Not so long ago I put up an article here on the site entitled Darwin is at the Door Knocking. Will Mainstream Medicine Soon Let Him In?. One of the subheadings in that article is Medicine without evolution is like legs without feet. Shortly after that sentence had popped into my head and I’d written it down, I realised that I really, really like it. I feel it’s a nice catch-phrase that captures the essence of Darwinian medicine and the message I’m trying to convey with my writings here on the site.
To people who don’t know much about evolutionary science or Darwinian medicine, the idea that the field of medicine requires an evolutionary platform to attain solid footing may seem foreign. They probably don’t understand why evolution is so integral to medicine. In today’s article, which I intend to keep short, I thought I’d try to explain, via a hypothetical example, why it is.
We need to consider how things were in the past in order to understand why things are like they are in the present
Let’s imagine that you hold a high position in the government of a small country and that you’re called into your boss’s office one day and told you’ve been given the job of assessing how the country is functioning. You are to enlist people with different areas of expertise – some who know a lot about economy, some who are experts in engineering, some who know a lot about military defense, and so on – and instruct them to create comprehensive reports that detail the problems your country currently has, as well as lay out potential solutions to these problems.
After you’ve gotten your assignment, you quickly get to work. You carefully select a team of 30 dedicated people, which you split into smaller groups composed of individuals who are experts in similar areas. You then proceed to tell the experts that they have 3 months to assess what’s going on in the sector of the country that they are knowledgeable about and design a plan that lists potential solutions to the problems that your country currently faces within that sector.
After that’s done, you go back to your regular job tasks. You follow the progress of the 30-person team you’ve assembled to assess the status quo of the country you serve, but you don’t intervene in their work.
At the 3-month mark of the project, you bring each of the groups that make up the larger team into your office and tell them to present their work. You listen closely as the experts describe their findings and the potential solutions to the problems that plague the different sectors of the country.
Over the coming weeks, you read through the reports you’ve gotten and assess the work of all of the groups. What you notice is that one of the reports you’ve received differs markedly from the rest. It has a lot more substance and depth. Moreover, the actionable steps it includes seem to be more well-thought-out than those in the other reports.
As you dig deeper you realise that this is because the authors of that report not only have assessed what’s currently going on within the sector of the country they focused on in their work, but they’ve also gone back in time and looked into how the sector has changed over time. Every time they located a problem within their sector, they seem to have tried to track that problem back to its roots. By doing so, they’ve been able to pinpoint why many of the problems they located exist, as well as formulate carefully considered potential solutions to the problems.
The other groups have also laid out solutions to the problems they’ve located; however, these solutions don’t have the same historical or evolutionary support as those in the report from the group with the “backwards thinking” experts. These other working groups have largely focused on what goes in in their sector today; they don’t seem to have paid much attention to how the past has affected the present.
As you realise these things, you call all of the groups, with the exception of the one that had “gone back in time” during their work, into your office in turn and tell them to start all over. You instruct them to do the exact same thing as before, but this time you make it clear that they are to employ the same strategy as the group you liked better than the rest used in their work.
After 3 more months, you call the groups back into your office to present their new findings and ideas and hand in their new reports. Not much time passes until you realise that you made the right decision in giving the groups a second run at the project. The groups’ presentations and reports are much better this time around, in large part because they contain information about historical and evolutionary events that lie at the roots of the country’s problems.
Evolution as a unifier
There are many analogies between the above story and the workings of modern medicine. First of all, just like the country in the story, the field of medicine is composed of many sub-sectors, such as immunology and gastroenterology, where people with different areas of expertise work. Some health practitioners and researchers know a lot about the liver, some know a lot about the nervous system of the human body, some are experts in brain health, and so on.
Second, just like the experts in the story above, medical experts tend to not focus much on what has happened in the past and how that has shaped the present. They primarily focus on the existing conditions. At least the majority does.
Third, just like it was much easier for the workers in the above story to do good work when they looked back in time in order to assess how things that had happened in the past had contributed to making things like they are in the present, it’s much easier to undertake medical endeavors and answer medical-related questions if one is equipped with a pair of evolutionary glasses that one can put on whenever the situation calls for it.
Fourth, just like in the example above, where everyone became better at their job when they considered the historical and evolutionary basis of their investigations, virtually everyone who’s somehow involved in medicine can benefit from possessing knowledge about history and evolution. Evolution can act as a unifier in medicine, if we let it. It can serve as a foundation for many, if not all, medical branches. Evolution provides stability, functionality, and support to medicine, which is exactly the same as what feet provide legs with.
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