Cutting Through The Crap

Showing posts with label alternative medicine. Show all posts
Showing posts with label alternative medicine. Show all posts

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]

Friday, August 3, 2012

Snake Oil


If it's true -- and it is -- that conservatives tend to ignore reality when it comes to politics, economics, human rights, foreign policy, it's also true -- sadly, embarrassingly, incomprehensibly -- that liberals have blinders on when it comes to "alternative and complementary medicine." The Huffington Post, for example, is so filled with medical woo that it's hard to go there at all.

I've said it before, and it's not an original thought: if a therapy can be shown, by proper studies, to work, it's not "alternative" or "complementary," it's medicine. And, since virtually all of the woo has either been shown to be ineffective, or hasn't been studied at all, what it is is bullshit. And whereas I don't know how far it's penetrated into the right side of our political divide, it sure as hell doesn't belong on the left. But there it is.

Anyhow, the reason I bring it up is this article, which, in turn, refers to another:

Paul Offit’s editorial in The Journal of the American Medical Association (JAMA. 2012;307(17):1803-1804.) goes through the history of the National Center for Complementary and Alternative Medicine(NCCAM) and nicely points out that studies funded by NCCAM have failed to prove that complementary or alternative therapies have any more benefit than placebos.

Offit points out how NCCAM spent $374,000 proving lemon and lavender scents do not promote wound healing, $750,000 to prove that prayer does not cure AIDS, or improve recovery from breast reconstruction; $390,000 to find that ancient Indian remedies do not control type 2 diabetes, $700,000 to find that magnets to not treat arthritis or even carpal tunnel syndrome; and $406,000 to show that coffee enemas do not cure pancreatic cancer.

As much as we would love to find the new treatment that is available in your grocery store, or Ace Hardware, or Starbucks – it just has not been found.

Still, proponents of acupuncture, homeopathy, naturopathy, and even HCG diets, insist they have proof it is always in their own journals, with less than rigorous studies, and never reproduced in major medical journals. But clearly, science is less important to those who take these “treatments” than the potential of placebo effect.


As a surgeon I welcomed anything that might make a patient feel better about their upcoming operation or recovery. As long, that is, as it didn't lead them to rejecting rational therapy. "I don't think it can hurt," is something I often said. But I also saw the consequences of people who chose obvious bullshit over something that would have helped. A post I wrote a few years ago on Surgeonsblog still gets comments, most of them righteously huffy. There's nothing I can say that will convince believers that curds in their turns are not gallstones. (None, of course, has taken my suggestion to have them chemically analyzed, or simply to get before and after ultrasounds of their gallbladder.)

For whatever reason, the human brain is prone to magical thinking. In the case of medical woo, it only hurts one person at a time; and, as long as it's used along side real medicine, it might not even do harm at all. The teabagger form of magical thinking, on the other hand, has the potential to harm millions at once, and, in fact, to take down our entire country. So I guess it's worse than woo.

But neither form ought to have a place at anyone's table.


Tuesday, July 6, 2010

Spotting Virgins


Something about a red spot behind the ear proves whether a man is a virgin or not. So says a Vietnamese acupuncturist. Of great interest, and happily, neither gay sex nor jerking off affects the test.

She says she was first taught how to determine if a man has ever had sex by feeling their pulse. She later developed the ear-spot method on her own. She says the spot will only disappear after heterosexual intercourse and is not affected by gay sex or masturbation.


It's in print, so it must be true. It's so true, in fact, that it led to the freeing of three men convicted of rape. To the admiration of lots of folks.
Vietnamese newspapers have dedicated profiles to Hong and her virginity test, crediting her with helping to free the men while not expressing any skepticism of her ability. Earlier this week, she went on an online chat on Pioneer newspaper where readers expressed their "great admiration" for her efforts.

There's a reason I'm posting this. It shines a bright light on belief in silly things, like "alternative medicine." This lady's techniques are no different from homeopathy, reiki, you name it: unproven claims (disproved, in many cases), supported with wild credulity. I'd assume that most Western people who believe in alternative medicine (I repeat: if it works, as proved by studies, it's not "alternative," it's medicine) would laugh at this lady's virginity test. But they're totally down with their water and its memory, their chakras and chi, their flushes and detoxifiers. From twenty thousand feet, there's not a bit of difference: needing sop, wanting magic, hating the hard stuff, people buy the b.s. peddled by fakers, quacks, and the self-deceived.

For that matter, it's exactly like teabaggerism and Reaganomics; and all of it is explained by this.

Monday, May 10, 2010

Puzzlement


Lying within a couple of bytes of permanently fallow, my better blog, Surgeonsblog, still gets visitors. Some find it when searching for a specific surgical topic; others seem to stumble upon it from a moldering link on another site. When comments are left, questions asked, I reply. That it remains viable after I've mostly left it, still providing useful information or entertainment for people (or, quoting an email I just received, "inspiration") gives me satisfaction. Too, once in a while, it drives me nuts.

