Medicine

Alternative medicine, by definition, consists of medicine that either has not been shown to work or has been shown not to work. To paraphrase an old adage yet again, medicine that has been shown to work with an acceptable risk-benefit ceases to be "alternative" and becomes simply "medicine." Unlike the case for many conditions commonly treated with alternative medicine, whether or not a treatment works against cancer is determined by its impact on the hardest of "hard" endpoints: Survival. A patient either survives his cancer or he does not. Even the "softer" endpoints used to assess the…
Here we go again. Antivaxers don't like vaccines. This, we know. They blame them for everything from autism to autoimmune diseases to diabetes to sudden infant death syndrome. They even sometimes claim that shaken baby syndrome is a "misdiagnosis" for vaccine injury. However, there are two vaccines that stand out above all as the objects of antivaccine scorn. the first, of course, is the MMR vaccine. That's on Andrew Wakefield., of course, who almost singlehandedly popularized the fear that the MMR vaccine causes autism. The second most hated vaccine (by antivaxers) is Gardasil or Cervarix,…
A few of the recent pieces I recommend reading: Larissa MacFarquhar in the New Yorker: When Should a Child Be Taken from His Parents? Brian Rinker at STAT: 32 churches and no methadone clinic: struggling with addiction in an opioid ‘treatment desert’ Renee Bracey Sherman in the New York Times: The Right to (Black) Life Brianna Ehley at Politico: ‘I just started flowing. It was the only thing that helped.’In tough neighborhoods, can high-school mental health counselors cut the school-to-prison pipeline? Yamiche Alcindor in the New York Times: In Sweltering South, Climate Change Is Now a…
Someone yesterday was not very happy with my attitude towards naturopaths, as evidenced in my post yesterday about the death of a young woman named Jade Erick due to intravenous infusion of curcumin by—you guessed it—a naturopath. Amusingly, that someone going by the 'nym of JR said that he or she didn't "like the tone of this article and it’s complete disregard for naturopaths." Well, JR, you're right. I do have a complete disregard for naturopaths because they are quacks who mix a small amount of good advice about diet and exercise with a whole lot of pure quackery (like homeopathy) and…
Kim Kelly, ND (Not A Doctor). He prescribed the dose of intravenous turmeric that killed Jade Erick. Finally, a mystery has been solved. Nearly five months ago, a 30 year old woman named Jade Erick suffered a cardiac arrest, most likely due to anaphylactic shock, during the infusion of intravenous curcumin ordered by a California naturopath named Kim Kelly, ND (for Not-a-Doctor). Because Erick's death was so sudden and dramatic, the story briefly made national news. I viewed the tragic incident as yet another example of why "licensed" naturopaths, such as those in California or other…
"In the future, maybe quantum mechanics will teach us something equally chilling about exactly how we exist from moment to moment of what we like to think of as time." -Richard K. Morgan It’s absolutely true that, in quantum mechanics, there are certain pairs of properties that we simply can’t measure simultaneously. Measure the position of an object really well, and its momentum becomes more uncertain. Measure its energy, and its time becomes more uncertain. And measure its voltage, and the free charge becomes more uncertain. Although this is disconcerting to some, it’s a fundamental part of…
Umair Shah’s story isn’t an uncommon one in public health. Starting out in medicine, with a career as an emergency department doctor, he said it quickly became clear that most of what impacts our health happens outside the hospital and in the community. Today, that philosophy drives his work as executive director of Harris County Public Health (HCPH) in Houston, Texas — an agency that serves the third-largest county in the nation, home to about 4.5 million residents. In fact, Shah, who first joined the agency in 2004 and become director in 2013, said the agency’s mantra is this: “Health…
One of the most important responsibilities pediatricians have to assure the health of the children they take care of is to make sure they are vaccinated. Over the last 100 years, childhood mortality has plummeted such that it is no longer common to lose a child (or children) to infectious disease. Indeed, it is now very uncommon, if not rare, to lose a child to the diseases that were the scourges of prior generations of children, largely thanks to vaccination. Diseases like polio, whooping cough, smallpox, diptheria, the measles, and several more, that once were the scourges of children…
One of the gratifying things about having been blogging so long—nearly 13 years now!—is that you start to see stories that you wrote about a long time ago resurface, allowing you to see the resolution. For instance, I've not infrequently written about people who, mistakenly believing the blandishments of alternative medicine practitioners that they could forego all that nasty chemotherapy and radiation and survive their cancer to live a happy, normal life, made the disastrous decision to eschew conventional medical therapy and pursue alternative medicine. My interest in this topic comes from…
I wasn't sure if I should do this post, mainly because I could find so little information to elaborate on a bit of information that I discovered. Then I thought about it a bit more. Perhaps my not being able to find out will illustrate my point better than a detailed progress report on a woman whom I blogged about once nearly 16 months ago. Also, it's a hopeful story. At least I think it is, because it looks as though the young woman at the center of it has abandoned quackery. Basically, this was the story of a young woman with a bad cancer who had eschewed conventional therapy, particularly…
