White Coat Underground

Here in the U.S. our rich are very rich and all but our poorest live better than most Haitians. In this context it’s easy to lose perspective and to be a bit naive about the survival needs of the people in post-quake Haiti.

Or maybe that’s being too generous. How hard could it be for an adult to realize that finding food, water, shelter, and basic medical care for yourself and your family take precedence over any other needs? Does it really take being subjected to life-threatening conditions yourself to have such a basic level of empathy?

The hordes of medical cultists descending on Haiti probably represent both ignorance and frankly cynical self-promotion. There have been many reports of the Church of Scientology’s faith healers walking around in yellow t-shirts trying to “assist” people’s nervous systems. Homeopaths, the folks who sell water panaceas, have been offering to “help” as well.

Poor and less-industrialized countries are a target-rich environment for alternative medicine cults. Since many alternative medicines don’t require an industrial base, they can be made readily available anywhere. Homeopathy is just water; if a homeopath can simply provide a water remedy that contains fewer fecal coliforms than the local water, they can get away with quite a bit before people realize they’ve been duped. In fact, unless a population has had exposure to real medicine, the altmed folks can fool people for a very long time. But hungry people can also be very pragmatic, and they know that eating grass will only give a false satiety. The same may be true of medical help.

When faced with an immediate threat to life and limb, most people find out rather quickly the difference between real and fake medicine. In rich countries such as the U.S., people have the luxury of indulging in alternative remedies. We have good public sanitation and vaccination and so suffer more from diseases of excess rather than those of desperate poverty. If you have access to food and clean water, so much that you even consume to excess, then you may have time to explore fake cures. But when the world falls down around you and your children are crying for food, everything changes.

Fellow med-blogger Orac tipped me off about a story in Canada’s national paper the Globe and Mail about a Windsor, ON naturopath who took off for Haiti to offer his idea of help. Canada seems to have a serious naturopath problem. Naturopaths in Canada tried to co-opt the flu pandemic with a worse-than-misleading educational campaign, and have made in-roads into getting the same rights as real doctors (without the concomitant responsibilities—we real doctors have to have at least some evidence on our side).

So it was with no small amount of Schadenfreude that I read about a naturopath’s failure in Haiti (but also sadness for the Haitian people for being subjected to him). Denis Marier, a naturopath practicing not far from me, took his altruistic impulse and a whole lot of fantasy and boarded a plane for Hispanola. His particular medical fantasy seems to be centered around vitamin C.

I’m also trying something new this mission – intravenous vitamin C injections to assist with tissue and wound healing. I don’t have access to refrigeration, but should be able to keep the vitamin C, calcium, magnesium, selenium and zinc stable for a few days. I’ve brought enough from my clinic to give approximately 100 treatments of 5 grams of vitamin C plus support minerals.

Well, I’m sure that vitamin C will fix up those traumatic amputations just fine. And with neonatal tetanus, it sure couldn’t hurt, right? I’m sure he cleared his “trying something new” with the appropriate human subjects committees and with the Haitian health authorities. Right?

The elderly lady with the maggots in her sinus cavity from an earthquake injury went to surgery today – she’s expected to recover well. I’m hoping the IVC administered over the last several days, as well as the homeopathic (Pyrogenium) have contributed to her positive prognosis.

You can hope all you want, but unless devitalized tissue is debrided, no amount of magic water will help. In an unsanitary environment like a disaster zone, any extra skin punctures simply add to the risk of infection, so rather than being simply useless, Mr. Marier’s medicines are likely to cause additional harm. The Haitians seem none too impressed with Mr. Marier anyway:

Unfortuantely (sic), as I’ve experienced on previous missions, the local community is arriving at a free “medical clinic” expecting medications, not homeopathic remedies to help with post-traumatic stress from the original disaster.

Those pesky Haitians! Coming to a medical clinic expecting medical help! You’d think centuries of crushing poverty would have sucked the hope out of them by now, but apparently they still expect medical clinics to practice medicine. According to the Globe and Mail report:

After he saw two patients the lineup just melted away… Before he [Marier] left, he disposed of the leftover injectable Vitamin C he brought with him from Canada (it’s a new-ish remedy, apparently, to stimulate tissue healing) because he was worried that, in his absence, it would be used improperly. When I left him, he was also contemplating disposing of a huge load of traumeel, a homeopathic anti-inflammatory.

