For example, several years ago significant cataract improvement was achieved by applying to eyes lanasterol (chemical in your body clearing cataract naturally) with DMSO (well known widely used solvent which is used in particular to deliver various medicine through the skin, etc., and some adventurous people are also using it to for example deliver dye into eyes to change the eye color). Several other scientific teams at different places tried to reproduce the result by applying lanasterol without DMSO, and no improvement happened. They concluded that the original study effect is non-reproducible and that the application of lanasterol is non-effective. I'm not kidding - you can google these articles yourselves.

https://pubmed.ncbi.nlm.nih.gov/36484206/

I see stories about this being used for cataracts going back almost a decade.

Medicine advances so slowly.

>Medicine advances so slowly.

This is one on my deepest existential fears - not just in medicine - the Ancient Greeks could have had steam turbine based ships, yet it took more than 2000 years, and i'm wondering with a tint of fear what wonderful things we're missing on and what Dark Ages we have to pass through before getting to those things (and i'm not going to see them being long gone before it). The high-tech with AI, etc. is the only area where i feel that the progress has at least some minimally reasonable speed (or at least it is hardly reasonable to ask Nature for something faster than the Moore law), and if it were in high-tech there would be already 10 start-ups funded by at least $100M each perfecting and productizing the combinations of DMSO+lanosterol and exploring the similar approaches :) Unfortunately it seems there is no money here, and the Robin Warren's discovery didn't make him a billionaire.

Mining garbage dumps for resources could of course be a thing, but probably not abundant energy.

This time there is no plan B. We either become an interplanetary species or this planet eventually becomes our tomb. Probably a couple millennia.

> We either become an interplanetary species or this planet eventually becomes our tomb.

Yes, only my version of the "tomb" is that it would be our planetary scale ant city/colony as we become totally connected and our societies naturally become highly totalitarian (not necessarily due to some ideology, you'd just naturally have less and less space/resources/opportunities for your private endeavors). Some ant colonies exist uninterrupted for several thousand years, no progress, just happy busy ants doing their happy stuff. Only few of us who'd get off that planet will have a chance to continue the civilizational progress. Kind of bifurcation of our species. Interesting that Musk advances our civilization in both directions - neural implants as well as SpaceX.

https://en.wikipedia.org/wiki/Planck%27s_principle

And yeah, it can take a while.

My dream is to a have a dumb doctor/mechanic/plumber/blah that just researches even the most basic questions unless it’s something really odd-ball and only then defaulting to their “expert opinion”.

So some part of new medical information might spread faster than I had thought.

* My ear problem turned out to be that my ear canal was full of wax. I guess we didn't really need ChatGPT that day.. ¯\_(ツ)_/¯

I guess on HN we're all relatively pro-science. But the world would be a better place if we recognised that our scientific knowledge in some areas is poorer than we like to pretend.

I started feeling that way when I worked alongside some "Evidence-Based Medicine" advocates. Years later I've landed in data science and the standards of statistical analysis and understanding I see especially in the biological sciences has only made me more sceptical.

Way back in 2007 the BMJ as part of its Clinical Evidence project published its systematic research into standards of evidence in support of common medical treatments. Some 2500 treatments were evaluated to determine whether they are supported by sufficient reliable evidence.

• 13% were found to be beneficial. • 23% were likely to be beneficial. • 8% were as likely to be harmful as beneficial. • 6% were unlikely to be beneficial. • 4% were likely to be harmful or ineffective. • 46% were unknown whether they were efficacious or harmful.

It's quite hard to find the original Clinical Evidence project resources (might be a job for the wayback machine) but you can find it referenced all over, e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2071976/ .

In the 1970s the US Office of Technology Assessment conducted a similar evaluation of medical treatments' efficacy and found that only 10% to 20% of medical treatments had evidence of efficacy. I would love to see more recent research in this vein.

There are clearly many complications and caveats around all this. Not all "common treatments" are easily studied -- the gold standard of the RCT is not always feasible or ethical. And of course absence of evidence is not evidence of absence, etc... but it sometimes feels we should be a bit more humble about even our best science.

"What are you talking about?" I asked.

"You said the stress of getting ready to leave for the office triggers your attacks," he said.

"I work from home!!" I said. "_YOU_ posed a hypothetical and I answered with a hypothetical: that it would certainly be stressful if that happened. I also said I still have the IBS attacks when I don't have a stressful day."

In my opinion general practitioners (who are not therapists) putting their patient's issues down to "anxiety" or stress is like doctors diagnosing "hysteria" in 19th century women: it contains the in-built subtext that you're not a reliable narrator of your own symptoms, and there is no evidence you can present to disprove the accusation of "hysteria" or "anxiety".

I'm not saying that stress doesn't have effects, but I think a diagnosis based on "stress" can often be reductive; who doesn't feel some stress throughout the day?

So is IBS. I am not sure its fair to expect precise diagnosis for a nebulous "disease".

Those hormones change things in your body, like redirect the blood in your body contracting or extending blood vessels.

>who doesn't feel some stress throughout the day?

It is a quantity thing, you can feel stressed during seconds, or during hours or during entire days.

For example, in a war when your family members could die at any moment, you feel stress for days. In you live in peace you just don't have an idea what that means.

I have not lived war myself but I had close contact with people in Ukraine and in the past conflicts like Congo or Central Africa Republic and other African wars.

Stress effects were obvious for people living in farms. Animals like hens can stop laying eggs or cows stop giving milk just by stress alone.

Why zebras don't get ulcers

I really wasn't stressed at that time; outside of the typical annoyances of being alive, my life was going pretty ok at that point, which I tried telling the doctor and he didn't believe me. After that I went to a different doc and she gave me antibiotics and I healed after a few weeks.

I am extremely thankful that I have not had an ulcer again since then, because it was the worst thing ever.

Like, it's not a good excuse, don't get me wrong, but as much as I try, I simply cannot keep up with the entire state of the art of computer science. I wish I could, and a younger me without a family and responsibilities actually would mostly keep up with everything, but now it just feels like there's never quite enough time to learn everything I really should.

I do try and keep up, I have a million textbooks and the like, and I try and at least go through the example problems for them, but it's pretty easy to fall behind in that stuff.

While a GP should keep up to date with ulcer research, and "I'm busy!" isn't a great excuse when serious pain and/or lives are on the line, but it's something I at least understand better now.

This is the part of this conversation that I don't get. Yes, it is impossible for one person to contain the entire body of knowledge, which means you're not going to know some of the time, and that might be embarrassing or otherwise troublesome.

However... it should be rare that you operate in complete isolation. You should be regularly interacting with other practitioners, including people whose entry into the field is newer, and therefore should be aware of the current state of the art. There should be interactions where that information is shared, both allowing projects you work on to take advantage of advances in the state of the art even if you don't know about it, and for you to become aware of advances in the state of the art.

“Doctor”