Medicine
oracknows | May 1, 2016If there's one lesson that I like to emphasize while laying down my near-daily dose of Insolence, both Respectful and not-so-Respectful, it's that practicing medicine and surgery is complicated. Part of the reason that it's complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their treatment as well as they can in the context of incomplete information and understanding. The biology of cancer, in particular, can be vexing. Some cancers appear to progress relentlessly, meaning that it's obvious that all of them must be…
oracknows | April 27, 2016I hate these stories, because they so seldom end well. Unfortunately, this one is more messy than even the usual messiness of the typical story of this type. The type of story I’m referring to, of course, is one that I’ve told from time to time ever since near the first year of this blog’s existence, that of the child or teen with cancer who, for whatever reason, refuses curative chemotherapy in favor of some sort of quackery. The litany of names depresses me to contemplate: Katie Wernecke, Abraham Cherrix, Sarah Hershberger, Daniel Hauser, Makayla Sault...the list goes on. In the vast…
oracknows | April 26, 2016About a month and a half ago, I became aware of the case of Ezekiel Stephan, a 19-month-old Canadian toddler living in Alberta who in 2012 developed bacterial meningitis. Unfortunately for Ezekiel, his parents, David and Collet Stephan, were believers in alternative medicine. They didn’t take Ezekiel to a real doctor. Instead, they relied on herbal remedies and consulted a naturopath while their child suffered and died. As a result, they were put on trial for failing to provide the necessaries of life for Ezekiel. During the trial, they raised money by appealing to the worst quacks, claiming…
oracknows | April 24, 2016Arguably, one of the most popular forms of so-called "complementary and alternative medicine" (CAM) being "integrated" with real medicine by those who label their specialty "integrative medicine" is acupuncture. It's particularly popular in academic medical centers as a subject of what I like to refer to as "quackademic medicine"; that is, the study of pseudoscience and quackery as though it were real medicine. Consider this. It's very difficult to find academic medical centers that will proclaim that they offer, for example, The One Quackery To Rule Them All (homeopathy). True, a lot of…
oracknows | April 21, 2016I heard the news yesterday morning.
I was in clinic seeing patients. It was a bit of a slow morning; there was time between patients. So I spent it, as is my wont when clinic is a bit slow, signing charts (OK, signing off on charts in the electronic medical record; I haven’t actually physically signed a chart in a while) and idly checking Facebook and Twitter when finished with that. Then I saw it: Authorities Respond to a Medical Call at Paisley Park, with a comment that Prince was dead. I read the article; it said that someone had been found dead at Prince’s estate in Minneapolis and that…
oracknows | April 13, 2016Of all the forms of quackery that have been “integrated” into medicine of late, arguably one of the most popular is acupuncture. It’s offered in fertility clinics. It’s offered in hospitals and medical clinics all over the place. The vast majority of academic medical centers that have embraced quackademic medicine offer acupuncture. (Quackademic medicine, for those not familiar with the term we reserve for the study of alternative medicine in academic medical centers that really should recognize it as quackery.) Hell, quite a few that haven’t embraced quackademic medicine offer acupuncture.…
oracknows | April 5, 2016If there's one thing that really animates me and angers me, it's the unnecessary death of a child due to quackery. Competent adults, of course, are perfectly free to choose any form of quackery they wish for themselves or even to refuse treatment at all (which is less harmful than quackery). Children, on the other hand, must trust that their parents or guardians will act in their best interests. When they betray that trust and their duty to act in the best interests of the child, I wonder how this can happen. When there the government sides with the parents, I become even more agitated.
So it…
oracknows | March 30, 2016And now for something completely different.
Yes, it's about time for that, isn't it? I've probably beat the Tribeca Film Festival story into the ground, even for me, having spent the last week blogging about it. Scratch that. There's no "probably" about it.
I frequently write at length about the quackery that is homeopathy. One reason I do this is because it is one of the most perfect forms fo quackery there is. There is about as close to no chance that it could work as there can be, and the only reason I don't call homeopathy completely impossible is because I have a hard time calling…
oracknows | March 25, 2016After a trilogy of posts on the lamentably bad decision on the part of the Tribeca Film Festival to screen a pseudoscience- and misinformation-filled documentary by hero to the antivaccine movement, Andrew Wakefield, that is basically one long conspiracy theory, I thought it was time for a change. I had briefly toyed with the idea of having some fun with the flying monkeys (a.k.a. antivaccine commenters) who've descended upon the Tribeca Film Festival entry for the documentary, but, as of this writing, the total number of comments is over 1,700 and it wouldn't surprise me if it were over 2,…
oracknows | March 20, 2016One of my favorite topics to blog about over the last six or seven years has been the topic of overdiagnosis and overtreatment. These are two interrelated phenomena that most people are blissfully unaware of. Unfortunately, I'd also say that the majority of physicians are only marginally more aware than the public about these confounders of screening programs, if even that.
