Respectful Insolence

The infiltration of quackademic medicine continues apace.

I know, I know. I say that a lot, but it’s only because it is, alas, so very, very true and so very, very distressing to supporters of science-based medicine. It’s not as though I haven’t written about it many, many times over the last six and a half years; indeed, it’s become a major theme of this blog and at least one other blog that regular readers here might be familiar with. Whether it be the American Medical Students Association (AMSA) pitching woo, Georgetown going beyond electives in “complementary and alternative medicine” (CAM) or “integrative medicine” (IM) and “integrating” quackery into its mandatory medical school curriculum, or the National Center for Complementary and Alternative Medicine (NCCAM) funding pseudoscience, I’ve done my best to bring these issues to the attention of my readers, hoping that education will lead to action.

Of course, arguably the epicenter of the woonami currently engulfing medical education in the U.S. is a kindly-appearing, rotund, bearded man who looks much like a desert Santa Claus. This man is clearly one of the “thought leaders” (if you can call it that) of the CAM/IM movement, not to mention a pioneer in bringing quackery into the medical school curriculum. He currently makes his home in Arizona and has built up a bastion of CAM/IM at the University of Arizona, from which it has metastasized to medical schools all over this great nation of ours, having had his CAM/IM program designated a “center of excellence,” an oxymoron when applied to CAM/IM if ever I’ve heard one.

I am referring, of course, to Dr. Andrew Weil.

This time around, he’s gone beyond having his Arizona Center for Integrative Medicine designated a “center of excellence.” Now, the University of Arizona College of Medicine-Tucson has partnered with the Arizona Center for Integrative Medicine to reward medical students for pursuing a career in quackery:

Medical students in the new Distinction Track in Integrative Medicine will learn healing-oriented and preventive medicine techniques during an intensive four-year program.

The Arizona Center for Integrative Medicine and the University of Arizona College of Medicine-Tucson have announced a new Distinction Track in Integrative Medicine for UA medical students.

The track is an intensive four-year study program, in addition to the standard curriculum. Students who complete the requirements will graduate with distinction, as recognized by the college’s dean.

That’s right. Students who pursue extra study in this Distinction Track in IM will get a nice notch on their CV regarding what a great student they were. Given that there are only three other such Distinction Tracks, for example, Global Health and Research. Does IM rate being among the very few such areas of focus that include medical areas of focus as important as global health and research? I think not. It’s like including shamanism and witch doctoring as an area of focus co-equal to research. Come to think of it, that’s just what Dr. Weil is doing, and somehow he’s snookered the board at UA to think that it’s a good idea to make its medical school such a magnet for pseudoscience. It’s a depressing sight to see, but not unexpected.

What makes this development so depressing and disturbing is that Weil is an expert at the “bait and switch” of alternative–excuse me, “integrative”–medicine. Much of his health advice is unobjectionable–science-based, even–but he sprinkles it with woo, appeals to “open-mindedness,” and highly dubious medicines, all while recommending and selling various supplements, his books, and, above all, himself, as in the Andrew Weil brand. Not surprisingly, coverage of the announcement of the Distinction Track in IM is no different:

Preventive medicine is a crucial part of a medical professionals’ training and is often minimalized in conventional medical training,” said Dr. Andrew Weil, center founder and director. “Receiving this additional training early in their career will give UA College of Medicine students an advantage in their residency and practice and a more comprehensive set of skills for treating and communicating with their patients.”

I really hate it when Weil or other promoters of “integrating” quackery into medicine pull this gambit. It’s so common that I’m surprised no one that I know of has given it a name before; so I’ll dub it the “prevention gambit,” you know, to go along with the “pharma shill gambit” or the “toxin gambit.” Basically, CAM/IM promoters use the prevention gambit to try to convince people that only CAM or IM deals with prevention. Never mind that at least half or more of what a family practitioner or internist who practices primary care does every day is prevention. For example, what is the point of trying to control hypertension if not the prevention of atherosclerotic cardiovascular disease leading to stroke, heart attack, or peripheral vascular disease? True, practitioners of science-based medicine might all too often fail to emphasize prevention and wellness as much as they should or would like, but that is mainly a function of a reimbursement system that doesn’t reward time spent with patients, leading to very short patient visits. The answer to that problem is not to “integrate” woo with medicine because quacks are allegedly better at spending time with patients and making them feel better. Rather, it’s to fix medicine to align reimbursement incentives to encourage spending more time with patients and emphasizing preventive care more strongly. In contrast, Andrew Weil promotes the tired old CAM/IM false dichotomy that implies that the only way to practice preventative care is to “integrate” CAM into standard medical practice.

The problem, of course, is that, in the name of prevention or fixing medicine to make it more “humanistic,” CAM/IM advocates “integrating” into the medical school curriculum (and then later into medical practice) pseudoscience like:

Introductory sessions and workshops will be presented by community preceptors focusing on different modalities of integrative medicine: botanicals, homeopathy, mind/body, naturopathy, nutrition, traditional Chinese medicine, osteopathy, and energy medicine.

How many times does it have to be repeated? Homeopathy is quackery. It’s water that a homeopath has cast a magic spell on. Naturopathy is mostly quackery, a potpourri of pseudoscientific, prescientific, mystical, and vitalistic practices, anything that naturopaths can represent as being more “natural” than science-based medicine. Traditional Chinese medicine is based on a prescientific understanding of disease rooted in vitalism. There is no reason that practices like this should be taught in a medical school in 2011, except to make sure that medical students know what they are, in case any of their patients is using them and know potential interactions with real medicine. That’s it. Medicine has moved on from the days when TCM seemed reasonable. CAM/IM has not, and it appears that it never will.

So what does the woo-minded medical student have to do if he or she is admitted to the Distinction Track? This:

It will require participation in the center’s month-long integrative medicine elective rotation, attendance at grand rounds presentations and patient conferences, monthly special-topics lectures, facilitation of a “healer’s art” course, completion of more than 30 hours of online courses, a capstone paper suitable for publication and an oral exam.

Oh, goody. I wonder if there will be questions about homeopathy on that oral examination. Thinking back to my oral board exam for surgery, which was one of the most intimidating, nerve-wracking examinations I’ve ever had to take. Think of it this way. You fly out to a strange city, where the gods (or at least the demigods) of surgery were there to determine whether you are sufficiently knowledgeable and therefore worthy to be admitted to the club of board certified surgeons. These are the surgeons who literally wrote the textbooks I studied as a medical student and resident. They would be paired with local surgeons, so that there were two examiners for each session, each sitting in one hotel room, and candidates would go from room to room for a total of three half-hour sessions.

The thing is, the oral boards made sense, as intimidating as they were at the time. Each pair of surgeons would present two or three cases and the candidate would have to tell them how he or she would take care of the patient. The examiners would try to throw some curveballs in there, and if you waited too long to act or did something wrong they’d make sure the patient started getting sicker and sicker. However, the answers expected were science-based and had to fall within the realm of safe, science-based practice. The answers or courses of action that would flunk a candidate had to fall well outside of of safe surgical practice.

Why am I telling you this? Simple. It’s because I wonder how on earth you can have an oral examination, which, I’m guessing, includes patient cases? I mean, seriously. How does a medical student choose whether to use acupuncture, homeopathy, or TCM, for instance, on a given position? In a world where all manner of pseudoscience is considered “integrative,” how can one have any standards based on any sort of objective evidence that allows a practitioner to decide among different varieties of magic? In such a world, how can there be such a thing as a wrong answer?

Sadly, UA is completely behind this effort:

“This endorsement by the UA College of Medicine acknowledges the impact and acceptance of integrative medicine as an important field of study, and recognizes our center’s role as a leader in medical education,” said Dr. Victoria Maizes, executive director of the Arizona Center for Integrative Medicine. “Creation of this track expands our educational opportunities to virtually every level of medical education, from student to seasoned practitioner.”

Well, it all depends on what you consider an “educational opportunity.” There’s no doubt that adding CAM/IM to the curriculum–or any curriculum–would “expand educational opportunities,” but is that a good thing? I would argue that it is not, at least not when those additional educational opportunities involve mixing pseudoscience with science and shaking vigorously until it’s hard to tell one from the other.

Yet that is exactly the path that medical education is taking here in 2011, with Andrew Weil and UA leading the way.

Comments

  1. #1 Ashtanga London
    July 27, 2011

    You think shamans and witch doctors shouldn’t be regulated?

    Anything that is driven underground or excluded from mainstream checks, measures and research, is going to be more dangerous than if it was upfront, properly defined and properly assessed.

    The alternative (pardon the pun) is to keep on having situations like the one in Africa where some bum lazy shaman who never spoke to a spirit in his life (i joke) decided that the logical way to cure AIDS is to have sex (most took this to mean rape) with a virgin. The villagers only cried foul when they started to run out of virgins under the age of 3.

    Have you ever heard of a procedure called ‘Crazy Wisdom’, and how subjecting one’s apprentice to years of pointless woo is all part of that procedure, and that is the only real function that all those tons of woo ever had?

    Woo probably had it’s roots in something real. The further you go back in time, the less people could afford to indulge in pointless ineffective practices.

