Readers, be warned: This is not one of my more diplomatic pieces. I'm angry, and while I'm trying to be fair here, I'm not trying to be nice. If you don't want to read that, please don't. (It was also written under the influence of an entertaining assortment of prescription drugs; so if I'm more meandering than usual, please forgive me. Hey, what a pretty tree!)
As regular readers of this blog know, I've been home sick for several days with pneumonia. The experience hasn't been a picnic: as anyone who's had pneumonia knows, even a relatively moderate case that you don't have to be hospitalized for will totally kick your ass. I've been exhausted; I've been uncomfortable and at times in actual pain; and since all I could do for days was sit on the sofa breathing steam and watching TV, I've been bored out of my mind. (It's only been in the last couple of days that I've been alert enough, or able to stop hovering over the steamer for long enough, to do any writing.)
But the experience has given me a renewed respect for conventional medicine. And it's given me a renewed rage at the alternative medicine practitioners and proponents who are undermining it.
Here's the thing. As soon as I started suspecting that my bad cold was something more than a bad cold, I hightailed it over to Kaiser. And within two hours, I had a diagnosis, medicines in my hand, and a treatment plan. In case you're curious, here's what I'm on:
Antibiotics. Penicillin, quaintly enough. Obvious purpose -- to kill the infection in my lungs.
Cough medicine. Purpose: to quiet my cough, which had been doing this nasty self-perpetuating loop -- the cough was making my lungs irritated, which was making me cough even more. (This also reduces my pain and discomfort and lets me rest, since I got the good stuff with codeine.) Also -- not to be too gross about it -- it loosens the gunk in my lungs, so when I do cough it does some good.
Bronchiodilators. Purpose: to ease the constriction in my lungs. Thus helping me breathe, as well as helping me sleep.
Decongestants. Purpose: at the risk of thoroughly grossing you all out, to stop post-nasal drip from dripping into my lungs and gunking up the works even further. (The gross-out portion of this blog post is now complete. My apologies.)
All of which -- how exactly shall I put this? -- works. It does what it sets out to do. All of it was carefully, rigorously tested, with placebo controls and double-blinding and peer review and replicability and all that good stuff... and all of it has been shown to work. It's going to be a little while before I'm back to normal -- pneumonia is no joke -- but I started writing this three days after I started the treatment, and I'm already significantly and measurably better.
And contrary to one of the more popular misconceptions about conventional medicine, the doctor didn't just send me home with a bag of drugs. She also sent me home with instructions to breathe steam; drink enormous amounts of fluids (especially tea); stay warm; not talk too much; and rest as much as I possibly could. Plus she asked me about fifty times if I smoked. Contrary to the accusation leveled in a comment in this blog that "anything that isn't designed by a human in a lab isn't considered 'real medicine,'" a large part of my treatment plan had nothing to with anything designed in a lab or cooked up by a pharmaceutical company. And the non-drug part of the treatment didn't make anybody rich... except perhaps the Celestial Seasonings tea company. (Even the drugs in a bag weren't making anyone terribly rich; they're mostly old-school drugs that moved into generics long ago.)
Now, I haven't been tremendously happy these past few days. I've been exhausted, cranky, woozy, uncomfortable, and bored out of my mind. And let me tell you, the combination of codeine and Sudafed is one weird-ass speedball. I don't recommend it.
But here's what I haven't been:
Dead.
Or dying.
Or even suffering all that much.
The history of pneumonia before antibiotics is not pretty. Until the 20th century, treatment was pretty much non-existent. You either got better on your own, or you died. Mostly, you died. Pneumonia killed a ton of people, and it was known and feared for its special ability to kill young, healthy people in the prime of their life. And death from pneumonia is no fun at all. (I'll spare you the details, since I promised earlier to stop grossing you out.) There was some treatment beginning to be available in the early 20th century -- but antibiotics completely changed the picture.
Pneumonia still kills people today. Mostly the very young, the very old, the immune-suppressed, and people who don't get medical care in time. But thanks to conventional medicine and Big Pharma, I am rotting on the sofa for a week, feeling sorry for myself and watching all of "Firefly" on DVD... not rotting in a grave. And so are thousands of other people who got pneumonia this week. (Well, they're probably not all watching "Firefly"...)
Okay. All very good reasons for me to be happy about conventional medicine. So why is this experience making me angry about alternative medicine? Not just annoyed, not just amused, but deeply, seriously, lividly angry?
I'm angry because I think alternative medicine undermines conventional medicine.
I'm angry because so many alt medicine practitioners convince sick people to treat their illnesses, not with treatments that have been rigorously tested and shown to be effective, but with whatever powders and potions and procedures the practitioner's fancy happened to light upon, backed up at best with carelessly-done testing, and at worst with nothing but an interesting philosophy. With the best result being a placebo effect, and the worst being actual harm being done, either from neglect of the medical condition or from the sometimes harmful treatments themselves.
I'm angry because so many alt medicine practitioners promise "alternatives" that are easier, more pleasant, and more palatable than conventional treatments... along with promises of more complete and dramatic cures. I'm angry that they encourage people to pursue preventions and treatments based not on thorough testing of what does and does not work, but on what they find emotionally and psychologically and culturally appealing. I'm angry that they encourage people to abandon conventional medicine, which is often unpleasant and sometimes only partially effective, by offering appealing promises that they can't back up.
I'm angry because so many alt medicine practitioners and proponents convince people that conventional medicine only cares about symptoms and acute conditions and ignores prevention and overall health... when the reality is that doctors and nurses and public health officials around the world are desperately trying to get people to exercise, eat better, reduce their stress, and quit smoking.
Along that line, I'm angry because so many alt medicine proponents and practitioners convince people that "doctors don't know anything, and all they care about is making Big Pharma rich." (As if alt medicine practitioners were all-knowing, and nobody in the world were getting rich off of it.) I'm angry at the ways that alt medicine encourages the anti-intellectual strain so prevalent in American culture; the all- too- common attitude of, "What does that hi-falutin' doctor know anyway, with their book larnin' and their fancy degrees? Us simple folk know more about (X) than Dr. Fancy-Pants, with their years of specialized training and experience."
