely cool kitchen with my hands over my face to shield my eyes from the still for me overly bright 5 PM daylight barely seeping in at low and dim angles.  So you’re forewarned.  This may not be the easiest read.

It’s said that the practice of medicine is an art.  That would be to distinguish it from a science, or a trade I suppose, in that “art” calls on elements of talent, creativity, contextual awareness and sensitivity, humanity, flexibility or malleability.  I suppose it also evokes less articulable properties having to do with indefinable processes and validity of the idiosyncratic, lack of universal procedures, and a sort of non-decompositionality.

That said, I personally think that this is one of those increasingly unnecessary divisions that is so prevalent in how we formally classify things, entities, and processes in our world.  A high-falutin way of putting that would be a false dichotomy in (ontologic) epistemology.  My reason for saying this is that I’ve seen the poor outcomes and sometimes nearly malicious or just plain ridiculous processes in both health care provider “artists” and “scientists” – often seeming that one should have a bit more of the other.  Why the exclusionary classification?  Why is it that, it would seem, you can either find a doctor who insists on overapplication of observations from only an abundance of strictly controlled (i.e. semi-artificial), readily replicable studies to clinical practice; or a provider (doctors sometimes but usually naturopaths etc.) who over-relies on the subjective and utterly uncontrolled experiences of patients and other non-traditional providers communicated via anecdote?

Can’t we have a little give on both sides?  Why the split?  Why the rigid adherence to only one or the other?  If this were the 18th century and we were still so limited technologically that we had no way to uncover/observe truly spooky natural phenomena, I probably wouldn’t be lodging this complaint.  Well, I would likely be feeling its effects, the gut feeling that this doesn’t have to be this way but I wouldn’t have as good a grounding for the sensation of unreasonability of drawing a line down the various parts of our world and saying “this goes over here, that goes over there and never the two shall meet”.

Another and related matter that’s kicking around in my migrainous head today is an emerging pet peeve.  Doctors/providers of the former type, the “Scientist”, who practice poor methodology.  E.g. Dr. Dumbfuck.  He puts all his eggs in the basket of “tried and true” procedure and result, presumably because it was derived using sound and carefully considered scientific method.  And then our dear empiricist goes and fucks it all up by walking into a clinical encounter with an orientation which, rather than being describable as having a strong hypothesis (based on all that science) is more properly defined as walking in with a raging bias which he seeks only to confirm.

That ain’t science.  That’s faith.  And faith masquerading as science in the application of medicine is not just bad science or bad medicine.  It’s also bad, in a firmly moral sense.

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  1. R. G. Maines

     /  April 24, 2011

    Interesting read. I found your description of the two effects of your migraines on your communication skills to really hit home. For me, I experience the first, unable to put together a sentence, remember words and their usage.

    I am becoming terribly cynical, in that I really feel Doctors are, by and large, pretenders. They know what’s written in text books but they don’t necessarily know how to apply said content and they surely don’t know what to do when someone presents with something inconsistent with the text books, therefore they poo-poo the symptoms and complaints so they don’t have to admit they have no clue what to do.

    I hope your migraine has ceased. 🙂

    • I think that is definitely the case in some. Maybe even many, given what I see in higher ed. My sense has been, for some time now, that we allow (maybe even promote) overspecialization. Be a doctor! Better be good at Bio, Organic Chem, and Anatomy…but to hell with the philosophy classes. My ex confided in me how he barely passed college English/writing. And you know what they call the guy who had to wheedle his way through his liberal arts degree and who then went on to get into and graduate from med school anyhow? Doctor.


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