In Part Three of her book, High Tech, Dr. Sanders looks at how testing has changed how medicine is practiced. Please address both questions below by class time on Monday.
- There are many different kinds of medical tests that were mentioned in this chapter; would you trust the results from all tests equally? Please explain with an example.
- What point is she trying to make by focusing on Lyme disease?
14 comments:
1. I would be hesitant to trust the tests results of the ELISA and weston blot test. but, I'm not in the position of an ailing patient eager for a diagnosis. these tests aren't conclusive by any means such as the ELISA which can show positive results that only stem from the bacteria in the large intestine. Since there are so many species of bacteria trying to identify them by their antibodies seems impossible. a test to identify the actual bacteria is what would be ideal.
2. i think the point of the chapter is we don't know the answer to everything. in this high tech world full of diagnostic tests people assume that practically every disease can be accounted for when in reality there are many gaps in using technology for diagnosis. Furthermore, Doctors need to demonstrate humility in not feeling obligated to give some diagnosis and empathy for patients who they can't figure out a diagnosis for.
I would not trust the results of all tests equally. The tests for Lyme disease are not very conclusive. These tests look at the antibodies rather than at the actual Lyme bacteria. Because people have different immune responses and different bacteria already living in their digestive tracts, it is difficult to characterize people's antibodies with tests. Other tests, however, are more reliable. Testing for a pathogen directly by growing it in a culture is more reliable.
Dr. Sanders is trying to show how idiotic many doctors are with her example of Lyme disease. The "Lyme literate" doctors are ignorant and refuse to be wrong, even in the face of overwhelming evidence against them. Maybe the larger point she is trying to make is that since not all high-tech tests are cut-and-dry, there is room for skeptics and believers to question and interpret the data.
1. No, I would not trust the tests equally. The tests for Lyme disease (ELISA and the various Western blot tests) don't seem to be nearly conclusive enough. Because they test for antibodies instead of bacteria, they often aren't definitive enough to determine whether or not someone actually has Lyme Disease. As Sanders says, the tests often aren't positive when they should be because it's either too early for the tests to detect the antibodies or the antibodies will never be produced. Additionally, both types of tests need to be used together in order to detect Lyme Disease, and they're still not that effective together.
2. I think that Sanders chooses to focus on Lyme disease because it's an excellent example of a disease which many physicians believe they know a lot about, but is actually quite a mystery. The supposed "experts" who are "Lyme literate" actually tend to incorrectly diagnose patients with Lyme disease, thus causing them greater harm, more often than correctly diagnosing people suffering from the disease. Lyme disease seems to be somewhat of "go-to" disease for doctors, and it's an example of exactly how eager patients are to hear a diagnosis, even if there's a chance that it may be incorrect. Sick people feel better if they think they know what's wrong with them, so it's somewhat understandable for modern medicine to play onto that.
1. I don't think I would trust all tests equally. Tests such as the ELISA and the western blot test don't seem to give solid enough results, as the test for antibodies rather than the bacteria itself. Since everyone has different bacteria in their digestive tracts, testing for antibodies may not be the most accurate method.
2. I think the point Dr. Sanders is trying to make is that doctors don't have the answers for everything. While they may have various high-tech tests that they can use to diagnose patients and people assume that doctors will always be able to find the cause for their illness, doctors can still make mistakes. Doctors shouldn't feel obligated to give a diagnosis if they're not sure of the cause of illness, as this can cause harm to the patient.
1. While medical testing in modern day is miles ahead of any other time in history, I would still be skeptical about the weston blot test and the ELISA test, as they don't actually identify the Lyme bacteria, but rather look for antibodies that the immune system makes to attack the Lyme bacteria. Unless it was confirmed that that antibody only was produced to combat the Lyme bacteria would I trust those tests.
2. I think that this chapter highlights two things: firstly, that despite how far medicine has come, we're still far from knowing everything about how the body works and how to treat diseases. Lyme disease is one of many along with cancers and aids which we still haven't cracked, and it will be a long time before disease is entirely routed. Also, I think the controversy over "Lyme literacy" is meant to highlight the fact that in today's society medicine is still a business, and filling a unique medical niche is key to ensuring an income. Therefore, when new science threatens a niche, the doctors within that niche have to respond defensively in order to preserve their higher paycheck. I believe that this is one of many examples of business sense getting in the way of medical progress, and that is what Dr. Sanders is trying to convey to the reader.
1. Many have commented that they would not trust the tests used to detect Lyme disease, but when used as the CDC recommends, these two tests provide an accurate diagnosis 90% of the time (see p. 181). Although these tests are somewhat complicated because they do not test for the bacteria directly, they are actually fairly reliable and accurate. The problem is not the test--the real problem is that some doctors are/were not following the guidelines (e.g. at least 5 of the 10 antibodies have to be present).
2. "Chronic Lyme Disease" is a phantom disease, not a real one. By using it as an example, Sanders shows that doctors' and patients' desire for diagnoses, combined with improper interpretation of tests, can lead to false diagnoses and consequently to useless or harmful treatment. The patient's story, physical exam, and tests must all be considered together objectively.
