White Coat Underground

The blogosphere is doing a reasonably good job of covering this, but I’m still fuming over Senator Tom Harkin’s (D-IA) health care policy hearings. Each morsel of the hearing contains more idiocy than the last. In my attempt to shed some light into Harkin’s guano-filled cave, I’m going to examine some of the specific testimony, starting with that of Dr. Dean Ornish.

Medicine today focuses primarily on drugs and surgery, genes and germs, microbes and molecules, but we are so much more than that.

When I hear statements like this, my bullshit detector asplodes. Sure, it’s only one sentence out of many, but it really sums up the entirety of the testimony. It asks the question, “what is medicine, really?”

I’ll take a shot at that one, given that I’m actually a practicing internist. Doctors practice medicine. Medicine is the application of science in the prevention and treatment human disease. Not so long ago, medicine was defined only by the final clause—science wasn’t as critical, and any well-intentioned healer could be said be be practicing medicine. We’ve grow a bit. How? By understanding how drugs act on they body and what outcomes they produce. By discovering genetics and how genes influence health and disease. By discovering micro-organisms and the diseases the cause, and by learning how to stamp them out. By understanding that human beings are, in the end, simply a part of the physical world—they are made of “star stuff”, but that star stuff is organized into molecules, genes, cells, tissues, organs. One of those organs is the brain, through which we interact with and alter our environment. But we are still physical beings, and our health depends on physical processes. In short, we are not “so much more than” matter.

Sure, our consciousness makes us kinda special, but it doesn’t really change the story. Doctors who utilize scientific medical knowledge with compassion are doing their job. Those that claim to have special knowledge above and beyond the physical universe should have gone to seminary.

Comments

  1. #1 PalMD
    March 3, 2009

    BTW, h/t Blind Watchmaker for the Harkonnen gag.

  2. #2 Strider
    March 3, 2009

    You make guano-filled caves sound like a bad thing! On behalf of all cave ecologists, we are not amused!

  3. #3 Quiet_Desperation
    March 3, 2009

    Strider is correct. Guano filled caves are a valuable resource in some parts of the world. The Niah caves in Borneo, for example. It’s a major economic driver there.

  4. #4 Stephanie Z
    March 3, 2009

    Fine, send him to Borneo. Maybe he can do some good there.

  5. #5 Badger3k
    March 3, 2009

    Wasn’t Harkonnen the bad guys from Dune?

    I first read Orac’s report on this, and loved the quote where the one guy basically denied the germ theory of disease – it did sound like he was saying that diseases are caused by lifestyle choices (as someone said, the old “unbalance of the humors” bit from the middle ages. I’d joke about it more if it wasn’t so serious an issue. I’ll just leave with Bugs Bunny “What a maroon!”

  6. #6 Denice Walter
    March 4, 2009

    In mid-January, Ornish appeared on Null’s Woo-topia(WNYE radio)and it was horrifyingly surreal:the actual doctor did not in any way question, debate, or challenge the phoney one.He didn’t correct any of the latter’s prattle about “our” work on lifestyle change.He was even complimentary. Mon Dieu!Mein Gott in Himmel!(and I’m an atheist)

  7. #7 Donna B.
    March 4, 2009

    You fight woo on the internet and in your office, I fight it at home. I couldn’t stop my husband from buying one of Null’s books, but the book itself (and subsequent reading on the internet) finally convinced him that Null was a faker, a quack, and a snake oil salesman.

    Every family reunion I go to I hear about another elderly (and some not-so-elderly) relatives going for acupuncture treatments, talking about this new pill they heard advertised on TV cured their arthritis, they’re feeling better than they ever did, or….. other such crap which was so obviously not true, as the arthritics were still limping and having trouble getting out of their chairs and the others were still complaining about their aches and pains.

    In those situations, I only try to find out if they are also seeing a real doctor regularly also. If so, I don’t say much. Who wants to get into an argument at a family reunion?

    There are exceptions. One aunt was ecstatic that some new herbal drink she found had cured her diabetes and that now she didn’t need to take her metformin. I enlisted the aid of another diabetic aunt for an “intervention”.

    What I’m trying to get across here is the woo isn’t just ineffective, it’s downright dangerous sometimes and for some crazy reason, people want to believe it.

    Yes, good medicine is a bit more than molecules, genes, etc. I’m reminded of the rheumatologist I went to for six months. I had no problem with the medical treatment per se, and learned quite a bit from him, but he made me feel like such a useless little turd, that I was usually near tears by the time I got back to my car.

    He is the rare rare exception and I’ve seen countless doctors over my lifetime. A few were excellent, most are very good, and there were a few that had me shaking my head and laughing as I left their office never to return again.

    But only that one that did as much or more harm along with the help. To me, he is the exact opposite of the woomeister types who literally woo their patients with a charming personality while doing medical damage — both are dangerous, but the number of quacks far far exceeds the number of cruel and hateful docs.

    I really would like to see research into why people want to believe in such crapola. Surely it’s been done and I just don’t know about it.

  8. #8 Denice Walter
    March 5, 2009

    @ Donna B.: Yes, there are studies.But you might first want to look at “why” people go woo in general(@ Quackwatch).Dr.Laidler (Autismwatch)has a revealing personal story.Also three docs @ science blogs but their names escape me.