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SnowyDoc's Avatar Joined about 7 years ago
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Go to: Why I watched a snake-handling pastor die for his faith

SnowyDoc's Avatar Jump to comment 39 by SnowyDoc

Darwin Award, please. :-)

Sat, 02 Jun 2012 02:09:43 UTC | #945131

Go to: Understanding Evolution and Being a Good Doctor

SnowyDoc's Avatar Jump to comment 18 by SnowyDoc

Saying a doctor doesn't need to fully understand or apply the principles of evolution by natural selection in order to practice competently could be reasonably argued (as some have commented above), however such an approach leaves us in "stamp collecting" territory; learning by rote, and relying on recalling and applying purely descriptive knowledge without the understanding of how and why things are the way they are. And, more importantly, how they are likely to change in the future.

It would be a bit like a 17th century biologist dutifully discovering, cataloging and classifying species phenotypically, devoid of the underlying principle that would later allow molecular/genetic cladists to probe those relationships in an entirely more refined, complete, and intellectually satisfying way. Indeed, it's something like the difference between knowing that stuff falls to the ground (and even measuring how fast stuff falls, quite accurately) and having an understanding of Newtonian mechanics and Kepler's laws. An entirely new vista of knowledge and understanding and, importantly, predictive power, is revealed. Working out pretty well how you can expect a cannonball to fly based on trial and error is a very different kettle of fish to accurately and confidently putting space probes into precise orbit around distant celestial bodies.

The obvious see-evolution-happening-before-your-very-eyes case is the development of antimicrobial resistance in bacteria (and I highly recommend anyone curious and with a cellular biology bent to read up a little bit on the myriad ways in which the sneaky little buggers do it... it is fascinating). But beyond this most overt, and now almost culturally bland, example of the importance of evolutionary principles to the practice of medicine, there is a panoply of applications of immediate relevance to our efficacy as physicians.

Ordering the right laboratory investigations and making the correct diagnosis can hinge on an informed understanding of the pre-test probabilites of potential underlying conditions... the genetic differences (small though they are) between peoples who have evolved (quite recently on the timescales we usually bandy about when discussing evolutionary change) in different parts of the world can crucially alter our ability to get a diagnosis right (or even consider it in the first place), and can mean the difference between an optimal outcome, and unnecessary (and potentially harmful) investigations and incorrect treatment.

Knowing how microbes have co-evolved with our immune system is at least as important as simply knowing that "antibiotic resistance happens". For example, the fact we know the mechanisms that have evolved in encapsulated organisms (Strep.pneumonia, N.meninigitidis ("meningococcus"), etc...) to enable them to evade most of our usually highly effective immune response means that as well as knowing what drugs I need to kill these bugs, I can also pretty confidently predict that in 10 years' time if I have a patient who needs his spleen removed after a bad motorcycle accident, I will need to immunise him with a vaccine for the newly discovered encapsulated pathogen (that I don't even know exists yet) that started making the rounds in humans say 5 years from now.... because whether by sharing genes with older strains of bug, or by convergent evolution, the new bug will very likely be difficult to opsonise with antibodies and without a fully functional splenic reticuloendothelial system, my patient will be particularly susceptible to such an infection.

It allows us to offer useful advice to people who may, or do, carry certain genetic traits regarding antenatal screening for specific conditions, or it may even affect whether they have children at all.

It helps us understand our own mortality. We fall apart after a certain age because our selfish genes have little practical use for us after we've passed them on, and maybe hung around long enough to be helpful and effective grandparents beyond that.

It guides our decision-making about where our research funding should most fruitfully go, and informs our interpretation of new research findings and our application of those findings to our practice.

If nothing else, it enables us to do what... for the longest time... was the only real service a doctor could offer a patient; provide a prognosis, and explain... truthfully... why this ailment has happened to them, and how and why it would either progress, or improve.

Evolution by natural selection is the central explanatory and predictive principle of all biology as we know it and, by extension, all medical science, upon which we base our medical practice. A fellow by the name of William Osler once said: “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.” I would humbly suggest that practicing medicine without embracing and understanding evolution is, perhaps, a bit like heading out onto those same seas, but without an understanding of plate tectonics, oceanography and meteorology. Knowing roughly what the coastlines look like is very helpful and necessary, but a deeper understanding of why they are where, and how, gives us a much better grasp of what we are likely to find when we get there, as well as an improved ability to both predict and adapt to problems we might encounter along the way.

Sun, 27 May 2012 04:04:48 UTC | #943759

Go to: Military A-Week: How to put ATHEIST on your records (all branches)

SnowyDoc's Avatar Jump to comment 19 by SnowyDoc

Looking at my dogtags now... "NREL"... hmmm...

I'm in two minds, though... which is the more correct? That I have or follow or belong to no religion, or that atheism is my religion?

I'm note entirely sure that I want to label atheism as a religion. :-)

Fri, 23 Mar 2012 02:40:44 UTC | #929794

Go to: Tennessee Passes ‘Monkey Bill’ To Teach The ‘Controversy’ On Evolution And Climate Science

SnowyDoc's Avatar Jump to comment 38 by SnowyDoc

Do these people have any insight at all into how much this sort of thing makes them and, unfortunately, other Americans, look like backwards, unthinking, irrational hillbillies?

Fri, 23 Mar 2012 02:28:34 UTC | #929789

Go to: Civilian Pastor Attacks Atheist Soldier - Reverend Bryan Griem Claims Atheist Solders Are "Big Fat Chickens"

SnowyDoc's Avatar Jump to comment 43 by SnowyDoc

I would like to think that my body would be recycled enthusiastically by all manner of bacteria, fungi, plants and animals... not just worms. :-)

My partner assures me I do not taste like chicken.

And as a serving military officer and atheist, might I suggest the good Reverend can kiss my arse.

If he would be so kind as to accompany any of our troops into close combat, I can probably arrange for him to be thrown on any loose grenade encountered, thus providing an example so that we atheists might know what we should do next time?

Sun, 18 Mar 2012 14:29:36 UTC | #928315

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