Our minds are seas, easy to pollute but difficult to clean.

      In science, truth travels slowly.  Before the advent of science, man-made myths evolved to explain the mysteries of our universe.  As science advanced, traditional beliefs were challenged and great battles were fought against scientific truths.  When Galileo proclaimed that Copernicus was correct in that earth rotated around the sun, his proclamation offended the Roman Catholic Church, which held to the Aristotelian view that the universe was geocentric.  In 1632, Pope Urban VIII referred Galileo’s case to the Roman Inquisition, which forced Galileo to recant, banned his book, Dialogue Concerning the Two Chief World Systems, and placed him under house arrest until he died in 1641.  This verdict was not ratified until 1822, 181 years after that scientific truth was first promulgated.  The battle between science and myth is the ever-present battle between truth and tradition, whose battlefields continue to be the polluted minds of humanity.
      Scientific truths evolve from hypotheses based on observations.  These hypotheses are then subjected to the scrutiny of experimentation where they are either proved or disproved.  During this tedious process, which may take a very long time, opinions multiply and beliefs are deeply held despite the lack of evidence.  However, when enough evidence accrues to constitute solid proof, all the other hypotheses and beliefs are discarded in favor of the new truth.  Hence, the ever-poignant aphorism of Thomas Huxley (1825-95), “The great tragedy of science—the slaying of a beautiful hypothesis by an ugly fact.”
      Medicine is a discipline whose feet rest on tradition but whose eyes look to science for guidance.  Medical experiments avoid bias by using controls, whereby a treatment is given under double-blind conditions.  To achieve that, a cohort of patients is randomly split into two similar groups.  Then, unknown to the doctors and to their patients, one group receives a placebo while the other receives the real treatment.  At the appointed time, the code is broken and the data analyzed by statisticians to see if the treatment had made a difference.  When a significant difference is found, and when the experiment is replicated and its results confirmed by other observers, then its findings will be held as true.  Such prospective, double blind, controlled studies are the gold standards that guide medical therapies.
      Many of our current treatments are based on prospective, double blind, controlled studies.  However, when such studies are not available, then our treatments tend to be based on extrapolations from non-prospective data.  Here, opinions vary, treatments differ, and believed truths continue to change and evolve until that time when the matter is settled by definitive studies.  In situations such as these, patients may become confused and disillusioned by the many and often conflicting opinions they receive.  Indeed, as stated by Oscar Wild (1854-1900), “The truth is rarely pure and never simple.”
      In this rapidly changing medical world, patients need to become proactive.  Ask your doctor about the data upon which his opinion is based.  Ask if there are prospective, double blind, controlled studies that support his proposed treatment.  If there are no studies, get second opinions from doctors who have had the greatest experience with your disease.  Ask them how many cases have they treated and what was their success rate.  Insist on evidence-based medical care whenever possible.
      The practice of medicine is an art and a science.  Whereas the art grows fat on experience, the science grows robust only with truth, and that truth can only be discovered with experimentation.  Just as it is the duty of the scientist to prove what he believes, it is also the duty of the doctor to resist belief when there is no proof.  John Keats, the famous English poet, was also a careful physician who cautioned us against belief without evidence: “The only means of strengthening one’s intelligence is to make up one’s mind about nothing—to let the mind be a thoroughfare for all thoughts.”
      A medical mind must not only be satisfied with making observations; it has an obligation to test them.  Some of our most important medical discoveries began as incidental observations that were noticed and developed by eager minds.  The words of Louis Pasteur (1822-95), one of the greatest benefactors of humanity, are as a poignant today as they were when he discovered the germ theory, “In the fields of observation, coincidence favors naught but the prepared minds.”