A fellow medical student once asked me why I thought people become hostile to science-based medicine. Certainly our own failures contribute. When we have no treatments for a disease, or if the treatments themselves may also incur significant morbidity, it is understandable that patients will become disillusioned with what doctors have to offer.
However there is another cause for this hostility towards medicine, and it isn't the occasional crank scibling with an axe to grind against MDs. It's the constant anti-science propaganda being spouted out by the hawkers of alternative medicine.
Orac and others have despaired over the infiltration of woo into mainstream medicine under a banner of tolerance and the noble goal of avoiding confrontation with patients over deeply-held beliefs. However this has proved more and more a tactical error as we've seen that CAM and altie medicine do not seek detente but is at war with legitimate medicine and science itself. Besides the fact that there is no good reason to water down medical school with unproven nonsense and the latest placebo fad being sold by crooks, alternative medicine should not be taught because doing so is not just a failing to meet the barbarians at the gate, but is actively inviting them in to destroy everything we've worked for.
As examples of the despicable attacks on medicine from altie-med practitioners, I say we start with that aggregator of woo-practitioners Natural News. A site started by HIV/AIDS denialist Mike Adams, he features writing from various alties ranging from reiki therapists to naturopaths to chiropractors. What unifies them is their contempt for science-based medicine. Take for instance their attack on science based medicine for the death of former White House Spokesperson Tony Snow and more recently Bernie Mac .
Former White House press secretary Tony Snow died in July 2008 at the age of 53, following a series of chemotherapy treatments for colon cancer. In 2005, Snow had his colon removed and underwent six months of chemotherapy after being diagnosed with colon cancer. Two years later (2007), Snow underwent surgery to remove a growth in his abdominal area, near the site of the original cancer. "This is a very treatable condition," said Dr. Allyson Ocean, a gastrointestinal oncologist at Weill Cornell Medical College. "Many patients, because of the therapies we have, are able to work and live full lives with quality while they're being treated. Anyone who looks at this as a death sentence is wrong." But of course we now know, Dr. Ocean was dead wrong.
The media headlines proclaimed Snow died from colon cancer, although they knew he didn't have a colon anymore. Apparently, the malignant cancer had "returned" (from where?) and "spread" to the liver and elsewhere in his body. In actual fact, the colon surgery severely restricted his normal eliminative functions, thereby overburdening the liver and tissue fluids with toxic waste. The previous series of chemo-treatments inflamed and irreversibly damaged a large number of cells in his body, and also impaired his immune system -- a perfect recipe for growing new cancers. Now unable to heal the causes of the original cancer (in addition to the newly created ones), Snow's body developed new cancers in the liver and other parts of the body.
This is a rather stunning piece of scientific illiteracy in it's own right, without being disgusting for the ghoulish use of this man's death to attack those who were doing the best to keep him alive. We see of course toxin-woo (if anything there are fewer toxins in your body without your colon because the chyme is diverted earlier out into a colostomy), and a complete inability to understand the process of metastasis. The author makes the stunningly ignorant assertion that all the cancers that spread throughout his body were somehow unique and caused by the chemo, when we can use simple histopathology to determine the source of such cancers and we know that such a spread represents metastatic spread from a single source - the colon. Further we know that if cancer has already spread before surgical resection it may not be detectable and appear even after removal of the diseased organ, even if they did indeed resect Snow's entire colon as opposed to performing a hemicolectomy. All this passage does is expose the promoters of this anti-doctor spite for their complete ignorance of even basic biology.
The author goes on to accuse doctors using chemo of committing a criminal offense:
Before committing themselves to being poisoned, cancer patients need to question their doctors and ask them to produce the research or evidence that shrinking a tumor actually translates to any increase in survival. If they tell you that chemotherapy is your best chance of surviving, you will know they are lying or are simply misinformed. As Abel's research clearly demonstrated, there is no such evidence anywhere to be found in the medical literature. Subjecting patients to chemotherapy robs them of a fair chance of finding or responding to a real cure and deserves criminal prosecution.
A pretty stunning statement no? Does anyone want to see some real data on what chemotherapy can do?
The efficacy of cancer treatments has been tracked for decades by the National Cancer institute, and one can see that medical treatments for cancer over the decades have increased the survival rates from cancer, though more modestly than we would like.
Even from this figure though, we see the lie of the writer of this article. Certainly there are cancers we are still incredibly poor at treating. Pancreatic, certain brain cancers, and lung cancer come to mind. But what these cranks represent as our success rate is absurdly low. Further, their general disparaging of chemotherapy as a potentially curative treatment is belied by one of it's greatest successes - that is the incredible cure rates of the so-called liquid tumors, like leukemia and lymphoma. One of my favorite figures is this one from St. Judes showing the success rate of chemotherapy regimens for a childhood leukemia called AML over time:
This chart of 5 year survivals of patients since the 1960s is from this paper from 1993, and I've seen the updated data from St. Jude's researchers showing the most recent 5 year survival rates as high as 95%. To see our therapies which unquestionably are effective in the treatment of deadly diseases be disparaged so dishonestly is understandably upsetting.
