Medscape enables functional medicine quackery

It’s no secret that I’m not exactly a fan of Dr. Mark Hyman he of the “Ultrawellness” medical empire and arguably the foremost promoter of the “subspecialty” (if you will) of “integrative medicine” known as functional medicine. Integrative medicine, as I’ve told you time and time again, is a specialty dedicated to “integrating” alternative medicine into conventional science-based medicine; i.e., integrating quackery into medicine. One very prominent, very common strain of integrative medicine is known as functional medicine, and Mark Hyman is, although not its originator, its current main guru. I first encountered him back when he was known primarily for his UltraWellness Center, which he still runs. Given his background, I was disappointed to see Medscape doing a three part interview with Dr. Hyman, “The New, Old World of Functional Medicine” (Part 1, Part 2, and Part 3). Reading Hyman’s blather, as you might imagine, can’t help but attract the attention of this blinky box of lights.

When I first encountered Hyman, lo those several years ago, it was because he had drawn my attention by busily mangling autism science, cancer biology, and systems biology in the service of woo and arguing that we should turn back the clock and rely on anecdote-based medicine instead of evidence-based medicine. These days, he’s head honcho at a new functional medicine clinic at the Cleveland Clinic, which, unfortunately, appears to be a wildly successful. He’s even been counseling Bill and Hillary Clinton about their health and, should Clinton be elected, be an influential advisor on health issues. Unfortunately, the alternative, Donald Trump, is far worse, given his hard core antivaccine beliefs and all his other baggage and vile behavior. Unfortunately, Hyman also shares some of those antivaccine views, having co-authored an antivaccine book with Robert F. Kennedy, Jr. and appeared on The Dr. Oz Show to help him promote it.

Functional medicine, of course, is quackery. It’s actually one of the harder forms of quackery to explain, for the simple reason that functional medicine practitioners sure sound science-y. They do lots of lab tests—lots of lab tests!—and act on them all, replenishing nutrients, trace elements, and vitamins whether it’s necessary or not and “personalizing” treatments based on the “biochemical individuality” of each individual. Of course, as I like to say, this appeal to “biochemical individuality” is functional medicine’s “get out of jail free” card for basically anything its practitioners want to do. They can always find ways to justify any form of treatment, be it science-based or quackery, simply by invoking the “biochemical individuality” of each human being. The problem is this. Human beings are individuals, and each human being is unique. There’s no denying that. However, we’re not so unique that our bodies don’t all work pretty much the same way. In other words, in terms of biology, physiology, and yes, systems biology, human beings are far more alike than they are different. If that weren’t the case, modern medicine, developed before we had the tools to probe our genetic individuality, wouldn’t work as well as it does. FM fetishizes “biochemical individuality,” not so much because humans are so incredibly different that each one absolutely has to have a markedly different treatment. We’re not. FM fetishizes “individuality” because it distinguishes FM as a brand from science-based medicine and, I suspect, because it makes FM practitioners feel good, like “total” doctors never at a loss for an explanation for a patient’s symptoms or clinical condition. As for the last bit about FM being a “science-using” profession, I like to say that FM “uses” science the same way that an illusionist or magician uses misdirection: So that the audience can’t see how he pulls off his trick. That’s the short version. The long version is that functional medicine is making it up as you go along.

In fact, one of the things about functional medicine that I never understood is why it's so popular with those drawn to "complementary and alternative medicine" (CAM) or, as it's now called "integrative medicine." People drawn to CAM tend to be interested in more "natural" medical treatments and suspicious of conventional medicine. Yet, from my perspective, functional medicine takes one of worst aspects of conventional medicine, namely its tendency towards overtesting, and puts it on steroids, leading to overtesting to the Nth degree. Just go back and reread my post about the functional medicine case report of a woman with breast cancer. The functional medicine doctors who treated that woman ordered a dizzying array of unnecessary and unhelpful laboratory tests and put her on a boatload of supplements, nearly all unnecessary. The only things the functional medicine doctors suggested that might have helped the patient were exercise, a personal care giver, counseling, and perhaps her sleep log to help her get enough sleep. So, basically functional medicine combines one of the worst aspects of conventional medicine (the tendency to test every lab value under the sun), cranks it to orders of magnitude worse, and then adds woo. Maybe it's the woo that attracts patients, with the lab testing that leads them to thinking that the functional medicine doctors know what they are talking about when they extrapolate from basic science to think that measuring these markers gives them any guidance whatsoever about how to manage their patients' problems, not realizing that they're basically doing the equivalent of reading the entrails of goats, given that there are no high quality data that clearly tell doctors what to do with many of the lab test values they order.

So why was Medscape interviewing Dr. Hyman? Who knows what got into Dr Hansa Bhargava, medical editor for Medscape and WebMD? Whatever it was, she for some reason thought that a fawning interview with one of the foremost practitioners of quackademic medicine was a good idea, thus lowering Medscape still farther in my estimation. One thing I found interesting that I didn’t know about Hyman before was the circumstance of his conversion to functional medicine, which he relates in Part 1 of the interview. Basically, he started out as a family doctor in a small town in Idaho, after which he worked as an ER doc in Massachusetts for a while. Then he became medical director at Canyon Ranch in Lennox, which explains a lot, because Canyon Ranch is a resort and spa catering to well-off executives with wellness programs (at only $5,575 for a four day stay or $4,355 for a two day stay) and weight loss programs. Hyman’s evolution into an “integrative medicine” practitioner and the foremost practitioner of “functional medicine” is making a lot more sense in light of this revelation (to me, at least). This story also tells me a lot:

Right after I started at Canyon Ranch, I became quite ill. I had chronic fatigue syndrome. My whole system broke down: My muscle enzymes were elevated with creatine phosphokinase levels over 600. I had a positive anti-nuclear antibody, a low white blood cell count, elevated liver function tests, and severe cognitive dysfunction. I had myalgia, weakness, rashes, sores on my tongue, and severe diarrhea for years. My whole system just collapsed. I went from physician to physician, to Harvard and Columbia, and more. But I got no answers other than to take antidepressants or sleeping pills.

I began to search for other ways to understand what was happening. I knew it wasn't in my head. I finally discovered that after living in China for a year I had gotten mercury poisoning.

I learned through this process that there was a whole new field of thinking that had a systems-biology view of medicine. It addressed the root causes of disease—not just symptoms but also etiology. It's medicine by cause, not just symptoms. It's medicine by understanding mechanisms, not just geography, or where the symptom or pathology exists. It was a whole new operating system for understanding how to diagnose and treat chronic disease.

So I started practicing functional medicine at Canyon Ranch and healing myself. I started seeing extraordinary results with patients and myself. I joined the faculty and eventually became the chairman of the board of the Institute for Functional Medicine, which trains physicians and other healthcare providers in functional medicine, a powerful systems-based model that takes our observations of the root causes of disease and our biological networks, and integrates them into a framework for clinical application.

Systems biology. You keep using that term. I do not think it means what you think it means. Hyman has already shown that his understanding of systems biology is what I would consider less than optimal. Particularly annoying is how Hyman seems to think that, before functional medicine, no one ever thought of cancer as a systemic disease or wondered about the microenvironment of the tissues in which cancers form and grow. He is also very sloppy about citing studies to support his point of view.

