Perhaps because I don't blog anonymously, or maybe for other reasons, I don't write that much about my personal life. That kind of writing can be self-important, insipid, and boring. But it can also have real power. A number of the anonymous bloggers here describe the intersection of the scientific life and family life with powerful relevance. Still, that's not my talent, and I don't do it much. One of my med school classmates, when I showed him one of my first pieces, said, "that's good, Pal, but how do you feel?" That has always stuck with me (thanks, S!), and it's in that spirit, and not the spirit of kvetching, that I'd like you to know that doctors are human. Yeah, I know, no surprise there, but still, sometimes patients forget it, and more important, sometimes doctors forget it. Besides, since no one reads the blogs on Sunday, it's a good day for self-reflection.
I come from a family of very smart people. Very smart---sometimes I feel like the village idiot (but in the best possible way). They are intellectually active professionals, all have advanced degrees, and many of them are musicians as well. Along with smarts, my family has been endowed with some unusual medical problems, so even the non-medical folks have used their formidable intellects to learn a little medicine. These are not "google scholars"---these are the real thing.
So when my family challenges me about my skepticism, I have to take it seriously, not just because they're my family and I love them, but because unlike some of the vacuous trolls that haunt this site, they're very smart and well-informed.
I have a number of good friends and family members with cancer. Is my hypertrophied skeptical sense depriving me of sharing with them "other ways of healing"? My sister, who is pretty good at reminding me that I don't actually know everything, challenged me pretty rigorously on my medical skepticism. Of course, my wife and cousin had to help her out. These aren't garden-variety challenges to my beliefs. A random blog troll can bring up the same canards and fallacies over and over, but when the people you love use good reasoning and good knowledge to call you out, you gotta take it a little more seriously. When the people you love have nasty diseases, it's got that much more gravitas. Those of us who devote our intellectual resources to science-based medicine are often accused of lacking compassion, a charge I try very hard to avoid, not because it's false (and it is), but because compassion is the great immeasurable, the ars longa in the vita brevis. Without compassion, science-based medicine might as well hand over the keys to the reiki shamans, the homeopaths, and other smiling quacks, because no matter how right you are, a doctor who lacks compassion can't be an effective healer.
So I don't tell my friends, family, or patients that they're crazy for going to the chiropractor. I prefer to focus on communication, compassion, and maintaining a useful rapport (and of course guiding people toward rational, science-based practices). Thankfully, no one who knows me considers me an oracle of rationality. They respect my opinion, and that's great, but they help me keep my reasoning skills honed. We were hanging out with some old friends the other night. They have a kid my daughter's age (and nearly as cute). The husband and I grew up together, and his sister is a colleague of mine. And the wife has stage IV ovarian cancer. They're good folks, the kind of people who you can just hang out with and watch the kids play, which is exactly what we did. It's pretty hard not to question your own mortality when you friends are sick, and I need to thank her, at least in part, for helping me focus on what's important.
If you have kids, you probably understand what I'm talking about here. My daughter is everything (well, not everything, but my wife knows what I mean). I work a lot. On the clock, I have twenty hours in my office, and 32 at the hospital---on the clock. It works out to be about 60-70 hours per week away from home. When I go to the hospital on the weekend, my kiddo comes with me. It might not be the greatest idea to have her around a hospital, but I need that time with her, and she loves going to the hospital to "see all of her friends".
My father-in-law is pretty ill right now. I arranged for him to be admitted to my hospital for what will likely be a very, very long stay (if all goes well). When the nurses heard he was my dad-in-law, they said, "Oh! You're Little Pal's grandpa!" She charms everyone she meets, and everyone who meets her falls for her (so I imagine). I don't want to spend time with my daughter, I need to. I simply can't relate to dads who don't change diapers, don't play, go out to the bar when they could be hanging out with the kids. Every diaper, every bedtime, every meal is a treasure. I'll be very sad when my daughter is too old for me to help her in the bath. I'll miss the giggles, the crying, the playing. Of course, every milestone makes you proud, but I always long for the previous stage, wanting to hang on every second in the rocking chair. When she stops wanting her songs at night, I'll be off to my room to cry.