For fuck’s sake, this guy takes a bunch of suffering trauma victims, subjects them to medical experiments, and then worries his magic potions may get misused? It’s too bad the Haitian cops were too busy rounding up baby-snatchers to go after guys like this.

Comments

#1 Dan
March 1, 2010

Hang on, why is this clown immune from informed consent and human experimentation ethics rules? He said himself, he was trying a brand-new therapy on disaster victims. Is there no way to censure him?

I’m with you, Orac; it pisses me off how alt-med types get a free ride.
#2 Dan
March 1, 2010

*Pal. Not Orac. Don’t you hate when you think one thing, yet type another?
#3 PalMD
March 1, 2010

I wouldn’t know, it never happens to me. ; )
#4 Pascale
March 1, 2010

Unfortunately, no human subjects oversight would be necessary in this case. If he is using homeopathic remedies, most are considered supplements and not subject to FDA regulations.
Also, once a “drug” is approved by the FDA for one use, off-label use is allowable by the prescribing physician as “treatment.” Even though MMF is not approved for treatment of a number of conditions, we still try it (for nephrotic syndrome, etc). Only when we want to test its effects systematically in controlled trials do we have to seek human subjects protection.
As one of my instructors once put it, once a drug is out there, you can choose to treat all of your patients with it. But you can’t choose to treat just half of them.
#5 History Punk
March 2, 2010

It’s impressive how little oversight and regulation these clowns receive. Do you know how many hoops I’d have to jump through to get permission, assuming it was granted, from my university to interview these individuals for say, a thesis?

You don’t prescribe medicine based on guesses. At least [you] don’t since Tuskeegee and Mengele.
#6 Mu
March 2, 2010

I hope he disposed of his excess vitamin C by diluting it to 500 mg/teaspoon and handing it out to kids. That might have actually done some good.
#7 Vicki
March 2, 2010

Pascale–

The FDA is entirely irrelevant here: this is a Canadian “practicing” woo-woo healing in Haiti. Does anyone reading this know what either Canadian or Haitian law says about this sort of human experimentation with woo-woo “remedies”?
#8 Jeanne
March 2, 2010

I applaud your concern for the welfare and lives of the Haitian people. However, where I can’t comment on the Canadian naturopath as apart from what you write here I have no information on what he did or did not do, your criticism of Scientology Volunteer Ministers is uninformed and incorrect. The Volunteer Ministers in Haiti were there to assist the doctors, nurses and EMTs. They did whatever tasks were needed–fed patients, cleaned wounds, saw that needed medical supplies were organized so they could be used (tons of supplies had been dumped, unlabeled, in piles at the airport while patients died for lack of the IVs sitting in those boxes). They left home, family and job and lived under the same conditions as the Haitian people–sleeping in tents and eating canned beans. Ask the doctors who were there at General Hospital or the University of Miami hospital tent what they thought of the yellow shirts. You will find your comments about these volunteers to have been completely unfounded. Those of use who stayed at home owe them our thanks for a job very well done.
#9 ebohlman
March 2, 2010

Jeanne: Can you link to some non-Scientology-affiliated sources that can confirm what you’re saying?
#10 Tsu Dho Nimh
March 2, 2010

Jeanne –
There were also “yellow shirts” doing ‘assists’ and other Scientology crap. http://www.google.com/hostednews/afp/article/ALeqM5jeF5ussei3k0K7yvLch535NNxuYQ “Carol Delva, 29, suffered a crushed knee when her house collapsed on her, and lay inert on damp sheets in the courtyard while LA-based Scientologist Dave McGregor touched her feet, legs and torso, thanking her with a “merci” after each poke.

To the extent that they fetched, carried and followed orders, or had useful medical skills, “merci”. But yellow-clad vultures are still vultures.
#11 PalPenetrator
March 2, 2010

PalMD is too smart to be guilty of foggy thinking. So I conclude he thinks we’re too stupid to see through his propagandizing attempts. He wants us to mistrust every health practice except his pure AMA policy manual—and the treatments he can bill an insurance company for.