It's not just chemotherapy being disparaged though, recently they've chosen to blame us for the death of Bernie Mac as well. Check out this nonsense by Adams himself:
The number of famous people dying at the hands of conventional medical doctors is increasing at an alarming rate. Today comedian Bernie Mac (best known for appearing in Oceans Eleven and The Bernie Mac Show) died following hospitalization and treatment for pneumonia. At the young age of 50, Bernie Mac joins an increasing roster of other notable celebrities who have died while being treated with conventional pharmaceuticals or chemotherapy: Heath Ledger, Peter Jennings, Tim Russert and many more.
The most common treatments for sarcoidosis are dangerous steroids (like Prednisone) or immune system suppressing drugs like Methotrexate. Following his treatment with one or both of these pharmaceuticals, Bernie Mac was described as having his sarcoidosis go into "remission." That's conventional medicine's code word for masking symptoms with dangerous chemicals while ignoring the underlying cause of the disease.
"Sarcoidosis," meanwhile, is just a fancy-sounding name for an out-of-control autoimmune response caused by an imbalanced immune system which is disrupted by dietary imbalances and exposure to toxic chemicals through processed foods, pharmaceuticals, personal care products and other environmental sources (like pesticides or cleaning solvents). Bernie Mac didn't really have sarcoidosis; he was merely given that label by doctors who attached a fancy name to a pattern of symptoms that Bernie Mac expressed.
But doctors never told Bernie Mac this information. They never even gave him the option to be healthy. Doctors are predominantly in the business of causing the deaths of patients through a process of authoritative ignorance -- keeping patients unaware of natural alternatives, and thereby forcing them to rely on toxic treatments that unfortunately harm more people than they help.
Wow. Not only do we get Bernie Mac, we get a whole host of other celebrities who died as well, not from the underlying diseases or cancers, but from medicine itself. But these accusations, besides being absolutely ghoulish are beyond the pale. Not only do we see the denial of legitimate medicine, we see an attack on the science of medicine itself. After all, we are the only ones involved in this fight that consistently document the efficacy of our treatments. As always, if a better treatment exists, we would love for someone to prove it, at which point we'll accept it happily. However, with this vague allusion to "natural" treatments and "nutrition" we see the typical vague refrain of the altie-med crank. No evidence, no proof of anything, just bile being spouted at those who spend their lives trying to use human knowledge for human benefit.
Sarcoidosis is a terrible disease for some folks and I wish modern medicine had better treatments that could cause more than temporary remissions. But one thing is certain, magic diets are not going to cure it. If anything, Adams and his constant harping on vitamin D would kill a sarcoid patient if they ever got their hands on one because if anything such a vitamin excess would cause them a great deal of harm. If they have some knowledge of a sarcoid cure, we'd be thrilled to know about it, and use it, but the fact is, they're spouting their usual arrogant omniscience about some concept of dietary perfection that does not exist.
But to get back to the original point of this post, how can it be that medical schools are increasingly willing to integrate CAM into their curriculum, and medical centers are creating centers for this nonsense when the practitioners of CAM are so hostile to legitimate medicine?
The fact is they are undermining medicine at the same time they seek to be legitimized by it. The prospect of being able to attract more patients and more money by offering access to woo stands at odds with the historical practice of medical professionals of rightly attacking and exposing the snake oil salesmen for what they are - fraudsters. Those that propose cooperating with the enemies of science have lost their way and instead of keeping the barbarians out, and maintaining our grip on reality they have begun to sacrifice their scientific legitimacy and their morals by adopting the religion of these cranks.
1. Rivera, Gaston K., Pinkel, Donald, Simone, Joseph V., Hancock, Michael L., Crist, William M. Treatment of Acute Lymphoblastic Leukemia -- 30 Years' Experience at St. Jude Children's Research Hospital N Engl J Med 1993 329: 1289-1295
If the woo worked, especially if it worked as well as they claim, setting up a double blind trial would be simple and fast. They could use science to prove the scientists wrong. You would think if their "cures" cured they would be publicshed all over The Lancet and New England Journal of Medecine.
Oh, that's right. Science is burying their evidence because it doesn't like competition. Like there isn't a reputible scientist that wouldn't want to be known for finding the cure for "EVERYTHING!" Idiots, that's what the woomeisters are. Greedy, ignorant idiots.
Yeah, the Natural News article blaming chemotherapy for Tony Snow's death was particularly odious and despicable. Mike Adams went so far as to liken Tony Snow to being Hitler's press secretary.