  2. #2 Ashtanga London
    July 27, 2011

    @Kreboizen, the tooth fairy does not exist.

    If you don’t believe in shamans, then what are these imaginary beings that need banning, how come Orac can see them and we can’t and don’t you realise that all tooth fairies are fake and they invariably look startlingly similar to one’s own parents if you happen to be awoken by it. That’s the fake ones, your parents.

    I hate to break it to you but Santa Claus is the same kind of thing.

    No Krebs, I’m not aware of shamans outperforming traditional psychiatrists at citations, in fact, not giving a flying one about your citations is probably mandatory for real shamans.

    ‘Illegal’ Shamans out perform all legal SBM protocols for treating drug addictions by using the illegal dehabituant known as Ibogaine. I gather that Ibogaine is a serious hallucinogen so you’d need an experienced hallucinator to look after you. That’ll be a shaman not a psychiatrist, usually.

    The second area in which they outperform SBM is simply not up for discussion because it is an area in which SBM can be rather abusive and, trolls being trolls, there is no point arguing with abusive factions.

  3. #3 Ashtanga London
    July 27, 2011

    PMID: 21391058 – The need for ibogaine in drug and alcohol addiction treatment.

  4. #4 Ashtanga London
    July 27, 2011

    I don’t advocate treating your own addictions by getting illegal ibogaine off a street dealer.

    If you’ve been following you’ll understand that I believe that this powerful ‘medicine’ is better off in the hands of science than in the hands of shamans or amateurs.

    What remains to be seen is if trained scientists would be able to use ibogaine to the same effect as the existing illegal ibogaine based addiction treatment specialists. With it being in Schedule 1, it’s going to be difficult to find out.

  5. #5 Ashtanga London
    July 27, 2011

    PMID: 9895205

    Scratch that second one, it’s not true everywhere in the world. The Japanese appear to be on the case.

    By the looks of things, SBM will at some point in the future be able to out-perform traditional shamans in all relevant areas.

    Until then and while the world still has, shall we say, a certain bias towards both drug use and mental illness, we have and game of two halves and for some there is no real SBM option, only illegitimate options will suffice.

  6. #6 Ashtanga London
    July 27, 2011

    lilady I take it you do not agree with JR Donnelly?

    You believe things are fine just the way they are with an embargo on research and street dealers stealing big pharma’s profits (if there ever was any profit in ibogaine. Seriously, who would do that for fun? Have you seen the vids? It looks like hell. You’d only do it to escape the hell of addiction, surely?).

    In fact, the only sane reason you could possibly have for defending it’s schedule 1 status is that you are a heroin dealer who doesn’t want to loose customers. I put it to you lilady, that you are one step away from pushing heroin.

    Are you surprised it’s not an actual clinical study? Have any positive studies into uses of Ibogaine ever been given funding or clearance to go ahead? I can’t believe NIDA would treat it any differently to they way they treat pot and we all know what goes on there.

    lol – my citation did not work so I must be a shaman!

  7. #7 Ashtanga London
    July 27, 2011

    That’s ridiculous. You get challenged on anything and you bring out the Jacob card!

    Anyhow, I can’t believe the webmaster of any website would give private details to a user in order to identify which ‘puppets’ belong to the same person.

    I do hope not, because you have just confessed on someone else’s behalf that they have broken privacy laws and also Scienceblogs’ own privacy policy.

  8. #8 Composer99
    July 27, 2011

    As has been noted on this blog and over at Science-Based Medicine, TCM also has deleterious effects on rare wildlife as well as on patients who use it at the expense of actual medicine and the integrity (intellectual & ethical) of practitioners.

    Overall, the integration of sCAM into MD programmes serves to reduce the effectiveness of future MDs, to waste scarce financial and personnel resources, and to reduce the confidence of prospective or actual patients in the system (I know I would not have much confidence in a doctor who suggested homeopathy for, well, anything).

    While Dr Weill might be a ‘true believer’, I would not be surprised if some boosters of integrative medicine had cynical enough motives such that the last consequence I outlined above was the aim of their support.

  9. #9 Ashtanga London
    July 27, 2011

    Vicki there is no distinction, all Homeopaths and all homeopathy is fake.

    You really think that the way I teach yoga encourages woo? Blimey, that’s an assumption and a half. You should see their confusion when a yoga teacher tells them (I tell them):

    1) Don’t believe anything a yoga teacher says unless your own experiences back it up, and even then you could both still be wrong.
    2) Chakra just means wheel, from back when wheels were top science!

    If you think the baby rape guy was real then you’re sadder than I thought. Just goes to show what your opinion is of Africans.

  10. #10 Ashtanga London
    July 27, 2011

    And do those unimpeachable sources state that the guy who came up with the idea was a real shaman or a bad shaman?

    The first thing me and my friends all said when we first heard that story was ‘That’s not a shaman’, someone’s inherited that job.

    Not an position you can necessarily pass on to your children because not everyone can do it, unless it’s one of those fake symbolic shaman who are really just priests and no-one goes to a vicar when they have a serious illness. You go to the best local healer that you can afford and that you trust.

  11. #11 Anna
    July 27, 2011

    The University of Arizona is also the home of Gary Schwartz, IIRC.

  12. #12 Hemlock
    July 27, 2011

    “The alternative (pardon the pun) is to keep on having situations like the one in Africa where some bum lazy shaman who never spoke to a spirit in his life (i joke) decided that the logical way to cure AIDS is to have sex (most took this to mean rape) with a virgin. The villagers only cried foul when they started to run out of virgins under the age of 3.”

    And you think legitimising it and regulating it is the best way to go? I don’t think so, the best way to go is to stop these damaging practices, not ensure they are done “safely”.

    It’s also likely to be untrue that woo has it’s roots in something real. In some cases it has turned out a folk remedy has real effects, but many more are just like your rape of virgins curing AIDS – they cause vastly more harm than good or have no actual effect on the condition they claim to cure. Aristolochia (Aristolochic Acid) is a great example of that. Used for many hundreds of years for such things as stomach pain, headache and fever but nothing to link it with something that painlessly causes damage that only appears months and years later in what seems to be an individual case. Except it’s not an individual case, it’s just that no one was watching what was happening and was able to put together the bigger picture.

  13. #13 James Hanley
    July 27, 2011

    In a thread over at Dispatches from the Culture Wars I commented on the danger of phrasing things at too general a level, which allows the speaker to be lulled by how good a concept sounds and prevents them from digging into the details. I also noted that demagogues regularly make use of this kind of broad generalization to sweep people along with them.

    The phrase “healing-oriented and preventive medicine techniques” is a perfect example. How could anybody possibly object to doctors being “healing-oriented” or practicing “preventative medicine”? But as you note, this glosses over the fact that science-based techniques are also designed to heal, and can help us understand proper preventative techniques. And when we dig down into the details underlying that smooth phrase we find there’s no valid empirical evidence underlying them.

    “Natural” is another such too-general phrase. I’ve known too many people who rely heavily on herbal remedies because they’re “natural,” and natural things are good. To which I usually reply, “just like nettles, poison ivy, and snake venom, right”?

    As a political scientist, it appears to me that a part of the problem is that we have too few scientists, or people with a real understanding of empiricism, in serious leadership positions, whether at our universities, or in our state governments and federal governments. The best we ever get is the occasional medical doctor, and as we can tell from the frequent reports on this blog, that’s (sadly) no guarantee of a real appreciation for empiricism. So we get too many leaders at all levels who are impressed by woo. I actually respect the fact that scientists tend to avoid politics, but I think we need to recruit more of them into it.

  14. #14 Ashtanga London
    July 27, 2011

    Ok, take me to court then, see how you get on. For the record, no, I do not realise that (with an s or a z) and I deny that allegation.

    See how you get on subpoenaing my identity too.

    Or you could draw up a very short list of male Ashtanga teachers in London who have studied with Pattabhi Jois and one by one see if any of them ever wrote or talked like me. I’m the only one with a 100% woo free ashtanga yoga offering.

    Not hard to find. Subpoena away, and how much cash did you need?
    If you’re short why didn’t you say? The foundation can help if you’re any kind of medical practitioner, anywhere in the world.

    Just out of interest, what is your real reason for believing it belongs in schedule 1?

  15. #15 Ashtanga London
    July 27, 2011

    Some argue that all psychiatry is fraud but I’m not gonna push that argument.

    Before modern stuff, when there were only shaman and witchdoctors and money wasn’t even invented, was it still a con? How could it be? Why would the tribe tolerate it?

    Yes Ibogaine is lethal like any other drug (or vehicle) so it’s use should be studied, regulated, taxed, controlled all the more. Underground is unsafe.

    Kreb, what’s your success rate for getting people off their addictions and can you guess mine? (I use ashtanga yoga and acceptance, nothing else)

  16. #16 Ashtanga London
    July 27, 2011

    Hi Hemlock,

    By woo I mean things like the complex rituals and chanting that can accompany yoga. I don’t mean ‘plants’. Plants are plants, woo is a kind of ‘talk’ that is all too common in the standard yoga mentality.

    Ban bad shamans? Right, how do you spot a dodgy shaman?

