We are currently studying evolution in our biology class. Even though one wouldn't directly relate this topic to medicine, when practicing medicine knowing the evolutionary process behind the human body may facilitate and support our decisions when making a diagnosis or carrying out a procedure. Regarding this topic I came across an article in the new scientist titled ‘ Darwinian medicine: Does intensive care kill or cure?
Darwinian or also known as evolutionary medicine only in the past decade has become popular but is definitely still not a part of mainstream medicine. The philosophy behind this practice is to find out what evolutionary changes and traits have caused the patient's condition. Doctors don't only focus on thinking on how to cure the person given the symptoms, but rather go a step further and think about how the disease or condition evolved in the patient in order to then carry out a more appropriate response and procedure.
Darwinian medicine doesn’t immediately or necessarily direct a symptom as an issue. It allows us to see the bodies responses of our body as a natural defense rather than a problem. For instance a fever. As soon as we get a low fever at around 38° we tend to immediately take paracetamol or ibuprofen to bring our temperature down. What many people fail to realize that a fever is a natural defence of our body to get rid of intrusive microorganisms in our bodies, by raising our body temperature we are trying to kill microorganisms such as bacteria. A premature intervention to a favere will hinder our body from protecting us from these harmful intruders.
In the particular article that I read Mervyn Singer, director of the Bloomsbury Institute Center for Intensive Care Medicine at University College London suggests that we should pay more attention to evolutionary medicine. He says that in the past 10 years none of the advancements in intensive care have proven to improve patient recovery rates.
He specifically refers to the case of systemic inflammatory response syndrome (SIRS) which patients in trauma tend to undergo. In this period, known as sepsis, stress hormones are secreted and the patient’s temperature and heart rate tend to go up. If the patient does not return to equilibrium then organs will start to malfunction. This is one of the leading causes death causes in intensive care. According to the accepted theory during trauma the necessary oxygen levels fail to reach the organs and cells die causing organ failure. Singer disagrees with this statement since there is evidence that shows that the organs in patients who died of organ failure had fairly normal oxygen levels. He has made a different interpretation of why it is that organs fail and lead to patient death. He states that during trauma our body goes into “fight mode” in which many chemicals and hormones are secreted by our bodies that modulate our immune response. As a consequence metabolism slows down because these same chemicals damage the mitochondria (the organelles in our cells responsible for energy production). Since the cells can’t keep up with its regular activity rate with less mitochondria it goes into a dormant mode since otherwise it would die. Singer interprets organ failure as a temporary response of our body while it focuses on fighting with our immune system whatever is intervening in our body as a last resource. Once a patient recovers this phase, the mitochondria will have to be re-established, which when taking antibiotics and sedatives can often be prevented by. In conclusion Singer states that our bodies are not adapted to have multiple tubes and monitors attached to ourselves in order to recover from trauma.
Therefore this is another prime example which shows how important it is to understand why the body responds a certain way due to its evolution. The mode in which our bodies go into during trauma, is clearly a result of evolution which our ancestors developed in order to survive. Before intervening we have to understand the course of action that our body will take to ensure a positive outcome. After listening to Singer’s many physicians agree that we should starts thinking more broadly and approaching problems in new angles while others, even though they were amused by the idea, were not fully convinced. The article then goes on saying that evolutionary medicine suggests what we should think about and what studies we should do. I think evolutionary medicine is very important since it could stop or motivate us from making one decision over another. If a doctor is not aware of why our bodies suffer certain symptoms and what, if any, their purpose is, then he/she won't be able to make a decision as appropriate as if when he/she did.
This topic has actually surprised me on how interesting it is. And i must honestly say that when I become a doctor I will like to be able to introduce and involve darwinian medicine in my years of practice.
Darwinian or also known as evolutionary medicine only in the past decade has become popular but is definitely still not a part of mainstream medicine. The philosophy behind this practice is to find out what evolutionary changes and traits have caused the patient's condition. Doctors don't only focus on thinking on how to cure the person given the symptoms, but rather go a step further and think about how the disease or condition evolved in the patient in order to then carry out a more appropriate response and procedure.
Darwinian medicine doesn’t immediately or necessarily direct a symptom as an issue. It allows us to see the bodies responses of our body as a natural defense rather than a problem. For instance a fever. As soon as we get a low fever at around 38° we tend to immediately take paracetamol or ibuprofen to bring our temperature down. What many people fail to realize that a fever is a natural defence of our body to get rid of intrusive microorganisms in our bodies, by raising our body temperature we are trying to kill microorganisms such as bacteria. A premature intervention to a favere will hinder our body from protecting us from these harmful intruders.
In the particular article that I read Mervyn Singer, director of the Bloomsbury Institute Center for Intensive Care Medicine at University College London suggests that we should pay more attention to evolutionary medicine. He says that in the past 10 years none of the advancements in intensive care have proven to improve patient recovery rates.
He specifically refers to the case of systemic inflammatory response syndrome (SIRS) which patients in trauma tend to undergo. In this period, known as sepsis, stress hormones are secreted and the patient’s temperature and heart rate tend to go up. If the patient does not return to equilibrium then organs will start to malfunction. This is one of the leading causes death causes in intensive care. According to the accepted theory during trauma the necessary oxygen levels fail to reach the organs and cells die causing organ failure. Singer disagrees with this statement since there is evidence that shows that the organs in patients who died of organ failure had fairly normal oxygen levels. He has made a different interpretation of why it is that organs fail and lead to patient death. He states that during trauma our body goes into “fight mode” in which many chemicals and hormones are secreted by our bodies that modulate our immune response. As a consequence metabolism slows down because these same chemicals damage the mitochondria (the organelles in our cells responsible for energy production). Since the cells can’t keep up with its regular activity rate with less mitochondria it goes into a dormant mode since otherwise it would die. Singer interprets organ failure as a temporary response of our body while it focuses on fighting with our immune system whatever is intervening in our body as a last resource. Once a patient recovers this phase, the mitochondria will have to be re-established, which when taking antibiotics and sedatives can often be prevented by. In conclusion Singer states that our bodies are not adapted to have multiple tubes and monitors attached to ourselves in order to recover from trauma.
Therefore this is another prime example which shows how important it is to understand why the body responds a certain way due to its evolution. The mode in which our bodies go into during trauma, is clearly a result of evolution which our ancestors developed in order to survive. Before intervening we have to understand the course of action that our body will take to ensure a positive outcome. After listening to Singer’s many physicians agree that we should starts thinking more broadly and approaching problems in new angles while others, even though they were amused by the idea, were not fully convinced. The article then goes on saying that evolutionary medicine suggests what we should think about and what studies we should do. I think evolutionary medicine is very important since it could stop or motivate us from making one decision over another. If a doctor is not aware of why our bodies suffer certain symptoms and what, if any, their purpose is, then he/she won't be able to make a decision as appropriate as if when he/she did.
This topic has actually surprised me on how interesting it is. And i must honestly say that when I become a doctor I will like to be able to introduce and involve darwinian medicine in my years of practice.
https://www.newscientist.com/article/mg20727731-600-darwinian-medicine-does-intensive-care-kill-or-cure/