It's been over a month now since I started paying real attention to that wretched celebrity hive of scum and quackery founded by Gwyneth Paltrow known as Goop. It was a long time coming, and I feel a bit guilty for not really paying much attention to the "wellness," "lifestyle," and, of course, expensive quackery being sold by Paltrow and her minions through Goop. It began when Goop caught flack for selling pricey magic energy healing stickers. Well, it wasn't so much for that as much as for the amusing intervention of NASA, which slapped down Goop's claims that these stickers were made with…
As a skeptic, I can't help but taking an interest in conspiracy theories. The reason, of course, is because behind virtually every commonly accepted pseudoscientific and antiscience ideas there is conspiracy theory. For instance, in the case of the antivaccine movement, the conspiracy theory is that some combination of the CDC, big pharma, and the FDA is conspiring to hide the truth—excuse me, The Truth—that vaccines cause autism, brain damage, autimmune disease, diabetes, sudden infant death syndrome, shaken baby syndrome, and whatever other disease, injury, or condition that antivaxers like…
Over the last two or three weeks, you might have noticed a disturbance in the alternative medicine force. Unlike disturbances in the Force in Star Wars movies (which usually result from horrors like the obliteration of millions of lives on Alderaan), this was a joyous, celebratory disturbance in the mystical nonexistent energy fields in which promoters of alternative medicine cancer cures and haters of chemotherapy and "conventional" cancer treatment (the two almost always go together) thought that a major study in a reputable journal had put yet another "final nail in the coffin of…
With the future of the Affordable Care Act still up in the air, most of the news coverage has gone to insurance coverage, premiums and Medicaid. And rightly so. But also included in the massive health reform law were a number of innovative measures to improve the quality and value of the medical care we actually get in the doctor’s office. With repeal still on the table, those measures are at risk too. One of those ACA efforts is the Hospital Readmissions Reduction Program, which reduces Medicare payments to hospitals with relatively high rates of often-preventable hospital readmissions. The…
I've written quite a few times about stem cell quackery. Although I had taken an interest in dubious stem cell treatments before, because I live in the Detroit area, the stories from a couple of years ago about hockey great Gordie Howe's stem cell treatment for his stroke, how it was credulously reported in the media, and how expressing the slightest degree of skepticism about "miracle cure" testimonials like Howe's is not appreciated by the media or patient families because it's interpreted incorrectly as attacking the patient or the family. Basically, people want to believe and don't like…
Here we go again. It's been a while since I've written about the cruel sham that is known as "right to try." Anyone who's been reading this blog a while (or even read the first sentence of this paragraph) knows that I'm not a fan of right-to-try laws. Basically such laws, which have sprung up like kudzu since the movement to pass them gained momentum three years ago, claim to allow terminally ill patients the “right to try” experimental therapeutics. Thus far, they have been sold to the public as giving terminally ill patients “one last shot” and touting how such laws could save some of their…
I have to start this post with a mea culpa, perhaps even a mea maxima culpa. I've been going on and on, in essence gloating about how the antivaccine movement was once again betrayed by Donald Trump. After the betrayal that was the appointment of the ultimate pro-vaccine pharma shill as FDA Commissioner, the second betrayal was the appointment of Dr. Brenda Fitzgerald as the new director of the Centers for Disease Control and Prevention. And, yes, on the surface, Dr. Fitzgerald doesn't appear to be that bad a pick for CDC director. She has a history of being very pro-vaccine during her…
In Cuyahoga County, Ohio, nearly 200 people have died from opioid-related overdoses in the first five months of this year. That means that this one U.S. county is on pace to lose more than 700 people to fatal overdoses by the end of 2017. Terry Allan, health commissioner at the Cuyahoga County Board of Health, and colleagues across the county have spent years building and scaling up a multifaceted response to the opioid addiction and overdose epidemic that includes getting people into treatment, changing clinical prescribing habits, preventing deadly overdoses, and dealing with the often-…
Orac gets fan mail. Yes, as hard as it is to believe, my blog sometimes ticks certain people off, and sometimes I even hear from them. For instance, last week a reader wrote me. The subject header read, "Why do you hate naturopathic physicians so much?" and the letter went something like this (OK, exactly like this other than the name of the reader, which I've withheld, and to whom I will refer as "T"): Having stumbled across one of your diatribes against licensed naturopathic doctors, I can't help but wonder what that profession has done to hurt you? If you have examined the evidence,…
In pseudomedicine, fake diseases predominate. Basically, fake diseases are diseases that do not exist in conventional medicine as diagnostic entities because there does not exist sufficient sufficient evidence to support them as one or there exists compelling evidence that they are not. Naturopaths, for instance, like to diagnose people with "adrenal fatigue," which is one of the prototypical "fake diseases." Basically, it involves a constellation of vague symptoms that may include a combination of several of the following: fatigue, inability to handle stress, cravings for salty foods,…