    In my experience, only genuine shaman can out a fake. How will you find a genuine shaman you can trust to kick off the process, or do you ban the genuine shaman too?

    Do you realise that some shamanic techniques can out perform traditional psychiatry in a couple of areas?

    I agree that in a perfect world, the best way is to ‘stop these damaging practices’ but I don’t see any evidence of damaging practices being stopped without offering a safer legitimate alternative (moonshine vs a regulated alcohol industry).

    Successful prohibition of ‘grey markets’ is a fallacy. There is no white market without a grey or black market. Science based medicine only exists because we need a ‘white wizard’ to compete favourably with the grey stuff.

    Until SBM can separate itself from biased political forces, it is unlikely to win the trust of everyone anytime soon so the best we can do is to make grey practices safe. Keep your friends close and your enemies closer…

    The best way to destroy your enemies is to turn them into friends.

  17. #17 Ashtanga London
    July 27, 2011

    Bring it on then, take me to court. I look forward to it :)

    Has your male accomplice got a London office so you can bully me more effectively?

    Hang on;

    You cannot deny that allegation. It is fact that you put on a public website

    So you admit that the thing I put on a public website is a fact. Can’t be liable for deformation you told me it’s a fact. I also know for a fact that all Americans break some law about 1000 per day without even realising it.

    Tell me, would a jury be involved in your trial of messed-up pride?

  18. #18 Ashtanga London
    July 27, 2011

    And the Judge isn’t going to tell you to stop being a big cry baby and stop wasting legal resources?

    Judges do have some judgement you know and they can tell when a fat lady is trying to use the law to pick on a fit person just for making her feel inferior.

    Just for the record, no one here really believes what I write so no defamation can occur as the statement cannot affect anyone’s beliefs about you (apart from you being fat) because everything I say is a terminological inexactitude of sorts.

  19. #19 lilady
    July 27, 2011

    Simply unbelievable that students get an advantage by automatically “graduating with distinction” from medical school if they take a woo module.

    When I was in college, there were very few “electives”…the course study was crammed with nursing courses, clinical rotations, organic and inorganic chemistry and labs. The few electives were specific additional courses for sub-specialties in nursing…non-woo-type nursing. I chose epidemiology…in my case a fortuitous choice for a later career in public health. I worked my butt off for my B.Sc-Nursing Magna Cum Laude.

    The stipulation to automatically “graduate with distinction” is an outrage. It should only be awarded for taking the dean’s ugly daughter to the prom (groan, I couldn’t resist).

  20. #20 Ashtanga London
    July 27, 2011

    Oops! I just accidently clicked the button marked ‘transfer all assets to a charitable foundation where legal sharks cannot touch it.’

    Damn.

  21. #21 Mu
    July 27, 2011

    I hope they introduce distinguished clothing for med school students at UofA, I don’t want to have to toss out my memorabilia in embarrassment.

  22. #22 Todd W.
    July 27, 2011

    Perhaps alumni could write to the university with their concerns. In particular, if you have been a donor, express your displeasure and indicate that if the university persists in this course, they may find your dollars going somewhere other than into their coffers.

  23. #23 Ashtanga London
    July 27, 2011

    Gray, have you got a PMID to go with your claim that I believe my perceptions to equal reality.

    I don’t think it’s true but maybe your PMIDs will prove me wrong.

    And yes, prohibition is immoral, of course it is! So yes, if you still disagree with Orac and support prohibition then you are immoral, unlike me and Orac who have decent upstanding morals.

    You don’t have to be a drug user to see that.

  24. #24 Ashtanga London
    July 27, 2011

    Did you read that experiment where two groups describe the same symptoms but one group leads with the disclosure that they are deeply religious.

    Only 40% got a psychosis diagnosis from the deeply religious group compared to 60% from the non religious control group.

    Tell me, if you had your first psychosis, and you were afraid, any you had a choice:

    An experienced schizotypal joins you in your mad world and leads you back to reality and you never have scary psychosis again or,
    A doctor knocks it on the head with antipsychotic meds which you stay on for life and if you come off them you may suffer psychosis and the average schizophrenic dies 23 years earlier on those meds compared to only 3 years earlier for those who have not has the meds.

    Which would you choose?

  25. #25 Krebiozen
    July 27, 2011

    Why would anyone want real doctors learning nonsense like homeopathy that has been shown in clinical trials to be useless? The usual retort, apart from special pleading about how CAM modalities are not testable by clinical trials, is to claim that CAM provides a useful placebo. But all science based medicine comes with a built in placebo effect. So CAM is only useful in treating conditions for which there is no science based treatment. In other words it is only useful for people who don’t need to see a doctor, so why train doctors in using it? Why not refer such patients to a dietitian, a counselor, or a massage therapist?

    Ashtanga London,

    Right, how do you spot a dodgy shaman?

    The same way you spot a fake Tooth Fairy?

    Do you realise that some shamanic techniques can out perform traditional psychiatry in a couple of areas?

    Citation?

  26. #26 kktkkr
    July 27, 2011

    I looked at that list, and I don’t see real medicine.
    That may actually be a good thing, if only by preventing medicine from degenerating into pseudoscience.

  27. #27 Beamup
    July 27, 2011

    Nobody said anything about banning shamans. Read again.

    No Krebs, I’m not aware of shamans outperforming traditional psychiatrists at citations, in fact, not giving a flying one about your citations is probably mandatory for real shamans.

    Without citations, you have no grounds to claim that they do anything useful at all, much less outperform psychiatry.

    The second area in which they outperform SBM is simply not up for discussion because it is an area in which SBM can be rather abusive and, trolls being trolls, there is no point arguing with abusive factions.

    In other words, you know it’s complete BS and that we’d call you on it.

  28. #28 lilady
    July 27, 2011

    @ Krebiozen: You are doing a great job on our resident “yogi” who now flip-flops our of frustration betwixt stating one or two sentences that make sense…versus the usual ramblings.

    I suspect you inadvertently used “dieticians” when you meant nutritionists in this sentence:

    “In other words it is only useful for people who don’t need to see a doctor, so why train doctors in using it? Why not refer such patients to a dietitian, a counselor, or a massage therapist?”

    There is some ambiguity with both these words…perpetuated by woo meisters, much to the consternation of Registered Dieticians who are licensed by each state and are accredited by the American Dietetics Association. Registered Dietiticians have a four year degree from an accredited university and have rigorous boards and standards as opposed to “nutritionists” who may or may not have some traditional background and are engaged in selling magical curative supplements. No hospital, nursing home or reputable company ever employs a “nutritionist” in lieu of a Registered Dietician who are part of the health care team.

    @ Yogi: You do realize that you are “pushing” Ibogaine which is not approved for drug withdrawal treatment? It is classified as a Schedule I Drug in the United States and can be procured through “underground sources” and street pushers.

    You are sounding more and more like Jacob’s sock puppet.

  29. #29 Denice Walter
    July 27, 2011

    Oh, I don’t know… I’m trying to figure out what is worse: an under-educated poseur using homeopathy/ nutrition/ TCM or a doctor using the same magic formulae. The former is probably more dangerous but the latter succinctly illustrates the inevitable waste of time, money, and talent, and thus, is more dis-heartening. Oh well, it’s in Tucson, home of Mike Adams.

    Beside the obvious damage quackademic medicine brings forth, announcements like this will be spun relentlessly by woo-meisters as “proving” how well homeopathy et al are the “wave of the future”, how a “paradigm shift” is underway, and how they indeed were “ahead of the curve”**. If watering down remedies makes them stronger this will be strong medicine- if you think that way, if you can call that *thinking*. I think not.

    Now suppose I used research-based methods in counselling and decide that I would like to be a *little* more creative when I assist clients. Since I don’t know the Harry Potter books inside-out ( I’ve seen the movies), I’ll have to go back to LOTR for my analogy. And I’ve got a doozy: the Mirror of Galadriel! Speak with clients, then we both consult the Mirror to see what ( hushed voice)*may* occur. I’m being facetious, but I think my idea ( because of its relation to projective testing) has more of a chance of “working” ( getting people to express themselves, reveal current issues, etc.) than homeopathy does ( nil). Relax, I’d never do anything of the sort.

    If you can’t provide data for a method, it’s basically asking clients to rely on magic. Possibly interesting, maybe evocative, probably inconsequential but definitely not based in the real world.

    ** their words not mine, thankfully.

  30. #30 Ashtanga London
    July 27, 2011

    While I look for the citation, which would you choose?

    I gave you two treatment options for your first psychosis and no-one has chosen one. Is there another option I missed, that you would all take instead?

    Or do you all believe you are psychosis-proof?

    Does anyone feel like actually linking to some of the stuff that made Jacob so unforgettable and special? I feel like I missed a great movie that everyone can’t stop talking about!