PalMD pulls the old trick of attacking someone he dislikes by pretending (falsifying) the other party is guilty of something they’re not guilty of, like using vitamin C to cure amputations. PalMD’s exact words: “I’m sure that vitamin C will fix up those traumatic amputations just fine.” No one alleged that—except a too-slick MD named Pal. (Perhaps he should read Linus Pauling, recipient of a Nobel Peace Prize and Nobel Prize in Chemistry, on vitamin C.)

Once falsely painted, rivals are easy to attack. Just lie about them first. That’s just sleazy.

I’d never attack Pal’s medical knowledge. But I’m suspicious of the medical ethics of people who exhibit his “dog in the manger” attitude about alternative medicines that might heal a patient before PalMD gets to see him/her and bill an insurance company.
#12 PalMD
March 2, 2010

-sleeping in tents and eating canned beans

Yeah…those tents and beans are in short supply. Better had you stayed home.
#13 PalMD
March 2, 2010

I’s “suspicious of” anyone using the handle “PalPenetrator”. Ewws.
#14 PalPenetrator
March 2, 2010

So now we learn, again by PalMD’s own words, that the doctor, who views alternative medicine practitioners as competitors to be smeared, is also homophobic.

So we have yet another reason to mistrust his advice, distrust his narrow-minded worldviews, and avoid his medical office (may I say?) like the plague.

All that’s in addition to his using the most vulgar of four-letter words in his column AND hoping to pimp his views to gullible teenagers by using grammar-destructive jargon.

Tune in shortly as PalMD reveals his Klan membership.
#15 PalMD
March 2, 2010

It may be necessary to point out that declining involuntary sodomy does not equal homophobia.
#16 Mu
March 2, 2010

I can’t wait on your report trying to make Channukah popular with the Klan.
#17 James Sweet
March 2, 2010

Well, I’m sure that vitamin C will fix up those traumatic amputations just fine.

Why can’t alternative medicine heal amputees?
#18 Theresa
March 2, 2010

I don’t know of any registered Naturopaths who claim to heal serious wounds through Vitamin C treatments. It’s a supplementary system of treatment aimed at aiding in healing. From someone who sees both her MD and ND and takes both with a grain a salt… because let’s face it, there’s a lot of FDA approved medicine out there that causes a lot of harmful side affects too… It’s too bad there is so much hostility between ND’s and MD’s – if the two groups would put their “doctor egos” aside and begin to work together, we might actually get somewhere. Instead it always just turns into a pissing contest.
#19 PalMD
March 2, 2010

Yes, I totally see how, because science is sometimes wrong, that non-science must be right.

You do see the flaw in that right? Real science works by testing hypotheses, some of which will test negative. Non-science doesn’t bother.
#20 Jeanne
March 2, 2010

PalMD, I honestly think you are misinformed as you seem like the kind of guy who wants to help people. And I believe the purpose of your post here was to ensure people aren’t deceived or ripped off or harmed in some way. But what you are saying about the Scientology disaster response team is inaccurate and prejudicial. These guys are doing so much good that if your blog turns people against them, that would be a grave mistake. The following, from someone who is definitely NOT a Scientologist, is an example of what I mean:

…it became apparent that these young people were here to assist us and render aid to the suffering. We were asked by the hospital administrator to employ these volunteers in yellow; and like any good Special Forces troop, we found work for our newest grunts. Immediately we had theses young believers of a different power cleaning bed-pans, escorting patients between wards, stacking the endless ocean of relief surplus and simply doing some really tough work. With a smile on their faces and a warmth for the suffering, these young people executed each task in a manner all of us as Americans would be proud.

Day after day they entered the camp (0700 hrs), yellow shirts fading daily from the previous day’s work but they never stopped or even slowed. Never a mal-word, never questioning our request (ok, sometimes our requests sounded like orders being barked) but always doing whatever was required to assist the people of Haiti. My team and I had the opportunity to talk with many of the Scientologist volunteers. Of course there were a few jokes, (SF-types always like to pick-fun at folks different from us) and to be honest they could dish it out as well as they receive it; but what a group of people! Religious beliefs aside (Hell, I really have no clue on what they believe in; only what I have read or heard about through media channels) these guy and girls are OK by me. They lived the selfless service motto; never questioning, always doing for others. Day after demanding day.

