Thursday, 7 July 2016

Barbaric Medical Practices

In Star Trek, The Original Series, the pilot episode, not seen until many years after TOS was done, was called "The Cage". It was basically about aliens who could control minds, making people see and feel what the aliens want them to see and feel. This episode actually became a two part show in the very first season. It was called "The Managerie".

In that two part episode, the original captain of the Enterprise, Captain Pike, has been seriously deformed and burned in an accident. He is trapped in a fancy looking wheelchair with a red and green light. Red for no, green for yes. That's it. The Star Trek crew, now lead by Captain Kirk, take Captain Pike to Talos, where the Talosians affect Pike's mind so he looks and feels strong and healthy once again, to both the crew of the Enterprise, and to himself. But Pike has to stay in his cage, in the managerie.

A few years later, in 1986 to be exact, the movie, Star Trek IV; The Voyage Home came out. In that movie, Chekov is hurt and has a possible epidural hematoma, a bleeder in his brain. The 20th century doctors want to drain it using trepanation. Dr. McCoy sneeringly describes their attempts to save Chekov as "barbaric", and uses his tricorder to resolve the problem. In the same episode he gives a woman a pill to help her grow a new kidney, eliminating the need for dialysis or a transplant.

There are a few really interesting things about the maturing view of technology from 1966 to 1986. It's interesting that all they could come up with in 1966 for Captain Pike was a fancy wheelchair. It was up to the aliens to come up with some sort of resolution, and even that wasn't a physical change, but an illusion, the maintenance of which required that the good Captain stay in what was essentially a cage where he could keep his healthy image of himself.

Then, 20 years later, the ideas of non-invasive solutions to both a kidney problem and a brain injury were the standard, if not in the present at least in 2286, the home setting for the crew of the Enterprise. In those years, medicine matured sufficiently in present times for people to postulate something truly different 200 years in the future, and the audience was able to see it not only as possible, but to see the humour contained within the sneer of Dr. McCoy. I remember the audience laughing as he snorted "barbaric".

We are barbaric, and remain barbaric, especially when it comes to ALS. A broken bone cannot be healed. All we can do is set it, cast it, and wait for nature. A kidney cannot be healed. All we can do is replace a bad one with a healthy one from another person. There has been progress in the last 200 years, for sure, with most medicine. There has been almost no progress with ALS. We are in the same place as we were 200 years ago, except we understand the process a little better.

Doctors don't heal much of anything. They look at x-rays, they poke where it hurts, they make educated guesses. Then they try to create a situation where the body can heal itself. All they really are is highly paid technicians with a modestly workable understanding of most serious illnesses. They are barely beginning to understand neurological processes. I expect we will have to wait for a long time yet until something comes of that understanding. Most certainly with ALS. I hope it's not 200 years.

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