Overdiagnosis has long been appreciated to be a major impediment to translating programs to screen for disease into better outcomes in a number of diseases but has only recently really seeped into the public consciousness…
kkrisberg | March 16, 2016At Vox, Sarah Kliff writes about the side of medical errors we rarely hear about — the doctors and nurses who make such errors and the mental health toll of living with that responsibility. In an article that explores whether health care workers are getting the support they need to deal with such experiences, Kliff begins with the story of nurse Kim Hiatt:
Kim Hiatt had worked as a nurse for 24 years when she made her first medical error: She gave a frail infant 10 times the recommended dosage of a medication. The baby died five days later.
Hiatt's mistake was an unnecessary tragedy. But what…
oracknows | March 13, 2016One of the most pernicious lies promoted by the antivaccine movement is a trope that I've labeled the "toxins gambit." Basically, it's the lie, oft repeated in hysterical terms, that there are all sorts of horrible toxic chemicals in vaccines, and it is those toxic substances that are responsible for the claimed adverse effects of vaccines. Now, it is true that there are substances in vaccines that can be toxic, but the toxins gambit completely ignores a little thing known as the dose-response curve or, if you want to go hundreds of years back in time, the admonition attributed to Paracelsus…
oracknows | March 11, 2016A couple of days ago, I wrote about a story of a sort that I've had to write about far too many times over the last eleven years. I wrote about the death of a child—but not just any death of a child, the death of a child who could have—should have—lived. The child's name was Ezekiel Stephan, and his parents are David and Collet Stephan. The reason that child should have lived is because he suffered from a disease that medicine can treat, meningitis. Unfortunately, his parents didn't take him to a real doctor. They took him to a naturopath, who recommended maple syrup, juice with frozen…
oracknows | March 4, 2016Acupuncture is quackery.
As with naturopathy (a medical pseudo-"specialty" that embraces acupuncture and other so-called traditional Chinese medicine), when I write about acupuncture I like to start out with a provocative statement, a statement of—dare I say it?—judgment in order to shock new readers and let them know exactly where I'm coming from. Why I consider acupuncture to be quackery now, after years of not being sure, is simple and well documented in many posts on this blog. (Just type "acupuncture" into the search box if you don't believe me; here's an example.) Basically, I started…
oracknows | February 23, 2016I didn't think I'd be writing about Stanislaw Burzynski again so soon, but to my surprise a very good article in Newsweek describing cancer quack Stanislaw Burzynski popped up in my Google Alerts yesterday. I hadn't expected much in the way of news coverage about Burzynski for several months, given that the second half of Burzynski's trial before the Texas Medical Board had been delayed by his having suffered a heart attack and isn't expected to begin again for several months. Entitled Cancer "visionary" Stanislaw Burzynski stands trial for unprecedented medical malfeasance and by Tamar…
oracknows | February 12, 2016Ever since the beginning of this blog, there's one topic I've explored many, many times, mainly because of its direct relationship to my profession as a cancer surgeon. That topic is, of course, the question of why people fall for alternative medicine cancer "cures." It started with one of my very earliest posts and continued right up to deconstructing Presidential candidate Ben Carson's very own alternative medicine cancer cure testimonial last fall. It continues again now.
Regular readers, particularly long time readers, have already come to recognize common themes in these alternative…
oracknows | February 8, 2016Katie May was a model, and by all accounts a very successful one, having appeared in Playboy, Sports Illustrated, and other magazines and websites. Self-proclaimed the "Queen of Snapchat," she also had nearly two million Instagram followers and was a major social media force, having recently parlayed her modeling and social media career into becoming an entrepreneur. She also died unexpectedly on Thursday night at the too-young age of 34, leaving behind a seven-year-old daughter. What makes May's tragic death an appropriate topic for this blog is not so much her young age but rather the…
kkrisberg | February 5, 2016For public health workers, it’s no surprise that social, economic and political conditions shape the distribution and burden of disease. They’ve always known that it takes much more than medicine to keep people healthy. Still, when public health scientist Kristina Talbert-Slagle decided to study the impact of social and public health spending on HIV/AIDS, she wasn’t sure what she’d uncover.
“We thought that maybe there would be a connection, but we didn’t really know what to expect,” said Talbert-Slagle, a senior scientific officer at the Yale Global Health Leadership Institute and a lecturer…
oracknows | February 4, 2016It's an oft-stated cliche that our children our our future. That's the reason stories involving dire threats to children are considered so terrifying. It's why, for instance, Arthur C. Clarke's Childhood's End resonated so creepily. After all, as part of the end of civilization, a frightening change came over the children, who became far superior in abilities and mental power to their parents. Another example includes Greg Bear's Darwin's Radio, whose plot involves the human race being plagued by a new disease called "Herod's Flu," which causes pregnant women to spontaneously abort their…
oracknows | January 20, 2016I like to say that homeopathy is The One Quackery To Rule Them All (although of late I've debated whether homeopathy or reiki is the most properly referred to as that). It's a strange beast, homeopathy. Its two main "Laws" are so clearly pseudoscience that you'd think that no one could ever fall for something that dumb, but, well over 200 years after Samuel Hahnemann pulled those two Laws out of his nether regions, not only is homeopathy still popular in large swaths of the developed world, but there are actual physicians who use it.
Just consider homeopathy's laws. The first is the Law of…