The rise and fall of modern medicine by James Le Fanu

This is a great book. It's a great read and I feel that I have learnt a lot from it. Le Fanu is apparently a GP in London and also does freelance journalism for various newspapers such as the Daily Telegraph (I hate the fucking telegraph but he is a good writer).

In this book Le Fanu looks at the scientific development of medicine throughout the 20th century analysing key advances such as antibiotics, steroids and intensive care. He points out how many of these advances have been 'lucky accidents' as opposed to the result of structured scientific research. Millions of lives have been saved by luck (although a lot of hard work has supported that luck).

He also goes on to discuss the blind alleys that medicine has wandered down in the later decades of the 20th century. In particular he singles out the social theory of disease and the empty promise of genetics as dead ends. I have a sneaking suspicion that Le Fanu's assault on the social theory of disease may be motivated by his political views I do agree with some of his opinions on epidemiology. Sociology took up six months of time at my medical school that I feel may have been more usefully spent on pharmacology or something. Most of the sociologists that I had the misfortune to encounter were dogmatic lunatics (although some were nice enough).

He makes interesting points about how genetics has not really paid off in a useful way in day to day medical practice. His discussion of the rising discontent among doctors is echoed in todays headlines. Many junior doctors now regret their choice of medicine as a career. The ranks of the 'worried well' seem to swell every day.

Medicine is stagnant. Drug companies play it safe by repackaging old drugs to increase profits. New research is on the back burner because it is dangerous (think of the men involved in the Northwick Park incident last year). The medical progress that we see is analagous to a 20 mile run on a treadmill. It's going nowhere.

'Genuine progress, optomistic and forward-looking, is always to be welcomed, but progress as an ideological necessity leads to obscurantism, falsehood and corruption'.

Think about it the next time you talk to a drug rep about the latest treatment for osteoporosis.

funky