Paradigm Shifts in Medicine–Can Lifestyle Change Cure?

Modern medicine is scientific, evidence based, and very conservative.  Doctors like to treat patients with medicine and procedures that offer the best known odds for success.  No doctor wants to try out something new only to discover it kills their patients.

Patients on the other hand are fearful folk.  They usually know little of their newly diagnosed conditions and they are afraid of suffering or dying.  They are quick to take any cure they are offered.  If they have faith in their doctor and she says  take these pills and have this surgery, they will comply.  However, many people are afraid of pills and surgery.  They hate to suffer, but they are afraid of the cures offered them.  If they hear about alternative medical treatments that are less scary they will chase after them.

I’ve recently discovered I have clogged arteries, but won’t know how bad until next Thursday when I get a heart catheterization.  This is the kind of personal experience where I get to explore very concrete details of reality.  I have choices to make.  If I decide wrong I could die.  If I decide right I get restored health.

The conservative medical solution is to put in a stint and have me take Plavix for a year.

The alternative is a proposed paradigm shift that claims if I eat a radically different diet, I can reverse the buildup in my arteries.  My doctor says there’s not enough research to support this conclusion.  Books by Dr. Ornish and Dr. Fuhrman claim otherwise.  My doctor replies that those doctor’s claims are meant to sell books, and are unproven.

Here’s my problem.  I can’t handle drugs.  My doctors usually pooh-pooh my fear of drugs.  But here’s what topical steroids did to me.

steroid-reaction

And that photo was after I healed considerably.  It took a year for my face to clear up.

I’ve taken other medicines that filled my mouth and throat with sores.  I often take medicine that tears up my stomach.  I’ve taken medicine that gave me sores under my eyelids.  I’ve taken medicines that gave me pains in my intestines.  I’ve taken medicines that distorted my sense of time.  Taking penicillin once sent me to the emergency room.  And statins really did a number on my body.  I have a hard time taking a 81mg “baby aspirin.”  I even had to give up caffeine.

So the idea of getting a stint and then having to take a powerful drug for a year is pretty scary.  If it was just a stint, I’d say great.  When I had a heart arrhythmia they eventually fixed it by zapping something inside my heart.  That was after years of torturing myself with various heart drugs.  They had offered me the ablation when they offered me the drugs, but I believed I could control my heart arrhythmia with beta blockers, diet and exercise.  I did for years, but ultimately I couldn’t.  Letting them zap my heart was great.

Once again, I’m back toying with the idea of curing myself by diet and exercise.  However, this time, there’s more evidence, supported by real doctors, to suggest that the lifestyle change is a possible cure.

I’ve already shifted towards the new diet, but it’s hard.  Even though I’ve been a vegetarian since 1969, I’m a very poor eater who is addicted to junk food.  Food I found comfortable for my stomach was slowly attacking my heart.  Now switching to healthy food sometimes tears up my stomach like some medicines.  Yet, I do feel better, and I believe if I learn to eat the healthy, and especially if I learn to cook it and make it an easy routine, I could switch my lifestyle.

I do have a proven record of changing.  I did go vegetarian at 16.  And in recent years I’ve control my back and leg pain with physical therapy exercises.  I gave up pain pills and anti-inflammatory meds.

One reason I think conservative doctors are against lifestyle cures is they know few people can change their way of living.  My dad died at 49 after three heart attacks and a stroke.  He never gave up his Camels, Seagram 7, or steaks.  Nor did he try to exercise.  I was in my teens at the time, and I wondered why he wouldn’t change.  Now I know how hard it is to change.  Sometimes I think I’ve lived 12 years longer than my dad because I became a vegetarian.  It also helps that I didn’t follow in his footsteps of smoking and drinking.  What choices can I make to live another 12 years, and maybe 12 more after that?

One reason I believe lifestyle change might work is because bad lifestyle habits clogged my arteries in the first place.  The other bit of logic is if I got a stint and continued to eat and live like I did, wouldn’t I just clog up other arteries?  Isn’t clogged arteries a sign that I’m doing something wrong and should stop?

Such logic can be deceptive.  I’m reading Thinking Fast and Slow by Daniel Kahneman who details all the ways our own brain tricks us.  He chronicles a long list of deceptive psychological mechanisms our brains use to convince us that wrong things are right.  So, how do I know if my cardiologist is right, or Dr. Ornish and Dr. Fuhrman?  Decades ago some researchers suggested that stomach ulcers might be caused by the helicobacter pylori bacteria.  Most doctors said that was insane.  But over time there’s been a paradigm shift.

Are we at the beginning of a paradigm shift with chronic diseases and diet?  We know that the western diet has led to the increase in various chronic diseases, so logically it would seem if we gave up that diet, we might reverse course?