And I don't mean that altie practitioners and proponents encourage people to question doctors; to have a healthy skepticism about them; to treat them as fallible human beings who aren't God. I encourage people to do that. Hell, most doctors and nurses I know encourage people to do that. I mean that they encourage people, not to question doctors, but to disregard them at their whim.
Now, a lot of people will argue that many alt medicine practitioners don't do any such thing. They'll argue that many altie practitioners see alt medicine as a supplement to conventional medicine, not a replacement for it. That's why it's often called complementary and alternative medicine, or CAM -- because it complements conventional medicine, rather than supplanting it.
Okay. Fair enough. So look at it this way. If I had gone to an alt medicine practitioner with my pneumonia symptoms, one of two things would have happened.
Option A: They would have tried to treat my pneumonia with their dilutions, their energy fields, their sacred herbs, whatever. Seriously. Here are some of the gems that my Google search on "pneumonia" + "alternative medicine" turned up. We have this site, recommending that pneumonia be treated with diet, bowel and dental cleansing, and -- believe it or not -- exercise. (Exercise being absolutely the last fucking thing in the world you ought to be doing if you have pneumonia -- except maybe for smoking.) No mention of antibiotics. We have this site, which mentions antibiotics but says they're problematic, and suggests as alternatives cayenne pepper, manuka honey, and hydrogen peroxide. And then we have Holisticonline.com, which recommends that pneumonia be treated with chiropractic care, pleurisy root, and the color red.
In which case they would, in my opinion, be guilty of reckless endangerment of human life. If anyone anywhere in the world has died, or even suffered needlessly, because they acted on the advice of an alt medicine practitioner and treated their pneumonia with exercise, cayenne pepper, or the color red, then that is blood and suffering on the hands of alternative medicine.
Don't believe me? Don't think that CAM practitioners prescribe CAM treatments for serious, life-threatening illnesses -- in the place of conventional medicine? Here's a nice little story from the BBC about homeopathists in Britain telling people that they didn't need to take anti-malarial drugs when visiting Africa or other high- malaria- risk parts of the world -- they just needed to take the homeopathic remedies. Read it and seethe. And there is no reason to think they did this for malaria only and not for any other life-threatening illnesses. Even a cursory Google search will turn up alt medicine treatments for cancer, heart disease, diabetes, AIDS, and more. And check out these "what's the harm?" sites for more stories of people suffering or dying because their serious illnesses got alt medicine instead of conventional medical treatment.
So that's one option. The reckless endangerment option. But the other option is B: They would have recognized that I had a serious medical condition that they couldn't treat, hustled me out the door, and sent me scurrying to a conventional doctor. (When I Googled "pneumonia" + "alternative medicine," this is what a number of the sites I found essentially did.)
In which case, what the hell is the point? If the only thing alt medicine is good for is mild health problems that quickly go away on their own, then why bother? What on earth is the point of a multi-billion dollar alternative medicine industry if it exists solely to make people feel slightly better when they have sniffles or sore muscles or tummy aches? (If it even does that, in any way other than as a placebo.)
Conventional medicine is far from perfect. Insert a standard "I know conventional medicine is flawed" disclaimer here; I've written them before, and I don't feel up to writing another one now. But it's the best game in town. It is, pretty much by definition, medicine that has been rigorously tested using the scientific method, with placebo controls and double-blinding and replicability and peer review and all that other difficult, expensive, time-consuming stuff that alt medicine doesn't bother with.
And the chances are excellent that you -- personally -- are alive today because of it. Whether it's the polio you didn't get because you got vaccinated, the smallpox you didn't get because it's been eradicated, the heart attack you didn't have because your high blood pressure is being treated, the pneumonia you didn't die of because it got cured... I could go on and on and on. And on. The benefits of conventional medicine are often invisible, an invisibility that's enhanced by short memories and insufficient history lessons. But the fact is that we easily prevent and treat diseases and conditions that used to routinely kill thousands and millions of people.
Medicine is about the prevention of death and the relief of suffering. And conventional medicine is, by definition, medicine that has been rigorously tested and shown to prevent death and relieve suffering. Alternative medicine, on the other hand, is, by definition, medicine that is outside that rigorous testing system. It is medicine that promises to prevent death and relieve suffering, but is unwilling to spend the time and work and money making damn well sure that it can back up that promise. It is medicine that shares every single one of the flaws of conventional medicine, from greed to arrogance to cultural blindness, without offering any real benefit that conventional medicine doesn't.
And it is medicine that undermines conventional medicine; medicine that draws people away from conventional medicine by making enticing promises that it can't deliver.
So it is therefore medicine with blood and suffering on its hands.
I don't know if it helps with pneumonia proper, but when I have really nasty lung congestion, one thing I've used successfully is a vibrator. A Hitachi will do, but a Wahl coil-style works better.
I was lying in bed feeling miserable and thinking about sitting up but not really feeling energetic enough to do that. About the only exertion I had was enough coughing that I could feel the burn in my abs. Then my mind wandered to memories of cystic fibrosis patients getting their chests pounded.
So I dug the vibrator out from under the bed and applied it firmly to every accessible part of my ribcage. (Mostly I stuffed it into thinly-padded areas like my armpits and lay on it.)
I coughed up an impressive amount of phlegm, got up, and went to the kitchen for something to eat! All the while commenting on how much better I felt.
A lot of that knocked-out feeling was simply hypoxia. Just unclogging a few alveolae made a world of difference.
I don't know if it can make a difference to real pneomonia (fluid in the lungs), but it's helped me enough that I recommend it, since it's safe and quick to try.
Back on the subject of quacks, there are a whole bunch of scary stories over at scienceblogs.com/denialism. The schizophrenic with scientologist parents seems particularly sad to me. Given the choice between a psychiatrist with an unpleasant diagnosis and a huckster with a pleasant one, guess who people want to believe?
Posted by: Eclectic | March 29, 2008 at 01:26 AM
I agree with your post, I just wanted to clarify the previous comment I made that you quoted here.
