Friday, November 14, 2008
I had my first real experience with alternative medicine in residency. Sure I had heard of it before, and was even a little skeptical of the completely outlandish stuff like psychic healing and homeopathy, but I accepted a lot of it at face value. When a commercial for chiropractic came on I didn’t think twice about it. These are licensed doctors of the spine after all. And everyone knows that acupuncture has been proven for things like pain and nausea right? But just as I was discovering the skeptical community thanks to an interview by Penn and Teller of someone named James Randi, I met a little girl one night in the pediatric emergency center who couldn’t breathe.
This little girl, the daughter of a singer who I happened to be a huge fan of, was in something called status asthmaticus, which is when an acute asthma attack isn’t responding well to the standard treatments like albuterol inhalers and intranasal steroids. Her asthma had been flaring up for about a week prior to the acute worsening and the call for an ambulance to bring her in. During this week she had been receiving care by a chiropractor who did not believe that inhalers and steroids were necessary. Now I can’t say that if she had used standard medical treatment at home, her respiratory failure would have been prevented, but I can say with certainty that chiropractic care did nothing to prevent it. Later in the same week I encountered another young girl with difficulty breathing, this time because of an abscess in her throat that had been growing larger and had begun to block her airway. She had been brought to both a chiropractor and an acupuncturist for complaints of fever, cough and sore throat. Any intern, if not most medical students, would have been able to make the diagnosis based on classic findings but it was missed. The ironic thing is that she might have actually benefited somewhat from having a needle shoved into her if it had been shoved into the pocket of infection so that it might drain and decrease in size. The girl with asthma narrowly avoided being placed on a ventilator, the second girl recovered well after emergency surgery, and I became inspired to seek out as much knowledgeable as possible about quackery in all its forms.
These situations are thankfully not that common, but even one child that suffers because of delayed medical care while a parent is seeking out so-called alternative medicine is too many, especially when you consider that in all of these cases there is no chance of a cure. But, like I said, these kind of catastrophic events are not common with kids. Adults are much more likely to make use of alternative therapies and diagnostic modalities when faced with serious medical conditions. And a large number of people of all ages make use of alternative medicine for non-life threatening concerns, especially common signs and symptoms of just getting older like aches and pains, fatigue, decreased memory, etc, etc. So if alternative medicine is so popular, shouldn’t we at least have a decent grasp of what exactly it is?
The truth is that there is no such thing as alternative medicine. There is no such thing as western medicine or eastern medicine either, and claims of the existence of such entities as complementary or integrative medicine are grossly exaggerated regardless of what you may see on Oprah. The simple fact of the matter is that there is only medicine. There is medicine that works, medicine that doesn’t, and medicine that hasn’t yet been evaluated for efficacy. Of course, it goes even deeper than this. There is the question of safety as well as efficacy. Some treatments, thalidomide comes to mind, are very effective for one concern but still not safe for use. Thalidomide treated the nausea associated with early pregnancy very well but was found to cause birth defects.
The foundation of science-based medicine, the scientific method and subsequent development of such tools as the double-blinded placebo-controlled clinical study, although not perfect, are extremely powerful means of rooting out what works, what doesn’t, what is safe, and what isn’t. The bogus category we know as alternative medicine, or any of the other fictional categories I mentioned before, are marketing terms or terms employed with political intent and came about as a means of helping proponents of quackery to circumvent the process that has led to things like vaccines, antibiotics, or any of a vast array of medical treatments that have significantly increased our life spans and added unprecedented quality to our lives.
Within the confines of an all-inclusive category such as alternative medicine are hundreds, if not thousands, of different, often contradictory therapies. Many chiropractors makes claims that the root of poor health is the obstruction of an innate healing force, which travels from the heavens through the spine. Believers in traditional Chinese medicine accept the existence of a mystical healing energy that flows, not through the spine, but along a number of energy pathways throughout the body known as meridians. Homeopaths propose that water remembers the healing essence of substances no longer present in their pills and drops, and naturopaths, who also accept homeopathy, prescribe herbs and supplements with measurable quantities of ingredients in them. Reflexologists look at the bottom of your feet to diagnose and treat medical maladies while iridologists believe that the pathway to discovering what was, is, or will be ailing you is in the flecks of pigment in your iris. All of these systems, and considerably more, fall under the all-inclusive term alternative medicine.
Thursday, November 13, 2008
"I just don't think that there are a lot of people out there right now taking this seriously," Democratic Senator Hort Perkins explained. "They are either too distracted by the failing economy or tonight's Latin Grammy Awards to realize what is at stake."