I'd love to cut back on my work hours. I'm very fortunate compared to my scientist colleagues, in that I'm certainly paid much better, but economic realities being what they are, the 65 hour week won't be ending any time soon. Medical school is expensive, and paying it back is a long, slow process, especially when the rust belt economy forces your employer to cut your pay. When the hospital announced that all doctors would have their pay cut by 10%, there was one important consolation (two if you count still having a job). Our pay cut saved the jobs of 250 other employees, and all of us have family, friends, and patients who are struggling, so we know what that means. A recent New York Times article talked about how arrogant and abusive doctors are scaring away nurses and endangering patients. All of us have seen these docs, and some of us have been these docs, but it's still the exception. My interactions with hospital workers has not, of late, been listening to complaints, but accepting their thanks; thanking us for taking a pay cut to save their jobs.
So my daughter is learning a lot this holiday season. She's learning about giving (as there are plenty of folks in this part of the country who need the things we no longer use). She's learning about her neighbors (we went to a Christmas tree decorating party last night, and a Channukah party today), and she's learning about mortality, a lesson I really don't want to have to teach her. When we visited grandpa Friday night, she brought him a little stuffed animal and tucked it in with him. Nothing gives comfort like hugs and kisses from a smiling toddler. I know it won't heal him as such, but I know it makes him smile, and before he goes under the knife tomorrow, he needs all the comfort he can get.
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You can learn some profound and valuable lessons from your children. One that my daughter taught me, by example, is that the best possible age is now. She never wanted to be older than she was and never wanted to hold on to the past. She was so busy making the most of today that when it was over she was done with it. Even when it hurt, it was all part of the script.
Enjoy the baths, the rocker, the songs. When she doesn't need them, don't waste tears. They'll just keep you from seeing the next wonder as it comes around.
$DAUGHTER is now away in grad school, and we have long talks nearly every day. She's still teaching me wonderful things.
-- Joni Mitchell
My best to your FIL, I hope the surgery goes well and he has a speedy recovery.
Thanks for this article. At least one person read it!
I don't feel so bad about all the alternative therapy other family members have tried. It is a hard balance when loved ones and friends are pursuing this. I once had my beloved Aunt send me a lump of...hard black tissue, about 1cm in diameter. It supposedly fell out of her nose. She had been told by a dermatologist, who had biopsied it, that it was a cancer, basal cell I believe. She didn't want to have the plastic surgeon remove her nose and reconstruct it, so someone told her about "black salve", that it cures everything, and she put it on her cancer. Over a few weeks she said it hardened into a firm mass and finally fell out, leaving a hole in her nose. So she decided to send it to me, I was a resident at the time. My mother relayed this crazy story, and I was rolling my eyes, OMG! So I told one of my classmates who was a pathology resident and he offered to check it out. It was not preserved, and he said he couldn't see anything in it on the slides. My Aunt returned to the dermatologist who was, I'm sure, shocked, but there was no cancer remaining and her nose filled in. I'm still shaking my head at that one. I can't explain it, and she chalks it up to the "black salve". I have wondered what is in "black salve". I should probably use my google PhD to check it out!
My kids are everything. I understand. I got a lot of flack for "retiring" 5 years ago. No one really understands the challenges of having a child with autism, and it is a full time job. We were dragging him into the hospital 2 out of 3 nights because of emergency surgery, my husband to do the anesthesia, me to help my partners with a C-section even when I wasn't on call. Not good for any child, much less with autism. He is doing really well, has learned so much, and he means everything to me and I will do whatever it takes to give him what he needs. We were lucky enough to have another little guy who turns 4 in a week. I miss practicing very much, but they need me more right now.
I appreciate your sharing. It wasn't too narcissistic ;0)
You really don't want to know. Trust me -- the very idea of putting those chemicals in contact with living tissue is scary.
The funny thing is that the same people who push "black salve" also are very vocal in their contempt for "cut, burn, and poison" medicine.
This post brought tears to my eyes. :) I feel the same way about my son. One of the greatest things about having a child with autism is that their babyhood lasts so much longer. I am grateful for every cuddle, every hug, every time he falls asleep in my lap. I hope I adequately communicate to him how much I treasure him!