  31. #31 Denice Walter
    July 27, 2011

    @ lilady: Right, the woo-meisters I review work very hard to create confusion about nutritionists and dieticians. Since they believe nutrition is a cure-all their evaluation of nutritionists is above that of doctors ( in their fevered imaginations)

  32. #32 Ashtanga London
    July 27, 2011

    Oh here’s your citation. You’re making my brain hurt!

    http://images.icanhascheezburger.com/completestore/2008/12/30/128751462598337910.jpg

  33. I can understand that some people can believe there is/might be something to certain sCAM modalities, such as acupuncture (although the science says there isn’t). What I can’t understand is how people that should know better can lend any credence to the vitalistic, energy based underpinnings of nearly all sCAM modalities and how anybody with a basic understanding of chemistry and what homeopathy is can think homeopathy is anything but absolute, pure, unadulterated bunk.

    Additionally, the Trojan Horse metaphor is very appropriate. The Trojan Horse wasn’t a legitimate gift of art that had a downside, it was a pure ruse. Nutrition, relaxation, physical therapy for aches & pains, and light exercise are valid health practices, but sCAM approaches to these are not science based. They often get as much wrong as they get right (at best), go too far with their claims of effectiveness and scope of application, and what they get right is often by chance and for the wrong reasons, bringing along the baggage of unsceintific thinking.

    -Karl Withakay

  34. #34 lilady
    July 27, 2011

    @ Yogi: Your PMID citation didn’t work. However, inventive source that I am I “googled” the title you provided:

    “The need for ibogaine in drug and alcohol addiction treatment”

    I found the title you provided on the “medic debate” website. It is not a peer reviewed journal article and is written by Jennifer R. Donnelly a 3rd year law student at Southern Illinois University. Her argument for Igobaine would never stand up in Moot Court in her law school…a solid “Fail” for the presentation. Donnelly presents no legal points, absolutely no science and only speaks of the absence of God in society.

    Try again Yogi sock puppet.

  35. #35 Ashtanga London
    July 27, 2011

    What about the shaman who are able to induce a controlled religious psychosis in their apprentices without the use of drugs? That’s quite a talent – anyone know any modern doctors or psychiatrists who know how to do that?

  36. #36 Vicki
    July 27, 2011

    Ashtanga: There are people who claim to be able to use ultra-diluted water to cure disease. However, they are wrong. They are either lying or deluded. Since homeopathy doesn’t work, there is no such thing as a “real homeopath” any more than there is a “real Superman” or a “real perpetual-motion machine.” It doesn’t matter how many questions someone can answer about why they think it might work, when it doesn’t work.

    At best, you’d be helping these frauds to cheat sick people out of money. At worst, you’d be in the situation of saying “He’s a real witch doctor, so take his advice: to cure AIDS make sure to fast for two days and take potion X before raping a little girl.”

  37. #37 lilady
    July 27, 2011

    Yogi/Jacob Sock Puppet just keep it up. My questioning your sock puppet status has been confirmed.

  38. #38 Ashtanga London
    July 27, 2011

    Venna what is actually going on with your knees? Are your menisci intact?

  39. #39 lilady
    July 27, 2011

    @ Yogi Sock Puppet: A little paranoid, eh. Of course you can’t conceive that your many postings off-topic and now on “street drugs” would give you away as a sock puppet.

    Sad to say, baby rapes in Africa is true, not an urban legend. Stop labeling Vicki as a racist fool, and check the many impeachable news sources on the internet about the incidence, the arrests and the convictions of baby and child rapists in Africa.

    Cripes, when is this sock puppet going away?

  40. #40 lilady
    July 27, 2011

    Oops, I meant to post…and check the many unimpeachable news sources on the internet about the incidence, the arrests and the convictions of baby and child rapists in Africa.

  41. #41 Dangerous Bacon
    July 27, 2011

    As long as there are large amounts of money being dangled in front of universities/med schools with the additional incentive of providing “relevance”, there will be temptation to allow onself to be bought.

    Instead of just denouncing quackademic medicine (though public embarassment and potential loss of alumni donations might in some instances be therapeutic), what evidence-based medicine needs are wealthy donors/organizations to support med school coursework or a “distinction track” in EBM, teaching prospective physicians how to critically evaluate research, dubious claims and outright quackery. A major selling point could be the coming critical need to keep down health care costs by eliminating funding for ineffective modalities.

    In lieu of a “Call For (Research) Abstracts”, how about a “Call For Sugar Daddies”? If Bill Gates isn’t all tapped out through his generous support of vaccine programs, maybe he’d consider funding some med school EBM programs. After all, Gates has been the target of considerable venom from the loonier woo types over his support of vaccination (and World Depopulation Schemes, if you believe the crazies). He might realize the importance of not giving these people an exclusive foothold in medical education.

  42. #42 Ashtanga London
    July 27, 2011

    Hell no, nothing can be diagnosed via writing on the internet, except perhaps writing disorder if there is such a thing.

    I just know about meniscus injury because that’s the first injury that egotistical idiots get if they try to force their legs into full lotus!

    Until I found a proper teacher who showed me the gentle way of ashtanga I kept periodically hurting my knees and it was Indian Temple Dance that made them good again. It involves a lot of stepping with slightly bent knees! Now if I have any knee pain I can fix it with yoga, always learning!

    I’m sure I could show you how to rescue your knees in the flesh but you’re right, not online, and I can’t honestly say another ashtanga teacher would know how to treat them so I wouldn’t recommend you seek one out. Big no-no!

    There shouldn’t be grinding normally, can you get an MRI scan? That’s what a yoga teacher should advise in the first instance, via a doctor. You cant rely on sensation to tell you what’s going on deep inside the knee.

    It sounds to me like your knees are a bit worn out.

    I know you have a very stressful life and schedule but try to take that extra split second to check which way your knees are pointing before you move, no torsional twisting, plenty of fish oil, whatever it takes get them checked by a specialist soon, please, don’t be a hero!

    Use your hands to help take weight off your knees as much as possible, if you have to take things up and down stairs, get your kids to help or put things in a backpack.

    If there is arthritis, yoga can’t get rid of it but it can slow it down. I know a guy with arthritis in his knees who swears by pot but that’s maybe not your bag!

    Ouch! I feel your pain. I’ve just kissed both knees and apologised to them for all the years of dance abuse!

  43. #43 lilady
    July 27, 2011

    @ Yogi sock puppet: You do realize that your statement, “In fact, the only sane reason you could possibly have for defending it’s schedule 1 status is that you are a heroin dealer who doesn’t want to loose customers. I put it to you lilady, that you are one step away from pushing heroin.”…is a libelous statement, don’t you?

    What you may not realize is that I am a licensed registered nurse whose license could be on the line…it’s called “material damages” that you would be liable for. Orac’s strict policy of never revealing the identity of posters, would be open to a subpoena to secure your identity. And, I would collect substantial damages for your libelous statement.

  44. #44 Ashtanga London
    July 27, 2011

    Sastra,

    A guy I knew once had a major psychotic breakdown, he was at his computer at the time so he was able to google his options once the dream like visions had subsided enough. He didn’t like the sound of the antipsychotic drugs and their side effects so he decided to take his chances with a natural recovery.

    Along the way he encountered two kinds of people. The ones who kept telling him to stop being mad and try to force him back to reality caused the hallucinations to start again. It was only when he made his way to a drug den (in order to escape judgement) that he found people who were happy to agree with his mad ramblings. When people agreed, he began to loose his grip on the mad world and eventually returned to a new normality.

    Afterwards he realised he’d not really understood the world and other people all his life, and after the psychosis he didn’t return to his previous state, he became unshakeably down to earth and was actually saner because of what he had seen.

    Now he spends his time fighting for the rights of people with psychosis and schizophrenia and he insists that everything, including the voices and visions he encountered came from his own body via a physiological process that will one day be identified properly by science.

    He says that there is no such thing as spirits or telepathy and anyone who denies that the voices came from his own body are tacitly implying that they do believe the voices came into his head from outside of his body.

    What he also maintains is that he was not in possession of those voices before the psychosis, and the voices told him things he never knew about the past that actually turned out to be pretty accurate.

    His latest theory is that we inherit snippets of important situations from our ancestors so if if those (highly stressful life or death) situations ever come up, the ancestors can come forward to help and we don’t have to learn the hard way time and time again.

    Sorry no PMID.

  45. #45 Vicki
    July 27, 2011

    If you present something as truth, you don’t then get to call other people bigots for taking you at face value.

    The point is, there is _no_ evidence for a “real shaman” any more than there is evidence for a “real homeopath.” Yes, there are people with assortments of instruments. There are people who will walk clients through rituals (that covers homeopaths and shamans alike). There are people who will claim that they have “credentials.” But there’s nothing behind the curtain.

  46. #46 Ashtanga London
    July 27, 2011

    Yes Venna that’s what I said, doctor for you not yoga!

    I just googled my Jacob remark, you’re right, not many google hits for ‘cannabis and arthritis’, only 2.4 million.

    Even ‘cannabis and autism’ gets more than that at 3 million.

    I’m gonna google that list of crackpot autism treatments: ‘xxxxx and autism’ and see how many hits the more popular ones get.

    Ah, ‘ABA and autism’ only 2.4 million. I wonder how google works? Must be some mistake.

    Are you guys interested in Autism treatment at all? I found an autism and yoga video earlier.