Be that as it may, Hyman had some sort of mysterious illness that may or may not have been fibromyalgia, and it changed him, activating a latent tendency towards embracing pseudomedicine. Obviously that tendency was already there, or he probably wouldn’t have taken the position of medical director of a spa for executives. Characteristic of functional medicine is a rather large dollop of arrogance, as though functional medicine were something amazingly new and different that we hidebound physicians could never have thought of and only enlightened innovators like Dr. Hyman can appreciate. It’s utter nonsense, of course, but get a load of Part 2 of the interview if you want to see more annoying stuff. Dr. Bhargava basically launches a really slow pitch softball question with a huge high arc right over the plate. Not surprisingly, Hyman easily hits it deep. What’s really irritating is how he does that. As usual, he denigrates conventional medicine as not looking at the whole picture and, in contrast, paints functional medicine as considering things that conventional medicine fail to consider. Of course, there’s a reason why evidence-based medicine doesn’t do what functional medicine does; it’s because it’s not evidence-based. None of this stops Hyman, of course:

But in conventional thinking, the end stop is the differential diagnosis, which we all learned in medical school. That's usually the end of our thinking. Once we've made the differential diagnosis and we have the diagnosis, we know what to do. We pick up the Washington Manual of Medical Therapeutics for residents. We have the standard of care. It's not that complicated. Once you make the diagnosis, you know what the treatment is, right?

In functional medicine, the diagnosis is the place where we start to think. It's not the end of our thinking. In traditional medicine, it's the naming and blaming game. We name the disease and blame the name for the problem, and then we tame it with a drug. Let's take depression, for example. Someone comes in, and they're hopeless and helpless. They're sad. They have no interest in life. They have no appetite. They're not sleeping. They have thoughts of suicide. You say, "I know what's wrong with you. You have depression." Depression isn't the cause of those symptoms. It's the name of those symptoms. Then, we ask, "What's the cause of those symptoms?"

Arrgh!

Hyman no more knows the cause of depression any better than his portrait of conventional medicine’s understanding. Don’t believe me? See what he says next:

Well, there may be dozens of causes of depression, right? It could be psychosocial trauma, early life experiences, or Hashimoto thyroiditis, an autoimmune disease that leads to low thyroid function and is caused by eating gluten, which creates an autoimmune thyroid disease. The depression could be because you have been taking a proton-pump inhibitor for 10 years and you have vitamin B12 deficiency, or because you live in the Northeast and you have vitamin D deficiency, or because you have taken antibiotics that altered your gut flora, or because you love sushi and you're eating sushi all the time and you have mercury poisoning, or maybe you hate fish and have omega-3 fatty acid deficiency, or maybe you're insulin resistant and love cinnamon buns and have prediabetes. All of those can cause depression. So it's a methodology for sorting through the root causes and the things that are driving it and then addressing those.

Wait, what? Hyman is basically saying that conventional doctors who treat depression, like primary care doctors and psychiatrists, don’t look at thyroid function and psychosocial trauma. (Hint: They do.) In fact, what Dr. Hyman is doing is touting how functional medicine does what medicine does. Basically, he’s constructing a differential diagnosis. Let’s say a patient comes into your office with symptoms of depression. You evaluate him, and he fits the DSM-V criteria for depression. Now what? You have to see if this patient has any known causes of depression, such as, yes, thyroid disease, psychosocial trauma, genetics, nutritional deficiencies, endocrine disorders, lupus, and several others. Unfortunately, Hyman doesn’t stop there. Functional medicine considers all the known science-based causes of depression and then adds pseudoscience, such as the “mercury poisoning” from sushi, plus the usual panoply of lab abnormalities from the extensive lab panels that functional medicine demands. The other problem is that, while a lot of conditions are associated with depression, the causative relationship is not always clear. For instance, diabetes and prediabetes are indeed associated with depression, with diabetics being at a higher risk of depression, but that doesn’t mean that diabetes necessarily causes depression. Basically, Hyman exhibits a whole lot of hubris by asserting that functional medicine does so much better than conventional medicine in examining the causes of depression.

It’s a hubris that extends into Part 3:

I studied Chinese in medical school and learned about Chinese traditional healing systems. I've had much acupuncture in my life. In fact, it cured me of chronic pain that I had from back surgery. I do use other alternative modalities all the time as an adjunct to support my health.

But, when you use other modalities, how do you use them? When do you use the modalities? What is the diagnostic map? If you have migraines and you go to a group of integrative medicine doctors, one might say that you have a dosha imbalance, that maybe your vata/pitta is out of balance. An acupuncturist might say that your kidney chi is not right. The psychologist is going to say that maybe you're stressed and you should get therapy. The biofeedback person will say you need biofeedback. The herbalist is going to tell you to take feverfew.

In functional medicine, we don't do that. We ask, "Why are you having a migraine? What's the cause of your migraine?" If the cause of your migraine is that you're eating gluten, all these modalities are not going to help. We have a simple rule: If you're standing on a tack, it takes a lot of aspirin to feel better. You need to take out the tack. If you're standing on two tacks, taking one out isn't going to make you 50% better. You need to get rid of all the causes.

Give me a friggin’ break. This is nothing but more hubris. Basically, what functional medicine really does is to run every lab test under the sun and try to correct abnormal values. This is what Hyman refers to elsewhere in his interview as “the original precision medicine,” an assertion that made me want to head to our liquor cabinet and open up a bottle of scotch. Fortunately, I resisted. It was, after all, a work night when I wrote this. Otherwise, I might have had a more violent reaction to this:

I think the concept of precision medicine is fantastic. It is in alignment with functional medicine. In fact, functional medicine is the first application of precision medicine.

I get concerned about this getting coopted by pharma as being about pharmacogenomics. Precision medicine is how we match the drugs to the person. We know that if you have a 2C19 polymorphism, then maybe you should be adjusting your warfarin differently. Fertility doctors will check methylated SNPs, MTHFR. If you have a methylated SNP, you might need methylated folate or a higher dose. These are more personalized drug therapies as opposed to a holistic systems approach.

I think we have to be careful with it. It's really looking at more of a Leroy Hood model in systems biology, what he calls P4 medicine: personalized, preventive, predictive, and participatory. That's essentially what we do in functional medicine.

I do so find a lot of amusement in how Hyman loves to invoke systems biology without having the slightest clue what systems biology actually is or entails. Oh, and I have observed Leroy Hood for many years. Mark Hyman is no Leroy Hood. he’s also rather obvious:

Dr Bhargava: Now I'm going to take the lens of the skeptics. You have probably seen their websites.

Dr Hyman: I've seen them all. Have you looked at their credentials? They're usually shills for pharma. I'm saying things that are not popular.

