His own words are worse. (Antifragility)
“I once broke my nose walking… In the emergency room, the doctor and staff insisted I apply ice to my nose… In the middle of the pain, it hit me that the swelling Mother Nature gave me was most certainly not directly caused by the trauma. It seemed to me that it was an insult to Mother Nature to override her programmed reactions unless we had good reason to do so, backed by proper empiric testing to show we humans can do better… So I mumbled to the emergency room doctor whether he had any statistical evidence of benefits from applying ice to my nose or if it resulted from a naive version of an interventionalism.
His response was: “You have a nose the size of Boston and you are now interested in numbers?” I recall developing from his blurry remarks the thought that he had no answer.
Effectively, he had no answer, because as soon as I got to a computer, I was able to confirm that there is no compelling empirical evidence in favour of the reduction of swelling… it was pure sucker-rationalism in the mind of doctors… coupled with interventionalism, this need to do something, this defect of thinking that we knew better, and denigration of the unobserved… this confabulation plagues the entire history of medicine… the onus is on the doctors to show us why reducing fever is good, why eating breakfast before engaging in activity is healthy…”
- the conclusion the swelling was not directly caused by the trauma is probably wrong; can we agree it is if there was a broken facial or nasal bone or bleeding beneath the skin or in the nose, caused by the fall?
- he concludes the doctor had no answer, probably falsely, probably not fairly (is imagining an answer or not)
- he confirms this based on his own computer, somehow; with good info? Because every doctor knows patients draw wrong conclusions from an Internet search all the time. Is swelling to the face after a fall the same as general swelling if you have to pull a dislocated nose back into place? Is the intervention “ice”, or ice plus pressure - a distinction important in the presence of bleeding…
- elsewhere asking “what is the evidence?” is weak (climate change, thalidomide) if effects are small or slow
- does “ice” help with pain? Is reduced swelling helpful to evaluate facial symmetry to estimate the likelihood of a broken bone, so which imaging test would be better?
- most doctors would agree reducing fever is not that important, but breakfast has been studied at length with different conclusions for different situations - if you are hungry when you get up is it Mother Nature making you so?