I had the happiness of seeing a large part of the evolution of half a century of medicine, half a century is enough to have a strange idea about the human being, half a century seeing sick people makes that through reflection we evolve a lot, we can (we should at least) be better doctors.
The study of medicine of those who took me two decades was very tedious, very anatomist, three years of that subject, of course there was much less research in other fields that could be taught in medical schools, today I believe that five years of theoretical career it is too little, unless specialization is achieved in all physicians.
There is incredible research development in the last two decades, although people continue to die (and will continue to die because it is the end of this life), sometimes without a diagnosis.
I go back to the beginning of the article, “I had the good fortune to see…”, yes, to see the great evolution of biomedicine research, although we hardly reached our beaches, today it does not matter to be at the Columbia University School of Medicine, at the UCR, at the Complutense or at another university, everything is known almost simultaneously, that is, the information age is here (that of disinformation too, but that is another matter), scientific investigative journalism works globally.
The Great Plague of the 21st century (Covid19) has taught us a lot, despite still having a little or a lot of secrecy, we know much more about DNA and RNA today than two years ago, we better understand the role of genes within the biological gear, we can already bet on genetic manipulation to cure diseases or avoid them, we are already on the threshold of post-modern medicine.
Quantum physics, which, although it explains almost all cellular and ultra-molecular biological phenomena, has not yet finished leaving the slates: it is still very theoretical, but it generates immense changes in scientific medical thought.
When I fell in love with human physiology, fifty years ago, I saw that this was the matter that I had to understand point by point to be able to understand diseases and therapeutic possibilities, which I never believed were only our medicine, no, the possibilities they are in everything, including alternative medicine and acupuncture itself, nothing can be excluded in the search for a cure and the prevention of diseases, I speak of a cure, research must go hand in hand without stopping the therapeutic possibilities.
Today I understand better the reason that made me doubt so much about “bulk prosthetic replacements” by stopping looking for alternatives to the healing of the articular cartilage itself, especially in the knee (I remember Sir John Charnley when he said in New York in 1981, that had put progressive hip replacement in the wrong hands).
Everything has been evolving and the sword of that Cid Campeador, which is medicine, passes from one hand to another and will continue to do so, that is the way in which existence works.
Today with all the paradigm shift that the XXI century Plague (or the first of many more plagues) has brought, we cannot ignore how little curative medicine has been able to give, based especially on the ultra-specialized support in ICUs. , rescuing seriously ill patients, a tremendous task for these professionals.
It is still debated whether or not Ivermectin, despite the regrets, that is, we were unable to handle Covid as another infectious-contagious disease. We panic (rightly or wrongly) and we lock ourselves inside the shell of fear, leaving it to the epidemiologists to manage it, and therefore putting our security in the hands of the politicians (the worst hands, by the way).
The medicine of the future is a very scientific medicine on the one hand and on the other it must involve all traditional and non-traditional therapies, enough to defend at all costs as many have done (some like sheep following the head of the tribe to the slaughterhouse) to the great world pharmaceutical emporiums, putative sons of the oil kings.
The development of vaccines should be in the hands of institutions completely linked to teaching and research, primarily state, delegating of course to private companies (the non-corrupt) what is necessary for proper operation, we can not make boxes and bottles in the Universities, no, everything in its place, but universities will have to demonstrate that they are capable of research that benefits everyone, only in this way will these succulent salaries (of some) and the exclusion of immense numbers of capable people be explained.
Regarding the medical curriculum vitae, it should be readjusted to the era of post modernity, we have to have in each doctor a true doctor, not simply an ultra-specialized technician who does not know how to remove a nail.
Dr. Rogelio Arce Barrantes is a Physician.