Science and medicine, when nobody knows…

I always wonder about the limits of our knowledge. Socrates has shown millennia ago the limitations of conventional wisdom. The scientific method is more robust, but it is also limited. Not understanding something well enough is not ideal. Watching people die without any reasonable explanation is even worse. What can be done? Read some more here, here, here, here, and here.

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Medically unexplained symptoms

This is actually a diagnosis for people dying without providing any medical cues. They just died. And I am not talking about doctors too lazy to perform an autopsy, but about autopsy leaving the doctors clueless.

This happens much more than we think. Recently my cat died. She was 12 years old. Active and passionate. When she died she looked perfectly well. There was a sort of a smile on her face, after all, she was of British breed. I took her to the vets, and they tried to resuscitate her. Nothing helped. MUS. Medically unexplained symptoms.

Humans die of MUS just like cats. Typically nobody cares to check. “Maybe there was a stroke. Or possibly the heart stopped suddenly. We cannot exclude severe analeptic shock. Better pay your last respect, cremate of burry her as she deserves”.  Not just cat owners get this medical recommendation. Usually, we do not care to learn more, and the medical tools we have do not show more anyway. She is gone…

I talk as if I know

People often catch me talk about the subjects as if I know them. When asked deeper I stumble. I go back to the comparative study I used as my reference. It sends me back to the original study which was used by it. And then to the fundamental study of the particular paradigm.  And then nothing…

I cannot run the fundamental experiment. What if it was faulty? I cannot do anything about it.

There was a certain Nasa experiment showing a very strange propulsion system. Nobody understood how or why the propulsion system was possible, so it was called an impossible drive. After 30 years of independent testing, an issue was found with the experimental setup generating a resonance in the measurement tools. The impossible drive was indeed impossible.

Could I or anyone else know about it beyond speculations? I am not sure.

Newtonian mechanics

Physics is the most well-behaved of our sciences. Experiments are large-scale, repeatable, and mathematically sound. Already in the 17th century, Newton explained almost everything we needed to know. There were some minor issues with the data tables. Several French mathematicians invented a new kind of differential calculus and explained the motion of celestial objects. Everything was clear… only…

There were some strange phenomena in some resins. And why do we see lightning? Fast-forward to 19th century. Add the electromagnetic theory, which was pretty huge. And there was nothing for scientists to explain. Everybody knew that the electromagnetic waves moved in ether. All was left to do: find the ether.

Only no ether was found in several experiments. Moreover, electromagnetic waves strangely behaved like particles. When adding the theory of relativity and quantum theory the scientists already were puzzled. The theories made very little common sense and did not work well together. Black holes and gravity waves are strange objects, that required 100 years for the right equipment to be ready.

During these 100 years we discovered weak and strong forces keeping the atomic nucleus together and causing it to break. And we built some standard theory for somehow expanding the known universe.

Only now we do not find 70% of the energy and 70% of the matter that should have been there. And there is some strange new force causing some particles to misbehave.  Oh, and our devices cost 10B each to build.

The funny thing is: we still use Newtonian mechanics for the vast majority of our activities. We even use outdated principles to explain our intuition. We kind of know that they are wrong, but they provide a damn good approximation.

How much do we know in medicine?

Physics is the most well-behaved science I know. Psychology is the least well-behaved science I am aware of. I would place medicine somewhere in the middle.

Medicine is very important since we naturally want to be healthy and live. While a government can pay 10B USD for an accelerator or a fusion device, and several governments can pay 100B USD for a space station, healthcare expenses can be counted in trillions. And we do not need huge devices for that. Maybe except for the genome sequencing project.

Yet medicine is extremely frustrating. Doctors do not know why things work, and most of our big discoveries were discovered by mistake. And the rest is possibly illegal.

1. Placebo effect. It is there. It heals EVERYTHING. Often better than the actual medicine. Nobody knows why.
2. Antibiotics. Were discovered by mistake. Are the most potent tool in our medical arsenal.
3. Genetics. Probably very important: our blueprints in computer-readable code. We have permission to check some of it.  We even tried to patent stuff. Some of the research is illegal. And much more is not even understood. Epigenetics, anyone?
4. Anesthesiology. The highest-paid job in the USA. Possibly because the drugs are so damn good and addictive. Most of our operations are painless. Occasionally patients do not wake up. Sometimes it is a mistake. Other times nobody knows.
5. Euthanasia. Almost everybody wants it right before the actual death, when in pain, possibly dementia, and without a cure. To preserve some decency and reduce suffering. Highly controversial and highly illegal.

The Optalgin I take against headache is illegal in the US. The melatonin I take to sleep better is illegal in Israel. The food supplements I take to function better are not scientifically sound…

Do you know that studying anatomy was highly illegal 500 years ago? And you kind of understand that only 100 years ago doctors started to help more than they harmed? How much do we really know?

Notice that the medical establishment is financially interested in treating the symptoms and not letting the patient die. Preventing suffering is important as a path to more complex and costly treatments.  What about preventing the disease itself? Doctors are humans and they want the best for everybody, but there is a very little financial incentive for that.

Psychology

In medicine, we at least know what to measure. Psychology does not have clear anatomy or a periodical table of behaviors. Maybe there is a theory of the big five character traits, but even that theory is in question.

What we have are millions of experiments in different settings with known results. Changing the settings generates different results. We do not understand the results, so we generate very complex theories.

Everybody has theories. These theories are fun. Some of them produce ideas that actually work. We can practice and improve memory, perception speed, creativity, decision-making skills.

To be honest we do not really know how everything works. We do know that certain drugs, food supplements, meditative tactics, and coaching is extremely effective. And we have some forefathers.

Freud provided mythology which is very interesting, but not scientific in any way. Hysterical women simply needed sexual gratification – not strange medical theories.

Pavlov made extremely important scientific experiments, that were highly unethical. Dogs and orphans suffered and salivated.

Skinner trained animals and measured their responses. The attempts to weaponize these experiments failed.  Fortunately, the bats did not burn Tokyo and the pigeons did not activate smart bombs. So this is good science.

Kahneman and Tversky wrote wonderful books about cognitive biases. These biases are fantastic for further experiments. Now, how do we eradicate them? By using algorithms instead of people?

Humanitarian studies

There are huge faculties in good schools dealing with scholastics. Comparative study of arts… Counting the words of the Bible. Trying to understand who influenced Shakespear… Is that even science?

I love literature, arts, history… But then I also love greek mythology. You cannot apply any scientific experiment either way. Maybe communists can… How many people died in China during the Great Leap Forward?

What did we learn from our political sciences? How effective demagogues can cause any crazy person to become the most powerful person in the world? Was that good for the people ruled by those demagogues? The USA was built according to religious masonic doctrines, and so far it is arguably the best country ever!

Do not get me wrong. I think that humanitarian studies are a great intellectual exercise. And I personally enjoy the results and love the people who produce them. Only I would not call their methodology scientific.

So we do not really know, do we?

Ask six questions looking for the root cause of any phenomena and you are likely to hit something we do not know or understand. This does not stop us in any way. Our technology is very effective, even if we do not fully understand it. The assumptions and approximations we use enable us to improve our technique. We may be able to state certain correlations, and maybe even to show causation. This makes us very capable. We are a menace to ourselves and the planet earth.

Does it make us wise?

Do we fake our knowledge the same way people used to fake when Socrates walked the earth?

Why do we even need to claim scientific soundness? Isn’t clear engineering or clinical efficiency enough?