  47. #47 Krebiozen
    July 27, 2011

    @Lilady,

    I suspect you inadvertently used “dieticians” when you meant nutritionists in this sentence:

    I originally wrote ‘nutritionists, but realized that some nutritionists give bogus and potentially dangerous information, whereas counselors and massage therapists generally don’t do too much harm, so I substituted ‘dietitians’. Whenever I see ‘nutritionist’ written I remember Dara O’Briain’s stand-up comedy piece in which he says that ‘dietitian’ is to ‘nutritionist’ as ‘dentist’ is to ‘toothiologist’ ;-)

    @Ashtanga London,

    the tooth fairy does not exist.

    Neither does a real shaman with supernatural powers, as opposed to a ‘dodgy shaman’. I have had an interest in shamanism for over 30 years, and studied it at university (SOAS, if you’re interested). I also worked for the Institute of Psychiatry in London as a research anthropologist for a while, looking at cross-cultural aspects of psychiatry, so I do know a bit about what I write. In my opinion all shamans are frauds of one sort or another, and I think most of them would admit it if pressed. Some of them make a very nice living giving hallucinogens to gullible westerners.

    As for ibogaine, there are some interesting tales of people quitting drugs after taking it, but it has also caused several deaths. Ibogaine is not used by shamans, and the drug has no traditional use as a cure for drug addiction. Iboga, the plant from which ibogaine is extracted, is used by members of the Cult of Bwiti in Gabon. Initiates frequently die from the large initiatory dose of the root.

    BTW, in the early 20th century a crude extract of iboga became a quack medicine called Lambarene, used for “everything from neurasthenia to syphilis”, but especially as an aphrodisiac (Emboden, ‘Narcotic Plants’).

  48. #48 lilady
    July 27, 2011

    @ Yogi sock puppet: In answer to your last post, point by point:

    “Ok, take me to court then, see how you get on. For the record, no, I do not realise that (with an s or a z) and I deny that allegation.”

    Oh, I’ll get far (see my comments further down) Ignorance of the libel laws are not a legal defense. You cannot deny that allegation. It is fact that you put on a public website.

    “See how you get on subpoenaing my identity too.”

    I know how I’ll get on subpoenaing your identity by recent case law.

    “Or you could draw up a very short list of male Ashtanga teachers in London who have studied with Pattabhi Jois and one by one see if any of them ever wrote or talked like me. I’m the only one with a 100% woo free ashtanga yoga offering.”

    See my answer above; no short lists needed, once my attorney gets your identity.

    “Not hard to find. Subpoena away, and how much cash did you need?”

    No cash needed, such a great winnable case will be taken on by any attorney on a contingency basis.

    “If you’re short why didn’t you say? The foundation can help if you’re any kind of medical practitioner, anywhere in the world.”

    I won’t be short. My husband is a U.S. based attorney whose specialty is plaintiff’s and defendant’s international litigation. He has attorney colleagues all over the world who would gladly provide legal service, gratis.

    “Just out of interest, what is your real reason for believing it belongs in schedule 1?”

    Yogi the Schedule I is Roman numeral I. See the listing for Igobaine by “Googling”:

    DEA Drug Scheduling

  49. #49 Gray Falcon
    July 27, 2011

    Once again, Ashtanga, do you believe your perceptions color reality? Just because you suspect us of some motive, does not mean you are correct. I suggest you learn about the concept of “evidence” before you post here again.

  50. #50 lilady
    July 27, 2011

    @ Gray Falcon: He’ll never see it coming…once I secure his identity and do a background check on any assets (open or hidden) to ascertain if the judgment can be executed…before he gets served with a summons and complaint.

    If he does live in the U.K., then the winnable case in the U.S. is even more winnable in the U.K….with their lowered burden of proof in libel cases.

  51. #51 Gray Falcon
    July 27, 2011

    Here’s your exact statement:

    In fact, the only sane reason you could possibly have for defending it’s schedule 1 status is that you are a heroin dealer who doesn’t want to loose customers. I put it to you lilady, that you are one step away from pushing heroin.

    That’s an direct accusation of a serious crime, and proof that you believe your perceptions are equal to reality. Most people would look for evidence, but you simply believe that someone who disagrees with you must be immoral.

  52. #52 Venna
    July 27, 2011

    Ya know, I always thought (beware, I’m revealing my geekhood here) shaman was a class your could be in any number of MMORPG games such as World of Warcraft or Everquest. I played a Shaman Barbarian in Everquest for a little while. It got boring really fast though. I still preferred the monk and enchanter classes.

    Shamans only exist in stories and fairy tales. They aren’t real, just as the tooth fairy and Santa Claus are not real. Therefore, there is no such thing as separating the ‘real’ shaman from the fake one. Anyone can call themselves a shaman, but it really doesn’t mean anything because it’s just a make believe title and essentially means they may suffer from Schizotypal Personality Disorder if they really believe they can do magic.

  53. #53 larry
    July 27, 2011

    What really does SBM have to offer Frank?

    What should Frank do?

    http://premium.naturalnews.tv/May_I_Be_Frank__NN.htm

  54. #54 Vicki
    July 27, 2011

    “Not intended as a factual statement,” eh? So there’s no point in anyone bothering to read or answer anything you write, because you don’t mean it yourself?

    That’s useful for me to know, but I have no idea whether a judge is going to buy the argument “nobody who reads Orac’s blog could possibly have believed what I posted, because after I’d said those things I announced that I didn’t mean them.”

    *plonk*

  55. #55 Chris
    July 27, 2011

    larry, why are you spamming for Mike Adams? Do you get a cut each time someone pays to stream that movie?

  56. #56 JohnV
    July 27, 2011

    No, we didn’t read that experiment. If you’d provide a citation, perhaps we could.

  57. #57 Lawrence
    July 27, 2011

    I’ve noticed a change in tone & posting style of AL over the past couple of days. I’m getting a feeling that this isn’t the original, but actually a jacob sockpuppet…..

  58. #58 Beamup
    July 27, 2011

    I doubt that. It seems unlikely that Jacob would actually give up one pet obsession for another. Rather, I think it’s just that AL is miffed that we won’t simply accept his claims simply on the strength of his personal endorsement.

  59. #59 Melissa G
    July 27, 2011

    I take it back, all my comments from yesterday concerning trolls. This is the BEST COMMENT THREAD EVER!!!

    *munches popcorn*

  60. #60 Composer99
    July 27, 2011

    On topic:

    I like the idea suggested above of wealthy donors possessing sensible viewpoints on medical practice providing funds with the intent of nudging med schools back towards the study & practice of actual medicine.

    I suspect a ‘carrot and stick’ approach will be required, with the promise of donations & support to increase the incentive to adopt and maintain evidence-based curricula, and the calling out of quackademic ‘integration’ whenever it arises.

    Universities should leave the evidence-free speculation to philosophy departments (I refer here to a joke by University of Toronto philosophy professor Joseph Heath in his book Filthy Lucre) and the making, er, stuff, up to literary & performing artists (such as myself).

    ———
    Off topic:

    As far as I can see, the practice of yoga and the infiltration of quackademic medicine into university curricula are completely unrelated (save perhaps that some of the would-be integrators of quackademia may use yoga or similar methodologies for their own purposes).

    So it would be nice if off-topic discussions on yoga, yoga vs psychiatry, or shamanism in Africa, were dispensed with. They contribute little or nothing to the discussion and are tiresome to come across.

  61. #61 Venna
    July 27, 2011

    I wonder if there is any way that a doctor would be required to disclose if they graduated with distinction due to going through the quackery courses so we can avoid them? I don’t want to go to a medical doctor who might tell me to drink his magic water to cure my bad knees.

  62. “I like the idea suggested above of wealthy donors possessing sensible viewpoints on medical practice providing funds with the intent of nudging med schools back towards the study & practice of actual medicine.”

    The other stick available is for doners to divert funds away from institutions that embrace quackademic medicine towards more purely science based institutions. Institutions like Harvard might have to think twice before accepting funds for quakademic medicine if it cost them more in lost funding than it brought in.

  63. #63 Venna
    July 27, 2011

    @ AL

    What you are referring to is called BRAIN WASHING, CONDITIONING, INDOCTRINATION. ANYBODY can do that if they know how to manipulate people. Look at Charles Manson… With what you are claiming, he could have been a shaman. Get it through your head, there is no such thing as magic, shamans do not exist. Now, kindly get back on topic or leave.

  64. #64 Venna
    July 27, 2011

    AL

    I don’t know what’s going on with them as I’ve not been able to get a doctor to look at them when I had a doctor and now I am having trouble finding a doctor to go to to try and have them looked at again. All I can do is describe the symptoms: pain upon walking for long periods of time, bearing my weight (standing from sitting, kneeling or going up or down stairs), weakness (sometimes they feel like they over extend on their own, like the ligaments or muscles that keep them from bending the wrong way are not working correctly) and grinding when I use them. The grinding has been going on for about 12 or so years. The pain started in the past 6 years or so. I really hope you don’t try to ‘diagnose’ my symptoms because I won’t believe anything you say. Without a physical exam I wouldn’t trust anything anyone said so please don’t waste our time.