We all have differing values, beliefs and ethos we live by. I may not understand the Scientology church (if it is even referred to as a church) but I can attest to the fact that theses volunteers in once bright and now fading yellow shirts are a credit to whatever affiliation they serve.

full posting here
#21 PalPenetrator
March 2, 2010

Again, Pal’s emotions run away with him. He admits zero benefits from naturopaths, or other “altmed” practices.

You know someone has fallen below objectivity when his/her “analyses” and opinions are 100 percent one-sided. It is a comfortable and lazy mind that loves to lump together, when a more objective mind will differentiate and learn what may be valid in a field he natively dislikes.

Again, Pal shows he thinks we benighted non-MDs are stupid, because—after decades of what he thinks are zero results—we occasionally visit naturopaths, homeopaths, chiropractors and others of whom he disapproves.

It would never occur to him that alternative medicine practitioners are often a viable way to avoid the dangers of prescription medications.

It would never occur to him that people would walk away from those products, services and practitioners if they delivered no result. He hasn’t realized that alternative routes to recovery (a) thrive only as a function of their efficacy and the positive word of mouth their positive outcomes generate, and (b) that most MDs’ obsession with cut `n drug medicine might occasionally be less than the optimum route to healing.

Perhaps Pal could differentiate modern alternative medicine from the hippy, flower-chi practitioners of the 1970s.

Although such may still exist, many proponents of today’s alternative approaches and supplementation are MDs or PhDs who broadened their minds and healing alternatives when standard Western medicine was failing their patients.

Maybe when Pal reads something positive that another MD writes about alternative medical approaches, then he will give it some credence.
#22 Jimbo Jones
March 2, 2010

Shorter “PalPenetrator”:
Fallacy of the golden mean, straw man, lack of supporting arguments, la-la-la-I-can’t-hear-you.

Yawn, come back when you have something substantive.
#23 Passerby
March 2, 2010

Haiti was a political, social and environmental disaster before the earthquake. Fully half of the population lacked access to potable water because they had sullied the aquifers so badly. Haiti’s poor subsisted on less than $2/day and yet multiply like rabbits, thanks to the Catholic prudence, popular ignorance and ready acceptance abroad, of an endless flow of Haitian refugees. Compare Haiti’s population density to that of it’s Dominica Island neighbor with a mere fraction of the hordes in Haiti. Compare the pre-earthquake satellite images that depict, starkly, open-pit mined, eroding, sterile, treeless landscape of Haiti with the relatively lush, green and thickly vegetated state of the Dominican Republic, with its ample clean water and prolific food supplies with with to feed its populace.

I am going to let you in on a little secret: the Haitians may have inadvertently nudged forward the date of catastrophic geologic rupture. Record torrential rains and no less than five extreme storm events worsened hillside slumping and worsened exceptionally problematic soil erosion in the past year. The highly porous, denuded land added to decades of sediment runoff into parallel coastal fault systems, pressing down onto local sections of microplate faulting that had ground to silent, uneasy stasis, accruing enormous potential energy over nearly two hundred and fifty years.

Although major ruptures had occurred elsewhere along the fault, they were distant reminders on neighboring islands in this arc. Generations of Haitians came and went without the vital reminder of geologic risk beneath their feet.

The present situation is dire, but not novel. Like the situation in hot pockets of constant military strife, griding poverty and chronic corruption worldwide, the consequences of environmental disaster have brought another population to a dismal, shell-shocked state of hopelessness. The resulting tent camps of homeless people are rife with malnutrition, personal violence and infectious disease.

There are no fast fixes – not money, not food, not medicine. Until the cesspool land is attended to, they will be unable to feed themselves. Until the Haitian people are told in blunt terms that an overpopulated world can no longer afford to feed their human excess, that there is no immigrant mecca waiting to take their castoff children, that there is no endless humanitarian largess that can cure their malnourished masses and rebuild their land – the Haitian people will look everywhere but to themselves for the remedy, in respect for life, law and property.

Haiti is not the first place, nor will it be the last, where dark ecological reality is laid bare: a surfeit of the species will inevitably strip natural resources to their limit and cause a massive population crash.
#24 Louanne
March 3, 2010

Less time in a canoe, more time spent on actual research = better article. You get the idea. May I inspire you to read up on the work of the Scientology Volunteer Ministers? Start here:

Youtube ScientologyVM Channel
Scientology Volunteer Ministers Blog
#25 imominous
March 3, 2010

Well, it appears that the Scientologists have found your blog and are well on their way to spreading lies and attacking your character.

