Dear Friends,

Subject:  The difference between "engineering-science" and
     "medicine".

Re:   Learning to be brutally honest with objective, scientifc
     facts concerning the proven behavior of the fundamental eye.

Re:   Supporting ODs who SUPPORT the second-opinion, and
     will help YOU with prevention on the threshold.

    If you read my post under "Engineering" (below) you will
understand how and why engieering-scientific truth must be
separated from "medical-truth".

    While there is no exact analogy between a child at 20/50
(-3/4 diopter) and a young child who is 20 percent over-weight,
there are striking similarities when:

1.  The issue is considered from a physical-science point-of-view.

2.  The issue is considered from a "medical" point-of-view.

    This analysis speaks to the nature of scientific (not
medical) proof.

    People in medicine must deal with the CONSEQUENCES of obese
children -- and our "bad habits".

    In engineering-science there is no question about children
"getting fat", nor is there any question about the solution -- in
engineerng.  Excess calories "in" result in obese-kid "out".  Very
clear, very clean -- in engineering-science.

    But "medical science" can't seem to figure this out.

    Is this a failure of the law of conversation of energy, or is
the fault of the child's "excessive eating habits".  Or is it this
habit of "medicine" where you are "polite" with the person and
parent -- by not stating the "engineering" truth.

    In "engineering" you simply state the scientifc truth -- and
the parents and child will HATE YOU for being technically honest.

    As an engineer -- I do not deal with a person's "bad habits".
I will tell him what will happen to him if he persists in that
"bad habit" of reading or writing at -11 diopters for long periods
of time -- months and years.  And when the "kid" keeps on doing
it -- and becomes nearsighted at 20/70 (-1 diopter) what am I
supposed to do about it?

    At that point the situation could be "reversed" but it would
take a strong "will" with the plus lens to do it.  I have no power
to do this -- and very few ODs have any desire to get into even a
"discussion" with the parents at that point.  Tragic!

    In effect engineering, as I state it is "pro-active", while
medicine is necessarily "re-active".  That issue must be
understood.  No "fault" or "blame" should be attached either to
engieering-science statements (that tend to be a matter of "brutal
truth" about our "bad habits"), versus the "polite medical"
approach under these circumstances.

    But these issues must be resolved by the person himself.
Truly an honest but difficult situation.  It is probabaly true
that I will be "hated" because I am engineer-enough to tell the
"brutal truth" about this tragic situation.

Best,

Otis

+++++++++++++++++++++++++++++++++

Post:  "Engineering"

    Dear Carl,

Subject:  Part II:  Human Nature is separated from "engineering
            science".

    I have good friends in optometry.    They respect me -- and I
respect them -- despite the effort by SOME ODs on sci.med.vision
to destroy the "second-opnion" concept.  (See below)

    I separate engineering-science from "medicine" in the
following manner.

    The "medical" person must have an "immediate solution", which
largly consists of a minus-lens.  The public (with rare
exceptions) expects EXCLUSIVLY that quick-fix with the minus lens.
I describe that as a "medical process", that can not be "broken"
by reason, logic, common-sense or engineering-science.

    When you realize this -- you understand the need to separate
pure-science from "medicine".

    The USA has a major problem with obese children.  In terms of
engineering-science (objective, factual truth) this issue is
simple:

1.  Respect the conversiation of energy law.

2.  If the calories into child less are less than child "burns",
   the following will result:

3.  The child WILL LOSE WEIGHT

    The enginering-scientific solution is absolutly clear.

    Why then, does "medicine" struggle with the obese children.

    Because the "MD" can not be brutally honest about the above
scientific truth -- and because the great mass of people love to
over-eat.

    The "engineer" knows the correct answer -- but can never
"implement" it.

    The "medical" person must deal with the CONSEQUENCES of this
"over-eating".  Very few in medicine will explain the
engineering-scientific solution -- because they know the "public"
will not listen.

    That is the difference between an "engineering" approach to
understanding and representing the true-facts concerning the
dynamic behavior of the natural eye -- and the means that
"medicine" uses to deal with the great mass of the public that
walks in off the street -- when the child is slightly nearsighed.

    The problem for me develops when I make "clean" statements
about the behavior of a population of natural eyes (in terms of
measured refractive-state.)

    My analysis is an engineering test to determine if the natural
eye is dynamic -- and has NOTHING to do with "defect" at all.  The
natural eye can and does have postive and negative refractive
states -- depending on its average visual-environment.

    Part of this effort is to get you (and others) to think in
that abstract way about the natural eyes behavior.  Truly an
"intellectual" enterprise -- dispite the "slams" posted by the ODs
on sci.med.vision who does not "like" or even understand the
concept.

    This is an "open" forum, and I alway hope to have a pleasant
coversation -- where we "grow up" in wisdom and knowledge.

    Perhaps in presenting scientific knowlege I have hit a
"nerve" for the ODs on sci.med.vision.  Final scientifc truth does
seem to hurt them -- for some reason.  That is NEVER my intention.

Best,

Otis Engineer

PS:  What follows are the usual "slams" about this abstract
    approach to understanding the natural eye's proven behavior.

(Previous posted discussion on sci.med.vision)

Enjoy!  Thoughtful analysis and intelligent
understanding is how we solve very difficult
problems.