  65. #65 Jarred C
    July 27, 2011

    I like the idea suggested above of wealthy donors possessing sensible viewpoints on medical practice providing funds with the intent of nudging med schools back towards the study & practice of actual medicine.

    This whole topic reminds me of a story Dr. Steven Novella told on his blog, replicated here (two paragraphs):

    Most physicians are what we would categorize as “shruggies” when it comes to CAM. They don’t really know what it is, they are not steeped in the data or the discussion, and they largely know what proponents tell them – it’s all about “patient centered” medicine (the “touchy feely” defense). They are not aware of the misinformation being promoted by CAM practitioners, nor the rank pseudoscience.

    I have told the story before of my experience at Yale. In a meeting of respected academics whose job it was to craft the curriculum for students, we discussed the idea of the content of a CAM course. The other physicians were all shruggies – they liked the “patient centered” approach and didn’t see the harm. I pushed the issue, however, until we actually cracked open a syllabus and read what was going to be taught by the “integrative” physician who was going to teach that class. The relevant physician read quietly for about ten minutes while the rest of us continued to chat. He then looked up, a bit stunned and even outraged, and said, “This is all nonsense.” He was shocked, and the prior discussion had not prepared him for the level of abject pseudoscience that was about to be taught to our students. Later he confessed to me that he did not believe me about CAM (he thought I was being dogmatic) until he read that syllabus – and then he realized it was far worse than even I had made it seem.

    You can read the full article on his website: http://theness.com/neurologicablog/index.php/follow-up-on-atlantic-article/

  66. #66 Liz Ditz
    July 27, 2011

    On-topic, since Orac mentioned shamanism:

    I assume Ashtanga London is not a native of North or South America.

    First Nations, Native Americans, or indigenous peoples of North and South America take a dim view of the commercialization of their traditions.

    A good guide to the frauds can be found at

    New Age Frauds & Plastic Shamans (NAFPS), a website maintained by an activist group of Native people and non-Native supporters.

    There is also the matter of telling people they can be shamans and charging them for it. If you were interested in Judaism, would you pay money to someone who said he could make you a rabbi in just one weekend seminar? If someone did this and then claimed Jewish objections were foolish, we would recognize he was anti-Semitic. Think about the lack of respect these operators show to native people and beliefs, and to their own followers, by defrauding people.

    Native people DO NOT use the label “Shaman.”

    There’s a long-running thread at NAFPS on the follies of “Core Shamanism”.

    Evidently there are a lot of these claiming-to-be-Native-American plastic fantastic shamans fleecing the gullible in Europe.

  67. #67 Sastra
    July 27, 2011

    Ashtanga London #49 wrote:

    Tell me, if you had your first psychosis, and you were afraid, any you had a choice:1.)An experienced schizotypal joins you in your mad world and leads you back to reality and you never have scary psychosis again.

    You know, I very much doubt that an “experienced schizotypal” will successfully lead someone who has had a psychotic episode back to reality. They are more likely to confirm a schizophrenic in their delusions — and keep them there.

    I’d take my chances with the medical professionals.

    And as for your post at #40: shame on you.

  68. #68 Venna
    July 27, 2011

    LOL! No yoga for me thanks. I’ll put my faith in a real medical practitioner, once I find one.

    Yeah, I think it’s safe to say this is a Jacob sock puppet. How cleverly it reintroduced pot into the discussion without it being the ‘main’ point of quackery promotion.

  69. #69 Liz Ditz
    July 27, 2011

    Another example of the woonami, this time from RI commenter Prometheus, this time not from medical education, but a physician — on the seductive certainty of fantasy-based medicine.:

    Another aspect of “alternative” autism therapy – and “alternative” medicine as a whole – that this conversation brought up is the “Magic 8-Ball” nature of “alternative” diagnosis and therapy. Although these practitioners usually claim to provide “individualised treatment”, many (if not most) follow very rigid diagnostic and therapeutic algorithms. Practitioners seem to “specialise” in either the diagnoses they make (e.g. “Lyme disease”, “heavy metal toxicity”, etc.) or the treatments they administer (e.g. chelation). Some even do both, “specialising” in – for example – the treatment of Lyme disease with chelation. Thus, every patient who walks through the door is fated to receive either a limited range of diagnoses, a limited range of therapies, or both.

    And while the Magic 8-Ball has twenty possible answers, many of these practitioner have far, far fewer choices in their armamentarium. No matter what the problem, it always seems to need the same treatment (or treatments – shotgun therapy is the norm in ”alternative” medicine). This is not to say that they are consistent, however. Many, including my friend’s “DAN! doctor”, blow with the prevailing winds of “alternative” medicine. They can be counted on to provide the latest fashion in “alternative” medicine without the slightest concern that today’s “miracle cure” directly contradicts yesterday’s “medical secrets THEY don’t want you to know”.

    Does the American medical education system really need to be turning out more of the Magic 8-Ball kind of physicians?

  70. #70 kd
    July 27, 2011


    How does a medical student choose whether to use acupuncture, homeopathy, or TCM, for instance, on a given position?

    If examining the phase of the moon and relevant astrological indicators doesn’t work, there’s always haruspicy!

    If the candidate suggests reading the patient’s entrails rather than those of one of the sacrificial goats provided specifically for this purpose, then the patient fails the exam.

    Selecting the incorrect goat for a given patient counts against the examinee, but (unlike disemboweling the patient) is not grounds for immediate disqualification.

  71. #71 Sastra
    July 27, 2011

    I once knew a woman who as a teenager had begun to have psychotic episodes. She fell in with a group of New Agers who convinced her that her delusions were actually spiritual experiences and she was very lucky indeed, with much to teach them. Nothing was wrong: she was just gifted. Deep down, however, she was terrified — and quickly spiraled out of control. After someone less “spiritual” got involved (and got her to a doctor) the medication and therapy gradually allowed her to gain her normal life back. When I met her she was still angry with the people who had blithely ignored the seriousness of her symptoms and instead used her illness to bolster their own personal spiritual journeys.

    He says that there is no such thing as spirits or telepathy … His latest theory is that we inherit snippets of important situations from our ancestors so if if those (highly stressful life or death) situations ever come up, the ancestors can come forward to help and we don’t have to learn the hard way time and time again.

    Not quite unshakably down-to-earth.

  72. #72 kd
    July 27, 2011

    mixing pseudoscience with science and shaking vigorously until it’s hard to tell one from the other.

    Someone please remind Dr. Weil that, per the laws of homeopathy, diluting the concentration of pseudoscience in this mixture to 30C will increase its potency dramatically, and patient outcomes will improve noticeably as a result.

  73. #73 Venna
    July 27, 2011

    @ Sastra

    This reminds me of a story I learned about recently about a mother who put her autistic son through a religious ceremony (several actually if I recall) to have his demons exorcised out of him. The religious people convinced this woman her child was possessed by devils and that is what was causing his autism. Just a quick and easy exorcism and his autism would be gone along with the demons. The only problem is the ceremonies resulted in the boys death, by being crushed by the person performing the ceremony. In court, they said the reason the boy died was because it was God’s will, otherwise he wouldn’t have put this woman in their path to have the demons exorcised to begin with. The boy never indicated that he was in any kind of distress (he was non verbal and apparently the kicking, screaming and fighting and crying wasn’t him actually protesting or trying to tell them he was in danger of dying, but the demons fighting the power of God to make them leave.) THAT made me sick to my stomach, but that is what these practitioners of woo tell people who aren’t cured every day. “Well, you waited too long to get the proper treatment. So it is your own fault, not the fault of the woo we practice.” Do they honestly believe this? Do they really think their argument is plausible? It boggles my mind.

  74. #74 Liz Ditz
    July 27, 2011

    The autism exorcism death Venna refers to is the 2003 death of Terrance Cottrell Jr., who died at the hands of Ray Anthony Hemphill, who laid upon him during a “healing ceremony” at the Faith Temple Church of the Apostolic Faith, founded by Hemphill’s brother.

    Hemphill was convicted of felony physical abuse of a child causing great bodily harm.

  75. #75 Denice Walter
    July 27, 2011

    @ Dangerous Bacon & Composer 99:

    Last year ( 8-4-10) Warren Buffett and Bill Gates got 40 billionaires to pledge to give half of their fortunes- totalling 230 billion USD- to charity ( US News; MSNBC). IIRC, Micheal Bloomberg was mentioned as being one of the group.

    Should we start making calls?

  76. #76 Krebiozen
    July 27, 2011

    Apologies for perpetuating an off-topic discussion, but I think this is important. It’s really not a good idea for amateurs to mess about with psychosis or drug withdrawal. I have seen what can happen in both cases first hand, and it wasn’t pretty.

    Some years ago a good, and brilliant friend of mine slid off the rails, He stopped working, lived in a squat and started selling and smoking vast amounts of cannabis. After a while he began acting very strangely, and was clearly unwell. I and other friends tried to help him, but he was paranoid and wouldn’t see a doctor. The doctors I spoke to said they couldn’t do anything unless he was a danger to himself or others, and there was no evidence of that.