There's a Mike Adams special up there right now blaming modern medicine for Christina Applegate's breast cancer and decrying her decision to have a bilateral mastectomy as her having been duped by those evil doctors. I debated taking that one on. I still might; the burning stupid is just too intense. Maybe Monday, as it would give me the opportunity to do a nice evidence-based assessment of the role of bilateral prophylactic mastectomy in breast cancer.
I remember, after the tragic death of Phil Hartman, that the family of his wife tried suing some pharmaceutical manufacturer(s) or doctors. Apparently his wife had been on some medications prior to her going bonkers and murdering Hartman, so obviously they were to blame!
And, of course, not the tons of booze and pills she had been doing concurrently.
CAM is a trillion dollar industry if you count vitamin supplements into the mix. Until that industry is fully dissected and brought to the same standards as real medicine then the hucksters will have a potent conspiracy theory on their hands. If the goal is make them impotent then you MUST take away the very thing that makes them a compelling story: "traditional medicine" kills people because "they" don't have the courage to investigate anything other than the what the pharmaceutical industry will profit from. I see it analogous to the tendency of ugly girls to form a coalition to verbally attack the prettiest girls in the room behind their backs. This fight is no different. The pretty girls have to make the ugly girls trust them as an ally or suffer their constant conspiring against the pretty ones. Likewise, Abraham Lincoln once said that the best way to get rid of your enemies is to make them your friends.
I know that's a tall order but maybe trying to build an elegant evidence based argument to combat "buring stupid" may be self defeating. I think it's more effective to erode their ability to make compelling stories. Stories are the currency of motivation. People don't get moved by statistics and really killer graphs. The great thing about science is that it is just as much about all the failures as it is about all the successes. Hucksters keep really terrible records about their failures. That's where the benefit of bringing them into medical curriculum becomes paramount: you give them enough rope to hang themselves. Failures will no longer be pushed under the carpet.
Don't embrace the CAM industry but don't dismiss them as cranks because it actually makes them stronger. It gives them a good story. If you really want them to disappear, then kill their story.
What I find particularly revealing (if not particularly surprising) is the fact that the writer diagnosed both Tony Snow and Bernie Mac without (I assume) ever having actually met them. Quite an amazing talent, no? To diagnose at a distance from a press release?
Maybe that's the solution to high health-care costs! Instead of paying for expensive office visits, just get this guy to train doctors how to diagnose from afar. Then I could just email my doctor a press release about my runny nose, and she could tell me I don't actually have allergies, I'm just not eating enough organic food!
Re Dr. Kate
Like Dr. Frist diagnosed Terri Schiavo over the phone from a 10 second video tape without conferring with her physician or examining her medical records.
I would argue that this is not a failing on the part of science to get this information to the public. The efficacy of traditional medicine is all over the news, medical dramas, and in the cases of ones own personal circles. I think the popularity of alternative medicine comes from the distrust not in the science, but in the fear that doctors are self-interested. It's not that the average alternative medicine enthusiast believes the science is wrong, I feel that she believe that the companies who administer that medicine can't be trusted to not give them the most expensive treatments. Sadly, health care reform and offering cheap/free remedies to illness would do more to win back the hearts and minds of the layperson than trotting out more research ever will. Either that or a greatly publicized court case with corrupt acupuncturists and homeopaths being made to pay fines for fleecing the public.
I agree, we need to sop these guys.
The next thing you know we will be using
leeches and maggots .... oh wait .... The AMA and
FDA already cleared those treatments.
Just have to comment on that awkward sentence - it must be difficult to scribble with an ax. And the less I hear about grinding against MDs the better!
One of the worst examples of a celebrity dying needlessly because he delayed seeking help from conventional medicine until it was WAY too late is that of Peter Sellers. There's an account of his tragic and fatal reliance on phony "psychic surgeons" in THE FAITH HEALERS by James Randi. This was mostly avoided in the otherwise interesting movie about Sellers that HBO did with Geoffrey Rush. And of course, the real idiots blame conventional medicine for Sellers' death, but they got him on the operating table after it too much damage had transpired.
Rob K: sadly we have many of the same problems in the UK, our alties generally seem slightly less crazy than yours but that may be due to us having started a little later. They're also having problems in other countries with health care free at the point of use - like the NZ chiropracters' legal kerfuffle. The mistrust of conventional medicine must go deeper than the profit motive because it's not something that most people will ever think about.
I have ME and I've met a lot of people from support groups who've sworn that crazy diets or CAM therapies have cured (well, normally improved) their conditions. I suspect that it's largely because conventional medicine can offer them so little and the CAM merchants have no scruples about offering false hopes. And there's an argument for offering CAM on the NHS as placebo treatment for those who can't be helped any other way. What's despicable is CAM practitioners like those in this post who offer false hope to the dying whilst taking away their chance of genuine recovery, by manipulating them into refusing conventional treatment.
