Old is NOT always Gold

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So for those of you who don’t know me, I am a freshly graduated Doctor from Mumbai. For those of you who do, well; skip the first line. I recently returned from a Neurosurgical Conference in Gurgaon, a city in the northern part of India. During the discussion, which was largely based on the use of intraoperative imaging in neurosurgery, I observed one thing. Man is, and has always been resistant to change. Now, Darwin might beg to differ, after all we survive because we adapt to change quite well, but you get my point. I see this especially in India where the attitude is that “itne salo se chal raha hai, badal ne ki koi jarurat nahi hai” which translates to ” it’s been going on for so many years, why bother changing”. Technology is not embraced as willingly as it should. What does this have to do with my conference? See this argument came up at one point, where someone said, the introduction of better imaging capabilities has led to the downfall in clinical diagnosis. In the past, neurosurgery was done purely on clinical diagnosis. This meant you had to be very good at picking up subtle hints from patients. But today the role of clinical medicine is rapidly declining. That’s not to say it’s a vital step. I can’t imagine a Doctor asking for investigations without getting a rough clinical impressions. But, let’s say I am equal to the medical legends of the past, would you still let me operate on you simply based on a weakness in a muscle without imaging you. I hope not. When a surgeon is operating using, what is today’s trend of minimally invasive surgery, wouldn’t you rather have him see in real time with the help of images or a navigation system (which is widely used in neurosurgery, similar to the technology used by drones to self navigate themselves) where he is at in the patients brain and how he should proceed. People in the past were excellent at distinguishing normal tissue from abnormal but they weren’t perfect. There was still a high level of error and morbidity. Let’s face it, the human eye is only capable of telling you so much.

Then comes the argument that when for whatever reason this technology is not available today’s doctors struggle. I don’t see where this argument is going. The debate should be on why this technology is not available rather then what the doctors shortfalls are. So yes, at the cost of being rubbish without gizmos, i’d rather be the best with some. In the 1920’s when William Bovie invented the electric cautery to help with bleeding during surgery, procedures were routinely performed without it. It would be unthinkable today to do a procedure without one. Does that mean residents should be trained to operate without one in case it’s not “available”. I can’t see that happening unless the apocalypse hits. Then again, if it does,I doubt much of surgery will take place.

This got me thinking. There is this notion that in the old times there was less disease, people were much more healthier, so we should do what they did. That is incomplete logic. It’s like the logical fallacy post hoc ergo prost hoc ( after this therefore because of this). Firstly, people had disease. Probably more than today’s world. They lived shorter. There’s an argument that heart disease and the dreaded C weren’t as prevalent in the older times as they are today. Who said it wasn’t? How many blood samples were collected for testing 200 years back? How many deaths were attributed to the Gods rather than simple heart failure? So modern technology has it’s own problems like bringing obesity and back pains and cancer due to radiation exposure. But the age old times people died of stomach infections, pneumonia and wound infections far more than people die today. Yes, maybe diet and lifestyle was better back then and there is certainly value to ancient Indian medicine, but unless we can prove how it works and more importantly IF it really works, i’d rather bet my life on a doctor saving me then a potion promising to cure me of cancer. Again, I’m not of the belief today’s medicine is flawless. It certainly is far from it. It’s a continuous learning branch of science. We haven’t figured out everything. Ancient medicine has a lot of answers which we don’t have and it certainly has given a lot of answers to modern medicine, but blindly saying that in our times we used to take a mixture of this to cure malaria so I’ll skip the drugs, seems ridiculous to me.

Let’s take another aspect of my life. Running. In the past, if you want to be a good runner, you run fast and run hard and work your ass off. It still certainly holds true today, but now it’s about adjusting your training. There’s fartlek, interval runs, tempo runs, hill repeats and so on. You do core strength exercises and stretches. It’s a fact people are getting faster and running longer today. Science has helped with that. If I say, all this is rubbish. To be a good runner, I have to just run, i’ll never beat the world record for a marathon( haha not to say that if I train properly I will). There’s a global movement for barefoot running. Now i’m not saying it’s bad. But it also has it’s own variety of problems. Cushioned shoes in the market today might not be the answer, but simply dismissing it and moving to barefoot running because that’s how our ancestors ran is certainly not. Unless you can prove scientifically that it’s better, i remain a skeptic. The day that’s done, I’m all game for it.

Yes. The things from our past were certainly good. Look at the benefits Yoga has brought to the world. But change is good and embracing improvements shouldn’t be this hard. We learn from the past and try to improve on it. Iphone 3 was better than the 2. Iphone 7 may not be better than the 6. But to continue using an iphone 6 for your whole life because it worked for you at one point and to say, “that’s what everybody used at that time” is hindering progress. My argument isn’t against ancient methods, it’s about trying to understand what was better then and what is better today?

What do you think?

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Author: The Kale Runner

Ramblings of an Atheist Vegan Trail-Running Neuroscientist

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