Broken links in the chain of faith

Last week the New York Times ran a series of articles (read it here) on problems arising from the growth of radiation treatments for cancer and the horrible health effects resulting from accidental overdoses. What strikes me on reading these articles is that for all its grounding in high-tech science, radiation therapy requires tremendous acts of faith from everyone involved.

Of course all medicine requires patients to exercise a certain amount of faith--in doctors, treatments, medicines--but if you go to the doctor with a migraine and he accidentally amputates your big toe, it will be immediately apparent to all involved that someone has made a terrible mistake.

Radiation, though, is invisible, and an accident won't necessarily produce visible or visceral effects right away. The patient has to trust the technicians to get her positioned in the right place and operate the equipment properly, and the technicians have to trust the radiation oncologist and medical physicist to properly plan the treatment and program the equipment, and the doctors have to trust the manufacturers and installers of radiation equipment to make the equipment operate as specified, and the general public has to trust the Powers That Be to enforce regulations promoting safety.

The Times articles explore some broken links in this chain of faith: medical personnel faked degrees, software glitches deleted essential settings, radiation technicians monitored the wrong computer screen, state and federal regulations had holes in them big enough to drive a linear accelerator through, or people trusted what the computers were telling them without using their eyes to verify that the machine was doing what it was supposed to be doing--and patients suffered horrible painful disfigurement or death.

I'm glad I didn't read these articles before undergoing radiation treatment because they would have scared the bejeebers out of me, but I'm glad they published the series because perhaps they will inspire changes in regulation and administration of radiation treatment. I have to remind myself, though, that the Times focused on a small number of horrific cases rather than on the huge number of patients who undergo radiation treatment successfully every year. Successful treatment doesn't make news--and I, for one, am delighted to be, at this point, utterly un-newsworthy.