Modern medicine: medieval torture or not?

" modern medicine still isn't very far removed from medieval torture. The only big difference is anesthetic.

Sounds like the start of another thread to me. Hmm..... "

Well, you're on, dood...

I disagree on the basis of my experience and what I have observed in and out of various facilities over the years. Specifically, five years ago, I received a new heart valve. Pain and discomfort throughout the procedure was trivial, but more importantly I am still functioning today and remain reasonably active, especially for someone in their late 70's. Without the new valve, I would have died about two years ago. Just last week, I encountered another guy, hale and hearty, who had experienced the identical procedure, also with good results .

More importantly, the vast majority of medical folks are dedicated to alleviating human suffering and improving quality of life (There are exceptions, of course. Today's paper had a front page story about the conviction of a physician for second degree murder - wantonly careless drug prescriptions).

I have delivered accident victims to ERs many times, and I have been there myself on occasion as a patient, and I have seen only positive intentions, usually with the same results.

What in your experience leads you to equal medical care with medieval torture? It seems to me that the intent and mindset of your average medieval torturer differs greatly from that of today's doctors and nurses by quite a bit, to say nothing of the different methodologies involved.....

I won't comment on intent, as that is something far too personal to interpret and irrelevant to the argument anyways. Whatever motivation they may have, it is strictly their technique I observe and compare

Likewise, the outcome of these modern procedures is also irrelevant to the argument. There are certainly successes and failures, but no one survives forever, and the fact is people die in a hospital. Lots of people.

It is wonderful that some lives are extended, some ailments alleviated, some illnesses healed. Also irrelevant.

Were it not for the anesthetic, the experiences your body went through while you were being "treated" would've been unbearable. How long can a person tolerate having their chest split open, multiple cardiac electrocutions, needle stitchings, and so on? Or a splenectomy, or a caesarian, or an amputation, or intra-cardio chemotherapy, without being rendered unconscious, paralyzed, sedated, numbed, and having all memory of the event erased from their minds, assuming they survive?

That is my comparison, that is what I've seen. Euthanasia is perhaps comparatively more humane. Having lived enough of a life to accept the inevitable, I've already directed a DNR in my file. I don't need to go through that experience. I don't want to see anyone else go through what I've seen either. They may be unconscious, they may not remember it, but after what I've seen, what happens on that cold steel table in that sterile, unfamiliar room is not something I will ever look forward to, regardless of the outcome.

YMMV

This is just ridiculous. Of course modern medicine in America is nothing like medieval torture -- even the worst inquisitor didn't bill you for their services afterwards, make you file claims, reject your claims because you entered the wrong code or because the iron maiden they used on you was "out of network." Torture was strictly a single-payer system back in the Middle Ages. After you were burned at the stake, you were done, and I mean you were DONE!

I guess this thread really hits home after my valve replacement. The fact is they wheeled me into the OR, got me situated, and then went to work - anesthetic, stopped my heart, shunted blood through a heart/lung machine, popped the hood (so to speak) and got down to work, putting in my new valve fabricated from cow and pig tissues, sewing me back up and restarting my heart. I woke about eight hours later, feeling OK(this had something to do with the morphine I was given). Three days later I walked out of the hospital - that was a really good moment! Useful life has resumed.

I have executed an Advanced Care Directive, or whatever you call it, because there will be a time to pull the plug and walk away. Maybe I will be in a hospital, although a hospice would be preferable. Who knows when? Until that time comes, I will enjoy the benefits of modern medicine.

It is clear, BTW, that my good health requires my active participation, working with the medical establishment to keep the wheels turning.

I encountered the member of the team who stitched me up at the end of the operation (definitely a "closer") and chastised him for such a neat job. I was planning to run away and join the circus, making a fortune by showing my hideous scar for 50 cents a pop. His neat work ruined those plans, so I am back to digging for science....

While we're listing differences between modern medicine and medieval torture, in addition to anesthesia, let's list the following important differences:

-Pre-operation consultation
-Free-will
-Sterilization
-Post-operation care
-Nurses
-Waiting rooms for family
-Visiting hours
-Philosophy
-Hippocratic Oath
-Medical schools
-Etc.

Saying "the only big difference is anesthetics" is an oversimplification and fundamentally inaccurate. It's also a slight toward doctors who have dedicated their lives to helping heal people.

+1 very well stated

Great list, ireckon. Let me add to that the scientific method. While the medical practitioners I know are clear that medicine is still a large component of "art" vs. science, it's evolving rapidly and improving constantly. Just looking at how the TCCC guidelines have evolved over the last few years is astounding.

Equipped.org, where hyperboles are evaluated for their accuracy.

Now that's on the mark!