A post that gets regular traffic is this one, about gallbladder flushes. Like all "cleansing" procedures -- especially colon cleanses, a favorite among liberals for some reason, if reading the Huffington Post (which I do, regularly [no pun]) is any indicator -- such holy happenings are peddled prodigiously by the deluded or the deceptive, and carried out with commitment by the credulous. Unlike colon cleansing, which has no visible verifier except the expected effluvium, gallbladder flushes produce something tangible, something magical, something given the credence of a brickbat. It's real, it's there for the looking. It's proof positive.

It's bullshit.

And yet, I still get testimonials for the treatment, along with vigorous personal derogation for dissing it. Did so again recently, got into quite a little tête á tête. Hand in hand, such belief is accompanied by certainty that doctors are liars and thieves, and that the only reliable health care is to be received from -- you name it -- naturopaths, chiropracters, homeopaths, and chi-ters. The less evidence, the better.

What impresses them beyond recall to reality is the production of "stones" in their feces after they drink the potion. With minor variations, the flushee takes a combination of oil and something acidic and, by golly, like cottage cheese, it produces little curds in the turds that the true believer is convinced are gallstones. I've had them brung to me, with smug certainty, in little cups, a wrong thing on many levels. Without recounting the simple physiology of the gallbladder and the only slightly more complicated chemistry of bile, not to mention the geometry of bile ducts and the physical nature of gallstones, I'll assert, and the reader will accept based on my decades of care for patients and my hundreds of posts which have never deviated from factual, that there simply is no way taking that brew or anything else by mouth will cause a gallbladder to disgorge itself of stones. Believing these potions can work is like thinking you can change your spark plugs by flushing the radiator.

But them cute little curds: what more proof does a believer need? (Suggestion: pick one up and rub it between your fingers.)

Which brings me back into this blog's bailiwick: why do humans need to believe stuff that's so obviously untrue, easily disproved, completely bogus? Whether it's Obama's birth, the age of the earth, a homeopath's worth, or evolutionary dearth, people can be persuaded of the damndest things. Why? In the human brain, how can such disparate things dwell as art, music, love, engineering, architecture, invention... and... belief in gallbladder flushes, Sarah Palin, and Glenn Beck? With so much in us that strives for perfection, for understanding our world, for discovery, we remain capable of -- in need of, evidently -- self-delusion of the most remarkable and refractory sort. My latest in the thrall of flushes was absolutely convinced, while derisively dismissive of factual input. Not unlike some commenters here. So deep is the need.

Philosophers can wrestle with it, theses can be written. But to me, if it's frustrating and depressing, it's also simple: our minds have not kept pace with our ability to create. We've made the world too complex and too dangerous for the limited capacity we have to understand what we've done or, from the beginning maybe, to handle uncertainty. It's a paradox of evolution. Capable of so much, our brains have significant and perverse lacunae. Faced with inescapable reality, like the kid who spills ink on the carpet, we turn to pretense. When we can't deal with the world we've made, we make stuff up that feels good, that's easy, magical. Water memory. Death panels. Creationism. Fair and balanced. For that matter, in terms of demonstrating failures of human cerebration, I find it hard to make much distinction between believing there's a red-skinned guy with horns and a tail living in the center of the earth, that martyrdom gets you a two-month supply of virgins, and this. All evidence that in apprehension of reality we're fatally flawed. (By "fatally," I mean "fatally." And by "we" I mean "they.")

If we're going to save ourselves from ourselves, we have a hell of a long way to go, which means we better find a way to pick up the pace of evolution in a big hurry. I wonder if lemon juice and olive oil would work...

Monday, March 2, 2009

Nuts


Thanks to Spiny Norman, I read this little item. Tom Harkin is upset: the National Center for Complementary and Alternative Medicine (NCCAM) has been uncovering too much quackery. Established by the good senator (among others), with the intention that it would look into woo and crazy sh*t and find it wasn't woo and crazy sh*t, they've been going all sciencey and debunky. Water doesn't have memory? Magnets don't cure headaches? What good is legitimate research if it leads to conclusions like that?

As a proud liberal, I must say this is one aspect of (some of) my brethren and cistern that embarrasses me: credulity in the face of crazy. "Alternative Medicine" is an oxymoron: if it can be proven to work, it's called "Medicine." "Alternative" and "Complementary" in the context of medicine, mean "Discredited" and "Bullsh*t." As much as I am troubled by wingnuts who reject the science of evolution, age of the earth, and climate change (not to mention continuing to insist on trickle-down economics), I am no less appalled by Senator Harkin in his love of CAM, and Robert Kennedy, Jr, in his riding of the antivaccination bandwagon. As much as I like reading The Huffington Post I find a little too much credence given there to unproved or disproved medical woo.

It seems to be a liberal lacuna.

.