🎓Hippocrates Meets AI🌐
EPISODE #2: To Help or at least to Do No Harm
👴Monday morning:
Mr. Manolis is 70 years old. Ηe faces several helath issues, including Diabetes. He's already taking quite a few pills - sometimes he misses some doses.
"Doctor, my friend told me about a newer drug for blood glucose management. I want it too."
👩🦳Tuesday afternoon:
Mrs. Nikoleta is close to 65 years old and already receiving medications for vascular and metabolic issues. She's been suffering from muscle pain within the past few years.
"Doctor, my cholesterol levels are elevated, but I'm afraid a pill might worsen the pain."
👱♀️Wednesday noon:
Anna, 30 years old. She presents with symptoms of upper respiratory infection starting 4 days ago.
"Doctor, I want an antibiotic in order not to get worse. I also need to get better, because I'm traveling abroad in 3 days."
🧔Friday morning:
Mr. John, a supplement enthusiast. Already taking 5-6 different ones.
"Doctor, I've heard about supplements that boost the immune system and lower cholesterol levels. Which should I take?"
💡Four different stories.
One common point:
Everyone expects - or asks - me to add something.
📜And in all these moments, I hear a voice - 2,400 years ago:
"Ἀσκέειν, περὶ τὰ νουσήματα, δύο, ὠφελέειν, ἢ μὴ βλάπτειν"
Hippocrates, Epidemics, Book I, 400 BC
"Practice two things in your dealings with disease: either help or do not harm the patient."
⏩️Later, the phrase was summarized as:
"Primum non nocere" - First, do no harm.
🌠🔥The lesson? Before you think about what to do, think about whether you may cause harm.
In each of these cases, adding something would be the easy choice.
But would it be the right one?
🤔Mr. Manolis:
He misses doses of his current medication. Will a 6th or 7th help or confuse him even more?
🤔Mrs. Nikoleta:
A cholesterol lowering agent might worsen her myopathy. The cholesterol levels aren't ideal, but they're not prohibitively high either. Will the pill help or make her suffer even more?
🤔Anna:
She has a viral infection. The antibiotic won't help at all. All it can do is cause vaginitis, diarrhea or nausea and make things even worse on her trip.
🤔Mr. John:
Supplements often don't do what they promise. They create the illusion that they replace healthy exercise and diet habits. They can have interactions. Finally, "natural" doesn't always mean "safe".
🤖💻I use computer systems, treatment guidelines, algorithms.
And they often tell me: "Add this."
• "Blood sugar isn't ideal → Use this add-on therapy"
• "Cholesterol high → Start medication"
• "The patient has this → Suggest that"
❌AI and protocols aren't designed to see:
• The confused patient with a bag full of pills
• The woman who is suffering from pain and is afraid
• The self-limiting virus in 3 days
• The marketing behind supplements
✅My decisions:
📌To Mr. Manolis: "Let's maximize the benefits of your current medication first. Get a box that divides them by day so you don't miss any dose."
📌To Mrs. Nikoleta: "Given your pain and cholesterol levels that are not dangerously high, the risk is greater than the benefit. Let's improve your diet and increase aerobic exercise first."
📌To Anna: "The antibiotic won't make you better. Rest, fluids, supportive measures. In 2-3 days you'll be fine for the trip."
📌To Mr. John: "The majority of supplements don't have proven results. Let's talk comprehensively about your lifestyle - that's where the real solution is."
💎Four times this week:
The right decision was to do 'nothing'.
2,400 years after Hippocrates:
The hardest thing in medicine isn't knowing what to do.
It's knowing when to do 'nothing'.
And having the courage to defend it - to the patient, to colleagues, to yourself.
‼️Postscript:
The next time the doctor tells you "it's not needed", think:
May "nothing" be the wisest answer?
🔜In the next episode:
The hardest words a doctor can say