5 ms·

Ah, the human as a specimen in a petri dish approach to so-called health care. Flies directly in the face of study after study after study that says: diet and l

Ah, the human as a specimen in a petri dish approach to so-called health care. Flies directly in the face of study after study after study that says: diet and lifestyle are major factors in all deadly diseases. Probably driven by modern tech, completely inadvertently, because x-ray machines and MRIs and such demand that the patient go to the clinic or hospital rather than the doctor going to the patient's home. Star Trek's Dr. McCoy and his tricorder was a dream of tech that you could carry in the proverbial little black bag. We aren't there and have forgotten a lot of important principles in the process of pursuing shiny tech. But it's generally a bad idea to critique any of that. Gets one nothing but hatred.

dekhn 3y ago
I think this is a pretty thoughtless statement. Ashkenazi women often have genetic mutations that cause them to get breast cancer and the cancer prognosis is much worse than average. This cannot be addressed by diet or lifestyle. However, genomic sequencing detected common patterns that can be tested for, and with that information, women can make informed choices about treatment or other actions, ideally well before they ever have a malignant tumor. I won't disagree that we could do a lot better overall with large-scale changes in diet and lifestyle. But it still would leave a lot of people dying of heart disease and cancer as well as infectious diseases. Those x-ray machines and MRI machines make a huge difference for people with internal injuries as well. No amount of diet and lifestyle will heal a shattered bone.
- DoreenMichele 3y ago
  That's a wild misreading of my comment.
  - dekhn 3y ago
    All the comments I make on Hacker News are done in good faith and assume good will on the part of the person I'm replying to. If you really think I misread, please rewrite what you wrote; as far as I can tell, I read and interpreted it clearly. It's best if you come out and say things directly, while your statement's thesis isn't entirely clear, but I read it as: Flies directly in the face of study after study after study that says: diet and lifestyle are major factors in all deadly diseases. <- yes, this is true. However, it's not a useful statement when criticizing medicine based on technology. Even if everybody in the world had a "perfect" diet and lifestyle, it wouldn't address the majority of diseases at a very large scale. Probably driven by modern tech, completely inadvertently, because x-ray machines and MRIs and such demand that the patient go to the clinic or hospital rather than the doctor going to the patient's home. <- OK, not sure what to say about this other than, it's an unfair comparison; there's plenty of in-home care and in-home doctors can't resolve a wide range of issues at a person's house. It also brings risk to the doctor, as well as causing them to spend their day travelling around. Star Trek's Dr. McCoy and his tricorder was a dream of tech that you could carry in the proverbial little black bag. We aren't there and have forgotten a lot of important principles in the process of pursuing shiny tech. <- actually, doctors and medical researchers, for all that they pursue shiny tech, still mostly have a good appreciation for "important principles". For example, I watched my surgeon count the sponges that they took out of my spouse after surgery, to make sure they hadn't left any in (this was a surprisingly common problem with surgeries). They don't try to make a "sponge detector machine". That's just one example out of millions; if you've followed doctors on Rounds, you'll see that most of what they do isn't technology. But it's generally a bad idea to critique any of that. Gets one nothing but hatred. <- I explicitly wrote my comment to be friendly, fact-based, and make my thesis as clear as possible. If you're going around pointing out that "medical basics that we've known for a while matter", nobody is going to agree with you. But if you attack doctors/medical researchers the way you do, you instance cause people to interpret you as somebody to argue with.
lazide 3y ago
All interventions that don’t require a patient being in a coma first requires patient compliance. Diet and lifestyle are nearly impossible to address from the perspective of the Dr, as they require the patient to want to and be willing to change foundational elements of their life. Unless the patient comes to you requesting that, good luck. Many will get actively angry if you mention even obvious and severe issues like obesity, to the point of slandering Dr’s or avoiding going in for serious issues later. Taking a pill, patients will often be able to do that (but definitely not always!). Getting a surgery, similar. Is it any wonder that Dr’s use the tools that people will let them use, instead of the ones people won’t?
- DoreenMichele 3y ago
  I have no idea why both of these comments assume that I am talking about treating people with only diet and lifestyle. Other than possibly prejudice and people know more about me than they are willing to admit. I'm talking about doctors having a tradition of being some of the wisest and most knowledgeable people in a community and going to someone's home allowing them to know things about their lifestyle by seeing it with their own eyes instead of taking a history and hoping the patient didn't lie or leave out something important. And we've lost a lot of medical wisdom that will not be available should some version of the tricorder ever empower doctors to take MRIs, x-rays and similar diagnostics to the patient's home in their little black bag. Those traditions are gone, possibly forever, as an unintended side effect of placing tech on a pedestal above human wisdom. I'm talking about diagnosing things effectively, not denying people drugs and surgeries. And I don't intend to reply further because from where I sit, it looks to me like HN is going out of its way to intentionally misunderstand me here lately.
  - lazide 3y ago
    I don’t know why you think I was saying only diet and lifestyle, because I definitely wasn’t? You seem to be imagining that this scenario where the Dr. Goes to your home and gives you something useful was ever a mainstream phenomenon, which as far as I’m aware is just not true. So maybe the issue is not HN?
- 3y ago