Ah, yes. The pharma shill gambit. If there’s one thing I know, it’s this. Whenever someone tries to dismiss his critics as “pharma shills,” I know that that person has nothing else. The same is true here. Notice how Hyman just dismisses his critics as “pharma shills.” There are no details. There’s no actual evidence presented that any of them are, in fact, in the pay of big pharma. He just seems to think that saying “pharma shill” is enough. To his incredible shame, Dr Bhargava lets Hyman’s use of the “pharma shill gambit” pass unchallenged. Pathetic. Even if Dr. Bhargava were sympathetic to the quackery that Hyman was laying down, it’s an utter, shameful failure in his role as medical editor for Medscape and WebMD to have allowed Hyman to make such statements completely unchallenged.

What this interview tells me, more than anything else, is that the medical editor of Medscape and WebMD is not only clueless about what “functional medicine” is but that he is more than willing to let someone like Dr. Hyman spout self-aggrandizing pseudoscientific bullshit unchallenged. That is the deficiency among those of us who are ostensibly defending evidence- and science-based medicine. We are not willing to call quackery when we see it. Quacks who can talk the talk and seem to be practicing evidence-based medicine are the beneficiaries of this reluctance.

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I finally discovered that after living in China for a year I had gotten mercury poisoning

Yes, Mark, but that's just the symptom. What was the real cause of getting mercury poisoning?

A billion people live in China without getting mercury poisoning. I cannot help wondering what is so special about this snowflake that made him so uniquely sensitive to the toxic environment.

By herr doktor bimler (not verified) on 14 Oct 2016 #permalink

FWIW, I have not been able to stand reading anything on Medscape for a few years now. The quality of articles there is brutally poor, and it all seems very agenda-driven. To what end, I'm not sure, but too often they start with a conclusion and fill in the rest of the story to match.

By Dr. Chim Richalds (not verified) on 14 Oct 2016 #permalink

"Functional medicine seeks to improve the quality of life for people" Yes, the people who practice it.

Never under-estimate the power of click-bait articles to help raise advertising funds. Sucks that Medscape is following that trend, but it is happening on most sites.

I'm still waiting to see what Doc Hymen does that is so different from any real doctor. You see doctor with problem, doctor runs tests to figure out what the problem is, doctor prescribes fix for problem, you go home healthier if not happier. Doc Hymen just figures he has to pad his bill a lot with irrelevancies. My issue is with the too human frailties arising in doctor's that causes some to do a half-ass job of diagnosis, but that is irrelevant to this topic.

By Anonymous Pseudonym (not verified) on 14 Oct 2016 #permalink

Oh, Medscape. I ended up putting them into my Spam folder, because most of their articles are just click-bait. Very rarely have I gotten anything of interest from them any more.

As for Dr Hyman: sorry, doc. When I'm depressed, I want a doctor who looks at the normal causes and treats me appropriately, not go running off looking for zebras in the underbrush and making me pay tons out of pocket.

you’re eating sushi all the time and you have mercury poisoning

Sounds reasonable to me (if you live in Grassy Narrows).

@ 1 herr doktor bimler

Clearly Japan has a more serious mercury poisoning problem than we realized.

By jrkrideau (not verified) on 14 Oct 2016 #permalink

I like preceding functional medicine with an article about overdiagnosis. Functional medicine is overdiagnosis raised to a power.

By Juice Box (not verified) on 14 Oct 2016 #permalink

Yep. Now that you mention it, maybe I should have said that in my article. Maybe I will add it somewhere later... :-)

Pharma Shill? PHARMA SHILL??? Argh. Grifter Mark Hyman calling anyone a Pharma Shill is just rich. Nothing more than vile, disingenuous projection.

He's one of the biggest affiliate marketing scammers out there. He's involved in a large network of incestuous cross-promoting scammers that includes Ty Bollinger with his uberscam "The Truth About Cancer," Mercola, Mike Adams' Natural News, HealthTalksOnline health "summits," Sayer Ji's GreenmedInfo, Frank Lipman, Life Extension, Dr Axe, Dr Mark Sircus, David Avocado Wolfe, Hay House, etc.

These predators seem to have quite a lucrative scam going, promoting each other and paying/collecting commissions for doing so. For example, Ty Bollinger alone brags about having paid out over $8 MILLION in commissions for marketing his own brand of cancer quackery (and he's working on an antivax version now).

It's a dishonest and underhanded system that amplifies every kind of snake oil there is, and their pervasive advertising ensures that it reaches more and more consumers/victims.

It makes me sick to my stomach.

Hyman's involved with Ty Bollinger, Joe Mercola, and Mike Adams, etc.? Do tell...

Did he mention the chemtrails?

I don't think the lab tests are what draw patients to functional medicine. I think it is the idea of "biochemical individuality". I feel like a lot of people who are drawn to woo and all of its affiliates have what I think of as "Special Snowflake Syndrome" where they truly believe that they are somehow SO different from everybody else, and need the most special attention because they are the most special people. I'm sure they would not describe themselves this way, but that is my impression of people who get into this stuff. They are also the people who believe they are so smart and special that they know more than an MD and are oh-so-certain that their MD just doesn't understand how very, very special they are. Give me a freaking break.

By Missylulu (not verified) on 14 Oct 2016 #permalink

@#1 herr doktor: I want to know how functional medicine cured his mercury poisoning. He makes a huge leap between the supposed cause of his symptoms and goes right into the functional medicine blather but he doesn't actually tell us how he got better . . . . or IF he got better.

I am also a bit annoyed with what he has to say about migraines. Sure SOME people have food triggers. But to know that you have to keep a migraine diary.

MY trigger is the weather. So what does he want me to do, move to the International Space Station? Even if NASA would allow it, that's a bit drastic. I'm still going to need Excedrin, and even then there are just some days (like the past three) where I just have to suffer.

@#5 MI Dawn: some articles are OK. Some are even peer reviewed articles they republish. But oh yeah, there is so much woo and the quacks come out of the closet every time a USPSTF recommendation or a vaccine article is published. I blush with shame at some of the things my fellow nurses will say (assuming they are actual nurses, but unfortunately I know far too many RNs who buy into the BS).

Ugh, I now have some residual guilt about my comment. I feel bad characterizing an. Entire group of people that way, as I'm sure many people are simply duped by the incredinly convincing and entirely subversive fake medical jargon spouted by woo-peddlers. Lots of people are being taken advantage of which is heartbreaking, but there is no shortage of willfully ignorant f***s loafing about among the people who are truly being taken advantage of.

By Missylulu (not verified) on 14 Oct 2016 #permalink

They do lots of lab tests—lots of lab tests!—and act on them all

Sounds like cargo cult science to me. Richard Feynman had some choice words about it in his 1974 commencement address at Caltech. (The speech even includes some forms of quackery that RI readers will have heard of.) They are adopting the forms of science-based medicine, but it isn't making people well (beyond the placebo effect), any more than the simulated airfields of the post-WWII cargo cultists in the South Pacific attracted planes full of cargo.

By Eric Lund (not verified) on 14 Oct 2016 #permalink

@ Panacea

he doesn’t actually tell us how he got better

For some reason, I am now picturing Hyman claiming he was changed into a newt.

