MAIN IDEA:

In this book, the author reviews the history of medicine as a profession and very convincingly demonstrates how far away from science were typical methods of treatments and even overall approaches to all kinds of medical problems. For the first few thousand years of documented medical treatments, doctors killed by far more people than they healed. The author also describes real progress in medicine achieved in the last 150 and how it really helps in healing. Here is how the author presents his conclusions: “Before 1865 all medicine was bad medicine, that is to say, it did far more harm than good. But 1865 did not usher in a new era of good medicine. For the three paradoxes of progress—ineffectual progress, immoral progress, progress postponed—are still at work. They may not work quite as powerfully now as they did before 1865, but they work more powerfully than we are prepared to acknowledge. There has been progress; but not nearly as much as most of us believe.”

MY TAKE ON IT:

I think that the author’s approach and conclusions are very valid. Yes, there is real progress and medicine, so lots of people did not die from appendix or smallpox. However, this progress is much more limited, and many treatments are still pretty much in the dark ages: relying on authority instead of factual data, treating patients with the primary objective of making money, rather than making patients healthy, and so on. It is probably inevitable as long as doctors depend on the money flow from patients either directly or indirectly via the government. Actually, consciously or unconsciously, but doctors have to aim to keep patients in a condition somewhere between being healthy or being dead. Neither healthy nor dead people produce income for doctors. I have experience with two organizational forms of medicine: Soviet 100% government care and American somewhat private healthcare. This experience demonstrates that in the Soviet form when doctors depend on government salary, the objective moves a bit closer to a patient being dead, albeit doctors’ humanity and character somewhat tempered it. The American form has more space for this humanity because there are no Soviet-style directives like not treating anybody older than 60. After all, it is a waste of resources. However, the use of the medical treatment as a money pump is very pervasive. In short, one has to remember that there is always a conflict of interests between doctor and patient: the doctor needs the patient to be moderately sick and pay lots of money, while the patient wants to be healthy and pay as little as possible. On the bright side, they both want to prevent the patient from being dead.