I trust in science. As an inquisitive person, I marvel at the scientific explanations of events happening around us. Also, as a doctor, I am enamoured of how science has unboxed the human body and its functions so intricately. But science is never completely foolproof. It is a continuously evolving tool to understand the universe, its existence, and the phenomena happening in it. There are still millions of things that are not completely explained by science. When patients pose the unavoidable question, “Is the treatment completely safe, or is there no other way around, doctor?”, I pause for a second before explaining them the improbabilities of medical science.
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Our past is replete with instances where sometimes strictly relying on science and its recommendations can be catastrophic. A classic example in case is the incarceration of Mary Mallon. She was a 35-year-old Irish lady who joined as a cook in an affluent household in New York in 1906. A few weeks down the line, several family members developed typhoid, which then had significant mortality. The head of the family was a wealthy banker who immediately invited the services of a private investigator to identify the source of infection. The sleuth, after extensive enquiry, came to a startling observation that in six of the seven households where Mary had worked previously, there were outbreaks of typhoid and he promptly reported this to the banker and health authorities. Mary had no signs of typhoid either in the present or in the past, and vehemently denied any role in the typhoid outbreak. But medical authorities and police enforced their power and found that she was harbouring loads of typhoid bacilli in her stools. She was branded as a healthy carrier of typhoid bacilli, which was a new medical concept then.
As per recommendations based on scientific evidence available at that time, she was swiftly quarantined for isolation in a secluded facility on Long Island, along with people suffering from leprosy and other communicable diseases, though she was hale and hearty. The unfortunate Irish immigrant, who was a single woman without a family, spent her next 30 years in isolation till she died there. Sometimes decisions based on science can be harsh and insensitive. The limitations of science must be judged and weighed against human sensibilities. Though medical students remember her fondly as Typhoid Mary, even a hundred years after her demise, her story should also be remembered as one of the pitfalls of ever-growing science. What now appears ludicrous and punitive, would have been considered highly scientific then.
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Science can give only recommendations based on the knowledge accrued at that time period. But political decisions and injunctions based on science have to be more humane. During the COVID-19 pandemic, science showed us that the virus spreads through air, and isolation and quarantine are the key measures to control the disease. But how the states used this scientific knowledge and how it imposed that on the citizens of the world were widely different. The timing and patterns of the lockdown, zero-covid policy in some countries, mask recommendations and types of vaccine prescribed, anti-viral therapies and medical management varied widely across nations, causing several hardships. It would be interesting to see how scientists in future would respond when they review how the pandemic was handled across the globe.
One of our well-decorated surgery professors used to recite the emotional story of a two-year-old child to reinforce the importance of limitations of science. The child was born to parents after many years of their marriage and multiple efforts at artificial fertilisation. But when he was born, he had a serious, congenital problem in the intestines and had to be operated on the second day. A masterly surgeon, he saved the precious child and the parents were ever grateful to his surgical expertise. He grew into a healthy child and around two years of age, was brought for a routine check-up. The professor noticed that the playful child had a small extra-toe hanging loosely from his nimble right foot. He suggested to the parents that it be removed since it can cause injury and difficulties in wearing shoes. It is a small procedure performed within a few minutes considering the complicated surgeries routinely performed by our professor. He relied on science; he assuaged them that it is a simple surgery without any complications. The parents were not very keen but could not refuse the life-saviour’s suggestion. But during the surgery, the child developed severe spasm of the laryngeal muscles that he had to be kept in mechanical ventilation for a week in the intensive care unit, leaving the parents in absolute mayhem. Till he recovered fully, the professor also spent sleepless nights. It could be one in a thousand event. But still, it has happened and could not be explained purely by science alone. He always ended the story with the moral that science keeps giving us answers to unravel the myths of the world but one must understand its limitations.
Science is a powerful tool which keeps reinventing itself every day. Whether it is an individual like Mary Mallon, or a society facing pandemics, decisions taken based on science should always include the social, familial, and economic implications it could impact.
rishiortho@gmail.com