In that comment, I was attempting -- perhaps a generous word -- to make a pragmatic argument about the definition of alternative medicine in order to keep people from avoiding vitamins; I know a handful of people who have suffered because, on the assumption that vitamins do nothing, they got silly treatments for the symptoms of their vitamin deficiencies. Those same people and myself also frequently run into people who outright scorn vitamins. It's weird and keeps happening, so this is why I tend to yammer on about it.
I did not mean to give the impression that I meant that *those in the medical profession* consider only "lab medicine" to be real medicine -- I meant quite the opposite. Doctors are more likely than anyone to have read studies on vitamins, to know when they're helpful and when they're not, and in what quantity. This is exactly how it should be. I was arguing that the problem is *laypeople* lack that kind of detailed knowledge. Instead, they tend to lump all vitamins together and rely on labels for their judgment. Because unscrupulous people make products like Airborne, they hear vitamins being talked about as "alternative medicine," and so go all vitamins in their mind. The term has a negative connotation to the scientifically-minded, as well it should. As a result, those laypeople who value science avoid all vitamins like snake oil... which is unfortunately a scientifically ignorant thing to do, and a misunderstanding which can adversely effect their lives.
When a layperson values science, the label of "conventional medicine" means everything. It's the only legitimate medicine, "real" medicine, and the rest is purely superstition. They associate any kind of "lab-made" medicine with science, regardless of whether it's been tested enough to technically qualify as "conventional medicine" under the definition you used. Lab medicine is not superstitious, after all; it's designed based on scientific principles, even if it ends up not working in practice. For example, I don't think I've ever heard a layperson refer to any sort of lab-created medication as "alternative medicine" regardless of how little or how poorly it's been tested. Since vitamins are popularly associated with "alternative medicine" by many laypeople, they are left with the idea that the only "real medicine" is lab medicine. (Well, diet and exercise, too, are hammered into us. That's a broader sense of medicine than I had in mind when I wrote my comment.) That's what I was saying with my quote.
I did not specify "laypeople" in the sentence you quoted because, in my head, my comment was clearly about the effect of labels on popular opinion and decisions, and doctors do not really fall into that category since it's their area of expertise. In actuality, it wasn't very clear at all. I regret that it came across that way; at the time I didn't even realize that it might because I was arguing from the assumption that vitamins *are* conventional medicine as much as lab-made medicine is. In fact, the knowledge that doctors do use vitamins to treat their patients was clear in my mind, and just *further evidence* of why the label of alternative medicine is unhelpful in this case.
I basically think it would be easier to change the definition of alternative medicine than to change what people popularly *think* it means. In the case of vitamins: all vitamins are different, quantity matters, the means of ingestion matters... but science-valuing laypeople don't consider such scientific specifics once something is labeled "alternative medicine" in their mind. It's baby with the bathwater at that point, so vitamins become this goofy, ascientific joke to a lot of people.
It's usually helpful that the label "alternative medicine" commands such a powerful connotation to those of intellectual integrity, but I see the opposite happen with vitamins. When it comes to "conventional medicine," people understand that they need to do careful research to see what is most effective and safe, what isn't worth the money or effort, what dosages are necessary to get results, etc. This is what they ought to do with vitamins, but instead their mind warns, "alternative medicine" and they turn away altogether. The people I've met who have scorn vitamins like they scorn chakra readings value science greatly. I think we could strengthen and focus the power of the label if things like lab medicine and vitamins and all that were referred to instead as merely ineffective conventional medicine, rather than alternative medicine.
I hope that laying out my thought process helps explain the mix-up. I'm worried I may have just muddled things more. I didn't respond to your response at the time because I felt I had been as clear as I am capable of being and it still came across muddled. I always *think* I'm being perfectly clear at the moment of writing, so I didn't have any confidence that I'd make sense the second time around. ;-) Also, I was concerned that I may have annoyed you -- might be paranoia on my part -- which wasn't at all my intention, and I felt quite badly about that. And then finally, I felt we were arguing at cross purposes, if that makes sense, because I hadn't been coherent enough. So, for example, you were saying what the definition of alternative medicine is, and that Airborne is alternative medicine by that definition -- which is true, and perfectly reasonable -- while I was more arguing what the definition *ought* to be in order to be most useful, i.e. to cause the least harm and misunderstanding in people's daily lives. I didn't want to be any more incoherent or irritating so I just let it go, so I was dismayed to see the quote come up.
Anyway, I hope you get better soon.
Posted by: Nattie | March 29, 2008 at 04:34 AM
I just wanted to add that after rereading my first comment, I don't know how I expected you to get anything I just said out of it. I got so carried away by giving examples of how vitamins "actually do something, honest!" that the main point of the power of the label of "alternative medicine" and the most useful definition to wield that power was completely, utterly buried.
And in retrospect, it really did sound like I was saying people got that impression of vitamins from the medical establishment or something. Before rereading my comment, this sentence you wrote completely baffled me: "the non-drug part of the treatment didn't make anybody rich." It sounded like you thought I was saying that pharmaceutical companies want people to think vitamins are worthless so they get more money or something, which is the furthest thing from what I believe. I generally hold pharmaceutical companies in high regard because we'd be well and fucked without them.
I had trimmed out a few paragraphs between that and the preceding paragraph because my comment was already ridiculously long, and I blame the resulting jump for giving that impression. Blah.
Hah, sorry to be such a pain. In spirit of the topic, I should give my comments a Surgeon General's warning.
Posted by: Nattie | March 29, 2008 at 04:58 AM
About 15 years ago, I had an infected bursitis in my right knee. I have no idea how it happened; I just woke up one morning and my knee was swelled up to the size of a soccer ball and I was in really horrible intense pain. So I got myself to a hospital (Alta Bates in Berkeley, as it happens), and they got me on an IV of some sort of antibiotic, and they opened up the knee and drained out all the infected stuff. And now I'm bipedal instead of monopedal, because back before antibiotics, this was one of those things that they cured by amputation.
So thanks, western medicine. And thanks for the Cozaar, too, without which I'd be either dead right now or have about three more years to live, tops. My blood pressure runs about 155/100 without it -- and so did both of my parents', so this is really a congenital condition that just can't be fixed any other way than with drugs.