    In the end I got in touch with his mother, and arranged for him to go and stay with her in another part of the country. I paid his train fare and sent him off myself. I thought the change of scene and some fresh air would do him good, but he had an acute psychotic episode and killed his mother rather horribly. He ended up in a secure psychiatric unit. He’s out now, I know he was ill, but I never felt quite the same about him, and have since lost touch.

    I also knew someone who tried to withdraw from drugs cold turkey, thinking he could handle it on his own. He also had an acute psychotic episode and ended up hospitalized for two weeks.

    So Ashtanga (or whoever you are) I strongly suggest you reconsider trying to treat serious problems like drug addiction and psychosis. Things can go very badly wrong very quickly.

  77. #77 Michael Ralston
    July 27, 2011

    Has everyone heard of this?

    http://www.guardian.co.uk/world/2011/jul/11/cia-fake-vaccinations-osama-bin-ladens-dna

    Because quite frankly, I am furious.

  78. #78 The Necromancer
    July 27, 2011

    Perhaps this is a problem of terminology, but it seems to me like you put too fine a point on the difference between mainstream and alternative practices. There are undoubtedly deep strains of quackery in the CAM community, but your use of the words “vitalism” and “vitalistic” without an appreciation for their historical complexity and contemporary subtlety and relevance is unfortunate. Clear-thinking and rationality are not necessarily antithetic to a vitalist perspective, especially as it is understood in some of its more current guises. If anything, thinking about “vitalism”, broadly understood, can give all physicians, mainstream and alternative practitioners alike, a deeper understanding of the meaning of health and healing. Of course, this is just an opinion, not an absolute. Your condemnation of anything outside the mainstream in medicine, in contrast, seems to approach an absolute.

  79. #79 Gopiballava
    July 27, 2011

    @Necromancer:
    “Your condemnation of anything outside the mainstream in medicine, in contrast, seems to approach an absolute”

    Is there anything that Orac has criticized that you think he is incorrect about? Any specific treatments that you think he has unfairly criticized?

    I’m fairly sure that Orac avoids criticizing treatments that aren’t clearly BS.

    The topic of this post is medical education, not research. Education for practicing doctors should be based on treatments with strong, robust evidence for them. It should not consist of tentative speculation, of new ideas that are not yet proven.

    A vast percentage of new ideas turn out, upon careful investigation, to not work out. Some of them turn out to be more harmful.

    Medical education should not claim that facts outside of mainstream medicine are true. When claims that fall outside of mainstream medicine have enough evidence to be true, they become part of mainstream medicine.

  80. #80 Sastra
    July 27, 2011

    The Necromancer #75 wrote:

    Clear-thinking and rationality are not necessarily antithetic to a vitalist perspective, especially as it is understood in some of its more current guises.

    Define “vitalism.” In a current guise.

    I think your real problem here is not going to be with medicine, or even biology. You’re now getting into chemistry and — uh oh — physics.

  81. #81 Orac
    July 27, 2011

    @The Necromancer

    How do you know that I am not aware of the “historical complexity” or “subtlety” of vitalism? I simply consider it irrelevant, given that vitalism is now known to have been wrong. It might have been a reasonable philosophy of medicine back in the days before germ theory and before physicians figured out the pathogenesis of many diseases. Now that we know these things, there is no reason to continue to believe in vitalism, given that there is no evidence for it. It really doesn’t matter how much its proponents try to exercise their “reason” to defend it. Such arguments are akin to debating how many angels can dance on the head of a pin.

    I also think that you are misconstruing my requirement for solid evidence for an absolute rejection of “alternative medicine.” Show me the evidence, and if it is compelling enough I will adjust my beliefs.

  82. #82 Ashtanga London
    July 28, 2011

    As far as I am aware, there are at least 3 different versions of ‘god’ that are verifiable by science.

    The one that doesn’t exist is the omnipotent one with a white beard and a nightie who hangs out in heaven with his bird, Asherah (she’s the one nestling in the crook of Yah’s elbow – they forgot to airbrush her out of Michaelangelo’s ceiling doodle).

    The easiest one to ‘prove’ is the ‘consensual concept of god’ which is brought into existence by our very discussion of it.

    The second one is the one that can be experienced by people having psychosis or by people who are very lucky with dangerous drugs or people who have had a go on the god helmet: http://en.wikipedia.org/wiki/God_helmet

    The third kind is the human insisting he be accepted as god on pain of death, historically the norm rather than the exception and you only need to go back to WWII Japan to see evidence of that.

    4 versions of ‘God’, three are verifiable, one is a logical impossibility.

    Who’s interested in the God Helmet?

  83. #83 augustine
    July 27, 2011

    I simply consider it irrelevant, given that vitalism is now known to have been wrong.

    Vitalism has been proven wrong? I think some of your loyal typers will disagree if they what that means to their philosophies and religious leanings. You leave no interpretation except that of materialism and atheism.

    Only if they deny self-contradiction can they continue to believe in what the skeptics have defined as science based medicine.

  84. #84 Gopiballava
    July 27, 2011

    @augustine:

    If you’re saying that applying rationality and the scientific method to everything you believe results in either atheism or internal contradictions, I think you’ve just made your most coherent post yet. Congratulations!

    If what you’re saying is that God exists, and that proper application of the scientific method requires a disbelief in God, and thus the scientific method is invalid, well, that’s about par for your posts.

  85. #85 Ashtanga London
    July 28, 2011

    Response to Kreb:

    Apologies for perpetuating an off-topic discussion, but I think this is important. It’s really not a good idea for amateurs to mess about with psychosis or drug withdrawal. I have seen what can happen in both cases first hand, and it wasn’t pretty.

    This is a CAM topic so unless you think treating addiction with yoga is SBM now, it is still relevant to the debate. Especially if I am being a danger to people without knowing it.

    Some years ago a good, and brilliant friend of mine slid off the rails, He stopped working, lived in a squat and started selling and smoking vast amounts of cannabis. After a while he began acting very strangely, and was clearly unwell. I and other friends tried to help him, but he was paranoid and wouldn’t see a doctor. The doctors I spoke to said they couldn’t do anything unless he was a danger to himself or others, and there was no evidence of that.

    In what way was he brilliant? Is he London based? Do I know him?
    That’s a very common scenario. Why wasn’t he living with his parents at this time? There must be a reason. When he started getting into financial difficulty, why did he not involve his parents then?

    In the end I got in touch with his mother, and arranged for him to go and stay with her in another part of the country. I paid his train fare and sent him off myself. I thought the change of scene and some fresh air would do him good, but he had an acute psychotic episode and killed his mother rather horribly. He ended up in a secure psychiatric unit. He’s out now, I know he was ill, but I never felt quite the same about him, and have since lost touch.

    I’m so sorry you must have felt awful. Clearly it was very wrong to send him to his mother. There’s a reason he chose a squat over the comfort and safety of home.

    I also knew someone who tried to withdraw from drugs cold turkey, thinking he could handle it on his own. He also had an acute psychotic episode and ended up hospitalized for two weeks.

    Sorry, which ‘drugs’? That words isn’t very helpful. Be an SBMer and call them by their proper names or I can’t learn anything from your story.

    So Ashtanga (or whoever you are) I strongly suggest you reconsider trying to treat serious problems like drug addiction and psychosis. Things can go very badly wrong.

    Kreb I don’t treat psychosis and I have not claimed to. I’m with the doctors. If the ‘patient’ isn’t physically threatening himself or others, who can judge what are the right words and movements?

    You don’t have a clue how Ashtanga Yoga helps people with addictions so it’s a bit weak of you to judge. For me, the most dangerous thing was being threatened by the dealers for eroding their business.

    Just little gains, bit by bit, no sudden withdrawal just an insidious process of slowly loosing the need for the drugs and the interest in the drugs and replacing them with an interest in just naturally feeling good.

    To make it easier. I ran a class at 11 am every day. It was 2 whole weeks before even one of them understood that it was every day at 11.

    Where most fail is that they expect the addict to turn up ‘clean’ for a yoga class. I just tell them to feel normal for it so if they are an addict I expect them to turn up normal (i.e. not high, not in withdrawal, on the drug).

    Recreational drug users sometimes try to come along and enjoy the lesson ‘high’. I can root them out in two seconds and summarily expel them.

    For alcohol addiction the safest strategy is alcohol replacement therapy combined with counselling and, most important, social inclusion and support in re-joining dry society.

    Other than alcoholics I have worked with ketamine addicts and cocaine addicts. I’m am well aware that a different approach is needed for opiate addiction, legal med addiction, amphetamine addiction etc. I don’t touch those. Besides, they only turn up to classes because they think a yoga teacher is a soft touch who’ll give them money for the next fix!

  86. #86 augustine
    July 28, 2011

    Gopiballava, the former is correct. That latter is wrong.

    Now if you can convince your contradictory “christian” bloggers, such as Grey Falcon, novalox, and lilady, of this then we can get somewhere.

  87. #87 Gopiballava
    July 28, 2011

    @augustine:

    Are you an atheist?

    And, why should I care, as a commenter on a blog about pseudoscience and quackery in medicine, about whether people consistently apply their skepticism in all areas of their life?

    Perhaps they are subscribers to non-overlapping magisteria?

