The present applications of mathematics in medicine are insufficient to support doctors, patients and policy-makers to comprehend biological systems in context or to intervene wisely and sustainably in reduction of human pain and suffering. The main reason for this insufficiency is the narrow formulation of present human ailments and the consequent failure to care for or cure them in the context of life on earth, which in turn leads our species to disregard its impact sufficiently to act as a case of galloping consumption on the body of life. It is true that late modern complex systems have enabled many medical advances on which the species has come to depend, such as sanitation and vaccination programs, emergency services, and systematic prenatal and well-child care. It is also true that the rigidity and unresponsiveness of such systems has divided doctors from life and time and thus limited awareness of rapidly evolving human ailments, our ability to respond to them now and into the future, and our ability to care for the living systems of which we as a species form an integral part.
The remedy for this state of affairs begins with using methods that enable us to view and to comprehend human ailments in context. Specialists in Public Health and Preventive Medicine have been developing suitable methods rapidly, though not as rapidly or effectively as our profession and the parent society that forms it have been developing its capacity for destruction. To do better we can examine the eradication of smallpox, which shows firstly that in public health–and related specialties such as infectious disease–the patient is the species, and secondly that smallpox was eradicable because it did not extend beyond the human species–whereas most diseases affect aggregated bodies that include other species. To do better we can learn from modern deconstructionists who have become aware that objectivity is not achieved when the observer pretends to be absent or to exist independently of the biosphere. Similarly, we can note that decisions can only be understood in context, and that the context that matters in all of the biological sciences–including medicine–is that of the universe of life on earth–not universes defined by so-called hard sciences.
These general–and therefore basic and fundamental observations–would be sufficient to prompt a deeper exploration of other methods of abstraction, but it may be useful here to consider a number of specific observations. One is that standard multivariable statistical models–where they fit reality enough to be taken seriously–consider only those few variables that interest us at the moment, and not the thousands or millions more that may be critical for comprehension and wise action. This limitation is aggravated by the fact that the models are decontextualized, that is, they assume that everything else in the universe of life can be ignored, an assumption that may seem reasonable in the context of a clinic or conference room but that does not apply to living systems and is therefore questionable at best. And, most of the exposures with which we are rapidly filling the biosphere are already ubiquitous, which means that there is no unexposed group to use as a comparison for estimating risk. The worst facet of all late modern models that purport to guide personal and policy decisions is the habit of behaving as if the observer and the observed were independent of life on earth and could be estimated by sampling one group of interest at a time. In medicine it is clearly more reasonable to assume complete dependence on the body of life and to sample it completely.
To make wise choices we must use methods that enable us to take the big picture into account. Ideally, these would take the perspective of the biosphere and regard the aggregated bodies that nest in it as completely dependent, nested sets subject to structured abstract thinking and to operations that would be of immediate use in guiding practical decisions by individuals and groups. These methods would ideally allow for complete sampling and complete dependence from the perspective of the universe of life; would yield highly intuitive displays that resemble Venn diagrams; that allow for temporal functions; that support decision models for individuals and groups that enable trade-offs inclusive of resource utilization and impact on life as a whole that enable concerned individuals to make sustainable decisions that support the survival and thriving of the individual in the context of time and of life on earth.
The macrobiology project is in formation. Dr. Anna Barón, Professor of Biostatistics and Informatics at the University of Colorado School of Public Health, is a member of the core working group of the Institute for Emerging Paradigm Medicine and the lead for macrobiology. You can help by teaching your spell-check to recognize and accept the word macrobiology–the absence of which is a clear indicator of the need for scalar balance in medical science.