Model stories written by young professionals/students.
The One and Only Biomedicine
Western medicine, or biomedicine, is typically thought of as the gold standard of healthcare by those of us here in the United States. While there is no real, universal measure to determine if one medical society is better than another, the disappearance of certain deadly diseases, the ever-increasing life expectancy, and many other characteristics of our health seem to offer some evidence in support of our belief. Indeed, there is a lot upon which to base our pride in biomedicine.
Though biomedicine is highly regarded, it is not without its critics. Horace Miner paints the picture of a people with an underlying belief that “the human body is ugly and that its natural tendency is to debility and disease,” causing them to worship medication and give excessive gifts to the elect who can provide them with more of these “charms” (503-504). Through his satire, Miner conveys an American people focused on obsessing over image and a medical community intent on gaining prestige and wealth. Similarly, David Rosenhan and his colleagues experimented to show how flawed and inconsistent the diagnosis and treatment of mental illness is in America (179-185). What they found was a culture in psychiatric facilities which cultivates feelings of powerlessness and depersonalization of those who have been labelled as mentally ill, even when these labels are unjustly applied.
Perhaps even more critical was Arthur Kleinman, who tabbed Western medicine as “biomedicine” because of its focus solely on biological beings and processes as the cause of any decline in well-being (21-40). Although he gives many characteristics specific to biomedicine and a valid critique of each of these aspects, I would like to focus my attention on his assessment of biomedicine in a tradition of singularity, with one cause being the source of all symptoms and one treatment being the solution to any health problem.
When physicians are assessing a patient, they must synthesize all of the signs and symptoms of disease given to determine a particular root cause. We spend much of our time focusing on connecting all the dots to identify what biological or physiological process has been disrupted to lead to the entirety of a patient’s pathology. Once a reasonable explanation has been determined, there is some kind of intervention, most often in the form of a drug, prescribed to correct the problem. Once the prescription is made and filled, the problem is considered solved as long as the severity of the symptoms seems to be lessened.
One issue with this process is the fixation on identifying a singular cause of all symptoms. While I agree that searching in depth to treat the illness instead of the symptoms is the best plan of action, I think there is a point when we spend too long trying to pin down one source when there are two or three issues that could have been quickly discovered and addressed if not for our eagerness for singularity. Additionally, once an assessment has been made, all new abnormalities and behaviors identified after the diagnosis are viewed as a result of the predetermined ailment, similar to how psychiatrists tended to explain normal behaviors as symptoms of an identified mental illness (Rosenhan, 182). This common course of action neglects the possibility that people are capable of developing multiple illnesses at the same time.
Often, the symptoms of the patients are the result of a single biological or physiological pathology. When these are identified and treated with medication, we think that all problems are solved. Our focus on a single biological cause can lead us to be oblivious of other factors that are the root of the diagnosed problem. Environmental and lifestyle factors can very likely lead to the development of pathologies, but these influences are often not addressed in our search for the biological source. If this is the case, we may temporarily “cure” the sickness, but in doing so we allow for the underlying problems to fester and grow, which may be part of the reason why chronic diseases are so prevalent in our society.
Because environment and lifestyle are often part of the root of the problem when dealing with disease, interventions focused on one mode of treatment are lacking. Prescribing drugs and medications in the absence of modifications to living circumstances and personal choices is not an effective way to treat illness. Though I believe there is much work to do in broadening our scope of diagnosis and treatment, to say no strides have been made would be completely incorrect. For example, metabolic diseases, such as diabetes, are typically treated with medication, recommendations on changes that can be made to diets, and exercise programs. We must continue to be willing to view medicine through a wider lens if we are to truly become the most effective medical society, fostering optimal health and well-being for all people.
Kleinman, Arthur. "What Is Specific to Biomedicine?" Writing at the Margin: Discourse Between Medicine and Anthropology. Berkeley: U of California, 1995. 21-40. Print.
Miner, Horace. "Body Ritual among the Nacirema." American Anthropologist 58.3 (1956): 503-07. Web.
Rosenhan, D. L. "On Being Sane in Insane Places." Science 179.4070 (1973): 179-85. Web.