Our ability to understand and diagnose far outpaces our ability to do anything about that understanding…we’ll know more and more about what’s wrong with you, but we won’t be able to do anything about it. Doctors have pills and scalpels…that’s it. The FDA approved less than 10 new drugs in 2009. About seven in 2008. Our ability and technology to treat hugely complex problems is dwindling. There aren’t any magic bullets in the making in any of the big pharma companies. Our bodies are far more complex than anything we’ve ever known in our universe and reductionist thinking is no match for the multitude of complexities that can be found in our bodies with 30,000 genes and billions of different ways each of those genes react as a system within every individual’s body. Pills aren’t going to save us. Genetic engineering may save us, although I highly doubt it.
Stephen J. Gould described a concept called punctuated equilibrium that describes a theory on how species evolve. It basically says that most species experience little evolutionary change over time (an alligator has been the same for hundreds of millions of years), and new species branch off in these very rare, rapid events due to a special sauce of random events in the environment and in mutations in a few individual members of the species that creates a new branch of plant or animal.
I bring this up because I think medical treatments are sort of in this evolutionary stasis. There simply hasn’t been that many magic bullets developed in the past century beyond clean water, vaccines, and antibiotics. I’m still waiting, and watching for, this special sauce in the tech and biology world that creates whole new opportunities for rapid, massive advances in our ability to do anything about our ever-improving ability to diagnose.
But at this point in the history of medicine, we’re turning into expert diagnosticians with very little ability to do anything about what we diagnose.