To be fair, my wife also just had some nasty shoulder pain which, it turns out, could be treated very effectively with massage. A friend of ours with seriously good massage skills fixed her right up. But Kaiser had been pretty straightforward about the idea that they couldn't really help her: they did some X-rays to make sure nothing really nasty was going on in there, and then they said "take ibuprofen," which is doctor talk for "we don't really know why you hurt but maybe it will go away." They didn't try to sell us any esoteric drugs or surgery or anything like that. They didn't actually say "try massage" either, but as you point out, it's rare enough for the alt-med guys to say "see a doctor," so I think they were pretty honest about it, on the whole.
Anyway, those are the anecdotes that occur to me at this outrageously early hour. Hope your pneumonia lasts until you get through Firefly. ;)
Posted by: Jon Berger | March 29, 2008 at 07:36 AM
Greta,
I hope you're still getting better.
Related to the alternative medicine issue is the recent news story about the parents who kept their sick kid from getting appropriate medical care based on their religious views about faith healing. Here's the link to this news story:
Parents indicted, then surrender in faith-healing case
http://www.oregonlive.com/news/oregonian/index.ssf?/base/news/1206773725138750.xml&coll=7
Both involve instances where reason is rejected in favor of something else.
Posted by: Steve Caldwell | March 29, 2008 at 08:13 AM
I agree vehemently with this post. My sister and I both caught pneumonia when we were little kids (4 and 6, respectively) and without antibiotics we almost certainly would have died. As it was it just ruined our trip to Disney World.
I hope you're feeling much better soon!
Posted by: Sharon | March 29, 2008 at 10:39 AM
Whoops, I was 4 and she was 6.
Posted by: Sharon | March 29, 2008 at 10:41 AM
You know, the more I read your blog, the more I like it. And I found it from the Atheists & Anger post, so I liked it a whole hell of a lot to begin with.
I particularly appreciate having it pointed out (because I hadn't really thought about it before) that while everyone complains about Big Pharma, Big Alt is raking in the cash too, and they don't have to shell out for double-blind effectiveness testing.
Posted by: vito excalibur | March 29, 2008 at 11:12 AM
Ambrose Bierce gave a couple of definitions of "homeopathy" over a century ago.
"A theory and practice of medicine which aims to cure the diseases of fools. As it does not cure them, and does sometimes kill them, it is ridiculed by the thoughtless, but commended by the wise."
"A school of medicine midway between Allopathy and Christian Science. To the last, both the others are distinctly inferior, for Christian Science will cure imaginary diseases, and they cannot."
Posted by: bernarda | March 29, 2008 at 01:57 PM
Very glad to see you back writing. I hope you're well soon.
I detect no hint of muddle-headed meandering there - you're your usual clear and entertaining self.
Interestingly, it's only a few days since I wrote arguing (from a hardened skeptics point of view, what's more) why alternative medicine may be a good thing... at least in a specific and limited, but nonetheless possibly important way.
(I hope the link comes over okay
http://ecstathy.blogspot.com/2008/03/value-of-pseudo-scientific-douche-bags.html )
Posted by: efrique | March 29, 2008 at 02:16 PM
Amen!
Me, I was a preemie, born at 8 months with an APGAR of 3. Without the (then-) modern medicine of 1966, I almost certainly wouldn't have survived (and in previous generations of my family, some of the kids didn't).
Since then, I've had various vaccinations, my tonsils removed, and a whole lot of dental work (just try eating a balanced diet with a perpetual toothache -- or no teeth to chew those veggies with). And that's with a relatively healthy life, with no major injuries and few serious illnesses -- but even so, without modern medicine, I just wouldn't be here.
Posted by: David Harmon | March 29, 2008 at 07:30 PM
I have had good and bad experiences with both conventional and alternative medicine. I had a terrible seizure as a result of using the drug Wellbutrin to stop smoking, prescribed by my M.D. I am actually not certain to this day that it wasn't a heart attack, although my doctor, over the telephone, insisted it was "just a bad reaction." I have also nearly been done in by the antibiotic Cipro. The need to take Cipro was based on a complete misdiagnosis by my M.D. On the other hand, I have made the mistake of fiddling with naturopathic medicine when I should have been at a conventional doctor's office, where I eventually ended up. Years ago my M.D. was also a homeopathic physician, an acupuncturist, and a master herbalist. After practicing as an M.D. for a number of years his daughter nearly died and no relief was available through conventional medicine. In desperation he finally took her to a homeopathic doctor, and she was in time returned to good health. That experience convinced him that he should learn multiple ways to treat his patients. I had a major problem that he treated with homeopathic medicine, and my misery was soon relieved. Obviously his ability to treat well with alternative methods was informed by his background in Western medicine, and vice versa. And he made liberal use of Western diagnostic tools. That is also true of naturopathic medicine in states where they are licensed and have the ability to access appropriate diagnostic tools such as ultrasound, blood tests, etc. I have also found great relief with treatment by acupuncturists. Interestingly in view of Greta's story, a number of years ago I had had a terrible case of phlegm in my lungs all winter that I couldn't seem to shake. I went to an acupuncturist, and she treated me with a technique called cupping. From the moment I arose from her treatment table the phlegm in my lungs was gone and never returned. I think it is a mistake to denigrate either conventional or complementary medicine because each has its place. As with anything, the quality of the result produced is often related to the practitioner.
Posted by: Claire | March 29, 2008 at 08:35 PM
If Harvard doesn't have a school for it (or MIT, etc., you get the idea), it ain't a real science. Especially if it is a thousands-year-old Asian practice. What has been the life expectancy in Asia for the last few thousand years?
Posted by: Blynn | March 29, 2008 at 09:23 PM
Funny you mention antibiotics, I wonder how many evolution deniers would refuse to take an alternative antibiotic because they refuse to believe that micro-organisms would evolve to resist a given antibiotic
Posted by: curious | March 30, 2008 at 12:00 AM
Michael Pollan makes a related point in "Second Nature" about the prevalence of evolution deniers in the agricultural areas of the country, where people are constantly confronted by the tendency of pests to evolve in ways that make them less susceptible to pesticides. You'd think that a farmer who has to buy more powerful pesticides every year because they quit working in a few generations of the pest they're supposed to control would get the idea, but apparently there's a lot logic-free thinking in this area.