My trust would be very dependent on both the doctor and the type of test I would be undergoing. For example, the Lyme test is very unreliable; it has two parts and in the second part if you have 5 out of the 10 symptoms, you most likely have Lyme disease. But I also think the doctor would make me believe more in whether the tests were right or not. For example, Dr. Davidson lied to Ms Carol. He told her lies; by not following regular guidelines for this disease, he made an unreliable test even worse.
By using Lyme disease as an example, Dr. Sanders is showing that we just do not know everything. There is no way around it; doctors can be super confident in what they know, and in modern technology, but at this day and age there are still certain things we do not know the answer to. And both doctors and people need to recognize this. The use of Lyme disease makes it seem more relevant to me than say HIV. To me, Lyme disease seems more likely and common to me, as ticks are everywhere. In addition, people acknowledge that a disease like HIV has no cure yet, while many do not realize that we don’t know everything about Lyme disease, like the Lyme literate doctors. Sometimes, people just need to acknowledge that they do not know everything, even with all the knowledge that our society has accumulated.
1. I wouldn't trust all tests equally because a test that tests for antibodies, rather than bacteria like the ELISA, would be inconclusive for all patients. The ELISA can turn out a positive diagnosis from bacteria that live in a person's small intestine. So I wouldn't trust a test that could misread me as ill when I'm perfectly healthy.
2. Dr. Sanders mentions Lyme Disease because it's an illness that many doctors see as a one size fits all diagnosis. Any doctor can think they know everything about Lyme by simply knowing classic symptoms and causes and then they think they are "Lyme literate". However, this causes many misdiagnoses and make patients suffer more harm than they would've if they had gone to a specialist.
1. I wouldn't trust all tests equally because if a test like the ELISA can turn out a positive result just from picking up on bacteria that is naturally in a human's system, it would be completely inconclusive. Tests that simple tested the antibodies produced could also be inconclusive because not all humans respond to attacks on the immune system with same antibodies.
2. I think Lyme disease is just a classic example of a disease that doctors feel "literate" in, and confidant enough that it is a go to diagnoses, when in actuality, they know very little. This, combined with the fact that most of these tests seem to be pretty ineffective at actually diagnosing Lyme Disease, leave it to still be, consequently a very inconclusively known disease.
1. No I would not trust the tests equally because the tests like ELISA and the western blot tests are not conclusive because they only test for antibodies instead of bacteria, which means they can't actually determine if someone has the disease. This is because it is often too early for the tests to detect the antibodies or the antibodies will not be produced. Sanders says both tests needy o be used together to successfully detect Lyme Disease.
2. Dr. Sanders uses Lyme disease to show that current medicine can't always find the right answer when clouded by the doctor's or patient's desire to solve the problem. Doctors obviously still make mistakes, so it's good to double check if there is any skepticism. Doctors should also not be feel obligated to produce a diagnosis if they can't figure it out correctly.
1. No i would not trust the tests equally. The test for Lyme disease tests the antibodies. This is very unreliable because people have different bacteria and antibodies growing in them. It would be much more effective to take a sample of the pathogen itself and test it verses testing and collecting your bodies response to it.
2. I think the point she is trying to make is that doctors really don't know everything. And that you should take a rushed diagnosis or a generally inaccurate test with a grain of salt.
I don't think I would trust all of the tests equally, as the ELISA and Western Blot Tests do not actually test for the bacteria itself but for the antibodies created in response to the bacteria. At the same time, because diagnosing someone with Lyme disease seems to be a matter of figuring out everything they don't have, I would trust the tests once I had eliminated all other options.
I think that Sanders focuses on Lyme's Disease to show the incredible complexity of diagnosing just one illness. When this complexity is applied to every possible diagnosis, it shows the incredible complexity of diagnosing any illness.
1. I personally wouldn’t trust the tests equally, just because they don’t seem conclusive enough. The test for Lyme disease, ELISA, and the many western blot tests seem inconclusive to me because they are not even testing for bacteria, but for antibodies- which makes them less certain if a person actually has Lyme disease. And because everyone possesses different forms of bacteria in their digestive tracts, this form of testing doesn’t seem accurate enough.
2. I think what Dr. Sanders is trying to highlight is that there are medically mysteries out there even to the most experienced doctors, and that doctors do not always have all of the answers. Eventhough methods are far more progressive than they have been in past history, these forms of testing are still a bit skeptical. I think another area of focus the doctor was trying to make was that it is the patients personal story and proper examination that must be equally taken into account when making a diagnosis.
1. Without question, I would not trust the results of all the different medical tests equally. Each test is different in some way, and two medical tests, which have a huge impact on people's lives, cannot be taken with a grain of salt. A test for lyme disease, which tests for antibodies is not nearly as effective as one that would test for bacteria. Because everybody has different bacteria living in their body and different immune responses, it is pretty difficult to get a good read on one's antibodies in comparison to others. A test to simply identify actual bacteria would serve the doctor best.
2. I think the point of focusing on Lyme's disease in this chapter is to expose the weaknesses of doctors. Even with how far medicine has come, we are still far from knowing everything about the body and different types of diseases. For example, the tests for Lyme disease are sometimes inconclusive. This is unacceptable for something so important. The main point is that medical world has a lot to learn and can become much more effective
Post a Comment