The doctor wants to cure the patient, and the patient wants to be cured by the doctor. This very natural symbiosis, however, lies at the very heart of what is wrong with medicine.
There is great pressure on the doctor to do something, but oftentimes what he has to offer is inadequate, ineffective or, worse, dangerous.
HRT is the most recent example of this, but medicine is littered with similar cases through the years. As one Glaxo executive revealed recently, drugs work in only 30 per cent of patients. And it has always been thus.
In a thoughtful essay, Jenny Doust, a senior research fellow at Queensland University, tries to unravel the paradox. Why do we, as a society, persist with a medical model that cannot deliver regularly?
It's partly down to the very pragmatic reason that, for many people, there is no other option. But it goes much deeper, and includes all the ritual and mystique associated with modern medicine, and which is the ideal replacement for religion in a secular age. Illness itself is often mysterious, and the perplexed sufferer may believe that it will respond only to the ministrations of the modern-day priest in the white coat, the hospital consultant.
The consultant is put in the position by society where he is supposed to have the answers. So he responds by ordering a barrage of tests that have been proven in various trials to be pointless.
From there, he may prescribe drugs that probably won't work, or perform a surgical procedure that may, or may not, be effective.
Faced with someone in pain, it is a very human response to try to do something, no matter how inadequate it may be. Once upon a time, we carried out any number of supplications to placate the gods, and to ensure a good harvest. Despite all the scientific strides we've made, we can still be overtaken by the dark forces of illness. But science has taught us why harvests fail, and it's little to do with rain gods. If we better understood why our bodies fail, and the full spiritual and emotional cause of illness, perhaps we would not need to call on our medical priests quite so readily.
(Source: British Medical Journal, 2004; 328: 474-5).