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unintended consequences

                                        Unintended Consequences (As in using long words as in the title above!)
   There are so many examples of unintended consequences undermining any positive effect of the original intent!
  • Kudzu planting was encouraged to reduce soil erosion in the south from 1935 to the mid-1950’s; now it is ubiquitous and seems unstoppable!
  • The Cobra Effect – The British governor of India wanted to reduce the number of cobras and put a bounty on them, so people started raising cobras to turn them in for the bounty. (There are MANY examples of this unintended consequence.)
  • Agricultural land in Israel was to remain fallow in the 7th year, so Jewish farmers “sold” the land to Gentiles at the end of the 6th year, farmed it the seventh, and then “bought” back the land.
  • Suburban growth requires more and bigger highways which allow greater suburban growth requiring more and bigger highways which allow greater suburban growth which….
  • And so many more!
And we have seen some of this in health:
  • Antibiotic use created antibiotic resistant pathogens.
  • Elective Surgery was probably an oxymoron before anesthetics – who would have thought anyone would choose surgery, whether cosmetic or otherwise?
  • Collateral Damage of drugs, in general, are unintended consequences (“collateral damage” is a more accurate term since the effects of the drug are what they are, but “side effects” sounds kinder, gentler).
  • Did patient satisfaction surveys contribute to the opioid epidemic (good scores for docs who prescribed opioids, bad for non-prescribers), or is the profit motive of Purdue Pharma to blame for its over-zealous promotion?
  • A strong belief that numbers – like 98.6 degrees and all of those numbers on your blood test report - indicate health, and then treating the number (or other symptoms) rather than the cause, leads to false goals and vulnerable people.
  • Do we just not yet understand how everything in the body is connected to everything else and keep making the same mistakes?
 
   Maybe all of our success in treating diseases has led us to believe that there is a pill or vaccine or surgery for whatever threatens our health rather than recognizing the power of the human body to maintain health when given sufficient resources.
 
   The primary unintended consequence of our current medical system is that it encourages us to avoid change.
   And the unintended consequences will only get worse as efforts move from drugs to genetic modification.
   From the Freakonomics radio show on 96.8 degrees for body temperature mentioned above:
DUBNER (interviewer): So, I have a broad question for you. The human body is, I think you and I would agree, an extraordinarily complex organism. And over history, doctors and others have learned a great deal about it. But if we consider the entire human body — from the medical perspective only, let’s leave out metaphysics and theology and what have you — from the medical perspective, how would you assess the share of the body and its functions that we truly understand and the share that we don’t really yet understand?

JENA: Huh, that’s a tough one. We’ve made a lot of headway, but to put a number on it — I would say maybe 30 percent, 40 percent that we don’t know. 
JEREMY GREENE: Ooh, that’s a tough question for me to quantify.
  • Anupam Jena, health care economist and physician at Harvard Medical School
  • Jeremy Greene, physician and historian of medicine at Johns Hopkins University
   There is no way to quantify the answer to how much do we know about the body’s functions, but 30-40% indicates that there is much to be learned!
   Further down in the article there is talk of Donald Rumsfield’s quote (paraphrased) as accurate: there are things we know, things we know we don’t know, and things we don’t know we don’t know about the body.
   Since we are constantly learning more about the interconnectedness of the human body (that is a hope), we are constantly moving the goal posts farther out. At what point we will understand the ramifications of what we are doing when we interfere with body processes by a drug or surgery or genetic modification, is hard to know. We will never uncover all of the possibilities.

   So, no, we cannot wait until we know all of the facts before trying a new medicine or therapy; that will never happen.
   What we can do in the case of chronic or recurring diseases is to have faith that the body is not out to get us. The body will do the best it can with what it is given.
   If the body is not doing well, we must look for the cause. We must be willing to adjust, to change, for better health.

​   Again, what the body needs are the following:
  • Nutrition
  • Water
  • Exercise
  • Rest
  • Moderation
  • Fresh air & sunlight
  • Peace with God, other people, and ourselves
   I do not know the unintended consequences of such a prescription other than those associated with healthily growing older, but the side effects are relatively minimal and surely include reduced healthcare expense.
                                                                                          Next article

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