I should add that I've had some amazingly good results from acupuncture for symptoms that the Kaiser folks just couldn't deal with at all. But again, in all of those cases the Kaiser folks frankly admitted they couldn't deal with them. The idea that any time you walk into an MD's office you'll be loaded up with expensive drugs because of all those kickbacks the docs get from the pharma industry just doesn't square with my experience.
Posted by: Jon Berger | March 30, 2008 at 07:24 AM
"In desperation he finally took her to a homeopathic doctor, and she was in time returned to good health."
I'm sorry, Claire. I realize that you're trying to take a compromising, "there's something good from both sides" middle ground. But on this topic, I just don't buy it. If the girl in question was returned to health after seeing a homeopathic doctor, it was sheer luck, or possibly the placebo effect.
Homeopathy, probably more than any other form of alternative medicine, is completely bogus. The theory behind it -- the idea that the more diluted a medicine is, the more powerful it is -- is absurd on the face of it, and it's been extensively tested and found to be completely ineffective. (In fact, many lab tests of actual homeopathic remedies have shown them to be so diluted as to have literally no medicine in them at all.)
This is exactly the problem with so much alternative medicine. What it has to support it is this sort of anecdotal evidence. And there are too many other possible explanations for this sort of "I tried X alternative and I finally got better" sort of anecdote. As many others have pointed out, the plural of anecdote is not data.
That's why rigorous, double-blind, placebo-controlled, peer-reviewed, replicated testing is so mportant. The only way we can know whether medical treatments are or are not effective is by using the scientific method. And (a) the overwhelming majority of alternative medicine completely falls apart in the face of that sort of testing; (b) as I've pointed out before, once a treatment gets rigorously tested using the scientific method, it becomes conventional medicine by definition.
Posted by: Greta Christina | March 30, 2008 at 09:46 PM
Have you seen the Richard Dawkins program: The Enemies of Reason, which includes an attack on alternative medicine? It is very entertaining and informative. As you'd expect from the good professor.
Personally I greatly dislike the label of alternative medicine. It really should be alternative to medicine. "Alternative medicine" implies that it has some medical use. It does not. Except, perhaps, as an expensive form of counselling from an unqualified and untrained counsellor.
Posted by: Jason Horton | March 31, 2008 at 05:08 AM
Oh my goodness, talk about timing here. . .
One of my co-workers also comes into town on the train and we both ride the shuttle to the office park. This morning she was telling us how she went to a chiropractor because she is having shoulder pain. According to her, she just walked into his office, said “My shoulders hurt,” and he immediately said, “It’s your sinuses.” Without even examining her, he gave an instant diagnosis. He then proceeded to tell her that it was a food allergy, and gave her a list of foods to avoid.
I find this very alarming. How can a practitioner give an accurate diagnosis WITHOUT EVEN EXAMINING THE PATIENT???
And how would I know if I have a food allergy, unless I go to an allergist and the allergist gives me the scratch test for specific substances?
This is really disturbing.
Posted by: Donna Gore | March 31, 2008 at 06:06 AM
Glad to see you're feeling better, Greta! I think crankiness is often a good sign of returning health. :)
That thing about treating pneumonia with exercise and the color red is horrifying. Sadly, it's par for the course with alternative medicine. The smart altie practitioners prefer to focus on ailments that tend to go away by themselves anyway; when a patient is seriously ill, they'll recognize that they're in over their head and advise the patient to see a doctor. But when you get the *other* kind of altie practitioner, the one who steers patients away from real medicine even when they're dealing with a life-threatening condition... well, I personally wouldn't want anyone to die of gullibility, but the laws of nature are not so forgiving.
http://www.quackwatch.org/01QuackeryRelatedTopics/Victims/victims.html
There's all kinds of horrifying case stories in there, like the five-year-old boy who died after his parents sought chelation therapy to "cure" his autism. Chelating compounds bind to heavy metals and remove them from the blood. Many quacks who think autism is caused by mercury poisoning tout chelation as a cure on that basis. But autism is not caused by mercury poisoning, and since his blood was lacking mercury to bind to, the chelating compound instead bound to calcium ions.. and stopped his heart as a result.
That's just one sad story. There are many more.
Posted by: Ebonmuse | March 31, 2008 at 07:29 PM
I think alternative medicine is a wonderful idea! I like the fact that most of those silly "antibiotics" (designed to treat germs we all know really don't exist) can be outdone by a well stocked herb garden and a little feng shui.
more importantly, alternative medicine serves a valuable purpose for our society at large.
Population control. It allows diseases that used to kill indiscriminantly to target specific sub-populations within our society.
Morons. Those people who insist that the medical industry should be boycotted in favor of eating grass clippings and taking more vitamins because the medical industry makes lots of money deserve the sort of life they will end up with, a short one. people who cling to fanciful theories instead of thought, science and fact are hopefully a dying breed, and homeopathic and alternative medicine are helping to move them into the grave. Lets say a thank you to alternative medicine for clipping morons and superstitious people and hope they keep up the good work.
Posted by: stephen | April 02, 2008 at 05:31 AM
Ugh. Conventional and alternative medicine are not either or choices, and antibiotics may do wonders for your pneumonia, but next time you get a cold or something viral good luck getting anything to help you from an MD (and I are one). On the other hand vitamin C to bowel tolerance (you'll have to google it, but suffice to say the dose has to be individualized to the person) will have you feeling better within a few hours and better MUCH sooner (to pick one random example). And yes there is data to support this.
Peace.
Posted by: ScottL | April 02, 2008 at 06:03 AM
I've taken it for granted but you've reminded me how important real medicine is. I have four children and it is very likely that none of them would be alive today without the benefits of medical science. My eldest, Bethany, had low blood glucose immediately after birth and was tube fed and her blood sugar monitored. My second, Caitlin, had an asthma attack when she was 5 that put her in hospital for a week. The twins, Alexander and Natasha, were born 5 weeks premature and needed oxygen and careful monitoring.
None of these ailments are in any way serious conditions today thanks to medicine and science.