What about John Ritter?
Wow, Charlotte's comment about "CAM merchants have no scruples about offering false hopes," and "CAM practitioners...offer false hope to the dying whilst taking away their chance of genuine recovery, by manipulating them into refusing conventional treatment." I wonder if all those thousands of people who died from taking VIOXX would like to come back and try something ALTERNATIVE instead, ya think? "False hope to the dying?" Isn't that what most toxic chemo drugs and radiation do? "Offer false hope to the dying," because most of them don't recover. A FIVE-YEAR survival rate (usually of extremely poor quality of life - i.e. sick as a dog from the chemo and/or radiation) is not really considered "SURVIVING" and you know it. Many people today are achieving TOTAL REMISSION and complete cures using alternative cancer therapies, and that too, is a known FACT. I have 3 family members, all of whom went through conventional medicine, with oncologists telling them they could cure their cancers, or extend their lives with chemo and radiation. All THREE died just a few months after these "false hopes" treatments were used on them. All THREE went through death before death with all the toxic effects and destruction to their immune system. Don't give me that garbage about the statistics and how many people lived FIVE more years after receiving chemo. Statistics can be manipulated and YOU KNOW IT - to show anything! People die all the time of breast cancer. But they are put on Tamoxifen and the Tamoxifen often causes them to have uterine cancer. Then they die of the uterine cancer, but the statistic will show that the drug helped their BREAST cancer, because it wasn't the BREAST CANCER that killed them, but the uterine cancer - so there goes ONE MORE STATISTIC on the charts to show the patient survived breast cancer (course she's dead from uterine cancer) and what ELSE IS NEW! And you said that "CAM merchants have no scruples about offering false hopes?" REALLY??? Have you ever picked up a recent issue of any popular magazine (i.e. Reader's Digest) and counted the 150 FULL PAGE ads for DRUGS in them? Many of them - drugs with very TOXIC side effects?! What about all the people killed by Baycol, the babies that Propulsid killed, the thousands that died from Vioxx - or all the deaths from Rezulin?! Uh - I don't THINK it was CAM that gave these people false hopes, I do believe, if you do your homework, these were CONVENTIONAL DRUGS. You need to get the rose-colored-drugged-up-pharmaceutical glasses off and take a look at the REAL WORLD! The world of nature and natural products that help heal the body's immunity, instead of killing it!
notiz="Get lost crank"
Rene, do you ever stop to stare at the world and wonder why the rest of the globe (with some exceptions) is passing by the United States? Why we're graduating more foreign science students and engineers than Americans? Why we're falling behind in every single conceivable measure of progress?
I'll give you a really big hint: It's people like you.
You are stupid. I'm sorry, I know it's hard to accept, but you are.
I realize this thread is pretty much dead, but I have to tell you that it is people like you who are creating pretty much every problem in the world right now. If you talk to anyone who actually pays attention to the world and reads from more than biased, equally stupid sources, you would find out how damaging and blindingly stupid you really are.
Well, obviously someone is concerned that I'm smarter than them - considering my entire message was put into text language to make it harder for some people to read. Gee, Damien, I happen to be one of those "science students" that has graduated with two degrees --- I wonder - have YOU? From what I have read about your comments, you are the TOTAL MORON. It is moron's like you who are totally stupid! I know, I'm sorry too - it must be hard to accept, but you truly ARE! There are a lot of idiots in this world who have no idea how pathetically stupid they really are! Sad thing is, they go thru life THINKING they are better than everyone else and DECEIVED into thinking that they are smart, when they are total dumbells.
I speak to a lot of people who "pay attention in the world," some of whom are international reporters - do YOU? You are a poor, sad, pathetic excuse for a human being.
Wow! What an amazing display of the "I Know You Are, But What Am I" ploy, combined with a massive ad hominem dump! Do we have another contender for the Trollympics? Does Chuckles have a stalker? Does the Pope wear a funny hat?
Stay tuned, faithful reader, for more on this exciting new development!
But, LanceR, just LOOK at all those CAPITALIZED WORDS! Surely this is the sign of a SOPHISTICATED, EDUCATED MIND and not an UNHINGED LOONTROLL!
Next you'll be telling me that Reader's Digest (I assume that's what Rene was referring to in the disemvowelled post) isn't a peer-reviewed scientific journal.
ZOMG! Do you mean to tell me that I can't get my SCIENCE news from Reader's Digest?!? But they have such a great reputation! I guess I'll just have to take more CNVNTNL DRGS to sedate myself!!!eleven!!one!
No response from Rene? I guess we don't have a contender for the next Trollympics. <pout>
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