  88. #88 augustine
    July 28, 2011

    Perhaps they are subscribers to non-overlapping magisteria?

    Richard Dawkins would say it doesn’t matter.

    There are elephants in the room, Gopiballava.

  89. #89 Gopiballava
    July 28, 2011

    @augustine:

    Dawkins would be correct. But I’m not interested in arguing with them on the matter unless they want to discuss it with me.

    Are you an atheist?

  90. #90 The Very Reverend Battleaxe of Knowledge
    July 28, 2011

    You’ve got idiots defending vitalism in this thread? Vitalism was exploded in 1828 when Friedrich Wöhler synthesized urea! I know morons like augustine are behind the times, but seriously….

  91. #91 Chris
    July 28, 2011

    Well the guy who brought up vitalism has the ‘nym “The Necromancer.”

  92. I didnt get the exact point at what sort of medicine you are talking about. as if you want it to be understood by the general public u should explain in detail i think so. dont take me rude but i just want to know about it. if you can kindly explain it to me

  93. #93 Krebiozen
    July 28, 2011

    Ashtanga,

    In what way was he brilliant?

    Double-starred first class degree in maths from Cambridge University.

    Is he London based?

    He was, this was more than 20 years ago and as I said I have lost touch with him.

    Do I know him?

    Possibly, but how would I know? I’m not going to name him here, for obvious reasons. He has rebuilt his life and I’m sure he doesn’t want this dragged up again.

    That’s a very common scenario. Why wasn’t he living with his parents at this time? There must be a reason. When he started getting into financial difficulty, why did he not involve his parents then?

    He was in his forties, his father was dead, he had fallen out with the rest of his family. As far as I know he made a choice to ‘drop out’ and live an alternative lifestyle.

    There’s a reason he chose a squat over the comfort and safety of home.

    He had been living with friends but they moved, and he had to move out. I couldn’t put him up as my wife was pregnant and was terrified of him and his weird behavior. In retrospect I’m glad I didn’t.

    Sorry, which ‘drugs’? That words isn’t very helpful. Be an SBMer and call them by their proper names or I can’t learn anything from your story.

    Again this was several years ago – he was using gammahydroxybutyrate (GHB) back when it was legal in the UK and touted as a natural, safe sleeping aid, but slipped into using it 24/7 for a long time. I don’t think he expected such a severe withdrawal.

    Kreb I don’t treat psychosis and I have not claimed to.

    I assumed you were referring to yourself when you talked about a schizotypal joining a psychotic in their mad world and guiding them out. Apologies for my error.

    You don’t have a clue how Ashtanga Yoga helps people with addictions so it’s a bit weak of you to judge.

    Maybe, but you may just have been lucky so far. I hope not. Anything that helps people get out of and stay out of an addiction is a good thing, of course. I got the impression that you thought yoga could deal with acute psychoses and acute drug withdrawal, but I was clearly mistaken.

  94. #94 Venna
    July 28, 2011

    Not everyone who posts here is an atheist or agnostic. Just because person believes fact and science when it comes to medicine doesn’t mean they aren’t also a person of faith. Generally the discussion of God and religion stays out of this forum as it has no place here because religion isn’t science or fact, it is personal belief and faith. They don’t always coincide, but they can exist together in the same person. There are some who would be wise to remember that and follow everyone else’s lead and keep religion out of it.

  95. #95 augustine
    July 28, 2011

    Venna

    Generally the discussion of God and religion stays out of this forum as it has no place here because religion isn’t science or fact, it is personal belief and faith.

    Who told you this blog was just about science and facts? Even the practice of medicine itself isn’t just about science and facts.

  96. #96 Gray Falcon
    July 28, 2011

    augustine@95: Got any specific examples, or are you just throwing out more scary words?

  97. #97 Mu
    July 28, 2011

    It’s a self-fulfilling statement. Everything little Augie writes is neither science or fact.

  98. #98 The Very Reverend Battleaxe of Knowledge
    July 28, 2011

    See, Venna, it comes up because little augie showed up on here screaming about how we were all atheists and that’s why we had no conscience, and advocated poisoning little kids for Pharma money, and robbing the “productive” classes (like him—snerk!) to support worthless welfare queens…every once in a while he’ll get back on a tear like that when his meds get low.

  99. #99 augustine
    July 28, 2011

    @Gray Falcon, where do spiritual laws come from?

    Do you believe that life can be completely explained by the laws of physics and chemistry alone?

    Do you believe in a soul or spirit? Is it real?

    @Moo

    Everything little Augie writes is neither science or fact.

    99.99% of americans, before mass measles vaccination, did not die from measles.

    Moo, you are wrong. I just debunked you in front of all of your intranet friends.

  100. #100 Gray Falcon
    July 28, 2011

    Augustine, you didn’t answer my question. Got any specific examples, or are you just throwing out more scary words? And that statement you made was a half-truth, you failed to mention that most people got measles, quite a number of people died (1 in 10000 adds up in a large population), quite a number had other permanent side effects, and almost nobody dies of measles or suffers such effects now that the vaccine is available. Tell me, do you think it is honest to withdraw important facts?

  101. #101 Jarred C
    July 28, 2011

    Mu (and others),

    There are things that Augustine writes that are factual; it just happens that Augustine is also dishonest, evasive, and accusatory. So it would be in error to state that everything Augustine writes is false (in the Boolean sense).

  102. #102 Anton P. Nym
    July 28, 2011

    Who told you this blog was just about science and facts?

    Well, the URL “scienceblogs.com” is what tipped me off…

    — Steve

  103. #103 augustine
    July 28, 2011

    Got any specific examples, or are you just throwing out more scary words?

    What scary words?

    quite a number of people died (1 in 10000 adds up in a large population)

    450 if you need to know.

    and almost nobody dies of measles or suffers such effects now that the vaccine is available.

    If you’re a vaccine injury denialist then you believe nobody dies or suffers from vaccine injury.

  104. #104 Lawrence
    July 28, 2011

    Extremely intellectually dishonest – focusing on “deaths” & totally avoiding / ducking / ignoring the non-fatal permanent side-effects, which constituted a much larger percentage of the total population.

    One good concrete example is the decline in need for “deaf” institutions like Gallaudet University, which has suffered a major decline in enrollees, attributed to first, and foremost, the near eradication of measles, and cochlar implants being the most recent second improvement.

    We are accused of viewing everything in “black & white” while our responses are anything but. Instead, it is boring troll & its ilk that view the entire world through their own warped sense of reality (and some, through a very insane prism). Once again, the trolls will ignore all evidence and rational responses to their tirades – it does become very boring to hear them repeat the same tired old debunked rants over and over again.

  105. #105 augustine
    July 28, 2011

    Well, the URL “scienceblogs.com” is what tipped me off..

    I know it’s confusing and deceptive isn’t it, Steve. It’s as if “science” has a sockpuppet.

  106. #106 Gray Falcon
    July 28, 2011

    You asked “what scary words?” Here’s some:

    Even the practice of medicine itself isn’t just about science and facts.

    You didn’t give any examples, you just made a vague accusation against medicine. That isn’t how we do things around here. You can’t just say “He’s a bad man,” you need to show that he’s done bad things.

  107. #107 Anton P. Nym
    July 28, 2011

    It’s as if “science” has a sockpuppet.

    To channel Mandy Patinkin for a moment, I do not think that word means what you think it means.

    — Steve

  108. #108 augustine
    July 28, 2011

    To channel Mandy Patinkin for a moment, I do not think that word means what you think it means.

    – Steve

    Inconceivable!

  109. #109 herr doktor bimler
    July 28, 2011

    There’s a reason he chose a squat over the comfort and safety of home.
    Anyone who thinks a squat in London was necessarily uncomfortable or unsafe should have got out more.

    Vitalism has been proven wrong? I think some of your loyal typers will disagree if they what that means to their philosophies and religious leanings.

    This is the “Let’s you and him fight” approach to trolling.

  110. #110 larry
    July 29, 2011

    I love my Sports surgeon-(he’s surgeon to the jets)-He’s honest with me and
    thank you honest surgeons!

  111. #111 Kelsey
    July 29, 2011

    Back on topic, if you please.

    This is disgusting. Given this nonsense I will probably not apply to schools that have ‘distinctions’ for crackpots regardless of how they perform.

    I also don’t know how I would handle ‘mandatory’ courses in CAM. I’ve heard of it being offered as a summer elective, but a mandatory course would just infuriate me. Is there such a thing as a conscientious objector? Considering how difficult it is to get into medical school to begin with, it is dismaying to consider that one might have to play along or drop out.

  112. #113 lilady
    August 2, 2011

    @ zz: The link you provided from the New York Times was a result of the article that appeared in the Archives of Internal Medicine.

    Dr. Steven Novella wrote an excellent article about this at the Science Based Medicine web site:

    The Neurontin Seeding Trial

    Dr. Novella clearly defines how this “trial” was devised with the input of marketing staff a definite “no-no” in the science community. BTW, the fact that the drug manufacturer was facing lawsuits for marketing Neurontin for “off label” uses, another “no-no” in the science community, was also a factor in the seeding trial.

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