The path of non-conformity
BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5036 (Published 07 August 2014) Cite this as: BMJ 2014;349:g5036
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Albert Einstein wrote many years ago that “a perfection of means, and confusion of aims, seems to be our main problem.”
There are three vital parts of this editorial. The first one is about courage. I must admit that I will not have the courage to look after Ebola patients. I respect those that offer to help those patients. They are our real heroes unlike the heroic surgeons amongst us who operate taking great risks, not for themselves but for the hapless patient in the hero’s role.
Mercy killing is beyond my comprehension as birth and death are definitely not in our hands. The so called science cannot answer those esoteric questions. Peter Medawar in his classic, Limits of Science, (1) so aptly wrote that our science is not designed to answer those questions.
As a physician-cardiologist treating patients with vascular diseases for nearly half a century I have definite views on statins as panacea for many human ills. We have an electronic data base which highlights statin dangers, which are innumerable and many of them are not even seen in the so called reductionist scientific evidence base which is being touted to be the foundation for selling statins as a preventive strategy. I have serious doubts about our data base itself. Long term follow up turns all our data upside down. The 25 year follow up of MRFIT study (2) showed that there are no real risk factors while there is the real risk of precocious death. Altering the risk factors might not alter the real risk!
The almost one hundred years follow up in both The Grant study and Terman studies (3) did not even mention any of the risks that we are talking about. The very ingenious way of using the English language in Ben Goldacre’s editorial in BMJ: "Without such innovation in the use of medical data, we can say only that statins are—broadly speaking—likely to do more good than harm. That is not good enough." (4) Do two negatives make one positive? The essence of communication is to understand the reader and trying to be understood by the reader. The above sentences will only further confuse the reader. Reminds me of what E. F. SCHUMACHER wrote: "Any intelligent person can make things bigger, more complex, and more violent. It takes a touch of genius and a lot of courage to move in the opposite direction." Einstein’s above statement makes lot of sense in this background.
In simple English statins are dangerous drugs and will have to be used sparingly with caution is my considered opinion. The new blood thinner, dabigatran, also belongs to the same category. “Your intellect may be confused, but your emotions will never lie to you, “wrote Roger Ebert.
References:
1. Medawar P. Limits of science. 1988 Oxford University Press.
2. MRFIT study. clinicaltrials.gov/show/NCT00011206
3. The grant and the Terman studies. english.farsnews.com/newstext.aspx?nn=13930410000132
4. Editor’s choice (BMJ 2014;348:g4745, doi:10.1136/bmj.g4745)
Competing interests: No competing interests
Sadly, the professions are Procrustean beds of peer pressure and neophobic conformity. This is counter-productive because art and science advance by dissension, as well as consensus. So let's stop cloning the status quo, and instead promote real progress by including the disaffected, because they understand that peer pressure is an impediment to progress and conformity is a deformity.
Competing interests: No competing interests
Dear Dr Abbasi,
The so called humanitarian crisis in Gaza pales in comparison to the loss of lives in, to mention a few places: Nigeria where Boko Haram is massacring Christians, The Central African Republic where there is also a genocide against Christians , Libya, Sudan, Syria where the ongoing conflict has claimed 180 000 lives, Afghanistan, Iraq, Ukraine, and the list goes on and on. ISIS is going into villages and cities in Iraq and Syria and beheading people and forcing genital mutilation on the female population of whole cities such as Mosul and converting Christians by the sword. There used to be 160 000 Christians in Mosul and now there are less than 1000. By definition a genocide is being perpetrated right now against Christians in the Middle East and in central Africa. I am, therefore, interested to know why you have singled out the so-called humanitarian crisis in Gaza as opposed to any of the other places that I have mentioned.
It surely isn't based on the number of lives that have been lost in Gaza because by any rational accounting 100s of thousands of lives are being lost in other ongoing battles. Are Christian lives less important? Or is it that there are Jews involved in a defensive war against terrorists in Gaza who choose to protect their ordinance with civilian human shields? Please enlighten me. As doctors we should be concerned by any loss of life, and the more lives that are being lost, the more concerned we should be. While the media has chosen to pretend that since the conflict in Gaza arose there are no other conflicts going on in the world, it is precisely at a time like this that a medical journal should highlight the fact that there are far more serious conflicts happening around the world and infinitely more lives being lost. Our concern for the loss of lives should be free of any agenda other than to prevent the loss of lives - if that is the case, the conflict in Gaza in terms of triage would be at the bottom of the list.
Competing interests: No competing interests
Re: The path of non-conformity
You do not need courage to be a nonconformist. You just have to have contempt for the common herd.
Today, even Archbishops and Popes surrender to the whims of the populace. Our congregation does "this". Therefore we will do "this". For a millennium or more our orthodoxy has frowned upon certain practices. Now the orthodoxy just smiles.
We know alcohol is bad for us. Yet we smile upon distilleries. We know teenage sex is bad for you. Yet, we simply provide contraception and yes, HPV vaccine.
We know tobacco is bad for us. Yet we do not ban its cultivation in the EC, Africa, India. The speciality of Public Health at least should call for action on lines suggested above. Or, it should tell us where I am wrong.
Competing interests: A free spirit, congenitally (but not genetically ) non-conformist