The paradox of contemporary medicine

Abstract

In the medical field, between the end of the 19th century and the half of last century, great results were obtained in the discovery of the causes (microbial agents) and cures (antibiotics) of infectious diseases, which in the previous centuries had determined catastrophic epidemics. The successes of this model of disease led to apply it in the cases of other pathologies including cardiovascular, respiratory and oncological ones. Despite the great effort during the following years, with all the innovations both in diagnostic field (sophisticated lab and instrumental tests) and in therapies (the development of numerous heart and circulatory drugs or against neoplasia), improvements have been proportionally less impressive. Compared to the first half of last century, 27 years of life have been gained, from an average life span of 55 years to 81 for men and 84 for women. The 17-year gain has been possible thanks to the decisive action on the infectious diseases, whereas the intervention on heart diseases led to a gain of 7 years of life, and that on the neoplastic ones resulted in a gain of 3/4 years. This discrepancy depends on several reasons, among which a fundamental one is the difference between the models of the infectious disease and other pathologies: the first ones are characterized by only one agent attacking the organism in a short time and can be eliminated only by one drug (the antibiotic), used for a short time as well; in the case of other diseases, the pathogens are multifactorial, the damaging actions take place over many years and possible therapies must be multiple and performed over a long period of time. There has been a shift from a simple to a complex issue, to the extent that some believe that only new technologies of artificial intelligence (AI) will be able to offer effective remedies. If we add to all this the idea that for several reasons, both socio-cultural and inherent to this discipline, Medicine has been taking on more and more reductionism and detached stands, one might understand the current perceptive paradox We have never been better, we have never felt so bad. Thus, it has become necessary to meditate upon these topics in order to better understand the real problems and possible solutions to the benefit of that essential good for everyone, our health.