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Modern life and medicine

Science
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Physician treating a patient (480–470 BC).

Can our ancestral medical progress keep up with modern life? Naomi Elster asks.

Devised around 400 BCE, the Hippocratic Oath is a reminder of how modern medicine is built on ancient knowledge (also a reminder that we are indebted to Greece for medicine, learning and democracy, so maybe we should call it quits as far as financial debt is concerned).

Can all of the medical miracles wrought by our ancestors keep up with our fast-paced modern living? Maybe it’s time to slow down and think about whether we in the Western world have stopped appreciating medicine as we should.

I don’t know who first coined the phrase ‘wonder drug of the 20th century’, but plenty of pharmaceutical companies have rushed to claim it, for medications as diverse as cholesterol-lowering statins, the anti-depressant Prozac, and that failed heart drug which became a blockbuster when scientists started wondering why the men on the failed clinical trial were so reluctant to give the pills back (Viagra).

The original ‘wonder drug of the 20th century’ was penicillin, which belongs to a class of antibiotics called beta-lactams. Beta-lactams kill bacteria by attacking the cell walls that surround and protect them. Because bacterial cells are so different from ours, an antibiotic can obliterate unwelcome bacterial guests from our bodies and leave us unharmed. Win-win, until the development of antibiotic resistance, which has been described as ‘as big a threat as terrorism’.

Bacteria live fast and die young, evolving at dizzying speed. Thanks to what evolutionists call selective pressure, if just a few bacteria in a large population learn to avoid being killed by an antibiotic, soon, many more will have adapted along the same lines, and suddenly we have ‘superbugs’ like MRSA spreading like wildfire around our hospitals.

The rise of antibiotic resistance is partly down to the ability of bacteria to quickly adapt and change in stressful conditions. But it was triggered by society: a major culprit was industrial farming. Beef farmers, hoping to beef up their profits and prevent disease in their herds, gave their animals a constant, low dose of antibiotics, not enough to significantly kill bacteria, just enough to stress them and induce selective pressure. And, because they were cheap and low in side effects, antibiotics were over-prescribed for decades. Taken just in case a viral infection (antibiotics useless) paved the way for a bacterial one (antibiotics needed), given so that a worried patient could have the reassurance of a pill to swallow.

‘Germ theory’, the idea that diseases are caused by micro-organisms and can be prevented with hygiene, is rightly considered a turning point in human civilization. But are we living too cleanly? Allergies are our immune system recognizing a non-threat (like pollen) as a threat and overreacting. Through indoor living, we’re less exposed to ‘good bacteria’, like those that train our immune system to work properly. This might be causing allergies to increase.

With comfortable lives far removed from some of the terrible diseases our ancestors feared, and which those in less-developed countries still face, I think we’ve forgotten why we invented vaccines and how they changed our world.

In the late 1990s, a single, fraudulent, scientific study reported a link between the MMR (measles, mumps, rubella) vaccine and autism. This ‘research’ was completely and quickly discredited but despite a lack of evidence for any harmful effects of the MMR vaccine, or a link to autism, the fear persists. This is fuelled in part by our current media and social media giving former Playboy models who oppose vaccines as much of a platform for their views as medical experts who know the vaccines’ benefits.

A Canadian father wrote a powerful open letter when he feared his infant daughter had contracted measles from her unvaccinated peers. ‘Vaccination is not a choice: it is a social responsibility… your selfishness (or perhaps more accurately, the fact that you are a fucking moron) has put an entire new generation of children at risk to contract diseases that had been a non-issue for more than 100 years.’ Measles has claimed children’s lives in Britain, and in June this year, a Spanish child died from diphtheria, a gruesome disease that hadn’t been seen in Spain for 28 years. Unsurprisingly, the 6-year-old’s parents felt tricked by the anti-vaccination movement.

When my grandparents were ill they hesitated to ‘bother the doctor’, and in the village where I grew up, the older generation speaks of doctors in hushed, revered tones. This attitude is obviously not good, but perhaps sometimes a little more respect for people who spend years of their life educating themselves about health and disease would be to all our benefit. Last year I presented research – years of hard work by a team of experienced, highly trained scientists – and a member of the public belligerently introduced himself with ‘I know you think you’re a researcher but I’m a researcher, same as you,’ and announced that the doctors and scientists at the event were wasting our time. The Ancient Aztecs routinely cured themselves of cancer by chewing cannabis. This man’s ‘research’, by his own admission, was a few hours on the internet, and his grandstanding meant that genuine cancer patients and survivors didn’t get the opportunity to speak with us.

He left before I could ask him if a race which practised cannibalism and human sacrifice and had a low life expectancy was really the best model for a modern healthcare system.

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