By the way, this notion was not contrived. I spent the better part of an evening at elk camp discussing this with a good friend, who worked as an ER doc at a local hospital. This was when my observations became a tangible comparison of what the similarities of the two gendres would be like.

Obviously the main difference- technology aside- is intent. Torture was meant to extract information or to cause suffering for its own sake. Modern surgery is meant to cure or correct an illness, injury or other condition. It's the difference between arson and lighting your fireplace.

Major surgery is not a pretty sight to be sure. However, I am truly thankful for the wonders of modern medicine. I have several family members and close friends with serious disability or health conditions that would not be alive today without first-rate healthcare, highly qualified professionals and high tech equipment that makes all the difference between life and death.

We tend to forget that many procedures performed routinely nowadays were either uknown or technically impossible just a few decades (or maybe even years) ago. What was state-of-the art medicine in 1900 would be considered barbaric today. And if you think modern battlefield surgery borders on torture, imagine how you would feel about a field hospital of the Napoleonic era for instance.

I agree that sometimes modern medicine tends to prolong life even when rationally speaking, it might be better to let nature take its course. On the other hand, it's also true that we are wired as human beings to cling to our earthly existence for as long as possible. I don't think you can really appreciate life until you're on the brink of losing it.

And of course, procedures change, usually for the better, through time. Case in point. my traditional open heart procedure (which I tend to refer to as "Aztec sacrificial cardiology") is being replaced by less disruptive procedures with incisions through the chest wall or even introducing the new valve at the femoral artery. Apparently the results are good, with less stress for the patient.

I was never offered any photos of my appearance on the operating table, although I imagine it both very unusual and not very pretty, like a good many procedures. So what? The end results are what count.....After all, I am a happy camper - my new heart valve came with a lifetime warranty.

Did you fill out the warranty card? I can never decide... It seems like just a way for corporations to collect information on us.

So true, in a very specific and literary sense, that it is faboulus hillarious! Or is it the other way around? My lifetime ends with the hearth valve warranty...

Back on topic: You may be surprised to find that both modern medicine and medievial torture has the very best intentions for the long term velvare of the patient (deliquent)? The difference is that modern medicine tries its very best to save the earthly flesh, whereas medieval torture does the exactly oposite. The idea is that your body is just a disposable, short-lived container of not much interest anyway -- what matters is the choices affecting your eternal afterlife. Confess your sins, and your soul may be saved from eternal damnation. So the torturer is in fact doing you a favour!

And if an innocent person is wrongfully subject to such treatment... well, the innocent goes straight to heaven anyway, a little torture is just a way to speed up the process. The phrase "patient consent" does strike me at somewhat relevant in this context...

I think it's being overly charitable to say that torture was generally undertaken for the good of the victim's soul. And since modern surgery techniques are designed to fix the body, not the soul, I think you're comparing apples to blood oranges.

Hmm, perhaps I am still too vague in my assertion. Let me try again.

It is not the outcome that I am drawing a comparison on, it is the activity.

In Napoleonic and even American Civil War era medical practice, there were a lot of prospective patients that flatly refused treatment even in the face of probable death without it rather than succumb to the conventional remedies of the time, such as amputation of an injured limb to better control profuse bleeding and/or risk of infection.

Could we imagine going through open-heart surgery without anesthesia? Who would be willing to endure such an experience fully conscious and able to feel every slice and tug? At the time you are about to go through such an event, would you consider refusing the procedure? Would you be able to even lay there unrestrained and let them do what they need to do to you?

Yes, intent is a fundamental difference, but has absolutely nothing to do with the experience of the recipient. Without the anesthesia, there is no physical difference in the sensation, the fear, or the physical trauma inflicted, other than the surgeon will have a more aesthetically acceptable technique.

If faced with a choice of going through such an experience and dying, or not going through such an experience and dying, what is the sane conclusion? Twould be consterning for one in their youth/prime to face such a dilemma, not so much for one who feels they have already lived a full and satisfying life.

A quote I often cite: "Everybody gotta die sometime, Red."

I think I get your point, and can relate to it to some extent. However...

Before the introduction of chloroform the best/only widely available kind of anesthesia was hard liquor, which was used very commonly. Unfortunately, it's not particularly effective for the purpose and hence many advanced surgical procedures were either extremely painful or impossible to pull off with any chance of success.

I don't think you can perform open-heart surgery or anything like it without proper anesthesia and life support equipment in the first place, neither of which existed in 19th century. Even today, no military field hospital with limited equipment and supplies could do that sort of thing, it requires top notch medical facilities.

However, if you do have the privilege of modern healthcare at hand I think it would be pretty hardcore to deliberately turn down say, open-heart surgery that could save your life simply because you can't bear the pain (which you're not going to feel anyway) of the operation being performed on you while you're out cold.