dekhn 3y ago

I think this is a pretty thoughtless statement. Ashkenazi women often have genetic mutations that cause them to get breast cancer and the cancer prognosis is much worse than average. This cannot be addressed by diet or lifestyle. However, genomic sequencing detected common patterns that can be tested for, and with that information, women can make informed choices about treatment or other actions, ideally well before they ever have a malignant tumor. I won't disagree that we could do a lot better overall with large-scale changes in diet and lifestyle. But it still would leave a lot of people dying of heart disease and cancer as well as infectious diseases. Those x-ray machines and MRI machines make a huge difference for people with internal injuries as well. No amount of diet and lifestyle will heal a shattered bone.

DoreenMichele 3y ago
That's a wild misreading of my comment.
- dekhn 3y ago
  All the comments I make on Hacker News are done in good faith and assume good will on the part of the person I'm replying to. If you really think I misread, please rewrite what you wrote; as far as I can tell, I read and interpreted it clearly. It's best if you come out and say things directly, while your statement's thesis isn't entirely clear, but I read it as: Flies directly in the face of study after study after study that says: diet and lifestyle are major factors in all deadly diseases. <- yes, this is true. However, it's not a useful statement when criticizing medicine based on technology. Even if everybody in the world had a "perfect" diet and lifestyle, it wouldn't address the majority of diseases at a very large scale. Probably driven by modern tech, completely inadvertently, because x-ray machines and MRIs and such demand that the patient go to the clinic or hospital rather than the doctor going to the patient's home. <- OK, not sure what to say about this other than, it's an unfair comparison; there's plenty of in-home care and in-home doctors can't resolve a wide range of issues at a person's house. It also brings risk to the doctor, as well as causing them to spend their day travelling around. Star Trek's Dr. McCoy and his tricorder was a dream of tech that you could carry in the proverbial little black bag. We aren't there and have forgotten a lot of important principles in the process of pursuing shiny tech. <- actually, doctors and medical researchers, for all that they pursue shiny tech, still mostly have a good appreciation for "important principles". For example, I watched my surgeon count the sponges that they took out of my spouse after surgery, to make sure they hadn't left any in (this was a surprisingly common problem with surgeries). They don't try to make a "sponge detector machine". That's just one example out of millions; if you've followed doctors on Rounds, you'll see that most of what they do isn't technology. But it's generally a bad idea to critique any of that. Gets one nothing but hatred. <- I explicitly wrote my comment to be friendly, fact-based, and make my thesis as clear as possible. If you're going around pointing out that "medical basics that we've known for a while matter", nobody is going to agree with you. But if you attack doctors/medical researchers the way you do, you instance cause people to interpret you as somebody to argue with.

lazide 3y ago

All interventions that don’t require a patient being in a coma first requires patient compliance. Diet and lifestyle are nearly impossible to address from the perspective of the Dr, as they require the patient to want to and be willing to change foundational elements of their life. Unless the patient comes to you requesting that, good luck. Many will get actively angry if you mention even obvious and severe issues like obesity, to the point of slandering Dr’s or avoiding going in for serious issues later. Taking a pill, patients will often be able to do that (but definitely not always!). Getting a surgery, similar. Is it any wonder that Dr’s use the tools that people will let them use, instead of the ones people won’t?

DoreenMichele 3y ago
I have no idea why both of these comments assume that I am talking about treating people with only diet and lifestyle. Other than possibly prejudice and people know more about me than they are willing to admit. I'm talking about doctors having a tradition of being some of the wisest and most knowledgeable people in a community and going to someone's home allowing them to know things about their lifestyle by seeing it with their own eyes instead of taking a history and hoping the patient didn't lie or leave out something important. And we've lost a lot of medical wisdom that will not be available should some version of the tricorder ever empower doctors to take MRIs, x-rays and similar diagnostics to the patient's home in their little black bag. Those traditions are gone, possibly forever, as an unintended side effect of placing tech on a pedestal above human wisdom. I'm talking about diagnosing things effectively, not denying people drugs and surgeries. And I don't intend to reply further because from where I sit, it looks to me like HN is going out of its way to intentionally misunderstand me here lately.
- lazide 3y ago
  I don’t know why you think I was saying only diet and lifestyle, because I definitely wasn’t? You seem to be imagining that this scenario where the Dr. Goes to your home and gives you something useful was ever a mainstream phenomenon, which as far as I’m aware is just not true. So maybe the issue is not HN?
3y ago