Improvement or Cure?

I used to work in a ophthalmology clinic. When I first started, part of my duties included talking to patients about their treatment options and what they could expect after treatment. The big word was "improvement" - one we've all heard, but one that means so many different things. In a medical setting, the word "improvement" is not synonymous with the word "cure". In an ophthalmology clinic, improvement could mean better contrast or reading an extra line on an eye chart. It is almost never perfect vision. Improvement, especially in cases of allergy and atopy, can mean a partial or temporary alleviation of symptoms.

The reason why this is important to understand is because thinking about allergies and atopic conditions in these terms can help one cope throughout life. It's optimism tempered with reality. There may one day come a cure (hopefully, soon), but until then, there isn't. So, instead of chasing non-existent cures or expecting miracles from any kind of treatment, what parents and patients should be looking for is the treatment option that leads to the best improvement.

I'll use my atopic dermatitis as an example of improvement. My skin has been visibly affected by over three decades of trauma. At present, I do not have any major flare-ups. Everything is under-control. So, at this moment, it's a question of maintenance. To maintain this level of improvement, I have to ensure that I continue my skin care regimen. It's not romantic or miraculous. I never found a cure and no one thing has lead me to this level that I am at currently.

Still, it's improvement. I don't lay awake itching like I did as a child. I don't have to put socks over my hands, but I do keep my nails short. I don't have to use corticosteroids every day, but I always have some on hand in case I need it.

I like to brag that my immunologist gushes about my skin whenever I see him. Not because it's flawless, but because the texture has improved. It's not something I could have imagined when I was young. I also couldn't have imagined that I would wear t-shirts, despite the areas of depigmentation on my elbows. More importantly, I never guessed that I would genuinely like the way I look when I see myself in a mirror.


All of that is improvement. It's not a cure, but it's pretty spectacular nonetheless.