Doctor, Lewis Thomas Traces the Essay

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Thomas also addresses what he perceives to be shortcomings in the modern approach to advance medical education provided to medical students. Specifically, he argues that substantial portions of the contemporary medical school curriculum of the first two years of medical school should be replaced by courses detailing the many fundamental gaps in medical knowledge of human disease. Second, Thomas recommends that much more medical research should be devoted to diseases that are still insufficiently understood to be prevented despite the impressive ability of modern medicine to treat their symptoms.

In that regard, Thomas makes a cryptic reference to the fact that, in some respects, medical science has now progressed to the point where it sometimes causes pain by virtue of its extensive focus on symptoms: he suggests that extending our life expectancy into our eighties may, in fact, be "for the worse" as much as for the better. Likewise, Thomas characterizes the focus of much of modern medicine, with all of its advanced technologies, as merely "putting off the end-game" rather than treating disease much beyond ameliorating its symptoms.

According to Thomas, much of the medical advice that filters down to the level of public consumption (such as advice about "living healthily" and exercising) contribute only minimally to human wellness compared to a better fundamental understanding of the disease mechanisms necessary to eliminate them altogether through the directed efforts of medical science concentrated more intensely on that objective.
In some respects, Thomas seems to have downplayed the breathtaking advances of medical science and focused too heavily on what is still left to learn in the future instead of appreciating the degree to which even the still-imperfect understanding of human disease has benefited mankind in the meantime. If anything, Thomas' own description of the evolution of modern medicine from superstitious beliefs and useless (sometimes harmful) practices to all of the sophisticated illness interventions available in modern medical facilities is enough to appreciate the latter. As Thomas illustrates, medicine is still a growing field of science. Undoubtedly, future levels of understanding will improve our ability to benefit patients, but unlike previous medical revolutions, future advances are more likely to incorporate much of what we understand now than to completely replace what we know now in the manner that earlier medical….....

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