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Thread: The word "cure"

  1. #1

    The word "cure"

    I think people need to maybe not use the word CURE. A cure would mean for me getting back to running and jumping and controlling my body like I did up to the minute of my accident. This is more about therapies that improve levels of function which can still be huge for most of us. Whether that means getting back finger function or bladder or some leg muscles is TBD but will be a great start.

  2. #2
    Senior Member khmorgan's Avatar
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    Quote Originally Posted by Lyerly View Post
    I think people need to maybe not use the word CURE. A cure would mean for me getting back to running and jumping and controlling my body like I did up to the minute of my accident. This is more about therapies that improve levels of function which can still be huge for most of us. Whether that means getting back finger function or bladder or some leg muscles is TBD but will be a great start.
    I think people, who read this forum regularly, realize that no treatment will turn back time. Most people here consider a "cure" to be Dr. Young's definition: ".. that a person would be cured if a well-informed observer cannot tell that a person has had spinal cord injury."

    If you can convince people to use the term "significant recovery" in the place of "cure", more power to you.

  3. #3
    I moved this post from the ChinaSCINet topic into a separate topic because I think that it deserves a separate discussion.

    Lyerly,

    I use to feel the same way about the word "cure" as you. I had this discussion with Christopher Reeve and he convinced me to use the word cure. I argued that no therapy will eliminate spinal cord injury (there is no "cure" for being unlucky or stupid and these two factors are the main causes of traumatic spinal cord injury), no therapy will restore people to their pre-injury state (we can't turn back the clock on aging), and no therapy will restore the spinal cord to exactly the state it was (the "cured" spinal cord wll be a different spinal cord). I argued for the term "functional restoration". Christopher asked a question, "why aim low?"

    After thinking about it, I realized that I agree with him. We should be aiming as high as we can get. Who knows how far we can get with the research. Just because we are skeptical about curing spinal cord injury based on our current knowledge does not mean that we should say that a cure is impossible. History is littered with the bodies of naysayers who have said that it is impossible to talk to people thousand of miles away without wires, that getting to the moon is ridiculous, and that we will never travel faster than the speed of sound. Our notions of impossible are constantly changing. We should not be so arrogant to assume that we know what the future will bear.

    On the other hand, I also realize that it is counterproductive to set a goal that we are unlikely to reach in our lifetime. Setting unreachable goals is a recipe for failure. Therefore, I thought about what we can achieve within our lifetime and decided that we should be able to have therapies that can restore function sufficiently that a knowledgeable third party observer would not be able to tell that a person was spinal-injured. We all know that many people with "incomplete spinal cord injury" can and have recovered sufficiently from spinal cord injury that would not be apparent to others.

    For example, if you met Patrick Rummersfield, most people would probably not know that he had severe spinal cord injury and that he was unable to move from neck down for several years. Over 14 years, he recovered to the point where he is a successful triathlete and ultra-marathoner. While he would admit that he has not been "cured", it is clear that getting people to a functional state that most people would not know that he had severe spinal cord injured is not just possible but should be achievable in our lifetime. I thought that getting people to that state would a worthwhile and achievable goal that I can set for myself.

    I do agree with you that we should not be saying that we have failed if we do not achieve the "cure", whatever definition that you may have for that word. Getting part way there is worthwhile as well. Demonstrating that a therapy consistently restores useful function in people would be very worthwhile and should not be considered a failure.

    Wise.

  4. #4
    Thank you for reframing the issue, Dr. Young - and posthumous gratitude to Christopher Reeve, as well. Use of the word "cure" in relation to SCI has always bothered me, since I think of any kind of cure as the endpoint of a cause-and-effect spectrum; and since SCI is so multifactorial (with no two cases being exactly alike, and each person's course predictable only within wide general parameters), it has almost seemed nonsensical to me to think in terms of the, or even a, cure. But by defining the word in terms of process, you make it possible to understand the whole concept differently - even in relation to MS and other non-traumatic neurological conditions whose causes are deeply mysterious. I'm glad that you and Christopher Reeve had that conversation, and grateful that you shared it with us.

  5. #5
    I broke my wrist and arm fairly badly in a motorcycle accident years ago. My wrist has never been the same after the accident, but the bones healed and I have full use of the hand (in fact it helped my golf game because of the lack of movement in my wrist). I view a "cure" to SCI like that, I don't define it as returning to the functionality I had before I just define it as just being able to be able to function.

  6. #6
    As far as activism and fundraising go, "cure" terminology is also useful to differentiate between genuine scientific efforts to restore function vs all the other activities large sci foundations seem to spread into.

  7. #7
    Quote Originally Posted by t8burst View Post
    I broke my wrist and arm fairly badly in a motorcycle accident years ago. My wrist has never been the same after the accident, but the bones healed and I have full use of the hand (in fact it helped my golf game because of the lack of movement in my wrist). I view a "cure" to SCI like that, I don't define it as returning to the functionality I had before I just define it as just being able to be able to function.
    If Dr. Young can come up with a "cure" and improve each of our golf games then they're going to have to give him an extra large bonus along with the Nobel Prize for Medicine.

  8. #8
    The term “cure” means that, after medical treatment, the patient no longer has that particular condition anymore.
    http://kidshealth.org/teen/your_body...e/curable.html
    Please let’s not get into the trap of re-defining a CURE, the meaning of the word CURE is clear and well understood.
    we may want to call “effective treatment” what can restore functions.


    Paolo
    In God we trust; all others bring data. - Edwards Deming

  9. #9
    Quote Originally Posted by paolocipolla View Post
    The term “cure” means that, after medical treatment, the patient no longer has that particular condition anymore.
    http://kidshealth.org/teen/your_body...e/curable.html
    Please let’s not get into the trap of re-defining a CURE, the meaning of the word CURE is clear and well understood.
    we may want to call “effective treatment” what can restore functions.


    Paolo
    It is a valid lexical point. For example we haven't "cured" allergies but there are medicines that mitigate the symptoms to a point where you aren't running around sneezing with snot all over your face. That is kinda what I want from medical science with regards to SCI. Control of my bodily fluids

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