Dr. Golem: How to Think About Medicine (review)

This is the third volume of the Golem series where the authors turn their attention to medicine. A golem is described as a creature of Jewish mythology, an animated being created from clay and water by man, knowing neither the extent of his strength or his ignorance. The golem is considered well-meaning but sometimes causes harm through innate clumsiness. That is, there is no intent to cause harm although it happens. In this book, medicine is treated as a golem.

The authors view medicine as a body of expertise, rather than a combination of logic and fact. Medical doctors have expertise in their area just like lawyers, car mechanics, and plumbers have in theirs. Sometimes they get it right and other times they make mistakes. Even skilled practitioners may fail on occasion. Of course, there is a big difference between repairing a body and fixing a car as the consequences for the former are much more serious. The topics covered in the various chapters are the placebo effect (leave the body alone and it may heal itself), bogus doctors (how they get caught), tonsils (diagnosing and dealing with uncertainty), alternative medicine (vitamin C and cancer), contested diseases (yuppie flu), defying death (cardiopulmonary resuscitation), AIDS activists, and vaccination (parents rights). The theme of the book is both interesting and promising, but the topics selected provide only a snapshot of the issues addressed, thus leaving the reader with more questions than answers about the efficacy of medical care in relation to mainstream areas like heart disease, diabetes, surgery, obstetrics, women's health, and the like. To prove its case, the golem needs to take a bigger bite out of the elephant.