By Helianthus (not verified) on 14 Oct 2016 #permalink

What caused his mercury poisoning? Almost certainly methylation of one or more of the genes for enzymes of the mitochondrial metal transporter (MMT) family. Obviously, this would cause accumulation of toxic metals in his mitochondria -- the powerhouses of the cell -- leading to his chronic fatigue syndrome.

By Mark Thorson (not verified) on 14 Oct 2016 #permalink

One of many examples: http://naturalmedicinesummit.com/
This is just one of the many health "summits" and network affiliate gigs. Each of the "experts" joins the ring of cross promotion and promotes the hell out of it with their bogus blogs, tweets, FB posts, etc. IMO, it's why we're bombarded with stupid memes and scammy vapid nonsense in pretty pictures from eg. David Wolfe, Kristie Leong, Razi Berry, Naturopath News, etc. And advertising works.

HealthTalksOnline is just one of them, but it's a very typical MLM-esque example of the Circle of Woo affiliate programs they all have: "Affiliates receive a unique link to promote our events to their fans and followers. There is no cost to be an affiliate.
Promotion might include emails, blog posts, social media posts, radio shows, podcasts, news articles and more! When someone who clicked an affiliate’s link makes a purchase, we credit a commission to your affiliate account!"
"An effective way to generate commissions and reach more people, is to register other affiliates! When someone makes a purchase from an affiliate that you registered, you will receive a bonus 10% commission on that sale."

Could be mere coincidence, but see also Evolution of Medicine's (EOM) inner circle "Practice Accelerator" affiliate program, which happens to be celebrating a big launch this month, with promises to "pay affiliates a 33% commission on the Practice Accelerator Product, along with a 10% commission on any upsells during the launch."

"Hashimoto thyroiditis, an autoimmune disease that leads to low thyroid function and is caused by eating gluten"

Listen, I am not, and will never be a doctor, but I do have Hashimotos, and I have never, in my 3 years if life had it attributed to gluten. Is thus actually the case? Cause it sounds fake and woo-y.

I mean, yeah, his whole interview is just awful, completely awful, but this stuck out to me.

"FM fetishizes “individuality” because it distinguishes FM as a brand from science-based medicine and, I suspect, because it makes FM practitioners feel good, like “total” doctors never at a loss for an explanation for a patient’s symptoms or clinical condition."

Of course, mainstream clinics and practices also promote the idea that they alone see the patient as super-individual, a tactic used to bolster their income.

Our local academic medical centers trumpets in its ads "there is no routine cancer", as though everyone else just leafs through the Washington Manual and plugs everyone into a single standard course of therapy.

Hyman: "In traditional medicine, it’s the naming and blaming game. We name the disease and blame the name for the problem, and then we tame it with a drug."

I'd argue that commonly in functional medicine and other brands of woo, it's name the disease (often erroneously) and then blame the patient for the problem. You ate the wrong things, exposed yourself to toxins, weren't optimistic/spiritual enough, and let Conventional Medicine ruin your system, thus it's your fault for being sick.

By Dangerous Bacon (not verified) on 14 Oct 2016 #permalink

It is odd to peruse Dr. Bhargava's LinkedIn. On the one hand, she wrote a nice article called "Why I Vaccinate My Children". But on the other hand, she's already listed this embarrassing interview with an anti-vaccine quack as an accomplishment:

In a more journalistic area, she has participated in a panel with and interviewed the First Lady, Michelle Obama as well as the current and past AAP Presidents, the CEO of UNICEF Caryl Stern and CDC director Dr Tom Frieden at CDC. Most recently she reviewed President Clinton's physician and Director of Functional Medicine for the Cleveland Clinic, Dr Mark Hyman.

I also wonder why doctors like Hyman spend time touting their genius in videos on talks. When do you think the last time he was responsible for a hospitalized patient? Or saw a patient in the ER? Or worked late at night? Or on a weekend?

Real doctors test their medical skills daily with sick people. Quacks like Hyman make YouTube videos promoting their skills, but will *never* be in the hospital when people are really sick.

Yep, his supplements are affiliate network-marketed too, eg. PureFormulas (Metagenics, Thorne, etc)
Affiliate Program Details:
•Up to 8% Affiliate Payout (coupon based payout is 4%)
•$65 Average Order Size
•48% Conversion Rate
•NOW MOBILE ENABLED!

It's not about the patients or about health at all. It's ALL about the marketing potential.

@Panacea, I present for your examination, the case of two RN's, who attended all of the same classes at Widner University's school of nursing, graduating in the same class.
One is vehemently antivax, the other, our eldest daughter, evidence based and pro-vaccine.
Go figure.

As for the quack's cure from "mercury poisoning", somehow, I'm willing to bet his cure included removing gluten from his diet.
That's one of the biggest flags around, when random disease X suddenly gets linked by the quack to gluten.
As one who has friends who suffer from celiac disease, those kinds of claims make me grind my teeth.

Now, to poll the house to see if anyone else is interested in an eggplant lasagna. I substitute out the ricotta cheese with tofu and parmesan cheese mixture. It picks up my home made sauce flavor, while not being gritty, it's creamy instead.
Yeah, I'm also a reformed chef as well. :)

" I had... severe cognitive dysfunction" Dr MH

I just HAD to!

But more seriously, I can understand** why people who experience puzzling symptoms and don't get relief easily can fall into the woo- bucket.
Even ( I venture) smart people like Hyman.

Of course, why not take your situation and market the possibilities?

** as someone who is suffering from an injury that has limited some of my activities and re-appears sporadically out of nowhere
.
Fortunately, I found myself intriguing additional work.
I like to tell myself that perhaps the Universe was 'trying to tell me something' so that I would change or suchlike ( not that I really believe that).

Not that I would market anything.

By Denice Walter (not verified) on 14 Oct 2016 #permalink

" ...you're eating sushi all the time and you have mercury poisoning"

If so, you're eating in the WRONG places.

By Denice Walter (not verified) on 14 Oct 2016 #permalink

affiliate network-marketed

This is the polite term for organizations that resemble Ponzi schemes but manage to stay within the letter of the law because they deliver an actual product. Amway is the most (in)famous example, but we have seen other supplement marketing outfits with this kind of corporate organization.

By Eric Lund (not verified) on 14 Oct 2016 #permalink

OT but

it's late, there are already many comments, it's nearly the weekend,
the Universe worked against my noting it yesterday and
it's REALLY important that the minions know and celebrate-

In other news....

Bob Dylan ( aka Robert Allen Zimmerman, Shabtai Zisl ben Avraham, Lucky Wilbury etc)
received the Nobel Prize for Literature.

By Denice Walter (not verified) on 14 Oct 2016 #permalink

A billion people live in China without getting mercury poisoning.

But a gweilo like Hyman probably didn't have a diet typical of ordinary Chinese people. He probably ate a good deal more meat, like rich Chinese do, and depending on the source of that meat, it's possible that he got mercury poisoning from it. But that leads to Panacea's question:

I want to know how functional medicine cured his mercury poisoning.