Extolling the “help” these untrained, ignorant cultists offer is misleading. They fed patients scheduled for surgery. One cut himself on a scalpel in the operating room. They came unprepared, with the odd notion that supplies could simply be purchased in Port au Prince. They take up space and resources, and do work any Haitian could perform. They should have stayed home, but in exchange for fanciful “touch and nerve assists,” they reap major benefits in public relations to be shown to Scientologists.

I think there should be some world regulatory commission that addresses this kind of twaddle during major disasters. The Volunteer Ministers and other altmed practitioners are using Haitians as guinea pigs. Injecting patients with anything they imagine may be of benefit, subjecting them to untested quackery should not be allowed.

And I hate to think of the fate of the Haitian orphans who wind up in a Scientology orphanarium! They will probably wind up slaving for the cult in the US one day; passports confiscated, powerless victims of a cult which is rapidly circling the bowl in the media. They will need slaves to keep their racket running. What better source of such than orphans of disaster in a country where the government is marginal to begin with?
#26 Igor
March 3, 2010

If only there was some way to relocate ALL the Scientologists to Haiti and all Haitians to the vast properties owned by the Church of Scientology.
#27 OleanderTea
March 3, 2010

If only there was some way to relocate ALL the Scientologists to Haiti and all Haitians to the vast properties owned by the Church of Scientology.

Igor, what did the Haitians ever do to deserve such a thing?
#28 Igor
March 3, 2010

Made a deal with Xenu for their independence from the Psychlos?

I think I’m getting my science fiction all mixed up.
#29 Igor
March 3, 2010

“He admits zero benefits from naturopaths, or other “altmed” practices. ”

Nice strawman. No he does not, he merely points out that any perceived benefit is greatly outweighed by the risk. It is mostly those firmly set in their absolutist thinking, that fail to recognizer the constant risk/utility analysis prevalent in life and medicine, to wit, those who practice faith based medicine.
#30 Calli Arcale
March 3, 2010

Theresa @ 18:

I don’t know of any registered Naturopaths who claim to heal serious wounds through Vitamin C treatments

I believe PalMD’s point was that the overwhelming medical need in Haiti right now is critical trauma care, and vitamin C injections are not really helpful with that. He didn’t say anyone actually is expecting vitamin C to regrow limbs.

There are lots of reasons why injecting vitamin C is not helpful in this situation, not the least of which is that it’s pretty much the ideal environment for gangrene. It might be useful to provide these people with oral vitamins; the vast majority of them are malnourished, and vitamin deficiencies are real problems there. But don’t stop at vitamin C, and don’t use the expensive injectable stuff that requires special handling. Save those fridges for blood and vaccines and anti-tetanus shots. If you’re going to give vitamins, give ones that will help.

But none of that will matter if people can’t get their wounds debrided or their stumps properly treated. Vitamins are very useful. But we’re talking about a situation where pediatricians are performing orthopedic surgery on toddlers and then releasing them to be transported on motorcycles to the patch of sidewalk where they now live, with only a dim hope that they’ll be able to come back to have the fixiters removed (which *will* be needed, given that children keep growing, lest the child be lamed by the fixiter itself). The naturopath’s intentions are noble, and he may even have prevented a few cases of scurvy. But there are much more dire needs right now, and frankly, I’ve yet to see any good evidence that Linus Pauling was right about vitamin C being good for anything more than preventing scurvy. He was brilliant, but even brilliant men get weird ideas. (Just look at Isaac Newton and his efforts to transmute lead into gold.) Having plenty of vitamin C means nothing if you die of cholera tomorrow.
#31 Not A Radiologist
March 3, 2010

PalMD, here’s a VM talking about Haiti:

http://www.youtube.com/watch?v=tDsYSvalBHI&feature=player_embedded

At 2:48 she mentions a room in radiology with floor to ceiling water bags. The Scientologists assumed this represented a distribution problem, so they took it upon themselves to hand out the water to thirsty Haitians.

However, to me the set-up sounds like an emergency radiation barrier.

