This started off as a reply to Laura, but it grew so long it was rejected. How did I get so long-winded? (LOL)
It's taken me a while to get around to drafting this; we've had the flu here lately (yuck). But Laura IS right, there can be NO doubt that the pharma money is a major problem. And on a certain level, I agree that it's true that non-scientist parents shouldn't have to turn into scientists.
But ... then again ...
I am increasingly skeptical about the ability of institutions to deliver the things we intend from them. On the one hand, there are a lot of efficiencies to be gained from the type of society we have constructed here today -- increased specialization and all that. And I love (sort of) this idea of a great body of experts dedicating themselves to an issue, problem-solving, and coming back to us with these great state-of-the-art solutions/policies/proclamations that will tell us what to do. Meanwhile I can go join a different body of experts, right? It's just that there are certain costs I think to such a construct.
It's a bureaucracy ... it will have its own politics. It's a group of human beings ... therefore, it (they) will care about things like image, prestige and status. They will have their own group identity, and group members will probably eventually grow to care more about the opinions of the others in the group than anyone (or anything) else. They will develop their own culture, their own framework for viewing the world and the problems they work on. They will resist any suggestion that they look at the problem from another perspective. Stuck inside the system, they will struggle to see the problem from any perspective except that which they were taught. I am exaggerating somewhat here, but I think this is true.
For thos of us who are lawyers, how hard is it to think about a "legal issue" without "thinking like a lawyer"? How hard is it to explain the law ... REALLY explain it ... to a layperson? Now, I realize that law is not science, and so scientists have a certain advantage in being able to keep their frameworks more or less in line with reality. But I am skeptical about their ability to resist utterly what I see as the natural forces of human nature, which will keep them from always getting it right.
And there will always be a limit to the extent to which the policy decisions of a large political body charged with making decisions for a society as a whole are going to be best for a particular individual, whether they are based on science or not. I think really that the vaccine is a perfect example of that. My friend, the infectious diseases fellow, tells me (and I hope I am accurately representing her here) that you know, what the policymakers and even the community of physicians she belongs to as a whole worry about most is the herd immunity of society in general. For them, the cost-benefit analysis is very different. They want every child to get that vaccine so they can save a certain percentage of lives, even though they know for a fact that a smaller percentage will suffer side effects.
What I believe is that just like everyone else, these people "spin" what they say in the hopes of manipulating people into doing what they want. I do the same, I'm sure. It's human nature. So they downplay the risks and emphasis that the benefits outweigh the costs, yet I really think that their math here is society-wide. Of course it is, because their pronouncements are society-wide.
They count on individual physicians, perhaps, to step in and help patients with the case by case decisions as to whether or not to vaccinate. And this would make sense, if most people had physicians who were as smart as they should be, as dedicated as they should be, as well-rested as they should be ... but the reality is that most of us get herded in and out of those offices like cattle.
So many doctors have all convinced themselves that because they are smarter than the rest of us they can smell what's relevant and what's not in under 30 seconds and they don't have to review the file. It rarely if ever occurs to them that there could BE anything relevant that they didn't learn about in medical school or hear about in their continuing educatino class.
Regular pediatricians are reading the same press releases as everyone else, and how much do most of them know about autoimmune diseases or autism spectrum disorders? My mother (the psychiatrist) says most doctors never understood immunology and didn't do so well in these courses in medical school. Not until recently did I ever wonder what my physician's medical school transcript would look like. It's not like they all made As in everything. I don't know where you went to law school, but I went to a mid-ranked school where by definition half the class made a C or below. I think that everyone in medical school is so smart, and medical school is so hard, that just because they made a poor grade does NOT mean they didn't eventually master everything. I think probably most of them made some poor grades in SOMETHING. They probably had to, because medical school imposes some expectations that probably aren't realistic. But my point is, that what I'm sure is true but I never contemplated before, is that every physician you ever see has weaknesses, gaps in his or her knowledge. The real question is what are they? And will he or she admit it to you? To him/herself? Because that's the key.
I guess what I'm leading up to is that the older I get the more I realize that I have to take responsibility for my own health decisions, as poorly equipped for it as I am. Maybe I need to get better at picking doctors, I don't know. But I will never again have the kind of faith that I had even at age 30.
Thoughts on Newtown
4 years ago