Saturday, January 24, 2015


Robert Browning could not have been more direct in using those words when he described the painter Andrea del Sarto’s obsession with his unfaithful wife Lucrezia to the detriment of his painting career. "Carelessly passing with your robes afloat,— Yet do much less, so much less, Someone says,
(I know his name, no matter)—so much less! Well, less is more, Lucrezia: I am judged."
Yes indeed! Less is more. It is so in human affairs of every walk in every life. Shakespeare also in his infinite wisdom said through Polonius “Brevity is the soul of wit, and tediousness the limbs and outward flourishes…” and it behooves us to consider them in our daily affairs.

Less is More

Too many words take away from the immediacy of a well-crafted story. Too many in supply and profit of their hope spend a litany of words to try to invoke need, want and desire in another or something. They do not realize better can be accomplished with a few choice ones.

We choose to do more in medicine as well. The cause of this effect “or rather the cause of this defect, for this effect defective comes by cause:” merely remains unseen through the eyes  “purged thick amber and plum-tree gum” of those who remain blinded to the cause yet steeled against the effect.

Less is More

Indeed if we were to limit the diagnostics that have made us take steps forward in curing cancers and burgeoning the legions of cancer survivors in the millions, one might think that a stitch in time does save nine later, we might arrive at a different universe. So here careful diligence of the real “less” helps in the more. But this does not mean that each x-ray should be followed by a CT scan for confirmation and then an MRI ordered for confirming the confirmation or a PET scan for overall reducing the p-value further to limit ambiguity.  Yet we must all know, there is never a 100% in the 100% offered. Similarly a chemical profile does not have to be done daily to see trends by watching the milligrams per deciliter rise and fall within the laboratory range. Above all do no Harm! Repetition and injudicious use are all harmful in ways we cannot fully fathom.

Less is More

If less medicine was offered through various outlets and vendors, prescriptions and over the counter, acquiescing to demand for instant cures and for allaying anxiety then there would be fewer “superbugs,” lesser resistance to antibiotics and fewer people walking the streets in states of perpetual depression.

Less is More

Triplet regimens in chemotherapeutic regimens had similar outcomes as doublet regimens in lung cancer therapy. Less here was equal in response but more in lesser side effects. Now however with personalized medicine, we might arrive at a single “silver bullet.” A form of that bullet was attempted in the 80s and 90s via the chemosensitivity assays by Sidney Salmon, MD and Larry Weisenthal, MD, PhD. Those were heady times like the ones we are in nowadays. Soon nano-wires and nano-dots made of gold and impregnated with appropriate fluorescent antibodies and “sniffer” devices will diagnose the beginnings of maladies and swarming molecules of antibodies will swoop down and commit murder on those blinded wayward cancerous and other excited cells. And soon we might be able to convert the wayward cells into compliant ones and rehabilitate them back into the society of trillions. But until then, less is more.

Less is More

Maybe we need a longer umbilical cord between the anxiety-riddled patient who has been thrown into the fear-mongered world of journalism gone stupid. “No Mr. So, there is no need for antibiotics for your sore throat, it is viral in nature and antibiotics do not work against viruses,” might be the appropriately expressed sentiment. To allay anxiety with words is one thing, but for the pharmaceutical drumbeat of “you need this…call your doctor” or provider immediately (as it is fashionable to label the physician) is what feeds the one-eyed monster of this fetish.

Less is More

Regulatory fiat in medicine that forces physicians into mock compliance by taking away their eyeballs from the patient and forcing the sight upon useless paperwork, meaningless-metrics, dotting the “I”s and crossing the “t”s, filling in glossary-based jargon into digital records to keep the mandate-makers happy and the revenue floating in to keep the business of medicine from folding, there is little time to do what doctors are wont to do, like for instance care for a patient. Definitely here, less is more!!

More is less!

More hurts! More pains! More diminishes! More subjugates! More creates more calamities for the future. More hurts us all in a myriad of ways. More back surgeries hurt when not indicated. More knee surgeries do the same. More chemicals ingested lead to a plethora of ailments. More diagnoses without relevance in psychiatry are a detriment to individual health. All medications are chemicals. So more is harmful!

Time to reign in these words  and thoughts in search of brevity.

1 comment:

  1. "Less is more" pretty much sums it up, doesn't it? Tremendous.