I think your daughter will cherish the memories of her daddy bringing her to work with him! She will grow up knowing you love to spend time with her, and that is a great gift to give your child.
Whatever it is, it's always very caustic. It works by, in essence, burning the skin away.
I could never understand why people who would burn skin lesions off in an uncontrolled fashion with some nasty black salve recoil in horror at the thought of having a minor surgical procedure to remove the same lesions.
Black salves (escharotics) discussed here, there are some disturbing photos:
http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/eschar.html
The most woo-infested NewAgers I know still get anything not minor treated ASAP by an MD. That might be because real medicine is affordable up here.
Yeah, I can't resist poking.
You want rational you have to make the rational choices available to people.
"Every diaper, every bedtime, every meal is a treasure."
Only a truly involved Dad would consider a diaper a "treasure" :) My wife and I have three of our own, the youngest of which is almost three (and out of diapers!); everything you said about raising and interacting with your child hit home with me as I read this post this morning. I'll have to take time for an extra song tonight...
Perky Skeptic: You're quite right that she'll remember that time fondly. I know I do. My mom would often bring me to the hospital with her when I was young, and while I don't remember most of it, I do remember the little circular alcove-library. I'd sit on the bench there and read like the little bookworm I was. It's about the only thing I specifically remember, but I thought it was a nice place to hang out and enjoyed myself quite a bit.
Long story short, it's good that you're getting some time with her. I remember my dad being home quite a bit more than my mom, so it's probably just as well I tagged along every so often. And I guess I should join in the chorus of "enjoy it while it lasts". :)
"One of the greatest things about having a child with autism is that their babyhood lasts so much longer. I am grateful for every cuddle, every hug, every time he falls asleep in my lap. I hope I adequately communicate to him how much I treasure him!"
Perky, that is my sentiment exactly! I am so lucky to get the sweet, innocent, cuddly boy for much longer than the usual childhood! I savor every moment! Every day he amazes me with something new. Yesterday, after googling and YouTubing the Disneyland Matterhorn, he drew it for us and told us there was a Matterhorn ride in his imaginary "World of Brunswick" theme park he has made up!
I looked up the black salve, there are some pictures that look like the picture my Aunt took and the "sample" she sent me. Very caustic looking. I'm still rolling my eyes!
I'm new to this site and interested and appreciative of what you are doing here. To my dismay, however, after reading the part on identifying cranks, I find that I am one. I am trained in family medicine and have worked in public health for most of my career. When I developed type 2 diabetes, I literally stumbled into the discovery that it was entirely reversible if I avoided carbohydrates. I have spent the last six years looking into this, attending conferences, reading literature, meeting researchers and doing my own dietary trial (not yet published). I have read your earlier posts on diabetes and, although I don't find any that refer to the use of carb restriction, I suspect you would relegate this to the woo category. I learned that you have asthma and, true to form for a crank, I would suggest that you might consider carb restriction yourself. I haven't seen it myself but colleagues with more clinical experience in this area tell me that they have seen big improvements in asthmatics with this dietary approach. Bottom line, it appears to me that people like Semmelweiz, Pierre Charles Alexandre and Galileo would also have met the definition of a crank here. How to you determine whether someone is a crank vs someone ahead of the wave of a legitimate paradym shift?
BTW - my son is eight now and I miss the early years when I started every day with his first diaper change. Who knew that changing a diaper would be thought of so endearingly!
That NY Times article is quite disturbing, particularly this part:
PalMD, a number of months ago, you stated the following in one of your posts here:
Sounds to me like the NY Times article provides evidence that arrogant paternalistic behavior on the part of doctors, while on the decline, is still a systematic problem. What do you think?
""One of the greatest things about having a child with autism is that their babyhood lasts so much longer. I am grateful for every cuddle, every hug, every time he falls asleep in my lap. I hope I adequately communicate to him how much I treasure him!"
Perky, that is my sentiment exactly! I am so lucky to get the sweet, innocent, cuddly boy for much longer than the usual childhood! I savor every moment! Every day he amazes me with something new. Yesterday, after googling and YouTubing the Disneyland Matterhorn, he drew it for us and told us there was a Matterhorn ride in his imaginary "World of Brunswick" theme park he has made up!
