SOME LESSONS I LEARNED FROM HISTORY

A few years ago, I had the opportunity to teach History of Pharmacy at university. It was a highly enriching course, during which I learned (yes, teachers learn by teaching, as Paulo Freire says) three main lessons:

1. That human beings are remarkably similar across the globe. Traditional medicinebearing in mind that in ancient times, medicine and pharmacy were essentially the same discipline, with the same individual diagnosing and preparing the remedywas quite similar regardless of the region. In other words, the globalized world we live in today was, in many ways, already globalized thousands of years ago, despite the lack of contact between civilizations. This is because human beings have always sought, with varying degrees of success, ethics, or morality, the same answers. And, in their limited understanding of the world, they created an all-powerful divine figure to close the circle of explanations for the inexplicable.

2. That Western medicine, which emerged with Hippocrates and advanced rapidly thanks to the scientific method, was built on the rejection of divine causes and supernatural curses as the primary sources of disease. This paradigm shiftdefining illness as a bodily imbalanceenabled medicine and pharmacy to progress in ways unmatched elsewhere. The development of scientific methodologies to seek the best remedies against human suffering played a key role in this advancement. However, this detachment from the divine, and the conception of disease as a merely biological phenomenon, alongside Descartes separation of mind and body, has greatly limited our ability to understand patients emotions and suffering in the current era of chronic conditions. Traditional medical systems, though less scientifically advanced (if we understand "scientific" as strictly biomedicalwhich is itself a topic for debate), are often more attuned to this dimension. As a result, we frequently underestimateor outright ignorethat despite having highly advanced pharmaceuticals, patients lack of adherence to treatment is closely linked to the biomedical models failure to account for the emotional impact of illness and its treatment. In short, if therapeutic decisions are not based on an understanding of the illnesss psychological and social significance for each individual, the likelihood of biomedical failure as the sole therapeutic framework is highas evidenced by the alarming rates of nonadherence. And as with most human failures, we tend to look for someone else to blame, leaving self-criticism to the historians.

3. That in order to change the course of things, we must revisit the path of history. Without rejecting the immense advances brought about by biomedicinepast, present, and futurewe must reclaim what we left behind: the inexplicable. We must embrace patients emotions and allow them to positively influence our approach to illness. All of uspatients and professionals alikeneed to understand that while medicines may play a crucial therapeutic role, sometimes the best we can offer is to accompany the patient through their process with respect and understanding. Too often, illness stems from social problems. Strengthening the therapeutic relationship, as some traditional medicines do, can lead to successnot only in clinical terms, but also in psychological, social, and spiritual dimensions, regardless of the beliefs held by those involved in the care process. This broader notion of success helps us become better people and more human.

We need to change the care model. Healthcare does not fail because we lack physicians or nurses. It fails because the current model is no longer sustainable. Medicine is no longer just biomedicine, because illness is not merely a biological disorder, as Hippocrates once argued. Often, biological imbalance is the consequence of deeper disturbancesrooted in a world marked by social inequality, rampant individualism, and a pressing need to rediscover our nature as social beings. In this context, pharmacistsas medicine expertsmust break free from the constraints of product-based management and economic pressures. We must actively participate in the process of deprescribing, ensuring that medications are used only when strictly necessary, and applying the health technologies we already possess but too often fail to use, to optimize outcomesunderstood them as physical, emotional, social, and spiritual well-being.

And if this sounds idealistic, dear reader, it is not because the vision itself is innocent. As I also learned while teaching that course in history, those who hold power are not usually the ones seeking to improve the world. More often than not, they are invested in preserving the very conditions that allowed them to rise to power in the first place. This fourth pointpower as a barrier to progressundoubtedly warrants a broader reflection.