Meditopia -- Chapter 10

aving examined the contributions to the science of optimal health from the standpoint of entropy and exosomatic axis (thermodynamics), Occam's razor (logic), Gresham's law (economics), The Matrix (philosophy), M-Fields (quantum physics, some would say metaphysics), we work them under the umbrella of evolutionary potential (arguably both biology and sociology), upon which they all share one or more tangents.

A host of books now crowd the market that place the corruption of organized medicine at the feet of politics and greed. (Read a sampling from my own "medical corruption and suppression of technology library"). Alpha Omega Labs' own byline clearly reflected our understanding of this from our inception. But I propose that politics and greed are only symptoms or subsets of larger conditions that run much deeper in a system as complex and specialized as our monolithic, monocultural, monopolitical, monopolistic system of health care.

Service's 'law of evolutionary potential' provides insights as to why. 2.

Specialization is a hallmark of civilization. Indeed, Adam Smith emphasized division of labor as a key component of wealth in the life of the nation. "The division of labour, however, so far as it can be introduced, occasions, in every art, a proportionable increase of the productive powers of labour . . . This separation, too, is generally carried furthest in those countries which enjoy the highest degree of industry and improvement . . . " 6. The explosive growth of specialization in graduate medical education of late is a clear sign that 7, wittingly or unwittingly, we have committed the "productive powers" of our expanding medical establishment to the idea that specialization is good, more specialization is better, and maximized specialization is what's best for business . . . I mean, medicine . . . I mean, the patient.

Just who the real beneficiaries of this monumental conjoining of medicine, corporate interest, and higher entropy therapies are is debatable. We won't speculate on how the battle lines are drawn because we already know that the polemical combatants will be found in accordance with where they derive their paychecks. That the exosomatic side of things delivers the heftier paychecks explains why the message of endosomatics is so faint and confused in the competition for mind share, market share -- everywhere.

We can, however, surmise how such a exosomatic system will fair if the surrounding infrastructure were forced to subsist on a lower entropy diet. The outcome clearly falls into the Catton's "die-off" category. 3.

Service's theory tells us that "specific evolutionary 'progress' is inversely related to general evolutionary 'potential.' Within this view, success at adaptation breeds conservatism; dominant polities are less able to accommodate change. Successful complex societies [i.e. high entropy, highly exosomatic] become locked into their adaptations, and are easily bypassed by those less specialized [i.e. low entropy, more endosomatic]." 8. R. N. Adams believes this rigidity and conservatism "result from investment in controlling major energy sources," which would follow because a high entropy culture, by definition, requires a high energy diet. 9,

Tainter continues to comment on the long-term viability of more specialized social structures. "So by having greater flexibility, less complex border states gain an increasing competitive advantage, and are thus able ultimately to topple older, established states." 10. The implications of this development, which we can see, drawing from current news reports from the war on terrorism -- are easy to draw and we will get to them later, but for now I want to focus on two important extrapolations on Service's observations.

Life for man, or any other species on this plant, entails an unending stream of adaptations as the environment undergoes constant change. The deadly microbes of one era give way to those of another. Ecological challenges that may impinge on the health of one community at one time or place may be unknown to any other. Optimal health care, if it could speak on its own behalf, would choose a healing, therapeutic paradigm that maximized its potential, not restricted it. It would choose to be eclectic, not provincial. It would choose to be iconoclastically committed in seeking out the most empirically efficacious, not narrow in its rigid adherence to peer review, maximum profiteering, and the nasty business of pseudo quack-mongering.

Our evolutionary potential is minimized by rigidly specialized structures not because they fail to serve their needful, specialized function -- but because PEOPLE give them a life of their own that rejects the notion that generalized and specialized forms can co-exist in cooperation and not competition.

The second point worth mentioning in connection with Service's law is the disservice inherent in 'tunnel vision' medical specialization. As we mentioned in the Entropy chapter, the human body is an endosomatic creation to which modern medicine insists on applying exosomatic solutions. Even Tainter falls into the trap of thinking of medical technology advances in the same terms as you would think of advances in chemistry, metallurgy, or astronomy. "As more generalized knowledge is established early in the history of a discipline, only more specialized work remains to be done. This tends to be more costly and difficult to resolve, so that increasing investments yield declining marginal returns . . . Moden science is becoming less producive overall (there are always countervailing trends in some fields) because it has become increasely specialized and expensive." 11 Tainter than goes on to quote a principle close to the heart of physicist Max Planck, one that Rescher calls 'Planck's Principle of Increasing Effort' which states that ' . . . with every advance [in science] the difficulty of the task is increased.' 12,

This is where Tainter's otherwise brilliant observations break down, just as Newton's seemingly imperturbable laws break down under the microscope of quantum mechanics. My experiences exploring various healing traditions at Alpha Omega Labs taught me that the best solution is, more times than not, the simplest one, the inexpensive one, the one that isn't specialized or complicated, the one that proud men of esteemable learning would be most likely to overlook. ("What the builders have rejected has become the cornerstone.")

Simplicity and having one's eye on the endosomatic does something more than allow us to 'pass to the next stage,' it allows us to attune to the miracle of life, to stand in awe of its wonder, to realize that it's alright to acknowledge our ignorance and allow a creative intelligence that the highly specialized mind will never grasp to reveal the whole, manifest the wondrous possibilities of the whole . . . to heal the whole -- in us and in everyone and everything around us.

Only in that light is real evolutionary potential possible.

Elman R. Service, The Law of Evolutionary Potential. In Evolution and Culture, edited by Marshall D. Sahlins and Elman R. Service, University of Michigan Press, Ann Arbor, 1960 p. 93-122; as quoted in Tainter, p. 236.
Joseph A. Tainter, The Collapse of Complex Societies, Cambridge University Press, 1988, p. 56.
William R. Catton, Jr., Overshoot, University of Illinois Press, Urbana, IL, 1980.
Tainter, ibid. Starting with "Explaining collapse" on page 118 and continuing through Chapter 4 ("Understanding collapse: the marginal productivity of sociopolitical change").
In what is otherwise a fine work, Tainter demonstrates his thorough lack of knowledge about the health care industry and the facts underlying my exosomatic axis with some wrongheaded applications of his theory to medicine on p. 114 - 115.
Adam Smith, An Inquiry Into the Nature and Causes of the Wealth of Nations, as re-published in The Great Books, Volume 39, Encyclopedia Britannica, Inc., Chicago, IL, 1952. p. 8.
Donini-Lenhoff, et. al., "Growth in Specialization in Graduate Medical Education," JAMA, 2000; 284: p. 1284-1289.
Service, p. 97, as quoted in Tainter, p. 56.
R.N. Adams, Energy and Structure: a Theory of Social Power, University of Texas Press, Austin, 1975. Quoted in Tainter, p. 56.
Tainter, p. 56.
Tainter, p. 114.
Nicholas Rescher, Scientific Progress: a Philosophical Essay on the Economics of Research in Natural Science, University of Pittsburgh Press, Pittsburgh; 1978. p. 80. As quote in Tainter, p. 114.