I looked up the black salve, there are some pictures that look like the picture my Aunt took and the "sample" she sent me. Very caustic looking. I'm still rolling my eyes!"
*vomits* You people seriously are GLAD your children's 'babyhood' is much longer?
I'm glad I'm never giving birth, and frankly, anyone who wants to prolong their offspring's childhood and keep them from growing up at a reasonable rate and learning and becoming a successful, functional adult is disgusting.
PP:
This is an issue that is actively being worked on, meaning it's been recognized as a problem, and it's being rooted out. Is the process complete? No, and it will never be, as docs are human, but the fact that hospitals and medical schools are actively training against and intervening in such behaviors shows that it is no longer an accepted part of MD culture.
At least mostly. At some institutions. And some specialties.
Katherine -
And you make me want to vomit, with your disgusting, and I might add, pointless interjection of complete and utter bullshit.
No, no one wants their child to have stunted development. But many parents who end up with a child who's development is stunted take the pleasure and joy they can from the situation. Most of us don't live in your world, which apparently assumes that parents of children with special needs should live in misery, wishing in vain that their child developed like neurotypicals.
Parenting is challenging. Parenting children with neurological issues is challenging squared, especially when the parent also has neurological issues (like me and my children). It is important to take every break we get, every ounce of pleasure we can get. Snuggling and loving our kids is one of the greatest joys we get as parents, second only to watching our children hit yet another milestone in development. When you can't get the latter, the former becomes even more valuable.
I'm glad you won't reproduce either, it's obvious that your a selfish, scum that would be very ill suited for raising a child - especially if your child needed something more than neurotypicals do.
Sincerely and from the bottom of my heart, I would invite you to go fuck yourself.
Pal, is it a fair interpretation of your comment to say that you are backing away from your earlier blanket assertion that "it's just not part of the culture anymore" and accepting that there still is a cultural problem that continues to require attention, and is being assiduously attended to by conscientious docs, administrators, and educators?
@Dr J
You are somewhat confused, and I blame myself.
Of course monitoring carbohydrates can be an important tool in the treatment of diabetes. Depending on how you approach a particular case, carb counting with insulin supplementation is a useful technique. In Type II dm, reducing carb intake will of course lower blood sugars. But to claim simplistically that DM is "reversible" with a carb-restricted diet is just not consistent with reality. It is true that DM type II is often treatable only with diet and exercise, but frequently this is not the case.
And please, before you use the Galileo gambit, remember that "to wear the mantle of Galileo, it is not enough to be persecuted...one must also be right."
(and please learn to spell "paradigm" and "Semmelweis".
Oh my gods, you're also studying neurology? Please, if this is how you are going to deal with the parents of children with neurological issues, find a different field or grow a heart. Because your manner is for shit.
I really do believe it is not part of the culture, although your results may vary (it is institution, and even department dependent).
Medical schools actively teach normative social behavior, and hospitals, if for nothing other than risk mgt, actively intervene with problem physicians.
If you're looking for a black and white answer, or for me to say that my statement from before is or isn't exactly as I see things is not useful.
The fact is that paternalism used to be taught and encouraged, and now, even though it still lingers, it is hunted down and killed, sometimes even too aggressively, leaving some docs to basically ask their patients what kind of treatment they want.
Thank you for engaging honestly on this topic, Pal, which is clearly an important one. Do you think that the docs who do manifest paternalistic, arrogant, or other harmful behaviors--which the Times article convincingly documents lead to adverse patient outcomes--are all rogue psychos, unrelated to any structural features of the medical profession or training system?
And welcome back for the next round of "Bait the Doctor"! Watch as our contestant tries desperately to bait PalMD into an embarassing admission with misleading "Gotcha" questions and strawman responses to straightforward comments! Listen as he fails to win valuable prizes! Learn how to annoy friends and influence people (to run away)!
Srsly? It's obnoxious.
Some are relics, some are rogues, some are left-overs. Some surely were outcomes of a system that encouraged that type of behavior.
These days, with shrinking markets, JCAHO, nursing shortages, etc, there is a strong financial disincentive for hospitals to tolerate this type of behavior. In fact, one time when I snapped at a lab tech on the phone, i received an immediate call from the vice chief of medicine strongly recommending a written apology.
