HEART BEAT:Medicine is awash with waves of pseudo knowledge - sure everybody knows that, writes Maurice Neligan.
WHEN EVERYBODY and their canine best friends, "the dogs in the street", know something positively, it should not be taken as a licence to take your brain out of commission and subscribe uncritically to this apparently universal truth.
Everybody knew the earth was flat. The dogs in the street knew there was a place called Limbo. Didn't we all believe in witches? I could go on and on.
Galileo did not "feel obliged to believe that, that same God who has endowed us with senses, reason, and intellect has intended us to forgo their use and by some other means to give us knowledge". I wonder if, by other means, He meant everybody and the aforesaid dogs. If so that should fairly put them back in their kennels. It should, but it doesn't.
Medicine is awash with these waves of pseudo knowledge. You're not even expected to think about the proposition being offered, you can accept it as part of the lattice of knowledge.
No room here for the doubters, or worse, the apostates or those miserable wretches who will not see the light and write books or articles questioning the "known facts".
"Who do they think they are? Sure everybody knows that." No discussion: "Move along there and don't be wasting our time."
Heinrich Heine foresaw what was coming a century later in his own homeland. "Wherever they burn books, they will also, in the end, burn human beings."
Mind you, I don't expect to be burned but neither do I accept that these truths should be swallowed without a reasonable seasoning of salt. The same salt that the dogs in the street know is bad for you.
Salt is a mild example of what I am talking about. The physiological systems in the body regulating the concentrations of sodium and chloride in the intracellular and extra cellular components of the body fluids are, at the same time, simple and exceptionally complicated.
If you have too much, it is simply excreted. If you have too little, every attempt is made by your bodily regulators - circulation, nervous system, hormonal control and renal system - to conserve what you have.
Most ordinary folk need not worry about their salt intake. Some people with kidney and heart disease and in some conditions in pregnancy need professional advice and management.
At least there seems little commercial advantage to some doleful dog mournfully intoning that salt is bad for you. Clearly also even the most trusting and credulous among us can work out that somebody peddling hair restorer or a cream that is guaranteed to leave you wrinkle-free for eternity might just possibly have a commercial interest in same.
If you believe your hair will sprout again or that you will become a perpetual billiard ball, that indeed is your prerogative. These are harmless affectations and it's your money.
I am not equally tolerant of those who play on human fears rather than vanity and who promote products that in some way or another are meant to protect against illness and death itself.
An example would be the veritable industry founded on the extremely dubious proposition that lowering blood cholesterol will, per se, convey major benefit on the potential patient.
I stress potential, because such advertising is aimed primarily at the well, most of whom will have no blood lipid (including cholesterol) abnormality whatsoever. It seeks to create a category of "sick well" who are meant to worry about the possibility that their cholesterol may run amok if they fail to take these magic potions designed altruistically to keep it in check.
A succession of well-known people (God help me, I nearly wrote celebrities) earnestly assure us that consuming this yoghurt or margarine staved off for them the disaster posed by these rampant malevolent fats.
Everybody knows cholesterol is bad for you. Well it's not and is indeed an integral part of bodily metabolism. There are problems with high cholesterol and there are equally serious problems with low cholesterol. The body is pretty adept at sorting things out and when things go amiss there are always the doctors who can attempt to correct whatever combination of factors has made us ill.
"But," sez you, "the dogs in the street know the doctors are only lining their own pockets." All right folks have it your way, and if the fates go against you, may you find a comfortable trolley in the A E department.
Maurice Neligan is a cardiac surgeon