One of the major questions I was confronted day by day while being on my “Get rid of AFib”-Journey and maybe also the most time of my life but without recognizing it that much was: “What is truth?”.
Especially regarding the concept of evidence based medicine I was, before I “stumbled” into my Atrial Fibrillation (AFib) condition, nearly completely convinced that “Western medicine and science is the one and only truth!”. Maybe based on my engineering mind I had the idea that a structured approach inevitably leads to a true result. But what is a structured approach and what is a true result (and for whom)?
One example for “truth”: If you would measure, in an physical experiment, the gravitational acceleration (typically known from school as g=9,8 m/s2) maybe in Hamburg (Germany) you will get a certain value and this might be, for the moment, your “truth”. As a next step you phone a colleague from Nepal to do the same experiment on the top of the Mount Everest to confirm your result. Surprisingly the measured result is different to yours (Maybe approx. g=9.773m/s2).
Did you or your colleague do the experiment in a wrong way?
No, as we know today the gravitational accelleration is slightly different at different locations on earth. (Note: Another parameter e.g. that could influence the measured results might be the air resistance.)
This means the “real truth” can be very complex and based on many different parameters.
What to learn form this example?
As stated before truth often means that many parameters and relationships are involved that are sometimes very hard to be overseen, but it is very important to know this “gap” of knowledge when talking about truth. In some cases it doesn’t matter, if we only know 80% of the “real truth”. For a student it is not relevant if he or she solves his physical exam with an acceleration value of 9.8 m/s2 or 9.773m/s2, but for an engineer that develops a new aircraft-system it might be very essential.
Getting back to the Western medical system it is, in my eyes, very important to know which parameters and interrelationships for “truth” for a diagnosis and a possible cure or treatment have been taken into account when talking about a suitable therapy. (For an example why this is so important please also see my post: “CHA2DS2–VASc, ATRIA and HAS-BLED Score for AFib risk prediction”.)
Typically our doctor or health care provider should do this “truth”-analysis for us and choose the best therapy with the best results seen from the patients perspective. Sadly as I have experienced it, it is system immanent that this often can’t be done properly. Possible reasons for this “gap”: Too less time, too less options, too much pressure, too less money available for the research of less invasive therapies and so on.
Nevertheless I am completely convinced that individualized medicine is the key to adress this problem in the future, but there are also many risks regarding the implementation of this concept. Please also see my post “Some thoughts on Individualized Medicine”.
Some scientists, like Kamala Patal on a TEDx Talk in Calgary, are saying there is no truth in science. I don’t quite agree with that without a closer explanation, because to say that there is no truth in science implies in itself that this IS the truth, which is a logical break. But of course as I said before I totally agree to her point that science is a journey in getting new knowledge step by step what means it is dangerous to put something on a throne and worship it as truth even when you know that you know very little at least.
From my point of view science especially medical science needs to learn to point out much more directly and openly that a particular therapy is only “one idea” and that there may be many other ideas (or lets say options) that have not yet been investigated because, for example, a lack of money for research, the therapy is not lucrative to develop further, etc. .
But this can be only achieved if the medical system is responsible for societies increased costs and reduction of life quality that illnesses are resulting in.
As I have stated in my post “‘The Worst Case’-Medicine” there are many factors that can (not must) prevent doctors from providing the best therapy to their patients.
(Sometimes I had the discussion with my family doctor: “This medication has more side effects but is covered by your insurance, the other one has less side effects and is more effective, but has to be paid by yourself.”)
Another example: Why should a pharma / medical company or research organization do an expensive study on weight loss to reduce or cure AFib, if an ablation procedure brings in 16.500 Dollars per procedure (or even more) per patient in a few hours, no matter, if it was successful or not (Note: “They” might get even more if it was not succesful by performing another procedure.).
But there are also exceptions from this “rule”, please also see: PREVEntion and regReSsive Effect of weight-loss and risk factor modification on Atrial Fibrillation: the REVERSE-AF study.
Another “truth” is that pharma companies are not in general “bad companies”, they just only follow the idea of maximizing their profit as every other company also does.
(Note: However, it becomes problematic if this profit maximization is done immorally and intentionally, no matter in what kind of business model it is been done.)
So, my point about “truth” is that it is sometimes very hard to determine the “real truth” but it is always existing and we should try to get as close as necessary to it depending on which level our awaitings regarding the expected results are – in other words can we life with g=9,81m/s2, g=9.773m/s2 or is g=9m/s2 even “true” enough for us.
Looking at this blog, all things I present here are my personal view on “truth” and sometimes I am more or less close to the “real truth” based on my specific parameters that I have considered and those I did not (consciously or unconsciously).
Seen from my todays perspective I always question myself first: “How close is the “truth”, that somebody is telling me about, to my own parameters?”, before I adapt it.
Furthermore I also try to keep always in mind that my view on “truth” might be reduced and incomplete too and probably is not that much true for someone else like it is for me.
To close this “gap” it is, in my eyes, very helpful to continously gain as much knowledge as possible about the factors that are relevant to get closer to the “real truth”. One way in doing this is to listen to different stories from different people who were facing and solving different problems successfully but differently and questioning yourself:
- What is similiar between them and what is not?
- Which abilitues did they use to face their challenges and which of those do I have myself, where do I need the help of others?
- What is similiar to my situation what is not?
- What is my personal definition of success?
Note: It is also very helpful listening to people whose stories were not that 100% successful, because also failing can be success.
One of these stories I have in mind is “How I cured my AFib” from Jay Clarke. Jays story was very inspiring for me and maybe the first publication I have read from someone who cured his AFib himself. This was a new truth for me because curing AFib naturally was something that was always denied as an option from 99% of all of all the doctors I have met.
Another one is “Slick AF: The AFib Rabbit Hole” from Kristian Davidson. Be prepared that the author uses a quite direct language in expressing what he thinks about Western medical approaches. But remember it is “his truth” and I can understand him.
The third one I like to mention here is the story “Life on hold” from Kevin J. Kauffman. Kevin really went through hell but he kept his humor through the whole story and also got some very interesting findings while being on his AFib journey.
(Note: You can find a more detailed information about the publications mentioned above at the library.)
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