THE RISE AND FALL OF MODERN MEDICINE

English physician and Daily Telegraph columnist Le Fanu writes a thoughtful history of the only 20th-century revolution that turned out brilliantly.

During the century before 1940, people grew healthier and lived longer through improved hygiene, housing, and nutrition. Once they got sick, however, doctors weren’t that much help: except for a few treatments (such as thyroid hormone, insulin, and vitamins) a patient got better pretty much on his own—or he didn’t. WWII marked the beginning of a torrent of miraculous advances. To label these “miracles” is no hype. Dreadfully sick people received penicillin, cortisone, or lithium—and suddenly they weren’t sick. Every single child who contracted leukemia in 1950 died; today almost all live. Victims of congenital heart disease or kidney failure lived as pitiful invalids if they lived at all; now they live normally. This was a wonderful period full of heroes, and Le Fanu describes it superbly in the first half of his story. Then he grows sober, thoughtful, and pessimistic. Medicine’s golden age peaked in the 1960s, he writes. Important discoveries trailed off after 1970, introduction of genuinely new drugs dropped sharply, and two disturbing trends appeared. He calls one the Social Theory. Misled by triumphs of the golden age (proof that smoking causes cancer and treating hypertension prevents strokes), doctors embraced a utopian theory of prevention with enthusiasm unaccompanied by proof. Readers will be jolted by the author’s claim that diet, lifestyle, and pollution contribute only marginally to ill health. Obsessive efforts to fine-tune our diet and environment (“medical correctness”) have, in Le Fanu’s view, produced little beside anxiety. The author also takes a dim view of the New Genetics: science’s fascination with DNA, genetic engineering, and genetic therapy. He points out that 20 years of expensive research, media obsession, and wildly optimistic claims have produced only minor benefits to patients.

Le Fanu’s doubts about prevention and genetic engineering place him in the minority among laymen as well as doctors, but he makes a convincing case in this readable and informative account.