"Formerly when religion was strong and science was weak, men mistook magic for medicine. Now when science is strong and religion weak men mistake medicine for magic."

So goes the quote from Thomas Szasz in his 1973 work 'Science and Scientism'. That we still place an almost unreserved trust in the medical proffession and it's ability to heal our ills goes without saying but the following two anecdotes should serve to illustrate it's limitations and bring what can and can't be expected of it back into perspective. Some ten years ago my father in law started having pains in his abdomen. he went to the doctor who diagnosed irritable bowel syndrome and prescribed a peppermint based preparation that had no effect whatsoever. For 18 or so months Ted returned intermittently to the GP with the same complaint which, while he could live with, was making his life uncomfortable. After this period had elapsed the GP referred Ted, in his 70's, to a consultant. The wait for the consultants appointment was some 6 months, by which time the trouble was getting more problematic and he was clearly loosing weight. The consultant recognised that something was amis and within two weeks Ted was attending his local hospital for scans etc to determine the nature of the problem, Sure enough the expected diagnosis of cancer of the large intestine was made and a short while later we took Ted in to have a colostomy opperation.

As we waited in the waiting room for Ted to be admitted we were given some information to read about his forthcoming opperation. Sucess (if it can be called such) was, we were informed entierly dependant on early diagnosis. The leaflet gave a range of 'five fear survival rates' based on the speed of the diagnosis being made after the condition had developed. If diagnosed in six months, survival rates after five years were good. After 1 year, a little less so. After two years (Ted's diagnosis time) the chances of being alive in five years time were pretty bleak. Given our situation I breathed hard but did not make the observation that had Teds GP reffered him at the outset then we would have been in a much better situation and it remained to be seen how much that delay was going to cost him!

The colostomy was performed and for the next 18 months or so Ted muddled along, not unwell but not well either. After this period of time he was again feeling pretty rotten and was refered again to see his consultant who carried out a colonoscopy examination and gave him the all clear. Ted began to loose weight and suffer from collapses and following a particularly nasty one of these was readmitted to hospital. A CAT scan was carried out and again the all clear was given. Ted was sent home after being given a 'talking to' by the nurse. "You have to eat." she told him. "No wonder you are falling over all the time!"

Ted returned home and tried to follow the advice but he was feeling sick all the time and couldn't keep his food down anyway. He was as thin as a stick and it was obvious he was dying. Two days after returning home he collapsed, was readmitted to hospital and an exploratory opperation carried out. When we saw the egyptian doctor who had performed this he was grave. "I'm afraid your father is dying." he said to my wife (not too great a shock as I had already told her this some weeks before), "He has no functional bowel left due to the spread of the cancer and will pass away soon." Within three days he was dead. This a man who had been given an all clear by his consultant, an all clear by a CAT scan and sent home with the instructions to 'feed himself up' all within two weeks of being dead.

My second anecdote is a sad story concerning the father of a girl I work with. The man, in his fifties, was suffering chest pains, arm pains, pains in his jaw etc (ie all the normal indicators of heart problems) and attended his GP. He was referred to a consultant and a thorough examination was carried out. He was subjected to exercise stress on the treadmill, blood samples for heart function taken, ECG's and scans perforned. Given a clean bill of health the man was sent back to work. On the strength of this even the man's family started to doubt that his symptoms were 'for real' (this was one of the hardest things of all to deal with said the girl). He returned to work and then one evening a short while later died of a massive coronary heart attack. The doctors somewhat weakly said that 'other vessels in his heart must have been taking up some of the work-load and thus disguising his symptoms'. Cold comfort to the mans family I'm afraid.

My point in recounting these sad tales is important. Medicine is not magic. Make no mistake there is far, far more that doctors do not know about what goes on inside us than what they do. But here is the thing you have to remember - doctors are trying their best. They are doing what they have been taught - and are often fooled themselves by their own press. They have allowed this image of themselves as infalable beings to be built up in the public mind and have done nothing to stop it. They have flown high on borrowed wings and it is no suprise that often do they take a fall. And one final thing; medicine may when all is said and done be pretty weak - but it's the best we've got!