His Doctors Were Stumped, Then He Took Over
I wrote my thoughts about how to work with your doctor here:<p><a href="https://news.ycombinator.com/item?id=12266170" rel="nofollow">https://news.ycombinator.com/item?id=12266170</a><p>My wife has since passed away unfortunately. I really need to write this all up at some point to close it off.<p>Anyway, I've come to understand that most doctors look at the scientific evidence <i>indirectly</i>.<p>They often have an excellent ability to follow a decision tree and work through the differential diagnosis. However, that decision tree is based on (a) observations and (b) what other doctors have tried. There's no attempt to look at the underlying mechanism to find novel solutions. So new basic research (e.g. on mTOR and VEGF as in the article) will have no effect on practice until it is proven in trials or until enough mavericks (like the patient in the article) have created a precedent.<p>It does make sense in terms of avoiding cost and harm -- biology is very complicated -- but I do think this conservative bias goes too far in cases where the treatments have been already proven safe in other contexts, or in cases where the alternative is already bleak.