Editor's Desk
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EDITORIAL DESK
© Indian Institute of Science 2020.
Editor’s Desk G. K. Ananthasuresh*
Four years ago, I had the privilege of meeting a distinguished retired scientist couple from Mysuru, Drs. D. Rajagopal Rao and Vijaya Rao. Their generous endowment helped set up a laboratory for biomedical research in the Centre for BioSystems Science and Engineering in IISc. That was not the only gift they gave. I had a personal gain in my interaction with them when Dr. Rajagopal Rao mentioned, in a conversation over dinner, a book with a tantalizing title The Rise and Fall of Modern Medicine, which he said I must read. He even took the trouble of writing the name of the author ‘James Le Fanu’ on a paper napkin. I promptly got a copy of the book which was the second edition published in 2011, while the first edition was in 1999. More than a decade after the first edition, the author proclaimed in the preface to the second edition that “the pattern of rise and fall… still holds”. I was curious to know what ‘fall’ the author was referring to, although I could well imagine the ‘rise’. At about that time, Prof. Vijay Chandru, the guest editor of this issue, sowed the seed of a ‘digital hospital’ in my head. I simultaneously read Le Fanu’s book, which chronicles the history of modern medicine in the twentieth century, and browsed the internet for information on the latest advances in telemedicine and digital health in the twenty-first century. The book is a wellresearched and well-articulated tome of 500 pages as compared to the tidbits of incoherent information one can glean from the internet. The contrast was jarring at times not because I was reading about the same subject as it developed in two different centuries or because of the difference between an organized printed book and haphazard online sources, but because of the conspicuous differences in perspectives and approaches to the same problem—to heal patients. Le Fanu refers to the 3 decades from the 1940s as the period of rise of modern medicine. He describes the factors and the mindset that led to 12 big triumphs from the discovery of antibiotics and steroids to the development of open-heart surgery, implants, and transplantation. The major
J. Indian Inst. Sci. | VOL xxx:x | xxx–xxx 2020 | journal.iisc.ernet.in
factor that made these breakthroughs possible, he notes, is the dawn of the new ideology of clinical science wherein clinicians were engaged in unraveling the mysteries of biology and inventing diagnostic and therapeutic devices. In the decades that followed, this led to cornucopia of new drugs as well as medical devices of three kinds, namely, life-sustaining, diagnostic, and surgical. This success that improved medical practice significantly, Le Fanu argues, paradoxically also brought with it four “perverse consequences” that led to modern medicine’s fall: “disillusioned doctors, the worried well, the soaring popularity of alternative medicine, and the spiraling costs of healthcare.” According to Le Fanu, the doctors are disillusioned because of “over-speciali
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