Tuesday, August 12, 2008

Controversies--6--Darwinian Evolution--III

Scientific theories are known to most men almost exclusively through their applications to their lives. In the case of Darwinian evolution, the most important application has been to the practice of medicine and health care. A little thought will make it clear that there are at least three ideas stemming from Darwin's thought which have been devastating to the practice of medicine and health-care in general.

The first is the idea that man's body is a work in progress. This has resulted in the idea that certain of men's organs and body parts have become more or less superfluous through the process of evolution. Hence, it was the custom for many years to simply remove the tonsils upon the slightest provocation, or even on no provocation whatsoever. Because it has been found that the tonsils do indeed serve a purpose, there is an increasing reluctance to simply remove them when a child gets a sore throat. When I was young, the tonsils were routinely removed. I, and all my siblings, had our tonsils removed. Of my own children, only the eldest has lost his tonsils. Nevertheless, the tonsils, the appendix, the gall bladder, and probably other body organs are seen as removeable without serious side effect, because we have sort of evolved beyond their usefulness. Indeed, our whole attitude toward body organs has been deeply influenced by this thought. The emphasis in modern medicine is hardly what can we do to spare an organ, but can it be removed or replaced. In many ways this has grown almost frightful. Can anyone really believe that it will soon be that people who are rich or important have a right to the organs of those who are poor or unproductive or in some other way superfluous?

The second is the idea that what goes on inside the body mirrors what goes on outside the body. If Darwinian evolution were a company instead of a theory, its motto would be "progress through violence". Just as life in society is viewed in the Darwinian world view as "survival of the fittest" in a "dog-eat-dog" world. So what goes on inside the body is viewed as a constant struggle between body parts that, for the most part, are kept in control when you are young or if you have very good genes, but as you age, or if you are genetically unlucky, parts of your body begin to overcome other parts. Your white corpuscles eat up your red corpuscles or vice versa. The sodium begins to overpower the potassium, the body cells in one part of the body become renegades and begin overpowering everything, one organ begins doing the work of another, and so on. And, of course, there is the ever on-going relentless struggle against germs of all kinds. This kind of thinking has so predominated our thinking about medicine and health that we almost worship youth and youthfulness. It seems impossible for us to believe that there are actually societies that revere age, not only for its wisdom and experience, but because, until extreme old age, the elderlly are the most productive and healthiest members of society.

The third is the idea that live at every level is reducible to physics and chemistry. This has led to the belief that life can be restored and even enhanced through physical and chemical means. Of the three ideas, this is the most destructive. It, more than any other idea, has led us to believe that we can live irresponsibly, and that with a pill, or an operation, be restored to "my old self".

The tragedy of this thinking is that we spend more time and money in escaping the consequences of poor choices than in correcting a poor lifestyle. Medicine has become an endless quest for new cures rather than a study of what we must do to live healthfully.

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