Comment by xtracto | Hacker News Reader

Comment by xtracto | Hacker News Reader

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I got to half of it so far (will deffo watch it later).

One thing that struck me was the mention of what I call the "destructive" paradigm of medicine.

If we look at most current medical procedures, they are barbaric. Chopping stuff mainly.

How do you fix a fissure in the anus? LIS: Chop a bit of the sphincter and hope it heals back.

How do you fix GERD? Make a knot in the esophagus.

How do you fix Crohns? Chop the bowel and open a hole in the stomack .

Dont get me wrong, I applaud all the stuff current medicine helps with. And I'm far from a radical anti medicine . .

But those things make me think that in 500 years, people will turn back and see these sort of procedures the same way we see now how our ancestors treated bacterial infections: intentional bleeding, using leeches and other similar medieval procedures.

We as a society should start puahibg for more constructive or generative medicine. As the Guy in the video says, fixing the problem instead of alleviating the symptom.

I haven’t watched yet but this seems highly selective. There’s so much creative building in medicine, from what’s done in orthopedics with rebuilding joints (often using a patients existing tissue with new hardware) or with reconstructive surgery, etc. if you consider medicine more broadly to include pharmacology or therapy then there’s more room for constructive creativity.

Brain surgery might be particularly skewed toward feeling barbaric. They are cutting a hole in someone’s head and digging around in brain tissue, often permanently removing tissue or skull. In 500 years time I assume they’ll give you a small drink of nanobots which find their way to the problem and solve it at the microscopic level. Until then, pass the bone saw.

"If we look at most current medical procedures, they are barbaric. Chopping stuff mainly."

One has to agree with your view, at least partially. I've heard it said that surgeons are akin to carpenters—some are skilled craftsmen who craft fine furniture, others like builders whose skills are pretty much limited to joining bits of 2x4s but none of whom know the underlying mechanism of how trees grow or how they produce wood.

Nevertheless, with the fusion of modern chemistry, a refined understanding of biological processes, and advanced computing and specialist manufacturing techniques (micro sensors etc.) we're just now beginning to see the end of some of the 'chopping'—or at least how in the future we might end it.

I've been around for quite some decades so I'm unlikely to benefit from any new technique—they being too immature for deployment—but on current evidence those who are around in 50+ years are very likely to do so.

How do you fix a fissure in the anus?

A: Rectal Glyceryl trinitrate

How do you fix GERD?

A: For the majority of people weight loss and dietary changes will do the job

How do you fix Crohns?

A: You don’t ’fix’ Crohn’s per se as there is no cure. But most people with Crohn’s can be have their disease managed well with -mab medications

In all those conditions you named surgical management is very much at the end of the list and for a minority of patients who do not respond to the above. The first line management in all of these conditions very much does look at ‘fixing the problem’ contrary to what your espousing.

Reminds me of Star Trek IV where Bones cures a woman’s kidney disease in the 80s and rhetorically asks if it’s the “Dark Ages”.

https://youtu.be/_R_WbAhKyAk?si=KSnC6OYJArhnKe0W

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