Top Tweets for #Medicalworld

To understand why medicine is so complex, let's make a crude simplifying assumption that there are only 100 biomarkers that are important (in reality there are vastly more). Let's also crudely assume each market is allowed only two values. That gives us 2^100 possibilities, which is about 10^30. That is vastly more than humans that ever lived. And this is with the extremely over-simplified model. We face a practical infinity of possibilities. In reality, no two patients are ever really alike. No statistical model can give you very high confidence on how to treat. That is why AI can never treat patients, because human doctors exercise something called "clinical judgment". That judgment is what enables a doctor to tell us "this is not a serious issue, get good sleep" vs "this definitely needs deeper investigation". That judgment is hard. Often they cannot even explain why they arrived at this but great doctors have that intuition. The entire Big Medicine is about systematically dismantling clinical judgment and convert doctors to mere "protocol pushers". Great doctors resist this. Now on top of the measurable biomarkers, there is the unmeasurable factor called "mental state". Every good doctor knows a positive mental state in a patient leads to far better clinical outcomes. That is why good doctors practise compassionate medicine, not just numbers based medicine. I know an outstanding skin doctor in Chennai who prescribed me medicine for my very-itchy Eczema that I had endured for months, and he also told me "try to avoid stress and it may go away, and you may not even need the medicines I prescribed". I consciously reduced my stress level and the problem went away without medicine. That is a truly great doctor. What does it have to do with autism-vaccine connection? As my crude numerical analysis showed, we have the problem of N=1 way too often in medicine and that is even more true for autism where each kid is truly unique, and that is why statistics are mostly useless and clinical judgment is mostly all we have. We cannot have broad sweeping mandates, definitely not broad vaccine mandates. Each doctor has to exercise their judgment with their patient. And they have to listen to the patient concerns first. What Big Medicine is about is to try to reduce medicine to be a pure statistical science and it is not. Conditions like autism do not fit that paradigm at all. That is the battle here. At its core it is not just an autism battle, it is a philosophy of medicine battle. I pledge to keep fighting this fight because I nearly wanted to commit suicide at one one point in my life. Just this morning, a depressed parent approached me for advice and that started my X thread today. I urge intelligent doctors to debate this philosophy of medicine issue. I will not respond to the arrogant "stay in your lane" types.