Change over Time - Baba Brinkman

We’ve come a long way since the Hippocratic Oath

Doctors no longer take vows to Apollo

And call the gods and goddesses to witness

«Please let me do less harm than most physicians!»

Medicine was easier under polytheism

One god made you sick,

another relieved symptoms

Balance those humours,

it’ll take away your fever

Today’s version is the Declaration of Geneva

Which is good, but it needs one addition

«I will not ignore findings that are scientific

If that knowledge could possibly make a difference

In treating, understanding, or preventing my patient’s sickness»

Evidence-based medicine has been a panacea

Antibiotics, vaccines and anaesthesia

Despite their modern hypocritical critics

Who never saw somebody die from gangrene, syphilis

Or any other dangerous condition such as measles

Treatments need to be tested against placebos

And now for the next phase in medicine’s evolution

A Darwinian revolution

If they reject evolution

Because of the Old Testament

Give ‘em last year’s flu shot

Nothin' but old medicine

Change over time is comin'

There’s no place to hide

Evolution might save your life

Tonight

The evolutionary view is not an alternate

It’s just another layer added to the proximate

It doesn’t change what’s proven to work

But it does suggest ways of improvin' our search

For truth, and makin' a body’s imperfections clear

Not a machine design by an engineer

Built by genes hell-bent on reproduction

And that simple fact predicts dysfunction

The organs in your body are all adapted for somethin'

The stomach for digestion, the heart for pumpin'

And every disease has an evolutionary cause

Which is not what medical students are taught

Why not?

Because of freedom of religion

Superseding freedom from religion?

Medical school curriculum revision

Just add one more category of description

Teach the etiology and epidemiology

And pathophysiology, and treatment policy

And differential diagnosis courses

And one more: evolutionary origins

If they reject evolution

Because of the Old Testament

Give ‘em last year’s flu shot

Nothin' but old medicine

Change over time is comin'

There’s no place to hide

Evolution might save your life

Tonight

So when I go to the doctor with a throat full of

Streptococcal villains and get some amoxicillin

And she tells me to keep on poppin' pills until

The bottle’s gone regardless of how I’m feelin'

I want to know exactly what that’s a precaution against

And how drug resistance is an evolutionary event

And how the threat of rheumatic fever is driven

By an arms race,

‘cause strep is a molecular mimic

Impersonating cellular signals,

which triggers

Antibodies that attack my own body’s tissues

I want the doctor to understand the underlying issues

And tell me that every tool in the tool box get used

In our quest to improve prevention and treatment

So it’s not just me,

I want the species beaten

So what if they multiply 200, 000 times

For every generation of ours,

we’ve got science!

And science includes an evolutionary branch

It’s a place to hang a million arbitrary facts

And synthesize into a unifying vision

The chaotic enterprise known as medicine

If they reject evolution

Because of the Old Testament

Give ‘em last year’s flu shot

Nothin' but old medicine

Change over time is comin'

There’s no place to hide

Evolution might save your life

Tonight