The areas where more of this goes unchecked, i suspect, is ossified institutions, institutions who are somehow financially insulated. Most important, specialists who are highly productive for a hospital are often given the most leeway to behave badly. Orthopedic surgeons, for example, do lucrative procedures that involve generally short hospital stays, and often order imaging tests. Hospitals like this, and are willing to put up with a lot more from them than, say, from a lowly internist.
Is it fair to infer from this that you don't think that the current system has any features which encourage that type of behavior? And I'm not trying to bait you; I am just trying to get very clear on what your opinion is.
In the interest of transparency, I will tell you that my opinion is that while there are explicit efforts to expunge paternalism, arrogance, and consequent poor treatment from the medicial profession, there are also still implicit features of the medical profession and training system that continue to encourage those things.
Such as...?
And are they general trends or institution/program-specific?
Authoritarianism, hierarchy, excessive deference to authority, and insularity and hostility to external criticism. The airline industry has discovered that this professional structure in relation to pilots leads to bad outcomes in high stakes situations, and is a major factor in most plane crashes.
I am convinced that it plays a similar role in the medical profession, which can learn from the measures taken in the airline industry to fix this shit, and which has led to a dramatic increase in airline safety over the last ten years.
I think you may have identified a sub-issue of medical safety and medical errors. The primary system for "dealing" with medical errors in this country is malpractice litigation, but as root-cause analysis and systems evaluations become more a part of hospital culture, physician "attitude"-based errors will be one of many types of systems and individual errors identified, and dealt with.
The new IOM report may go a long way to assisting with some of these issues...it recommends further reforms of residency training, especially relating to work hours.
One of the major factors identified in airplane cockpits in crashes was inability of subordinate pilots--co-pilots or engineers--to be able communicate to captains important information. And a major factor in this communication breakdown was excessive deference on the part of subordinate pilots, and excessive arrogance and self-certainty on the part of captains.
This sounds exactly like the anecdote in the Times article about the nurse who couldn't get the on-call resident to listen to her until it was too late.
People participating in these failures are not "rogues", any more than the "temporary tattoo" doctor, but rather rare--but predictable and preventable--outcomes of structural features that can be repaired. Defensive reactions that personalize such failures as the aberrant actions of "rogues" only get in the way of decreasing the prevalence of such bad outcomes.
CPP -
And I'm not trying to bait you; I am just trying to get very clear on what your opinion is.
In all honesty, if baiting is not your goal, your doing a bad job of proving it to the casual observer. I think that Pal has been pretty damned clear what his opinion is.
In the interest of transparency, I will tell you that my opinion is that while there are explicit efforts to expunge paternalism, arrogance, and consequent poor treatment from the medicial profession, there are also still implicit features of the medical profession and training system that continue to encourage those things.
Right after the sentence where you claim your not trying to bait him, you come out with that line of crap.
Please, where is your evidence? I understand that you teach at a med school - great. You know, maybe the problem isn't systemic. Have you considered that this phenom you seem to be observing is a problem at the school where you teach - or just with certain members of the faculty? Because I've paid some attention to this discussion as it's wandered the science and medical blogosphere and the medicos all seem pretty convinced there is a systemic move to eliminate this shit from the field of medicine - a move that seems to be fairly successful.
What I'm also curious about, is why you chose this post to raise this question. I'm not seeing the bit where it has a damn thing to do with the questions your raising. Not only does it smack of bait the nice midwestern doctor, it also smacks of lets blindside the doctor. Bad form man, bad form.
My bad, when I initially read this post, I glanced over the Times article. Of course that just throws us back to the question of what you're after, because Pal's pretty clear in the initial post what his opinion is.