What do you think? Are the VMs responsible for making a few Haitians radioactive? Should someone be notified?
#32 PalPenetrator
March 4, 2010

What I can’t wrap my head around is the several examples of hate and villification that I see in the article and in some of the anti-naturopath and anti-scientology comments.

These people aren’t charging for their help, they’re not reimbursed by insurance companies, and they’re not working counter to the very few MDs and EMTs who are there.

I gave money to a couple of charities to help Haiti, but I still don’t have the conviction to GO THERE, lose income, risk health, and actually help, hands-on. So I highly respect those who do.

So, the expressions of hate I see in this blog above tell me a lot more about the commenter than they do about his/her intended victim.
#33 titmouse
March 4, 2010

My last comment in the spam filter. Wuz a major scoop just for you, palmd.

VMs in Haiti dismantled an emergency water bag radiation barrier in a dept of radiology, which they passed out to thirsty Haitians, lol.

link in next post
#34 Dangerous Bacon
March 5, 2010

“What I can’t wrap my head around is the several examples of hate and villification that I see in the article and in some of the anti-naturopath and anti-scientology comments.

These people aren’t charging for their help, they’re not reimbursed by insurance companies, and they’re not working counter to the very few MDs and EMTs who are there.”

They’re sidetracking people from getting treatment that might actually help. I ran into one chiro organization’s website that described doing adjustments for sepsis and other grave internal medical problems. And they’re using resources needed for useful purposes, apart from what harm they might be doing via quack treatments.
And let’s be real – a major reason that quacks have been flocking to Haiti is to generate good p.r. for their practices and for their brand of woo. Naturopaths, chiros, Scientologists etc. can proclaim in their press releases and on their websites what wonderful things they allegedly are doing.

“It would never occur to him that alternative medicine practitioners are often a viable way to avoid the dangers of prescription medications.

It would never occur to him that people would walk away from those products, services and practitioners if they delivered no result.”

As always, this nonsense overlooks the key fact that prescription meds actually are efficacious in treating medical problems, and any side effects must be viewed in that light – whereas any side effects associated with useless quack remedies are unconscionable. And I’m sure it’s occurred to Pal as well as to most people that quackery has flourished from day one because of gullibility, slick promotions and the desire of people to find a permanent solution to chronic problems that can be ameliorated but not cured by current mainstream medical practice.
Haitians are stuck in a bad situation – they need real help, not “relief efforts” from quacks.

It takes a high degree of self-absorption and contempt for others to try to achieve favorable publicity on the backs of suffering people, which is what the twilight practitioners are doing in Haiti.
#35 bob dobbs
March 5, 2010

@PalPenetrator

Prove to me that Scientology has spent one dollar of it’s own money and I’ll take back anything bad I’ve said about
Volunteer Ministers.
#36 Pal Penetrator
March 7, 2010

Wow, this is cool to see!

It looks like all of PalMD’s apologists are just as belligerent as he is. No room for anyone else at the trough besides brain-washed MDs, eh?

And you have all done such a magnificent and cost-effective job of it that the USA is now facing a “healthcare” debacle that will force the closure of small companies and flood the USA with even less-competent doctors from Squatwater U.

Thanks a lot for botching up a sacred trust.

I began to understand your profession better when I learned that “First, do no harm” isn’t even really part of your Hypocritic Oath.
#37 Not the crazy one
March 7, 2010

Actually, it is the creed of the SCIENTOLOGISTS to always attack, never defend. I see they’re proving the point quite nicely in this loony thread.

Pro-tip: Scientologists look silly when they use words like “apologist” and “brain-washed.” Spend some time lurking at ExScientologist Message Board and check out what healing looks like.
#38 TheDissenter
March 8, 2010

Yet another post that makes it plain as day to any astute reader that this blog has nothing to do with helping people through medicine, and everything to do with trying to instill irrational fear in anyone who doubts the obviously very frightened mainstream medical practitioners. PalMD seems to think that we are all fooled if he throws around the term “science” enough as if the mere sound of the word lends credence to dogma. Very little in modern medicine is “science-based” as evidenced by a recent admission by the BMJ.

I can sense the fear in the subtext that mainstream medicine is slowly losing their very well protected monopoly and thus feel they must do anything they can to counter the attack with propagandist techniques calling into question anything that deviates from AMA endorsed treatment. We’ve seen this before in other industries and it never works in the long run.