Not everyone in Congress is as concerned about the switchover as Senator Perkins, however, with some, like Republican Jenkins Chortworth, disagreeing with portions of proposed legislation geared towards encouraging American citizens to purchase add-on digital tuners. "I find it hard to believe that a few million people losing their television signal will result in widespread panic, riots, and the overthrow of the American government. That being said, while I disagree with government handouts for consumers unable to afford the new equipment, a few months of martial law would probably do the country good."
Tuesday, November 11, 2008
"I think that this is a victory for all Americans," Sacramento Msgr. Mathew J. Kavandish, pastor of St. Piscapo Parish, explained. "This will forever serve as a source of hope for any large groups of people whose basic human rights have been denied by the desire of a much smaller group of people to share in those same rights."
Some Proposition 8 proponents, like Mormom Priest Marcelle Wittmire, are worried that supporters of same-sex marriage might think that a religiously motivated vendetta against homosexuals is involved. "I have nothing against the gays. It's just that I have yet to meet one that isn't a wicked and hellbound wretch bent on dragging down those around them into the Satan's dominion."
Sunday, November 9, 2008
The WHO is no stranger to making unfounded conclusions regarding so-called alternative medicine, an essentially meaningless marketing term that is highly politicized and unfairly allows a large number of modalities utterly lacking in legitimate scientific support to ride the coattails of a few high-profile but equally unfounded therapies. In a May 2003 for instance, the WHO claimed that,
"Acupuncture has been proven effective in relieving postoperative pain, nausea during pregnancy, nausea and vomiting resulting from chemotherapy, and dental pain with extremely low side effects. It can also alleviate anxiety, panic disorders and insomnia."This is true only if the lack of plausibility and the totality of the medical literature on acupuncture is ignored, and only cherry-picked poorly conceived, or small and unconvincing, studies are used to support such claims. The information on traditional medicine provided by the WHO is full of equally unfounded and misleading statements.
A Reuters report on the aforementioned conference reveals just how uncritically the WHO is approaching the subject of traditional medicine. According to the article, the conference, which was attended by representatives from 70+ countries, was an opportunity for brainstorming on how to achieve a wider distribution of traditional medical systems, and how to better combine them with conventional medicine so that both systems benefit. This is, of course, pure and total hogwash. Alternative medical modalities add nothing to conventional medicine.
One WHO official is quoted as saying that"Integration of traditional medicine into national health systems will not only bring benefits to patients, but will also ensure safety and proper use." This sounds reasonable but never pans out. Putting the weight of the WHO behind treatments that are not based on good science, and which often call for the bending of fundamental laws of reality, benefits nobody but those who sell such treatments. And one need look no further than the efforts of the NCCAM to realize that calls for increased research in order to determing what is safe and what works is an expensive waste of time. Proponents of alternative medicine don't care about research unless it supports their belief system.
The author writes that WHO director-general Margaret Chan called traditional medicine "a valuable source of leads for therapeutic advances and the discovery of new classes of drugs." It's true that modern medicine owes much to substances derived from the natural world, but this is a classic bait and switch. The fact that some ingested plants have measurable effects on human physiology that can be harnassed for our benefit in no way supports the silly pre-scientific notions behind most of these traditional systems of healing. There are already rational scientists looking into natural medicines and we don't need the wholesale acceptance of a seemingly unbounded entity such as alternative medicine to encourage more to enter the field.
The article further reveals that,
"Traditional medicine is used throughout China and in other developing countries, even with access to Western-style health care growing. Leech therapy is used in parts of India to treat pain and skin diseases, and hospitals in China often offer both Western treatment and traditional cures like acupuncture or herbal antidotes."This is merely the WHO applying the illogical argument that popularity serves as valid proof of efficacy. It doesn't or else we would still be bleeding folks to relieve their excess blood or purging impurities from our patient's bodies with oral mercurous chloride. But pandering to the masses is the name of the game these days, as evidenced by the growing number of alternative medicine departments in academic medical centers across the United States.
The WHO isn't all bad, not by a long shot. They provide a valuable service and add much to international efforts to end suffering and save lives. But they leave a lot to be desired when it comes to rationally evaluating the place of alternative medicine in global healthcare. The position they are taking runs the risk of adding suffering to the world but emphasizing therapies that have failed to meet the standards of science-based medicine in a number of areas by placing far too much importance on popularity and anecdotal evidence.
Monday, November 3, 2008
"We have reached a point where the luxury of human medical research subjects, acid mine laborers, and game for recreational hunting has become a financial liability that we just can't afford," Commerce Droid BX-419 explained. "To feed, clothe, and sterilize a single human for just one flort cycle costs nearly two remlangs, which is significantly less than the total expenditure of transporting them all back where they came from."
The failing galactic economy has been traced to the financial policies of Overlord Zorg XII, known by his billions of subjects as both the Bringer of Eternal Peace and World Eater. "Geez, I invest the royal treasury in one Emu farm and these guys are calling for my borgle on a plate!"