Your reply to my earlier post was gratuitously patronizing. That was unnecessary but not altogether surprising. You also avoided my question. I will repeat it. In your zeal to expose every possible woo, how do you ensure you are not throwing the baby out with the bathwater? How do you know that that crank you are dissing is not the next Semmelweis? Someone whose idea seems so preposterous that you cannot take it seriously and won't even consider it a possibility. As to whether I am right or not, consider that I had florid type 2 diabetes six years ago and currently have a HgA1c of 5.1, excellent lipids and BP and a CRP of 0.59 on zero meds. All I have done is eliminate carbs from my diet. I know that doesn't fit with the CPG we were taught but it is real, I can assure you. I have since met colleagues who use this approach in clinics at Duke, in New York and Kansas. They get these kinds of results with their diabetics routinely. I have seen remarkable cases like a fellow who had been on insulin for 17 years, using humulin qid, FG still running well over 150, hypertensive and dyslipidemic, who stopped eating carbs and within two weeks had achieved normal FG and completely discontinued his insulin. That was four years ago and he maintains normal metabolic markers on no meds as long as he stays off carbs. When he doesn't, he has to start taking meds and insulin again. So, yes, I know I am right. I don't presume to "use the Galileo gambit", I just point out that there may be a flaw in your perfect world of woo-busting here that no amount of faux-humility can disguise.
@Dr J,
It is difficult to believe that restricting carbs can eliminate insulin dependence, yet nobody else has noticed and published it. It sounds like big news, why haven't you sent a case study to a good medical journal?
As for your name-dropping about colleagues at Duke, New York etc.; we are aware of plenty of quackery at major medical schools (including Duke and schools in NY) http://scienceblogs.com/insolence/2008/10/beth_israel_joins_the_academi…
You have offered anecdotes and appeals to authority (and the "throwing the baby out with the bathwater" gambit). Can you cite a review, or major article with leading references, in support of your claims?
What??!?!? You want actual "evidence"? Would you ask Gallileo for "evidence"? We don't need no stinking "evidence"... oops, wrong rant.
Of course there's no review or major article supporting his claims. His claims are, at best, limited to a few anecdotal cases, and at worst a completely contrived lie.
I can smell the BS coming already... "They laughed at Gallileo, too!" Yeah, and they laughed at Bozo the Clown.
Yes, it is odd that you haven't heard about this from someone smarter than me. I get this reaction all the time. Here are some relevant studies you may want to dig up: Forsythe et al, Lipids 2008, Gannon and Nuttal, Diabetes Care 2004, Dashti et al, Mol Cell Biochem 2007, Volek and Feinman, Nutrition and Metabolism 2005, Westman et al, AJCN 2007, Phinney, Nutrition and Metabolism 2005. I have published in peer reviewed journals as co-author on some review articles. I have recently completed a 12 month dietary trial in which a number of participants had results similar to the case I described earlier. We have presented posters with preliminary results at a couple of conferences and a manuscript is currently being prepared.
LanceR,
Commenter or blogger's head explodes, calls denialist an idiot.
Denialist says he won because commenter or blogger resorted to ad hominem.
I suppose that in your tautological way of thinking this will have now proved that I am a crank.
I certainly don't think Dr J is an idiot, but perhaps s/he is not communicating well.
It is entirely obvious that if you take in no carbohydrate calories, your sugars will certainly be lower, and many type 2 diabetics are treated with diet alone.
It is also standard for many type I and type II diabetics to count carbs.
But it is unclear what is meant by "carb-restricted diets cure diabetes". It's a meaningless statement, since first, type I and type II diabetes are completely different diseases, both etiologically and phenotypically, and second, because type II diabetes itself is a wide spectrum of various metabolic phenotypes.
Not to mention that cutting carbs does not "cure" diabetes, but merely works around its effects. It's as dumb as saying wheelchairs cure quadriplegics for crying out loud.
