Wednesday, January 15, 2014

More insight from Heraclitus

We've posted on some of the classics of science before, such as on Galen the famous Roman-era physician.  By chance we were going through the fragmentary philosophy of Heraclitus from about 7 centuries before Galen, roughly Hippocrates' time.  Heraclitus wrote very influential philosophy, which is cited by many of the greats such as Plato, but unfortunately all that survives are 130 fragmentary short sayings, bits of wisdom and observation by Heraclitus and about his time.

We yesterday used a couple of these fragments to reflect on things happening today in science, including the question of understanding causation in genetic and medical contexts of our own time, though a lot of the sayings of Heraclitus are just generalities about the nature of things, not scientific discoveries, because science wasn't his thing.

Heraclitus' wisdom wasn't just about understanding causation in Nature, but instead about people and their nature.  Here's one, aphorism #58 in his fragments, that shows how so much about medicine has not changed.

   "Good and ill to the physician,
     surely must be one,
     since he derives his fee
     from torturing the sick."

Of course, we're lucky that we personally are just academics, and thus rather pathetically of no use to the world beyond the coffers of our university administration.  Nobody gets sick (or, even, gets better) as a result of our work.  We are risk-free in that sense, which makes it easy to cite this bit of ancient observation.  Drug reps don't bother us (though textbook reps do).

Anyway, if science has changed, a striking thing you learn from the classics, and here in regard to medicine, is to see how much hasn't changed!

Of course, it's very easy to critique the healing profession.  Those who tend to our urgent needs have a lever by which to extract not just teeth and tonsils, but large fees from us.  Whether any culture can keep that leverage under much control is debatable and we don't know the history (e.g., of the socialist countries in recent times, or even of the average physician over the past).  The public demands immortality and thus also expensive diagnostic and intervention methods.  After all, the effete methods of prayer can hardly compete these days, and apparently not in ancient Ephesus either.  And in that belief in science, we're willing to pay for what the Doctor orders.  How can you blame the beneficiaries?

Facts such as that exercise is free, and as good or better for most disease conditions (recently shown), don't seem to matter if in our culture we love technology and think of it, rather than divine providence, as the source of miracles.


Anonymous said...

Healthcare is a bottomless pit of unmet perceived needs.

Ken Weiss said...

As can be religion, when it plays on fear of death as the plate is passed around. It is, I think, the recognition of our mortality that is largely responsible. Also, even since Hippocrates, the guild protection of health professions (yet, of course, if that were not there, we'd all be victimized by charlatans). No easy answer....