Cutting Through The Crap

Sunday, March 3, 2013

Column



Here's my weekly column that's appearing today in our local paper.

Putting on my doctor hat again, for an oxymoron alert: “Alternative Medicine.” There’s no such thing. If a treatment is effective, it’s not alternative medicine, it’s medicine. “Alternative,” in other words, means either ineffective or untested. Colon cleansing. Liver flushes. Detoxification. Various “natural” concoctions. Homeopathy. Chiropractors (appearing between miracle cloth and car wax at county fairs) for anything except back problems. 
Ridiculous on its face, homeopathy might be the most risible of them all: potions of supposed disease-causing material, diluted to non-existence, given as treatment. Not only is it an idea born in a vacuum; it’s been tested repeatedly, and found to be no more effective than placebo (“sugar pills.”) I’ve been known to criticize today’s Republicans over their recently acquired distaste for facts. But this is among the things that bug me about many liberals. For some reason, they trust this stuff with the same credulity as followers of our huckster native son, Glenn Beck, buy his weepy fear mongering. And not just liberal “civilians.” Tom Harkin, Democratic Senator from Iowa, has shepherded millions of taxpayer dollars into researching this baloney. And when the results, predictably, showed it to be just that, he didn’t stop. 
Our minds are at once spectacularly creative and mystifyingly fallible. Or maybe it’s all the same: when things get too tough to handle, we can head for the heuristic hills, make stuff up to feel better. This tendency is manipulable, for good and for bad. (For non-medical “bad,” see Rush Limbaugh, to identify someone other than Fox “news” for a change.) As a military doc, I treated lots of aches and pains. Back then there was a great pill, called Parafon Forte. Touted for muscle spasms, it was a real showstopper: not only did the very name scream potency; it was a honking horse pill. And it was green! And eight-sided, like a STOP sign!! Testing eventually showed it to be about as effective as placebo, but boy did it look the part. When I ordered it, I’d write “No Refill!!!” on the prescription. (I used it when nothing stronger was needed; and before its minimal effectiveness was known.) Was I calling upon the placebo effect? Sure. But at least I knew it. I don’t think that’s true of dispensers of, or believers in, “alternative” medicine, which, to the extent that it works, does so the way Parafon did. Despite an immense body of proof, they deny that. 
I guess so-called complementary medicine is different. Unlike alternative medicine, which represents itself as something to be followed instead of mainstream (i.e., tested and proved) medicine, “complementary” treatments are promoted as adjuncts to it. When my patients asked me about such things, I never discouraged them, as long as they were also following a sensible plan. When it comes to meditation or massage or other relaxation techniques, why not? Acupuncture? Certain kinds of nerve stimulation can lessen pain, which makes its usefulness theoretically possible. But in most studies comparing it to sham poking, it’s no better. Reiki, well, I guess it’s really just massage; so okay. But the touchless kind? Manipulating Qi? Gimme a break! Pure placebo. Which is not to say entirely useless. But let’s recognize what it is: Parafon. 
I readily acknowledge that modern, research-based medicine is imperfect. But it constantly questions its own claims, and self-corrects as evidence demands. Better drugs, operations, approaches are appearing all the time. Alternative medicine, for the most part, doesn’t change. For centuries, in some cases. To its credit, our local bastion of naturopathy, Bastyr University, has occasionally conducted credible testing. Echinacea, they found, for example, doesn’t prevent or shorten colds. Elsewhere, ginger has been shown to be effective in treating nausea. Which makes it medicine. Like aspirin, discovered in willow bark. 
I always tried to promote a positive outlook: although studies show it has no effect on cure, it speeds recovery from treatments. If any modality helps that, it’s a good thing. So where’s the harm, you ask? Here: Several years ago this newspaper reported the story of a woman who’d previously had breast cancer successfully treated by standard therapy. Years later, when cancer arose in the other breast, she chose alternative treatment from a crackpot doctor in Seattle. The glowing and credulous three-part series ended with contact info for the charlatan. What wasn’t covered, except in the usual way, was the obituary it ran several months later.
[Image source]

No comments: