>In other words, most causes of death other than the aging diseases are
>identifiably external, with effective treatments available. The progress
>against aging a.k.a. entropy accumulation diseases [specifically cancer;
>several of the cardiovascular diseases appear to be treatable with a
>moderately(?) low-fat diet--15%. [cf. Ornish, etc.]] is much less
>dramatic. Survival rates for most cancers seem to not be changing that
>much, yet. [Competent genetic engineering would help with the cancers,
>at least. "Come back in a month. We'll have a shot of Editor ready then."]
>
>I hope the phamaceutical companies find an antibiotic [or something
>equivalent] effective against those bacteria which are simply immune to
>all known antibiotics [as of 9/1/96]. If the resistance genes were to
>spread too fast first [courtesy of natural selection i.e. Elementary
>Differential Equations], things could get really interesting...
"Why Things Bite Back: Technology and the Revenge of Unintended
Consequences" by Edward Tenner was published this year by Knopf (New York,
1996). I think it's a good addition to the others I've recommended about
technology and the human condition. Tenner discusses medicine, natural
disasters, pests (animal and plant), the computerized office (RSIs anyone?)
and sports. His specific focus is the way in which advances which seemed
to promise solutions may result in even worse situations, as in DDT and
filtered cigarettes which encourage people to continue smoking because now
it's "safer"
His thesis is that many advances in technology do not provide us with the
ability to solve our problems but rather to distribute them in time and
space. We move (to paraphrase) from acute, catastrophic problems to
chronic ones. For instance, high smoke stacks on factories and power
plants end the industrial revolution's scene of sooty, smoky brick
industrial "parks"...and lead to acid rain. Static precipitators placed on
top of these stakcs in the 80's and 90's may actually be exacerbating this
process by removing the soot particles form the air that used to combine
with the sulfur and nitrogen compounds to produce non-acidic products.
In health the problem is similar. Medicine is good at dealing with acute,
catastrophic problems like gun shot wounds (thanks to generations of
military medicine) and virulent bacterial diseases like small pox and
gangreen. What it is not so good at is chronic, systemic problems like
chronic fatigue and carpal tunnel syndromes.
Most patients in the past didn't die of the disease they suffered, but
rather of a secondary opportunistic infection like pneumonia (reduced to an
uncommon occurence by sulfa drugs and penicillin). About the only time you
see this happening these days is with HIV infection and some cancers. We
solved (at least temporarily) the immediate causes of death by trauma and
infection...definately a plus...but those successes led us to the belief
that eventually medicine would/should bring us all perfect health (the high
water mark of this sentiment had to be just before Clinton's UHC policy was
defeated in congress).
Believe me, the chemists are working on new antibiotics. Don't hold your
breath for a new revolution, though. One problem is these days when a new
drug comes onto the market it gets prescribed so much (since it is very
effective initially) that it rapidly looses effectiveness. Also, many new
antibiotics are simply derivatives of old ones that operate by the same
mechanism...such derivatives are mare easily resisted by simple mutation.
Antibiotics is (like most things) not a technical, but a social problem.
1) Doctors shold prescribe antibiotics less and only for seriously
debilitating infections; not for colds, flus, and ecsecially not for zits
(the effectiveness of tetracyclene in now almost nil thanks to this).
2) People should follow the damn directions. Take all the pills, even if
you feel better, to ensure that you kill all the bacteria before they have
a chance to aquire resistance.
3) Silly surgery like liposuction and breast enlargements should be made
illegal. Surgery always involves antibiotics to prevent infection.
There are already tuberculosis strains immune to Vancomycin (the
"antibiotic of last resort" used when all else fails). If the medical
industry doesn't get it's ass in gear (Good Luck!) then look for the return
of "Terminal Wards" where people with incurable and debilitating infections
get stored until they die.
The best health advice is to eat well, don't smoke, don't binge drink
(well, not much, huh?), sleep on a regular schedule, and avoid hospitals
(which have a tendency to concentrate resistant strains of bacteria) but
don't avoid doctors (get regular health check-ups...early detection makes
most health problems much easier to resolve) live an active lifestyle and a
moderate body weight. Wear your galoshes when you go out in the rain and
take it easy when you get sick.
The fact that these suggestions currenly seem at odds with my lifestyle as
a graduate student doesn't worry me in the least, as I am in denial.
Reed
Reed Konsler
konsler@ascat.harvard.edu