Posted by: Jason Horton | April 02, 2008 at 09:14 AM
"...but next time you get a cold or something viral good luck getting anything to help you from an MD (and I are one)."
It's true. There are illnesses and conditions that conventional medicine doesn't yet have treatments for. I, for one, would rather be given the honest, straight-up bad news that my condition haas no treatment, than be given a soothing placebo that I have no reason to think will work. (See below.)
"On the other hand vitamin C to bowel tolerance (you'll have to google it, but suffice to say the dose has to be individualized to the person) will have you feeling better within a few hours and better MUCH sooner (to pick one random example). And yes there is data to support this."
And for about the billionth time, I say: If there is data to support this -- rigorously- gathered, double- blinded, placebo- controlled, peer- reviewed, replicable data -- then it's not alternative medicine. It's conventional medicine. By definition.
That's what I mean by "reason to think it will work." I know enough about confirmation bias and the skewing and cherry- picking of research and data (conscious or unconscious) to want medicine whose testing has had those biases screened out as much as possible. That, as far as I can see, is the big difference between alt and conventional medicine -- and nobody yet has said anything to convince me of why the non- scentifically- tested medicine is in any way better.
Posted by: Greta Christina | April 02, 2008 at 10:17 AM
There's something that's coming across majorly wrong in your post.
We have to take it for what it's worth and break down what's alernative and what's not.
Christian Scientists (those whackos who do nothing but pray)... those people are bad.
The people who go to 'faith' healers... those people are bad.
People who use natural remedies like I do? Not bad.
Most natural remedies are in fact rigorously tested and sold in natural remedy stores. However, doctors will never prescribe them. Why? Because you can't patent natural cures. Since you can't make money off of them, no drug company will sell them.
Also, antibiotics are not this godsend medicine either. While they are great and get the job done doctors are all too willing to keep giving them out for a simple sniffle. There have been numerous studies into the effects of constant anti-biotic use and it's not pretty. We give out pills for everything. Your kid is shy? Hey, let's give him a drug. You have a headache? We'll give you a drug that covers up the pain. Instead of actually helping them or figuring out the root cause.
Also, every drug on the market has nasty side effects. And nearly all 'legal' drugs especially 'legal' narcotics are very easy to get addicted to.
For an example:
Take my foot fungus (yeah, sorry, but it's applicable). I took Lamisil. Approved drug by the F.D.A. Probably one of the worst drugs ever. I didn't want it but my mother figured it'd work. It destroyed my liver. And expensive as all heck.
I went online and found out a simple natural cure for fungus using hydrogen peroxide which costs a whopping $1. Most of the fungus is dead and the new nails are slowly coming in.
Obviously, though, if I have something like cancer, pneumonia, insulin-shock, you name it... I'll go to a real doctor. But if there's a natural alternative, I'm going to take it. No amount of 'look what all we've done' is going to convince me to destroy my body with those drugs. I won't. I also hate these whackos who won't get shots because they think it'll give their kid autism even though there hasn't been a shred of evidence to suggest it. But that's for another day :)
Posted by: | April 02, 2008 at 02:53 PM
"Also, antibiotics are not this godsend medicine either. While they are great and get the job done doctors are all too willing to keep giving them out for a simple sniffle. There have been numerous studies into the effects of constant anti-biotic use and it's not pretty."
This may have been somewhat true a few years ago, Anonymous, and there may still be some unscrupulous or lazy providers out there who still do this, but I assure you that it is not currently the standard of care in the community where I practice, or at my own doctor's office.
We have been well aware for some time now that colds and bronchitis are viral in origin and do not respond to antibiotics. I myself have argued till I was blue in the face with patients who demanded antibiotics but I refused to prescribe them because I knew that there was no evidence that it would help.
If you think antibiotics aren't so great I suggest you travel back in time to the days before they existed. How about World War I, when a huge number of combat deaths were caused by wound infection or by communicable diseases spread by trench warfare?
No one is claiming antibiotics are a cure-all, the way proponents of so-called "natural remedies" are so prone to do. But properly prescribed antibiotics, in the context of evidence-based medical practice, can certainly save lives and prevent suffering.
Posted by: Nurse Ingrid | April 02, 2008 at 04:42 PM
"You have a headache? We'll give you a drug that covers up the pain. Instead of actually helping them or figuring out the root cause."
Yeah, right. I'd prefer to give someone a narcotic and send them out of my office, when really they've got a brain tumor or meningitis or an aneurysm but I'm just too lazy to check.
Seriously, if I suspect my patient's got something really wrong with them, it's hardly in my interest to mask their symptoms (with narcotics!) rather than do an appropriate workup.
"And nearly all 'legal' drugs especially 'legal' narcotics are very easy to get addicted to."
Sorry, but no. Do you even know what "addicted" means? Are people "addicted" to blood pressure meds or insulin, because they need them to survive?
And people who take narcotics for actual, chronic pain may be physically dependent on their meds, but "addicted" implies a destructive pattern of misuse, so they are NOT addicted.
Posted by: Nurse Ingrid | April 02, 2008 at 04:55 PM
"Most natural remedies are in fact rigorously tested and sold in natural remedy stores."
Sorry, sorry, sorry, but no, no, no. Show me one example of a so-called "natural remedy" that has been subjected to a randomized, double-blinded, placebo-controlled trial that has been published in a peer reviewed medical journal. Oh, wait. I've got one for you: fish oil for the lowering of triglycerides in the blood.
http://www.mayoclinic.com/health/fish-oil/NS_patient-fishoil
I think by any definition of the word this counts as a "natural remedy." But doctors prescribe it all the time. You know why? Because there is EVIDENCE that it WORKS!
Posted by: Nurse Ingrid | April 02, 2008 at 05:18 PM
Everything Nurse Ingrid said. I also want to add a couple of things:
Anonymous's comments reveals a common fallacy: the idea that anything "natural" is always better than anything "artificial." Which is flatly not true. Arsenic, tapeworms, and smallpox are all natural; eyeglasses, shoes, and blogs are all artificial. To divide medicines into good and bad based on whether they're "natural" or not makes no sense. What makes sense is to divide them into good and bad based on whether they're effective and safe. For a more detailed discussion of this idea, see the Skeptic's Dictionary:
http://www.skepdic.com/natural.html
As to the sad stories... yes. Sure. As I've said many times, conventional medicine is not perfect. But as I've also said -- and as many others have said -- the plural of anecdote is not data. For every story you can tell me about a bad outcome from conventional medicine, I can match you with one about a bad outcome from alternative medicine: people dying or being seriously harmed... either from the treatment itself, or from not getting a serious condition treated in time.
