Response essay on literature and critical analysis

¶ … Doctor, Lewis Thomas traces the history of medicine from its earliest roots in the common human fear of illness and death and the superstitious practices of the ancient shaman all the way through several modern medical revolutions in the 19th and 20th centuries. He characterizes medicine as a field of knowledge that does not accumulate in layers, but rather, one that undergoes wholesale revolutions of new information that completely replace previous understandings and therapeutic philosophies based on those understandings of disease mechanisms.

Thomas describes several of the classic useless procedures employed by physicians well into the 19th century, such as leaching and bloodletting, which he suggests caused only harm, including the possible premature death of George Washington. According to Thomas, modern medicine really began with the first medical revolution in the 1830s when physicians initiated the first controlled study to compare the outcome of disease in a group of untreated patients with the outcome for patients treated with then state-of-the-art medical intervention.

The subsequent realization that most medical treatments of the day had absolutely no beneficial effect on the outcome of illnesses caused physicians to reevaluate their field beyond making simple diagnoses and providing palliative symptom relief. Curiously, the revelation that many diseases actually resolved spontaneously with the passage of time and about the limitations of medicine of the time did not substantially decrease the public's demand for medicine subsequently.

Thomas describes the second revolution of modern medicine as beginning with the post-World War II period and the introduction of antibiotics capable of effectively treating diseases that were often fatal without treatment. Thomas acknowledges that the significant advances in medical technology have dramatically increased life expectancy and quality of life in the 20th century, but still describes modern medicine as largely ignorant of many diseases. According to Thomas, modern medicine is now in the very earliest stages of the third revolution in that the newest sciences of DNA technologies whose full development in the future promise to improve human life far beyond the capabilities of medicine even today.

On the other hand, Thomas points out that the ever-increasing technological complexity of medical machinery takes certain elements of medicine out of the hands of doctors altogether when reliance on sophisticated equipment and imaging technology replaces hands-on diagnoses. Furthermore, the sheer volume of patients requiring treatment in the modern therapeutic environment requires that nurses actually perform many of the actual tasks that were part of the traditional role of physicians.

Thomas also addresses what he perceives to be shortcomings in the modern approach to advance medical education provided to medical students. Specifically, he argues that substantial portions of the contemporary medical school curriculum of the first two years of medical school should be replaced by courses detailing the many fundamental gaps in medical knowledge of human disease. Second, Thomas recommends that much more medical research should be devoted to diseases that are still insufficiently understood to be prevented despite the impressive ability of modern medicine to treat their symptoms.

In that regard, Thomas makes a cryptic reference to the fact that, in some respects, medical science has now progressed to the point where it sometimes causes pain by virtue of its extensive focus on symptoms: he suggests that extending our life expectancy into our eighties may, in fact, be "for the worse" as much as for the better. Likewise, Thomas characterizes the focus of much of modern medicine, with all of its advanced technologies, as merely "putting off the end-game" rather than treating disease much beyond ameliorating its symptoms.