YMMV for sure, I have no axe to grind one way or another. But this much I know - most people are willing to take far greater pain and risk for the chance of living a little longer.

Except intent has everything to do with this comparison. Modern medicine has identified the brain and its effect on the body as being a physical system. Intent would affect how a person copes with the immediate physical trauma of surgery versus torture. Intent would also affect the brain's ability to heal the physical body afterward.

Somebody has to do this, and so I guess I will... The main difference between rape and consensual sex is intent. Oftentimes there is no difference in the immediate physical trauma inflicted. Because of intent, rape is extremely damaging (mentally and thus physically), while consensual sex is typically healthy.

That drives home the fact that anesthesia is an epic game changer! That's one of the reasons surgery and torture are so different. Antibiotics is another.

I don't see a proper comparison here. Coitus, whether willing or not, cannot compare to evisceration, willing or not. Without anesthesia, going through the act of evisceration, whether well intended or not, cannot be a sanely enjoyable experience (perhaps a masochistic mind could find ecstasy from such an undertaking, but we are not talking aberrations here). It is only through the application of anesthesia of sufficient potency that any invasive surgical application can be tolerated by the recipient, and no amount of consent on the part of the recipient or the provider can mitigate the physical trauma experienced by a normal person.

Further extension of the point would, by way of experience, indicate that a heightened level of pre-surgical anxiety is a common among many patients. Could this anxiety approach levels of those about to experience torture? It would seem a common practice to administer pre-surgical tranquilizers to make the practice routine. There is no doubt that the psyche is well aware of what is pending, and survival instincts will activate.

So if intent is not the inducement to the anxiety and fear so many patients experience prior to surgery, as no reasonable doctor intends to inflict suffering on their client, then what must we conclude about the cause of this aversion, even when we know it is for our own good? It is because we are aware of the risks, and we are aware of the pending trauma our bodies are about to go through, even though we will be rendered virtually unconscious and will have no memory of the event in any case. So many times, I have seen patients in prep tremble uncontrollably, right up until the nurse sticks the hypo into the IV and administers the "joy juice" as some of them call it. The purpose: to calm them down and help them deal with the anxiety. Imagine what effect such a thing would have on someone facing torture.

So intent is not a factor. Normal people don't consent to trauma without motivation, that being to endure for the chance at improved health. Who would rationally submit to any surgical procedure that was not deemed necessary? We do not need our appendix for anything, so why not line up to get them removed? We all face the risk of eventually developing appendicitis, and at a time and place that may preclude other remedies besides emergency surgery, so why not make it preventive care?

Ah, but isn't cosmetic surgery elective for the vast majority? Well, that is mitigated by other motivations, with perceived benefits. As before, normal people do not consent to trauma without motivation, and some feel that cosmetic surgery can lead to an improved quality of life. Ok, but they still require anesthesia for the operation, and many still need the pre-op tranq to deal with the anxiety.

So it would seem the similarities of torture to modern medicine, as we have all now had a hand in defining the parametric comparisons and exclusions, remains conclusive. Without the anesthesia, the experiences would be similarly miserable, and neither intent nor desire would have any differing effect on the endurability of either.

This thread reminds me of the scene from the movie Monty Python's the Meaning of Life, where the non-doctors have come to collect the liver from a man who filled out a donor card. Well intended fellows I suppose.

Interestingly enough, evidently none of us has commented on the one crucial difference between medieval torture and modern medicine - informed consent. You always have the option, as I understand it, to say "No mas!" and the medical establishment then packs away their tools and goes home. Again, before my open heart procedure, the surgeon went over the procedure, the risks and benefits (there was a 1% chance of dying - about as good as it gets), the recovery regimen, and my likely future prospects. I then gave my signed, written consent to the procedure.

I am not an expert on medieval torture techniques and procedures, but I don't believe those practitioners received consent before initiating their work.

Somehow informed consent makes a huge difference - in surgery as well as other aspects of life.

BTW, as I imagine someone might inquire, if a patient is unconscious or unresponsive, consent is implied....

Additional Comment: Just returned from receiving my annual flu shot, and guess what? I needed to fill out a one page form giving my consent to the procedure! A lot of medical practice today, like giving vaccinations, is preventive medicine which eases pain and suffering, as well as holding costs down. Definitely a long way from torture, medieval or otherwise

Would you have given consent if the doc said he could use no form of anesthetic during the procedure, and you would be fully awake and remember the whole thing? I am sure some would go ahead anyways, but how would that difference affect your decision to go ahead? How would it affect, say, a liver transplant go decision, or a lung transplant?

Consent is much easier to give when you know you won't be there for the experience. Consent is also irrelevant to my argument, as the comparison is of the event, not the outcome.