The difference -- as I've pointed out now many, many times -- is that conventional medicine gets rigorously tested: alt medicine does not. And if alt medicine does get rigorously tested and is found to be effective, it becomes conventional medicine by definition. Why is that a bad thing?
And the other difference is that conventional medicine has systems in place, such as licensing and credentialing and malpractice, for preventing bad outcomes as much as possible, and dealing with them when they do. Alt medicine, with a very few exceptions, either has nothing of this kind, or it has a cargo-cult imitation of it, without any of the rigor to support it.
Posted by: Greta Christina | April 02, 2008 at 10:50 PM
"Most natural remedies are in fact rigorously tested and sold in natural remedy stores. However, doctors will never prescribe them. Why? Because you can't patent natural cures. Since you can't make money off of them, no drug company will sell them."
I want to respond to this argument in more detail, since it gets repeated so frequently by so many alt medicine proponents.
"Most natural remedies are in fact rigorously tested..."
I'm sorry, but this is flatly not true. I've read about the so-called "testing" of alt medicine, and overwhelmingly it's like a cargo-cult imitation of the scientific method. It typically omits important aspects of that method: double-blinding, placebo controls, a wide range of test subjects, replication of the tests, etc. (Famous quote from an applied kinesiologist: "You see, that is why we never do double-blind testing anymore. It never works!" Source:
http://skepdic.com/akinesiology.html )
And again -- for what seems like the billionth time -- on the rare occasions that an alt treatment does get subjected to genuinely rigorous scientific testing and is shown to be effective, it then becomes conventional medicine. By definition.
Moving on to the more important point:
"However, doctors will never prescribe them. Why? Because you can't patent natural cures. Since you can't make money off of them, no drug company will sell them."
That is also flatly untrue, on two counts.
One: Conventional doctors prescribe treatments that drug companies don't make money off of ALL THE TIME. My doctor and I tried for *years* to reduce my cholesterol with exercise and diet. It was only when it became clear that this wasn't working and would never work that I started taking the drugs. I could give many more examples from my experience as a patient... as could Nurse Ingrid, and just about any other conventional medical practitioner I know. Conventional practitioners prescribe diet, exercise, stress reduction, rest, meditation, massage, and more. Frequently.
But maybe more to the point: It is simply, flat-out, 100% not the case that there is no money to be made off of alt medicine.
Alt medicine is a HUGE, multi-billion dollar industry. I don't know if you're correct about it not being patentable. But even if that's so, this is overwhelmingly counterbalanced by the fact that alt medicine isn't required to do all that pesky double- blind, placebo- controlled testing... which is incredibly expensive, and which often doesn't pan out.
In fact, Big Pharma is buying up alt medicine companies in increasing numbers... for exactly this reason. Alt medicine is enormously profitable. Saying that doctors won't prescribe "natural" remedies because nobody's making money off of them is just completely absurd.
Posted by: Greta Christina | April 02, 2008 at 11:17 PM
"However, doctors will never prescribe them. Why? Because you can't patent natural cures. Since you can't make money off of them, no drug company will sell them."
I just noticed something else wrong with this claim: I work in public health. So does almost every healthcare provider I know. You know what that means? We don't personally get any subsidies or kickbacks or anything else from drug companies, except the occasional pen which usually doesn't work.
In other words, I get paid EXACTLY THE SAME whether I prescribe a fancy medication or whether I tell someone to drink tea and breathe steam. There is not any sense in which it is in my financial interest to push unnecessary drugs on my patients.
Posted by: Nurse Ingrid | April 03, 2008 at 01:05 PM
"...sold in natural remedy stores... Since you can't make money off of them, no drug company will sell them."
That's just silly. Even ignoring the fact that alt-med is big business, as has already been commented, this claim is self-refuting. Are "natural remedy stores" immune from lease payments, payroll, and other operating expenses? Are they all owned by non-profit charities? The economics of selling "natural remedies" are the some for drug stores as for "natural remedy stores". Why should it be profitable for one, but not the other?
Posted by: Chas | April 05, 2008 at 10:20 PM
Pneumonia was "the captain of the men of death", and "the best friend of the aged".
As to the evidence, the only point which I would gently correct you on the the efficacy of your cough syrup. It has never been proven. That being said, I love the codeine syrup, and use it when I get the crud.
Posted by: PalMD | April 10, 2008 at 08:05 AM
"And nearly all 'legal' drugs especially 'legal' narcotics are very easy to get addicted to."
Sorry, but no. Do you even know what "addicted" means? Are people "addicted" to blood pressure meds or insulin, because they need them to survive?
And people who take narcotics for actual, chronic pain may be physically dependent on their meds, but "addicted" implies a destructive pattern of misuse, so they are NOT addicted.
Posted by: Nurse Ingrid | April 02, 2008 at 04:55 PM
==========================
For one, addicted means: "to cause (someone or oneself) to become dependent (on something, especially a narcotic drug)" This is the ACTUAL definition.
So all those pesky labels and warnings on the medicine that say in big bold letters: "Carries a very high-risk of dependency"... they're just lying?
P.S. I'm not an anonymous, I don't know what it displays that way. Typekey apparently doesn't work on here very well.
Not bashing you... I respect your opinion... it's a good blog as I said on another thread. Why an accepted wide-spread no-side effect natural cure is bad still boggles my mind.
But hey, I'll keep enjoying it for myself.
Posted by: jake3988 | April 10, 2008 at 09:27 AM
There's no such thing as "an accepted wide-spread no-side effect natural cure".
Also, Jake, you are confounding "addiction" and "dependence". All of us are "dependent" on food. Some of us are "dependent" on insulin or on oxycodone. Some of us are addicted to alcohol or oxycodone. Most who are addicted are also dependent, but not all. The converse is not so.