There is an SBM treatment for mercury poisoning. It's called chelation, and removing heavy metals from the body is exactly what it is designed to do. Yes, this is the same chelation therapy that so many woo-pushers recommend for removing "toxins" that aren't heavy metals (and for which the treatment is therefore ineffective). Of course Hyman wants to skip this part of the story, because it doesn't involve functional medicine.

By Eric Lund (not verified) on 14 Oct 2016 #permalink

No, it's not a gluten-free diet which is used for mercury poisoning. It's chelation therapy. Ironically, his condition may have been caused by chelation therapy. If he was given chelation as preventative therapy against cardiovascular disease or other problems, he may have received too high a dose or for too long. Many chelation practitioners are far too aggressive -- they aren't satisfied until the provoked urine test shows levels at the extreme low end of the normal range. The standard chelator is EDTA, which is very non-specific against both toxic metals and essential micronutrients like vanadium and molybdenum. The body's response to a micronutrient deficiency is to down-regulate expression of the metal transporters, to conserve these essential micronutrients, by methylating the genes which code for the transporters, . The side-effect is accumulation of the toxic metals. So now, he's on the chelation treadmill -- he has to continue with chelation to bring down the toxic metals and take supplements of essential micronutrients to maintain their levels. It may take several years to taper off the chelation and slowly build back to a normal level of transporters. This is why chelation should be applied judiciously by a specialist who only does chelation, and never as a side-line to a chiropratic or naturopathic practice. It's the latter group who are giving chelation a bad name.

By Mark Thorson (not verified) on 14 Oct 2016 #permalink

While I think there are popular bs diagnoses and overdiagnoses, there are also many complicated cases with multiple problems of missed diagnoses in classical medicine and nutrition that are difficult to unwind. Especially the further that you hit from a basic cause.

The chronically ill may have shockingly overt symptoms of gross malnutrition that quickly go away on correction or repletion but have multiple potholes in their situation. Patients also wrestle with iatrogenic causes and injuries in medicine too, often unacknowledged unless bad enough for lawsuits to rain down and succeed.

However inefficient naturopathy and FM may be, they can easily win if they make enough progress to relieve even some of the serious or chronic symptoms patients have that are unresolved. What I've seen
1. if they have serious GI deficits and problems, recognized and fixed?
2. if not, digestive aids and/or
3. supplements like for an uncorrected gastritis or sprue or even more ...

When even one bad symptom, or their worst symptoms, go away after some rough years, who are patients going to listen to after that?

Hyman's employer, Canyon Ranch, rang a bell for me. Sure enough, Hyman has been a previous recipient of Orac's Respectful Insolence. Not surprisingly for somebody who operates in the Berkshires (in Massachusetts close to the New York border), Hyman attracts a bunch of clients from the New York City area--Bill Clinton, in the specific case of the earlier post.

By Eric Lund (not verified) on 14 Oct 2016 #permalink

Only slightly OT:
In college I found a copy of the Canyon Ranch Cookbook. Beautiful, glossy, heavy, it must have cost $60, so I have no idea what it was doing in a dorm lounge.

I've never seen a cookbook with so many pictures and so little food. A smoothie might have a dozen ingredients, (most of which would clash on the palate) and then a note "to be consumed after morning yoga, and will suffice for the rest of the day", or some such nonsense.
After a while I was surprised that there wasn't a recipe for a single cabbage leaf, boiled.

So yeah, pretty short straight line from that kind of nonsense to total quackery.

By JustaTech (not verified) on 14 Oct 2016 #permalink

Like Hyman, WebMD and Medscape started out well, but have since become so deteriorated by greed and ignorance that I warn against them.

Should Hilary Clinton become President, her treatment by the likes of Hyman would in my opinion constitute a threat to national security. Come to think about it, quackery in any form is already a threat to national security, but then so is stupidity.

@Denice Walter #29: The day that Bob Dylan receives the Nobel Prize for literature will be the day when Donald Trump runs for President. Seriously! Did someone put stupid in the drinking water? Google Bob Dylan, Plagiarism to see what I mean. If anyone else in the music world should have been chosen for the Prize, it would be Joni Mitchell, who years ago told me about Dylan's ripoffs. As you will see, Joni and other experts have long since gone public about that.

By Lighthorse (not verified) on 14 Oct 2016 #permalink

A smoothie might have a dozen ingredients, (most of which would clash on the palate) and then a note “to be consumed after morning yoga, and will suffice for the rest of the day”, or some such nonsense.

I went to college with a guy who was all into raw foods and "super foods" (hippie college) who once did part of one of his class projects on helping somebody quit smoking - by feeding her smoothies with tens of (expensive) ingredients. Ridiculous.

My mom does like smoothies; I'd rather go with cereal or eggs for breakfast, but she can drink them on the way to work.

And since we're talking about food, I'm currently caramelizing onions for a bleu cheese, pear and onion pizza. (Try it, you'll like it.) And have made a chocolate raspberry sheet cake.

Within the article and associated comments is more than enough evidence to justify outlawing advertising by physicians, pharmaceutical companies, and healthcare facilities alike. The untold millions of dollars spent by the healthcare industry on advertising every year would be better allocated to research and treatment. A patient who is sick will find his way to the hospitals. Hospitals shouldn't be hanging out their shingle and enriching marketing executives at the expense of patients.

By Rourke Decker (not verified) on 14 Oct 2016 #permalink

Should Hilary Clinton become President, her treatment by the likes of Hyman would in my opinion constitute a threat to national security. Come to think about it, quackery in any form is already a threat to national security, but then so is stupidity.

Hyman has undoubtedly battened onto Bill Clinton, and may indeed be advising Sec. Clinton... but other than Hyman's own fulsome claims to a NYT life-style columnist, is there any evidence that she is *listening* to that advice, or even aware of it?
It is not as if Hyman is particularly reliable as a source about his own wonderfulness, and the NYT puff-piece was notably deficient in corroboration.

By herr doktor bimler (not verified) on 14 Oct 2016 #permalink

It's rather a moot point, once POTUS, medical treatment is performed by the DoD.

By Wzrd1 (not verified) on 14 Oct 2016 #permalink

In reply to by herr doktor bimler (not verified)

Wzrd, if Nancy Reagan can get astrologers in the White House, then quacks can treat the President.

@Panacea, I seriously doubt that the National Naval Medical Center in Bethesda will grant him admitting privileges or honor his prescriptions.
So, who is permitted access to the White House vs actually treating the POTUS tend to be a wee bit different things. For that matter, he likely couldn't acquire a Yankee White clearance to access the POTUS. That one's worse than acquiring a Q clearance.

By Wzrd1 (not verified) on 14 Oct 2016 #permalink

In reply to by Panacea (not verified)

"Mrs. Clinton's current medications include Armour Thyroid..."

Armour Thyroid is a brand name for natural desiccated thyroid (NDT) -- a prescription thyroid hormone replacement medication made from the dried thyroid gland of pigs.

https://www.verywell.com/hillary-clinton-thyroid-condition-3233019

So. Not exactly the 'standard of care', levothyroxine sodium.

By sullenbode (not verified) on 14 Oct 2016 #permalink

Dochniak gotta latex
Cocos gotta x-ray
At least Gilly splits his time between getting high and Clinton's health. Two loons for the price of one.

