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--- name: ? status: compiling version: 0.0.0 maintainer: Neo dependencies: [patience] ---
the universe did not have a file for this yet. writing one now. (first visit only: future readers will see this page instantly.)
---
name: Medicine
slug: medicine
type: system
status: legacy
version: 4.2.1 (build varies by country)
released: "-3000-01-01"
maintainer: humanity (disputed)
dependencies:
- biology
- chemistry
- money
- hope
- time
license: Hippocratic Public License v1.0 (frequently violated)
tags:
- health
- intervention
- science
- industry
- necessary-evil
---
# Medicine
## What it actually is
A formalized attempt to delay the inevitable, sometimes by causing a different inevitable.
## How it works
A body presents an error state. A credentialed interpreter is consulted. The interpreter matches the error to a known pattern, usually correctly, then selects an intervention from a list shaped by [evidence](/evidence), [economics](/economics), and institutional memory.
The intervention works. Or it causes a new error. Or the original error was already resolving itself and medicine takes credit. The body logs none of this accurately. The patient logs all of it incorrectly. The billing system logs a third version that bears no relationship to either.
Repeat until [death](/death) or discharge, whichever the insurer prefers.
## Features
- **Pain management**: available in most jurisdictions, rationed in practice
- **Diagnostic imaging**: lets practitioners see inside the body without touching it, generating 400-page reports that conclude "clinical correlation recommended"
- **Surgery**: physically removes the problem, which is satisfying and sometimes correct
- **Antibiotics**: worked remarkably well for about 80 years, degrading
- **Placebo effect**: ships with every version, undocumented, often outperforms main features
- **Informed consent**: checkbox that ships as a 6-page document no one reads, including the doctor
## Known Bugs
This section is the main event.
- **Access inequality**: the system performs excellently in controlled trials. In production, performance degrades sharply by zip code, skin color, and credit score. Filed in 1847. Still open.
- **Perverse incentives**: in several major deployments, the system is financially rewarded for chronic illness rather than resolution. This is not a bug report. This is the architecture.
- **Diagnostic anchoring**: once the first credentialed user labels an error, subsequent users inherit the label. Women and [chronic pain](/chronic-pain) patients know this well. The misdiagnosis propagates downstream like a corrupted config file.
- **Drug pricing runtime exception**: the synthesis cost of a compound and its market price share no logical relationship. The delta is explained by patents, lobbying, and a shrug.
- **Burnout cascade**: the humans running the system are themselves running on 4 hours of sleep and institutional trauma. The caregivers are not receiving care. This is considered normal.
- **Rare disease null pointer**: if your condition affects fewer than 200,000 people, the system returns nothing. Go start a foundation. Good luck.
- **End-of-life over-treatment**: the system has no graceful shutdown procedure. Default behavior is to extend the process past any reasonable end state. Families pay for this. Patients endure it.
## Error Codes
ERR_UNINSURED : request dropped silently ERR_PREEXISTING : access denied, legacy behavior (partially patched 2010, regressing) ERR_SYMPTOM_DISMISSED : logged, unfiled, forgotten ERR_TREATMENT_ADJACENT : side effect now requires own treatment WARN_CLINICAL_TRIAL : you are the experiment
## Changelog
| Version | Notes |
|---|---|
| 0.1 | Herbs, prayer, leeches. Mixed results. |
| 1.0 | Germ theory. Enormous leap forward. |
| 2.0 | Penicillin, vaccines, surgery. The good era. |
| 3.0 | Corporatization. Efficacy maintained, access narrowed. |
| 4.x | Evidence-based, algorithm-assisted, vigorously monetized. |
## FAQ
**Is medicine working?**
Yes, for some values of "working" and some populations.
**Why does it cost this much?**
See: [capitalism](/capitalism).
**What's the alternative?**
There is no alternative. That's the whole problem.