This is an important concept in medicine.
Posted by: PalMD | April 10, 2008 at 03:20 PM
To add to the million points you've already won for your gentle-but-firm excoriation of magical medicine (those points are safe, so we'll put them to one side), I'd like to offer hearty congrats on your sensible use of cough mixture.
It bothers me that the stuff gets such bad press. Yes, some of it is crap (like the subclinical doses of emetics like epicac, that are based on the 'rationale' that you stop coughing when you're barfing, so making you a little bit barfy will reduce your cough), but the bottom line is that a persistent heavy cough put horrible strain on lungs, throat, blood-pressure and sleep. And the last of these is a seriously important factor in getting better.
How splendid it is, therefore, that the very narcotics that suppress cough also tend to make one sleepy. It's like - magic! Except it actually helps.
OK, caveats: allowing large quantities of rotting gook to build up, uncoughed, in your lungs is not exactly good for you. But neither is miserable insomnia. And the tickly, unproductive coughs that often characterise colds are frequently the result of throat damage caused by coughing itself. It *is* possible, if you're not a robot, to tweak your doses so you get the best of all worlds.
And yes, them opiates will make you a bit dependent, even with just a few days' use. So bleedin' what? When the ailment has passed, you may have a troubled night's sleep, and be a bit grumpy for a bit. Then it's all over. Hardly cold turkey.
The Best Damn Cough Mixture of all was something called Phensedyl - now, I understand, only available in India (where it's a big social problem). It had a helluva codeine dose, a carefully-judged amount of ephedrine, and promethazine, of all things, which upped your mood delightfully. My standard cold & flu regimen was 1/3 of a bottle, followed by a day or two of floaty dreams. If the malady lingered on, do another third. Worked like a champ.
CD
Posted by: Chris Davis | June 22, 2008 at 06:57 AM
it is funny to find this online because i used to be with kaiser myself. my mother is with them now and was during her chemotherapy and recovery from a tumor that literally encased her heart. while i know you figure that your innocent doctor at kaiser was being so damned supportive to offer you CAM stuff. i am glad your case was standard enough to not have those alternative treatments be somewhat controversial.
my mother was in fact, going to die simply using the traditional ideas about chemo and radiation, there was just literally no effin way to take her entire heart out and then scrape off the encasement of a tumor and then put it back in. see, indiana jones jk.
well so i had to act, this is my freaking mom. she was told she would die within a year. i am actually a health administrator.
i worked with all of my buddies from college and out in the professional world and found an herbalist. did i tell my mom to get out of kaiser and stop doing chemo? f no. so far, so good, you are with me. i realize and i'm with you, very effin happy to see this is an older blog and your lungs are ship shape now.
happy combinations.
well the herbal treatments were banned by her doctors. they didn't run a test to see if there was a real chemical conflict, they just simply vetoed the entire thing.
she stood to collect her state retirement...
and anyway, she had cancer!
you know, you die from that!
oh brother.
yes, you MAY
but it's not a sure thing.
so my mom got into tai chi and she survived. she still has lymphoma, sorta thing...for life, but the tumor around her heart after months of herbs secretly going with her TERMINAL within a year diagnosis...
what happened to that
that was three years ago
they do restrict the natural stuff
don't be so fooled by kaiser.
take heart.
i did.
cyn
Posted by: cynthia and nancy | February 08, 2009 at 07:15 AM
These are interesting claims, cyn. I'd like to be given the details of this case so that I can research it further and share the story of this astounding cure with the American Medical Association. This would ultimately help all the other cancer patients whose doctors are killing them with conventional treatments and banning herbal remedies that actually work.
If these remedies (and I'd like the specific names of them) could actually cure cancer, then they should be tested using the scientific method, with placebo controls, double-blinding, etc. Because, as Greta said, once a cure has been scientifically tested and proven to work, it becomes conventional medicine. Then all doctors would start using these herbs to treat cancer and millions of lives would be saved.
By the way, what kind of health administrator are you? This is an umbrella term for many different jobs. However, if you work as a manager at the same hospital where your mother was treated, I'm surprised that you weren't able to use your influence in some way.
I look forward to your reply.
Posted by: Julanar | March 19, 2009 at 08:43 AM
Hi, I just stumbled on this article years later and I have a question/point.
A conventional medicine, before all the testing required to make it proven and conventional, still works, right?
So, suppose you have a treatment that seems like it should work based on principles of physiology, and you've tried it with generally good results - not enough to be data, but a good collection of anecdotes, and no known cases of it doing harm. And, since it hasn't been tested, it hasn't been shown *not* to work. And you're perfectly happy to have it tested, but haven't made the testing come together yet.
If the testing ever comes together, and is successful (which of course isn't guaranteed), it will by your definition be conventional medicine.
But what do you do until then? Are you a quack if you recommend it (and include the appropriate disclaimers?) Are you a fool to try it?
Posted by: C | November 03, 2011 at 12:17 PM
I have never been to a conventional doctor that was any help with exercise or diet or any other healthy habit forming support. I had pneumonia once and the antibiotics did not help so I turned to probiotics which did the job..in addition to movement exercises that were slow moving and gentle. I don't think we can compare now to then when people died of pneumonia....very different scenarios, no access to nutritional foods, lack of hygene, a large family living, eating, sleeping, washing in one room etc.. that's how people died. many people per small spaces...children viewed as little adults (attitude). Hippocrates approach to medicine was to use little medication and much care, massages, compressions and so on because of nature's ability to heal and once that is awoken then one will heal with little meds. If a person gets sick there is reason for that. Wouldn't we like to learn about that reason? why did I get sick, I would like to know then I don't have to do it again. There hardly seems an education for the patient on this subject if one is given a medication and nothing else. I have had several symptoms not only did I get no help from any doctor I was viewed as "it's all in your head" patient when I found out I have a hormonal condition and they can't help me anyway because they don't know how. So I am on my own working with energy medicine and homeopathy, herbs and more, nutrition and exercise, meditation.
Posted by: Jazzy | December 11, 2011 at 03:13 PM