On 17 January 2019, a report titled ‘End of Modern Medicine ’ was published in the online edition of The Statesman, in which Dr Biswaroop Roy Chowdhury had sought to highlight “evidence-based medical science”. The report said medical science had witnessed several changes in the last 10 years but doctors were still using “totally obsolete” knowledge to treat patients.

In response to the write-up, Sudipta Misra (MBBS, MD, DM, AGAF), Director, Pediatric Gastroenterology and Nutrition, at Trident Medical System in South Carolina, USA, had said the article showed “misrepresentation, distortion and cherry picking of ‘scientific evidence’ by the author”.

“As a medical professional I feel compelled to respond to the opinion piece, “End of Modern Medicine” (January 17, 2019), in the interest of patient safety. I object to misrepresentation, distortion and cherry picking of ‘scientific evidence’ by the author for self-aggrandization and interest,” Dr Misra said in an email to The Statesman. His detailed argument countering Dr Roy Chowdhury’s averments was published in a report titled ‘Modern medicine is alive and kicking, thrives on critical thinking, honesty and integrity’ in these columns on 2 February, 2019.

In reply to the criticism and objection posted by Dr Sudipta Misra,  Dr Roy Chowdhury has sought to address the issues raised.

“The first objection was on the title of the article ‘End of Modern Medicine’ itself. Dr Sudipta Misra claimed ‘Modern medicine is alive and kicking, thrives on critical thinking, honesty and integrity’ without giving any proof or evidence of the claim. Hence I would like to clarify that the title ‘End of modern medicine’ is not the work of my imagination nor is some exaggeration or fabrication of words,” he said in an email to The Statesman.

Referring to a report that appeared in The Lancet, titled AMR—the end of modern medicine?, Dr Roy Chowdhury said the claim he had made in his article was already established among the scientific community. “Moreover, GLASS ( Global Antimicrobial Resistance Surveillance System) which was launched in October 2015 reiterates that effect of modern medicine is dwindling as antibiotic resistance is increasing for majority of diseases,” he said.

On the contrary, he added, title of Dr Sudipta’s article seemed “aggressive and counter reactive”.

Taking up three issues raised by Dr Misra, Dr Roy Chowdhury has sought to offer clarifications.

Objection to the article’s claim that “a heart attack patient’s chances of death increased three times when he or she was given oxygen in hospital”, Dr Misra said in his response giving oxygen “does not cause any harm (Hoffman et al. NEJM;2017, 377:1240-7)”.

This is what Dr Roy Chowdhury has to say on this: “The review cited by Dr Sudipta Misra indirectly supports the study done by Cochrane stating that why patient require oxygen when there is no additional benefit though there is no harm. It adds on to the expenditure borne either by hospital or by patient himself. Moreover, Cochrane review (2010) which we have cited is a meta analysis which is considered as an upper hand to the review which the Objectioner has cited.”

On the claim that “whenever blood sugar is reduced by taking medicines, patient’s life span is reduced and the complications increase”, Dr Misra had said the “recent change is in accepting a less aggressive control, in lay man’s term letting the blood sugar stay higher and bringing it down slowly without causing low blood sugar”.

Dr Roy Chowdhury clarifies: “All the big trials like ACCORD, UKPDS, ADVANCE, VADT have shown that medicines used for the lowering of blood sugar reduces the life span and increases the complications. Based on that ACP guidelines 2018 were framed. While criticizing this point, the Objectioner has not given any literary proof to support the statement that why reduction of dose is advised.”

Dr Misra had also objected to the claim that chances of a heart attack patient’s survival is more at places away from hospitals, saying no one can “choose the place of heart attack”.

In response to this, Dr Roy Chowdhury says: “True, we are not claiming this but if Clinicians will remain working aloof without updated knowledge, hospitals will be a place of increased complications or even death.”