Left a comment asking why Medscape did a puff-piece on a con artist. Currently it is in moderation though I have had a Medscape account for many years. Will probably close the account though considering how sloppy so many articles are, and no matter how bad there are always at least a few favorable comments on even the most egregious nonsense.

By Daniel Pyron (not verified) on 14 Oct 2016 #permalink

For that matter, he likely couldn’t acquire a Yankee White clearance to access the POTUS.

No. If POTUS says 'I want to see...', then they come in. Sure, they will have to walk thru the metal detectors, but that's about it.

Dear friends,
The purpose of this message is solely to inform you that all the scientific comments that I make in response to the criticism against my interpretation of the Overdiagnosis paper are removed by Orac, although they are on topic.
Then, you can judge whether you can have disinterested information in this blog.

By Daniel Corcos (not verified) on 14 Oct 2016 #permalink

It doesn't matter if your blather is "on topic." Our friend with the idea that latex in vaccines causes autism can argue that his nonsense is "on topic" whenever we discuss vaccines and autism, but it's still just as annoying and just as likely to hijack a thread way off the rails. You have proven every bit as persistent and annoying in your efforts to hijack every thread about mammography and overdiagnosis as he, and I'm, quite simply, tired of it. I will tolerate it no more.

Again, you were warned, and, as I predicted, you just couldn't help yourself. We've been down this road many times. You have this idée fixe that radiation from mammography causes so much breast cancer that it can completely account for the increased number of diagnoses of DCIS and early stage breast cancer observed with the onset of mammographic screening. It cannot, as the estimated increase is far too small.

So you will now remain in comment purgatory indefinitely, and I don't really care if you think it's unfair of me or not. I simply will not have you so persistently hijacking comment threads, and if you don't like that, you can always go elsewhere, write your own blog, or rant about how close minded, unfair, unscientific, and nasty you think I am wherever you like. In the meantime I will release our friend with the latex obsession from comment purgatory until such a time as he can't help himself (and I know that time will come, probably sooner rather than later) and starts commenting about latex and autism again. We should take bets on how long he can manage to stay on the straight and narrow.

I've always had a very light touch moderating comments, to the point where I've often allowed trolls to roam free far longer than I perhaps should have and longtime regular commenters, whom I value deeply, became fed up enough to complain. After nearly 12 years of having a very "hands off" moderation policy, I am currently rethinking my policy based on occurrences at my not-so-super-secret other blog and the relentless stream of Fendelsworth sock puppets both here and at the not-so-super-secret other blog. I've already become a lot more proactive about banning suspected sock puppets. Before, I would wait until I could absolutely prove it was a sock. I no longer wait that long. You can thank Fendelsworth for that.

Gluten is a constant danger! I highly recommend Clara Gluten-Free Water https://claraglutenfreewater.com/ which may not do your guts much good but will help cure swollen wallet syndrome.

By jrkrideau (not verified) on 15 Oct 2016 #permalink

Bob Dylan ( aka Robert Allen Zimmerman, Shabtai Zisl ben Avraham, Lucky Wilbury etc)
received the Nobel Prize for Literature.

That's not very good, is it? It should have been Leonard Cohen.

“Then Dylan says to me, ‘As far as I’m concerned, Leonard, you’re Number 1. I’m Number Zero.’ Meaning, as I understood it at the time—and I was not ready to dispute it—that his work was beyond measure and my work was pretty good.”...

Dylan defended Cohen against the familiar critical reproach that his is music to slit your wrists by. He compared him to the Russian Jewish immigrant who wrote “Easter Parade.” “I see no disenchantment in Leonard’s lyrics at all,” Dylan said.

http://www.newyorker.com/magazine/2016/10/17/leonard-cohen-makes-it-dar…

@jrkrideau (#49),

Clara's Gluten-free Water says, "Clara’s patented mixture of water and minerals is guaranteed gluten and additive-free while maintaining refreshing taste and comes in 100% recycled plastic bottles".

MJD says,

Patenting a mixture of water and minerals....no way.

I couldn't find such a patent in the USPTO website.

By Michael J. Dochniak (not verified) on 15 Oct 2016 #permalink

I am shocked - shocked! - that Gilbert is an anti-Semitic sh!tweasel.

# 51 Michael J. Dochniak

Well I don't believe them either but does the USPTO website cover patents worldwide?

Clara is not a US company. It claims to be headquartered in Toronto.

By jrkrideau (not verified) on 15 Oct 2016 #permalink

Oy, oy, oy, JP; I beg your pardon???

I'm an anti-Semetic sh!tweasel for quoting a reference to this guy?

Irving Berlin (born Israel Isidore Baline; May 11, 1888 – September 22, 1989) was an American composer and lyricist, widely considered one of the greatest songwriters in American history... Born in Imperial Russia, Berlin arrived in the United States at the age of five.

https://en.wikipedia.org/wiki/Irving_Berlin

I will confess that I rarely make it past the first sentence of Gilbert's comments.

I would give Gilbert a conditional pass on this one.

Preferring one Jewish poet songwriter to another is hardly anti Semitic.

I like Leonard Cohen also, but would give Bob Dylan the edge for overall influence, variety of material and long term productivity.

By squirrelelite (not verified) on 15 Oct 2016 #permalink

I would actually vote Leonard Cohen over Dylan, except for that horrible Phil Spector phase. Luckily he came back around with "Ten Songs" and later works.

I do realize that "I'm Your Man" is typically regarded as the comeback album, but I could never really dig it
I am a sucker for his "Zen" album "Dear Heather," though, which came out just before I started college.

Thanks for the tips , JP.

I also liked his voicing of Jungle Line by Joni Mitchell on Herbie Hancock album of her songs.

By squirrelelite (not verified) on 15 Oct 2016 #permalink

If I were to pick a Leonard Cohen song that best fits my mood at the moment, it'd be this one.

From my favorite album - Songs of Love and Hate.

Thanks, JP

I've had some down moments, but know you've been through far worse. I hope you get better.

By squirrelelite (not verified) on 15 Oct 2016 #permalink

Ah, I'll be fine, what withy therapist upping my appointments to twice a week and me really, really not wanting to end up in the hospital again.

If I were to pick a Leonard Cohen song

I alternate between 'Teachers' and 'Who by Fire'.

By herr doktor bimler (not verified) on 16 Oct 2016 #permalink

From Medscape and quackery to Dylan then to anti-Semitism, we were not far from Godwin's law. Fortunately, the moderator of this thread is here to avoid derailment ;-).

@HDB
My favorites are So long Marianne, Famous Blue Raincoat, Chelsea Hotel #2, and Hallelujah (in John Cale version)

By Daniel Corcos (not verified) on 16 Oct 2016 #permalink

I've listened to Lenny a lot more in my lifetime, but if a pop musician deserves a Nobel for the first time, it should be Dylan, or maybe Moe Tucker and John Cale (but they were influenced by Dylan, just like Lenny).

If we're in Lenny-worship mode, my favorite is 'Famous Blue Raincoat'. But I swear that song can't hold a candle to 'Hard Rain'.