I must confess I have a hard time following your logic. Is it correct to say that you object to this kind of procedure simply because it looks rather grisly (I dare say! - Aztec cardiology and all that)? Your earlier comment, "It is not the outcome that I am drawing a comparison on, it is the activity." leads me to that conclusion.

I wouldn't have the option of open heart surgery without anesthetic, and several other technologies - remember my heart was not beating and in a certain sense I was dead with a fairly sophisticated heart lung machine continuing to maintain my organs, as well as a whole bunch of items of which I remain oblivious. I am fairly certain I was not a pretty sight on the table in the OR. But the outcome was extremely positive - I have remained fairly vigorous, continuing active fieldwork and doing a lot of bike riding. I ran into a chap the other day who had undergone the very same procedure and he was also rather vigorous, positive, and pleased with the final result.

I understand that surgical procedures were unspeakably primitive during the Civil War era, but fortunately that era is behind us and therefore irrelevant.

Let me offer an analogy - running a marathon. One endures a lot of physical punishment and pain, with the risk of traumatic injury. My first marathon (I completed five), especially, was really rough, particularly the last five miles, and I could barely walk the next day. Was it worth it? Absolutely! I was hurting, but I was extremely happy, satisfied, and content. One gets the same result on any challenging undertaking - finishing and writing up research, for instance. Go through the fire, achieve the objective, and enjoy the result. Pain inflicted becomes rather minor.

Yes, it is the activity, not the outcome I am addressing. Object would not be the right term; reluctance or aversion would be closer to it. Notwithstanding your cardiac procedure, what about the other examples I cited? Would there be an aversion to going through a liver or lung transplant without anesthesia?

Kudos to you for enduring the hardship of marathoning. It does have it's implicit rewards, and like many things in life, it is worth suffering for if you have a mind for it. I believe natural childbirth can sometimes be quite uncomfortable, yet many women willingly go through it for the benefit they hope to receive. Some do not share that desire. One of the fantastic things about the human psyche is its ability to deal with great suffering when properly motivated. I suppose there are those out there who might actually be able to endure going through a liver transplant without anesthesia as well. I don't think everyone would be, however.

I think we are making progress here. Your point thus far is well made, and while of a different focus than mine, does affirm the more positive aspects of modern medicine. If we can hold our civilization together, we should continue to make great progress in making and keeping people well, the good Lord willing and the river don't rise.

You know, I do find this conversation slightly amusing. Here we are on a survival forum of all places, discussing the cons of modern medical procedures that might very well save one's life - but which some apparently find too "grisly" for their taste...

Maybe it's just me but I happen to find that somewhat ironic. Also, it makes me wonder about that No. 1 commodity in any survival situation, the will to live. To keep on fighting no matter what, even when it hurts like hell and your chances are basically zero.

If somebody decides to turn down life-saving medical assistance out of entirely irrational fears or prejudice I think it's a pretty good sign that their will to live is lacking. Not really conducive to "survival" of any shape or form IMHO.

Please, do not take this the wrong way. I am not trying to judge anyone. If anything, I really appreciate Benjammin's honesty when talking about these fears openly. Then again, I like to think of that old saying - no pain, no gain.

Just a few days ago someone very close to me has had a somewhat "routine" but no less grisly surgery that, if gone wrong, could confine that person to a wheelchair. Fortunately, it seems the surgery was a success and that person's quality of life is going to improve drastically.

Would that person agree to the same procedure without anesthesia? Probably not, no way to carry out a surgery like that unless the patient is sedated and restrained. But that's not even an issue right now - anesthesia is available, for the time being at least, and it's not quite TEOTWAWKI... So what is the point, really?

Well stated - probably time to give this thread a rest.....

I reckon so.

Torture would be totally tolerable with anesthesia as well, though as we say, consent and intent are diametrically opposed.

Not so much fear, though there is an element of that in there. From my perspective, just not worth the trouble or the risk.

Yet here I sit, with all kinds of skills and supplies. I guess motivation is one of those have to have sort of things for survival as well. At least the experience has been entertaining. Sometimes people just get tired of putting forth the effort, of doing what has to be done all the time, and a break from the action starts looking like a reasonable concession. Of course, it helps knowing there's something waiting on the other side of the door.

Time to close the thread.

What, you guys are done already? Let's talk about other things that are like medieval torture --

1. spending time with my mother-in-law
2. flying these days!
3. Kim Kardashian
4. Watching Bear do his stunts

That just triggered my "Don't make me stop this car!" reflex.

I guess my MIL is more agreeable than you MIL, but for the ultimate analogue for medieval torture, how about child birth? That is something I have only experienced vicariously - even then it was pretty rough. Gotta be the ultimate for "no pain,no gain."