Rabies, Ebola, SARS. We have been reminded that some diseases are fatal because we have no treatment for them. But developing a cure is only half the job - the rest is public health in all its aspects, as this update reminds us.
Chronic pain can destroy your life - or is it the other way round? Here's an interesting discussion of chronic pain and how to tackle it. Two morals:
In physics, 'if you can't measure it, it doesn't exist'. But in medicine you probably shouldn't try to measure something until you understand it well.
Be careful when you cross the boundary from one clinical situation (acute pain) to a different one (chronic pain). Of course the trick is to spot that unmarked frontier.
Pain attracts a very high score in most quality of life scores, and hence heavy weighting in economic analyses of utility. So a pain relieving treatment will often get the go ahead from the economists. But what's needed may be a psychologist not an expensive drug. I remember a pain specialist assuring me that simply acknowledging the patient's pain - acknowledging the suffering - may be an effective way to relieve it. And indeed thinking of it as suffering rather than pain may be what's needed.
Michael Pollan's excellent book 'In defence of food' opens memorably:
'Eat food. Mostly plants. Not too much.'
The point is that we can analyse fibre and cholesterol and polyunsaturated fats but what we eat is food. So there is no straight line, in nature, from high blood levels of cholesterol to the humble, cholesterol rich, egg. Things only go awry when the food industry gets to work adding or substracting components we have labelled as healthy or harmful.
All of which came to mind when I read this interesting comment and response.