Archive for the ‘holism’ Category
Have you ever wondered why we have the International Classification of Disease codes, or ICD for short, but we don’t have an International Classification of Health? This is a major short-coming! Really! How are we to understand the significance genomic contributions towards our health, unless we have a standardized why to describe it? This goes back to my prior discussion, what is Health? It can’t just be the absence of disease!
The ICD codes have been around for a while and we are on the 9th iteration. Mostly they are used for billing purposes for insurance companies to approve or deny coverage. However, during my experiences with billing, I found it frustrating to try to classify a patient as ‘Healthy’. The only way I was able to get reimbursed from the insurance company was if I found something wrong with them. This is a fundamentally conflicting philosophy if my mission was to keep them well!
Ergo, I propose that we concentrate our efforts for a structured vocabulary to take Health into consideration and I therefore declare the start of the ICH codes, International Classification of Health, version 1 – ICH-1. Anyone want to help me?
I have been told that cancer genetics is the ‘low hanging fruit’ of personalized medicine.
I have my reservations about this analogy. As you all know, I am a big proponent of personalized medicine. And I also remain optimistic that personalized medicine will be a fruitful and rewarding endeavor. However, part of me is concerned that we are like ants picking away at the fruit of the tree of life. This sacred tree that hold the source code of life, that which holds our very identity… that which make us unique. Perhaps we should be more mindful of our actions and how we conduct ourselves during this technological adolescence. Sometimes, I think that the Genomic era is much like a modern day Gold Rush with everyone climbing over each other in a mad dash to stack their claim to the bounty.
By seeking the true knowledge of ourselves within our DNA, we seek a deeper understanding of ourselves and our place in the Universe, both from a Darwinian as well as a spiritual viewpoint. To this end, we should remind ourselves to walk uprightly, square our actions and walk confidently in this garden of good and evil motivated by the search of truth and not by material gain.
Put simply…. life is about balance!
We see it in our everyday life. Work and play, day and night, life and death, mind and body…. etc.
We are born from an already vast collection of information that has taken billions of years to evolve.
Our genes are a blue print that start us off and our environment nurtures us and allows us to thrive to reach our fullest potential. Thus life could be considered the complex interactions between genes and the environment.
I see it everyday in the delicate art of practicing medicine. I advise all of my patient to find balance in their lives. My mantra has always been … Work less, eat healthy, relax more, exercise more, find balance.
I also see it when I prescribe medications, too much medication they have an adverse reaction, not enough and they are under-treated. Find balance.
Thus I have come to the conclusion that life is about balance. It was once said that, “Life is the blended harmony of the yin and yang”
The yin-yang is an appropriate symbol for the struggle to find this balance. It represents the two sides of the equation, yet both in balance. And at the center of the other you find its opposite. Yin and yang are complementary opposites within a greater whole.
The western philosophy of science has long been depended upon reductionism. To put it simply; in order to understand a complex system some reduce it to more manageable parts.
Reductionist thinking is the basis of many areas of modern science. Biology and chemistry being a subset of physics, for instance. Or trying to identify the smallest subatomic particle, such as what we are trying to do with the Hadron collider.
Western medicine has, over the millennia, attempted to adapt to a more rigorous scientific primer, and as a consequence, adopted reductionism as it’s foundational philosophical approach. However, we, in medicine, know that there are so many things that we do that is such an art and not a science … from the empathy and compassion that we show, to holding someone’s hand when they need it or just listening to a patient without interrupting.
Moreover, medicine is more than the sum knowledge of applied biology and chemistry. It is social, psychological, spiritual and at times, existential. A patient is more than the sum of their parts. Why should their genes be any different?
Reductionism does do it’s job for us in science. We are, after all, human, and we can’t simultaneously comprehend the larger whole and how everything interconnects. However, we must know it’s limitations.
We should be mindful about the bigger picture. We must realize, we are not just the sum of our parts! We are more that it! We have a mind, a body and a spirit.
Genomics should be no different. We should approach the integration of genomic information into the clinical practice of medicine as yet another modality that facilitates expression of this magnificent art of medicine and not use it to divide us, or place us into bins!
“Wherever the art of medicine is loved, there is also a love of humanity!”
Hippocrates, c. 400BC