Saturday, August 9, 2008

Medicine as a "black box science"

My recent encounters with the (Israeli) health system left me puzzled as to how much of a science health is. It seems that medical doctors, especially when things are obscure, tend to hypothesize too much, and their hypotheses have too much to do with their previous experiences. Or, as my engineering mentor at work tends to say: "when you're a hammer every problem seems like a nail". In other words, they seem to impose their past experience as the diagnosis, and every doctor has his or her own guess as to what my Mother's cancer is. We heard 4 or 5 different diagnoses and it seems that none has been right so far.

This leads me to the conclusion that medicine is not a science, at least not one of the accurate sciences, for example math or physics. It's more like an art, where personal feelings play as much part as any other factor. There have been many developments in medical equipment and technology, but these developments serve mainly to improve the ability to "observe", rather as a means to understanding the real processes in the body. This is a real problem when the medical condition is mainly a process, like in cancer, Parkinson's disease, aging, or Alzheimer's disease. It's no surprise, then, that modern medicine found no cure to any of these diseases. It seems to me that the doctors are using a (complicated) form of "black-box" testing: they try something as input and observe its implications as output. Nothing is really known about the process within the body, although theories are abundant, and every doctor has his or her own.

Perhaps a new way of practicing medicine is in order. This kind of practice should start at medical schools, where the emphasis should be on the process rather than on its ramifications. The human body should be studied as a "system of systems", where each system plays a part in the overall view, with processes crossing the various systems. The interdependency between the systems, and the inner processes within each system should be known. The measurements and figures of merits that can be observed for each process should be learned. In other words, methods of systems engineering should be employed and can be employed successfully in medicine. Only by changing the paradigm will medicine become the science that will take us to the next level of Human longevity.

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