Linear Thinking in Modern Medicine

Linear Thinking: a process of thought following a step-by-step progression where a response to a step must be elicited before another step is taken. 

The application of linear thinking can be traced all the way back 2,500 years ago when Sun Tzu (The Art of War) recognized the value of it.

There are many benefits to making logical decisions in our life.

Logical Idea: If I leave the refrigerator door open too long then my ice cream will melt.

However, there is a danger in relying too heavily on logic.

highly illogical

With any logical process, there must be a decided upon truth as a starting point - the danger is in the determination of the starting point.

Assumed Truth: The refrigerator is cold enough for ice cream.

This is the beauty of logic - it allows us to reach an answer from a given starting point quickly. And it is easy. However, to rely upon starting points without revisiting and examining them is reckless- these starting points may either be false or may limit us from finding a much better answer.  

Superior Truth: It is better to store ice cream in the freezer, not the fridge.

If you take a chance to review, there are many medical practices that are based on incorrect knowledge yet doctors still employ faulty treatment because it is considered the logical thing to do - “I did it this way and I turned out fine.”

We experience this linearity in so many procedures in current modern medicine practice; from circumcision to treatment of depression – from obstetric practices to pediatric medicine.

Here are a quick two examples. Can you think of more? I know I can -

Febrile Seizure and Pediatric Treatment of Fever

One example of outdated linear thinking within the scope of modern medicine would be fever treatment in children. 

poop breath

Sure, it sounds logical –

Logical Idea: If my child has a fever then I should give him a shot of bubblegum flavor fever reducer for it to go away. Fevers in children can cause brain damage.

According to a report published in Pediatrics in 2011, nearly half of all parents consider a temperature of less than 100.4° to be a fever – of which about 7 out of 8 report waking their child from sleep to give them some form of fever reducer. [1]

Yet, there is a baseline starting point of misinformation regarding fevers: that a fever can result in febrile seizure which will result in brain damage.

Assumed Truth: To avoid brain damage, bodily temperature of children should be reduced.

Firstly – let’s get a few things straight.

2-5% of all children will experience a febrile seizure[2]

a febrile seizure does not cause brain damage or lead to epilepsy.[1][2] 

a febrile seizure most commonly occurs with the initial onset of fever (before a child’s caregiver is even aware the child is ill) not because of long lasting high body temperature[2]

It is routine for a doctor or parent to treat a fever because of this fear while overlooking the very real and beneficial purpose of a fever – stimulation of an inflammatory response and prevention of the spread of microbial invaders. [3]

(Check this article out which was published nearly 30 years ago which underscores the importance of fever and the obsolete methods of fever reducers)

This is what is known - The primary goal of treating healthy children with fever should be to improve the child's overall comfort rather than focus on the normalization of body temperature.[1] 

Superior Truth: Fever is not a primary illness but is a physiologic mechanism that has immense beneficial effects in fighting infection.

Please use common sense: High fevers over 104 which are accompanied by other problems like vomiting, diarrhea, and lethargy should be promptly diagnosed and treated in children of any age.  

Common sense would also be not taking advice from clowns
that live in the gutter.

Also, if you do decide to treat a fever – please go about it in the right way. Dosage should be based on weight not age. Also, leave the kitchen spoon for last night’s chili as it is not a reliable way to dispense any liquid medication.

Serotonin Levels and SSRI Treatment of Depression

One more excellent example of employing wrong baseline information is how current depression and anxiety is treated pharmaceutically. Treatment is based on the starting point idea that an individual is suffering from low levels of serotonin in the brain which ultimately produces depression.  Millions of people (including children and teens) are on some type of serotonin uptake medication in the US.

Logical Idea: People are depressed because they don’t produce an efficient amount of serotonin.

Assumed Truth: A depressed person must chemically alter their serotonin level to alleviate depressive symptoms. 

Not only has this theory been negated since the early 1980s - in fact, it has been found the opposite is true!

So that's why I've been getting headaches -

Evidence shows that increased serotonin activity is found in depressed persons.[4]

In fact, to view the brain as having a singular serotonin level is highly inaccurate. Neuroscientists are now moving toward a view that incorporates many different levels of serotonin neurons in the brain that are each independently regulated. [4]

Superior Truth: Scientists still don’t know why people become depressed.[5] 

Although we still don’t know why depression affects some individuals more then others, just because you are depressed doesn’t mean you should throw the towel in. There are more ways to effectively tackle depression then there are Friday the 13^th sequels. However, becoming dependent on SSRI’s to regulate brain chemistry isn’t a wise or logical choice when it comes to treatment. 

darn

(pretty interesting stuff - find more info here: The Serotonin Theory of Depression)

But what is the alternative?

Non - Linear Thinking: Thought characterized by expansion in multiple directions, rather than in one direction. Based on the concept that there are multiple starting points from which one can apply logic to a problem.

A non-linear position is experienced in a concept that advocates that all aspects of a person’s need (such as physical, social, emotional, spiritual, psychological) should be taken into consideration when treatment is sought (aka holistic treatment).

Holistic medical practice does not eliminate modern medical procedures. Rather, it incorporates them into a better working model for human health.

We can focus and think as intently as ever on the ice cream in the fridge – but the thinking will always lead to a melted bowl of milk because the baseline information is wrong. When we limit ourselves to solely thinking in a linear manner we are also limiting ourselves from completely new perspectives and innovative ideas. 

Novel Idea – Ice cream isn’t a health food; try fruit which doesn’t need to be refrigerated.

There are many facets of modern medical practice that facilitates great things in the lives of many people today. The big advantage of linear thought is how quickly results can be employed. Yet, if you think about it, it also carries the risk of jeopardizing health by moving too hastily-plus, how efficient is something if you must keep going back to check your starting logic? 

I think the goal toward optimal health is incorporating both linear and non-linear thought while also addressing the need to get the newest research to every health professional and their patients – making as much of as informed, educated decision as possible.

I mean, it says a lot if we’ve known the starting point logical for SSRI treatment and fever reducers were faulty for over 30 years but didn’t do anything about it.

I believe this is the direction medicine is being pushed. I think if parents and individuals research more and demand better care which incorporates all aspects of wellness, we will see that change happen sooner rather then later and this will no doubt benefit us all.

Reference:

Chuck’s lamp wrote more about linear and non-linear thinking in general – you can check that out here: Do we think differently? Linear vs. Non-linear thinking

[1] Janice Sullivan and Henry Farrar. Clinical Report – Fever and Antipyretic Use in Children. Pediatrics. Feb 28 2011

[2]eMedicine Health – Seizure and Fever (pages 1-13)

[3] Yale Medical Group – Fevers (Yale School of Medicine 2012) http://www.yalemedicalgroup.org/stw/Page.asp?PageID=STW026871

[4] Jonathan Rottenberg, Ph.D. The serotonin theory of depression is collapsing. Published on July 23, 2010

 

[5] National Institute of Mental Health – What Causes Depression Jul 2011 http://www.nimh.nih.gov/health/publications/depression/what-causes-depression.shtml