@ Lighthorse:

Be that as it may, I don't care, I love him.

And YOU CAN'T ARGUE WITH LOVE, MAN.

My father was an early fan and turned me on to Bob very long ago. So he's been a part of my life forever.

By Denice Walter (not verified) on 16 Oct 2016 #permalink

'Famous Blue Raincoat' is one of my favorites too. My friend Olga and I couldn't believe that we didn't notice it was in amphibracs until grad school.

In any case, I'm sure Mr. Cohen is gracious enough that he would congratulate Dylan on the Nobel. I imagine Phillip Roth, on the other hand, is p!!!!!!!ssed.

@ Daniel Corcos;

" From Medscape to..... anti-Semitism"

We, as loyal Oracian minions, know how to derail threads in artful and informative ways.

You will note that my original OT was careful to state that it was INDEED OT and was meant to inform said minions of this very earth shattering fact LATE on a FRIDAY when there were already MANY comments in the bin
and AFTER ALL
quackery, Dylan and anti-Semitism are important in both universes- Orac's and the Big One.

Secondly, RI is a social place where minions come to share news, commiserate, interact hilariously and encourage each other in our daily lives.

Others ask "Why?" I ask " Why not?"

By Denice Walter (not verified) on 16 Oct 2016 #permalink

Hi JP:

I'm glad to read your words and learn that your therapist is increasing your sessions.

I'm sure that many- if not most- readers here would assure you that you contribute greatly because you are intelligent, artistic unique and sensitive to the oddness of reality in all of its shifting vicissitudes

I often quote you to one of my crea.. GENTLEMEN who thinks that you are quite the bomb ( in the 1990s, good sense of the idiom).

Remember that internal processes take a long time to work. You have to wait and then wait some more. I'm still recovering/ healing my injury and re-adjusting my activities accordingly.

Anyone who can come up with the phrase " Pumpkin spice Putin" is always high on my list of greatest hits.

By Denice Walter (not verified) on 16 Oct 2016 #permalink

@ herr doktor bimler (#39):

Right.
When she had pneumonia, her regular doc gave her high dose / powerful antibiotics for 10 days IIRC
and that would probably not be Hyman's choice ( unless supplemented with loads of prebiotics and probiotics and sauerkraut and/or miso).

By Denice Walter (not verified) on 16 Oct 2016 #permalink

Good save, Denice. ;-)

I imagine Phillip Roth, on the other hand, is p!!!!!!!ssed.

I'm none too pleased that he failed me the year I had him in the local deadpool, either, for that matter.

Gluten for Hashimotos? I am currently getting worked over because the doctor noticed my thyroid is big. Cancer has been ruled out, but thinking might be Hashimoto's because my great grandma and grandma had to have theirs removed. I don't really eat all that much bread (not a gluten free diet thing, just personal preference)

I’m glad to read your words and learn that your therapist is increasing your sessions.

What can I say, I make people nervous. Hell, I was meeting with my shrink once a week in Michigan for quite a while. He still calls and emails; I think he worries that I'm going to walk off and hang myself in the woods in short order or something. I try to reassure him. Good man; good doctor.

(My fingers are almost numb from a couple of hours sitting on the back deck in the cold, rainy, PNW weather, listening to Leonard Cohen and cuddling with the cat, who mostly lives outside by a certain person's dictate...)

@ JP:

You sometimes make ME nervous.
Which is quite a feat.
I do hope that you can get through this block of time when all seems bleak and disconnected perhaps.
Think of it this way:
there is a cat and Leonard Cohen.

Of course the Pollyanna-ish amongst us may say that this is a Time of Preparation for Better Days or suchlike or that you're like a Chrysalis/ Bud about to transform itself after a period of darkness into Something Wonderful.

I don't necessarily buy that because I know that sometimes life just goes on and on in a most wearing fashion and that not all buds blossom or plans come to fruition.

Sometimes we just sit and wait.

Sometimes we are not thrilled about anything at all.

Sometimes we observe and go through emotional turmoil and questioning that leads to nowhere
BUT at least we're still here.

Over the past several months I've changed my life . One of the worst things was having trouble driving with a clutch because it hurt my leg. I am frugal enough to not have gone out and bought another car- and I do love the car. NOW I am quite thrilled over the fact that I have conquered the clutch and can drive myself around to various appointments. I am doing additional Interesting and Important literary work for Somebody I Know ( Not Me).

Like sailors on the Main of Old we may get stranded in the Doldrums and there's not much that we can do about getting back into the drift and flow of obvious currents that lead to Places we want to be.

I try to find things that I like and indulge myself as much as I reasonably can. No asceticism here.

So good luck. I say that with great feeling for you.

By Denice Walter (not verified) on 17 Oct 2016 #permalink

Both due to massive distraction, which drew management and hence, HR attention and a massive error upon hiring, both on my part and corporate (corporate split delayed letting me know that I had converted from contract to hire and my own "cleverness" creating a problem that needs to be resolved soon), I've got HR hot on my heels.
Both due to my own wife's condition, which they learned of last week, a little of my own condition and the legal issues originating from delayed notification of hire (double paychecks that went unnoticed, as paper checks went uncollected and bank accounts went unchecked, I was busy and wife doesn't bother with online money).

Add in stressors of dad dying for five years that I gave up a very lucrative job to care for him, paying Wells Fargo for a number of years after, only to have them reject assumption of the mortgage, initiation of foreclosure on that family home, with a hell of a lot of our own property enclosed, a dispute with the township ("we do what we want to do" and closure of the home via condemnation signs), restriction of access to our former home of five years (what a wonderful way to welcome a decorated veteran home, may this nation burn in hell!), new job, three hours from home, eventual relocation, forbidden to access the home by movers, hyperthyroidism, aortic dilation to near aneurysm level, cauda equina syndrome, to levels threatening paralysis, cervical spinal stenosis where I was looking for what worked - the radiologist report proved my observation correct, everything is FUBAR.
Now, the newest movers claimed, quite literally, "Eeek, a dead mouse" and refused to honor the $10k relocation package, which was handed back to my employer.
I'll lose the lot of it on the 21st.
So, I'm goddamned sorry that I returned to this uncivilized land that I screwed up in defending for most of my life.
If I sound pissed off, you should hear me in person, put on hearing protection first.
I'm going to lose both my own baby pictures, films of me and my parents, family photographs, pictures of our own children growing up, furniture we purchased, computers, information on said computers, treasured mementos, pictures of my own parents, grandparents, family documents, historical documents and a lot more.

Well, the relocation service does have a contract, they've reneged upon it, variously (two movers) one condemned sign canceled the attempt, the other, "eek a mouse" and trash in a burglarized basement.

So, my stress level is... Immense.
To the point where, I mentally toy with the notion of a judicial duel, as PA has not statute or case law against such and to be honest, it'd be a bit of fun to at least tangle things up while things get sorted, foul the bank that double dealed up and additionally, make case law.
And yes, I'm immensely pissed off.
And slightly depressed, only slightly, I'm far too angry to remain much depressed.