Nowhere did I say "carb-restricted diets cure diabetes". Yes, I know that type 1 and type 2 are different; we are talking about type 2 here. As I am sure you are aware, the insuln resistance that underpins type 2 can start many years before a diagnosis is made. During this time compensatory insuling secretion is high enough to maintain normal FG. The evidence (from peer-reviewed journals and scientific meetings) is pointing toward carb-restriction as a preferred treatment for insulin resistance. It turns out that pretty much all the conditions associated with insulin resistance respond to carb-restriction. This includes metabolic syndrome and type 2. There is also a number of additional conditions that cluster around MetS including PCOS, GERD, NAFLD, osteoporosis, depression and, yes, asthma. Some have already been studied in terms of their response to carb-restriction. There have been two published studies showing significant improvements in GERD and two with similar results for NAFLD (in my study, participants reported discontinuing their PPIs). Jeff Volek et al recently published a review of the mechanisms whereby carb-restriction leads to a unique metabolic state that explains why a lot of these things linked to insulin resistance get better. Jarrett et al recently published an article on how ketogenic diet improves pediatric epilepsy. The mechanism hinges on the fact that glucose metabolism leads to high rates of oxidative stress and the shift to burning fat and ketones reduces this. I predict we are going to find this mechanism can be extrapolated to other tissues to help explain why carb-restriction is salutory for a range of conditions. Steve Phinney is currently working with Craig Warden, co-discoverer of UCP2 and UCP3 at UCDavis, to discover how the oxidative stress of high carb consumption leads to metabolic disorders (they have started presenting posters and are currently preparing manuscripts for publication). Suffice to say that they have come up with a plausible mechanism. The big problem, of course, is that nobody is going to fund the big, long term RCTs with hard end points that would be needed to get the mainstream to accept this. There is no molecule here that is going to make the shareholders of a big company rich. People can carb-restrict with very little input or supervision. Last time I looked there were about 20 classes of drugs to treat the components of MetS and T2DM. If you subscribe to Occam's Razor you would have to agree that when a single dietary intervention delivers better results than a plethora of drugs, there just might be something worth paying attention to here.
StuV - nobody has said that carb-restriction cures diabetes. It does, however, reverse the manifestations of type 2 diabetes. A better analogy would be lactose intolerance. If you avoid eating lactose, you reverse the manifestations of lactose intolerance. Would we say you have cured lactose intolerance? Of course not, but it becomes a moot point as long as one avoids the foods that cannot be tolerated. Same for T2DM which could actually be viewed as carbohydrate intolerance. You may be interested to know that, prior to the discovery of insulin, this was the accepted therapy for diabetes (both types).
Dr J: fair enough -- I cued off of PalMDs "cure" statement, not yours.
The "they can't make money off of it" gambit is a little old, though. After RCTs, they can just buy the Atkins institute and roll in the dough. (Do you know what they charge for their shakes? And how GOOD those things are?)
StuV - it is a real problem for this and in other instances where a potential therapy cannot be patented. The current model of advancing the science requires huge investments in long-term RCTs with hard end points. Nobody does this unless there is money to be made at the other end. NIH should be doing this, like they did with the Women's Health Initiative, where they squandered almost half a billion on a flawed study to demonstrate the benefits of a low-fat diet. For reasons I could speculate on, they don't appear to have an interest in doing anything like that for this promising dietary approach.
Atkins Nutritionals, for a number of reasons, is not going to do this (full disclosure - they invited me to join their Scientific Advisory Board but I was unable to do that for other COI reasons).
@DuWayne
Thank you for answering Katherine's diatribe. It would indeed be a pity if she had contact with any individual with a neuro-developmental disorder or their family. Her ignorance on parenting is obvious, and her lack of compassion is quite amazing. It is a good thing she will not procreate to pass on her deficits.
It's nice to read such a sincere, honest post like this around here. How is your father-in-law doing now?
Despite probably being perceived as one of those "vacuous trolls", since you seem to know many people with cancer, I suggest that you listen to your sister's advice and be completely open to new possibilities. The question "How do you know that that crank you are dissing is not the next Semmelweis?" still remains unanswered after all. Because the most rational answer would probably be: You don't know. So here's something I found particularly interesting in regard to cancer treatment: http://condeve.blogspot.com/2008/11/new-medicine.html
I didn't make a detailed research about it, but I would do it if I were in your position. It's easy to dismiss new information because many others also do so, but those others also mess things up pretty badly sometimes. And if you consider that basically every business is flooded with conflicts of interest nowadays, it's not very smart to expect revolutionary information to be easily revealed on its own without facing tremendous resistance and "denial".
Even if you're having a hard time taking that stuff seriously yourself, you should still give the people you care about the chance to inform themselves and make their own decisions. Here's what the new medicine says about ovarian cancer for example: http://www.germannewmedicine.ca/documents/sbs-ovariancancer.html
There is also a testimonial at the end. Good luck...