It doesn’t matter what I think.  I know my brain tricks me.  What’s important is what science learns.  My doctor is right to be skeptical of any idea that’s not well backed by lots of scientific studies with huge numbers of participants.  Ornish and Fehrman claim the science is there.  I need to find it.

JWH – 5/3/12

The Defining Science Fiction Books of the 1990s

1950s 1960s 1970s 1980s 1990s
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The 1990s was the last decade of the century and the millennium, and although science fiction has been around for centuries, it feels like the genre blossomed in the second half of the 20th century.  By the last decade it feels fantasy flavored SF had overtaken hard science fiction in popular appeal, but many of the most successful science fiction books of the 1990s were about space travel.  Vernor Vinge, Iain M. Banks, Dan Simmons, and Peter F. Hamilton began paving the way for the New Space Opera of the 2000s.  Ben Bova, Greg Bear and Kim Stanley Robinson used NASA’s recent knowledge of the solar system to build new visions of interplanetary colonization.  And more than ever, science fiction is concerned with the post-human future.

SF writers of 1990s represents the centennial descendants of H. G. Wells, and his genre originating novels The Time Machine (1895) and War of the Worlds (1898).  Where Wells explored the impact of Darwinism, 1990s science fiction writers were inspired by NASA interplanetary probes, the Hubble Space Telescope, and the many breakthroughs in contemporary cosmology.  It’s quite amazing, but in the 1990s, both the scientific universe and science fictional universes are tremendously bigger than the objective reality of the 1950s and its science fictional universes.  Heinlein, Asimov and Clarke loom large in our history, but modern science fiction writers stand on their shoulders and see much further than they ever imagined.

Yet, I would claim by the 1990s that it was obvious that science fiction had forked in its evolution.  On one hand, we still have a branch of science fiction inspired by science, but on the other hand, it’s all too obvious that the larger branch of science fiction is inspired by older science fiction.  New sub-genres like Military SF, seemed descended from 1959’s Starship Troopers by Heinlein, and isn’t the sub-genre of galactic empire romances descended from Asimov’s Foundation stories?  NASA will never be able to send a probe to either of these universes.  Whereas, Kim Stanley Robinson and Michael Flynn are practically begging NASA to use their books as blueprints for its future budgets.

A handful of writers dominated the decade with their series books.  Lois McMaster Bujold, Connie Willis, Kim Stanley Robinson and Vernor Vinge, all won multiple Hugo and Nebula awards as well as getting many nominations, and winning other genre awards.

Kim Stanley Robinson set the standard for hard science fiction with his decade spanning Mars trilogy.  He won two Hugos and one Nebula by writing about a realistic colonization of the Red planet.

mars-trilogy

Lois McMaster Bujold had so many award winning books in the 1990s that picking the best is impossible.  The Vor Game, Barrayar, Mirror Dance, Cetaganda, Memory, Komarr and A Civil Campaign are probably getting even more readers today than in the 1990s.  The Vorkosigan Saga just keeps on growing.  And fans debate whether new readers should follow publication order or internal chronological order.

mirror-dance

Connie Willis won five Hugos and three Nebulas in the 1990s, with The Doomsday Book winning both.  Willis has carved out a much loved series based on time travel and history, blending two genres together, and like Bujold, Willis keeps expanding her series today.

the-doomsday-book

Vernor Vinge picked up two Hugos and two Nebula nominations for A Fire Upon the Deep and A Deepness in the Sky, proving that fans still love a good space opera.

a-fire-upon-the-deep

Some people have asked me how I make up these lists of memorable science fiction books.  The first one, about the 1950s, was more from personal memory, but eventually I discovered various resources I used for the later decades.  I start with Internet Speculative Fiction Database.  I use its advanced search and look up novels, language and type.   I only worry about books in English.  I go down their listings looking for books I remember reading or reading about.  I can right click on any title to bring up it’s bibliographic record which includes how often it was reprinted and whether or not it won any awards.  Most valuable is whether the book made the Locus Poll that year.  That’s the first indicator how popular a book was with the fans during the year it came out.

I also study various best of lists to discern long term popularity.  I look for books that get picked time and again.  This is how I create the short list called the Best Remembered books.  The longer Defining Books list are those books which got particular notice during the year they came out.  Most of these have been frequently reprinted and are often on some of the best SF of all time lists.  I avoided fantasy novels unless they won or were nominated for the Hugo, Nebula, or other SF award.

Best of Book Lists

The Best Remembered Science Fiction Books of the 1990s

The Defining Science Fiction Books of the 1990s

1990

the-difference-engine
1991

a-woman-of-the-iron-people
1992

snow-crash
1993

john-m-ford-growing-up-weightless
1994

permutation-city
1995

the-diamond-age
1996

bellwether
1997
Fools War Zettel
1998

1999

a-deepness-in-the-sky
1950s 1960s 1970s 1980s 1990s

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