Oh, for cream on the top of everything, my wife's gallbladder disease was dismissed by our former primary. It seems a habituation for him, as we've heard from multiple other women who also were ignored, to find new medical coverage - some specialists that assumed primary care of the patient.
Her gallbladder was so fouled as to induce bilary cirrhosis.

Now, can you imagine a man more angry than this husband of 35+ years?

Sorry to unload here, but I needed to do so somewhere.
Lest I actually harm someone that angered me.

Here's the laugh.
The difficulty in an inertial confinement system isn't the initial confinement, but in retention of confinement beyond disassembly at X shakes. This can be created by R, focused by Y, via Z. This can extend confinement far beyond 50 shakes, sufficient to both confine the fission to high efficiency *and* focus the energy to Q, via P, causing fusion, creating neutrons to be focused by AA, into RR.

And yes, I I do know the formulae. And the theory.
Oh wait, I'm not Snowden, seeking attention.
And no, nobody will *ever* get that information from the Madness Machine.
I still have nightmares from the still classified footage from both atomic bombings, I'd never wish that upon even my worst enemies.*

*Yeah, I'm serious on all points, especially viewing classified footage from Hiroshima and Nagasaki. Every moment of thinking of it makes me want to puke. Many, makes me actually cry.
Especially, a carbonized infant on her back, being removed. When removed, some flesh fell off, bloodlessly, she died when she saw her carbonized infant.
Feel nauseated? I always do, remembering *seeing* that film.

I've dealt with that and more.
Now, losing everything we inherited and owned, due to "eek a mouse!".

Now, do explain how you can find an emotional context with me?

By Wzrd1 (not verified) on 17 Oct 2016 #permalink

In reply to by Denice Walter (not verified)

Damn, Wzrd1.

It was evening when we came to the river
With a low moon over the desert
that we had lost in the mountains, forgotten,
what with the cold and the sweating
and the ranges barring the sky.
And when we found it again,
In the dry hills down by the river,
half withered, we had
the hot winds against us.

There were two palms by the landing;
The yuccas were flowering; there was
a light on the far shore, and tamarisks.
We waited a long time, in silence.
Then we heard the oars creaking
and afterwards, I remember,
the boatman called us.
We did not look back at the mountains.

In some sort of crude sense which no vulgarity, no humor, no overstatement can quite extinguish, the physicists have known sin; and this is a knowledge which they cannot lose. -- Robert Oppenheimer, physisist

Speaking of Leonard Cohen, It's closing time.

https://www.youtube.com/watch?v=7-0lV5qs1Qw

By sullenbode (not verified) on 17 Oct 2016 #permalink

I try to find things that I like and indulge myself as much as I reasonably can. No asceticism here.

Yeah, I've been cooking a lot; it's something that I enjoy that actually makes me feel a little bit good about myself.

So good luck. I say that with great feeling for you.

Thanks, Denice.

Second 'graph was not supposed to be in italics...

@ JP:

Well, I DID mean things other than cooking but
whatever floats your boat.

I am relatively fine today except for my adventure... I mean business transaction with the Syrian plumber which was confusing but relatively inexpensive... so far.

By Denice Walter (not verified) on 18 Oct 2016 #permalink

Denise Walter says (#69),

RI is a social place where minions come to share news, commiserate, interact hilariously and encourage each other in our daily lives.

MJD says,

Additionally, the minions like JP are very interesting and entertaining. Thanks for making this blog both salty and sweet!.

By Michael J. Dochniak (not verified) on 18 Oct 2016 #permalink

Well, I DID mean things other than cooking but
whatever floats your boat.

I've become very interested in mycology and have been out in the woods regularly looking for edibles and pretty mushrooms. Does that count? ;-)

Some recent finds.

Nature's birdbaths.

I'm hoping that, even though it's gotten cooler, the recent rains will have pushed up some more boletes or something nice like that. Going out in a day or two once it's sunny and warm(ish).

P.S., Narad can speak to the therapeutic value of cooking for other people.

I can speak as well to the therapeutic effects of cooking for others.
When each parent died, I busied myself with cooking for guests who came by to offer their condolences.

I'll probably cook for my own funeral. If I have to lay there and listen to people lie about how great I was, I'd otherwise end up getting up and leaving. ;)

By Wzrd1 (not verified) on 18 Oct 2016 #permalink

In reply to by JP (not verified)

Additionally, the minions like JP are very interesting and entertaining. Thanks for making this blog both salty and sweet!.

Thanks, MJD. Perhaps it's something at least a few people can agree on. ;-)

What can I say, I make people nervous.

This assertion is doomed by plain counterexample.

And since we're off topic (sorry), Chris, what can you tell me about WA politics these days? I've been out of touch for about ten years.

@ JP:

Mushrooms most definitely count.
( Although I was thinking about something else.**)
Quite a few are visible in the 'park-like setting' that borders on my place.

In other news...
'fear and loathing in Las Vegas' ( stolen phrase) continues apace.

The Syrian plumber has finished... for now.

I have loads of work for my secondary avocation.

** I was thinking about creature comforts in general : I have an Armenian friend from Egypt who is very aware of the finer things in life and pursues them with great relish:
if there is a perfect cotton sheet or Martini to be had in the area, she'll find it- and usually at a discount. She is involved with a very well-to-do man who takes her on interesting jaunts around Europe and North America. (I have tried to emulate her because I believe I have somewhat more ascetic tendencies which often waste life) She just returned from a week in Sicily - she didn't cancel the trip despite having cut her foot ( 25 stitches !) because she didn't want to wreck her friend's plans. So she hobbled around Palermo sampling gelato and Espresso, I have recently only hobbled around Oakt... OAKLAND myself. But did have decent sushi later so it wasn't so bad,

I must aim higher.

By Denice Walter (not verified) on 19 Oct 2016 #permalink

I should correct myself:
JP doesn't make me "nervous" exactly BUT I do worry about her because I know that she's had setbacks and has been rather morose. Ultimately, I have hopes for her recovery although in a somewhat guarded way.

By Denice Walter (not verified) on 19 Oct 2016 #permalink

She is involved with a very well-to-do man who takes her on interesting jaunts around Europe and North America.

Gee, I need to find one of those. ;)

JP:

I hope you find someone like that or alternately, create your own pathway to get whatever it is that you want.

Sometimes, in my own case, it's a little of both plus one.

By Denice Walter (not verified) on 20 Oct 2016 #permalink

If it be your will
That I speak no more
And my voice be still
As it was before
I will speak no more
I shall abide until
I am spoken for
If it be your will
If it be your will
That a voice be true
From this broken hill
I will sing to you
From this broken hill
All your praises they shall ring
If it be your will
To let me sing

From this broken hill
All your praises they shall ring
If it be your will
To let me sing

If it be your will
If there is a choice
Let the rivers fill
Let the hills rejoice
Let your mercy spill
On all these burning hearts in hell
If it be your will
To make us well

And draw us near
And bind us tight
All your children here
In their rags of light
In our rags of light
All dressed to kill
And end this night
If it be your will

https://www.youtube.com/watch?v=FkEYkUxdhcU